title: Evaluation of Soft Tissue Landmark Reliability between Manual and Computerized Plotting Methods.
abstract: OBJECTIVE
  The aim of the study is to evaluate the reliability of soft tissue landmark identification between manual and digital plot-tings in both X and Y axes.
  
  
  METHODS
  A total of 50 pretreatment lateral cephalograms were selected from patients who reported for orthodontic treatment. The digital images of each cephalogram were imported directly into Dolphin software for onscreen digi-talization, while for manual tracing, images were printed using a compatible X-ray printer. After the images were standardized, and 10 commonly used soft tissue landmarks were plotted on each cephalogram by six different professional observers, the values obtained were plotted in X and Y axes. Intraclass correlation coefficient was used to determine the intrarater reliability for repeated landmark plotting obtained by both the methods.
  
  
  RESULTS
  The evaluation for reliability of soft tissue landmark plottings in both manual and digital methods after subjecting it to interclass correlation showed a good reliability, which was nearing complete homogeneity in both X and Y axes, except for Y axis of throat point in manual plotting, which showed moderate reliability as a cephalometric variable. Intraclass correlation of soft tissue nasion had a moderate reliability along X axis. Soft tissue pogonion shows moderate reliability in Y axis. Throat point exhibited moderate reliability in X axis.
  
  
  CONCLUSIONS
  The interclass correlation in X and Y axes shows high reliability in both hard tissue and soft tissue except for throat point in Y axis, when plotted manually. The intraclass correlation is more consistent and highly reliable for soft tissue landmarks and the hard tissue landmark identification is also consistent.
  
  
  CONCLUSIONS
  The results obtained for manual and digital methods were almost similar, but the digital landmark plotting has an added advantage in archiving, retrieval, transmission, and can be enhanced during plotting of lateral cephalograms. Hence, the digital method of landmark plotting could be preferred for both daily use and research because of the advantages.
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Puducherry, India, e-mail: 21gaugewire@gmail.com.
authors.forename: Geetha
authors.initials: G
authors.lastname: Kasinathan
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Puducherry, India.
authors.forename: Pradeep B
authors.initials: PB
authors.lastname: Kommi
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Puducherry, India.
authors.forename: Senthil M
authors.initials: SM
authors.lastname: Kumar
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Puducherry, India.
authors.forename: Aniruddh
authors.initials: A
authors.lastname: Yashwant
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: Nandakumar
authors.initials: N
authors.lastname: Arani
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Puducherry, India.
authors.forename: Senkutvan
authors.initials: S
authors.lastname: Sabapathy
mesh_terms: D059925:Anatomic Landmarks / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D002508:Cephalometry / Q000379:methods / Q000592:standards; D006257:Head / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006801:Humans; D009970:Orthodontics / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results; D013813:Therapy, Computer-Assisted
keywords: Cephalometric; Dolphin software; Intraclass correlation Reliability.