Home Dental Radiology Evaluation of accuracy and reliability of OneCeph digital cephalometric analysis in comparison with manual cephalometric analysis—a cross-sectional study

Evaluation of accuracy and reliability of OneCeph digital cephalometric analysis in comparison with manual cephalometric analysis—a cross-sectional study

by adminjay

OneCeph is one of the few easily available software which can be downloaded from the Google Play store app in any of the current smartphones which run on the Android operating systems. The reliability and reproducibility of this newly launched software have not been compared with the conventional manual tracing. Hence in our study, we compared the accuracy of cephalometric analysis done using both OneCeph software and manual tracing to verify the accuracy of the software. Steiner’s analysis was chosen for this study because it is one of the most widely used cephalometric analyses which has both angular and linear measurements as well as skeletal and dental parameters.15 It is observed that when the hard copies of the radiographs are converted into soft copies the accuracy of scanning plays a vital role as it can lead to distortion.16 Therefore in our study the previous records which were mostly hard copies of cephalograms were not included in the study to avoid any errors in scanning.

The comparison of the mean measurements for all the parameters of Steiner’s analysis between the groups showed that there was no significant difference between both the techniques. The intra-operator reliability assessed by paired T-test showed that there was high reliability among the measurements.

Similar studies have been done for desktop software like Dolphin®, NemoCeph, VistadentTM, Quick Ceph, AOCephTM, FACAD®, and AutoCEPH©. The authors have claimed that the accuracy and reliability of this software are similar to the manual cephalometric tracing and therefore can be used as an aid in diagnosing, planning, monitoring, and evaluating orthodontic treatment both in clinical and research settings.3,4,5,6,7,8,9,10 However, the disadvantages of desktop cephalometric software are that it can only be used on a desktop or a laptop, expensive, and require an internet connection.

In recent years, much cephalometric software like Smile-Ceph, Ceph Ninja, and Smart Ceph Pro apps have been launched in the market, which can be used on tablets and smartphones. Few of the studies have found that these mobile digital cephalometric software and applications were accurate and can be used as an alternative to manual tracing.17,18 A study by Gorracci et.al showed good reliability for all cephalometric measurements obtained with an iPad-based software Smile-Ceph, desktop software NemoCeph and manual tracing.12 One of the disadvantages of this software is that it can be accessed on an iPad tablet and IOS devices only.

OneCeph is one such mobile software that is easy to use, quick, and easily dispensable, and user-friendly as it is operated by Android mobile phones.11 The software is versatile as it can be used to do most of the conventional as well as contemporary cephalometric analysis. OneCeph can work on a smartphone even without an internet connection; hence can be used in doing studies in rural centers with less accessibility to the internet. However, this software is currently available only in the android play store and not available in other operating systems like Windows, IOS, etc. Android smartphones are widely used in developing countries as it is easily available and affordable. Hence, OneCeph software can be conveniently used by dental practitioners and dental students serving in primary health care centers in rural areas. Since this software can do analysis only on 2D images hence the disadvantages of all the 2D analysis apply to this software as well. An integrated approach of diagnosis, treatment planning using smartphone cephalometric analysis software will be a valuable tool in rural villages in developing countries with little access to specialized oral health care services, where there is an immense need for orthodontic treatment, orthognathic surgery, cleft, and craniofacial deformity management. With the recent advent of the COVID-19 pandemic, orthodontic expertise can be shared with the general dental practitioners serving in rural dental clinics via teleconferencing and can successfully enhance the timely orthodontic intervention for patients with urgent need.

The influence of technology has become very prominent and has emerged as a critical part of medical and dental education, clinical research, diagnosis, and treatment planning. The widespread use of dentistry-related smartphone apps by students and practitioners to supplement their learning and clinical practice is a testimony of technological advancement. These apps can easily be integrated into the digital workflow thus improving patient management efficiency. Moreover, the cephalometric results obtained from the OneCeph app can be stored, used, and retrieved as per the need saving a lot of office space that would otherwise be consumed in the storage of records. This study used variables from an extensively practiced cephalometric analysis to simulate a real-life experience and to test uniformly the performance of the app.


This OneCeph application needs to be compared with other applications available in the market to find the difference in their accuracy, performance, and efficiency.

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