Reproducibility of Computerized Cephalometric Analysis Software Compared with Conventional Manual Tracing for Analyzing Skeletal Stability After Orthognathic Surgery.

Objective: This study aimed to compare the difference between analyzing skeletal stability after orthognathic surgery by lateral cephalogram measurement created from Dolphin software (version 11.95) compared with the manual technique.

Methods: Twenty-eight patients who underwent mandibular setback surgery (BSSRO) were randomly selected between 2015 and 2021. Serial lateral cephalograms were analyzed at four different time sets postoperatively, and a total of 112 cephalometric radiographs were obtained. Horizontal measurement (BX), vertical measurement (BY), and 3 angular measurements (SNB, ANB, and Gonial angle) were analyzed by manual tracing and Dolphin software by 2 examiners. The intraclass correlation coefficient determined the intra-rater reliability. Parameter differences between timelines were observed for skeletal stability, and mean values between methods were compared using the Student's t-test.

Results: Both examiners were generally consistent in the repeated measurements (ICCs of the manual method ranged from 0.926 to 0.994, and the digital method ranged from 0.719 to 0.956). All variables represented skeletal stability at T0-T1, T0-T2, and T0-T3 showed no statistically significant differences between methods except ANB (T0-T1; p value = 0.009).

Conclusions: Computerized cephalometric analysis software is relatively reproducible for assessing skeletal changes after orthognathic surgery and can be used routinely in follow-up.