Mandibular Osseous Changes in Children and Adolescents With Beta Thalassemia Major: A Panoramic Radiomorphometric Study.

BACKGROUND: Beta thalassemia major is an inherited hemoglobin disorder characterized by deficient β-globin production, chronic anemia, and expansion of hematopoietic marrow. Prolonged marrow activity can alter craniofacial bone architecture and reduce mandibular cortical integrity. OBJECTIVE: This study compared mandibular cortical characteristics in children and adolescents with beta thalassemia major and matched healthy participants using panoramic radiomorphometric measurements. METHODS: Sixty participants aged 8-19 years were included: 30 individuals with beta thalassemia major and 30 age- and sex-matched controls. Digital panoramic radiographs were examined using the Mental Index, Panoramic Mandibular Index, Antegonial Index, Gonial Index, and Mandibular Cortical Index. Repeat measurements were used to determine intraobserver agreement, and intergroup differences were assessed using appropriate statistical tests. RESULTS: The thalassemia group showed lower values for all quantitative mandibular cortical indices than the control group. Eroded C2 and C3 cortical patterns were also more frequent among affected participants, indicating reduced cortical integrity and increased endosteal remodeling. CONCLUSION: Panoramic radiomorphometric assessment can identify mandibular cortical alterations in young patients with beta thalassemia major and may support opportunistic screening during routine dental imaging.