Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Oral and maxillofacial radiologyAssessment of the trabecular structure of mandibular condyles in patients with temporomandibular disorders using fractal analysis
Section snippets
Materials and Methods
The clinical protocol was approved by the Human Research Ethics Committee of the Istanbul University Faculty of Dentistry (protocol 2014/10). The study group comprised patients who were referred to the Istanbul University Faculty of Dentistry Dentomaxillofacial Radiology Clinic because of TMJ symptoms. This group included 100 patients with TMD aged 18 to 72 years who were randomly chosen among systemically healthy patients. None of the study patients had conditions that affected bone
Results
The study group comprised 100 patients, of whom 69 were women and 31 were men. The mean age of the study group was 31.52 years. The study group had significantly lower fractal dimension values (1.22 ± 0.06) than the control group (1.25 ± 0.06) (t(198) = 3.328; P = .001).
Table I presents the frequency, types, and severity of degenerative changes in both groups. In the study group, the most commonly observed degenerative change was flattening (175 joints, 87.5%), followed by erosion (71 joints,
Discussion
Several studies have demonstrated that fractal analysis is capable of showing changes in the structure of trabecular bone in patients with osteoporosis, hyperparathyroidism, and sickle cell anemia. In these studies, the differences between the healthy control and patient groups' fractal dimension values of trabecular bone were associated with changes in trabecular bone architecture and density.10, 13, 15, 16, 17, 22 In the field of dentistry, fractal analysis has been used to demonstrate the
Conclusion
We calculated the amount of degenerative change on mandibular condyles using fractal analysis and found that fractal dimensions of mandibular condyles of patients with TMD were decreased when more severe degenerative changes were present. The trabecular structure of condyles in patients with TMD is altered in such a way that lower fractal dimension values represent decreased complexity, which represents erosive and sclerotic changes. Furthermore, fractal analysis revealed changes in the
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