Comparative Fractal Analysis of Mandibular Bone Modifications in Fixed and Removable Denture Wearers

Background : This study aims to assess the alterations in mandibular trabecular bone pre- and post-treatment in individuals utilizing removable and fixed prostheses, employing the Fractal Analysis (FA) method on panoramic radiographs. Methodology: Panoramic radiographs of 40 individuals who received treatment within a specified time frame in the Department of Prosthodontics at the Faculty of Dentistry, Adıyaman University, were divided into two groups. The study groups consisted of two separate treatment groups, each including 20 patients using either removable or fixed prostheses. In all participants, potential changes in the condyle, angle, and corpus regions of the mandible after treatment were examined using the Fractal Analysis (FA) method. Results: In the Removable Partial Denture (RPD) group, a significant reduction in fractal dimension (FD) values was observed in the condylar and corpus regions after treatment, while the angulus region exhibited a significant increase (p < 0.05). Likewise, the Fixed Prosthesis group showed a significant post-treatment decrease in FD values in the condylar and corpus areas, accompanied by a significant rise in the angulus region (p < 0.05). Gender did not have a significant impact on FD changes in either group (p > 0.05). Although intergroup comparisons revealed no significant differences in FD changes for the condylar and angulus regions (p > 0.05), the reduction in the corpus region was significantly more pronounced in the Fixed Prosthesis group compared to the RPD group (p < 0.05). Conclusion: The findings from this study suggest that prosthetic rehabilitation influences the trabecular pattern of the mandible. Specifically, the angulus region which accommodates the masseter muscle fibers and is affected by occlusal forces after fixed or removable prosthetic interventions appears to maintain resistance to bone resorption. Both types of prostheses were linked to an increase in trabecular bone density in this area. Overall, the results point to an association between chewing function and mandibular bone remodeling; however, to further elucidate this link, radiographic data should ideally be corroborated with electromyographic analysis.