Assessment of Radiographic Image Texture in the Maxilla and Mandible Around Titanium Inserts Used for Osteosynthesis of Dentofacial Deformities

Background: In the treatment of dentofacial deformities, miniplates and screws made of titanium and its alloys (Ti6Al4V) are currently used for osteosynthesis of bone segments, which is due to the high biocompatibility of these materials. Despite the unquestionable advantages of titanium implants, there is an ongoing discussion about their potential negative impact on the human body, both at the implantation site and systemically. This study aimed to assess the influence of titanium fixations (miniplates and screws) on the texture and to identify the texture features that vary in the surrounding bone tissue. Methods: The orthopantomograms were obtained from 20 patients who were treated at the Department of Maxillofacial and Plastic Surgery, University of Bialystok. Regions of Interest (ROIs) of bone tissue surrounding titanium fixations in the maxilla and mandible were annotated using separate masks and compared to healthy areas of the same structures in the same patients. The images were independently filtered using Mean, Median, and Laplacian Sharpening filters, followed by analysis of the texture parameters obtained through methods such as First-Order Statistics (FOS), the Gray-Level Co-occurrence Matrix (GLCM), Neighbouring Gray Tone Difference Matrix (NGTDM), Gray-Level Dependence Matrix (GLDM), Gray-Level Run Length Matrix (GLRLM), and Gray-Level Size Zone Matrix (GLSZM). Results: The results showed that FOS, GLCM, and GLDM provide the most informative features for quantitative assessment of the areas around titanium fixations, and that smoothing filters reduce measurement noise and artifacts. Conclusions: The findings confirm that texture analysis can support the diagnosis of structural alterations in the bone surrounding titanium fixations, in both the maxilla and mandible.