Cephalometric Tracing Software.free Download Google

Similar studies have been done for desktop software like Dolphin®, NemoCeph, VistadentTM, Quick Ceph, AOCephTM, FACAD®, and AutoCEPH©. The authors have claimed that the accuracy and reliability of this software are similar to the manual cephalometric tracing and therefore can be used as an aid in diagnosing, planning, monitoring, and evaluating orthodontic treatment both in clinical and research settings.3,4,5,6,7,8,9,10 However, the disadvantages of desktop cephalometric software are that it can only be used on a desktop or a laptop, expensive, and require an internet connection.

In recent years, much cephalometric software like Smile-Ceph, Ceph Ninja, and Smart Ceph Pro apps have been launched in the market, which can be used on tablets and smartphones. Few of the studies have found that these mobile digital cephalometric software and applications were accurate and can be used as an alternative to manual tracing.17,18 A study by Gorracci et.al showed good reliability for all cephalometric measurements obtained with an iPad-based software Smile-Ceph, desktop software NemoCeph and manual tracing.12 One of the disadvantages of this software is that it can be accessed on an iPad tablet and IOS devices only.

Recently, few studies have evaluated the accuracy of other AI driven fully automated cephalometric softwares. Alqahtani [12] assessed the reproducibility of 8 linear and 8 angular measurements of cephalogram tracings made with a web-based platform CephX® and tracings made using the FACAD® computer software. He concluded that the measurements obtained by both FACAD® and CephX® softwares are reproducible. Although significant differences were detected for some measurements like SNA, FMA and Pg to NB but all differences were not clinically significant.

Similarly, Meriç and Naoumova [13] compared 12 cephalometric measurements obtained from Dolphin Imaging 13.01 (Dolphin Imaging and Management Solutions, Chatsworth, California, USA), app-aided tracing using the CephNinja 3.51 app (Cyncronus LLC, Washington, USA), web-based fully automated tracing with CephX (ORCA Dental AI, Las Vegas, Nevada, USA) and manual tracing. They found that statistically significant differences were found for cephalometric parameters like GoGn- SN (°), I-NA (°), I-NA (mm), I-NB (°), I-NA (mm) and concluded that fully automatic analysis with CephX needs to be more reliable. However, CephX analysis with manual correction is promising for use in clinical practice because it is comparable to CephNinja and Dolphin, and the analyzing time is significantly shorter.

Traditional cephalometric analysis technique has many inherent disadvantages such as time-consuming, tedious, large inventory, archiving records, communication of data, and associated chemical hazard.[4] Recently, computer technology has enabled digital processing and on-screen cephalometric tracing.[3] Computerized cephalometrics has gained popularity because of simplicity, quick, precise, and easy archiving. Facility of resolution enhancement adds to the accuracy of digitization.[9] The accuracy of NemoCeph comparable to hand-tracing has already been established.

The time-consuming nature of conventional tracing and the high license cost of cephalometric software with overall bulk of armamentarium refrain the orthodontists from instant cephalometric reading, especially for outstation consultation. A cost-effective and portable alternative for daily use was much awaited to serve instantaneous cephalometric reading.

This study found the accuracy of free download CephNinja software for android comparable to commercially available NemoCeph for computers both clinically and statistically in majority. Therefore, CephNinja can be used with reliability as an alternative to commercially available cephalometric analysis software.

To perform manual hand tracing, the digital cephalometric images were printed out at a scale of 1:1. The radiographs were traced in daylight. The tracing was done using a 0.3 mm hard black (HB) lead pencil. Landmarks were identified by a single point. In case of superimposed bilateral anatomical structures and double images, the mid-point was chosen. After identifying the 22 selected landmarks and 7 planes (Figure 1), 26 linear and angular parameters (Table 1) were measured manually and digitally.

Thus, the aim of this study was to evaluate the reliability and reproducibility of the cephalometric smartphone application OneCeph, which runs on Android systems (Google LLC., Mountain View, Calif), and compare it with the manual tracing method. In examining the reliability and reproducibility of the OneCeph app, the use of cephalometric measurements was prioritized over landmark identification. Santoro et al.8 mentioned that any study that aims to evaluate the consistency and reliability of digital cephalometrics shall focus on the sources of errors and the use of measurements rather than landmarks because cephalometric measurements are the final product of the cephalometric tracing procedure and they are the basis of treatment planning. To minimize the errors in the digital technique, the grayscale of the digital images was kept at 24 bits. Ongkosuwito et al.9 showed that a grayscale less than 7 bits can lead to uncertainty for the reproducibility of cephalometric measurements.

Erkan et al.10 inferred that during the assessment of the reliability of computerized cephalometric software, intraexaminer error was much less than the interexaminer error. Therefore, this study was focused on intraexaminer errors (the reliability) for both linear and angular measurements. The reliability analysis (Table 2) showed a high correlation between the repeated measurements of the digital and manual methods (r2 > 0.9 for all measurements), indicating that the operator had no difficulty in accurately repeating measurements in each technique. There was good agreement between the current findings and those of previous studies. For instance, Sayinsu et al.11 found that the operator was consistent in repeated measurements, and all intraexaminer correlation coefficients were >0.90. AlBarakati et al. showed a high correlation between repeated measurements (the reliability) of both conventional and digital tracing techniques. In their study, all intraexaminer correlation coefficients for repeated measurements were at least 0.90, except for the maxillary length (ANS-PNS), which was not included in the current study.12

The number of studies that investigated the reproducibility of smartphone cephalometric apps are limited in the literature, and the available studies had targeted apps that run mainly on the iPhone (Apple Inc., Cupertino, Calif). Sayar and Kilinc13 examined the reproducibility of the CephNinja 3.10 app, which runs on Apple's IPhone operating system (IOS), in comparison with the hand-tracing method. They found that there were significant statistical differences for all measured parameters, but the differences were clinically insignificant. On the other hand, Aksakalli et al.14 investigated the accuracy of two cephalometric apps, CephNinja 3.3 and SmartCeph Pro 1.1, which run on iPad (Apple Inc.), and they compared those apps with the computerized Dolphin imaging software. The authors concluded that smartphone apps should be developed to provide more accurate results because most of the measurements differed significantly from the Dolphin imaging software. Although OneCeph is a smartphone app, comparison between the digital and conventional methods (the reproducibility) indicated statistically significant differences for only five measurements (SNB, N I to Pog, U1-A point, U lip to S line, and nasiolabial angle; P < .05, P < .01; Table 3). Similar findings were reported in previous studies that compared conventional tracing to digital tracing using software that runs on personal computers. AlBarakati et al.12 reported significant differences in SNB measurements. A possible explanation for such a difference according to previous studies was that the nasion can be difficult to locate precisely when the nasofrontal suture is not clearly visualized.15 In addition, the B point is located on a curve, and, thus, it might show slightly greater errors of measurement. Similarly, the S point (U lip to S line) is located on a curve with wide radii, and it might increase the chance of error.1 Celik et al.16 and Sayinsu et al.11 reported significant differences in N I to Pog measurements, which might have arisen from the fact that the porion is an inconsistent cephalometric point.17 Despite the previously reported explanations regarding the differences in SNB, N I to Pog, and U lip to S line measurements between the tracing methods, the intraexaminer reliability in the present study was high for both tracing techniques. This might suggest that the landmark identification for the operator was relatively unchallenging. The inconsistency between conventional and digital measurements (SNB, N I to Pog, and U lip to S) might be related to the operator identifying some cephalometric points slightly differently when projected on a mobile touchscreen, even if they could be repeated consistently within each method. However, it is important to emphasize that the differences were below 1 mm or 0.5 degree; thus, they clinically might be considered insignificant.

Raw data from the CBCT scan were coded into Digital Imaging and Communications in Medicine (Dicom3) file format. These data were then processed into Mimics software to perform 3D cephalometric tracings (version 20.0, Materialise, Leuven, Belgium; -innovation-suite/mimics). Two RLCs (right and left) were reconstructed for each CBCT scan by lateral radiographic projection of the entire volume using iCAT Vision software (Imaging Sciences International, Inc., -dent.co.uk/i-cat-vision/) (Fig. 1). All 2D cephalograms were then traced using a dedicated software (Dolphin Imaging Cephalometric and Tracing Software, version 11.9, Chatsworth, California, _OS_Safe_Name=20160913). 2b1af7f3a8