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The aim of this study was to evaluate the basic and advanced features of five different cephalometric analysis computer programs. The level of measurement agreement with hand-tracing and time demands was examined. The material consisted of 30 digital lateral radiographic images. Twenty-three measurements were calculated by one operator both manually and using five different cephalometric analysis software programs. Intraclass correlation coefficient (ICC) was used to detect differences in measurement agreement between hand-tracing and basic features as well as between hand-tracing and advanced features. Coefficient of variation (CV) was used to assess intra-user error and a Student's t-test to determine time differences. Of the 23 measurements tested for each procedure, one [(Ii to NB (mm)] showed better agreement with hand-tracing when the advanced features were used, 20 showed good agreement with hand-tracing for both basic and advanced features, while two (AB on FOP and Ii to A/Pog) showed poor intra-user reproducibility. Hand-tracing took a significantly longer time (P &lt; 0.001) than both the basic and advanced features. The advanced features took a significantly longer time (P &lt; 0.001) than the basic features. Both basic and advanced features showed good measurement agreement with the hand-tracing technique. The use of the basic features minimizes the time requirements for analysis. A computerized tracing technique, which consists of either basic or advanced feature, can be regarded as less time consuming and equally reliable to hand-tracing as far as cephalometric measurements are concerned.

A comparison of hand-tracing and cephalometric analysis computer programs with and without advanced features—accuracy and time demands