## 4 Discussion
\begin{table}
\begin{tabular}{c c c c c c c c c c} \hline \hline \multirow{2}{*}{**Group**} & \multirow{2}{*}{**Plane**} & \multirow{2}{*}{**Condyle**} & \multicolumn{3}{c}{**Fractal**} & \multicolumn{3}{c}{**Paired Differences**} \\ \cline{3-10}  & & & **Dimension** & & & **\%** & **Confidence Interval of Difference** & \(p\)**-Value** \\ \cline{3-10}  & & & **Mean** & **S.D.** & & & **Lower** & **Upper** & \\ \hline \multirow{4}{*}{Asymmetrical patients (n = 15)} & \multirow{4}{*}{Axial} & Hyperplastic & 1.215 & 0.036 & \multirow{4}{*}{0.065} & \multirow{4}{*}{0.061} & \multirow{4}{*}{0.032} & \multirow{4}{*}{0.099} & \multirow{4}{*}{0.001 \({}^{*}\)} \\  & & Contralateral & 1.150 & 0.069 & & & & & & \\ \cline{2-10}  & \multirow{4}{*}{Coronal} & Hyperplastic & 1.413 & 0.058 & \multirow{4}{*}{0.065} & \multirow{4}{*}{0.063} & \multirow{4}{*}{0.030} & \multirow{4}{*}{0.099} & \multirow{4}{*}{0.001 \({}^{*}\)} \\  & & Contralateral & 1.348 & 0.089 & & & & & & \\ \cline{2-10}  & \multirow{4}{*}{Sagittal} & Hyperplastic & 1.127 & 0.074 & \multirow{4}{*}{0.051} & \multirow{4}{*}{0.115} & \multirow{4}{*}{\(-\)0.013} & \multirow{4}{*}{0.115} & \multirow{4}{*}{0.110} \\  & & Contralateral & 1.077 & 0.086 & & & & & & \\ \hline \multirow{4}{*}{Symmetrical patients (n = 15)} & \multirow{4}{*}{Axial} & Right & 1.190 & 0.093 & \multirow{4}{*}{0.014} & \multirow{4}{*}{0.106} & \multirow{4}{*}{\(-\)0.045} & \multirow{4}{*}{0.073} & \multirow{4}{*}{0.626} \\  & & Left & 1.177 & 0.063 & & & & & & \\ \cline{2-10}  & \multirow{4}{*}{Coronal} & Right & 1.373 & 0.115 & \multirow{4}{*}{0.009} & \multirow{4}{*}{0.134} & \multirow{4}{*}{\(-\)0.065} & \multirow{4}{*}{0.083} & \multirow{4}{*}{0.793} \\  & & Left & 1.364 & 0.121 & & & & & & \\ \cline{2-10}  & \multirow{4}{*}{Sagittal} & Right & 1.177 & 0.181 & \multirow{4}{*}{0.089} & \multirow{4}{*}{0.037} & \multirow{4}{*}{0.155} & \multirow{4}{*}{\(-\)0.049} & \multirow{4}{*}{0.022} & \multirow{4}{*}{0.735} \\ \cline{2-10}  & & Left & 1.140 & 0.089 & & & & & & \\ \hline \hline \end{tabular} n: sample size; S.D. standard deviation; \({}^{*}\) Wilcoxon test: \(p\)-value < 0.05 indicates statistical significance.  
\end{table} 
Table 1: Mean values of fractal dimensions. CBCT scans of hyperplastic condyles were not used to compare FD with contralateral unaffected condyles in any of the published studies known to the authors. [PERSON] et al. [35] analyzed FD on panoramic X-rays of asymmetric patients and found statistically significant differences in the FD values: FD was higher in the left condyle in patients with right asymmetry and in the right condyle in patients with left asymmetry. They concluded that FD was greater in the condyle responsible for the asymmetry. These results are in line with those obtained in the present study in that all the hyperplastic condyles had higher FD values than the unaffected condyles. Furthermore, the differences in FD were statistically significant in the axial plane of the hyperplastic condyles. The mandibular condyles with hyperplasia shown by micro-CT analysis had different bone structures than the unaffected condyles, showing a higher cortical porosity, higher bone volume fraction, higher trabecular thickness and trabecular separation, higher number of trabeculae and lower mineralization [20]. Focal anomalies of the bone microarchitecture, including foci of osteogenesis, were detected by three-dimensional micro-CT models. These foci contained islands of calcified cartilage matrix with live chondrocytes, according to histological sections [53]. Hyperplastic condyles show a thicker cartilage stratum than healthy condyles [54,55]. This stratum might be more evident in the axial and coronal planes, which might explain why a significant difference in FD was shown between the hyperplastic and contralateral condyle in these projections. There are several limitations of this study.