Fractal analysis on dental radiographs to detect trabecular patterns in patients affected by periodontitis

Objective. To evaluate fractal analysis as a tool to quantitatively measure the impact of periodontal disease on surrounding bone.; Background. The current standard use of dental radiographs is visual inspection, often with no quantitative analysis. Fractal analysis can be used to examine trabecular bone pattern among periodontal patients.; Methods. Patients (n=108) from the USC School of Dentistry were classified into three groups: healthy, moderate, and severe periodontitis. The box-counting-method was used to calculate a fractal dimension.; Results. Significant differences in average fractal dimensions were measured between healthy and moderate-periodontitis groups (p<0.01) and between healthy and severe-periodontitis groups (p< 0.001) in the anterior mandibular region. Higher fractal dimensions were measured in healthy periodontal patients.; Conclusions. Fractal analysis evidenced significant differences between patients affected and not affected by periodontitis in the anterior mandible. The box-counting method quantitatively describes the severity of bone disease and can be used to improve current diagnostic techniques.