Document Type : Original Article


1 ITS Dental College

2 Ministry of health and family welfare

3 BJS Dental College,Ludhiana

4 Christian Dental College



The study aimed at determining the variability of landmark identification and its reproducibility by manual and digital methods of cephalometric tracing. Material and Method: Pre-treatment Cephalograms of Sixty subjects recommended for Orthodontic treatment were taken in the natural head position with the teeth in maximum intercuspation and were traced by a single operator. Statistical analysis was performed, and the mean, standard deviations, and coefficients of variation (CVs) were calculated for each parameter and imaging modality. For all the variables, test of normality (Shapiro-wilk’s test) was conducted to identify the distribution of each variable. Wilcoxon Signed Rank Test was used where, distribution was non-normal for at least one of the comparing variables.The repeated sample t-test was used, where normal distribution was detected for both the variables. Results: For digital tracing, the coefficients of variation (CV) were less than 1, suggesting high reliability. For most manually traced images, the landmarks with high coefficients of variation were porion, Basion, Sella, point B, and gonion. Coefficient of variation was invariably higher for the manual method than the digital method, implying readings were more consistent in the digital method for the above landmarks under observation. Out of the 29 parameters, mean difference from sixteen of them was calculated to be statistically significant from each other which shows that the digital method of cephalometric tracing can be relied upon for the reliability. Conclusion: Digital method gives a more consistent reading.


Main Subjects