Assessment of bone mineral density by fractal dimension in OI patients treated with bisphosphonates

Abstract Background The efficacy of radiographs in studying bone mineral density (BMD) through fractal dimension (FD) analysis represents a conservative method compared to other traditional examinations. Periapical and panoramic radiographs are routine imaging tests in the radiographic evaluation of...

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Main Authors: Laura Burgueño-Torres, Lara García-Boedo, Manuel Joaquín de Nova-García
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06687-8
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author Laura Burgueño-Torres
Lara García-Boedo
Manuel Joaquín de Nova-García
author_facet Laura Burgueño-Torres
Lara García-Boedo
Manuel Joaquín de Nova-García
author_sort Laura Burgueño-Torres
collection DOAJ
description Abstract Background The efficacy of radiographs in studying bone mineral density (BMD) through fractal dimension (FD) analysis represents a conservative method compared to other traditional examinations. Periapical and panoramic radiographs are routine imaging tests in the radiographic evaluation of pediatric patients with Osteogenesis Imperfecta (OI). Anti-resorptive therapies with bisphosphonates constitute the gold standard in the treatment of these patients, and assessing their effectiveness on bone mineral density is essential to determine the necessity of administering any of these drugs or their combinations. Therefore, this study aims to analyze the differences in fractal dimension measured on orthopantomographs of a sample of patients with OI compared to a matched control group. Methods   Panoramic radiographs from 66 patients with OI were analyzed, identifying six regions of interest (ROIs), in mandibular cortical and trabecular bone, using the ImageJ software (version 1.54d). Differences related to the impact of Osteogenesis Imperfecta and the administered anti-resorptive treatment were examined. Statistical analysis of the data was performed with SPSS Statistics 25.0 for Windows. Results The values obtained for ROI 3 showed statistically significant differences between the groups (p 0.002), while ROI 5 yielded values close to statistical significance (p 0.090). When analyzing the influence of antiresorptive therapy in these patients, a strong indication of a relationship was found between the values obtained for ROI 1 and 4 and the administration of zoledronic acid. Conclusions The studied OI patients showed lower bone mineral density compared to healthy controls. The type of OI influenced the fractal dimension values obtained, with those suffering from severe OI being more affected. Although no statistically significant differences were found, the statistical effect size related to zoledronic acid administration suggested a possible direct relationship with the bone mineral density of these patients.
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spelling doaj-art-d8830452b4064cc5ab78619f82d0749f2025-08-24T11:55:09ZengBMCBMC Oral Health1472-68312025-08-0125111010.1186/s12903-025-06687-8Assessment of bone mineral density by fractal dimension in OI patients treated with bisphosphonatesLaura Burgueño-Torres0Lara García-Boedo1Manuel Joaquín de Nova-García2Dental Clinical Specialties Department, Faculty of Dentistry, Complutense University of MadridDental Clinical Specialties Department, Faculty of Dentistry, Complutense University of MadridDental Clinical Specialties Department, Faculty of Dentistry, Complutense University of MadridAbstract Background The efficacy of radiographs in studying bone mineral density (BMD) through fractal dimension (FD) analysis represents a conservative method compared to other traditional examinations. Periapical and panoramic radiographs are routine imaging tests in the radiographic evaluation of pediatric patients with Osteogenesis Imperfecta (OI). Anti-resorptive therapies with bisphosphonates constitute the gold standard in the treatment of these patients, and assessing their effectiveness on bone mineral density is essential to determine the necessity of administering any of these drugs or their combinations. Therefore, this study aims to analyze the differences in fractal dimension measured on orthopantomographs of a sample of patients with OI compared to a matched control group. Methods   Panoramic radiographs from 66 patients with OI were analyzed, identifying six regions of interest (ROIs), in mandibular cortical and trabecular bone, using the ImageJ software (version 1.54d). Differences related to the impact of Osteogenesis Imperfecta and the administered anti-resorptive treatment were examined. Statistical analysis of the data was performed with SPSS Statistics 25.0 for Windows. Results The values obtained for ROI 3 showed statistically significant differences between the groups (p 0.002), while ROI 5 yielded values close to statistical significance (p 0.090). When analyzing the influence of antiresorptive therapy in these patients, a strong indication of a relationship was found between the values obtained for ROI 1 and 4 and the administration of zoledronic acid. Conclusions The studied OI patients showed lower bone mineral density compared to healthy controls. The type of OI influenced the fractal dimension values obtained, with those suffering from severe OI being more affected. Although no statistically significant differences were found, the statistical effect size related to zoledronic acid administration suggested a possible direct relationship with the bone mineral density of these patients.https://doi.org/10.1186/s12903-025-06687-8Osteogenesis imperfectaFractal dimensionPediatric patientBisphosphonatesOrthopantomography
spellingShingle Laura Burgueño-Torres
Lara García-Boedo
Manuel Joaquín de Nova-García
Assessment of bone mineral density by fractal dimension in OI patients treated with bisphosphonates
BMC Oral Health
Osteogenesis imperfecta
Fractal dimension
Pediatric patient
Bisphosphonates
Orthopantomography
title Assessment of bone mineral density by fractal dimension in OI patients treated with bisphosphonates
title_full Assessment of bone mineral density by fractal dimension in OI patients treated with bisphosphonates
title_fullStr Assessment of bone mineral density by fractal dimension in OI patients treated with bisphosphonates
title_full_unstemmed Assessment of bone mineral density by fractal dimension in OI patients treated with bisphosphonates
title_short Assessment of bone mineral density by fractal dimension in OI patients treated with bisphosphonates
title_sort assessment of bone mineral density by fractal dimension in oi patients treated with bisphosphonates
topic Osteogenesis imperfecta
Fractal dimension
Pediatric patient
Bisphosphonates
Orthopantomography
url https://doi.org/10.1186/s12903-025-06687-8
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