A comparison of angle measure reproducibility between manual and computerized tracing


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


Cephalometry, Reproductibility of results, Radiography, Radiographic imaging by dual photon emission


Introduction: digital cephalometry allows handling errors produced during manual tracing; the purpose of this study was therefore to evaluate the reproducibility and precision of angle measures between manual tracing and that obtained with Cephapoint in digital radiography. Methods: 11 direct digital radiographs taken to orthodontics students were introduced in the Cephapoint computer program. 9 angles were measured in both hand-tracing digital radiography and Cephapoint. All measurements were made by 3 operators with 1-week interval. We calculated the average interobserver error to find the reproducibility of each angle measure, and the average intra-observer error to determine the accuracy of each observer. Results: the FH/N/Pg angle showed the smallest interobserver error difference (0.10°) in both methods, favoring manual tracing. On the other hand, the angles with the smallest inter-observer error difference in computerized tracing were LI-NB (0.11°) and N-A/Pg (0.11°). Intraobserver reproducibility showed excellent Intraclass Correlation Coefficient (ICC) in both methods. Conclusions: reproducibility of angular measurements did not show significant differences between manual and computerized tracing. According to the findings of this study, the methods under evaluation offer equal diagnostic validity.

= 164 veces | PDF (ESPAÑOL (ESPAÑA))
= 25 veces|


Download data is not yet available.

Author Biographies

Margarita María Bonilla-Londoño, Fundación Universitaria San Martín

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

Judith Patricia Barrera-Chaparro, Universitaria San Martín

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

Ángela Patricia Arroyave-Godoy, Fundación Universitaria San Martín

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

Mónica Eliana Díaz-Roa, Fundación Universitaria San Martín

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


De Araújo 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.

Dana JM, Goldstein M, Burch JG, Hartigan PC. Comparative study of manual and computerized cephalometric analyses. J Clin Orthod 2004; 38(5): 293-296.

Roden-Johnson D, English J, Gallerano R. Comparison of hand-traced and computerized cephalograms: landmark identification, measurement, and superimposition accuracy. Am J Orthod Dentofacial Orthop 2008; 133(4): 556-564.

McClure SR, Sadowsky LP, Ferreira A, Jacobson A. Reliability of digital versus conventional cephalometric radiology: a comparative evaluation of landmark identification error. Semin Orthod 2005; 11(2): 98-110.

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.

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.

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.

Polat-Ozsoy O, Gokcelik A, Toygar Memikoglu TU. Differences in cephalometric measurements: a comparison of digital versus hand-tracing methods. Eur J Orthod 2009; 31(3): 254-259.

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.

Richardson A. A comparison of traditional and computerized methods of cephalometric analysis. Eur J Orthod 1981; 3(1): 15-20.

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

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.

Lim KF, Foong KW. Phosphor-stimulated computed cephalometry: reliability of landmark identification. Br J Orthod 1997; 24(4): 301-308.

Collins J, Shah A, McCarthy C, Sandler J. Comparison of measurements from photographed lateral cephalograms and scanned cephalograms. Am J Orthod Dentofacial Orthop 2007; 132(6): 830-833.

Chen YJ, Chen SK, Chang HF, Chen KC. Comparison of landmark identification in traditional versus computer-aided digital cephalometry Angle Orthod 2000; 70(5): 387-392.

Geelen W, Wenzel A, Gotfredsen E, Kruger M, Hansson LG. Reproducibility of cephalometric landmarks on conventional film, hardcopy, and monitor-displayed images obtained by the storage phosphor technique. Eur J Orthod 1998; 20(3): 331-340.

Baumrind S, Frantz RC. The reliability of head film measurements. 1. Landmark identification. Am J Orthod 1971; 60(2): 111-127.

Bonilla MM, Barrera JP, Arroyave ÁP, Díaz ME. Reproducibilidad en la ubicación de puntos cefalométricos de tejidos blandos en radiografías convencionales y digitales directas. Rev Fac Odontol Univ Antioq 2013; 25(1): 76-91.

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.

Hwang HS, Kim WS, McNamara JA Jr. A comparative study of two methods of quantifying the soft tissue profile. Angle Orthod 2000; 70(3): 200-207.

Park YC, Burstone CJ. Soft-tissue profile —fallacies of hard-tissue standards in treatment planning. Am J Orthod Dentofacial Orthop 1986; 90(1): 52-62.

Nanda RS, Meng H, Kapila S, Goorhuis J. Growth changes in the soft tissue facial profile. Angle Orthod 1990; 60(3): 177-190.

Formby WA, Nanda RS, Currier GF. Longitudinal changes in the adult facial profile. Am J Orthod Dentofacial Orthop 1994; 105(5): 464-476.



How to Cite

Bonilla-Londoño, M. M., Barrera-Chaparro, J. P., Arroyave-Godoy, Ángela P., & Díaz-Roa, M. E. (2014). A comparison of angle measure reproducibility between manual and computerized tracing. Revista Facultad De Odontología Universidad De Antioquia, 25(2), 299–312. Retrieved from https://revistas.udea.edu.co/index.php/odont/article/view/11748

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.