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Comparison of Digital Cephalometric Tracing by Onyx Ceph Software versus Manual Method

Reza Shahakbari, Mohammad Pahlevankashi, Majid Eshghpour, Atefe Ataii


Background: Cephalometric radiography is a valuable method for diagnosis, treatment design, and also for the study of growth and development of teeth and craniofacial complex. In addition to the above features, Onyx Ceph software has the ability to predict soft and hard tissue changes after jaw surgery and can be useful for orthodontists and surgeons. Aim: The purpose of this study was to compare the accuracy of linear and angular measurements between these programs and manual measurements. Materials and Methods: For this study, 30 cephalograms from 30 different patients of orthodontic candidates were selected. Initially, cephalometric analysis of printed stereotypes was performed manually and then using Onyx ceph v. 3.6 software. Eight angular measurements (FMA/IMPA/SNA/SNB/PNB/1.NA/1.NB/Y-AXIS) and four linear measurements (Co-Gn, Co-A, E-line lower lip, and LAFH). 10 lateral cephalograms were randomly selected and re-traced (5 cases manually and 5 digitally). Data were analyzed by t-test. Results: Regarding the results of the t-test, it was found that the measurements of the variables between the two groups were not statistically significant and these differences are significant only for the three variables: FMA, 1-NA, and 1-NB. Furthermore, there was no significant difference between any of the variables in these two different times for both manual and digital tracing methods. Conclusion: In this study, comparing the manual method and the digital method, there was only a significant difference between the FMA variables and there was no significant difference between the two periods of initial and recurrent trace. The results of this study showed that the digital tracing with the Onyx Ceph software had a same accuracy in comparison to manual tracing and could be used instead of the traditional methods. Clinical Significance: Due to the fact that digital tracing facilitates the tracing process and does not reduce accuracy, the use of these software could be recommended.


Cephalometric measurements; digital tracing; lateral cephalometry; manual tracing; Onyx software

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