ArticleBMC medical imaging2026
Evaluation of trabecular architecture and bone density in periradicular bone of dilacerated mandibular third molars: a cone beam computed tomography study.
Article in BMC medical imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aimed to evaluate and compare the periradicular trabecular bone density (BD) and microarchitecture of dilacerated and non-dilacerated mandibular third molars using gray values (GVs) and fractal dimension (FD) derived from cone-beam computed tomography (CBCT) images.
methodsThis retrospective cross-sectional study included CBCT scans of 54 patients with dilacerated mandibular third molars and 60 controls without dilaceration. Root dilaceration was defined as deviation > 20° from the long axis. The dilaceration group was further divided into subgroups based on severity (angle of dilaceration > 60° vs. ≤60°). Standardized regions of interest were selected adjacent to the curvature of the roots, excluding cortical bones. GVs were automatically measured by Romexis 6.2.1 (R®software, Planmeca, Helsinki, Finland), and FD was calculated via ImageJ using the box-counting method. Appropriate statistical analyses were performed, with significance set at p < 0.05.
resultsNo significant differences were found between dilacerated and non-dilacerated groups in GV (437.12 ± 184.83 vs. 439.25 ± 148.90, p = 0.645) or FD (1.07 ± 0.15 vs. 1.04 ± 0.17, p = 0.204). However, when dilacerated teeth were stratified by severity, roots with > 60° curvature exhibited significantly higher FD values than those ≤ 60° (p = 0.040), whereas GV values did not differ between curvature groups (p > 0.05). Spearman’s correlation revealed no significant association between dilaceration angle and GV or FD (p > 0.05).
conclusionWithin the limitations of this study, fractal analysis was used as a quantitative method to assess periradicular trabecular bone changes adjacent to dilacerated root apices. Although overall GV- and FD-based metrics did not differ between dilacerated and non-dilacerated teeth, the higher FD observed in severely dilacerated roots (> 60°) suggests increased trabecular complexity in the apical region, reflecting a potential biological bone response associated with pronounced root curvature.
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