Is the app-aided cephalometric analysis reliable in terms of airway measurements?

Background: Airway analysis, encompassing both upper and lower airway mea-surements, is essential for cephalometric analysis for orthodontic diagnosis. This retrospective study aimed to evaluate the reliability of the app-aided cephalometric analysis method for airway measurements. Methods: This study utilized pretreatment lateral cephalometric radiographs from 70 individuals (29 boys, 41 girls) with an average age of 14.4 years. Cephalometric landmarks, including soft palate, tongue posterior, pharyngeal wall for both upper pharynx and pharyngeal wall for lower pharynx points were identified. Linear dimensions of the upper and lower pharynx were measured manually and with the assistance of the App-aided OneCeph program. To determine the repeatability and intra-observer reliability, airway dimensions of 20 randomly selected radiographs were measured again by the same researcher. Intraclass Correlation (ICC) was used for intra-observer reliability, while Interclass Correlation (ICC) was used to evaluate inter-method reliability. A paired t-test was applied to analyze the data obtained from these paired measurements. Results: This study found no significant difference between the airway measurements obtained manually and those acquired using the OneCeph application. Both upper and lower airway measurements showed a very high and statistically significant agreement between the manual method and the OneCeph application. Furthermore, the observer’s reliability was found to be high. Conclusions: Our study demonstrated a very high level of agreement between manual and app-aided OneCeph methods for both upper and lower airway measurements. Consequently, the OneCeph application is confirmed as a reliable tool for the cephalometric measurement of airway dimensions.