Digital analysis of trabecular pattern in jaws of patients with sickle cell anemia

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Objectives: To characterize how the morphological features of the cancellous bone of the maxilla and mandible differ in patients with sickle cell anemia compared with normal subjects. Methods: Periapical radiographs of 18 young African American patients with sickle cell anemia and 18 control African Americans were digitized at 600 d.p.i. A customized computer program measured 24 morphological features of the trabecular and marrow architecture in the anterior maxilla and mandible. The mean values for each of the features were determined for the sickle cell and control groups and compared by anatomical site. Results: Patients with sickle cell anemia have a significant increase in area of the marrow (53% compared with 47% in controls) and a less complex trabecular structure as evidenced by fewer skeletal branch points per square cm (451 compared with 584 in controls in the anterior maxilla and, 553 compared with 678 in controls in the anterior mandible). All values are significantly different (P<0.001). Conclusions: The data support the hypothesis that an automated image-interpretation program can distinguish patients with sickle cell anemia from normal individuals.

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