This retrospective study evaluates how non-surgical treatment for gum disease affects the bone of the mandible. Gum disease (periodontitis) can lead to changes in the bone supporting the teeth, but these changes are not always easy to detect with routine clinical examination.

Previously collected clinical and radiographic data from patients with moderate and severe gum disease (Stage II and Stage III periodontitis), as well as individuals with gingivitis, were analyzed. All participants had received standard periodontal treatment as part of routine care. Radiographic images taken before treatment and 6 months after treatment were examined using fractal analysis, a method used to assess bone structure.

The results of this study may help improve understanding of how periodontal treatment influences bone structure and may support the use of radiographic analysis as a tool for monitoring treatment outcomes.

Periodontitis is a chronic inflammatory disease that leads to the destruction of the supporting structures of the teeth, including alveolar bone. Assessing changes in bone microstructure is important for understanding disease progression and treatment outcomes. Conventional clinical parameters may not fully reflect subtle alterations in trabecular bone architecture. Therefore, radiographic analysis methods, such as fractal analysis, have been proposed as objective tools to evaluate bone structure.

This retrospective observational study was conducted using previously collected clinical and radiographic data from patients treated at the Department of Periodontology, Akdeniz University Faculty of Dentistry. The study included patients diagnosed with Stage II and Stage III periodontitis, as well as individuals with gingivitis serving as a control group. All participants received non-surgical periodontal therapy as part of routine clinical care.

Periapical and panoramic radiographic images obtained at baseline and 6 months after treatment were analyzed. Fractal dimension analysis was performed on predefined regions of interest to assess changes in trabecular bone microstructure. In addition to radiographic evaluation, clinical periodontal parameters, including probing pocket depth, clinical attachment level, bleeding on probing, and plaque index, were recorded.

The primary objective of the study is to evaluate changes in mandibular bone microstructure following non-surgical periodontal therapy. Secondary objectives include assessing the relationship between radiographic findings and clinical periodontal parameters. The findings may contribute to a better understanding of bone response to periodontal treatment and support the use of fractal analysis as a quantitative tool in periodontal research and clinical practice.

Inclusion Criteria:

• Individuals aged 18 years and older
• Patients diagnosed with Stage II or Stage III periodontitis, or gingivitis
• Patients who received non-surgical periodontal therapy
• Availability of complete clinical periodontal records
• Availability of periapical and panoramic radiographs at baseline and 6 m

Exclusion Criteria:

• Patients with systemic diseases affecting bone metabolism
• History of periodontal treatment within the last 6 months
• Use of medications affecting bone metabolism
• Pregnant or lactating individuals
• Poor quality or missing radiographic records

Patients treated at the Department of Periodontology, Akdeniz University Faculty of Dentistry, with available clinical and radiographic records suitable for retrospective evaluation. The study population includes individuals diagnosed with Stage II and Stage III periodontitis, as well as individuals with gingivitis.

Individual participant data will not be shared due to privacy and confidentiality considerations related to retrospective clinical data.