Comparison of reproducibility of cephalometric measurements derived from handheld (smartphone) device application versus manual cephalometric tracing

Objective: The objective of this study is to assess the reproducibility of cephalometric measurements derived from an application designed for handheld (smartphone) devices and manual cephalometry. Materials and Methods: Thirty pretreatment lateral cephalograms obtained from the same digital cephalostat were analyzed. Tracings were done using CephNinja for iPhone (Cyncronus) and manually by the hand on acetate sheets. Cephalometric landmarks and angular and linear measurements were recorded. All tracings were performed by the same investigator. Statistical Analysis: To evaluate reproducibility, for each cephalometric measurement, the agreement between the value derived from CephNinja, and that measured manually was assessed with the intraclass correlation coefficient (ICC). Agreement was rated as low for an ICC <0.75 and an ICC >0.75 was considered indicative of good agreement. Furthermore, differences in measurements between those derived from CephNinja application and manual tracing were statistically evaluated (P < 0.05). Results: All the measurements had ICC >0.75, indicating high agreement among both the tracing methods. Differences in measurements between CephNinja and hand tracing were not statistically significant for any of the cephalometric parameters. Conclusion(s): Handheld (smartphone)-assisted cephalometric analysis shows good agreement with manual tracing and can be employed for clinical decision-making.