Comparison of Digital Analysis and Artificial Intelligence for Cephalometric Tracing
Cephalometric Tracing: A Comparison Between Digital Analysis and Artificial Intelligence
University of Pavia
100 participants
Jun 1, 2026
OBSERVATIONAL
Conditions
Summary
This study aims to evaluate the accuracy and reliability of artificial intelligence (AI)-based cephalometric analysis compared with digital manual tracing. A total of 100 standardized lateral cephalometric radiographs will be analyzed using Delta-Dent software with manual landmark identification and three fully automated AI-based systems (WebCeph, QuantX, and Smartee). Sagittal, vertical, dental, and soft tissue cephalometric parameters will be compared among the different methods. Statistical analysis will assess inter-method agreement and the clinical relevance of any observed discrepancies. The study seeks to determine whether AI-based systems provide measurements comparable to conventional digital tracing and whether they can be considered reliable adjunctive tools in orthodontic diagnosis and treatment planning.
Eligibility
Inclusion Criteria8
- Availability of digital lateral cephalometric radiographs of adequate diagnostic quality
- Radiographs acquired with patients in centric occlusion and proper head positioning using a cephalostat
- Patients of any age and sex
- Absence of congenital or acquired craniofacial anomalies
- No previous orthodontic treatment
- No previous orthognathic surgical treatment
- Absence of agenesis of incisors or first molars
- Absence of supernumerary teeth overlapping the region of interest
Exclusion Criteria6
- Radiographs presenting artifacts or inadequate visualization of anatomical structures
- History of significant craniofacial trauma
- Radiographs acquired without a cephalostat
- Presence of severe skeletal asymmetries
- Incomplete clinical or radiographic records
- Radiographs unsuitable for manual or AI-based cephalometric landmark identification
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Interventions
All included lateral cephalometric radiographs will undergo cephalometric analysis using both digital manual tracing and artificial intelligence-based automated systems. Manual digital tracing will be performed with Delta-Dent software by a single experienced orthodontist through manual identification of cephalometric landmarks. The same radiographs will subsequently be analysed using three fully automated AI-based software programs (WebCeph™, QuantX, and Smartee) without manual correction of landmark positioning. No therapeutic intervention or modification of patient treatment will be performed, as this is an observational comparative study based exclusively on retrospective analysis of radiographic records.
Locations(1)
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NCT07664488