Comparative Evaluation of Digital and Manual Cephalometric Analysis in Mouth-breathing Patients: An Ex Vivo Study.

Abstract

Background: Understanding the characteristics of craniofacial morphology as well as their growth pattern in children is essential in diagnosis and treatment planning. Lateral cephalometric analysis remains a key diagnostic tool, aided by various software options that improve efficiency, minimize errors, and provide consistent results. With the growing use of computer-aided cephalometric tracing programs in today's dental practice, it is important to evaluate the accuracy of these commercially available cephalometric tracing software and apps to allow the clinician to decide the suitable method of analysis.

Aim: To compare digital and manual cephalometric values of Tweed's, Downs, and Steiner's analyses in mouth-breathing patients.

Materials and methods: About 30 pretreatment lateral cephalograms of patients exhibiting mouth-breathing habits, who reported to the dental clinic/institute for various treatment purposes, were selected for study. Digital cephalograms were imported into EasyCeph application and Vistadent software for on-screen digitization. Additionally, manual tracings were performed using acetate sheets, 0.7 mm pencil, ruler, and LED-illuminated tracing board. After ensuring image standardization and calibration, 25 commonly referenced anatomical landmarks were identified on each cephalogram. A total of 22 cephalometric parameters from Steiner's, Tweed's, and Down's analyses were assessed. Descriptive statistics and one-way ANOVA were applied for data analysis.

Results: Linear and angular measurements obtained through digital cephalometric analysis were found to be comparable to those derived from manual tracing methods. Differences observed among the three groups were statistically nonsignificant (p ≤ 0.05).

Conclusion: Digital measurements obtained using EasyCeph and Vistadent software closely aligned with those from the manual tracing method for the majority of clinically relevant parameters. Hence, both EasyCeph and Vistadent can be considered reliable and effective alternatives to traditional manual cephalometric analysis.

Clinical significance: As mouth-breathing children seem to have various skeletal and dental abnormalities compared to nasal-breathing children, early diagnosis and timely intervention will prevent future dentofacial complications.

How to cite this article: Padmanabham S, AJ SS, E S, et al. Comparative Evaluation of Digital and Manual Cephalometric Analysis in Mouth-breathing Patients: An Ex Vivo Study. Int J Clin Pediatr Dent 2025;18(7):776-783.