Differentiation of evaluation of reliability of cephalometric analysis of cephalometrically diagnosed skeletal class i malocclusion using readily available digital imaging software such as IMAGE J and ICY and traditional manual tracing

Abstract

Background: The skeletal and soft tissue analysis of the face in total is a very important parameter of diagnosis. Readily available and non expensive imaging software are available which can be used for cephalometric analysis for hard and soft tissues of the face to make an appropriate treatment plan. Aims: The purpose of this study was to compare the accuracy of linear and angular measurements between the digital software IMAGE J, ICY and manual tracing. Objective: The purpose of this study was to compare angular and linear measurements obtained through manual and digital cephalometric tracings using IMAGE J and ICY software with lateral cephalometric radiographs. Material and Methods: The sample consisted of 50 lateral cephalometric radiographs. One properly trained and calibrated examiner performed the 50 manual tracing and then the same radiograph was traced digitally on a digital software. Five angular measurements SNA (Sella, nasion, A point), SNB Sella, nasion, B point), ANB (A point, nasion, B point), W angle, ULA (Upper lip angle) and three linear measurements ULT (upper lip thickness), projection of upper lip to TVL (true vertical line) & WITS appraisal were traced the conventional lateral cephalogram of 50 participants were obtained. Manual tracing was done and hard tissue landmark including the above mentioned angular and linear variables were marked. In a similar way a soft copy of the above 50 radiograph was obtained and uploaded in the digital imaging software IMAGE J and ICY. Results: SNA, SNB, ANB, W angle, WITS appraisal, upper lip thickness (ULT) upper lip angle, (ULA), projection of labrale superioris to TVL showed statistically significant values when measured manually and by digital software methods. Values measured by software methods had less errors. Conclusion: The results show statistically significant values between manual and digital tracing. The actual variation lies in identification of landmarks and their measurements. landmarks are identified better in software methods than manual methods and also there was a difference in measurements of angular and linear values of soft and hard tissue landmarks.