Evaluation of trabecular bone healing by fractal analysis and digital subtraction radiography on digitized panoramic radiographs: a preliminary study

We have evaluated radiographic changes in mandibular bone texture before and after surgical therapies using fractal analysis and digital subtraction radiography (DSR). Preoperative and postoperative panoramic radiographs of 10 patients were acquired and converted into digital format. The procedures for calculating the fractal dimension (FD) were performed using Image J 1.38x software, and the mean gray values (MGVs) for digital subtraction were implemented using newly developed software (RAIN). Data were analyzed statistically with the paired t-test and Pearson’s correlation test. The differences between the FD values (p = 0.0019) and between the MGVs (p = 0.0181) of the preoperative and postoperative images were statistically significant; the correlation did not reach statistical significance, however (p > 0.05). FD analyses and DSR application are proposed for quantitative determination of bone changes. Further studies are planned to provide a more detailed evaluation of these methods.