COMPARISON OFACCURACY AND RELIABILITY OF CEPHALOMETRIC LANDMARKS AMONG DIGITAL SOFTWARE WEB CEPH AND CARE STREAM WITH TRADITIONAL MANUAL TRACING

ABSTRACT OBJECTIVES This study aimed to compare the accuracy and reliability of AI-assisted software (WebCeph, Carestream) with manual tracing. METHODOLOGY This cross-sectional (analytical) study was conducted using the records of patients presenting to the Orthodontic Department, Rehman College of Dentistry (RCD), Peshawar, over a period of three months. Forty-two high-quality lateral cephalograms were traced manually for four skeletal (SNA, SNB, ANB, FMA), three dental (UI-SN, IMPA, Overjet), and three soft tissue parameters (UL-Eline, LL-Eline, and NLA). The same cephalograms were later digitally analyzed using AI-assisted software (Carestream and WebCeph). One-way ANOVA test and post hoc Tukey test were applied to assess any significant differences among the groups. Bonferroni correction was employed to adjust the significance level (alpha) for each test and multiple comparisons. Pearson Correlation coefficients were used to determine the correlation among the various group values. RESULTS Web Ceph and manual tracing revealed a significant difference in UI-SN, overjet, and UL-Eline (P<0.05). Comparison between manual tracing and Carestream showed significant differences in FMA, IMPA, UL-E line, and LL-Eline (P<0.05). While comparing Web Ceph and Carestream, significant differences were observed in UL-Eline, IMPA, and NLA (P<0.05). It was found that the differences in the mean values between AI-driven software and manual methods were clinically insignificant. However, differences among AI-driven methods were clinically significant. CONCLUSION AI-driven cephalometric digital tracing software, Web Ceph, and Carestream provide sufficiently reliable measurements for clinical application. Web Ceph showed better results for specific values than Carestream. The accuracy and consistency of automated software can be improved through manual adjustments and verification. Despite the clinical applicability, manual tracing cannot be replaced by computerized cephalometric.