The Effects of Celiac Disease on Mandibular Bone Complexity: Evaluation Using the Fractal Analysis Method

Objective: This study aimed to evaluate mandibular bone quality in celiac patients using radiomorphometric parameters, including trabecular bone fractal analysis and cortical bone assessments.Methods: Panoramic radiographs of 37 celiac patients and an age- and sex-matched control group were retrospectively examined. Fractal dimension values in nine mandibular regions, mandibular cortical width (MCW), and mandibular cortical index (MCI) were assessed. Statistical significance was set at P<.05.Results: Significantly lower fractal dimension values were observed in the condyle, angle, and molar regions of celiac patients, indicating a reduction in trabecular bone complexity. No significant differences were found in MCW (P:.699) or MCI distribution (P:.421), but the control group exhibited more frequent intact cortical borders (C1). High reliability was found in the measurements.Conclusion: Celiac disease is associated with the deterioration of trabecular bone quality in the mandible, although no significant differences were detected in cortical changes. The reduction in trabecular bone complexity suggests a simplification of the bone structure. Radiomorphometric evaluations may contribute to the early detection of bone changes in celiac patients, thereby aiding in management strategies.