SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2021
Use of fractal analysis in dental images for osteoporosis detection: a systematic review and meta-analysis.
Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
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Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mandibular Radiographic Assessment in Sickle Cell Disease: A Systematic Review of Radiomorphometric Indices and Fractal Dimension.Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric DentistryPooled it
- Fractal Analysis of Jaw Bone Structure in Individuals With Dental Fluorosis: A Retrospective Cross-Sectional Study.Clinical and experimental dental research · 2026Article
- Anatomical Evaluation of Localized Mandibular Trabecular Texture Differences in Children with Hypodontia Using Radiographic Fractal Analysis.Diagnostics (Basel, Switzerland) · 2026Article
- A preliminary study on the radiomic assessment of the surrounding trabecular bone microenvironment in taurodontism: Is it more than a dental anomaly?BMC oral health · 2026Article
- Fractal Dimension Analysis and Radiomorphometric Indices as Predictors for Low Bone Mineral Density in Postmenopausal Women: A CBCT-Based Study.Journal of menopausal medicine · 2026Article
- Fractal Analysis-Based Comparison of Mandibular Bone Remodeling in Clear Aligner and Fixed Orthodontic Therapies.Journal of clinical medicine · 2026Article
- Evaluation of the Effects of Diabetes Mellitus and Periodontitis on Alveolar Bone Radiodensity Using Hounsfield Unit Measurement and Fractal Analysis.Journal of imaging informatics in medicine · 2026Article
- Radiomorphometric and texture-based mandibular bone assessment in type 2 diabetes mellitus: correlation with vitamin D, osteocalcin, and glycemic control-an analytical cross-sectional study.Scientific reports · 2026Article
- Evaluation of oral manifestations and mandibular bone fractal dimension in pediatric inflammatory bowel disease.Frontiers in pediatrics · 2026Article
- Comparative Fractal Analysis on Orthopantomography Images of Bone Remodeling Changes at 3 Months Between Natural Socket Healing and Immediate Implant Placement.Diagnostics (Basel, Switzerland) · 2025Article
- Influence of cone-beam computed tomography reconstruction parameters on bone fractal dimension: A cross-sectional observational study.Imaging science in dentistry · 2025Article
- Evaluation of the efficacy of clear aligners in mandibular advancement and their effect on mandibular trabecular structures using fractal dimension analysis.BMC oral health · 2025Article
- Review
- Automated fractal analysis for mandibular bone evaluation in type 1 diabetes mellitus using a novel single click approach.Scientific reports · 2025Article
- Comparative evaluation of bone mineral density in premature birth and low birth weight children by fractal analysis on panoramic radiographs.BMC oral health · 2025Article
- Evaluation of mandibular bone quality with respect to enzyme inducement potential of antiepileptic drugs via fractal analysis.BMC oral health · 2025Article
- Post-Extraction Bone Changes in Molars Within Personalized Implant-Prosthetic Therapy as Evaluated with Fractal Analysis of CBCT.Journal of personalized medicine · 2025Article
- How does the direction of region of interest selection affect the fractal dimension?Oral radiology · 2025Article
- Evaluation of the First Metacarpal Bone Head and Distal Radius Bone Architecture Using Fractal Analysis of Adolescent Hand-Wrist Radiographs.Journal of imaging · 2025Article
- Assessment of cortical and trabecular bone structure in the mandible of patients with Behçet's Disease.BMC oral health · 2025Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Fractal dimension (FD) calculated on oral radiographs has been proposed as a useful tool to screen for osteoporosis. This systematic review and meta-analysis firstly aimed at assessing the reliability of FD measures in distinguishing osteoporotic patients (OP) from healthy controls (HC), and secondly, to identify a standardized procedure of FD calculation in dental radiographs for the possible use as a surrogate measure of osteoporosis. A comprehensive search was conducted up to September 2020 using PubMed, Web of Science, and SCOPUS databases. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was followed. Meta-analysis was performed on FD values calculated for HC and OP. Overall, 293 articles were identified. After a three steps screening, 19 studies were included in the qualitative appraisal and 12 were considered for meta-analysis. The methodological quality of the retrieved studies was generally low. Most of the studies included used White and Rudolph and box counting to process the images and to calculate FD, respectively. Overall, 51% of the studies found a meaningful difference between HC and OP groups. Meta-analyses showed that to date, FD measures on dental radiographs are not able to distinguish the OP from HC group significantly. From the current evidence, the use of FD for the identification of OP is not reliable, and no clear conclusion can be drawn due to the heterogeneity of studies. The present review revealed the need for further studies and provided the fundamentals to design them in order to find a standardized procedure for FD calculation (regions for FD assessment; images processing technique; methods for FD measurement). More effort should be made to identify osteoporosis using dental images which are cheap and routinely taken during periodic dental examinations.
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