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Radiographs are essential in the planning and assessment of treatment, as well as the study of growth patterns, but before subjecting a child to X-rays, the clinician must ensure that it is justifiable on clinical grounds. The use of cephalometric radiography, particularly in the young patient with a cleft of the lip and/or palate, has been questioned. The aim of this project was to investigate the validity and reproducibility of using a photograph or video image, compared with a radiograph, for measurement of the soft tissue profile of the face. A radiographic phantom head was used, which consisted of a dry bone skull encased in a soft tissue substitute. The method involved comparing direct measurement of the head in a Reflex Metrograph with the results of computerized digitizing of a cephalometric radiograph, digitizing a video image from a computer screen and measurement of a photograph. It was found that digitizing of the soft tissue outline of a radiographic phantom head from a video image was neither a valid, nor a reproducible method of replacing cephalometric radiographs in the measurement of the soft tissue profile of the face. A photograph may be a clinically acceptable alternative, but errors from this method are likely to be larger than those due to digitization of a radiograph.

A critical appraisal of measurement of the soft tissue outline using photographs and video