This study aimed to evaluate the mandibular bone structure in patients with multiple sclerosis (MS) using fractal analysis and radiomorphometric indices derived from panoramic radiographs.

A total of 34 patients diagnosed with MS and 34 healthy individuals were included in this study. Mandibular bone characteristics were evaluated using fractal dimension (FD) values, mandibular cortical width (MCW) measurements, and mandibular cortical index (MCI) categories. MS patients were divided into subgroups based on disease duration and the efficacy of disease-modifying therapy (DMT).

FD values did not differ significantly between the MS and control groups, except at the right anterior mental foramen. There was no significant difference in MCW between the groups. Regarding MCI, the proportion of individuals classified as C2 was significantly higher in the MS group than in the control group. Within the MS group, FD values of the right mandibular inferior cortical region were significantly higher in individuals classified as MCI C2 than in those classified as MCI C1 (p = 0.045). No significant relationship was observed between DMT subgroups and the MCW, FD, and MCI parameters. FD and MCI did not vary with disease duration; however, MCW was significantly lower in patients with disease duration >10 years.

This study found that the mandibular trabecular bone structure of MS patients was largely preserved. However, significant localized differences were observed in cortical bone parameters. These findings require confirmation through prospective studies involving larger patient populations.