Application of Fractal Analysis in Detecting Trabecular Bone Characteristics Around Mandibular Impacted Third Molars on Dental Panoramic Radiographs

Abstract

Purpose: Surgical extraction of third molars can be difficult for many reasons, including increased bone density, which causes bone structures to lose their elastic properties. The aim of this study is to compare the trabecular structure around the impacted mandibular third molar(M3M) and the normal alveolar trabecular pattern using the fractal analysis method. Materials and Methods: Panoramic images of 47 patients were included in the study. ROI1 is the area between the distal root of the second molar and the mesial of the third molar tooth. On the other hand, ROI2 was selected between the distal root of the first molar tooth and the mesial root of the second molar tooth. Fractal Dimension (FD) and Bone Marrow Dimension analyzes were applied to the selected ROIs using the ImageJ software. Results: The mean FD values of 47 patients were found to be 1.135 for ROI1 and 1.105 for ROI2, respectively (p=0,078).The mean Bone Marrow Dimension values were found to be 1.591 for ROI1 and 1.587 for ROI2(p=0.731). There was no significant difference in FD and Bone Marrow Dimension analysis when ROI1 and ROI2 were compared. It is very important to know the pattern of trabecular structure before surgical procedure on M3M. The bone density around the impacted M3M may be higher than the healthy alveolar bone, however, the fact that males have denser bone than females should not be ignored during the operation. Conclusion: The method of FD analysis can be useful for evaluating the trabecular structure of impacted M3M. Key words: fractal dimension; bone structure; panoramic imaging; impacted tooth; third molars