{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:49:48Z","timestamp":1791874188088,"version":"4.3.4"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical &amp; Exp Dental Res"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This retrospective cross\u2010sectional study aimed to evaluate differences in maxillary and mandibular trabecular bone structure in individuals with dental fluorosis using fractal dimension (FD) analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      The study included 47 individuals: 24 with dental fluorosis and 23 controls. Fluorosis severity was assessed using the Thylstrup\u2013Fejerskov Index and classified as moderate (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913) or severe (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911). FD analysis was performed on standardized regions of interest on digital panoramic and digitized analog periapical radiographs using ImageJ. Normality was assessed using the Shapiro\u2013Wilk test. Region\u2010specific FD values were compared using independent\u2010samples\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests or Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests, as appropriate. Generalized estimating equation (GEE) analyses were used to account for within\u2010participant correlation among repeated regional measurements.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In region\u2010specific comparisons, FD was significantly lower in the fluorosis group than in controls in the 33\u201334 panoramic region (1.46\u2009\u00b1\u20090.04 vs. 1.48\u2009\u00b1\u20090.03;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). FD was significantly higher in severe than moderate fluorosis in the 13\u201314 panoramic region (1.36\u2009\u00b1\u20090.05 vs. 1.28\u2009\u00b1\u20090.06;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and the 11\u201312 periapical region (1.63\u2009\u00b1\u20090.01 vs. 1.61\u2009\u00b1\u20090.02;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). GEE analysis showed a significant average marginal fluorosis\u2010control difference for panoramic radiographs (mean difference\u2009=\u2009\u22120.0210, 95% CI: \u22120.0386 to \u22120.0034;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020), without a significant group\u2010by\u2010region interaction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.840). For fluorosis severity, the severity\u2010by\u2010region interaction was significant for panoramic radiographs (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), while average marginal periapical FD was higher in the severe subgroup (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FD analysis identified differences in radiographic trabecular pattern complexity associated with dental fluorosis, although findings varied by anatomical region and imaging modality. Given the small sample, multiple regional comparisons, and moderate reproducibility of periapical measurements, these findings should be considered exploratory and require confirmation in larger studies using standardized imaging protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cre2.70480","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:16:01Z","timestamp":1791872161000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fractal Analysis of Jaw Bone Structure in Individuals With Dental Fluorosis: A Retrospective Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9516-6625","authenticated-orcid":false,"given":"Ozlem","family":"Gormez","sequence":"first","affiliation":[{"name":"Faculty of Dentistry, Department of Oral and Maxillofacial Radiology S\u00fcleyman Demirel University Isparta 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