Pediatric validation of an AI-assisted smartphone application (WebCeph) for cephalometric analysis: reliability,...

Although AI-assisted cephalometric applications are widely used, most validation studies involve adult radiographs. Pediatric craniofacial landmarks show greater variability due to growth, which may influence automated landmark accuracy. Therefore, pediatric-specific validation of AI-based smartphone cephalometry is essential.

This study evaluated the reliability, reproducibility, and time-efficiency of an AI-assisted smartphone application (WebCeph) compared with manual cephalometric tracing in children.

A retrospective cross-sectional study was conducted on 51 lateral cephalograms of children aged 7-12 years. Manual tracings were performed by a calibrated examiner, and digital tracings were obtained using the WebCeph Android application. Linear and angular measurements were recorded for both methods. Intra-examiner reliability was assessed using intraclass correlation coefficients (ICC). Agreement between methods was evaluated using paired t-tests and Cohen's d. Tracing time was documented, and normality was confirmed using the Shapiro-Wilk test.

Both methods demonstrated high reliability. Most parameters showed no significant differences, although a few (SNA, ANB, L1-MP) showed statistically significant but clinically negligible discrepancies. ICC values indicated excellent agreement. WebCeph significantly reduced analysis time (9.4 ± 1.82 minutes), compared with manual tracing (19.4 ± 2.65 minutes).

The WebCeph AI-assisted smartphone application provides reliable and clinically comparable cephalometric measurements to manual tracing in pediatric patients, with substantial time savings. It may serve as an efficient adjunct to routine pediatric orthodontic diagnostics, with consideration for growth-related landmark variability.