The purpose of this study is to evaluate the relationship between radiomorphometric indices and fractal dimension (FD) analysis in jawbone radiographic density using Cone-Beam Computed Tomography (CBCT). The study included 87 CBCT datasets from dental patients aged 50-79. Four radiomorphometric indices (Computed Tomography Cortical Index (CTCI), Computed Tomography Mental Index (CTMI), Computed Tomography Index-Superior (CTI-S), and Computed Tomography Index-Inferior (CTI-I)) along with age, gender, remaining teeth, and mandibular bone height were evaluated. FD was assessed in trabecular bone near the mental foramen (ROI 1) and on the mandibular cortical bone (ROI 2). Relationships between indices and variables were analyzed using Pearson chi-square, Fisher's exact, one-way ANOVA, Kruskal-Wallis, and Spearman's rho tests. ANOVA showed significant differences in mandibular bone height (p = .004) and FD at ROI 2 (p = .000) across three mandibular cortex types (C1, C2, C3). Spearman's rho indicated significant correlations between FD at ROI 2 and CTMI, CTI-S, CTI-I (p = .000), and between mandibular bone height and CTMI (p = .010). The correlations of FD at ROI 2 ranged from strongest to weakest with CTCI, CTMI, CTI-S, and CTI-I. High-risk osteoporosis radiomorphometric indices are associated with FD analysis of cortical bone.
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