Association Between Vertical Skeletal Pattern and Mandibular Cortical Morphology: A CBCT-Based Radiomorphometric Study

Background/Objectives: Mandibular cortical morphology has been associated with vertical facial patterns, but differences in standardized radiomorphometric indices remain unclear. This study compared five mandibular indices among vertical skeletal patterns using CBCT-derived panoramic reconstructions. Methods: This retrospective cross-sectional study included 181 adults classified as hypodivergent (n = 42), normodivergent (n = 67), or hyperdivergent (n = 72) according to the sella–nasion-to-mandibular-plane angle. Mental (MI), panoramic mandibular (PMI), gonial (GI), antegonial (AI), and mandibular cortical (MCI) indices were assessed by a blinded dentomaxillofacial radiologist, and bilateral measurements were averaged. Continuous indices were compared using ANOVA or Welch ANOVA and ANCOVA adjusted for age and sex, and the MCI using the chi-square test and logistic regression. p values across the five indices were corrected using the Holm method. Results: No index differed significantly among the groups after correction for multiple comparisons. The MI showed the most notable nominal between-group difference (hypodivergent, 3.92 ± 0.73 mm; normodivergent, 3.73 ± 0.60 mm; hyperdivergent, 3.61 ± 0.68 mm). After adjustment for age and sex, the MI was 0.35 mm greater in hypodivergent than in hyperdivergent subjects (95% CI, 0.04–0.66), but the overall group effect did not remain significant after correction (p = 0.024; Holm p = 0.118). The unadjusted association between the MCI and vertical skeletal pattern (p = 0.035) did not remain significant after correction (Holm p = 0.174) or after adjustment. The PMI, GI, and AI showed no differences. Conclusions: After correction for multiple comparisons, vertical skeletal pattern was not significantly associated with any of the five radiomorphometric indices.