Original Article

Assessment of Reliability of Three Different Computer-Assisted Analysis Programs


  • Ebubekir Toy
  • Sıddık Malkoç
  • Sedat Altındiş
  • Sertaç Aksakallı

Turk J Orthod 2013;26(3):134-142


The aim of this study was to assess the reliability of cephalometric analysis using 3 different digital analysis programs.


For this study, a dry human skull with the entire mandible, maxilla, and teeth was used. Fifteen lateral and 15 posteroanterior cephalometric digital images were taken by rotating the skull from 0° to ±14° at 2° intervals to obtain different images. Two researchers located the landmarks on the digital images independently using 3 computer-assisted analysis programs, Dolphin Image Software (Dolphin Imaging and Management Solutions), Quick Ceph Image (Quick Ceph Systems Inc), and Vistadent OC (GAC Int Inc). Following the first measurements (T1), all landmarks were relocated within a 2-week interval (T2) by each examiner. A paired and the independent Student t tests were used for intraexaminer and interexaminer measurements, and Pearson correlations were obtained. Intraclass correlation coefficients (ICC) were calculated to determine intraexaminer repeatability.


For the repeated measurements, mean differences were statistically insignificant, and high correlations for the repeated measurements were found, and the intraexaminer correlations were significant for each examiner (p<.001). When the interexaminer correlations of 3 analyses were compared, interexaminer correlations showed high consistency and the lowest Pearson r value was the same angular measurement (S ant-n-ss) (p<.001). ICC values demonstrated high intraexaminer repeatability. The highest value of ICC was the mandibular body length (go-me) for both examiners (p<.001).


The 3 tested analysis programs may be accepted as reliable for clinical use.

Keywords: Computer-assisted analysis, Digital images, Reliability, Repeatability