Introduction: Cephalometric radiographs have become an indispensable tool in the orthognathic setting. Traditionally, cephalometric images have been analyzed by manually tracing the radiograph, which was time-consuming. The development of computer technology has made digital tracing possible. The purpose of this study was to examine and compare the reliability and reproducibility of digitization using Viewbox imaging software (version 3.0) with traditional manual technique.
Materials and methods: The sample consisted of cephalograms from 30 randomly selected patients after orthodontic treatment. Twenty one cephalometric measurements calculated by 1 operator, both manually and with digital tracing software. Measurement error was assessed for each method by duplicating measurements of 15 randomly selected radiographs and by using Pearson's coefficient of determination. A paired t-test was used to detect differences between the manual and the digital method.
Results: An overall greater variability in the digital cephalometric measurements was found. Differences between the two methods for saddle angle, gonial angle, nasolabial angle and upper lip to E line were statistically significant (P<0.05), but the last one showed a mean difference lower than two units.
Conclusions: The two tracing methods provide accurate and similar clinical results except for some measurements, especially nasolabial angle; therefore, version 3.0 of this digital cephalometric software can be reliably chosen as a routine diagnostic tool with knowledge of its limited errors.