DOI: 10.7126/cumudj.1996948 ISSN: 1302-5805

Post-Loading Radiographic Texture Changes After Lateral Sinus Floor Elevation: A Compartment-Based Fractal Dimension Analysis

Özkan Karataş, Mehmet Murat Taşkan, Tuğçe Yapişoğlu
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Objectives: This retrospective radiographic study aimed to compare post-loading fractal dimension (FD) changes in loaded residual bone and grafted sinus areas with those in corresponding non-loaded areas after lateral sinus floor elevation with simultaneous implant placement.Materials and Methods: Thirty-five patients treated in the posterior maxilla were included. Panoramic radiographs obtained on the day of surgery (T0) and 18–24 months after functional loading (T1) were analyzed. FD analysis was performed using ImageJ according to the box-counting method. Loaded residual bone and loaded grafted area values were calculated as the mean of mesial and distal implant-adjacent regions, while non-loaded residual bone and grafted areas were evaluated separately. Longitudinal changes were calculated as ΔFD = T1 − T0. Within-region changes and paired comparisons between loaded and corresponding non-loaded areas were analyzed using paired-samples t-tests.Results: FD increased significantly in loaded residual bone from 0.719 ± 0.114 to 0.849 ± 0.059 (p < 0.001), whereas the non-loaded residual bone area remained stable (0.955 ± 0.105 to 0.974 ± 0.129; p = 0.220). FD remained unchanged in the loaded grafted area (0.811 ± 0.117 to 0.806 ± 0.096; p = 0.783), but decreased significantly in the non-loaded grafted area (0.962 ± 0.119 to 0.798 ± 0.055; p < 0.001). ΔFD differed significantly between loaded and non-loaded residual bone (+0.129 ± 0.096 vs. +0.019 ± 0.089; p < 0.001) and between loaded and non-loaded grafted areas (−0.005 ± 0.107 vs. −0.164 ± 0.126; p < 0.001).Conclusions: Compartment-based FD analysis revealed distinct post-loading radiographic texture patterns in residual bone and grafted sinus areas. Native residual bone and grafted compartments may exhibit different trabecular responses under the post-loading peri-implant environment. FD analysis may help monitor longitudinal radiographic pattern changes, but should not be interpreted as direct evidence of histological maturation or implant stability.

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