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VOLUME 18 , ISSUE 4 ( April, 2017 ) > List of Articles


Evaluation of Soft Tissue Landmark Reliability between Manual and Computerized Plotting Methods

Geetha Kasinathan, Pradeep B Kommi, Senthil M Kumar, Aniruddh Yashwant, Nandakumar Arani, Senkutvan Sabapathy

Citation Information : Kasinathan G, Kommi PB, Kumar SM, Yashwant A, Arani N, Sabapathy S. Evaluation of Soft Tissue Landmark Reliability between Manual and Computerized Plotting Methods. J Contemp Dent Pract 2017; 18 (4):317-321.

DOI: 10.5005/jp-journals-10024-2038

Published Online: 01-08-2017

Copyright Statement:  Copyright © 2017; The Author(s).



The aim of the study is to evaluate the reliability of soft tissue landmark identification between manual and digital plottings in both X and Y axes.

Materials and 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 digitalization, 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.


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.


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.

Clinical significance

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.

How to cite this article

Kasinathan G, Kommi PB, Kumar SM, Yashwant A, Arani N, Sabapathy S. Evaluation of Soft Tissue Landmark Reliability between Manual and Computerized Plotting Methods. J Contemp Dent Pract 2017;18(4):317-321.

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