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Comparison of Digital Analysis and Artificial Intelligence for Cephalometric Tracing

17. juni 2026 oppdatert av: Andrea Scribante, University of Pavia

Cephalometric Tracing: A Comparison Between Digital Analysis and Artificial Intelligence

This study aims to evaluate the accuracy and reliability of artificial intelligence (AI)-based cephalometric analysis compared with digital manual tracing. A total of 100 standardized lateral cephalometric radiographs will be analyzed using Delta-Dent software with manual landmark identification and three fully automated AI-based systems (WebCeph, QuantX, and Smartee). Sagittal, vertical, dental, and soft tissue cephalometric parameters will be compared among the different methods. Statistical analysis will assess inter-method agreement and the clinical relevance of any observed discrepancies. The study seeks to determine whether AI-based systems provide measurements comparable to conventional digital tracing and whether they can be considered reliable adjunctive tools in orthodontic diagnosis and treatment planning.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

This prospective observational study aims to evaluate the accuracy, reproducibility, and clinical reliability of artificial intelligence (AI)-based cephalometric analysis systems compared with digital manual tracing. Patients whose lateral cephalometric radiographs were previously acquired for orthodontic diagnostic purposes at the Unit of Orthodontics and Paediatric Dentistry, University of Pavia, will be retrospectively selected according to predefined inclusion and exclusion criteria. Written informed consent for the use of clinical records for research purposes will be obtained from all participants or their legal guardians. A total of 100 standardized digital lateral cephalometric radiographs will be included in the study. Each radiograph will be analysed using Delta-Dent software with manual landmark identification and three fully automated AI-based software systems: WebCeph™, QuantX, and Smartee. Cephalometric analyses will be performed without manual adjustment of landmarks in the AI-based systems. Ten cephalometric parameters representative of sagittal, vertical, dental, and soft tissue relationships will be evaluated, including SNA, SNB, ANB, SN-GoGn, L1-GoGn, U1-ANSPNS, nasolabial angle, facial angle, Wits appraisal, and N-Me. Manual digital tracing performed by a single experienced orthodontist will be considered the reference method. Intra-rater reliability will be assessed using intraclass correlation coefficient (ICC). Statistical analysis will be conducted using R software (version 3.1.3; R Foundation for Statistical Computing, Wien, Austria). Descriptive statistics will be calculated for all variables. Normality of data distribution will be assessed using the Kolmogorov-Smirnov test. Comparisons among the different methods will be performed using the Friedman test followed by Dunn's post hoc test. Statistical significance will be predetermined at p < 0.05.

Studietype

Observasjonsmessig

Registrering (Antatt)

100

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

    • Italy
      • Pavia, Italy, Italia, 27100
        • Rekruttering
        • Unit of Orthodontics and Pediatric Dentistry - Section of Dentistry - Department of Clinical, Surgical, Diagnostic and Pediatrics - University of Pavia, Pavia, Lombardy 27100
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Barn
  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

The study population consists of patients of any age and sex who underwent digital lateral cephalometric radiography as part of routine orthodontic diagnostic records at the Unit of Orthodontics and Paediatric Dentistry, University of Pavia. Radiographs meeting the predefined inclusion and exclusion criteria will be retrospectively selected for analysis.

Beskrivelse

Inclusion Criteria:

  • Availability of digital lateral cephalometric radiographs of adequate diagnostic quality
  • Radiographs acquired with patients in centric occlusion and proper head positioning using a cephalostat
  • Patients of any age and sex
  • Absence of congenital or acquired craniofacial anomalies
  • No previous orthodontic treatment
  • No previous orthognathic surgical treatment
  • Absence of agenesis of incisors or first molars
  • Absence of supernumerary teeth overlapping the region of interest

Exclusion Criteria:

  • Radiographs presenting artifacts or inadequate visualization of anatomical structures
  • History of significant craniofacial trauma
  • Radiographs acquired without a cephalostat
  • Presence of severe skeletal asymmetries
  • Incomplete clinical or radiographic records
  • Radiographs unsuitable for manual or AI-based cephalometric landmark identification

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
Orthodontic Patients with Lateral Cephalometric Radiographs
This study includes a single observational arm, since all lateral cephalometric radiographs included in the study will undergo the same analysis procedures. Each radiograph will be evaluated using one digital manual tracing method (Delta-Dent) and three fully automated artificial intelligence-based cephalometric analysis systems (WebCeph™, QuantX, and Smartee). No patient allocation, randomization, or therapeutic intervention will be performed.
All included lateral cephalometric radiographs will undergo cephalometric analysis using both digital manual tracing and artificial intelligence-based automated systems. Manual digital tracing will be performed with Delta-Dent software by a single experienced orthodontist through manual identification of cephalometric landmarks. The same radiographs will subsequently be analysed using three fully automated AI-based software programs (WebCeph™, QuantX, and Smartee) without manual correction of landmark positioning. No therapeutic intervention or modification of patient treatment will be performed, as this is an observational comparative study based exclusively on retrospective analysis of radiographic records.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Agreement between AI-based cephalometric analysis and digital manual tracing
Tidsramme: Baseline
Agreement between cephalometric measurements obtained with AI-based software systems and digital manual tracing will be assessed using the intraclass correlation coefficient (ICC) and differences in angular and linear cephalometric measurements.
Baseline

Sekundære resultatmål

Resultatmål
Tidsramme
SNA
Tidsramme: Baseline
Baseline
SNB
Tidsramme: Baseline
Baseline
ANB
Tidsramme: Baseline
Baseline
SN-GoGn
Tidsramme: Baseline
Baseline
L1-GoGn
Tidsramme: Baseline
Baseline
U1-ANSPNS
Tidsramme: Baseline
Baseline
Nasolabial angle
Tidsramme: Baseline
Baseline
Facial angle
Tidsramme: Baseline
Baseline
Wits appraisal
Tidsramme: Baseline
Baseline
N-Me
Tidsramme: Baseline
Baseline

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. juni 2026

Primær fullføring (Antatt)

30. september 2026

Studiet fullført (Antatt)

30. september 2026

Datoer for studieregistrering

Først innsendt

17. juni 2026

Først innsendt som oppfylte QC-kriteriene

17. juni 2026

Først lagt ut (Faktiske)

24. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

24. juni 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

17. juni 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • 2026-CEPHTRACING

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

Data will be available upon motivated request to the corresponding authors.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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