Longitudinal Association Between Severe Early Childhood Caries and Mandibular Condylar Trabecular Organization: A 3-Year Retrospective Controlled Study

Objectives: The objective of this study was to longitudinally evaluate mandibular condylar trabecular organization in children with a history of severe early childhood caries (SECC) and caries-free controls using fractal dimension (FD) analysis, and to compare the findings according to sex. Methods: This retrospective follow-up study included 100 children (50 with a history of SECC and 50 caries-free controls) with panoramic radiographs obtained at T0 (5 years) and T1 (8 years). FD analysis of the mandibular condyle was performed using the box-counting method on standardized regions of interest (ROIs; 21 × 21 pixels) following image calibration. Independent and paired t-tests and a linear mixed-effects model were used for statistical analysis at p < 0.05. Results: No significant difference in FD values was observed between the SECC and control groups at T0 (p > 0.05). At T1, the control group exhibited significantly higher FD values than the SECC group (1.151 ± 0.06 vs. 1.076 ± 0.10, p < 0.001). The linear mixed-effects model demonstrated a significant group × time interaction (p < 0.001), indicating different longitudinal trajectories between the groups. Within-group comparisons showed no significant longitudinal change in the SECC group (p > 0.05), whereas FD values increased significantly in the control group (p < 0.001). No significant effects of sex or related interactions were identified (p > 0.05). Conclusions: Children with a history of SECC did not exhibit the age-related longitudinal increase in mandibular condylar FD values observed in caries-free controls. These findings suggest that a history of SECC may be associated with an altered longitudinal pattern of condylar trabecular organization during growth; however, further studies are required to confirm this association.