Evaluation of bone change in smokers and ex-smokers using fractal analysis and lacunarity analysis

Objective

It is known that smoking causes many diseases such as oral and nasopharyngeal cancers, cardiovascular diseases and osteoporosis. With fractal analysis (FA), changes in trabecular bone can be detected. The cavities in the bone can also be evaluated with the lacunarity analysis (LA). In the light of this information, the aim of this study is to investigate how the duration of smoking and the duration of smoking cessation affect bone change in the mandible using FA and LA.

Methods

Panoramic radiographs (PR) of 140 patients were grouped according to the duration of smoking and the duration of smoking cessation. The changes in the mandibular bone were evaluated with both FA and LA, and the results were compared with the control group who never smoked. Kolmogorov-Smirnov test, Mann-Whitney U test and Spearman correlation analysis was used in the analysis.

Results

The smokers’ FA value was significantly lower than the control group and the ex-smokers group. The smokers’ LA value was significantly higher than the control and ex-smokers’ group. The ex-smokers’ FA value was significantly lower than the control group. Both FA and LA values did not differ significantly between the genders. No significant correlation was observed between both FA and LA values and age.

Conclusions

FA values were lower and LA values were higher in smokers. It is thought that in smokers, the trabeculation in the bone decreases and accordingly the intraosseous spaces increase, and the duration of smoking and quitting also affects the internal structure of the bone. PR can be used to evaluate bone structure with FA and LA analysis.