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Lim, Lee, Kim, Ohn, Choi, Oh, Min, and Lee: Study on bone healing process following cyst enucleation using fractal analysis
Original Article

J Korean Assoc Oral Maxillofac Surg 2011;37(6):477-482.

Published online: 10 January 2011

DOI: https://doi.org/10.5125/jkaoms.2011.37.6.477

Study on bone healing process following cyst enucleation using fractal analysis

Hun-Jun Lim1, Seung-Soo Lee1, Won-Ki Kim1, Byung-Hun Ohn1, Sang-Moon Choi1, Se-Ri Oh1, Seung-Ki Min1, 2, Jun Lee1, 2

1Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Daejeon, Korea

2Bone Regeneration Research Institute, Wonkwang University, Daejeon, Korea

Jun Lee Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University 1268, Doonsan 2-dong, Seo-gu, Daejeon 302-120, Korea TEL: +82-42-366-1146 FAX: +82-42-366-1115 E-mail: omslee@daum.net

Received 16 July 2011       Revised 5 September 2011       Accepted 12 October 2011

Copyright © 2011 Korean Association of Oral and Maxillofacial Surgeons

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction

Bone regeneration of cystic defects of the jaws after a cyst treatment requires lengthy healing periods. Generally, the bony changes are observed periodically through a visual radiographic reading as well as by the clinical opinion and radiographic images (panorama, periapical view), but it is difficult to compare the objective bony changes using only the radiographic density. In addition, it is difficult to observe minute bony changes through a visual radiographic reading, which can lead to a subjective judgment. This study exmined the bone density after the enucleation of a jaw cyst by fractal analysis.

Materials and Methods

Eighteen patients with a cystic lesion on the jaw were assessed. Panoramic radiographs were taken preoperatively, immediately postoperatively, and 1, 3, 6 and 12 months after cyst enucleation. The images were analyzed by fractal analysis.

Results

The mean fractal dimensions increased immediately after surgery and 3, 6 and 12 months postoperatively. The postoperative 6 and 12 months fractal dimension was similar to the controls.

Conclusion

Fractal analysis was used to overcome the limit of a subjective reading during an assessment of bone regeneration after cyst enucleation.

Keywords: Cyst enucleation, Bone regeneration, Fractal dimension

References

1. Peterson LJ. Contemporary oral and maxillofacial surgery. 4th ed.

Fig. 1.
Image registration processing by image subtraction tool program (Sunny, Biomedisys Co. Ltd., Seoul, Korea). A, B. Before registration. C, D. Reference point selection. E, F. After registration. Hun-Jun Lim et al: Study on bone healing process following cyst enucleation using fractal analysis. J Korean Assoc Oral Maxillofac Surg 2011
jkaoms-37-477f1.tif
Fig. 2.
Selection of region of interest. A. Selection of lesion region of interest (ROI). B. Selection of control ROI. Hun-Jun Lim et al: Study on bone healing process following cyst enucleation using fractal analysis. J Korean Assoc Oral Maxillofac Surg 2011
jkaoms-37-477f2.tif
Fig. 3.
Image processing. A. Original region of interest image. B. Gaussian blurring. C. Subtract between (A) and (B). D. Add 128. E. Conversion to binary image. F. Erode and dilation. G. Skeletonize. Hun-Jun Lim et al: Study on bone healing process following cyst enucleation using fractal analysis. J Korean Assoc Oral Maxillofac Surg 2011
jkaoms-37-477f3.tif
Table 1.
The change of fractal dimension over time
Time Average Standard deviation 95% confidence interval
Minimum Maximum
Pre-operative 1.108 0.097 1.059 1.156
Post 1 day 1.175 0.139 1.106 1.244
Post 1 month 1.126 0.117 1.064 1.188
Post 3 months 1.166 0.101 1.114 1.218
Post 6 months 1.217 0.108 1.157 1.276
Post 12 months 1.259 0.065 1.224 1.293

Hun-Jun Lim et al: Study on bone healing process following cyst enucleation using fractal analysis. J Korean Assoc Oral Maxillofac Surg 2011

Table 2.
Comparison with pre-operative fractal dimensions
Time (I) Time (J) Average difference (I-J) Standard deviation P-value
Pre-operative Post 1 day −0.067 0.147 0.070
  Post 1 month −0.029 0.150 0.456
  Post 3 months −0.067* 0.095 0.010
  Post 6 months −0.112* 0.108 0.001
  Post 12 months −0.149* 0.092 0.000

* P<0.05)

Hun-Jun Lim et al: Study on bone healing process following cyst enucleation using fractal analysis. J Korean Assoc Oral Maxillofac Surg 2011

Table 3.
Comparison with control group fractal dimensions
Time (I) Time (J) Average difference (I-J) Standard deviation P-value
Control Pre-operative 0.151 0.106 0.000
  Post 1day 0.088 0.146 0.024
  Post 1 month 0.133 0.139 0.002
  Post 3 months 0.100 0.103 0.001
  Post 6 months 0.049* 0.115 0.132
  Post 12 months −0.006* 0.074 0.754

* P>0.05)

Hun-Jun Lim et al: Study on bone healing process following cyst enucleation using fracta analysis. J Korean Assoc Oral Maxillofac Surg 2011

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