Accuracy of digital vs. manual cephalometric tracing: A systematic review

This systematic review aimed to assess the accuracy of digital cephalometric tracing with manual hand tracing.

PubMed, SCOPUS and Web of Science databases were searched for relevant articles. After an initial search, which revealed 279 potentially relevant articles, their titles and abstracts were screened. After screening, 23 full-text articles were assessed in depth. Fifteen publications were removed from the analysis considering the predetermined inclusion criteria. The quality of the methodology of the selected 9 studies was analyzed using 12-point criteria, which included study design, measurement, and statistical analysis.

The data thus collected was analyzed for reliable and reproducible variables. All studies were carried out on the digital format of lateral cephalograms. The analysis included both angular and linear measurements. The results brought about statistically significant differences in certain methods and were clinically acceptable even though they were minimal. A few measured variables were the cephalogram quality, lip posture, positioning, and difficulty in locating landmarks.

This review concluded that digital cephalometric tracing was equally reliable as tracing manually, with a moderate quality of evidence. This study also suggested that the literature presented here was accurate enough for clinical application. Thus, digital cephalometric analyses can potentially improve the workflow in clinical and research settings saving time and effort. PROSPERO - registration number (CRD42024537255).