Assessment of Bone Density Between Central Incisors Using Fractal Analysis in Patients Undergoing Surgically Assisted Rapid Maxillary Expansion

Abstract

Background: Surgically assisted rapid palatal expansion (SARPE) is a widely used method for correcting maxillary transverse deficiency. Aim: This study aims to investigate the changes in bone trabeculae and healing on the midline osteotomy line of the central incisors on panoramic radiographs taken preoperatively and 6 months postoperatively in patients who underwent SARPE using the fractal analysis (FA) method. Methods: The study population consisted of 36 patients (5 male and 31 female) diagnosed with maxillary transverse deficiency and operated with SARPE. Fractal analyses observed the alterations on the trabecular structure in the vertical osteotomy line between central incisors on panoramic radiographs obtained preoperatively and 6 months postoperatively. The box-counting method was used to evaluate the changes in trabecular structure by FA. P values of less than 0.05 were considered significant. Results: The fractal dimension values of the vertical osteotomy lines returned to their preoperative levels by the sixth postoperative month. There were no statistically significant changes between preoperative and postoperative 6 months on the panoramic radiographs in the vertical osteotomy line (P = 0.057). Conclusion: Postoperative fractal analyses can reveal trabecular changes and bone healing in structures such as the vertical osteotomy line. Six months after the SARPE, central incisors can be moved orthodontically toward each other. The bone healing between central incisors was uneventful, and the bone trabeculae structure was approximately the same as during the preoperative period.