Mandibular bone microarchitecture in patients with multiple sclerosis: A fractal analysis study

JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY, vol.127, pp.1-7, 2026 (Peer-Reviewed Journal)

Introduction: This study aimed to evaluate the mandibular bone structure in patients with multiple sclerosis (MS)

using fractal analysis and radiomorphometric indices derived from panoramic radiographs.

Methods: A total of 34 patients diagnosed with MS and 34 healthy individuals were included in this study. Mandib-

ular bone characteristics were evaluated using fractal dimension (FD) values, mandibular cortical width (MCW)

measurements, and mandibular cortical index (MCI) categories. MS patients were divided into subgroups based

on disease duration and the ef cacy of disease-modifying therapy (DMT).

Results: FD values did not differ signi cantly between the MS and control groups, except at the right anterior men-

tal foramen. There was no signi cant difference in MCW between the groups. Regarding MCI, the proportion of

individuals classi ed as C2 was signi cantly higher in the MS group than in the control group. Within the MS

group, FD values of the right mandibular inferior cortical region were signi cantly higher in individuals classi ed

as MCI C2 than in those classi ed as MCI C1 (p = 0.045). No signi cant relationship was observed between DMT

subgroups and the MCW, FD, and MCI parameters. FD and MCI did not vary with disease duration; however,

MCW was signi cantly lower in patients with disease duration >10 years.

Conclusions: This study found that the mandibular trabecular bone structure of MS patients was largely preserved.

However, signi cant localized differences were observed in cortical bone parameters. These ndings require con-

rmation through prospective studies involving larger patient populations.