Fractal properties of the trabecular pattern of the mandible in chronic renal failure

Abstract

Objectives: the purpose of this study was to evaluate fractal analysis as a tool to quantitatively determine the mandibular trabecular bone changes in patients with chronic renal failure (CRF). Methods: in the present study, fractal analysis was performed using ImageJ (National Institutes of Health, Bethesda, MD) program with box-counting method over panoramic radiographs of 25 patients (14 females and 11 males) with CRF and 26 healthy individuals (14 females and 12 males) as a control group. the fractal dimension (FD) values of the patients and healthy individuals were compared. in addition, average biochemical parameters [parathyroid hormone (PTH), calcium (Ca), phosphorus (P), product of Ca and P levels (CaxP), alkaline phosphatase (ALP), vitamin D] of the patients with CRF, as measured during the 3 months before the panoramic radiographs, were compared with FD values. Results: According to the results, FD values of the patients with CRF were found to be statistically lower than the control group (p < 0.05). the average PTH levels of the patients with CRF were 416.16 +/- 310.3 pg ml(-1); average Ca levels were 8.94 +/- 1.2 mg dl(-1); average P levels were 5.76 +/- 1.7 mg dl(-1); average CaxP values were 51.12 +/- 15.03; average ALP levels were 83.44 +/- 36.8 U l(-1); and the average vitamin D values were 19.43 +/- 9.7 ng ml(-1). in addition, there was no significant correlation between FD values and the biochemical parameters of the patients, and there was no correlation between age, gender and FD. Conclusions: the FD values of the patients with CRF were lower than those of the controls. This finding suggests that FD analysis might be a promising simple and cost-effective tool for evaluating trabecular bone structure.