Differences in cephalometric measurements: a comparison of digital versus hand-tracing methods

The aim of this study was to evaluate the accuracy of cephalometric measurements using computerized tracing of direct digital radiographs in comparison with hand tracing of digital radiographic printouts. Comparisons were made between methods in terms of accuracy of individual measurements as well as evaluation of treatment outcomes. Pre- (T1) and post- (T2) treatment cephalometric digital radiographs of 30 patients were traced using the Vistadent OC 1.1 computer software program (group 1) and manually (group 2) by the same investigator. A total of 26 anatomical landmarks were located and measured. Measurement reproducibility was evaluated by calculating intraclass correlation coefficients, and paired t-tests were used to compare differences in individual measurements and treatment outcomes between methods. Differences greater than 0.05 were considered to be statistically significant. Significant differences were found between the two methods for SNB, Wits appraisal, Cd-A, Cd-Gn, FMA, SN-PP, U1-NA (mm), U1-FH, L1-NB (mm), and Li-E plane. No significant differences were found between the two methods in the measurement of treatment changes. Cephalometric measurements of most parameters were reproducible for both methods. Despite some discrepancies in measured values between hand-tracing and the computerized method, any differences were minimal and clinically acceptable.