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

2026년 7월 31일 업데이트: 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.

연구 개요

상태

아직 모집하지 않음

정황

상세 설명

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.

연구 유형

관찰

등록 (추정된)

100

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 어린이

건강한 자원 봉사자를 받아들입니다

예

샘플링 방법

비확률 샘플

연구 인구

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.

설명

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.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

코호트 및 개입

그룹/코호트
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.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Mandibular Trabecular Bone Structure Assessed by Fractal Dimension Analysis
기간: 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

2차 결과 측정

결과 측정
측정값 설명
기간
Panoramic Mandibular Index (PMI)
기간: 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

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 7월 27일

기본 완료 (추정된)

2026년 8월 5일

연구 완료 (추정된)

2026년 8월 7일

연구 등록 날짜

최초 제출

2026년 7월 28일

QC 기준을 충족하는 최초 제출

2026년 7월 31일

처음 게시됨 (실제)

2026년 8월 3일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 8월 3일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 7월 31일

마지막으로 확인됨

2026년 7월 1일

추가 정보

이 연구와 관련된 용어

추가 관련 MeSH 약관

기타 연구 ID 번호

  • 2026/315

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아니

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