EVALUATION OF FRACTAL ANALYSES OF THE TRABECULAR BONE REGION IN LESIONED AND HEALTHY MANDIBULAR FIRST PERMANENT MOLARS ACCORDING TO AGE AND GENDER ON PANORAMIC RADIOGRAPHS

Objective: This study aimed to investigate the fractal dimension values of trabecular bone in periapical lesions and healthy mandibular first permanent molars, based on age and gender, using panoramic radiographs. Material and Methods: The panoramic radiographs of a total of 216 patients aged 6-16 years who applied to Dicle University Faculty of Dentistry Department of Pedodontics in 2022 were retrospectively examined. The patients were equally distributed by gender into three age groups: 6-9, 10-12, and 13-16 years. Fractal analysis was applied using the ImageJ program to the regions of interest (ROI’s) of 25x25 pixels determined from two different regions on each digital panoramic radiograph, and fractal dimension calculations were performed. The data were analyzed using the Shapiro-Wilk and/or Kolmogorov-Smirnov tests, as well as the Mann-Whitney U and Kruskal-Wallis H tests. The confidence interval for all statistical tests was set at 95%, and the significance level was accepted as p<0.05. Results: According to the results of the study, the average fractal dimension value of the lesioned region was 1.106, while the average fractal dimension value of the healthy region was 1.116. No statistically significant difference was found in the fractal dimension values between both the lesioned and healthy groups, as well as between the age and gender groups (p>0.05). Conclusion: Fractal dimension (FD) calculation is a reliable method for detecting early-stage periapical lesions. However, to achieve more comprehensive evaluations, future studies should integrate histological and clinical parameters and compare 2D and 3D imaging techniques with larger sample sizes.