Application of Fractal Analysis in Detecting Trabecular Bone Changes in Periapical Radiograph of Patients with Periodontitis

Introduction. Evaluation of detailed features of the supporting bone is an important step in diagnosis and treatment planning for teeth with clinical attachment loss. Fractal analysis can be used as a method for evaluating the complexity of trabecular bone structures. The aim of this study was to evaluate the trabecular bone changes in periapical radiographs of patients with different stages of periodontitis using fractal analysis. Methods. This comparative cross-sectional study was performed on patients with and without clinical attachment loss in mandibular first molars. Teeth with clinical attachment loss were divided into mild, moderate, and severe periodontitis groups. Digital periapical radiographs were obtained from the mandibular first molars using the same exposure parameters. DICOM file of the radiographs was exported to ImageJ software for fractal analysis. Three regions of interest (ROIs) were considered in each radiograph: two proximal ROIs mesial and distal to the mandibular first molar and one apical ROI. Fractal dimension (FD) values were calculated using the fractal box counting approach. Statistical analysis was performed using the chi-square test, Mann–Whitney test, intraclass correlation coefficient, and ANOVA (α = 0.05). Results. FD values were significantly different between moderate and severe periodontitis and healthy periodontal bone ( P < 0.05 ), except for the distal ROI for moderate periodontitis cases ( P = 0.280 ). However, FD values of the supporting bone in periodontally healthy teeth and teeth with mild periodontitis did not show a statistically significant difference ( P > 0.05 ). Conclusion. Fractal analysis is a useful tool for evaluation of bone alterations in moderate and severe periodontitis, but was not able to detect the most initial radiographic bone signs of mild periodontitis.

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Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.63.01.13 ◽

2017 ◽

Vol 63 (1) ◽

pp. 13-17 ◽

Cited By ~ 3

Author(s):

Lorete Maria da Silva Kotze ◽

◽

Carolina Tabata Costa ◽

Murilo Franco Cavassani ◽

Renato Mitsunori Nisihara ◽

...

Keyword(s):

Vitamin D ◽

Serum Levels ◽

Cross Sectional Study ◽

Cross Sectional ◽

Vitamin D Levels ◽

Significant Difference ◽

Bone Changes ◽

Bowel Diseases ◽

Intestinal Inflammatory Disease ◽

Irritable Bowel

Summary Background: Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are characterized by chronic inflammation of the intestine that can reduce the absorption of nutrients such as vitamin D and calcium. Objective: To investigate bone alterations and serum levels of vitamin D in patients with IBD. Method: This was a cross-sectional study based on a review of medical records of patients from a private office in Curitiba, PR, Brazil. Serum levels of vitamin D and bone densitometry were measured at diagnosis of IBD. A total of 105 patients were included; 38 (58.4%) with CD; 27 (41.6%) with UC and 40 with irritable bowel syndrome (IBS) as comparison group. Results: When compared to patients with UC, CD patients showed a higher prevalence of bone alterations, being 15.8% with osteoporosis and 36.8% with osteopenia. In UC, bone alterations occurred in 29.6% of cases, 3.7% with osteoporosis and 25.9% with osteopenia. As for vitamin D levels, among CD patients, 10.5% had vitamin deficiency, 65.8% insufficiency and 23.7% were sufficient. In UC, 7.4% of cases had deficiency, 74.1% insufficiency and 18.5% had sufficient serum levels of vitamin D. In the group with IBS, deficiency was observed in 17.5% of cases, insufficiency in 55% and sufficiency in 27.5% of them. There was no significant difference between groups. Conclusion: IBD patients have a high prevalence of bone changes, especially those with CD. Serum levels of vitamin D are below the recommended in all the evaluated groups.

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Qat Chewing as an Independent Risk Factor for Periodontitis: A Cross-Sectional Study

International Journal of Dentistry ◽

10.1155/2013/317640 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 12

Author(s):

Ali Kaid Al-Sharabi ◽

Hussien Shuga-Aldin ◽

Ibrahim Ghandour ◽

Nezar Noor Al-Hebshi

Keyword(s):

Risk Factor ◽

Oral Hygiene ◽

Independent Risk Factor ◽

Demographic Data ◽

Cross Sectional Study ◽

Clinical Attachment Loss ◽

Holistic Model ◽

Cross Sectional ◽

Attachment Loss ◽

Periodontal Index

This study assessed the effect of qat chewing on periodontal health, independent of other risk factors. Four hundred qat chewers and 100 nonchewers (20–50 years) were included. Demographic data and detailed information about chewing and smoking were obtained. Periodontal status was assessed using Community Periodontal Index (CPI) and clinical attachment loss (CAL). The qat chewers were older, included more males and smokers, and had worse oral hygiene but higher education levels; the majority were heavy chewers (mean duration of 14.45 years and frequency of 6.10 days/week). Regression analysis identified age, oral hygiene, education level, and cigarette smoking as independent predictors of periodontal destruction. Adjusted for these, qat chewing showed marginally significant association only with CAL (OR = 4.7;P=0.049). The chewing sides showed significantly higher scores than the nonchewing sides; however, equal scores on both sides or lower scores on the chewing sides (possibly no or beneficial effect) were still observed in 50% of the chewers. Heavy qat chewing is shown here as an independent risk factor for attachment loss. However, the possibility that the habit may have beneficial effects in a subset of the chewers cannot be excluded. A holistic model that resolves the existing contradiction is presented.

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SEVERE CHRONIC PERIODONTITIS AND C-REACTIVE PROTEIN LEVELS

Revista de Saúde Coletiva da UEFS ◽

10.13102/rscdauefs.v6i2.1168 ◽

2017 ◽

Vol 6 (2) ◽

pp. 1

Author(s):

Johelle De Santana Passos Soares ◽

Isaac Suzart Gomes-Filho ◽

Julita Maria Freitas Coelho ◽

Simone Seixas da Cruz ◽

Luís Claúdio Lemos Correia ◽

...

Keyword(s):

Chronic Periodontitis ◽

Descriptive Analysis ◽

Cross Sectional Study ◽

Blood Collection ◽

C Reactive Protein ◽

Clinical Attachment Loss ◽

Cross Sectional ◽

Protein Levels ◽

Reactive Protein ◽

Significant Difference

This study aims to analyze the relationship between chronic periodontitis and C-reactive protein (CRP), taking certain associated factors into consideration. A cross-sectional study was conducted on a sample of 75 adults of both sexes. After the participants had been interviewed, they underwent physical and dental examinations and blood collection. CRP levels were evaluated by means of nephelometry. A periodontal clinical examination was conducted by trained examiners and the diagnosis of chronic periodontitis was established when at least 30% of the individual’s teeth presented clinical attachment loss ≥ 5 mm. The analysis procedures consisted of descriptive analysis and linear regression. The results showed that there was no statistically significant difference in CRP levels between the groups with and without periodontitis. The median CRP level in the group with periodontitis was 2.3 mg/l (25-75% interquartile range, IQR = 0.74-5.4) and in the group without periodontitis, 1.8 mg/l (25-75% IQR = 0.79-4.54) (p = 0.417). Log CRP was significantly correlated only with the individual’s body mass index (BMI). The main findings from this study indicate that there is no association between severe chronic periodontitis and CRP, and factors like BMI need to be analyzed carefully in studies on this topic.

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Peer Review #2 of "Prevalence and extent of chronic periodontitis and its risk factors in a Portuguese subpopulation: a retrospective cross-sectional study and analysis of Clinical Attachment Loss (v0.1)"

10.7287/peerj.5258v0.1/reviews/2 ◽

2018 ◽

Keyword(s):

Risk Factors ◽

Peer Review ◽

Chronic Periodontitis ◽

Cross Sectional Study ◽

Sectional Study ◽

Clinical Attachment Loss ◽

Cross Sectional ◽

Attachment Loss

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Prevalence and extent of chronic periodontitis and its risk factors in a Portuguese subpopulation: a retrospective cross-sectional study and analysis of Clinical Attachment Loss

PeerJ ◽

10.7717/peerj.5258 ◽

2018 ◽

Vol 6 ◽

pp. e5258 ◽

Cited By ~ 12

Author(s):

Vanessa Machado ◽

João Botelho ◽

António Amaral ◽

Luís Proença ◽

Ricardo Alves ◽

...

Keyword(s):

Risk Factors ◽

Chronic Periodontitis ◽

Dental Treatment ◽

Cross Sectional Study ◽

Risk Indicators ◽

Multivariate Logistic Regression Model ◽

Sectional Study ◽

Clinical Attachment Loss ◽

Cross Sectional ◽

Attachment Loss

Objectives To assess the prevalence and extent of chronic periodontitis, and its risk factors in a Portuguese subpopulation referred to periodontal examination. Methods This retrospective cross-sectional study used a subset of data from patients who sought dental treatment in a university dental clinic in the Lisbon metropolitan area. The sample consisted of 405 individuals (225 females/180 males), aged 20–90 years. All patients underwent a full-mouth periodontal examination and chronic periodontitis was defined as Clinical Attachment Loss (CAL) ≥ 3 mm affecting two or more teeth. Aggressive periodontitis cases were excluded from the analysis. Results Prevalence of chronic periodontitis was 83.5% (95% CI [80.4–86.6%]). For these subjects, CAL ≥ 3 mm affected 86.0% (95% CI [84.7–87.2]) of sites and 83.7% (95% CI [81.7–85.6]) of teeth, respectively. Mean CAL ranged from 3.6 to 4.3 mm, according to age. In the multivariate logistic regression model, smoking (OR = 3.55, 95% CI [1.80–7.02]) and older age (OR = 8.70, 95% CI [3.66–20.69] and OR = 4.85, 95% CI [2.57–9.16]), for 65+ and 45–64 years old, respectively, were identified as risk indicators for CAL ≥ 3 mm. Conclusions This particular Portuguese adult subpopulation had a high prevalence of chronic periodontitis, with severe and generalized clinical attachment loss, and its presence was significantly associated with age and smoking. This data should serve to prepare future detailed epidemiological studies and appropriate public health programs.

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