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Fractal properties and radiomorphometric indices of the trabecular structure of the mandible in patients using systemic glucocorticoids

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Abstract

Objectives

The aim of this study is to evaluate the mandibular trabecular and cortical bone structure of patients using systemic glucocorticoid (GC) and compare to control group with the fractal analysis (FA) and radiomorphometric indices.

Methods

Two researchers retrospectively investigated 192 dental panoramic radiographs to compare individuals using systemic GCs to healthy controls. FA was performed in 4 different regions; geometrical center of the mandibular ramus (ROI1), cancellous bone on supracortical mandibular angle area inferior to the mandibular canal (ROI2), cancellous bone on mesial to the mental foramen (ROI3), basal cortical bone extending mental foramen to the first molars’ distal root in the mandibular corpus (ROI4). Panoramic mandibular index (PMI), mandibular cortical width (MCW) and mandibular cortical index (MCI) were performed for evaluate cortical thickness and porosity. The Shapiro–Wilk test was used to determine the normal distribution of the data, the independent t test for comparison of values and the chi-square test for descriptive statistics.

Results

There were statistically significant differences in ROI4 and MCW. The fractal dimension (FD) values in ROI4 and MCW were significantly lower in study group. There were no significant differences in FD values in ROI1, ROI2, ROI3 and PMI and MCI measurements between both groups.

Conclusions

FA and radiomorphometric measurements is an efficient method to detect early changes in bone mass. In our study, ROI4 and MCW were significantly lower in study group. Osteoporosis prevention should be considered in patients using systemic GCs.

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References

  1. Buttgereit F. Views on glucocorticoid therapy in rheumatology: the age of convergence. Nat Rev Rheumatol. 2020;16(4):239–46.

    Article  PubMed  Google Scholar 

  2. Roux C. Osteoporosis in inflammatory joint diseases. Osteoporos Int. 2011;22(2):421–33.

    Article  PubMed  Google Scholar 

  3. Canalis E, Mazziotti G, Giustina A, Bilezikian JP. Glucocorticoid-induced osteoporosis: pathophysiology and therapy. Osteoporos Int. 2007;18(10):1319–28.

    Article  PubMed  Google Scholar 

  4. Briot K. Bone and glucocorticoids. Ann Endocrinol. 2018;79(3):115–8.

    Article  Google Scholar 

  5. Briot K, Roux C. Corticosteroid-induced osteoporosis. Rev Med Interne. 2012;34(5):315–23.

    Article  PubMed  Google Scholar 

  6. Johnson RB, Gilbert JA, Cooper RC, Dai X, Newton BI, Tracy RR, et al. Alveolar bone loss one year following ovariectomy in sheep. J Periodontol. 1997;68(9):864–71.

    Article  PubMed  Google Scholar 

  7. Schulz MC, Kowald J, Estenfelder S, Jung R, Kuhlisch E, Eckelt U, et al. Site-specific variations in bone mineral density under systemic conditions inducing osteoporosis in minipigs. Front Physiol. 2017;8:426.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Johnson RB, Gilbert JA, Cooper RC, Parsell DE, Stewart BA, Dai X, et al. Effect of estrogen deficiency on skeletal and alveolar bone density in sheep. J Periodontol. 2002;73(4):383–91.

    Article  PubMed  Google Scholar 

  9. Morin C, Fardet L. Systemic glucocorticoid therapy: risk factors for reported adverse events and beliefs about the drug. A cross-sectional online survey of 820 patients. Clin Rheumatol. 2015;34(12):2119–26.

    Article  PubMed  Google Scholar 

  10. Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontol 2000. 2013;62(1):59–94.

    Article  PubMed  Google Scholar 

  11. Borrell LN, Papapanou PN. Analytical epidemiology of periodontitis. J Clin Periodontol. 2005;32(6):132–58.

    Article  PubMed  Google Scholar 

  12. Jolley L, Majumdar S, Kapila S. Technical factors in fractal analysis of periapical radiographs. Dentomaxillofac Radiol. 2006;35(6):393–7.

    Article  PubMed  Google Scholar 

  13. White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88(5):628–35.

    Article  PubMed  Google Scholar 

  14. Hwang JJ, Lee J-H, Han S-S, Kim YH, Jeong H-G, Choi YJ, et al. Strut analysis for osteoporosis detection model using dental panoramic radiography. Dentomaxillofac Radiol. 2017;46(7):20170006.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Gulsahi A, Yüzügüllü B, Imirzalioglu P, Genç Y. Assessment of panoramic radiomorphometric indices in Turkish patients of different age groups, gender and dental status. Dentomaxillofac Radiol. 2008;37(5):288–92.

    Article  PubMed  Google Scholar 

  16. Mansour S, AlGhamdi AST, Javed F, Marzouk H, Khan EA. Panoramic radiomorphometric indices as reliable parameters in predicting osteoporosis. Am J Med Sci. 2013;346(6):473–8.

    Article  PubMed  Google Scholar 

  17. Bajoria AA, Asha M, Kamath G, Babshet M, Patil P, Sukhija P. Evaluation of radiomorphometric indices in panoramic radiograph–a screening tool. Open Dent J. 2015;9:303–10.

    Article  PubMed  PubMed Central  Google Scholar 

  18. GöllerBulut D, Bayrak S, Uyeturk U, Ankarali H. Mandibular indexes and fractal properties on the panoramic radiographs of the patients using aromatase inhibitors. Br J Radiol. 2018;91(1091):20180442.

    Article  Google Scholar 

  19. Klemetti E, Kolmakov S, Kröger H. Pantomography in assessment of the osteoporosis risk group. Eur J Oral Sci. 1994;102(1):68–72.

    Article  Google Scholar 

  20. Cohen LH. Measurement of life events. Life events and psychological functioning: Theoretical and methodological issue. London: Sage; 1988. p. 11–30.

    Google Scholar 

  21. Evans JD. Straightforward statistics for the behavioral sciences. Pacific Grove: Thomson Brooks/Cole Publishing Co; 1996.

    Google Scholar 

  22. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.

    Article  Google Scholar 

  23. Gumussoy I, Miloglu O, Cankaya E, Bayrakdar IS. Fractal properties of the trabecular pattern of the mandible in chronic renal failure. Dentomaxillofac Radiol. 2016;45(5):20150389.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Avsever I, Orhan K, Özen T, Karaçaylı Ü, Görgülü S. Evaluation of mandibular bone structure in sickle cell anemia patients. Gulhane Med J. 2015;57:11–5.

    Article  Google Scholar 

  25. Demirbaş AK, Ergün S, Güneri P, Aktener BO, Boyacıoğlu H. Mandibular bone changes in sickle cell anemia: fractal analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(1):e41–8.

    Article  PubMed  Google Scholar 

  26. Sindeaux R, de Souza Figueiredo PT, de Melo NS, Guimarães ATB, Lazarte L, Pereira FB, et al. Fractal dimension and mandibular cortical in normal and osteoporotic men and women. Maturitas. 2014;77(2):142–8.

    Article  PubMed  Google Scholar 

  27. Southard TE, Southard KA, Krizan KE, Hillis SL, Haller JW, Keller J, et al. Mandibular bone density and fractal dimension in rabbits with induced osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89(2):244–9.

    Article  PubMed  Google Scholar 

  28. Kozai Y, Kawamata R, Sakurai T, Kanno M, Kashima I. Influence of prednisolone-induced osteoporosis on bone mass and bone quality of the mandible in rats. Dentomaxillofac Radiol. 2009;38(1):34–41.

    Article  PubMed  Google Scholar 

  29. Belgin CA, Serindere G. Fractal and radiomorphometric analysis of mandibular bone changes in patients undergoing intravenous corticosteroid therapy. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020;130(1):110–5.

    Article  Google Scholar 

  30. Lespessailles E, Siroux V, Poupon S, Andriambelosoa N, Pothuaud L, Harba R, et al. Long-term corticosteroid therapy induces mild changes in trabecular bone texture. J Bone Miner Res. 2000;15(4):747–53.

    Article  PubMed  Google Scholar 

  31. Adinoff AD, Hollister JR. Steroid-induced fractures and bone loss in patients with asthma. N Engl J Med. 1983;309(5):265–8.

    Article  PubMed  Google Scholar 

  32. Reid IR, Evans MC, Stapleton J. Lateral spine densitometry is a more sensitive indicator of glucocorticoid- induced bone loss. J Bone Miner Res. 1992;7(10):1221–5.

    Article  PubMed  Google Scholar 

  33. Baylink DJ. Glucocorticoid-induced osteoporosis. N Engl J Med. 1983;309(5):306–8.

    Article  PubMed  Google Scholar 

  34. Secgin CK, Kulah CK, Gulsahi A. Analysis of mandibular changes using panoramic-based indices in patients with chronic renal failure. Int J Artif Organs. 2018;41(1):11–6.

    Article  Google Scholar 

  35. Bayrak S, Bulut DG, Orhan K, Sinanoğlu EA, Çakmak EŞK, Mısırlı M, et al. Evaluation of osseous changes in dental panoramic radiography of thalassemia patients using mandibular indexes and fractal size analysis. Oral Radiol. 2020;36(1):18–24.

    Article  PubMed  Google Scholar 

  36. Ledgerton D, Horner K, Devlin H, Worthington H. Radiomorphometric indices of the mandible in a British female population. Dentomaxillofac Radiol. 1999;28(3):173–81.

    Article  PubMed  Google Scholar 

  37. Devlin H, Horner K. Diagnosis of osteoporosis in oral health care. J Oral Rehabil. 2008;35(2):152–7.

    PubMed  Google Scholar 

  38. Ardakani FE, Mirmohamadi SJ. Osteoporosis and oral bone resorption: a review. J Maxillofac Oral Surg. 2009;8:121–6.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Nomura Y, Watanabe H, Honda E, Kurabayashi T. Reliability of voxel values from cone-beam computed tomography for dental use in evaluating bone mineral density. Clin Oral Implants Res. 2010;21(5):558–62.

    Article  PubMed  Google Scholar 

  40. Hua Y, Nackaerts O, Duyck J, Maes F, Jacobs R. Bone quality assessment based on cone beam computed tomography imaging. Clin Oral Implants Res. 2009;20(8):767–71.

    Article  PubMed  Google Scholar 

  41. Katsumata A, Hirukawa A, Noujeim M, Okumura S, Naitoh M, Fujishita M, et al. Image artifact in dental cone-beam CT. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(5):652–7.

    Article  PubMed  Google Scholar 

  42. Lee S, Gantes B, Riggs M, Crigger M. Bone density assessments of dental implant sites: 3. Bone quality evaluation during osteotomy and implant placement. Int J Oral Maxillofac Implants. 2007;22(2):208–12.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey

    Nihal Ersu, Rıdvan Akyol & Meryem Etöz

Authors
  1. Nihal Ersu
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  2. Rıdvan Akyol
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  3. Meryem Etöz
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Correspondence to Nihal Ersu.

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All the procedures followed were in accordance with the ethical standards of the responsible committee institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study. Erciyes University Clinical Research Ethics Committee Protocol Number: 2021/117.

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Ersu, N., Akyol, R. & Etöz, M. Fractal properties and radiomorphometric indices of the trabecular structure of the mandible in patients using systemic glucocorticoids. Oral Radiol 38, 252–260 (2022). https://doi.org/10.1007/s11282-021-00552-4

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