Sozen Emre, Aytugar Emre, Ertas Elif Tarim, Cene Erhan, Kara Muhammed Isa
Department of Dentomaxillofacial Radiology, Faculty of Dentistry , Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Türkiye.
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Türkiye.
BMC Oral Health. 2025 Aug 21;25(1):1346. doi: 10.1186/s12903-025-06695-8.
Fractal dimension (FD) analysis is a method used to numerically characterize the complexity of structures or tissues. After sinus lift procedures, the graft material gradually transforms into natural bone over time. This study aimed to evaluate the interpretability of this transformation by assessing changes in FD values.
In this retrospective study, data from a total of 36 patients (42 hemimaxillae), including 13 females (17 hemimaxillae) and 23 males (25 hemimaxillae), were analyzed. Cone-beam computed tomography (CBCT) images obtained preoperatively and at six months postoperatively from patients who underwent sinus lift surgery with graft placement in the maxillary molar region were included in the evaluation. The pre- and postoperative images were superimposed using anatomical reference points. Examination areas were determined on cross-sectional slices from the grafted and adjacent non-grafted bone areas (used as control) within the maxillary molar region. FD analysis was performed on these areas. FD values from the grafted and control bone regions at baseline and six months were recorded. Paired and independent sample t-tests were used for statistical analysis, with statistical significance set at < 0.05.
FD values derived from CBCT images showed a statistically significant difference between the initial state of the graft immediately after placement (G0) and its state six months postoperatively (G1) ( < 0.05). The mean FD values were 1.297 for G0 and 1.279 for G1. However, no significant difference was observed between the initial state (B0) and the six-month follow-up state (B1) of the trabecular bone in the posterior region used as a control ( > 0.05). The FD values in the G0 group showed minimal variation across gender and age groups, consistently ranging between 1.295 and 1.299. No significant differences in FD values were identified based on gender or age groups ( > 0.05).
The findings of this study suggest that FD analysis may serve as a useful adjunctive tool for evaluating graft osteogenesis.
分形维数（FD）分析是一种用于从数值上表征结构或组织复杂性的方法。在进行上颌窦提升手术后，移植材料会随着时间逐渐转化为天然骨。本研究旨在通过评估FD值的变化来评估这种转化的可解释性。
在这项回顾性研究中，分析了总共36例患者（42侧半上颌骨）的数据，其中包括13名女性（17侧半上颌骨）和23名男性（25侧半上颌骨）。纳入评估的患者为在上颌磨牙区进行了上颌窦提升植骨手术，术前和术后6个月获得的锥形束计算机断层扫描（CBCT）图像。使用解剖学参考点对上、下颌骨术前和术后图像进行叠加。在上颌磨牙区内移植骨和相邻未移植骨区域（用作对照）的横断面切片上确定检查区域，并对这些区域进行FD分析。记录基线和6个月时移植骨和对照骨区域的FD值。采用配对和独立样本t检验进行统计分析，统计学显著性设定为<0.05。
CBCT图像得出的FD值显示，移植后即刻的初始状态（G0）与其术后6个月的状态（G1）之间存在统计学显著差异（<0.05）。G0的平均FD值为1.297，G1为1.279。然而，用作对照的后部区域小梁骨的初始状态（B0）和6个月随访状态（B1）之间未观察到显著差异（>0.05）。G0组的FD值在性别和年龄组之间变化极小，始终在1.295至1.299之间。基于性别或年龄组未发现FD值有显著差异（>0.05）。
本研究结果表明，FD分析可能是评估植骨成骨的有用辅助工具。
