Mobile-Based Digital and Manual Steiner Cephalometric Analysis: A Comparative Study of Accuracy and Efficiency

Cephalometric analysis is a cornerstone of orthodontic diagnosis, with the Steiner method serving as the gold standard. While traditional manual tracing on acetate is established, the advent of mobile applications promises enhanced efficiency. This study systematically compared the measurement reliability and time efficiency of manual tracing against digital analysis on Android and iOS devices. In this analytical observational study, Steiner analysis was performed on 63 subjects using three modalities: manual tracing (P1), smartphone-based digital analysis (P2), and iPad/tablet analysis (P3). Five applications were utilized: EasyCeph, OrthoCeph, WebCeph, OneCeph, and CephNinja. Key parameters (e.g., SNA, SNB, ANB) and processing times were recorded. Statistical significance was assessed using ANOVA, Kruskal–Wallis, and Mann–Whitney tests (p < 0.05). No statistically significant differences were found between manual and digital methods for the majority of landmarks, including SNA, SNB, ANB, interincisal angle, and soft tissue parameters (p > 0.05). While minor discrepancies occurred in linear measurements (U1NA and L1NB) between smartphones and tablets, the digital methods demonstrated a significant reduction in processing time compared with manual tracing (p < 0.05). Digital cephalometric analysis on mobile devices is as precise as manual tracing while being significantly faster. These findings confirm that mobile applications are reliable and efficient tools for modern orthodontics, streamlining diagnostics without compromising accuracy.