Estimation of Cancellous Changes Using Fractal Analysis in Patients with Periodontitis
Abstract
:1. Introduction
- To determine the relationship between the fractal dimension of the cancellous bone and different stages of periodontal disease.
- To estimate the changes caused by periodontitis.
- To provide an additional criterion for the staging of periodontitis.
2. Materials and Methods
2.1. Patients’ Selection
2.2. Statistics
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Inclusion Criteria | Exclusion Criteria |
---|---|
Patients within the age group of 30–60 years | Radiographs with poor resolution or diagnostic quality |
Systemically healthy patients | Patients having diseases which may affect the bone density |
Patients consenting to radiographic exposure | Patients not willing to have radiation exposure. |
Patients having at least 20 remaining teeth | Teeth with dental caries extending in the cervical area. |
Confirmed diagnosis of periodontitis (World Workshop Classification for Periodontal and Peri-Implant Diseases and Conditions, 2017) | Teeth with clinical attachment loss on the distal aspect of a second molar and associated with malposition or extraction of a third molar |
Teeth having previous root canal therapy or periapical lesions |
Study Group | Group Description |
---|---|
Group A | Healthy controls |
Group B | Interdental CAL at the site of greatest loss 1–2 mm (STAGE I) |
Group C | Interdental CAL at the site of greatest loss 3–4 mm (STAGE II) |
Group D | Interdental CAL at the site of greatest loss ≥ 5 mm (STAGE III) |
Group E | Interdental CAL at the site of greatest loss ≥ 5 mm (STAGE IV) Tooth loss due to periodontitis of ≥5 teeth. |
Stage | N | % Bone Loss | Kruskal–Wallis Test ‘p’ Value | ||||
---|---|---|---|---|---|---|---|
Mean | SD | Median | Range | Mean Rank | |||
Stage I | 15 | 12.1 | 2.6 | 12.9 (10.0–14.7) | (7.0–14.9) | 8.0 | p < 0.0001 |
Stage II | 15 | 25.4 | 4.7 | 25.3 (20.4–29.9) | (17.5–32.6) | 23.0 | |
Stage III | 15 | 57.9 | 6.1 | 58.8 (52.3–63.0) | (46.2–67.3) | 38.8 | |
Stage IV | 15 | 77.0 | 10.3 | 77.6 (70.5–87.2) | (54.7–91.5) | 52.2 | |
Total | 60 | 43.1 | 26.7 | 39.4 (15.6–64.9) | (7.0–91.5) |
Stage | N | FD Value | Kruskal–Wallis Test ‘p’ Value | ||||
---|---|---|---|---|---|---|---|
Mean | SD | Median | Range | Mean Rank | |||
Control | 15 | 1.21 | 0.07 | 1.23 (1.19–1.27) | (1.03–1.29) | 54.23 | p < 0.0001 |
Stage I | 15 | 1.21 | 0.06 | 1.21 (1.18–1.27) | (1.11–1.29) | 53.00 | |
Stage II | 15 | 1.19 | 0.05 | 1.18 (1.15–1.21) | (1.10–1.30) | 46.10 | |
Stage III | 15 | 1.11 | 0.05 | 1.12 (1.08–1.16) | (1.01–1.17) | 25.73 | |
Stage IV | 15 | 1.02 | 0.11 | 1.03 (1.01–1.08) | (0.63–1.10) | 10.93 | |
Total | 75 | 1.15 | 0.10 | 1.16 (1.09–1.22) | (0.63–1.30) |
Stages | % Bone Loss | FD Value (D) |
---|---|---|
Overall | Pearson Correlation | −0.739 ** |
Sig. (2-tailed) | 0.000 | |
N | 60 | |
Stage I | Pearson Correlation | −0.639 * |
Sig. (2-tailed) | 0.010 | |
N | 15 | |
Stage II | Pearson Correlation | −0.561 * |
Sig. (2-tailed) | 0.030 | |
N | 15 | |
Stage III | Pearson Correlation | 0.226 |
Sig. (2-tailed) | 0.418 | |
N | 15 | |
Stage IV | Pearson Correlation | −0.353 |
Sig. (2-tailed) | 0.196 | |
N | 15 |
ROC | Classification Variables | ||||
---|---|---|---|---|---|
Situation #1 (Stages I, II, III, and IV = 1, Control = 0) | Situation #2 (Stages III and IV = 1, Control, Stages I and II = 0) | Situation #3 (Stages III and IV = 1, Stages I and II = 0) | Situation #4 (Stage IV = 1, Stages I, II, and III = 0) | Situation #5 (Stage I and II = 1, Control = 0) | |
Sample size | 75 | 75 | 60 | 60 | 45 |
Area under the ROC curve (AUC) | 0.771 | 0.937 | 0.942 | 0.947 | 0.614 |
95% Confidence interval b | 0.659 to 0.860 | 0.856 to 0.980 | 0.850 to 0.986 | 0.856 to 0.988 | 0.458 to 0.756 |
Significance level P (Area = 0.5) | 0.0001 | <0.0001 | <0.0001 | <0.0001 | 0.2228 |
Associated criterion | ≤1.188 | ≤1.158 | ≤1.158 | ≤1.102 | ≤1.188 |
Sensitivity (95% CI) | 78.3 (65.8–87.9) | 96.7 (82.8–99.9) | 96.7 (82.8–99.9) | 100 (78.2–100) | 56.67 (37.4–74.5) |
Specificity (95% CI) | 80 (51.9–95.7) | 80 (65.4–90.4) | 80 (61.4–92.3) | 86.7 (73.2–94.9) | 80.00 (51.9–95.7) |
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Mishra, S.; Kumar, M.; Mishra, L.; Panda, S.; Panda, S.; Lewkowicz, N.; Lapinska, B. Estimation of Cancellous Changes Using Fractal Analysis in Patients with Periodontitis. Biomedicines 2023, 11, 2547. https://doi.org/10.3390/biomedicines11092547
Mishra S, Kumar M, Mishra L, Panda S, Panda S, Lewkowicz N, Lapinska B. Estimation of Cancellous Changes Using Fractal Analysis in Patients with Periodontitis. Biomedicines. 2023; 11(9):2547. https://doi.org/10.3390/biomedicines11092547
Chicago/Turabian StyleMishra, Sukanya, Manoj Kumar, Lora Mishra, Swagatika Panda, Saurav Panda, Natalia Lewkowicz, and Barbara Lapinska. 2023. "Estimation of Cancellous Changes Using Fractal Analysis in Patients with Periodontitis" Biomedicines 11, no. 9: 2547. https://doi.org/10.3390/biomedicines11092547