Evaluation of Mandibular Bone Microstructure Changes After Periodontal Treatment (M-BONE Study)

Overview

This retrospective study evaluates how non-surgical treatment for gum disease affects the bone of the mandible. Gum disease (periodontitis) can lead to changes in the bone supporting the teeth, but these changes are not always easy to detect with routine clinical examination. Previously collected clinical and radiographic data from patients with moderate and severe gum disease (Stage II and Stage III periodontitis), as well as individuals with gingivitis, were analyzed. All participants had received standard periodontal treatment as part of routine care. Radiographic images taken before treatment and 6 months after treatment were examined using fractal analysis, a method used to assess bone structure. The results of this study may help improve understanding of how periodontal treatment influences bone structure and may support the use of radiographic analysis as a tool for monitoring treatment outcomes.

Periodontitis is a chronic inflammatory disease that leads to the destruction of the supporting structures of the teeth, including alveolar bone. Assessing changes in bone microstructure is important for understanding disease progression and treatment outcomes. Conventional clinical parameters may not fully reflect subtle alterations in trabecular bone architecture. Therefore, radiographic analysis methods, such as fractal analysis, have been proposed as objective tools to evaluate bone structure. This retrospective observational study was conducted using previously collected clinical and radiographic data from patients treated at the Department of Periodontology, Akdeniz University Faculty of Dentistry. The study included patients diagnosed with Stage II and Stage III periodontitis, as well as individuals with gingivitis serving as a control group. All participants received non-surgical periodontal therapy as part of routine clinical care. Periapical and panoramic radiographic images obtained at baseline and 6 months after treatment were analyzed. Fractal dimension analysis was performed on predefined regions of interest to assess changes in trabecular bone microstructure. In addition to radiographic evaluation, clinical periodontal parameters, including probing pocket depth, clinical attachment level, bleeding on probing, and plaque index, were recorded. The primary objective of the study is to evaluate changes in mandibular bone microstructure following non-surgical periodontal therapy. Secondary objectives include assessing the relationship between radiographic findings and clinical periodontal parameters. The findings may contribute to a better understanding of bone response to periodontal treatment and support the use of fractal analysis as a quantitative tool in periodontal research and clinical practice.