•  
  •  
 

Abstract

Objective: The aim of this study is to evaluate the cortical and trabecular mandibular bone morphology of children and adolescents with type 1 diabetes mellitus (DM) and control group utilizing fractal dimension analysis (FDA) and different panoramic radiomorphometric indices through digital panoramic radiographic images (DPRIs). Methods: The study included 57 patients for the type 1 DM group (25 male and 32 female with a mean age of 11.5±2.4 years) and 57 patients for the control group (28 male and 29 female with a mean age of 10.5±2.1 years). The type 1 DM group was divided into the well-controlled, moderately-controlled, and poorly-controlled subgroups based on HbA1c. Mandibular cortical width (MCW) (according to Lengerton et al.) and panoramic mandibular index (PMI) (according to Benson et al.) were measured, mandibular cortical index (MCI) (according to Klemetti et al) and simple visual estimation (SVE) (according to Lee et al.) were evaluated, and FDA was conducted according to White and Rudolph, resulting in three areas of interest (IAs) being obtained in all of the DPRIs. Results: There was no significant difference between type 1 DM group and control according to the mean MCW, mean PMI measurements, MCI and SVE. The mean FD values were not significantly different between type 1 DM group and the control and between type 1 DM subgroups and control. Conclusion: This study revealed no cortical and trabecular bone changes in mandibula in children and adolescents with type 1 DM compared to the control group. In addition, metabolic control states of DM did not affect the bone structure.

References

  1. Hough FS, Pierroz DD, Cooper C, Ferrari SL. Mechanisms in endocrinology: Mechanisms and evaluation of bone fragility in type 1 diabetes mellitus. Eur J Endocrinol. 2016; 174(4):127-38.
  2. Wang JF, Lee MS, Tsai TL, Leiferman EM, Trask DJ, Squire MW, Li WJ. Bone morphogenetic protein-6 attenuates type 1 diabetes mellitus-associated bone loss. Stem Cells Transl Med. 2019; 8(6):522-34.
  3. Fuusager G, Milandt N, Shanbhogue VV, Hermann AP, Schou AJ, Christesen HT. Lower estimated bone strength and impaired bone microarchitecture in children with type 1 diabetes. BMJ Open Diabetes Res Care. 2020; 8(1):001384.
  4. Devaraja J, Jacques R, Paggiosi M, Clark C, Dimitri P. Impact of type 1 diabetes mellitus on skeletal ıntegrity and strength in adolescents as assessed by HRpQCT. JBMR Plus. 2020; 4(11):10422.
  5. Roh JG, Yoon JS, Park KJ, Lim JS, Lee HS, Hwang JS. Evaluation of bone mineral status in prepuberal children with newly diagnosed type 1 diabetes. Ann Pediatr Endocrinol Metab. 2018; 23(3):136-40.
  6. Sav NM, Kendirci M, Akin L, Kurtoglu S. Urinary levels of pyridinoline and deoxypyridinoline and bone mineral density in children with type 1 diabetes mellitus. Endocr Res. 2017; 42(4):281-6.
  7. Klemetti E, Kolmakow S. Morphology of the mandibular cortex on panoramic radiographs as an indicator of bone quality. Dentomaxillofac Radiol. 1997; 26(1):22-5.
  8. Cakur B, Sahin A, Dagistan S, Altun O, Caglayan F, Miloglu O, Harorli A. Dental panoramic radiography in the diagnosis of osteoporosis. J Int Med Res. 2008; 36(4):792-9.
  9. Ledgerton D, Horner K, Devlin H, Worthington H. Radiomorphometric indices of the mandible in a British female population. Dentomaxillofac Radiol. 1999; 28(3):173-81.
  10. Benson BW, Prihoda TJ, Glass BJ. Variations in adult cortical bone mass as measured by a panoramic mandibular index. Oral Surg Oral Med Oral Pathol. 1991; 71(3):349-56.
  11. Apolinário AC, Sindeaux R, de Souza Figueiredo PT, Guimarães AT, Acevedo AC, Castro LC, de Paula AP, de Paula LM, de Melo NS, Leite AF. Dental panoramic indices and fractal dimension measurements in osteogenesis imperfecta children under pamidronate treatment. Dentomaxillofac Radiol. 2016; 45(4):20150400.
  12. Alman AC, Johnson LR, Calverley DC, Grunwald GK, Lezotte DC, Hokanson JE. Diagnostic capabilities of fractal dimension and mandibular cortical width to identify men and women with decreased bone mineral density. Osteoporos Int. 2012; 23(5):1631-6.
  13. Neves FS, Barros AS, Cerqueira GA, Cruz GA, Reis AA, Alves LB. Assessment of fractal dimension and panoramic radiomorphometric indices in women with celiac disease. Oral Radiol. 2020; 36(2):141-7.
  14. Lee K, Taguchi A, Ishii K, Suei Y, Fujita M, Nakamoto T et al. Visual assessment of the mandibular cortex on panoramic radiographs to identify postmenopausal women with low bone mineral densities. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100(2):226-31.
  15. Yeung AWK, Mozos I. The innovative and sustainable use of dental panoramic radiographs for the detection of osteoporosis. Int J Environ Res Public Health Apr. 2020; 17(7):2449.
  16. Kato CN, Bar ra SG, Tavares NP, Amaral TM, Brasileiro CB, Mesquita RA, Abreu LG. Use of fractal analysis in dental images: A systematic review. Dentomaxillofac Radiol. 2020; 49(2):20180457.
  17. Ergün S, Saraçoglu A, Güneri P, Ozpinar B. Appl ica t ion of f r act al analysi s in hyperparathyroidism. Dentomaxillofac Radiol. 2009; 38(5):281-8.
  18. Kurşun Çakmak EŞ, Bayrak S. Comparison of fractal dimension analysis and panoramic-based radiomorphometric indices in the assessment of mandibular bone changes in patients with type 1 and type 2 diabetes mellitus. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018; 126(2):184-91
  19. White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999; 88(5):628-35.
  20. Terry K Koo, Mae Y Li. A guideline of selecting and reporting ıntraclass correlation coefficients for reliability research. J Chiropr Med. 2016; 15(2):155-63.
  21. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33(1):159-74
  22. Limeira FIR, Rebouças PRM, Diniz DN, Melo DPd, Bento PM. Decrease in mandibular cortical in patients with type 1 diabetes mellitus combined with poor glycemic control Braz Dent J. 2017; 28(5):552-8.
  23. Nemtoi A, Ladunca O, Dragan E, Budacu C, Mihai C, Haba D. Quantitative and qualitative bone assessment of the posterior mandible in patients with diabetes mellitus: A cone beam computed tomography study. Rev Med Chir Soc Med Nat Iasi. 2013; 117(4):1002-8.
  24. Green PT, Mol A, Moretti AJ, Tyndall DA, Kohltfarber HB. Comparing the diagnosticefficacy of intraoral radiography and cone beam computed tomography volume registration in the detection of mandibular alveolar bone defects. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019; 128(2):176- 185.
  25. Sansare K, Singh D, Karjodkar F. Changes in the fractal dimension on pre-and post-implant panoramic radiographs. Oral Radiol. 2012; 28(1):15-23.
  26. Demirbaş AK, Ergün S, Güneri P, Aktener BO, Demirbaş HB. Mandibular bone changes in sickle cell anemia: fractal analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106(1):41-8.
  27. Aydın ZU, Ocak MG, Bayrak S, Bulut DG, Orhan K. The effect of type 2 diabetes mellitus on changes in the fractal dimension of periapical lesion in teeth after root canal treatment: A fractal analysis study. Int Endod J. 2021; 54(2):181-9.
  28. Stagi S, Cavalli L, Cavalli T, Martino M de, Brandi ML. Peripheral quantitative computed tomography (pQCT) for the assessment of bone strength in most of bone affecting conditions in developmental age: A review. Ital J Pediatr. 2016; 26;42(1):88.
  29. Sánchez I, Uzcátegui G. Fractals in dentistry. J Dent. 2011; 39(4):273-92.
  30. Kalinowski P, Różyło-Kalinowska I. Mandibular inferior cortex width may serve as a prognostic osteoporosis index in Polish patients. Folia Morphol. 2011; 70(4):272-81.
  31. Runolfsdottir HL, Sigurdsson G, Franzson L, Indridason OS. Gender comparison of factors associated with age-related differences in bone mineral density. Arch Osteoporos. 2015; 10:214.
  32. Canbek U, Rosberg DBH, Rosberg HE, Canbek TD, Akgün U, Comert A. The effect of age, BMI, and bone mineral density on the various lumbar vertebral measurements in females. Surg Radiol Anat. 2021; 43(1):101-8.

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.