Quantitative assessment of regional variability in mandibular bone density based on cone-beam computed tomography data

Despite the widespread use of cone-beam computed tomography, regional variations in cortical and trabecular bone density remain insufficiently characterised. The aim of this study was to assess mandibular bone density across different anatomical regions and to identify clinical situations in which pre-implant bone augmentation may be required. The methodology involved the analysis of cone-beam computed tomography data with quantitative assessment of bone density in the anterior, premolar, and molar regions of the mandible. The highest bone density values were observed in the anterior mandible, averaging 944.9 ± 207 HU in the control group and 910.2 ± 198 HU in edentulous patients (p > 0.05). In the premolar region, bone density decreased to 643.8 ± 162 HU in the absence of teeth, compared with 826.4 ± 175 HU in dentate individuals (p < 0.05). The most pronounced reduction was identified in the molar region, where values reached 512.5 ± 148 HU in edentulous patients versus 789.7 ± 160 HU in the control group (p < 0.01), confirming the adverse effect of prolonged posterior tooth loss on bone quality. Furthermore, reduced bone density in the distal mandible was associated with compromised cortical bone characteristics, potentially affecting the primary stability of dental implants. These regional differences should be taken into account when selecting implant dimensions and planning the extent of bone augmentation, particularly in patients with long-standing edentulism. The findings are clinically relevant for optimising implant treatment strategies, determining the need for bone augmentation, and improving the predictability of surgical outcomes