CBCT-based fractal analysis of trabecular changes after intralesional corticosteroid therapy in central giant cell granuloma

Taşyapan S. A., Başkan M. B., Çakır Karabaş H., Ayhan M.

JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY, cilt.54, sa.9, 2026 (SCI-Expanded, Scopus)

Özet

Objective: To quantitatively assess treatment-associated trabecular bone changes following intralesional corticosteroid therapy in central giant cell granuloma (CGCG) using cone-beam computed tomography (CBCT)-based fractal analysis. Materials and methods: This retrospective pilot study included 10 adult patients with histopathologically confirmed CGCG treated with intralesional corticosteroid injections. CBCT images obtained before treatment and at 6-8 months follow-up were analyzed. Fractal dimension (FD) values were calculated from standardized regions of interest on corresponding cross-sectional slices using ImageJ software. Pre-and post-treatment FD values were compared to evaluate trabecular bone changes. Results: Post-treatment FD values were significantly higher than pre-treatment values across all evaluated slices (p = 0.002 for all comparisons). These findings remained statistically significant after Bonferroni correction (adjusted p = 0.010). Rank-biserial correlation coefficients indicated large effect sizes across all slice comparisons, and FD values increased in all patients during follow-up. No statistically significant differences were observed among slice-based FD changes (p = 0.665). Conclusion: Intralesional corticosteroid therapy was associated with increased trabecular complexity on CBCTbased fractal analysis. These findings suggest that fractal analysis may provide an objective method for monitoring trabecular bone reorganization during follow-up of conservatively managed CGCG lesions. Further studies with controlled designs are needed to clarify the relationship between these radiologic changes and treatment outcomes.