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Received Jan 20, 2018; Revised Feb 17, 2018; Accepted Mar 19, 2018
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1. Introduction
Sufficient bone quality is a prerequisite for a successful dental implant. Proper assessment of the bone quality is a primary objective to determine the osseointegration status. Excessive marginal bone loss after implant or following prosthesis may be seen in the first year [1]. Continuous bone resorption affects function and aesthetic; therefore, there are several ways recommended to restore and regenerate the bone such as advocating bone-grafting procedures, usage of growth factors, low-level laser therapy, and therapeutic ultrasound. Low-intensity pulsed ultrasound (LIPUS) stimulation is a safe noninvasive treatment, and it can accelerate bone regeneration [2]. In dentistry, LIPUS has been found to promote periodontal bone defect healing [3], bone regeneration after oral surgery [4], and osseointegration of an endosseous dental implant [5].
Histological analysis was usually considered the gold-standard method to evaluate successful osseointegration. However, due to the invasiveness of this method and related ethical issues, various imaging modalities have been proposed like intraoral radiographs, panoramic imaging, computed tomography (CT), cone beam computed tomography (CBCT), and micro-CT [6]. Periapical radiographs are traditionally interpreted by measuring peri-implant marginal bone loss. This method has been found with limited diagnostic value for early detection of bone changes [7].
Bone texture analysis provides information about bone structures in a noninvasive manner [8, 9]. Fractal dimension analysis is one of the noninvasive, well-suited methods to analyze the bone texture on a plain radiograph [10]. This method is used to quantify the trabecular bone pattern and bone marrow interface using the box-counting logarithm [11, 12]. The fractal analysis is a statistical analysis of texture based on fractal geometry for describing complex structural patterns recognized and expressed as a ratio termed as the “fractal dimension” FD [13, 14]. The FD method has been used to quantify trabecular bone structures under different conditions, like endodontic treatment [15], periodontitis [16, 17], and implant stability [18, 19]. Jolley et al. [20] showed that the FD can reliably analyze the changes in the alveolar bone density by using the periapical radiographs.
There has...