Intra- and Inter-examiner Reliability of the Genial Tubercle Versus Menton as Landmarks in Symmetric and Asymmetric Mandibles: A Cone-Beam Computed Tomography Study

Objective: This study aimed to assess intra-and inter-examiner reproducibility in identifying the genial tubercle (mental spine) and menton on cone-beam computed tomography (CBCT) images of adults with symmetric or asymmetric mandibles.Materials and methods: Forty CBCT datasets (20 per group) were evaluated independently by an orthodontist with more than five years of experience and a second-year orthodontic resident.Each examiner repeated the assessments after one week.Landmark positions were recorded relative to three orthogonal reference planes.Intraclass correlation coefficients and Bland-Altman agreement statistics were reported.Results: The reported intra-examiner coefficients ranged from 0.827 to 1.000 and inter-examiner coefficients from 0.829 to 0.998 across landmark-axis combinations.Patterns varied by axis and assessment; neither landmark was uniformly superior.The agreement analysis suggested small mean measurement differences; however, discrepancies in the reported values require verification.Group-level comparisons cannot currently be interpreted as evidence of equivalent diagnostic performance because the reported transverse values conflict with the stated >2-mm asymmetry criterion.Conclusions: Both landmarks demonstrated generally high reported reliability coefficients across repeated measurements in this cohort.The study does not establish anatomical accuracy, diagnostic interchangeability, or superiority of one landmark; these require independent validation and access to the underlying measurement data.