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@article{208460,
        author = {Manju Krishnan P and Tojan Chacko and Jose Jacob and Supriya Gopalakrishnan and Anuradha and Vineetha Menon and Midhun Raghav and Pooja Sanal},
        title = {Reproducibility of Manual and On-Screen Digital Cephalometric Tracing for Soft-Tissue Profile Variables: A Comparative Retrospective Study},
        journal = {International Journal of Innovative Research in Technology},
        year = {2026},
        volume = {13},
        number = {4},
        pages = {1919-1922},
        issn = {2349-6002},
        url = {https://ijirt.org/article?manuscript=208460},
        abstract = {Cephalometric analysis is an important component of orthodontic diagnosis and treatment planning. Although manual tracing has traditionally been used, digital cephalometric analysis offers advantages in image manipulation, measurement, data storage and workflow efficiency. The reproducibility of soft-tissue measurements remains a concern because many soft-tissue landmarks have indistinct radiographic boundaries.
Aim: To compare the reproducibility of manual tracing and on-screen digitalisation for soft-tissue cephalometric variables.
Materials and Methods:  This retrospective observational study included pretreatment lateral cephalograms of 60 patients aged 14–27 years with a skeletal Class I relationship. Radiographs were obtained under standardized conditions with the patient in natural head position and lips at rest. Soft-tissue cephalometric variables involving the lips, nose, chin and facial profile were assessed by two observers using conventional manual tracing and on-screen digitalisation with NemoCeph software. Data distribution was assessed using the Shapiro–Wilk test, and manual and digital measurements were compared using paired t-tests.
Results:  No statistically significant differences were found between manual and digital measurements for any of the evaluated soft-tissue variables (p > 0.05). Both methods demonstrated high intra- and inter-examiner reproducibility. Angular variables, including the H angle, Z angle and nasolabial angle, showed greater consistency than several linear soft-tissue measurements. Greater variability was observed in perioral variables, particularly lower-lip measurements, interlabial gap and soft-tissue pogonion. Digital tracing showed comparable or slightly lower variability for several measurements.
Conclusion:  On-screen digital cephalometric tracing using NemoCeph demonstrated measurement outcomes comparable with conventional manual tracing and may be considered a reliable alternative for soft-tissue cephalometric analysis. However, digitalisation does not eliminate variability associated with soft-tissue landmark identification. Particular care is required when interpreting perioral measurements and other parameters that are sensitive to small landmark-position differences.},
        keywords = {Cephalometry; digital tracing; manual tracing; soft-tissue analysis; reproducibility; NemoCeph; orthodontics},
        month = {September},
        }