Document Type : Original Article


1 Department of Orthodontics and Dentofacial Orthodopedics, Faculty of Dentistry, Zanjan University of Medical Sciences

2 DDS, Private Practice, Tehran, Iran

3 PhD in Biostatics, Department of Social Medicine, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran


Objective: Cephalometric analysis is one of the main diagnostic steps in orthodontics. Modern cephalometric analysis methods include using digital software or mobile applications.This study aimed to assess the validity and reliability of CephNinjaPro application for linear and angular cephalometric measurements.

Material and methods: In this cross sectional study, 30 randomly selected lateral cephalograms were digitized by a digital scanner. The required landmarks for 5 linear and 8 angular measurements were identified on all cephalograms using a fine tip pen by an experienced orthodontist, and they were scanned again. To assess the validity of manual versus digital landmark identification using CephNinjaPro application, the landmarks were identified on scanned cephalograms in both CephNinjaPro application and Dolphin software. The results were compared before and after landmark identification in use of Dolphin software, and in use of CephNinjaPro. The results of Dolphin and CephNinjaPro were also compared before and after landmark identification. Data were analyzed using paired t-test and Wilcoxon test.

Results: The results showed significant differences in SNA (P<0.001), SNB (P<0.001), inter-incisal angle (P=0.001), MP-SN (P<0.001), and Ga (P<0.001) between Dolphin and CephNinjaPro before landmark identification and also significant differences in Ga (P<0.001), and MP-SN (P<0.001) between Dolphin and CephNinjaPro after landmark identification.

Conclusion: CephNinjaPro has acceptable validity and reliability for most of linear and angular cephalometric measurements from clinical use perspective. Nonetheless, interpretation of results regarding some measurements should be done with caution.


Main Subjects