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Evaluation of chronic renal failure with cone beam computed tomography radiomorphometric indices and fractal analysis in the mandible

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Abstract

Objectives

The purpose of this study is to evaluate the mandibular bone structure of patients with chronic renal failure (CRF) and compare to control group via the fractal analysis (FA) and radiomorphometric indices in the cone beam computed tomography (CBCT) images.

Methods

Three observers retrospectively investigated 44 CBCT images to compare patients with CRF to healthy controls. FA was performed in two different areas, volume of interests (VOI) were chosen in the mandibular ramus and corpus. The CT cortical index (CTCI), CT mental index (CTMI), and CT mandibular index (CTI) were performed to determine cortical porosity and thickness. The normality distribution of numerical data was tested using the Kolmogorov–Smirnova and Shapiro–Wilk tests. According to the results, the Mann–Whitney U test and independent group t test were used for parameters. The chi-square test was used to evaluate the distribution of categorical variables by groups.

Results

There were statistically significant differences in VOI1 and VOI2. The fractal dimension (FD) values in VOI1 and VOI2 were significantly lower in study group. There were no significant differences in CTCI, CTMI and CTI measurements between both groups.

Conclusions

CRF is a prevalent cause of radiographic abnormalities in jawbones. The FD values in trabecular bone decreased in study group, although there were no significant differences in the radiomorphometric indices. FA in CBCT images could be useful for a three-dimensional evaluation of trabecular bone structure.

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References

  1. Nadir I, Topçu S, Gültekin F, Yönem Ö. The assessment of etiology in chronic renal failure. CU Fac Med Mag. 2002;24:62–4.

    Google Scholar 

  2. de la Rosa García E, Mondragón Padilla A, Aranda Romo S, Bustamante Ramírez MA. Oral mucosa symptoms, signs and lesions, in end stage renal disease and non-end stage renal disease diabetic patients. Med Oral Patol Oral Cir Bucal. 2006;11(6).

  3. De Rossi SS, Glick M. Dental considerations for the patient with renal disease receiving hemodialysis. J Am Dent Assoc. 1996;127(2):211–9.

    Article  Google Scholar 

  4. Proctor R, Kumar N, Stein A, Moles D, Porter S. Oral and dental aspects of chronic renal failure. J Dent Res. 2005;84(3):199–208.

    Article  Google Scholar 

  5. Henriques JCG, de Melo Castilho JC, Jacobs R, Amorim JBO, Rosa RR, Matai CVB. Severe secondary hyperparathyroidism and panoramic radiography parameters. Clin Oral Invest. 2014;18(3):941–8.

    Article  Google Scholar 

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

    Article  Google Scholar 

  7. 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  Google Scholar 

  8. 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  Google Scholar 

  9. Baum T, Carballido-Gamio J, Huber M, Müller D, Monetti R, Räth C, et al. Automated 3D trabecular bone structure analysis of the proximal femur—prediction of biomechanical strength by CT and DXA. Osteoporos Int. 2010;21(9):1553–64.

    Article  Google Scholar 

  10. Koh K-J, Kim K-A. Utility of the computed tomography indices on cone beam computed tomography images in the diagnosis of osteoporosis in women. Imaging Sci Dent. 2011;41(3):101–6.

    Article  Google Scholar 

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

    Article  Google Scholar 

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

    Article  Google Scholar 

  13. 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  Google Scholar 

  14. Panmekiate S, Ngonphloy N, Charoenkarn T, Faruangsaeng T, Pauwels R. Comparison of mandibular bone microarchitecture between micro-CT and CBCT images. Dentomaxillofacial Radiology. 2015;44(5):20140322.

    Article  Google Scholar 

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

    Article  Google Scholar 

  16. Klemetti E, Collin HL, Forss H, Markkanen H, Lassila V. Mineral status of skeleton and advanced periodontal disease. J Clin Periodontol. 1994;21(3):184–8.

    Article  Google Scholar 

  17. Mostafa RA, Arnout EA, Abo el-Fotouh MM. Feasibility of cone beam computed tomography radiomorphometric analysis and fractal dimension in assessment of postmenopausal osteoporosis in correlation with dual X-ray absorptiometry. Dentomaxillofac Radiol. 2016;45(7):20160212.

    Article  Google Scholar 

  18. Odgaard A. Three-dimensional methods for quantification of cancellous bone architecture. Bone. 1997;20(4):315–28.

    Article  Google Scholar 

  19. Arsan B, Yalcin-Ülker GM, Meral DG, Erdem TL. Is there any predictive bone parameter for implant stability in 2-dimensional and 3-dimensional radiologic images? Oral Surg Oral Med Oral Pathol Oral Radiol. 2021;131(3):371–9.

    Article  Google Scholar 

  20. Liebross BA, Coburn JW. Renal osteodystrophy. Calcium disorders, Butterworth-Heinemann. Amsterdam: Elsevier; 1982. p. 151–88.

    Google Scholar 

  21. Messier MD, Emde K, Stern L, Radhakrishnan J, Vernocchi L, Cheng B, et al. Radiographic periodontal bone loss in chronic kidney disease. J Periodontol. 2012;83(5):602–11.

    Article  Google Scholar 

  22. 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 

  23. Cakur B, Şahin A, Dagistan S, Altun O, Caglayan F, Miloglu Ö, et al. Dental panoramic radiography in the diagnosis of osteoporosis. J Int Med Res. 2008;36(4):792–9.

    Article  Google Scholar 

  24. Devlin H, Karayianni K, Mitsea A, Jacobs R, Lindh C, van der Stelt P, et al. Diagnosing osteoporosis by using dental panoramic radiographs: the OSTEODENT project. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endodontology. 2007;104(6):821–8.

    Article  Google Scholar 

  25. Queiroz SM, De Andrade ALDL, De Oliveira PT, Maia PRL, Oliveira ÂGRDC, Freitas RDA, et al. Correlation of radiomorphometric indices of the mandible and biochemical parameters in patients with secondary hyperparathyroidism due to chronic kidney disease. Eur J Dent. 2019;13(03):303–9.

    Article  Google Scholar 

  26. Abdinian M, Mortazavi M, Jandaghian Z. Comparison of skeletal changes related to patients with chronic kidney disease and healthy individuals in digital panoramic radiography. Indian J Dent Res. 2019;30(3):358.

    Article  Google Scholar 

  27. Güngör E, Yildirim D, Çevik R. Evaluation of osteoporosis in jaw bones using cone beam CT and dual-energy X-ray absorptiometry. J Oral Sci. 2016;58(2):185–94.

    Article  Google Scholar 

  28. Çağlayan F, Dağistan S, Keleş M. The osseous and dental changes of patients with chronic renal failure by CBCT. Dentomaxillofac Radiol. 2015;44(5):20140398.

    Article  Google Scholar 

  29. 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, Endodontology. 2008;106(1):e41–8.

    Article  Google Scholar 

  30. Berry JL, Towers JD, Webber RL, Pope TL, Davidai G, Zimmerman M. Change in trabecular architecture as measured by fractal dimension. J Biomech. 1996;29(6):819–22.

    Article  Google Scholar 

  31. Torres S, Chen C, Leroux B, Lee P, Hollender L, Schubert M. Fractal dimension evaluation of cone beam computed tomography in patients with bisphosphonate-associated osteonecrosis. Dentomaxillofac Radiol. 2011;40(8):501–5.

    Article  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, Gamze Şirin Sarıbal, Fatma Zehra Tanyeri & Mehmet Amuk

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  1. Nihal Ersu
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  2. Gamze Şirin Sarıbal
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  3. Fatma Zehra Tanyeri
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  4. Mehmet Amuk
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Correspondence to Nihal Ersu.

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All authors declare that they have no conflict of interest. This article does not contain any studies with human or animal subjects performed by the any of the authors.

Ethical approval

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.

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Ersu, N., Şirin Sarıbal, G., Tanyeri, F.Z. et al. Evaluation of chronic renal failure with cone beam computed tomography radiomorphometric indices and fractal analysis in the mandible. Oral Radiol 39, 133–142 (2023). https://doi.org/10.1007/s11282-022-00614-1

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  • DOI: https://doi.org/10.1007/s11282-022-00614-1

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