Evaluation of Trabecular Bone Healing Using Fractal Dimension Analysis After Augmentation of Alveolar Crests with Autogenous Bone Grafts: a Preliminary Study

Objective: The aim of this study is to evaluate bone remodeling after alveolar crest augmentation with autogenous bone grafts.

Methods: 50 patients who were applied augmentation due to alveolar deficiency were included in this study. Fractal dimensions were measured on the radiographs in the preoperative, postoperative, follow-up periods. The ROI was selected specific to each patient, but repeated in a standardized manner on subsequent radiographs.

Results: A total of 50 patients were included in the study; There were 31 females and 19 males. Implants were placed in all patients without any complications. The mean fractal dimensions on the graft recipient side were statistically higher in the postoperative 5th month compared to the postoperative 1st week (p = 0.002). The mean fractal dimensions on the donor side were statistically higher in the preoperative and postoperative 5th month compared to the postoperative 1st week (p < 0.001).

Conclusion: Any clinical imaging method cannot fully reflect the histological microstructures of the bone. Evaluating the fractal analysis together with the clinical results can demonstrate adequate bone healing and quality prior to implant placement. Fractal analysis is a non-invasive, reproducible, method but further, prospective, randomized, controlled clinical studies are needed to estimate bone quality prior to implant placement.