Cortical Bone Width Research Articles

A Comparison of Deep Learning vs. Dental Implantologists in Cone-Beam Computed Tomography-Based Bone Quality Classification.

Bone quality assessment is crucial for pre-surgical implant planning, influencing both implant design and drilling protocol selection. The Lekholm and Zarb (L&Z) classification, which categorizes bone quality into four types based on cortical bone width and trabecular bone density using cone-beam computed tomography (CBCT) data, lacks quantitative guidelines, leading to subjective interpretations. This study aimed to compare the performance of deep learning (DL)-based approaches against human examiners in assessing bone quality, according to the L&Z classification, using CBCT images. A dataset of 1100 CBCT cross-sectional slices was classified into four bone types by two oral and maxillofacial radiologists. Five pre-trained DL models were trained on 1000 images using MATLAB®, with 100 images reserved for testing. Inception-ResNet-v2 achieved the highest accuracy (86.00%) with a learning rate of 0.001. The performance of Inception-ResNet-v2 was then compared to that of 23 residency students and two experienced implantologists. The DL model outperformed human assessors across all parameters, demonstrating excellent precision and recall, with F1-scores exceeding 75%. Notably, residency students and one implantologist struggled to distinguish bone type 2, with low recall rates (48.15% and 40.74%, respectively). In conclusion, the Inception-ResNet-v2 DL model demonstrated superior performance compared to novice implantologists, suggesting its potential as an supplementary tool for cross-sectional bone quality assessment.

Tooth-Bone-Borne vs Bone-Borne Rapid Maxillary Expanders on Dentoskeletal Changes.

This study compared the insertion and thickness of the cortical bone, the parallelism of the midpalatal suture, and the skeletal transverse dimension using a microimplant-assisted rapid palatal expansion (MARPE) with those produced by bone-anchored maxillary expander (BAME) in adults. The sample comprised 18 patients (mean age, 29.9±9.4 years) selected for the MARPE group and 18 (mean age 24.8±6.8 years) selected for the BAME group. Cone-Beam computed tomography scans taken just before and after the expansion. After treatment, there was a significant palatal depth decrease. In addition, maxillary and mandibular width were increased in both groups. Regarding the cortical bone insertion and cortical bone width, it is shown an increase in both groups but those changes are not significant. However, the anterior suture opening effect occurs more frequently in the BAME than in the MARPE device. There are no differences in the frequency of opening of the midpalatal suture in the cases treated with MARPE and BAME, in both cases the most frequent opening morphology is parallel, independently of midpalatal suture maturation. There are no differences in the use of MARPE or BAME in the parallelism of the middle palatal suture, the cortical bone insertion, and thickness according to the maturation stages of the midpalatal suture but significantly increases the transverse dimensions of the maxillary skeleton.

Effect of breathing patterns on mandibular cortical bone quality in children and establishment of a preliminary screening model

ObjectiveThis retrospective study analyzed breathing patterns and age subgroups effect on cortical bone quality of the mandible in growing subjects, aiming to explore the application value of facial skeletal pattern combined with cortical bone density detection in early screening diagnosis of mouth breathing.MethodsOne hundred twenty-six participants were divided into four groups: mouth breathing group (7–9, 10–12 years old) and nasal breathing group (7–9, 10–12 years old). The mandibular anterior, middle, and posterior cortical bone mineral density (CBMD), cortical bone width (MCW), ANB, and FMA values were measured. Independent T-test and Mann–Whitney U test were used to compare the measured values. Binary logistic regression was employed to analyze the correlation between measured variables and the children’s breathing patterns. ROC analysis was used to determine the ability of the cortical bone density measurements in early screening diagnosis of MB.ResultsMouth breathing had a negative impact on CBMD and MCW of the pre-mandibular (Pog) in subjects aged 7–9 years and also impacted the development of (Pog) and submandibular (Me) sites in subjects aged 10–12 years. Older children in the nasal breathing group have higher CBMD, MCW, and SNB values and lower FMA values. Single-factor and multiple-factor logistic binary regression analysis showed that FMA, MSPogCBMD, MSPogMCW, and ANB are correlated factors for children at risk of mouth breathing.ConclusionMouth breathing pattern is closely associated with decreased mandibular CBMD and MCW values in children aged 7–12, where the anterior (Pog) and inferior (Me) sites of anterior mandible are more significantly affected. Furthermore, in combination with facial skeletal pattern, it provides a basis for the early warning diagnosis of mouth breathing.

A Cone Beam Computed Tomography Analysis of Bone Volume Variations of Extra-alveolar Region Based on Sex, Age, Vertical and Sagittal Facial Patterns.

The goal of this study is to measure mandibular buccal shelf (MBS) concerning angulation, bone volume, and cortical bone volume as well as bone depth and cortical bone depth of infrazygomatic crest (IZC) via cone beam computed tomography and evaluate the measurements according to sex, age, vertical, and sagittal facial types. This study collected lateral cephalograms and cone beam computed tomography scans from 100 individuals, which were used to observe angulation, bone and cortical bone volume entailing width and depth of MBS as well as the depth of IZC. FH-MP (mandibular plane angle) and A point-Nasion-B point were adopted to determine vertical and sagittal facial patterns respectively. Bone widths at 6mm and 11mm to cementoenamel junction (CEJ) and cortical bone width at 6mm to CEJ in MBS showed significant sex differences, while bone depths and cortical bone depths in IZC show significant age difference( P <0.05). Bone width and cortical bone width at 6mm to CEJ at the mesial root and 11mm to CEJ at both roots as well as angulations of MBS in the mandibular first molar region, bone depth and cortical bone depth at the maxillary first molar distal buccal root, and the proximity region were all correlated to FH-MP ( P <0.05). Short-faced individuals of Asian ethnicity tend to have greater bone width, greater projection in MBS, and greater bone depth in the posterior region of IZC. The optimal implant sites are 11mm apical to CEJ at the mandibular second molar distal root and 65° at the maxillary first molar mesial root.

Bone-Derived IGF-I Regulates Radial Bone Growth in Adult Male Mice.

Insulin-like growth factor-I (IGF-I) levels, which are reduced by age, and cortical bone dimensions are major determinants of fracture risk in elderly subjects. Inactivation of liver-derived circulating IGF-I results in reduced periosteal bone expansion in young and older mice. In mice with lifelong depletion of IGF-I in osteoblast lineage cells, the long bones display reduced cortical bone width. However, it has not previously been investigated whether inducible inactivation of IGF-I locally in bone in adult/old mice affects the bone phenotype. Adult tamoxifen-inducible inactivation of IGF-I using a CAGG-CreER mouse model (inducible IGF-IKO mice) substantially reduced IGF-I expression in bone (-55%) but not in liver. Serum IGF-I and body weight were unchanged. We used this inducible mouse model to assess the effect of local IGF-I on the skeleton in adult male mice, avoiding confounding developmental effects. After tamoxifen-induced inactivation of the IGF-I gene at 9 months of age, the skeletal phenotype was determined at 14 months of age. Computed tomography analyses of tibia revealed that the mid-diaphyseal cortical periosteal and endosteal circumferences and calculated bone strength parameters were decreased in inducible IGF-IKO mice compared with controls. Furthermore, 3-point bending showed reduced tibia cortical bone stiffness in inducible IGF-IKO mice. In contrast, the tibia and vertebral trabecular bone volume fraction was unchanged. In conclusion, inactivation of IGF-I in cortical bone with unchanged liver-derived IGF-I in older male mice resulted in reduced radial growth of cortical bone. This suggests that not only circulating IGF-I but also locally derived IGF-I regulates the cortical bone phenotype in older mice.

Investigation of the effect of oral and internal bisphosphonate use on bone density in the jaws in patients with osteoporosis in panoramic radiography

This study aims to quantitatively evaluate the effects of bisphosphonate use duration and route of administration on mandibular cortical and trabecular bone in postmenopausal women. Ninety postmenopausal women over the age of 50 were included in this study. Trabecular bone density was specified numerically by fractal dimension (FD) in the region of interest selected on the panoramic radiograph. The width of the mandibular cortical (MCW) bone under the mental foramen of the mandible was measured. Mann-Whitney U test was used for parameters that did not show a normal distribution. Spearman rho correlation test was used to determine the relationship between continuous measurement parameters. It was observed that FD and MCW of dentate and edentate individuals using bisphosphonate were statistically significantly lower than those of healthy individuals (P < .05). There was no significant correlation was found between the duration of use of bisphosphonates and the fractal values obtained from the relevant regions of the mandible (P > .05). Fractal dimension was found to be lower in oral bisphosphonate use than in intravenous bisphosphonate use. The width of the mandibular cortical bone values was found to be lower in individuals using bisphosphonate than in healthy individuals. Fractal dimension and MCW may benefit clinicians as quantitative parameters in panoramic radiography in the diagnosis of osteoporosis.

Impact of a modified implant macrogeometry on biomechanical parameters and bone-related markers in rats.

This study investigated the impact of a modified implant macrogeometry on peri-implant healing and its effect on bone-related molecules in rats. Eighteen rats received one implant in each tibia: the control group received implants with conventional macrogeometry and the test group received implants with modified macrogeometry. After 30 days, the implants were removed for biomechanical analysis and the bone tissue around them was collected for quantifying gene expression of OPN, Runx2, β-catenin, BMP-2, Dkk1, and RANKL/OPG. Calcein and tetracycline fluorescent markers were used for analyzing newly formed bone at undecalcified sections of the tibial implants. These fluorescent markers showed continuous bone formation at cortical bone width and sparse new bone formed along the medullary implant surface in both groups. However, higher counter-torque values and upregulation of OPN expression were achieved by test implants when compared to controls. The modified macrogeometry of implants optimized peri-implant healing, favoring the modulation of OPN expression in the osseous tissue around the implants.

Evaluation of the correlation between facial index and the cortical bone thickness of the maxilla and mandible—A computer tomography based study

Objectivescortical bone thickness confines the position of teeth and thus can be a limiting factor for orthodontic tooth movement. The study is aimed to correlate the cortical bone thickness of the maxilla and mandible with that of different face types, viz; dolichofacial, brachyfacial, and mesofacial. MethodsForty CT scans were analysed for the face types and were grouped into dolichofacial (13), brachyfacial (13) and mesofacial (14) face types. The scans were measured for the right and left side buccal and lingual cortical bone thickness at the central incisor, first and second molar regions on both the maxilla and mandible. Other parameters like basal cortical bone thickness, height, and width of cortical bone were also measured. To determine the correlation and difference between the different parameters, the obtained data was subjected to the correlation coefficient, t test, and ANOVA statistical analysis. ResultsMaxillary buccal cortical bone thickness of central incisors was found to be highly correlated to facial index with a correlation coefficient of − 0.833 * *. Mandibular buccal bone thickness correlated with face type and cortical bone thickness at the central incisor, first, and second molars by-0.531 * *, − 0.474 * *, and − 0.589 * *, respectively. There was a significant difference between the right and left side cortical bone thickness (p < 0.05) and also for all the parameters amongst the different face types (p < 0.05). ConclusionThere exists a definite correlation between the face type and the certain anatomical measurements of cortical bone morphology. Dolichofacial face types show thin buccal cortical bone, which implies the limitation of orthodontic tooth movement in these types of individuals.

Evaluation of the Nasopalatine Canal (NPC) in a subset of Pakistani population, using Cone Beam Computed Tomography (CBCT).

To evaluate variations in the shape, diameter, length and width of the nasopalatine canal along with the width of the buccal cortical bone anterior to it, using cone beam computed tomography imaging. The retrospective, cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from September to October 2020, and comprised pre-existing cone beam computed tomography scans taken between 2015 and 2020 of patients of either gender aged 18-60 years who had maxillary central incisors present. The shapes and dimensions of the nasopalatine canal were observed along with the buccal bone anterior to the nasopalatine canal. Data was compared with respect to age and gender. Data was analysed using SPSS 23. Of the 90 scans evaluated, 46(51.1%) belonged to females with a mean age of 37.85±18.19 years, and 44(48.9%) belonged to males with a mean age of 38.07±13.58 years. The mean length and width of the nasopalatine canal was 11.28±1.90mm and 2.62±0.91mm, respectively. The nasopalatine canal was significantly longer (p<0.01) and wider (p=0.02) in males than females. The mean diameter of foramen of Stenson was 2.99±1.17mm and incisive foramen was 6.09±1.80mm. The mean width of the buccal cortical bone at the most coronal, middle and most incisal levels was 7.20±1.70mm, 6.12±1.31mm and 6.12±1.31mm, respectively. Buccal bone width was wider in males than females, but the difference was significant only at the midpoint (p<0.05). There was a significant difference in the dimensions of the width and length of the NPC with respect to gender. No significant differences were observed with respect to age.

Computer-Aided System of the Mandibular Cortical Bone Porosity Assessment on Digital Panoramic Radiographs.

The loss of bone mineral density (BMD) in various sites of the body, including the mandible, is the main sign of osteoporosis. Thus, the computer-aided diagnosis (CAD) system was developed for bone density assessment and patients were classified into normal, osteopenia, and osteoporosis groups using a digital panoramic radiograph. Data of dental panoramic radiographs and corresponding BMD assessments from 123 postmenopausal women were collected. For the proposed CAD system test, regions of interest (ROI) that were located below the left and right mental foramen on dental panoramic radiographs were determined. The width and texture of the mandibular cortical bone in each ROI were used to classify the data into normal, osteopenia, and osteoporosis classes. The width of the mandibular cortical was measured using the polynomial fitting method. The texture feature of the cortical bone is obtained by calculating the average value of the grayscale intensity of cortical bone. The classification result was obtained by using a multiclass support vector machine. The experimental results using 10-fold cross-validation showed that the proposed system achieved an average accuracy of 86.50% for osteoporosis classification on dental panoramic radiographs. The average misclassification error and relative foreground area error of the segmentation process were 5.21 and 12.98%, respectively. From the analysis of the cortical width measurement process, highest average mandibular cortical width (MCW) was found in the normal patient category compared with the other classes. This research showed that the proposed computer-aided system can be used for osteoporosis and osteopenia assessment by measuring the MCW and texture on dental panoramic radiographs with the average system accuracy of 89.52%.

Three-dimensional morphological analysis of the thoracic pedicle and related radiographic factors in adolescent idiopathic scoliosis

BackgroundThis study aimed to investigate the laterality of the pedicle morphology at the apical vertebra (AV) level and identify the radiographic factors associated with the laterality ratio of the pedicle morphology at the AV level in patients with adolescent idiopathic scoliosis (AIS).MethodsOverall, 684 pedicles in 57 AIS patients aged 10–20 years, who underwent preoperative computed tomography (CT) and had Lenke type 1 or 2 with right convex main thoracic curves (MTC), were evaluated. Pedicle diameters of the MTC were assessed. We defined and compared the region containing two vertebrae adjacent to the AV (APEX±1) and the region containing two vertebrae adjacent to the neutral vertebra. We analyzed the pedicle diameter and laterality ratio of APEX±1 and performed multiple linear regression analysis to identify the radiographic factors associated with the laterality of the pedicle diameter.ResultsOn the concave side of APEX±1, the pedicles of 15 patients (26.3%) did not accept a 4-mm-diameter pedicle screw (PS), even with 25% cortical bone width expansion. Laterality ratio differences in the pedicle diameters of the cortical bone width in APEX±1 were large in patients with more proximal AV level (p < 0.001) and smaller apical vertebral rotation (AVR) (p = 0.029).ConclusionsPreoperative planning to accurately select and insert the PS in AIS should be based on the anatomical limitations in APEX±1, AV level, and AVR degree. In APEX±1, the correlation between AVR and the laterality ratio of the pedicle diameter may be useful for pathoetiological interpretation of the AIS deformity.

Comparison of panoramic mandibular cortical bone quality indexes in amlodipine users and healthy individuals

Hypertension and osteoporosis are believed to be linked to to each other. Previous studies have suggested that the imbalance of calcium metabolism in hypertensive condition and the use of calcium channel blockers such as amlodipine may lower the density and quality of bone. Panoramic radiography has been widely used as a reliable tool in assessing bone quality. One indicator of bone quality in panoramic radiograph is the macrostructure evaluation of mandibular cortical bone by using various indexes such as mandibular cortical index (MCI) and antegonial index (AI). This research aimed to compare the bone quality of hypertensive patients with amlodipine and healthy individuals using MCI and AI. In this study we used sixty panoramic radiographs of hypertensive patients with amlodipine and healthy individuals, thirty for each group, with various aspects of demography. The MCI analysis was done by dividing the mandibular cortical shape into three different qualitative categories and the AI analysis was done quantitatively by measuring the width of mandibular cortical bone in antegonial region using ImageJ software. There were statistically significant differences in the results between the two groups in terms of both AI (p = 0.000) and MCI (p = 0.001) in which hypertensive group had lower score. Based on this research, there were differences of mandibular bone quality of hypertensive patients with amlodipine and healthy individuals, particularly in its macrostructure.

Risk Assessment of Condylar Fractures Associated with Mandibular Cortical Bone Width Using Computed Tomography

Risk Assessment of Condylar Fractures Associated with Mandibular Cortical Bone Width Using Computed Tomography

Aluminum intake in the neonatal phase disrupts endochondral ossification in rodents

ObjectiveThis study evaluated the effects of aluminum (Al) intake on endochondral ossification during the neonatal phase. MethodTwelve male newborn Gerbils (Meriones unguiculatus) were randomly divided into control (C) and aluminum (Al) groups (n = 6 animals/group). From the 1st to 15th day of life, gerbils received an AlCl3 solution (10 mg/kg/day) via gavage. The control group received only the saline solution. On the 16th day, their tibias were processed for paraffin embedding and were submitted to histomorphometric, histochemical, and immunohistochemical analyses. ResultsIn the epiphyseal cartilage Al did not affect the proteoglycan content or cell proliferation; however, it increased matrix metalloprotease-2 (MMP-2) immunostaining and the hypertrophic layer thickness. In bone, Al decreased trabeculae number, trabecular width, cortical bone width, and proliferation. Furthermore, the relative frequency of bone matrix and fibrillar collagen decreased 3.9% and 16.2%, respectively. The number of osteoclasts and osteocalcin digital optical density (D.O.D) remained the same. ConclusionThe results suggest that Al intake during the neonatal period impairs endochondral ossification by affecting epiphyseal cartilage and bone architecture.

Relationship between torus mandibularis and mandibular cortical bone width using computed tomography

AbstractPurposeThis study aimed to investigate the relationship between mandibular cortical width (MCW) and torus mandibularis (TM) using computed tomography (CT).Materials and methodsThis retrospective case–control study included 34 patients with TM and 34 age‐ and sex‐matched patients without TM who underwent CT at our hospital between April 2017 and December 2020. TM was identified by a radiologist from CT scans as an exostosis continuous with the lingual cortical bone of the mandible. Patients with a history of bisphosphonate use, malignancy, or mandibular fractures were excluded from this study. The MCW was measured by estimating the thickness of the cortical bone at the lower edge of the bilateral mandible using a CT coronal slice and calculating the average value. Nonparametric Mann–Whitney U tests were used to assess the differences in continuous variables based on the MCW and mandibular cortical index status.ResultsThe MCW was significantly associated with the TM.ConclusionThe results of this study suggested that the MCW may be associated with the development of TM. MCW on CT images may help predict the future development of TM.

Case Report: Postmortem bone histomorphometric analysis in a 38-year-old Japanese man with immobilization osteoporosis because of orthostatic hypotension related to amyloid light chain amyloidosis

We performed a postmortem bone histomorphometric analysis of iliac bone on a 38-year-old man who had been bedridden for the nine months before his death because of orthostatic hypotension and severe malnutrition related to amyloidκ-light-chain amyloidosis. Cancellous bone volume was greatly decreased, with a trabecular bone volume to total bone volume ratio of 6.77% (normal value, 19.56% ± 5.62%). Trabecular thinning was also apparent, with a trabecular thickness of 78.9 μm (normal value, 131.3 ± 28.1 μm), although the trabecula was still preserved. Cortical bone width was normal, although areas of porosity area were clear throughout the cortical bone. Our findings indicate that immobilization-related osteoporosis may be closely associated with loss of cancellous bone.

Accuracy of Subaxial Cervical Pedicle Screw Placement Using Direct Visualization Versus Computed Tomography-Based Navigation.

Retrospective analysis of operative data from cadaveric cervical spines. To evaluate the accuracy of neuronavigation compared with laminotomy with direct visualization (DV) of the pedicle for placement of subaxial pedicle screws. Subaxial pedicle screws provide superior fixation compared with other posterior cervical fixation strategies. However, high accuracy is required for safe placement, given the proximity of critical neurovascular structures. Computed tomography (CT)-based neuronavigation has increased in popularity for placement of spinal implants, including subaxial pedicle screws. However, the accuracy of the technique for this application has not been extensively evaluated. Six fresh-frozen cadaveric spines (occiput to T2) were prepared. Pedicle screws were placed from C3 to C7 on either side using either the DV or neuronavigation technique (alternating sides between specimens). Pedicles with diameters <4 mm were excluded. For the DV technique, a hemilaminotomy was performed for DV of pedicle borders and to determine appropriate screw medialization and trajectory. Neuronavigation screws were placed using CT-based navigation with a reference frame mounted on the C2 spinous process. Screw position was evaluated using postoperative CT, and breaches were classified using the Neo classification. Fifty pedicle screws were placed at 25 levels in 6 cadaveric spines; 25 screws each were placed using neuronavigation or DV. No significant difference in accuracy was found between the 2 techniques. Three (12%) breaches occurred in the DV group, and 9 (36%) breaches occurred in the neuronavigation group (P=0.10). The breaches were evenly distributed across all levels. There were no high-grade breaches with DV and only 1 (4.0%) with neuronavigation (P>0.99). Average pedicle cortical and medullary bone widths were higher for levels with no breach (P=0.009 and P=0.02, respectively). High accuracy can be achieved with both neuronavigation and DV for placement of subaxial cervical pedicle screws in cadavers.

Mild stimulatory effect of a probiotic mix on bone mass when treatment is initiated 1.5 weeks after ovariectomy in mice.

Studies in humans and rodents show that probiotic bacteria can protect from bone loss caused by sex steroid deficiency. We showed earlier that a mixture of three probiotic bacteria, Lacticaseibacillus paracasei DSM13434, Lactiplantibacillus plantarum DSM 15312, and DSM 15313 (L. mix), protects mice from ovariectomy (ovx)-induced bone loss when treatment was started 2 wk before sham and ovx surgery. In addition, the same probiotic treatment protected against lumbar spine bone loss in early postmenopausal women. In the present study, we wanted to evaluate the therapeutic potential of L. mix by starting treatment 1.5 wk after ovx when most of the rapid bone loss as a result of estrogen deficiency has already occurred. Treatment with L. mix for 5.5 wk increased the trabecular thickness but not the trabecular number in the proximal metaphyseal region of tibia compared with vehicle treatment. Cortical thickness and cortical area of the middiaphyseal part of the tibia were significantly decreased in ovx mice but not in L. mix-treated ovx mice. The bone-protective effects of L. mix in ovx mice were associated with a protection against ovx-induced reduction of the frequency of regulatory T-cells and of the expression of Tgfβ in the bone marrow. In conclusion, the probiotic L. mix exerted a mild stimulatory effect on trabecular and cortical bone width when treatment is initiated 1.5 wk after ovariectomy in mice. This effect was associated with effects on bone-protecting regulatory T-cells. The results suggest that L. mix may exert beneficial effects on bone mass when treatment is started after ovariectomy.NEW & NOTEWORTHY The probiotic L. mix exerted a mild stimulatory effect on trabecular and cortical bone width when treatment is initiated 1.5 wk after ovariectomy in mice. This effect was associated with effects on bone-protecting regulatory T-cells. The results suggest that L. mix may exert beneficial effects on bone mass when treatment is started after ovariectomy.

Risk Assessment of Jawbone Fracture by Mandibular Cortical Bone Width Using Computed Tomography

Risk Assessment of Jawbone Fracture by Mandibular Cortical Bone Width Using Computed Tomography

Automatic measurement of mandibular cortical bone width on cone-beam computed tomography images

The computed tomography cortical index (CTCI), computed tomography mandibular index (CTMI), and computed tomography index (inferior) [CTI(I)] are indexes obtained from cone-beam computed tomography images for the assessment of the mandibular cortex quality for implant planning or osteoporosis. However, cross-sectional image reconstruction for the measurements is labor-intensive. This study aimed to develop and evaluate a method to automatically reconstruct cross-sectional images and measure the cortex width in all areas inferior to the mental foramen (MF). Seventy-one women (mean age: 52.4years; range: 20-78years) were enrolled. They were divided into four age and CTCI groups, including females younger (FY) and females older (FO) than 50years (C1: normal, C2: mild/moderate erosion, and C3: severe porosity). Automatic and manual measurements of CTMI and CTI(I) were compared, and the inter- and intraobserver agreements were assessed using the intraclass correlation coefficient (ICC). The relationships between CTMI or CTI(I) and CTCI were also assessed. The mean processing times for reconstruction and measurements were 31.9s and 1.22s, respectively. ICCs for the comparison of automatic and manual measurements were 0.932 and 0.993 in the C1 and C2/C3 groups, respectively. Significant differences in CTMI and CTI(I) were observed between the FY or the FO-C1 and FO-C3 groups (p < 0.05). The automatic and manual measurements showed a strong agreement. The new method could drastically reduce routine clinical workload. Additionally, our method enables the measurement of the cortex width in all the mandibular bones inferior to the MF.