Fractal analysis of mandibular bone structure in children with amelogenesis imperfecta.

Abstract

Amelogenesis imperfecta (AI) is a hereditary disorder that affects the structure and composition of primary and permanent teeth. Genetic mutations of AI, especially in the FAM83H gene, can reduce osteogenic marker expression and impair bone mineralization. This study aims to assess radiomorphometric indices and fractal dimension (FD) in dental panoramic radiographs of children with AI and to identify differences compared to control subjects. The study involved 12 patients with AI and 12 age- and gender-matched healthy individuals. Mandibular Cortex Index [1]. scores were assessed, and fractal analysis using ImageJ was conducted on selected regions from the condyle, gonial, and interdental areas to calculate FD values. Statistical analyses were performed using the Student t-test for normally distributed variables, the Mann-Whitney U test for non-normally distributed variables, and the chi-square test for categorical variables, with p < 0.05 considered statistically significant. Analysis of FD values revealed significant differences on the right side, where controls exhibited higher FD values than AI patients (p = 0.011 for condyle and gonial regions, p = 0.041 for dentate region). No significant differences were observed on the left side. Regarding MCI, the most common score was C1 in both groups, with no significant difference in distribution (p = 0.667). It was found that the FD of the mandibular bone in AI patients was lower than in healthy individuals and this was more pronounced on the right side. The results suggest that AI may affect not only tooth enamel but also the mandibular bone structure.