Comparative fractal analysis of mandibular condyles in temporomandibular disorder and non-temporomandibular disorder patients using cone-beam computed tomography

Introduction

Temporomandibular joint (TMJ) anatomy and microstructure is complex. Multifactorial disorders of the TMJ may affect the musculoskeletal and osseous structures of the joint. It is highly beneficial to detect these changes early in the development of temporomandibular disorders (TMDs) in order to prevent their progression. There are several pathological conditions that can affect the trabecular bone of the mandibular condyle in the TMJ. In order to analyse these changes, it is possible to measure them through the use of fractal dimensional analysis, as they are natural fractals.

Aim & objective

Fractal analysis was used in this study to examine the trabecular pattern of the mandibular condyle, with the objective of assessing fractal dimension changes in mandibular condyles for TMD diagnosis.

Methods

The 120 subjects are divided into two groups, a Control group (non-TMD's-60 each) and a Study group (TMD's-60 each). The study includes participants diagnosed with TMD's according to RDC/TMD Axis -I & Axis-II (Research diagnostic criteria,2014). Cone bean computed Tomography (CBCT) images are captured and converted into JPEG images. A fractal dimensional analysis is performed on the condylar portion of the trabecular bone. With Image J software version 1.51 program (National Institutes of Health, Bethesda, MD @; https://imagej.nih.gov/ij/download.html).

Results

The present study found that subjects with TMD had significantly lower fractal values than controls (p < 0.001 on right side and left side p < 0.021).

Conclusion

The study group had lower fractal values than the control group. This study in additional hypothesized fractal values for each type of TMD. The use of CBCT can enhance the diagnosis of TMD.