Yuksel Ibrahim Burak, Altiparmak Fatma, Gurses Gokhan, Akti Ahmet, Alic Merve, Tuna Selin
Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya 42090, Turkey.
Department of Periodontology, Faculty of Dentistry, Necmettin Erbakan University, Konya 42090, Turkey.
Diagnostics (Basel). 2025 Jul 9;15(14):1742. doi: 10.3390/diagnostics15141742.
Radiographic evaluation of bone regeneration following maxillary sinus floor elevation commonly emphasizes volumetric gains. However, the qualitative microarchitecture of the regenerated bone, particularly when assessed via two-dimensional imaging modalities, such as panoramic radiographs, remains insufficiently explored. This study aimed to evaluate early trabecular changes in grafted maxillary sinus regions using fractal dimension, first-order statistics, and gray-level co-occurrence matrix analysis. : This retrospective study included 150 patients who underwent maxillary sinus floor augmentation with bovine-derived xenohybrid grafts. Postoperative panoramic radiographs were analyzed at 6 months to assess early healing. Four standardized regions of interest representing grafted sinus floors and adjacent tuberosity regions were analyzed. Image processing and quantitative analyses were performed to extract fractal dimension (FD), first-order statistics (FOS), and gray-level co-occurrence matrix (GLCM) features (contrast, homogeneity, energy, correlation). : A total of 150 grafted sites and 150 control tuberosity sites were analyzed. Fractal dimension (FD) and contrast values were significantly lower in grafted areas than in native tuberosity bone ( < 0.001 for both), suggesting reduced trabecular complexity and less distinct transitions. In contrast, higher homogeneity ( < 0.001) and mean gray-level intensity values ( < 0.001) were observed in the grafted regions, reflecting a more uniform but immature trabecular pattern during the early healing phase. Energy and correlation values also differed significantly between groups ( < 0.001). No postoperative complications were reported, and resorbable collagen membranes appeared to support graft stability. : Although the grafted sites demonstrated radiographic volume stability, their trabecular architecture remained immature at 6 months, implying that volumetric measurements alone may be insufficient to assess biological bone maturation. These results support the utility of advanced textural and fractal analysis in routine imaging to optimize clinical decision-making regarding implant placement timing in grafted sinuses.
上颌窦底提升术后骨再生的影像学评估通常侧重于体积增加。然而，再生骨的定性微观结构，特别是通过二维成像方式（如全景X线片）评估时，仍未得到充分探索。本研究旨在使用分形维数、一阶统计量和灰度共生矩阵分析来评估移植上颌窦区域的早期小梁变化。：这项回顾性研究纳入了150例行牛源异种杂交移植物上颌窦底提升术的患者。术后6个月分析全景X线片以评估早期愈合情况。分析了代表移植窦底和相邻结节区域的四个标准化感兴趣区域。进行图像处理和定量分析以提取分形维数（FD）、一阶统计量（FOS）和灰度共生矩阵（GLCM）特征（对比度、均匀性、能量、相关性）。：共分析了150个移植部位和150个对照结节部位。移植区域的分形维数（FD）和对比度值显著低于天然结节骨（两者均<0.001），表明小梁复杂性降低且过渡不明显。相比之下，移植区域观察到更高的均匀性（<0.001）和平均灰度强度值（<0.001），反映了早期愈合阶段小梁模式更均匀但不成熟。两组之间的能量和相关性值也有显著差异（<0.001）。未报告术后并发症，可吸收胶原膜似乎有助于移植物稳定。：尽管移植部位在影像学上显示出体积稳定性，但其小梁结构在6个月时仍不成熟，这意味着仅体积测量可能不足以评估生物骨成熟度。这些结果支持在常规成像中使用先进的纹理和分形分析来优化关于移植窦中种植体植入时机的临床决策。
