Abstract
Objectives: This study aimed to assess the trabecular bone structural complexity in children with varying sunlight exposure using panoramic radiographs (PR) and investigate potential implications for bone metabolism. Fractal dimension (FD) and pixel intensity (PI) were employed for comparison.
Materials and Methods: Panoramic radiographs (n=120) of 6 to 9-year-old children, divided into more (n=60) and less (n=60) sunlight exposure groups, were assessed. ImageJ® software was used to analyze three regions of interest (ROI) in each radiograph. FD, determined by the box-counting method, and PI values were compared across ROIs and between exposure groups and genders using Kruskal-Wallis and t-tests (p<0.05).
Results: Children with less sunlight exposure exhibited higher FD values (3.60 ± 0.29) compared to those with more exposure (3.31 ± 0.29) (p=0.000), particularly in ROI2 and ROI3. No gender-based differences were observed (p=0.607). PI values were similar between exposure groups (p=0.735) and genders (p=0.553), except for a significant difference in ROI2 of less exposed children (62.76 ± 20.48) compared to more exposed ones (78.30 ± 65.20).
Conclusion: Reduced sunlight exposure in children was associated with higher FD values, impacting trabecular bone structural complexity. However, total PI values remained unaffected by sunlight exposure. This suggests that dentists, utilizing FD and PI analysis on routinely requested PR, can contribute to the early detection of potential bone variations in children.
Clinical Relevance: Understanding FD and PI applications in PR can empower dentists for the early identification of bone variations in pediatric patients during routine clinical assessments.