Evaluation of mandibular bone structure changes in patients with phenylketonuria through fractal analysis and radiomorphometric indices

Objectives. The aim of this study was to evaluate the effect of phenylketonuria (PKU) on mandibular bone structure by comparing the bone of PKU patients with healthy controls using fractal analysis (FA) and the radiomorphometric indices of mandibular cortical width (MCW) and mandibular cortical index (MCI). Study Design. In total, 32 patients with PKU were analyzed and compared with the control participants. Regions of interest in panoramic radiographs were selected and the fractal dimension (FD) obtained from FA was calculated. MCW was defined as the cortical thickness of the inferior border of the mandible at the level of the mental foramen. MCI classified the endosteal edge of the mandibular cortex as C1: straight and sharp, C2: the presence lacunar resorption spaces, and C3: distinctly porous and severely eroded. The significance level was P < .05. Results. All FD and MCW values were significantly lower in the PKU patients. The prevalence of C1 was significantly lower and prevalence of C2 was significantly higher in the PKU group. Conclusions. The differences in FD and radiomorphometric indices between patients with PKU and healthy controls may indicate a potential impact of PKU on mandibular bone structure.