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Abstract：
Introduction The cysts of the maxillofacial region account for one of the most common pathologies of the head and neck region after the mucosal pathologies. Radiography provides an essential clue in early diagnosis and triaging, but it continues further as it is used to evaluate the post-treatment outcome. However, manual analysis is prone to errors. In this scenario, fractal analysis (FA) in radiographs uses mathematical methods to analyse the changes in grey scales in a given radiographic image. FA in odontogenic cysts is used to characterise their complexity, uncover hidden patterns, monitor treatment response, and potentially provide prognostic information. This paper aimed to assess the fractal characteristics of the radicular cyst (RC), dentigerous cyst (DC), and odontogenic keratocyst (OKC) using cone beam computed tomography (CBCT). The objective was to calculate fractal dimension (FD) values expressed in each of these cysts, which could prove to be a radiological adjunct in diagnosing the above cysts. Materials and methods As this is a retrospective study, the archives of CBCT images from June 2021 to December 2023 were obtained from patients diagnosed and confirmed with a histopathological diagnosis with RC, DC, and OKC. The FA was performed using Image J Software (Ver 1.51, National Institute of Health Bethesda, Fiji). The cortical and cancellous bones were segmented using thresholding techniques and converted to binary images. The mean FD of the three planes was then compared to establish the distinctive fractal characteristic for the specific odontogenic cysts. A one-way ANOVA was performed using the Statistical Product and Service Solutions (SPSS) (version 23.0; IBM SPSS Statistics for Windows, Armonk, NY) to determine the difference between FD values of RC, DC, and OKC with a significance level less than 0.05. Results The FD values of DC, RC, and OKC were 1.33 ± 0.17, 1.08 ± 0.16, and 1.65 ± 0.12, respectively. The results indicated that OKC had higher FD values than DC and RC, which means that OKC had lesser bone destruction compared to DC and RC. Inferential statistics showed that the one-way ANOVA was used to compare the means of the three groups of FD data. When calculated for the three groups, the F-statistic value was at 7.29, which yielded a P value of 0.03, making it statistically significant for a 95% confidence interval (p<0.05). Conclusion Our CBCT study on bone trabecular pattern analysis using FD and FA in odontogenic cysts reveals distinct alterations in bone parameters among different cyst types. The probability of higher FD values in OKC is because of lesser cortical bone destruction in OKC compared to the other cyst types. These findings have potential implications for diagnosing, treating, and prognosticating odontogenic cysts.
摘要：
引言颌面部囊肿是继粘膜病变之后的头颈部最常见的病变之一。射线照相术为早期诊断和分类提供了必要的线索，但它仍在继续，因为它被用于评估治疗后的结果。然而,手工分析容易出错。在这种情况下，射线照相中的分形分析（FA）使用数学方法来分析给定射线照相图像中灰度的变化。牙源性囊肿中的FA用于表征其复杂性，发现隐藏的模式，监测治疗反应，并可能提供预后信息。本文旨在评估神经根囊肿（RC）的分形特征，牙质囊肿（DC），使用锥形束计算机断层扫描（CBCT）和牙源性角化囊肿（OKC）。目的是计算每个囊肿中表达的分形维数（FD）值，这可能被证明是诊断上述囊肿的放射学辅助手段。材料和方法由于这是一项回顾性研究，2021年6月至2023年12月的CBCT图像档案是从经RC组织病理学诊断和确认的患者获得的，DC,OKC使用ImageJSoftware（美国国立卫生研究院贝塞斯达，斐济）。使用阈值化技术对皮质和松质骨进行分割，并将其转换为二进制图像。然后比较三个平面的平均FD，以建立特定牙源性囊肿的独特分形特征。使用统计产品和服务解决方案（SPSS）（23.0版；IBMSPSSStatisticsforWindows，Armonk,NY)以确定RC的FD值之间的差异，DC,和OKC的显著性水平小于0.05。结果DC的FD值,RC,OKC分别为1.33±0.17、1.08±0.16和1.65±0.12。结果表明，OKC比DC和RC具有更高的FD值，这意味着与DC和RC相比，OKC的骨破坏较小。推断统计表明，单因素方差分析用于比较三组FD数据的均值。当计算三组时，F统计值为7.29,P值为0.03,95%置信区间具有统计学意义(p<0.05).结论我们在牙源性囊肿中使用FD和FA进行的CBCT骨小梁模式分析研究揭示了不同囊肿类型之间骨参数的明显变化。与其他囊肿类型相比，OKC中FD值较高的可能性是由于OKC中皮质骨破坏较小。这些发现对诊断有潜在的意义，治疗,和预测牙源性囊肿。
