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Not yet recruitingNCT07740889Updated Aug 3, 2026

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

An observational study in Onychophagia, sponsored by Recep Tayyip Erdogan University Training and Research Hospital. Not yet recruiting. Open to participants aged 8 Years to 10 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-03.

Sponsored by Recep Tayyip Erdogan University Training and Research Hospital · Observational

From the registry’s dates

  • Primary completion was expected by Aug 2026, 3 months ago, but the record still lists the study as not yet recruiting.
Study type
Observational
Model
Case-crossover
Time perspective
Retrospective
Enrollment
100
Ages
8 Years to 10 Years
Sex
All
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Study summary

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.

Read the detailed description

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.

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Conditions studied

  • Onychophagia
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In context

Lead sponsor

Recep Tayyip Erdogan University Training and Research Hospital is the lead sponsor of 88 studies on the registry; 19 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
8 Years to 10 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

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.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

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

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.
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Study design

Observational model
Case-crossover
Time perspective
Retrospective
Enrollment
100 participants (estimated)
Patient registry
No

Groups and cohorts

  • 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.

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What researchers measure

Primary outcomes

  1. Mandibular Trabecular Bone Structure Assessed by Fractal Dimension Analysis

    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.

    Time frame: Baseline

Secondary outcomes

  1. Panoramic Mandibular Index (PMI)

    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.

    Time frame: Baseline

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Study locations

No study locations are listed for this record.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 3, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07740889
Lead sponsor
Recep Tayyip Erdogan University Training and Research Hospital
Responsible party
DİLARA NİL GÜNAÇAR (Assoc.Prof., Recep Tayyip Erdogan University Training and Research Hospital) — Principal investigator
First posted
Aug 3, 2026
Start date
Jul 27, 2026 (estimated)
Primary completion
Aug 5, 2026 (estimated)
Completion
Aug 7, 2026 (estimated)
Last update
Aug 3, 2026

Study contacts

Dilara Nil GÜNAÇAR
Contact
dilaranil.tomrukcu@erdogan.edu.tr
+905412940104

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.

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