Advancing dentistry: fractal assessment of bone health in pediatric patients with celiac disease using dental images.

Abstract

To assess the effects of a gluten-free diet on bone structure in children with celiac disease using fractal analysis on panoramic radiographs. A total of 49 patients with celiac disease aged 6-13 years, separated into 2 groups as previously and newly diagnosed, and a control group of 32 healthy individuals were evaluated. In previously and newly diagnosed patients with celiac disease, body mass index (BMI) Z-scores were calculated, calcium, alkaline phosphatase, vitamin D3, and parathormone levels were measured and bone mineral density (BMD) Z-scores obtained from dual energy X-ray absorptiometry. In all patients, the fractal dimensions (FD) of the right and left temporomandibular condyles were evaluated with the fractal analysis method on panoramic radiographs. The mean values of serum biomarker levels and the BMI and BMD Z-scores for both celiac groups were within the normal reference range. No statistically significant difference was determined between right and left condyle FD values in the 3 groups examined. In terms of both right and left condyle FD values, there was a statistically significant difference between groups. The highest FD values were determined in the previously diagnosed group. Differences in FD values were observed among patients with celiac disease following the gluten-free diet. Utilizing fractal analysis on panoramic radiographs can prove valuable for dentists in evaluating BMD due to its cost-effectiveness, easy accessibility, and reduced radiation exposure for patients, enabling them to provide comprehensive oral health care and potential early interventions for patients with celiac disease.