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    A retrospective comparative fractal and radiomorphometric analysis of the effect of 3 generations of anti-epileptic drugs on the mandible
    (Elsevier Science Inc, 2023) Temur, Katibe Tugce; Magat, Guldane; Ozcan, Sevgi
    Objective. The present study investigated the possible impacts of anti-epileptic drugs (AEDs) on trabecular and cortical bone in the mandible.Study Design. Fractal dimension (FD) and the radiomorphometric parameters of mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI) were assessed on 497 dental panoramic radiographs (DPRs) of patients in the case group and controls. AEDs were compared according to 3 generations, duration of use, and patient age and sex.Results. FD of the angle and body of the mandible and MCW were significantly lower in the case group than in the control group (P < .001). FD values in the ramus and angle were lower in first-generation and third-generation AEDs than in second-generation drugs (P < .011). FD in the mandibular body was lower in first-generation and second-generation AED users than in third-genera-tion drugs (P = .017). Drug use for at least 1 year resulted in significantly lower values for all FDs and MCW values and more class 3 MCI assessments than short-duration use, but PMI was higher with more than 1 year of AED use (P < .020). Age and sex had no significant effects.Conclusions. AEDs caused significant changes in bone compared with controls in some FD values, MCW, and MCI. The effect of drug generation is pronounced in trabecular bone. Anti-epileptic drug use for more than 1 year had a greater effect than short-term use. (Oral Surg Oral Med Oral Pathol Oral Radiol 2023;136:255-262)
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    Assessment of maturation stages and the accuracy of age estimation methods in a Turkish population: A comparative study
    (Korean Acad Oral & Maxillofacial Radiology, 2022) Magat, Guldane; Ozcan, Sevgi
    Purpose: This study assessed the associations between chronological age, dental maturation (DM), cervical vertebrae maturation (CVM), and hand-wrist maturation (HWM) in individuals aged 9-19 years. In addition, this study aimed to derive practical methods to evaluate the skeletal age using DM, CVM, or HWM for orthodontic, medical, and forensic purposes and to compare which of these 3 developmental parameters is more accurate for estimating the age of individuals in a Turkish population. Materials and Methods: Panoramic, lateral cephalometric, and hand-wrist radiographs of 284 patients aged 9-19 years were used in this study. The DM, CVM, and HWM stages were determined. The Kolmogorov-Smirnov, kappa, Wilcoxon, Kruskal-Wallis, chi-square, and Spearman correlation tests and simple linear regression analysis were used for statistical analysis. The significance level was 0.05. Results: Statistically significant differences were found between chronological age and DM, chronological age and CVM, and chronological age and HWM in both sexes (P <0.05). DM did not show statistically significant differences according to sex (P > 0.05), but CVM and HWM were statistically different between males and females (P < 0.05). The DM-estimated age yielded more accurate values than the other methods. Conclusion: All correlations between skeletal and dental stages were statistically significant. Our results showed that there was no statistically significant difference between chronological age and DM-estimated age. Therefore, it can be concluded that DM stages have the potential to be used for legal purposes.
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    Comparison of cone-beam computed tomography and digital panoramic radiography for detecting peri-implant alveolar bone changes using trabecular micro-structure analysis
    (Korean Acad Oral & Maxillofacial Surgery, 2022) Magat, Guldane; Oncu, Elif; Ozcan, Sevgi; Orhan, Kaan
    Objectives: We compared changes in fractal dimension (FD) and grayscale value (GSV) of peri-implant alveolar bone on digital panoramic radiograph (DPR) and cone-beam computed tomography (CBCT) immediately after implant surgery and 12 months postoperative. Materials and Methods: In this retrospective study, 16 patients who received posterior mandibular area dental implants with CBCT scans taken about 2 weeks after implantation and one year after implantation were analyzed. A region of interest was selected for each patient. FDs and GSVs were evaluated immediately after implant surgery and at 12-month follow-up to examine the functional loading of the implants. Results: There were no significant differences between DPR and CBCT measurements of FD values (P>0.05). No significant differences were observed between FD values and GSVs calculated after implant surgery and at the 12-month follow-up (F50.05). GSVs were not correlated with FD values (P>0.05). Conclusion: The DPR and reconstructed panoramic CBCT images exhibit similar image quality for the assessment of FD. There were no changes in FD values or GSVs of the pen-implant trabecular bone structure at the 12-month postoperative evaluation of the functional loading of the implant in comparison to values immediately after implantation. GSVs representing bone mass do not align with FD values that predict bone microstnictural parameters. Therefore, GSVs and Ws should be considered different parameters for assessing bone quality.
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    Evaluation of mandibular trabecular bone by fractal analysis in pediatric patients with hypodontia of the mandibular second premolar tooth
    (Bmc, 2024) Temur, Katibe Tugce; Magat, Guldane; Cukurluoglu, Aykagan; Onsuren, Asli Sogukpinar; Ozcan, Sevgi
    Background It is still unclear whether the trabecular structure of the jaw is different in individuals with hypodontia than in those without hypodontia; this is important for clinicians. The aim was to determine whether the mandibular trabecular bone structure of children and adolescents with hypodontia differs from the control group by using the fractal analysis (FA) method in this study. Methods A total of 138 panoramic radiographs of 69 cases and 69 control subjects (mean age 13.2 +/- 10.1) were evaluated. The age and gender of subjects in the case and control groups were matched. Three regions of interest (ROIs) were selected from the panoramic radiographs. ROI1 refers to the center of the ramus rising above the mandibular foramen. ROI2 refers to the area between the apical level of the mandibular molar and the upper border of the mandibular canal. ROI3, the missing tooth region, refers to the apical third of the mesial side of the erupting or fully erupted permanent mandibular first molar. Mann-Whitney U and Wilcoxon tests were used. p < 0.05 was accepted for the significance value. Results The mean fractal dimension (FD) values of ROI1, ROI2, and ROI3 were 1,25, 1,20, and 1,13, respectively. The means FD values obtained from the ramus region were higher than the other regions (p < 0.05). The FD values did not differ significantly according to gender and age (p > 0.05). The FD values of the case group were lower than the control group for ROI3 (p < 0.05). Conclusion The results of this study showed that the mandibular trabecular bone quality of pediatric patients with one missing tooth was different from the healthy group. The difference in the mean FD values from the ROIs indicates that the ramus has a denser structure than the mandibular corpus. Clinicians should factor this into their dental treatment planning process.
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    Evaluation of the effect of sickle cell disease on the mandibular bone of children and adolescents by image texture and radiomorphometric analysis
    (Springer, 2023) Temur, Katibe Tugce; Magat, Guldane; Yilmaz, Melis; Ozcan, Sevgi
    ObjectivesSickle cell disease (SCD) can cause osteoporotic changes in the jaw bones. In this study, it was aimed to evaluate possible bone changes using fractal analysis (FA) and morphometric analyses in dental panoramic radiographs of children and adolescents diagnosed with both homozygous and heterozygous forms of SCD.MethodsSixty-five individuals (33 SCD, 32 controls) aged 6-17 years were included in the study. Four separate areas of interest (ROI) were selected for the right and left sides of all panoramic radiographs, and the FA value of the ROIs was calculated. Mandibular cortical width (MCW), panoramic mandibular index (PMI) and mandibular cortical index (MCI) and were evaluated. Data were statistically analyzed and p < 0.05 was accepted for statistical significance.ResultsFractal values of right and left ROI1 (the center of the mandibular angle.) and ROI4 (the cortical bone), and right ROI2 (the middle of the mandibular ramus) were statistically lower in the case group (p < 0.05). Right ROI2 and ROI4 fractal values of individuals in the case group were lower than those on the left side (p < 0.05). While MCI categories did not differ from the case-control group (p > 0.05), PMI and MCW values were lower in the case group (p < 0.05). All evaluated parameters did not differ according to age and gender (p > 0.05).ConclusionThe results of this study showed that SCD affects the mandible. FA, MCW and PMI parameters can be used to detect early osteoporotic changes in the disease.