Estimation of Cancellous Changes Using Fractal Analysis in Patients with Periodontitis

Sukanya Mishra; Manoj Kumar; Lora Mishra; Swagatika Panda; Saurav Panda; Natalia Lewkowicz; Barbara Lapinska

doi:10.3390/biomedicines11092547

Biomedicines (Sep 2023)

Estimation of Cancellous Changes Using Fractal Analysis in Patients with Periodontitis

Sukanya Mishra,
Manoj Kumar,
Lora Mishra,
Swagatika Panda,
Saurav Panda,
Natalia Lewkowicz,
Barbara Lapinska

Affiliations

Sukanya Mishra: Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
Manoj Kumar: Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
Lora Mishra: Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
Swagatika Panda: Department of Oral Pathology and Microbiology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
Saurav Panda: Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
Natalia Lewkowicz: Department of Periodontology and Oral Diseases, Medical University of Lodz, 251 Pomorska St, 92-213 Lodz, Poland
Barbara Lapinska: Department of General Dentistry, Medical University of Lodz, 251 Pomorska St, 92-213 Lodz, Poland

DOI: https://doi.org/10.3390/biomedicines11092547
Journal volume & issue: Vol. 11, no. 9
p. 2547

Abstract

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Periodontal disease is a broad term given when the periodontium is affected by inflammation. There are several methods to diagnose periodontitis, but no method to quantify the cancellous bone is presently used. For this purpose, a non-invasive tool that is efficient in analyzing bone quality called fractal analysis can be employed. The objective of the study was to utilize fractal dimension (FD) to evaluate cancellous patterns of interproximal alveolar bone using a digital intraoral periapical radiograph (IOPAR) in different clinical presentations of periodontitis classified according to the latest classification by the World Workshop for Periodontal and Peri-Implant Diseases and Conditions, 2017 (WWDC, 2017). The study aimed to numerically calculate the periodontitis changes in the cancellous bone around the affected tooth on an IOPAR using fractal analysis and to provide an additional criterion for the staging of periodontitis. In this cross-sectional observational study, 75 patients were selected and equally allotted to five groups based on the staging system proposed by the WWDC, 2017. The region of interest was selected on the IOPA radiograph of the tooth with the site having the most significant clinical attachment loss, and FD was calculated using Image J analysis. The association of gender and age with stages of periodontitis was studied using the chi-square test of independence. A comparison of % bone loss and fractal dimension among stages was studied by using the non-parametric Kruskal Wallis test. The relationship between % bone loss and fractal dimension within stages and gender was studied by using the Karl Pearson correlation. A receiver operating characteristic (ROC) curve analysis was performed for FD value as a marker of periodontitis patients. We demonstrated that the FD values decreased significantly with the increase in stages (p p < 0.0001), except for stages III and IV. FD can be utilized as a quantitative method for detecting cancellous bone changes in different stages of periodontitis, aiding in diagnosing periodontitis.

Published in Biomedicines

ISSN: 2227-9059 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Science: Biology (General)
Website: http://www.mdpi.com/journal/biomedicines

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