Reproducibility of soft tissue cephalometric landmark identification by conventional and digital direct radiography


  • Margarita María Bonilla-Londoño Fundación Universitaria San Martín
  • Judith Patricia Barrera-Chaparro Fundación Universitaria San Martín
  • Ángela Patricia Arroyave-Godoy Fundación Universitaria San Martín
  • Mónica Eliana Díaz-Roa Fundación Universitaria San Martín



Cephalometry, Results reproducibility, Radiography, Double-photon emission radiographic image


Introduction: there is little information on the reproducibility of soft tissue cephalometric points; the purpose of this study was then to evaluate the reproducibility and accuracy of soft tissue cephalometric landmark identification in direct digital radiography and conventional radiography. Methods: 11 pairs of conventional and direct digital radiographs were introduced in the Cephapoint program. 10 cephalometric points were located on a Cartesian plane (X and Y) in conventional and digital images. The measurements were taken twice by 3 operators with 1 week interval. Interobserver average error was calculated in order to assess reproducibility in each point, and intraobserver error was used to determine accuracy. Results: interobserver error in soft tissue cephalometric points was less than 1 mm for most points in both images, except in chin and pogonion, with no statistically significant differences. Statistically significant differences were found between the variances in the X axis, with less variability in the case of digital radiography in these points: labrale superius (p = 0.043), subnasale (p = 0, 013), columella (p = 0.038), stomion superius (p = 0.029), and stomion inferius (p = 0.015). The Y axis did not show statistically significant differences between the two methods. The assessment of intraobserver reproducibility showed an excellent Intraclass Correlation Coefficient (ICC) (0.935) in both methods. Conclusion: according to the findings of this study, the evaluated radiographs and methods offer similar diagnostic accuracy.

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Author Biographies

Margarita María Bonilla-Londoño, Fundación Universitaria San Martín

Dentist, Orthodontics Specialist. Fundación Universitaria San Martín. Bogotá, Colombia

Judith Patricia Barrera-Chaparro, Fundación Universitaria San Martín

Dentist, Epidemiology Specialist. Research Professor. Dentistry Graduate School. Fundación Universitaria San Martín. Bogotá D. C., Colombia

Ángela Patricia Arroyave-Godoy, Fundación Universitaria San Martín

Dentist, Orthodontics Specialist. Fundación Universitaria San Martín. Bogotá, Colombia

Mónica Eliana Díaz-Roa, Fundación Universitaria San Martín

Dentist, Orthodontics Specialist. Fundación Universitaria San Martín. Bogotá, Colombia.


De Araujo P, Nascimento J, Mesquita F, Nery E. A comparative study of manual vs. computerized cephalometric analysis. Dental Press J Orthod 2010; 15(2): 44-51.

Steiner C. Cephalometrics for you and me. Am J Orthod 1953; 39(10): 729-755.

Legan HL, Burstone CJ. Soft tissue cephalometric analysis for orthognathic surgery. J Oral Surg 1980; 38(10): 744-751.

Burstone CJ, James RB, Legan H, Murphy GA, Norton LA. Cephalometrics for orthognathic surgery. J Oral Surg 1978; 36(4): 269-277.

McNamara JA Jr. A method of cephalometric evaluation. Am J Orthod 1984; 86(6): 449-469.

Sassouni V. A classification of skeletal facial types. Am J Orthod 1969; 55(2): 109-123.

Chung RR, Lagravere MO, Flores-Mir C, Heo G, Carey JP, Major PW. A comparative analysis of angular cephalometric values between CBCT generated lateral cephalograms versus digitized conventional lateral cephalograms. Int Orthod 2009; 7(4): 308-321.

Bruntz LQ, Palomo JM, Baden S, Hans MG. A comparison of scanned lateral cephalograms with corresponding original radiographs. Am J Orthod Dentofacial Orthop 2006; 130(3): 340-348.

Uysal T, Baysal A, Yagci A. Evaluation of speed, repeatability, and reproducibility of digital radiography with manual versus computer-assisted cephalometric analyses. Eur J Orthod. 2009; 31(5):523-8.

Sayinsu K, Isik F, Trakyali G, Arun T. An evaluation of the errors in cephalometric measurements on scanned cephalometric images and conventional tracings. Eur J Orthod 2007; 29(1): 105-108.

Yu SH, Nahm DS, Baek SH. Reliability of landmark identification on monitor-displayed lateral cephalometric images. Am J Orthod Dentofacial Orthop 2008; 133(6): 790.

Bonilla M, Barrera J, Gutiérrez D, Paredes M, Puentes J. Comparación del error en la ubicación de puntos cefalométricos entre una imagen digital directa y una convencional. Revista Científica Sociedad Colombiana de Ortodoncia 2011; 18(17): 63-71.

Sandler PJ. Reproducibility of cephalometric measurements. Br J Orthod 1988; 15(2): 105-110.

Swennen GR, Grimaldi H, Berten JL, Kramer FJ, Dempf R, Schwestka-Polly R et al. Reliability and validity of a modified lateral cephalometric analysis for evaluation of craniofacial morphology and growth in patients with clefts. J Craniofac Surg 2004; 15(3): 399-412.

Wisth PJ, Böe OE. The reliability of cephalometric soft tissue measurements. Arch Oral Biol 1975; 20(9): 595-599.

Hagemann K, Vollmer D, Niegel T, Ehmer U, Reuter I. Prospective study on the reproducibility of cephalometric landmarks on conventional and digital lateral headfilms. J Orofac Orthop 2000; 61(2): 91-99.

Dvortsin DP, Sandham A, Pruim GJ, Dijkstra PU. A comparison of the reproducibility of manual tracing and on-screen digitization for cephalometric profile variables. Eur J Orthod 2008; 30(6): 586-591.

Eppley BL, Sadove AM. Computerized digital enhancement in craniofacial cephalometric radiography. J Oral Maxillofac Surg 1991; 49(10): 1038-1043.

Macrì V, Wenzel A. Reliability of landmark recording on film and digital lateral cephalograms. Eur J Orthod 1993; 15(2): 137-48.

Naoumova J, Lindman R. A comparison of manual traced images and corresponding scanned radiographs digitally traced. Eur J Orthod 2009; 31: 247-253.

Cooke M, Wei H. Cephalometric errors: a comparison between repeat measurements and retaken radiographs. Aust Dent J 1991; 36: 38-43.

Lim KF, Foong KW. Phosphor-stimulated Computed Cephalometry: Reliability of Landmark Identification. Br J Orthod 1997; 24: 301-308.

Polat-Ozsoy O, Gokcelik A, Toygar Memikoglu TU. Differences in cephalomatric measurements: a comparison of digital versus hand-tracing methods. Eur J Orthod 2009; 31: 254-259.

Ongkosuwito E, Katsaros C, Hof M, Bodegon J, Kuijpers-Jagtman A. The reproducibility of cephalometric measurements; a comparison of analogue and digital methods. Eur J Orthod 2004; 24: 655-665.

Tsorovas G, Karsten AL. A comparison of hand-tracing and cephalometric analysis computer programs with and without advanced features-accuracy and tune demands. Eur J Orthod 2010; 10:1-8.

Chen YJ, Chen SK, Yao JC, Chang HF. The effects of differences in landmark identification on the cephalometric measurements in traditional versus digitized cephalometry. Angle Orthod 2004; 74(2): 155-161.

Kazandjian S, Kiliaridis S, Mavropoulos A. Validity and reliability of a new edge-based computerized method for identification of cephalometric landmarks. Angle Orthod 2006; 76: 619-624.

Kawahara T, Goldenberg F, Gislaine C, Sannomiya E. Qualitative evaluation between conventional and digital lateral cephalograms. Rev Dent Press Ortodon Ortop Facial 2009; 14(3): 60-68.



How to Cite

Bonilla-Londoño, M. M., Barrera-Chaparro, J. P., Arroyave-Godoy, Ángela P., & Díaz-Roa, M. E. (2014). Reproducibility of soft tissue cephalometric landmark identification by conventional and digital direct radiography. Revista Facultad De Odontología Universidad De Antioquia, 25(1), 76–91.

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