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Effect of Nail Biting Habit on Mandibular Bone Structure: A Retrospective Radiological Study

31 juillet 2026 mis à jour par: DİLARA NİL GÜNAÇAR, Recep Tayyip Erdogan University Training and Research Hospital

Evaluation of the Effects of Nail Biting Habit on Mandibular Bone Structure Using Fractal Analysis and Panoramic Morphometric Indices: A Retrospective Radiological Study

Nail biting (onychophagia) is a common parafunctional habit characterized by repetitive and non-functional biting behavior. Although the effects of nail biting on dental structures and occlusion have been reported, its potential effects on mandibular bone structure remain unclear. This retrospective radiological study aims to evaluate the association between nail biting habit and mandibular bone characteristics using fractal analysis and panoramic morphometric indices. Existing panoramic radiographs of individuals with and without nail biting habits will be retrospectively analyzed. Trabecular bone complexity, mandibular cortical width, panoramic mandibular index, and Klemetti index values will be compared between groups to investigate whether nail biting habit is associated with alterations in mandibular bone morphology.

Aperçu de l'étude

Statut

Pas encore de recrutement

Les conditions

Description détaillée

Nail biting (onychophagia) is classified as a body-focused repetitive behavior and represents a common parafunctional habit, particularly among children and adolescents. Continuous repetitive mechanical forces generated during nail biting may affect the stomatognathic system; however, the possible effects of this habit on mandibular bone structure have not been sufficiently investigated.

Fractal analysis is a radiological assessment method used to evaluate trabecular bone architecture by quantifying structural complexity. Higher fractal dimension values indicate increased complexity of bone patterns. In addition, panoramic morphometric indices such as mandibular cortical width, panoramic mandibular index, and Klemetti index provide information regarding cortical bone quality and quantity.

In this retrospective case-control study, existing panoramic radiographs of individuals with and without nail biting habits will be evaluated. Radiological parameters including fractal dimension, mandibular cortical width, panoramic mandibular index, and Klemetti index will be compared between groups. This study aims to determine whether nail biting habit is associated with measurable changes in mandibular trabecular and cortical bone characteristics.

Type d'étude

Observationnel

Inscription (Estimé)

100

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Enfant

Accepte les volontaires sains

Oui

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

The study population will consist of systemically healthy children aged 8-10 years who previously underwent routine dental examination at the Department of Pediatric Dentistry, Faculty of Dentistry, Recep Tayyip Erdoğan University. Existing panoramic radiographs obtained during routine clinical care will be retrospectively analyzed. Participants will be categorized into two groups according to the presence or absence of nail biting habit. A minimum of 100 participants will be included, with equal distribution between the nail biting habit group and the control group and balanced sex distribution. Mandibular bone characteristics will be evaluated using fractal dimension analysis and panoramic radiographic morphometric indices, including mandibular cortical width, panoramic mandibular index, mandibular cortical index (Klemetti index), and other mandibular bone measurements. No intervention will be performed; only existing radiographic records will be assessed.

La description

Inclusion Criteria:

  • Children aged 8-10 years who were examined at the Department of Pediatric Dentistry, Faculty of Dentistry, Recep Tayyip Erdoğan University.
  • Systemically healthy participants.
  • Participants with available diagnostic-quality panoramic radiographs obtained during routine dental examinations.
  • Participants with and without a history of nail biting habit.
  • Panoramic radiographs with sufficient image quality for fractal dimension analysis and mandibular morphometric measurements.
  • Radiographs without periapical pathology in teeth adjacent to the regions of interest (ROI) used for fractal analysis.
  • Participants with at least 20 existing teeth.
  • Radiographic records with available parental radiographic information and consent documentation.

Exclusion Criteria:

  • Participants with systemic diseases or conditions that may affect bone metabolism, including diabetes mellitus, osteoporosis, osteomalacia, renal diseases, hypothyroidism, or hyperparathyroidism.
  • Participants using medications that may influence bone density or bone metabolism.
  • Participants with temporomandibular joint disorders affecting the subcondylar region.
  • Participants with mandibular pathological conditions, including cysts, tumors, or other lesions affecting mandibular bone structure.
  • Participants with periapical pathology adjacent to the regions selected for fractal analysis.
  • Participants with fewer than 20 teeth.
  • Panoramic radiographs with insufficient diagnostic quality or image artifacts that prevent reliable measurements.
  • Radiographs that do not allow accurate evaluation of mandibular cortical and trabecular bone parameters.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Cohortes et interventions

Groupe / Cohorte
Nail Biting Habit Group
This cohort includes systemically healthy children aged 8-10 years with a documented nail biting habit. Existing panoramic radiographs obtained during routine dental examinations will be retrospectively analyzed. Mandibular trabecular bone structure will be evaluated using fractal dimension analysis, and cortical bone characteristics will be assessed using mandibular cortical width, panoramic mandibular index, and Klemetti index measurements. No intervention will be performed.
Control Group Without Nail Biting Habit
This cohort includes systemically healthy children aged 8-10 years without a history of nail biting habit. Existing panoramic radiographs obtained during routine dental examinations will be retrospectively analyzed using the same radiological evaluation methods. Mandibular trabecular and cortical bone characteristics will be compared with those of the nail biting habit group. No intervention will be performed.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Mandibular Trabecular Bone Structure Assessed by Fractal Dimension Analysis
Délai: Baseline
Mandibular trabecular bone architecture will be evaluated using fractal dimension analysis on panoramic radiographs. Fractal dimension measurements will be performed using the box-counting method described by White and Rudolph. Four regions of interest (ROIs) in the mandible will be analyzed, including the condylar subcortical region, supracortical region above the mandibular angle, area above the mandibular canal distal to the mental foramen, and anterior region of the mental foramen. Measurements will be performed bilaterally, and the mean fractal dimension value will be calculated for each participant. Higher fractal dimension values indicate greater trabecular bone complexity. The fractal dimension values will be compared between individuals with and without nail biting habit.
Baseline

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Panoramic Mandibular Index (PMI)
Délai: Baseline
The panoramic mandibular index (PMI) will be calculated on panoramic radiographs as the ratio of mandibular cortical width to the distance between the inferior border of the mandible and the inferior margin of the mental foramen. Measurements will be performed bilaterally, and the mean value will be used for analysis.
Baseline

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

27 juillet 2026

Achèvement primaire (Estimé)

5 août 2026

Achèvement de l'étude (Estimé)

7 août 2026

Dates d'inscription aux études

Première soumission

28 juillet 2026

Première soumission répondant aux critères de contrôle qualité

31 juillet 2026

Première publication (Réel)

3 août 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

3 août 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

31 juillet 2026

Dernière vérification

1 juillet 2026

Plus d'information

Termes liés à cette étude

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • 2026/315

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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