The aim of this study was to evaluate the mandibular bone changes on panoramic radiographs of thalassemia and sickle cell anemia (SCA) patients using fractal dimension (FD) analysis and to compare the findings obtained from healthy individuals.A total of 90 panoramic radiographs (from 30 patients with thalassemia, 30 patients with SCA and 30 healthy individuals) were assessed to measure FD, mandibular cortical width (MCW), panoramic mandibular index (PMI) in the mandible. Three region of interests (ROI) of angulus, corpus, and interdental bone were created. FD was calculated using ImageJ program.In thalassemia group, the mean value of FD was 1.11, 1.03, and 1.02 in interdental bone, corpus, and angulus, respectively. In SCA group, the mean value of FD was 1.10, 1.05, and 1 in interdental bone, corpus, and angulus, respectively. In control group, the mean value of FD was 1.09, 1.04, and 1 in interdental bone, corpus, and angulus, respectively. FD value of interdental bone are significantly higher in thalassemia group than control group. FD values of corpus and angulus values did not show a significant difference between the groups.Fractal analysis may be used and recommended for evaluation of the bone changes induced by hemoglobinopathies.