Mandibular Bone Structure Research Articles

Evaluation of fractal analysis and radiomorphometric measurements of mandibular bone structure in bruxism and non-bruxism paediatric patients.

The goal of this examination was to compare the impact of probable sleep/awake bruxism on the mandibular trabecular bone structure by fractal analysis (FA) with digital panoramic radiograph (DPR) and radiomorphometric measurements in paediatric patients with bruxism. The examination included 130 participants with 63 patients with probable sleep/awake bruxism and 67 control groups. Bilateral regions of interest (ROI) in three regions were examined as ROI1: mandibular ramus, ROI2: mandibular angulus, ROI3: anterior to the molar teeth. Radiomorphometric measurements were taken of the mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI). p < 0.05 was approved for statistical significance. The ROI-1, ROI-2, and ROI-3 values were defined to be statistically significantly high in the bruxism group (p < 0.05). No significant difference was found between the groups in the other values (p > 0.05). There was no difference in the age and gender for any of the parameters (p > 0.05). In children and adolescents, the mandibular trabecular bone can be affected by bruxism. FA can be used as an auxiliary method for finding the mandibular trabecular differences of patients with bruxism in paediatric dentistry just as it can for adults.

Evaluation of mandibular bone structure changes in phenylketonuria patients using fractal analysis and radiomorphometric indices

ObjectivesThe aim of this study was to evaluate the effect of phenylketonuria (PKU) on mandibular bone structure by comparing the bone of PKU patients with healthy controls using fractal analysis and the radiomorphometric indices of mandibular cortical width (MCW) and mandibular cortical index (MCI). Study DesignIn total, 32 patients with PKU were analyzed and compared with the control patients. Regions of interest in panoramic radiographs were selected and the fractal dimension (FD) obtained from fractal analysis was calculated. MCW was defined as the cortical thickness of the inferior border of the mandible at the level of the mental foramen. MCI classified the endosteal edge of the mandibular cortex as C1: straight and sharp, C2: the presence lacunar resorption spaces, and C3: distinctly porous and severely eroded. The significance level was P<0.05. ResultsAll FD and MCW values were significantly lower in the PKU patients. The prevalence of C1 was significantly lower and prevalence of C2 was significantly higher in the PKU group. ConclusionThe differences in fractal dimension and radiomorphometric indices between patients with PKU and healthy controls may indicate a potential impact of PKU on mandibular bone structure.

Evaluation of mandibular trabecular bone by fractal analysis in pediatric patients with hypodontia of the mandibular second premolar tooth

BackgroundIt is still unclear whether the trabecular structure of the jaw is different in individuals with hypodontia than in those without hypodontia; this is important for clinicians. The aim was to determine whether the mandibular trabecular bone structure of children and adolescents with hypodontia differs from the control group by using the fractal analysis (FA) method in this study.MethodsA total of 138 panoramic radiographs of 69 cases and 69 control subjects (mean age 13.2 ± 10.1) were evaluated. The age and gender of subjects in the case and control groups were matched. Three regions of interest (ROIs) were selected from the panoramic radiographs. ROI1 refers to the center of the ramus rising above the mandibular foramen. ROI2 refers to the area between the apical level of the mandibular molar and the upper border of the mandibular canal. ROI3, the missing tooth region, refers to the apical third of the mesial side of the erupting or fully erupted permanent mandibular first molar. Mann-Whitney U and Wilcoxon tests were used. p < 0.05 was accepted for the significance value.ResultsThe mean fractal dimension (FD) values of ROI1, ROI2, and ROI3 were 1,25, 1,20, and 1,13, respectively. The means FD values obtained from the ramus region were higher than the other regions (p < 0.05). The FD values did not differ significantly according to gender and age (p > 0.05). The FD values of the case group were lower than the control group for ROI3 (p < 0.05).ConclusionThe results of this study showed that the mandibular trabecular bone quality of pediatric patients with one missing tooth was different from the healthy group. The difference in the mean FD values from the ROIs indicates that the ramus has a denser structure than the mandibular corpus. Clinicians should factor this into their dental treatment planning process.

Direct-Acting Oral Anticoagulant/Vitamin K Antagonists: Do They Affect the Trabecular and Cortical Structure of the Mandible?

Background: This study aimed to evaluate the mandibular bone structure of patients using oral anticoagulants (OACs) vitamin K antagonist drugs (warfarin) and other OACs including direct oral anticoagulants [(DOACs) apixaban, rivaroxaban, dabigatran, edoxaban]. Analyses were based upon the fractal dimension (FD), the panoramic mandibular index (PMI) and the Klemetti index (KI), which is also known as the mandibular cortical index (MCI).Methodology: Ninety participants were divided into three groups: group 1: 30 systemically healthy individuals who had not used any anticoagulants before, group 2: 30 individuals using warfarin, and group 3: 30 individuals using DOACs. FD was used to analyze trabecular bone architecture in the condyle, angle, and two sites in the alveolar bone. PMI was used to evaluate the quantity of cortical bone and KI was used to evaluate the cortical bone quality.Results: There was no difference between the groups regarding FD analysis and KI; however, a difference was found between groups 1, 2, and 3 in the PMI (P≤ 0.001). The PMI in group 1 was higher than in groups 2 and 3.Conclusion: Mandibular radiomorphometric indices can be used on panoramic radiographs to evaluate the quantity of mandibular cortical bone in patients using oral anticoagulants.

Fractal analysis and radiomorphometric indices: comparison of mandibular bone structure changes on digital panoramic radiographs of smokers

Purpose: The purpose of the study was to assess how smoking affected the mandibular bone structure using a variety of radiomorphometric indices and fractal dimension (FD) analysis.&#x0D; &#x0D; Materials and methods: 56 patients (28 smokers and 28 non-smokers) were included in this retrospective study. In the trabecular bone of the mandible, eight areas of interest of 45x45 pixels were chosen, and fractal dimension analysis was carried out. All digital panoramic radiographs were used to measure the mandibular index and mandibular cortical width. All values were compared between groups. Utilizing the Shapiro-Wilk and Mann-Whitney U tests, collected data were evaluated.&#x0D; &#x0D; Results: There was a statistically significant difference between the groups in ROI4 and ROI8, but not in the mean FD values of ROI1, ROI2, ROI3, ROI5, ROI6 and ROI7 in the mandibular trabecular bone. No statistically significant differences between groups were seen for PMI and MCW measures (p &gt; .05). The intraclass correlation coefficient (ICC) values for the FD, PMI and MCW measurements were excellent.&#x0D; &#x0D; Conclusion: The trabecular bone structures of the anterior of the mental foramen and the condyle were different in smokers. There was no difference in cortical bone structures.

Mandibular Bone Structure May Predict Future Height Loss

Mandibular Bone Structure May Predict Future Height Loss

Mandibular bone remodeling around osseointegrated functionally graded biomaterial implant using three dimensional finite element model.

Dental implantation surgery has been progressed as one of the most efficient prosthetic technologies, however, it still fails very often and one of the main causes is the large difference between implant mechanical properties and those in welcoming bony tissues, making it problematical in osseointegration and bone remodeling. Biomaterial and tissue engineering research shows that there is a requirement in developing implants with Functionally Graded Materials (FGM). Indeed, the great potential of FGM lies not only in the field of bone tissue engineering but also in dentistry. To improve the acceptance of dental implants inside the living bone, FGM were proposed to step up the challenge of ensuring a better match of mechanical properties between biologically and mechanically compatible biomaterials. The aim of the present work is to investigate mandibular bone remodeling induced by FGM dental implant. Three-dimensional (3D) mandibular bone structure around an osseointegrated dental implant has been created to analyze the biomechanical behavior of the bone-implant system depending on implant material composition. In order to implement the numerical algorithm into ABAQUS software, UMAT subroutines and user-defined material were employed. Finite element analysis have been conducted to determine the stress distributions in implant and bony system, and to evaluate bone remodeling induced by the use of various FGM and pure titanium dental implants over the period of 48 months.

The mandibular bone structure in children by fractal dimension and its correlation with pixel intensity values: a pilot study.

To identify a normal pattern of mandibular trabecular bone in children based on the fractal dimension (FD), and its possible correlation with pixel intensity (PI) values, to facilitate the early diagnosis of possible diseases and/or future bone alterations. The 50 panoramic images were selected and divided into two groups, according to the children's age: 8-9 (Group 1; n = 25) and 6-7 (Group 2; n = 25). For FD and PI analyses, three regions of interest (ROIs) were selected, and their mean values were evaluated for each ROI, according to each group, using the t test for independent samples and the model of generalized estimation equations (GEE). Subsequently, these mean values were correlated by the Pearson test. Comparing the groups, FD and PI did not differ from each other for any of the measured regions (p > 0.00). It was observed that in the mandible branch (ROI1), FD and PI means were 1.26 ± 0.01 and 81.0 ± 2.50, respectively. In the mandible angle (ROI2), the means were 1.21 ± 0.02 (FD) and 72.8 ± 2.13 (PI); and in the mandible, cortical (ROI3) values of FD = 1.03 ± 0.01 and PI = 91.3 ± 1.75 were obtained. There was no correlation between FD and PI in any of the analyzed ROI (r < 0.285). The FD means of ROI1 and ROI2 did not differ from each other (p = 0.053), but both were different from ROI3 (p < 0.00). All PI values differed from each other (p < 0.00). The bone trabeculate pattern in 6-9-year-old children presented FD between 1.01 and 1.29. Besides that, there was no significant correlation between FD and PI.

Does mandibular bone structure predict subsequent height loss? A longitudinal cohort study of women in Gothenburg, Sweden

BackgroundSeveral risk factors for loss of height with increasing age have been identified.ObjectiveTo investigate if mandibular bone structure predicts future height loss in middle-aged and elderly Swedish women.DesignProspective cohort study...

Combination of Moringa oleifera leaf extract and demineralized freeze-dried bovine bone xenograft (DFDBBX) on woven bone area post tooth extraction

Background: Tooth extraction is one of the most frequently performed procedures in dental practice. Resorption without bone regeneration can change the maxillary and mandibular bone structure, resulting lack of retention, stability, and comfort of the denture. Hence, adequate regeneration of alveolar bone is considered an important factor for successful dentures. Moringa oleifera is a plant rich in flavonoids, saponins, alkaloids and tannins. Purpose: This study aims to find out the effect of induction from combination of Moringa oleifera extract and demineralized freeze-dried bovine bone xenograft (DFDBBX) on woven bone area post tooth extraction procedure. Methods: Cavia cobaya was divided into eight groups, each group consists of seven. The lower incisors of Fifty-six Cavia cobaya were extracted. The first group (control group) was given polyethylene glycol, the second group with DFDBBX, the third group with Moringa leaf extract, and the fourth group with a combination of DFDBBX and Moringa leaf extract. Cavia cobaya were sacrificed on day 7 and 14. Histopathological examinations of woven bone area was observed under a 400x magnification light microscope. Kruskal-Wallis and Mann-Whitney tests were performed to analyze the data. Results: There was a significant difference in woven bone area between the groups (P&lt;0.05). The highest mean of woven bone area was found in the combination group on both day 7 and 14. Conclusion: The combination of Moringa leaf extract and DFDBBX could effectively formed new woven bone during the alveolar bone regeneration.

The influence of image processing of μ-CT images on mechanical behavior of mandibular trabecular bone structure using micro finite element method

Computational modeling plays an important role in assessment of biomaterial structures, living tissue and their mechanical properties. Microstructure investigation of bone tissue needs high-level computational models based on μ-CT images. A crucial factor when creating a computational model is image processing using tissue segmentation. The most common method for segmentation is thresholding. Threshold value can influence the geometry model and mechanical response in the bone tissue. One of the aims of the work is to determine and analyze the apparent mechanical behavior of mandibular trabecular bone structure based on different threshold value. Another aim of this study is to assess its influence on strain intensity from a local point of view, namely on one specific trabeculae. Fifty-four computational models including detailed trabecular structure of mandible were created based on μ-CT images. The thresholding was observed to have a significant effect on mechanical behavior of the trabecular bone structure.

Effects of conventional complete dentures and implant-supported overdentures on alveolar ridge height and mandibular bone structure: 2-year and 6-year follow-up study.

The aim of this study was to compare the changes in mandibular bone structure in edentulous patients who were rehabilitated with conventional complete dentures (CCD) and implant supported overdentures (ISO), by evaluating alveolar bone loss (ABL), panoramic mandibular index (PMI), mandibular cortical width (MCW), gonion index (GI), antegonial index (AI), and articular eminence inclination (AEI). Panoramic radiographs of 63 edentulous patients using CCD, 63 edentulous patients using ISO, and 126 patients without tooth loss were evaluated. Edentulous patients had a 2-year and 6-year follow-up panoramic radiograph image. ABL (anterior, premolar, and molar regions), MCW, PMI, AI, GI, and AEI were measured in each patient. Variation between measurements was analyzed using repeated measures ANOVA test and post hoc Tukey test. Both edentulous groups showed significantly lower mean than without tooth lost group in all measures (p < 0.000). ISO group showed significantly lower mean ABL than CCD group in anterior (p = 0.000), right premolar (p = 0.005), left premolar (p = 0.005), right molar (p < 0.000), and left premolar (p < 0.000) regions in short term. ISO group showed significantly lower mean ABL than CCD group in anterior (p = 0.021), right molar (p < 0.000), and left premolar (p < 0.000) regions in long-term. There is no statistically significant difference between the CCD and ISO groups in right premolar (p = 0.200) and left premolar (p = 0.134) regions in long term. Both edentulous groups showed significantly lower mean MCW (p < 0.000), PMI (p < 0.000), AI (p < 0.000), GI (p < 0.012), and AEI (p < 0.002) than the without tooth loss group. There is no statistically significant difference between the CCD and ISO groups in terms of changes in the mean MCW, PMI, AI, GI, and AEI measurement in short and long term (p > 0.000). In the short and long term, edentulism reduced alveolar crest height, MCW, and AEI in individuals, but had no effect on PMI, AI, or GI. The use of prosthesis did not prevent the decrease of alveolar crest height, MCW, or AEI (CCP or ISO). In the short and long term, however, ISO created less ABL in the mandibular anterior and molar regions than CCD. ABL cannot be halted in edentulous people, but by using ISO instead of CCD for rehabilitation, resorption can be reduced.

Effects of functional orthopedic treatment on mandibular trabecular bone in classII patients using fractal analysis.

The aim of this retrospective study was to evaluate the effects of functional orthopedic treatment on mandibular bone structure using fractal dimension (FD) analysis of panoramic radiographs. The study material consisted of the pre- and posttreatment digital panoramic radiographs of 80patients (mean age 10.1 ± 2.01years; 45girls, 35boys) with classII malocclusion who were treated with the monoblock or twin block appliances. The following regions of interest (ROI) were selected: ROI1, condylar process; ROI2, angulus mandibulae; ROI3, corpus mandibulae; and ROI4, mental foramen. Pre- and posttreatment FD values were compared for each ROI. FD values of the mandibular condyle did not change with the functional orthodontic treatment. FD values of the mandibular corpus region had the highest pretreatment values and significantly decreased with treatment (p < 0.05). Functional orthopedic treatment altered the trabeculation of the mandibular bone, but it is speculated that the changes in the occlusal forces seemed to be of primary significance for this effect.

Evaluation of chronic renal failure with cone beam computed tomography radiomorphometric indices and fractal analysis in the mandible.

The purpose of this study is to evaluate the mandibular bone structure of patients with chronic renal failure (CRF) and compare to control group via the fractal analysis (FA) and radiomorphometric indices in the cone beam computed tomography (CBCT) images. Three observers retrospectively investigated 44 CBCT images to compare patients with CRF to healthy controls. FA was performed in two different areas, volume of interests (VOI) were chosen in the mandibular ramus and corpus. The CT cortical index (CTCI), CT mental index (CTMI), and CT mandibular index (CTI) were performed to determine cortical porosity and thickness. The normality distribution of numerical data was tested using the Kolmogorov-Smirnova and Shapiro-Wilk tests. According to the results, the Mann-Whitney U test and independent group t test were used for parameters. The chi-square test was used to evaluate the distribution of categorical variables by groups. There were statistically significant differences in VOI1 and VOI2. The fractal dimension (FD) values in VOI1 and VOI2 were significantly lower in study group. There were no significant differences in CTCI, CTMI and CTI measurements between both groups. CRF is a prevalent cause of radiographic abnormalities in jawbones. The FD values in trabecular bone decreased in study group, although there were no significant differences in the radiomorphometric indices. FA in CBCT images could be useful for a three-dimensional evaluation of trabecular bone structure.

The effects of vitamin D deficiency on mandibular bone structure: a retrospective radiological study.

ObjectiveThe aim of the study was to evaluate the effects of vitamin D deficiency on the mandibular bone structure by fractal analysis and panoramic morphometric indices.MethodsNinety participants were divided into three groups as 30 individuals with severe vitamin D deficiency, 30 individuals with vitamin D deficiency, and 30 individuals with vitamin D sufficiency. Fractal dimension analysis (FD), panoramic mandibular index (PMI), mandibular cortical index (MCI), and mandibular cortical thickness measurement (CTM) were evaluated on panoramic radiographs.ResultsFD values of the patients with vitamin D deficiency were found to be statistically lower than the patients with vitamin D sufficiency (p < 0.05). FD value of supracortical area above the angulus mandible (FD2) in patients with severe vitamin D deficiency was significantly lower than FD values (p = 0.002). There was no statistically significant difference between the groups in the CTM (p > 0.05). PMI was significantly lower in patients with severe vitamin D deficiency (p < 0.001). There was a significant difference in MCI values between the groups (p < 0.05).ConclusionVitamin D deficiency causes a decrease in bone mineral density in the mandible, and an increase in alveolar porosity. FD analysis and radiomorphometric indices in panoramic radiographs can be used to assess osteoporotic changes in patients with vitamin D deficiency.

Mandibular cortical bone structure as risk indicator in fractured and non-fractured 80-year-old men and women

ObjectiveTo investigate the association between mandibular cortex parameters and fracture in a group of 286 men and women, 79–80 years of age.Study designIn a cross-sectional study, the mandibular cortex was evaluated with Klemetti’s index for cortical erosion. The cortical thickness was measured with a ruler adjusting for the magnification factor. The odds ratio (OR) for fracture when having a severely eroded cortex or a cortex thickness < 3 mm was calculated.ResultsA normal cortex was found in 65% of men, whereas only 7% had a severely eroded cortex. The OR for severely eroded cortex as fracture risk predictor was significant (2.32; 95% CI 1.3–4.2), also when the female group was evaluated separately. A significant difference was found between the mean thickness for men (3.96 mm) and women (2.92 mm), respectively. The OR for cortical thickness < 3 mm was significant (2.00; 95% CI 1.1–3.6) in the total group, but not when men and women were evaluated separately.ConclusionsAmong old women, the cortical parameters were significantly associated with prevalent fracture. In old men, other circumstances may be more important.

Effects of hyperlipidemia on trabecular and cortical structures of the mandible.

To evaluate the mandibular bone structure of patients with hyperlipidemia by fractal dimension (FD) analysis and panoramic radiomorphometric indices including mandibular cortical thickness measurement, panoramic mandibular index (PMI), mandibular cortical index (MCI) and to compare with the healthy group. In total, 60 panoramic radiographs were included, including panoramic radiographs of 30 individuals with hyperlipidemia and 30 individuals with systemically healthy. FD analysis in the mandibular condyle, angle of the mandible, the distal side of the second premolar and anterior to mental foramen, PMI, MCI, and mandibular cortical thickness measurements were evaluated on radiographs. Independent samples t-test was used for differences between healthy and hyperlipidemia groups with regard to age and PMI. Repeated measurement of variance with one within and one between factors in the comparison of four regions and two groups in terms of FD and cortical thickness measurements. Following this analysis, significant differences were detected by post-hoc Sidak test. Fisher-Freeman-Halton analysis was applied to determine the relationship between categorical variables. FD values of the hyperlipidemic patients were found to be lower than the healthy group. Between the hyperlipidemic and healthy groups, there was a difference in the angle of the mandible FD values (p = 0.020). There were no differences in the cortical thickness measurements and PMI between the groups (p > 0.05). There was a difference in MCI values between the groups (p < 0.05). The trabecular structure of the angle of the mandible and the cortical bone structure of the mandible were found to be negatively affected by hyperlipidemia.

Investigation of mandibular fractal dimension on digital panoramic radiographs in bruxist individuals

This study aimed to evaluate changes in mandibular trabecular bone structure in bruxism using fractal analysis on digital panoramic radiographs obtained with automatic dosing. In this prospective study, fractal analysis was performed on radiographs of 126 bruxists and 126 non-bruxists. Eight paired mandibular regions of interest were selected: the bilateral condylar and gonial regions, and the bilateral dentate regions between the apical areas of the first molar and second premolar and between the first premolar and canine. Fractal dimensions (FDs) were calculated at each site. Mean FD values in the bilateral gonial regions of the bruxists were significantly lower than those of controls (P ≤ .049). In both groups, FD values of the right dentate region anterior to the mental foramen were significantly lower than those on the left side (P ≤ .042). Females exhibited significantly lower FD values in both condylar regions in both groups (P ≤ .039) and in the right dentate regions in the controls (P ≤ .022). Correlations between age and FD in all regions were positive but nonsignificant in both groups (P > .05). FD values of mandibular trabecular bone are affected by bruxism in the gonial region and by laterality and sex differences in the condylar and dentate regions.

EFFECT OF DIFFERENT DOSES OF VITAMIN D3 SUPPLEMENTATION ON MANDIBULAR BONE IN RATS

Introduction: vitamin D is one of the most important biological regulators of calcium metabolism which ultimately promotes healthy bones. It is also helpful in reducing inflammation as well as enhancing immune functions and cell growth. Despite its importance, its deficiency is prevalent worldwide. Moreover, it is difficult to obtain this vitamin from diet because it is not present in many foods. Consequently, Vitamin D3 (cholecalciferol) supplementation is nowadays used worldwide to maintain optimal bone health. However, studies evaluating the effect of standard doses of vitamin D supplements on bone have been inconsistent. In addition, the effects of higher doses have not been revealed and needs further studies. Aim of the study: to determine the effect of supplementation of varying doses of dietary vitamin D3 on the structure of mandibular bone in albino rats. Materials and methods: Thirty adult female rats were randomly divided into three groups: Group I control, while Group II and Group III received daily dose of vitamin D3 (400 IU/Kg) and (1000 IU/Kg) respectively. All rats were fed on same diet. After 6 weeks animals were euthanized and their mandibles were dissected out. The effects of each dose of vitamin D3 on the mandibular bone structure were assessed by scanning electron microscope and energy dispersive X-ray microanalysis. Results:After6 weeks, Group I control and Group II supplemented with 400 IU/day, showed loss of its normal cortical bone smoothness. Moreover, the trabecular bone showed wide bone marrow spaces with thin trabeculae. However, group III supplemented with 1000 IU/day, showed smoother and more uniform cortical bone surface with wider trabeculae and narrower marrow spaces compared to the other groups. Conclusion: This study showedthatadministration of vitamin D3 (1000 IU/day) enhanced bone architecture in adult rats.However, the administration of 400 IU/day showed slight enhancement in bone structure.

The effect of selective serotonin reuptake inhibitors on the human mandible.

Selective serotonin reuptake inhibitors (SSRI) are a group of drugs that selectively and strongly block the serotonin transporter. Aim of this study was to evaluate the mandibular bone structure of patients who are using SSRIs with fractal analysis and panoramic morphometric indices [mandibular cortical width (MCW), panoramic mandibular index (PMI) and Klemetti index (KI)] and to compare with control group. Patients who declared using SSRIs for more than six months had been included in the study group. In total, 212 dental panoramic radiographs (DPR) were assessed. For fractal analysis; three regions of interest (ROIs) were determined: ROI1 and ROI2 were chosen within trabecular bone, ROI3 was selected from cortical bone. MCW, PMI, and KI were obtained from DPRs. The study group was categorized into five subgroups of various SSRIs. The fractal dimension (FD) values and panoramic morphometric indices of these subgroups were also compared. There was no significant difference between the groups for age and gender (p = 0.57, p = 0.5). There were significant differences in the mean FD values between the study and control groups both for the ROI1 and ROI2 (p < 0.01, p < 0.01). There was no significant difference between the groups for the mean FD value of ROI3, MCW, PMI and KI (p = 0.93, p = 0.98, p = 0.74, p = 0.06). There were no significant differences for all the values between the SSRI subgroups (p = 0.52, p = 0.7, p = 0.76, p = 0.24, p = 0.31, p = 0.08) CONCLUSIONS: Trabecular rich sites of the mandible were found to be affected by SSRI usage.