Investigation of Fractal Dimension Analysis and Radiomorphometric Indices in Children with Type 1 Diabetes Mellitus

Background: Diabetes mellitus (DM) disrupts bone metabolism, leading to slowed bone development, poor bone quality, and osteoporosis. Objectives: The aim of this study was to examine changes in the bones of adolescents with type-1 diabetes mellitus (T1DM) using fractal dimension (FD) analysis method and panoramic radiomorphometric indices. Methods: Fractal dimension values and radiomorphometric measurements of 36 children with T1DM and 36 healthy individuals were compared using panoramic radiographs. The panoramic mandibular index (PMI), mental index (MI), mandibular cortical width (MCW), amount of alveolar bone resorption (AABR), antegonial index (AI), and gonial index (GI) were measured. Mandibular cortical index (MCI) was recorded as C1, C2, and C3 classes. Results: For the angulus and corpus regions, the T1DM patient group had lower FD values, and there was a statistically significant difference between the T1DM patient group and the control group (P = 0.003, P = 0.029). Mental index, MCW, and AI values were higher in the control group than in the T1DM patient group and were statistically significant (P = 0.014, P = 0.001, P < 0.001, respectively). Conclusions: In this study examining the mandible in pediatric patients with T1DM using radiomorphometric measurements and fractal analysis method, it can be concluded that T1DM affects bone morphology and trabecular structure