Reliability in Landmark Plotting between Manual and Computerized Method - A Cephalometric Study

Introduction: In orthodontics, cephalometrics plays a key role in diagnosis and treatment planning. Cephalometric radiograph is the product of a two-dimensional image of the skull in lateral view, which helps in enabling the relationship between teeth, bone, soft tissue, and empty spaces in horizontal and vertical planes of space. It also helps in evaluation, diagnosis, treatment results, and prediction of growth. Aim: The aim of the study is to evaluate the reliability of landmark identification between manual and digital landmark plotting in both X and Y axis. Materials and Methodology: A total of 50 pre-treatment lateral cephalograms were selected from patients reported for orthodontic treatment. The digital images of each cephalogram were imported directly into Dolphin software for onscreen digitalization, while for manual tracing images were printed using a compatible X-ray printer. After the images were standardized and 10 commonly used hard tissue landmarks were plotted on each cephalogram by six different professional observers and the values obtained were plotted in X and Y axis. Intraclass correlation coefficient was used to determine the intrarater reliability for repeated landmark plotting obtained by both the methods. Results: The interclass correlation for manual in X and Y axis had a high reliability for all the 10 hard tissue points but when the intraclass correlation was performed, all the hard tissue landmarks showed high reliability both in X and Y axis except Point B which had moderate reliability with less agreement for cephalometric variables in X axis. Conclusion: The interand intraclass correlation in X and Y axis shows high reliability in hard tissue.