DOI QR코드

DOI QR Code

A clinical study of alveolar bone quality using the fractal dimension and the implant stability quotient

  • Lee, Dae-Hyun (Department of Periodontology and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Ku, Young (Department of Periodontology and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Rhyu, In-Chul (Department of Periodontology and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Hong, Jeong-Ug (Department of Periodontology and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Lee, Cheol-Woo (Department of Periodontology and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Heo, Min-Suk (Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Huh, Kyung-Hoe (Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National)
  • Published : 2010.02.28

Abstract

Purpose: It has been suggested that primary implant stability plays an essential role in successful osseointegration. Resonance frequency analysis (RFA) is widely used to measure the initial stability of implants because it provides superior reproducibility and non-invasiveness. The purpose of this study is to investigate whether the fractal dimension from the panoramic radiograph is related to the primary stability of the implant as represented by RFA. Methods: This study included 22 patients who underwent dental implant installation at the Department of Periodontology of Seoul National University Dental Hospital. Morphometric analysis and fractal analysis of the bone trabecular pattern were performed using panoramic radiographs, and the implant stability quotient (ISQ) values were measured after implant installation using RFA. The radiographs of 52 implant sites were analyzed, and the ISQ values were compared with the results from the morphometric analysis and fractal analysis. Results: The Pearson correlation showed a linear correlation between the ISQ values of RFA and the parameters of morphometric analysis but not of statistical significance. The fractal dimension had a linear correlation that was statistically significant. The correlation was more pronounced in the mandible. Conclusions: In conclusion, we suggest that the fractal dimension acquired from the panoramic radiograph may be a useful predictor of the initial stability of dental implants.

Keywords

References

  1. Friberg B, Jemt T, Lekholm U. Early failures in 4,641 consecutively placed Branemark dental implants: a study from stage 1 surgery to the connection of completed prostheses. Int J Oral Maxillofac Implants 1991;6:142-6.
  2. Shalabi MM, Wolke JG, Jansen JA. The effects of implant surface roughness and surgical technique on implant fixation in an in vitro model. Clin Oral Implants Res 2006;17:172-8. https://doi.org/10.1111/j.1600-0501.2005.01202.x
  3. Meredith N, Alleyne D, Cawley P. Quantitative determination of the stability of the implant-tissue interface using resonance frequency analysis. Clin Oral Implants Res 1996;7:261-7. https://doi.org/10.1034/j.1600-0501.1996.070308.x
  4. Meredith N, Friberg B, Sennerby L, Aparicio C. Relationship between contact time measurements and PTV values when using the Periotest to measure implant stability. Int J Prosthodont 1998;11:269-75.
  5. Mandelbrot BB. The fractal geometry of nature. 3rd ed. New York: W.H. Freeman; 1983.
  6. Weibel ER. Fractal geometry: a design principle for living organisms. Am J Physiol 1991;261:L361-9.
  7. Badwal RS. The application of fractal dimension to temporomandibular joint sounds. Comput Biol Med 1993;23:1-14. https://doi.org/10.1016/0010-4825(93)90103-8
  8. Yi WJ, Heo MS, Lee SS, Choi SC, Huh KH, Lee SP. Direct measurement of trabecular bone anisotropy using directional fractal dimension and principal axes of inertia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:110-6. https://doi.org/10.1016/j.tripleo.2006.11.005
  9. Yi WJ, Heo MS, Lee SS, Choi SC, Huh KH. Comparison of trabecular bone anisotropies based on fractal dimensions and mean intercept length determined by principal axes of inertia. Med Biol Eng Comput 2007;45:357-64. https://doi.org/10.1007/s11517-006-0152-z
  10. Huh KH, Yi WJ, Jeon IS, Heo MS, Lee SS, Choi SC, et al. Relationship between two-dimensional and three-dimensional bone architecture in predicting the mechanical strength of the pig mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:363-73. https://doi.org/10.1016/j.tripleo.2005.06.024
  11. Ruttimann UE, Webber RL, Hazelrig JB. Fractal dimension from radiographs of peridental alveolar bone: a possible diagnostic indicator of osteoporosis. Oral Surg Oral Med Oral Pathol 1992;74:98-110. https://doi.org/10.1016/0030-4220(92)90222-C
  12. Misch CE. Divisions of available bone in implant dentistry. Int J Oral Implantol 1990;7:9-17.
  13. Trisi P, Rao W. Bone classification: clinical-histomorphometric comparison. Clin Oral Implants Res 1999;10:1-7. https://doi.org/10.1034/j.1600-0501.1999.100101.x
  14. Friberg B, Sennerby L, Roos J, Johansson P, Strid CG, Lekholm U. Evaluation of bone density using cutting resistance measurements and microradiography: an in vitro study in pig ribs. Clin Oral Implants Res 1995;6:164-71. https://doi.org/10.1034/j.1600-0501.1995.060305.x
  15. Rosenthal DI, Ganott MA, Wyshak G, Slovik DM, Doppelt SH, Neer RM. Quantitative computed tomography for spinal density measurement: factors affecting precision. Invest Radiol 1985;20:306-10. https://doi.org/10.1097/00004424-198505000-00014
  16. Pouilles JM, Tremollieres F, Todorovsky N, Ribot C. Precision and sensitivity of dual-energy x-ray absorptiometry in spinal osteoporosis. J Bone Miner Res 1991;6:997-1002.
  17. Norton MR, Gamble C. Bone classification: an objective scale of bone density using the computerized tomography scan. Clin Oral Implants Res 2001;12:79-84. https://doi.org/10.1034/j.1600-0501.2001.012001079.x
  18. White SC, Rudolph DJ, Ma L. Influence of X-ray beam angulation and exposure on morphologic features of trabecular bone. Int J Oral Biol 1999;24:17-24.
  19. Southard TE, Southard KA, Jakobsen JR, Hillis SL, Najim CA. Fractal dimension in radiographic analysis of alveolar process bone. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:569-76. https://doi.org/10.1016/S1079-2104(96)80205-8
  20. Wojtowicz A, Chaberek S, Pirino A, Montella A, Bandiera P, Kinsner A, et al. The trabecular structure of developing human mandible. Clin Orthod Res 2001;4:161-71. https://doi.org/10.1034/j.1600-0544.2001.040306.x
  21. Nair MK, Seyedain A, Webber RL, Nair UP, Piesco NP, Agarwal S, et al. Fractal analyses of osseous healing using tuned aperture computed tomography images. Eur Radiol 2001;11:1510-5. https://doi.org/10.1007/s003300000773
  22. Heo MS, Park KS, Lee SS, Choi SC, Koak JY, Heo SJ, et al. Fractal analysis of mandibular bony healing after orthognathic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:763-7. https://doi.org/10.1067/moe.2002.128972
  23. Geraets WG, van der Stelt PF. Fractal properties of bone. Dentomaxillofac Radiol 2000;29:144-53. https://doi.org/10.1038/sj.dmfr.4600524
  24. Lee KI, Choi SC, Park TW, You DS. Fractal dimension calculated from two types of region of interest. Dentomaxillofac Radiol 1999;28:284-9. https://doi.org/10.1038/sj.dmfr.4600458
  25. Southard TE, Southard KA, Lee A. Alveolar process fractal dimension and postcranial bone density. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:486-91. https://doi.org/10.1067/moe.2001.112598
  26. Wilding RJ, Slabbert JC, Kathree H, Owen CP, Crombie K, Delport P. The use of fractal analysis to reveal remodelling in human alveolar bone following the placement of dental implants. Arch Oral Biol 1995;40:61-72. https://doi.org/10.1016/0003-9969(94)00138-2
  27. Bollen AM, Taguchi A, Hujoel PP, Hollender LG. Fractal dimension on dental radiographs. Dentomaxillofac Radiol 2001;30:270-5. https://doi.org/10.1038/sj.dmfr.4600630
  28. Meredith N, Book K, Friberg B, Jemt T, Sennerby L. Resonance frequency measurements of implant stability in vivo. A cross-sectional and longitudinal study of resonance frequency measurements on implants in the edentulous and partially dentate maxilla. Clin Oral Implants Res 1997;8:226-33. https://doi.org/10.1034/j.1600-0501.1997.080309.x
  29. Rasmusson L, Kahnberg KE, Tan A. Effects of implant design and surface on bone regeneration and implant stability: an experimental study in the dog mandible. Clin Implant Dent Relat Res 2001;3:2-8. https://doi.org/10.1111/j.1708-8208.2001.tb00123.x

Cited by

  1. Changes in the fractal dimension of peri-implant trabecular bone after loading: a retrospective study vol.43, pp.5, 2010, https://doi.org/10.5051/jpis.2013.43.5.209
  2. Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs vol.19, pp.2, 2015, https://doi.org/10.1007/s00784-014-1245-y
  3. Use of Fractal Analysis for the Discrimination of Trabecular Changes Between Individuals With Healthy Gingiva or Moderate Periodontitis vol.86, pp.12, 2010, https://doi.org/10.1902/jop.2015.150004
  4. Bone Texture Fractal Dimension Analysis of Ultrasound-Treated Bone around Implant Site: A Double-Blind Clinical Trial vol.2018, pp.None, 2010, https://doi.org/10.1155/2018/2672659
  5. A Comparison between the Implant Stability Quotient and the Fractal Dimension of Alveolar Bone at the Implant Site vol.2018, pp.None, 2010, https://doi.org/10.1155/2018/4357627
  6. Evaluation of trabecular pattern of mandible using fractal dimension, bone area fraction, and gray scale value: comparison of cone-beam computed tomography and panoramic radiography vol.35, pp.1, 2019, https://doi.org/10.1007/s11282-018-0316-1
  7. Comparison between fractal analysis and radiopacity evaluation as a tool for studying repair of an osseous defect in an animal model using biomaterials vol.48, pp.7, 2010, https://doi.org/10.1259/dmfr.20180466
  8. Use of fractal analysis in dental images: a systematic review vol.49, pp.2, 2010, https://doi.org/10.1259/dmfr.20180457
  9. Validity of fractal analysis of implants in individuals with healthy and diseased peri‐implant mucosa vol.31, pp.11, 2010, https://doi.org/10.1111/clr.13650
  10. Fractal analysis of the trabecular bone pattern in the presence/absence of metal artifact-producing objects: Comparison of cone-beam computed tomography with panoramic and periapical radiography vol.50, pp.6, 2010, https://doi.org/10.1259/dmfr.20200559
  11. Fractal analysis as a useful predictor for determining osseointegration of dental implant? A retrospective study vol.7, pp.1, 2010, https://doi.org/10.1186/s40729-021-00296-0