Assessment of Trabecular Bone Patterns in Periodontitis Patients with Systemic Diseases: A Fractal Analysis Study

Background & Objectives: Periodontitis results in progressive inflammation – mediated loss of periodontal supporting structures, including trabecular bone. This study aimed to evaluate the trabecular bone pattern changes in panoramic radiographs from patients with periodontitis and systemic diseases using fractal analysis. Study design: Panoramic radiographs from periodontitis patients without any systemic diseases and patients with periodontitis and systemic diseases like type II diabetes mellitus and hypothyroidism were collected. A region of interest was selected on panoramic radiographs between Mandibular first molar and second premolar. The fractal dimension values for this region were calculated using the box-counting method. The statistical significance of difference was evaluated at p < 0.05. Results: Fractal dimension values were lower in periodontitis patients with diabetes when compared with the other groups, but there was no statistically significant difference in fractal dimension values between the groups (p > 0.05). Conclusion: Fractal analysis serves as an adjunctive non-invasive diagnostic tool when used alongside clinical periodontal measurements and also helps for early detection of bone alterations & helps periodontists to assess bone quality beyond routine radiographs.