Evaluation of 3-year changes in panoramic radiomorphometric indices and fractal dimension values in primary hyperparathyroidism patients.

At 3 years, AI values were 3.55 mm in the control group and 3.24 mm in the PHPT group; here, the difference was at the borderline level of statistical significance ( p ≈0.050) and should be interpreted cautiously in light of multiple comparisons.

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By age group, the difference was more pronounced in participants younger than 35 years, whereas it did not reach statistical significance in those aged ≥ 35 years.

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Given the small effect sizes, the borderline significance at baseline, and multiple comparisons, integration of these metrics into screening or diagnostic algorithms should await confirmation in larger, multicenter, prospective studies that include contemporaneous biochemical profiling and reproducibility assessments.

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