Comparison of Accuracy and reliability of Automated tracing Android app with Conventional and Semiautomated Computer aided tracing software for cephalometric Analysis – A cross-sectional study

Introduction Cephalometry used as an adjuvant tool in orthodontic diagnosis has undergone significant changes from manual tracing to computer assisted digital tracing cephalometric analysis system. The smart phone apps running in android or other operating systems were introduced recently for doing cephalometric analysis. Hence this study was done comparing the accuracy and reliability of automated tracing (Webceph Android app) with gold standard manual tracing and semi-automatic tracing (NemoCeph). Materials and Methods The study was performed on 39 Pre-treatment lateral cephalograms. 10 angular and 11 linear skeletal, dental and soft tissue parameters were assessed by tracing the cephalograms manually, digitally using Nemoceph software and Webceph app. The mean and standard deviation were calculated, the overall intergroup comparisons were done using ANOVA test and individual intergroup comparisons were done by post-hoc analysis using Sidak Test. The overall interclass correlation coefficient (ICC) was calculated between the three groups. Results Angular measurements such as Occlusal plane to SN (P< 0.05) and Nasolabial angle (P< 0.05) showed significant difference between the different tracing methods and the linear parameters such as N perpendicular to Point A (P< 0.05) and Wits Appraisal (P< 0.05) showed significant difference between the different tracing methods. The overall reliability statistics showed good agreement (P<0.05) among all three groups. Conclusion Automated tracing (WebCeph) had more landmark identification errors when compared with manual or semi- automatic tracing (Nemoceph). Both WebCeph and Nemoceph were superior in their reliability when compared to manual tracing, with Nemoceph demonstrating greater efficacy compared to WebCeph.