Evaluation of Fractal and Radiomorphometric Measurements of Mandibular Bone Structure in Pediatric Patients With Molar Incisor Hypomineralization.

Background: Molar incisor hypomineralization (MIH) is associated with enamel's existing qualitative developmental defects.

Objective: This study aimed to assess the cortical and trabecular mandibular bone morphology in pediatric patients with MIH using fractal analysis (FA) and digital panoramic radiography (DPR) with various radiomorphometric indices.

Methods: A total of 75 patients, including 39 in the MIH group (MIHG) and 36 in the control group (CG), underwent clinical and radiographic examination. Three regions of interest (ROIs) were analyzed: ROI1 (mandibular ramus), ROI2 (mandibular angle), and ROI3 (mandibular anterior). Radiomorphometric measurements included mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI). Statistical significance was defined as p < 0.05.

Results: The study revealed that the right and left MCW and PMI measurements in the CG were significantly higher compared with the MIHG (p = 0.002, p < 0.001; p = 0.022; p = 0.003). However, fractal dimension (FD) analysis of the trabecular bone structure showed no significant differences between the groups across all ROIs (p > 0.05).

Conclusions: MIH may be associated with bone development due to shared developmental factors, and the assessment of MCW and PMI in DPRs can contribute to a multidisciplinary diagnosis and treatment approach based on the growth and developmental dynamics of pediatric patients.