Evaluation of antihypertensive drug-induced changes in mandibular bone using fractal analysis.

OBJECTIVE

The aim was to evaluate changes in trabecular and cortical mandibular bone caused by antihypertensive (AHT) drugs through fractal analysis.

STUDY

DESIGN

This retrospective study included 230 patients who were taking AHT medication and had no conditions affecting bone metabolism other than hypertension. A control group of 230 healthy, sex-matched individuals was also included. Patients were divided into subgroups according to AHT drugs: thiazide diuretics (TDs), beta-blockers (BBs), angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), and a combination of drugs. The fractal dimension (FD) was calculated bilaterally in 5 regions of interest (ROI 1 - ROI 5) including 4 trabecular regions and 1 cortical region using Image J software.

RESULTS

Mean FD values were significantly higher in all ROIs for the study group compared to the control group (P < .001). FDs were significantlty higher for BB, ACEI, ARB, CCB, and combined subgroups compared to controls in ROIs 1, 2, and 4; for ACEI and CCB subgroups compared to controls in ROI 3; and for TD, BB, ACEI, ARB, CCB, and combined subgroups compared to controls in ROI 5 (P < .001).

CONCLUSIONS

AHTs may increase FD values of the trabecular and cortical structures. Assessment of the effects of AHT drugs is essential for predicting the prognosis for bone healing after tooth extraction, osseointegration after implant surgery, or other surgical procedures.