Fractal Analysis of Periodontal Tissues in Geriatric Patients With Different Periodontal Conditions: A Retrospective Study
Dilek Ozkan Sen, Omer Ogutcen, Fatma Ucan Yarkac, Ibrahim Burak Yuksel, Muhammet Emin Arslan, Zeynep Tastan ErogluABSTRACT
Objective
This study evaluated the relationship between fractal dimension (FD) values and periodontal status in geriatric patients using digital panoramic radiographs.
Methodology
In this retrospective observational study, 147 elderly individuals were classified as periodontally healthy ( n = 30), gingivitis ( n = 32), Stage I periodontitis ( n = 26), Stage II periodontitis ( n = 14), Stage III periodontitis ( n = 20), and Stage IV periodontitis ( n = 25) according to the 2017 World Workshop Classification. FD values were calculated using the box‐counting method in ImageJ from standardized mandibular posterior trabecular bone regions (#35–36 and #45–46). Clinical periodontal parameters were recorded, and statistical analyses were performed using ANOVA and independent samples t ‐test ( α = 0.05).
Results
No significant differences were observed among groups regarding age or gender distribution ( p > 0.05), whereas clinical periodontal parameters and FD values differed significantly ( p < 0.001). The highest FD values were observed in the healthy and gingivitis groups, with progressive decreases corresponding to periodontal disease severity. Gender‐related differences were detected in gingivitis and periodontitis groups ( p < 0.05).
Conclusion
FD values vary with periodontal disease progression in geriatric patients, suggesting that fractal analysis may support radiographic assessment of trabecular bone changes when interpreted alongside clinical findings.