Objectives: To test the capacity of the digital tool, fractal dimension (FD) analysis, in identifying subtle differences in bone pattern in patients with renal osteodystrophy (RO), correlated with the time of hemodialysis, in different regions of interest, delineated on panoramic and periapical radiographs. Study design: A total of 34 patients with chronic renal disease undergoing hemodialysis were submitted to panoramic and periapical radiographs. Different regions of interest were delineated on the mandibular body and ramus. FD was analyzed by means of the software program ImageJ and correlated with the time of hemodialysis. Results: The sample consisted of 34 subjects. The time of hemodialysis varied from 1 to 286 months. There was significant correlation between the time of hemodialysis and the FD values in the region delineated in the mandibular angle ([Formula: see text]) and this was shown in the periapical radiographs as well ([Formula: see text]). Conclusions: FD analysis was a useful tool in detecting alterations caused by RO in bone pattern, in panoramic and periapical radiographs.