title: Fractal dimension and mandibular cortical width in normal and osteoporotic men and women.
abstract: OBJECTIVE
  To verify whether fractal dimensions (FD) on the mandibular trabecular and cortical bone and mandibular cortical width (MCW) differ between patients with normal bone mineral density (BMD) and osteoporosis.
  
  
  METHODS
  In this retrospective study, 133 dental panoramic radiographs from men aged >60 years and postmenopausal women with a bone densitometry report of the lumbar spine and hip classified as either normal or osteoporotic were selected. Fractal dimensions of five standardized trabecular and cortical mandibular regions of interest and mandibular cortical width were measured on the panoramic radiographs by an experienced oral radiologist, blinded to the densitometric diagnosis. The following statistical analyses were performed: ANOVA and a forward logistic stepwise regression to verify associations between dental panoramic measurements and the densitometric diagnosis. P values less than .05 indicated statistical significance.
  
  
  METHODS
  Fractal dimension and mandibular cortical width.
  
  
  RESULTS
  Differences were found in the FD values on mandibular cortical bone and MCW between patients with normal BMD and with osteoporosis, but not in the FD values of trabecular bone. The odds of having lower mean values of MCW and FD on cortical bone were 2.16, 3125 and 1005 times in osteoporotic patients, respectively, compared with patients with normal BMD.
  
  
  CONCLUSIONS
  The values of FD analysis on mandibular cortical bone and MCW were lower in women with osteoporosis. A well-adjusted logistic regression model showed that cortical bone measurements might be considered as auxiliary tools to referring patients for DXA exam.
authors.affiliation: University of Brasília, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Sindeaux
authors.affiliation: Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Brazil.
authors.forename: Paulo Tadeu de Souza
authors.initials: PT
authors.lastname: Figueiredo
authors.affiliation: Oral Pathology, Department of Dentistry, Faculty of Health Science, University of Brasília, Brazil.
authors.forename: Nilce Santos
authors.initials: NS
authors.lastname: de Melo
authors.affiliation: Biostatistics, Biological Sciences Department, State University of West Paraná, Paraná, Brazil.
authors.forename: Ana Tereza Bittencourt
authors.initials: AT
authors.lastname: Guimarães
authors.affiliation: Department of Mathematics, University of Brasília, Brazil.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Lazarte
authors.affiliation: University of Brasília, Brazil.
authors.forename: Fernando Borges
authors.initials: FB
authors.lastname: Pereira
authors.affiliation: Hospital de Base of Federal District, Brasília, Brazil.
authors.forename: Ana Patrícia
authors.initials: AP
authors.lastname: de Paula
authors.affiliation: Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Brazil. Electronic address: andreleite@unb.br.
authors.forename: André Ferreira
authors.initials: AF
authors.lastname: Leite
mesh_terms: D000368:Aged; D015519:Bone Density; D005260:Female; D017709:Fractals; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging*; D011862:Radiography, Panoramic; D012189:Retrospective Studies
keywords: Bone density; Dental radiography; Fractals; Jaw; Osteoporosis