To evaluate dental students' perceptions of manual and digital cephalometric landmark identification methods based on their preferences, difficulty level, and procedure time required to provide insights into the future of dental education, considering incorporating digital technology in dental schools. Fifty-five second-year dental students were randomly divided into two groups: (1) group A, students who performed manual landmark identification first, followed by digital method; and (2) group B, students who performed digital method first, followed by manual method. The duration of the procedure was recorded. Subsequently, all students completed a questionnaire regarding the difficulty they experienced using a visual analog scale and their preferences. Landmark identification accuracy was measured. Digital landmark identification was preferred by 93% of students. The mean procedure time for digital method was significantly lower than that of manual method (13.00±5.60vs. 9.70±4.60; p=0.002). Group B completed manual and digital methods in a shorter time than group A. Group A experienced less difficulty with manual procedure than group B. However, statistically significant differences were not observed in the difficulty level of digital technique. A statistically significant difference in the mean accuracy was shown in favor of the manual method. However, this difference is clinically insignificant (p=0.001). Students considered digital method to be effective for learning and preferred it over manual method. Furthermore, digital landmark identification demonstrated better performance and was faster than manual method, suggesting that this must be incorporated in undergraduate dental education.
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