Morphological, Fractal, and Textural Features of the Mandible in Familial Mediterranean Fever Patients: A Case-control Study

Objective: Familial Mediterranean fever (FMF) is an inflammatory disease and chronic inflammation may affect bone turnover and metabolism. This study aimed to compare the morphological, fractal, and textural features of the mandibular bone in FMF patients with healthy controls on panoramic radiographs. Methods: Fifty patients with FMF and, age-and sex-matched 50 healthy controls were included in the study. Morphological evaluation of the mandibular cortex on digital panoramic images of a total of 100 individuals was performed using the mandibular cortical index (MCI). For fractal dimension (FD) and texture analysis of trabecular bone, regions of interest with a size of 50x50 pixels were selected from the trabecular bone region between the roots of the second premolar and first molar teeth. The box-counting method was applied to calculate the FD. Since the pixel gray-scale levels of these regions showed different distributions, pre-processing was performed with histogram equalization for texture analysis. First-order and gray-level