Objectives: The purpose of this study was to evaluate fractal analysis as a tool to
quantitatively determine the mandibular trabecular bone changes in patients with chronic
renal failure (CRF).
Methods: In the present study, fractal analysis was performed using ImageJ (National
Institutes of Health, Bethesda, MD) program with box-counting method over panoramic
radiographs of 25 patients (14 females and 11 males) with CRF and 26 healthy individuals
(14 females and 12 males) as a control group. The fractal dimension (FD) values of the
patients and healthy individuals were compared. In addition, average biochemical parameters
[parathyroid hormone (PTH), calcium (Ca), phosphorus (P), product of Ca and P levels
(CaxP), alkaline phosphatase (ALP), vitamin D] of the patients with CRF, as measured
during the 3 months before the panoramic radiographs, were compared with FD values.
Results: According to the results, FD values of the patients with CRF were found to be
statistically lower than the control group (p,0.05). The average PTH levels of the patients
with CRF were 416.16 ± 310.3 pg ml21; average Ca levels were 8.94 ± 1.2 mg dl21; average P
levels were 5.76 ± 1.7 mg dl21; average CaxP values were 51.12 ± 15.03; average ALP levels
were 83.44 ± 36.8Ul21; and the average vitamin D values were 19.43 ± 9.7 ng ml21. In
addition, there was no significant correlation between FD values and the biochemical
parameters of the patients, and there was no correlation between age, gender and FD.
Conclusions: The FD values of the patients with CRF were lower than those of the controls.
This finding suggests that FD analysis might be a promising simple and cost-effective tool for
evaluating trabecular bone structure.