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How reliable are AI-Assisted cephalometric programs in assessing measurements involving bilateral landmarks?

Hakan Gurcan Gurel

Hakan Gurcan Gurel

Department of Orthodontics, Faculty of Dentistry, Biruni UniversityIstanbul, Turkey
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Gurel, Hakan Gurcan
, 
Pinar Alkumru

Pinar Alkumru

Department of Orthodontics, Faculty of Dentistry, University of TorontoToronto, Canada
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Alkumru, Pinar
 und 
Pavel Sectakof

Pavel Sectakof

Department of Orthodontics, Faculty of Dentistry, University of TorontoToronto, Canada
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Sectakof, Pavel
  
19. Juni 2025
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Online veröffentlicht: 19. Juni 2025
Seitenbereich: 123 - 129
Eingereicht: 01. Sept. 2024
Akzeptiert: 01. März 2025
DOI: https://doi.org/10.2478/aoj-2025-0017
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© 2025 Hakan Gurcan Gurel et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

Landmarks used in the study; Ar (Articulare): The point at the junction of the posterior border of the ramus and the inferior border of the posterior cranial base. Co (Condylion): The most superior point of the mandibular condyle. Gn (Gnathion): The most anterior and inferior point on the mandibular symphysis. Go (Gonion): The most posterior and inferior point on the angle of the mandible. Menton (Me): The most inferior point on the mandibular symphysis. Or (Orbitale): The most inferior point on the inferior margin of the orbit. Po (Porion): The superior-most point of the external auditory meatus. S (Sella): The centre of the sella turcica. (For the bilateral landmarks Ar, Co, Go, Or and Po, midpoints of the left and right images were used). Measurements used in the study; Frankfort-mandibular plane angle (FMA): The angle between Frankfort horizontal plane (Po-Or) and mandibular plane (Go-Me). Articular angle: The angle formed by joining the points S, Ar and Go. Gonial angle: The angle formed by joining the points Ar, Go and Me. Effective mandibular length: The distance between the points Co and Gn.
Landmarks used in the study; Ar (Articulare): The point at the junction of the posterior border of the ramus and the inferior border of the posterior cranial base. Co (Condylion): The most superior point of the mandibular condyle. Gn (Gnathion): The most anterior and inferior point on the mandibular symphysis. Go (Gonion): The most posterior and inferior point on the angle of the mandible. Menton (Me): The most inferior point on the mandibular symphysis. Or (Orbitale): The most inferior point on the inferior margin of the orbit. Po (Porion): The superior-most point of the external auditory meatus. S (Sella): The centre of the sella turcica. (For the bilateral landmarks Ar, Co, Go, Or and Po, midpoints of the left and right images were used). Measurements used in the study; Frankfort-mandibular plane angle (FMA): The angle between Frankfort horizontal plane (Po-Or) and mandibular plane (Go-Me). Articular angle: The angle formed by joining the points S, Ar and Go. Gonial angle: The angle formed by joining the points Ar, Go and Me. Effective mandibular length: The distance between the points Co and Gn.

Figure 2.

Cephalometric tracing of a study subject with analysis results on Webceph.
Cephalometric tracing of a study subject with analysis results on Webceph.

The descriptive statistics of the data used in the study

Methods n Minimum Maximum Mean Standard deviation Median
Webceph Articular Angle (degree) 51 137.50 161.20 148.45 5.44 147.90
Gonial Angle (degree) 51 108.00 133.10 122.72 5.73 123.40
Effective Mandibular Length (mm) 51 98.50 122.60 108.95 6.36 110.00
FMA (degree) 51 13.40 43.00 25.66 5.96 25.50
Manual Tracing Articular Angle (degree) 51 134 163 149.39 6.84 150
Gonial Angle (degree) 51 100 137 119.81 7.16 120
Effective Mandibular Length (mm) 51 97 142 113.29 8.72 113
FMA (degree) 51 12 37 25.96 5.56 26.5

Comparison of the means of clinical measurements based on the programs used in the study

Methods Mean Standard deviation Test statistics p
Articular Angle (degree) Webceph 148.45 5.44 -0.77 0.444
Manual Tracing 149.39 6.84
Gonial Angle (degree) Webceph 122.72 5.73 2.26 0.026*
Manual Tracing 119.81 7.16
Effective Mandibular Length (mm) Webceph 108.95 6.36 -2.87 0.005*
Manual Tracing 113.29 8.73
FMA (degree) Webceph 25.66 5.96 -0.261 0.794
Manual Tracing 25.96 5.56

Test-retest and intraclass correlation coefficients for clinical measurements

Manual Tracing
Webceph Articular angle rho 0.658
p 0.000*
Gonial angle rho 0.753
p 0.000*
Effective Mandibular Length rho 0.416
p 0.002*
FMA rho 0.869
p 0.000*
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