Evaluation of oral manifestations and mandibular bone fractal dimension in pediatric inflammatory bowel disease

Cege M. A., Cege E. E., DOĞRU Y., Eksi N., TULA B., ÖZGÜR T., ...Daha Fazla

FRONTIERS IN PEDIATRICS, cilt.14, 2026 (SCI-Expanded, Scopus)

Özet

Objective This study aimed to evaluate oral manifestations, caries experience, and mandibular trabecular bone microarchitecture using fractal dimension (FD) analysis in children with inflammatory bowel disease (IBD), and to compare these findings with a healthy control group. Methods In this multicenter case-control study, children with inflammatory bowel disease (IBD) and age- and gender-matched healthy controls underwent oral mucosal examination, dmft/DMFT indices, and the Community Periodontal Index of Treatment Needs (CPITN). Mandibular trabecular bone microarchitecture was evaluated using fractal dimension (FD) analysis applied to digital panoramic radiographs. The influence of medication type and duration on oral findings was additionally investigated. Results The study included 34 children with IBD (10 had Crohn's disease and 24 had ulcerative colitis) and 34 age- and gender-matched healthy controls. No significant differences were observed between the groups regarding caries experience or CPITN scores (p > 0.05). FD values were significantly lower in the IBD group at the condyle (p = 0.047) and molar (p < 0.001) regions. Children with Crohn's disease demonstrated lower condylar FD values compared to patients with ulcerative colitis (p = 0.046). Intraoral lesions were more frequent in Crohn's disease, with aphthous ulcers being the most common finding. No significant association was found between medication duration and oral findings (p > 0.05). Conclusion Children with IBD, particularly those with Crohn's disease, exhibited reduced mandibular trabecular bone complexity and increased oral mucosal involvement. Fractal dimension analysis may represent a useful non-invasive tool for assessing mandibular bone microarchitecture in this population.