A comparison of semi-automated AI-based WEBCEPH, Dolphin, Quick Ceph softwares and manual technique in lateral cephalometric radiographs tracing of orthodontic adult patients

Aim The aim of this study was to compare the accuracy and reliability of the Quick Ceph, Dolphin, and WEBCEPH softwares to the manual tracing of lateral cephalometric radiographs. Materials and methods Seventy-three lateral cephalograms of patients seeking orthodontic treatment were included in this study. Manual tracing and digital tracing using semi-automated WEBCEPH, Quick Ceph and Dolphin softwares were performed on each cephalogram. Sixteen measurements divided into nine angular and seven linear measurements were performed on each cephalogram using the four tracing methods. The results were compared using statistical analyses. Results There were no statistically significant differences in absolute differences from manual tracing among the three digital methods for most cephalometric measurements, with small effect sizes. Significant differences were observed for SNB, Ls–E line, Wits appraisal, and A–N perpendicular measurements. The absolute difference from manual tracing for SNB was significantly greater with Dolphin Imaging than with Quick Ceph ( P = 0.014). The absolute difference for the Ls–E line was significantly greater with semi-automated WEBCEPH than with Quick Ceph ( P = 0.019). Quick Ceph showed a significantly greater absolute difference for Wits appraisal than the other modalities ( P < 0.001), while Quick Ceph and semi-automated WEBCEPH showed significantly greater absolute differences for A–N perpendicular than Dolphin Imaging ( P < 0.001). Conclusion Cephalometric measurements produced using semi-automated WEBCEPH, Quick Ceph and Dolphin softwares showed no clinical significant difference when compared to the measurements resulted from the manual tracing technique. Clinical relevance Manually tuned cephalometric measurements of WEBCEPH, Quick Ceph and Dolphin softwares can be used as valid alternatives to the manual tracing technique.