# Retrospective panoramic radiographic evaluation of acute leukemia patients with fractal analysis

## TL;DR

This study uses fractal analysis to detect changes in jawbone structure in acute leukemia patients, showing reduced bone complexity compared to healthy individuals.

## Contribution

The study introduces fractal analysis as a novel method to assess osteopenia in acute leukemia patients using panoramic radiographs.

## Key findings

- FA values in acute leukemia patients were significantly lower than in the control group.
- Posterior FA values in female patients were significantly lower than in males.
- No correlation was found between age, blood values, and FA values in acute leukemia patients.

## Abstract

The aim of this study is to examine the changes in the trabecular structure of the jaw bones in acute leukemia (AL), which can cause extensive osteopenia using the Fractal Analysis (FA).

Panoramic images (PI) of 45 patients with AL who did not have any additional disease affecting the bone constituted the case group. PI of 45 patients without any disease affecting the bone tissue were used for the control group. For each PI, a total of 4 regions of interest (ROI) located on two anterior and two posterior regions of the mandible were determined. FA was applied to the determined ROIs and the results were analyzed statistically.

FA values ​​of the case group were significantly lower than those of the control group. With respect to gender, only the posterior FA values ​​of the females were significantly lower than those of the males, in the case group. There was no correlation between age, blood values ​​and FA values.

The changes in the trabecular structure of the bone due to the effects of AL can be detected by the FA. Gender and age have no effect on FA values, and there is no correlation between blood values ​​and FA values. AL causes extensive osteopenia and therefore reduced trabecular complexity, as the trabecular jawbone has a high bone turnover rate.

The online version contains supplementary material available at 10.1186/s12903-025-06625-8.