Burgueño-Torres Laura, García-Boedo Lara, de Nova-García Manuel Joaquín
Dental Clinical Specialties Department, Faculty of Dentistry, Complutense University of Madrid, Madrid, 28040, Spain.
BMC Oral Health. 2025 Aug 23;25(1):1367. doi: 10.1186/s12903-025-06687-8.
The efficacy of radiographs in studying bone mineral density (BMD) through fractal dimension (FD) analysis represents a conservative method compared to other traditional examinations. Periapical and panoramic radiographs are routine imaging tests in the radiographic evaluation of pediatric patients with Osteogenesis Imperfecta (OI). Anti-resorptive therapies with bisphosphonates constitute the gold standard in the treatment of these patients, and assessing their effectiveness on bone mineral density is essential to determine the necessity of administering any of these drugs or their combinations. Therefore, this study aims to analyze the differences in fractal dimension measured on orthopantomographs of a sample of patients with OI compared to a matched control group. METHODS : Panoramic radiographs from 66 patients with OI were analyzed, identifying six regions of interest (ROIs), in mandibular cortical and trabecular bone, using the ImageJ software (version 1.54d). Differences related to the impact of Osteogenesis Imperfecta and the administered anti-resorptive treatment were examined. Statistical analysis of the data was performed with SPSS Statistics 25.0 for Windows.
The values obtained for ROI 3 showed statistically significant differences between the groups (p 0.002), while ROI 5 yielded values close to statistical significance (p 0.090). When analyzing the influence of antiresorptive therapy in these patients, a strong indication of a relationship was found between the values obtained for ROI 1 and 4 and the administration of zoledronic acid.
The studied OI patients showed lower bone mineral density compared to healthy controls. The type of OI influenced the fractal dimension values obtained, with those suffering from severe OI being more affected. Although no statistically significant differences were found, the statistical effect size related to zoledronic acid administration suggested a possible direct relationship with the bone mineral density of these patients.
与其他传统检查相比，通过分形维数（FD）分析的X线片在研究骨密度（BMD）方面的功效是一种保守方法。根尖片和全景片是成骨不全（OI）患儿影像学评估中的常规影像检查。双膦酸盐类抗吸收疗法是这些患者治疗的金标准，评估其对骨密度的有效性对于确定使用这些药物或其组合的必要性至关重要。因此，本研究旨在分析与匹配的对照组相比，OI患者样本的曲面断层片上测量的分形维数差异。
使用ImageJ软件（版本1.54d）分析66例OI患者的全景片，在下颌骨皮质骨和小梁骨中确定六个感兴趣区域（ROI）。检查与成骨不全的影响和所给予的抗吸收治疗相关的差异。使用适用于Windows的SPSS Statistics 25.0对数据进行统计分析。
ROI 3获得的值在组间显示出统计学上的显著差异（p = 0.002），而ROI 5获得的值接近统计学显著性（p = 0.090）。在分析这些患者中抗吸收治疗的影响时，发现ROI 1和4获得的值与唑来膦酸的给药之间有很强的相关性。
与健康对照组相比，所研究的OI患者骨密度较低。OI的类型影响获得的分形维数值，重度OI患者受影响更大。尽管未发现统计学上的显著差异，但与唑来膦酸给药相关的统计效应量表明与这些患者的骨密度可能存在直接关系。
