Avaliação da dimensão fractal do osso alveolar em pacientes portadores de diabetes mellitus: estudo piloto

Abstract

Alveolar bone changes can indicate the onset and progression of periodontal diseases. For teeth with periodontal involvement, fractal analysis—which is based on mathematical morphology for analyzing bone trabeculae—is a method that theoretically can enhance the diagnostic potential of radiographs and may provide an opportunity to add value to conventional radiographs. In patients with diabetes mellitus, it can be a useful tool for early detection of changes in trabecular bone, favoring prognosis. The present observational pilot study aimed to evaluate the fractal dimension of the maxillomandibular trabecular bone in patients with diabetes mellitus (DM) using digital periapical radiographs obtained from the Dental Radiology department at UFJF/GV, through a semi-direct digital acquisition system using photostimulable phosphor plates (PSP) VistaScan® (Dürr Dental, Bietigheim-Bissingen, Germany)—clinically classifying the periodontal status and bone loss of patients in groups with and without DM. Eight patients were included, with 4 in the test group and 4 in the control group, consisting of men and women aged between their fourth and eighth decades of life, with participants matched by age and sex. Additionally, data from medical records were extracted, and patients were diagnosed based on periodontal health in reduced periodontium, with periodontal disease classified into stages I, II, III, and IV. Thus, the data were correlated, although limitations arose, such as the inclusion of a small number of patients. The literature is limited in studies evaluating the fractal dimension of alveolar bone in individuals with DM. Given the strong association between DM and periodontal disease, and the lack of studies quantitatively assessing the alveolar bone in patients with DM, the objective of the present study was to evaluate the trabecular bone of DM patients in periapical radiographs through fractal analysis. However, no significant influence on the fractal dimension of diabetic patients was found.