Investigating the Effects of Smoking on Trabecular Bone Structure Using Fractal Analysis: A Pilot Case-control Study

Abstract

ÖZ Objective: Fractal analysis (FA) is a method that performs the evaluation of complex and irregular body structures through mathematics. The aim of this study is to use the FA approach to determine how smoking affects mandibular trabecular bone structure on panoramic radiographs. Methods: While 55 smokers constituted the study group, 55 non-smokers constituted the control group. The study and control groups were paired for age and sex. Two region of interest (ROIs) with a pixel size of 100x100 were determined from the right mandibular angulus and the trabecular bone region between the right second premolar and first molar roots (interdental). Utilizing the box-counting technique, FA was conducted on the ROIs identified by the panoramic radiography. SPSS 21.0, developed by IBM Corp in Armonk, NY, USA, was used for the data analysis. At the 0.05 threshold, p-value was regarded as significant. Results: The mean age of 74 male and 36 female individuals included in the study was 23.54±3.57 years. Fractal dimension (FD) values of gonial (p=0.528) and interdental regions (p=0.490) did not differ statistically from each other between the study-control groups (p>0.05). When the correlation analysis of pack-year values of smoking exposure and FD measurements was performed, a negative correlation that was not statistically significant was found (p>0.05). Conclusion: As cigarette exposure increases, FD values tend to decrease. No effect of smoking on mandibular trabecular bone FD values was observed.