Assessment of mandibular trabecular structure and cervical vertebral maturation using fractal analysis

BACKGROUND: Changes in bone trabeculae occur during skeletal maturation. Fractal analysis is a technique for assessing changes in the internal structure of the bone. OBJECTIVE: The aim of this study was to investigate correlation of bone trabeculation measured on panoramic and lateral cephalometric radiographs with cervical vertebral maturation stages (CVMS). METHODS: CVMS was evaluated on lateral cephalometric radiographs of 120 individuals aged 6 to 18 years. The subjects were divided into 6 groups (n = 20 each) according to CVMS. On panoramic and lateral cephalometric radiographs, fractal dimension (FD) analyses were performed in mandibular corpus, gonial and condylar regions and cervical vertebral bodies (C2, C3, C4). RESULTS: FD measurements from the mandibular corpus region bilaterally and C2-C4 vertebral bodies showed significant positive correlations with CVMS (r = 0.418, r = 0.412, r = 0.324, r = 0.304, r = 0.263, respectively). Significant differences were found in the FD values of the right/left mandibular corpus and C2 and C3 vertebrae compared to CVMS (P < 0.001, P < 0.001, P = 0.005, P = 0.019, respectively). CONCLUSION: Significant positive moderate correlations between the FD values of the right and left mandibular corpus and CVMS suggest that fractal analysis may be useful in determining skeletal maturity stage. The significant FD values obtained from the right/left mandibular corpus, and C2 and C3 vertebra indicate that the complexity of the internal trabecular structure increases with maturation.