Arveda N, Migliorati M, De Mari A
… +5 more, Forin Valvecchi F, Schiavetti I, Annarumma F, Battista G, Aghazada H
Angle Orthod
· 2025 Sep · PMID 40936627
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OBJECTIVES: To compare a slow, rapid activation protocol for miniscrew-assisted maxillary expansion in adults. MATERIALS AND METHODS: Fifteen consecutive adult patients underwent miniscrew-assisted slow palatal expansion...OBJECTIVES: To compare a slow, rapid activation protocol for miniscrew-assisted maxillary expansion in adults. MATERIALS AND METHODS: Fifteen consecutive adult patients underwent miniscrew-assisted slow palatal expansion (MASPE) using a bone borne device. A control group treated with miniscrew-assisted rapid palatal expansion (MARPE) was matched for initial demographic data and expansion need. RESULTS: No statistically significant differences in bispinal expansion were observed between the MASPE and MARPE groups at the anterior, middle, or posterior levels. CONCLUSIONS: MASPE successfully achieved skeletal expansion of the maxilla in 86.7% of adult patients treated. The expansion pattern and results were comparable to MARPE.
Baena-de la Iglesia T, Navarro-Fraile E, Iglesias-Linares A
Angle Orthod
· 2025 Sep · PMID 40936626
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OBJECTIVES: To compare and validate two tridimensional diagnostic methods for quantifying and categorizing external root resorption using an artificial intelligence (AI)-aided, automatic, or manual digital segmentation p...OBJECTIVES: To compare and validate two tridimensional diagnostic methods for quantifying and categorizing external root resorption using an artificial intelligence (AI)-aided, automatic, or manual digital segmentation process. MATERIALS AND METHODS: 40 teeth were segmented from 10 cone beam computed tomography (CBCT) records from five patients. Stereolithographic files were created, and automatic, manual, or AI-aided segmentation of each incisor was performed by two double-blinded operators. Two quantification methods were used and compared by analyzing final segmented regions of the tooth. This study followed QAREL (Quality Appraisal of Diagnostic Reliability) and COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments) guidelines. Reproducibility was assessed using the Dahlberg formula, coefficient of variation, and intraclass correlation coefficient (ICC) ( value < .05). RESULTS: Intra- and interobserver correlations were high (ICC: > 0.736; < .01). Statistically significant differences were found between the two measurement methods for high-quality CBCT images of central incisors, mainly at the level of the apical third. Specific differences were found between methods when root resorption was evaluated in the middle and apical thirds using AI segmentation of the central incisor ( = .043). When referring to total volume loss of the lateral incisor, differences ( = .021) were observed between methods when segmented by manual or AI-aided procedures. Highest specificity (100%) was observed for AI-aided segmentation and Method 2 for evaluation of root resorption at the apical third volume. CONCLUSIONS: Assessment of root resorption with CBCT is highly dependent on CBCT definition, type of segmentation, and measurement method. Three-dimensional (3D) measurement method described by three landmark points yielded satisfactory results using any tested segmentations.
Kim JH, Kwon N, Park JA
… +3 more, Youn SB, Seo BM, Lee SJ
Angle Orthod
· 2025 Sep · PMID 40936625
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OBJECTIVES: To suggest a sample size calculation method to develop artificial intelligence (AI) that can predict soft tissue changes after orthognathic surgery with clinically acceptable accuracy. MATERIALS AND METHODS:...OBJECTIVES: To suggest a sample size calculation method to develop artificial intelligence (AI) that can predict soft tissue changes after orthognathic surgery with clinically acceptable accuracy. MATERIALS AND METHODS: From data collected from 705 patients who had undergone combined surgical-orthodontic treatment, 10 subsets of the data were generated through random resampling procedures, specifically with reduced data sizes of 75, 100, 150, 200, 300, 400, 450, 500, 600, and 700. Resampling was repeated four times, and each subset was used to create a total of 40 AI models using a deep-learning algorithm. The prediction results for soft tissue change after orthognathic surgery were compared across all 40 AI models based on their sample sizes. Clinically acceptable accuracy was set as a 1.5-mm prediction error. The predictive performance of AI models was evaluated on the lower lip, which was selected as a primary outcome variable and a benchmark landmark. Linear regression analysis was conducted to estimate the relationship between sample size and prediction error. RESULTS: The prediction error decreased with increasing sample size. A sample size greater than 1700 datasets was estimated as being required for the development of an AI model with a prediction error < 1.5 mm at the lower lip area. CONCLUSIONS: A fairly large quantity of orthognathic surgery data seemed to be necessary to develop software programs for visualizing surgical treatment objectives with clinically acceptable accuracy.
Miao Z, Ren L, Zhang H
… +5 more, Zheng C, Yang Y, Zhu J, Han Y, Wang S
Angle Orthod
· 2025 May · PMID 40328448
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OBJECTIVES: To evaluate the influence of personalized aligner replacement, with or without physical methods of acceleration using low-frequency vibration combined with a low-level laser, on the tooth movement rate and ac...OBJECTIVES: To evaluate the influence of personalized aligner replacement, with or without physical methods of acceleration using low-frequency vibration combined with a low-level laser, on the tooth movement rate and accuracy of clear aligners. MATERIALS AND METHODS: Forty participants were randomly allocated to three groups. Fourteen participants used the standard replacement protocol in Group A, Group B included 14 participants using a personalized replacement protocol, and 12 participants in Group C followed the personalized replacement protocol and used a physical device that combined low-frequency vibration and low-level laser. Aligner replacement cycles of the first 12 steps were recorded, and GOM inspect suite software 2022 (GOM; Braunschweig, Germany) was used to evaluate maxillary molar movement accuracy using digital models collected before treatment and at the end of the 12th step. RESULTS: No significant difference was found in the accuracy of maxillary molar movement between Groups A and B, but the tooth movement rate in Group B was significantly greater. The accuracy of maxillary molar movement was similar in Groups B and C, and the tooth movement rate in Group C was significantly increased. CONCLUSIONS: The personalized replacement protocol decreased the number of aligner replacement cycles without impacting the accuracy of tooth movement. With personalized replacement, a physical method of acceleration combining low-level laser and low-frequency vibration significantly accelerated orthodontic tooth movement and had little influence on the accuracy of tooth movement.
Angle Orthod
· 2025 May · PMID 40324781
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OBJECTIVES: To compare mandibular incisor root length (RL) and root volume (RV) changes after 6 months of wearing either a removable anterior bite plane (RABP) during meals (F + M) or not during meals (F - M). Additional...OBJECTIVES: To compare mandibular incisor root length (RL) and root volume (RV) changes after 6 months of wearing either a removable anterior bite plane (RABP) during meals (F + M) or not during meals (F - M). Additionally, changes in incisal maximum bite force (IMBF) and their correlation with RL and RV changes were assessed. MATERIALS AND METHODS: Thirty-six children with deep bite using RABPs full time were randomly assigned in equal numbers to either the F + M group or F - M group. Cone-beam computed tomographic radiographs and IMBF were recorded at baseline (CT0) and after 6 months (CT1). Within and between group comparisons of RL and RV were performed (P = .05) with Bonferroni correction applied for segmental RV differences (P = .008). Relationships between IMBF changes and RL and RV changes were analyzed (P = .05). RESULTS: Both groups showed significant reductions in RL and RV. RL decrease in the F + M group (0.25 ± 0.14 mm) was significantly greater than in the F - M group (0.21 ± 0.14 mm). Reduction in RV was not significantly different between the groups, but IMBF significantly increased in both groups. Significant correlations were observed between IMBF changes and RL (r = 0.56) and RV (r = 0.86) changes. CONCLUSIONS: Deep bite correction using RABPs for 6 months with F + M protocol resulted in a greater decrease in mandibular incisor RL compared to the F - M protocol. However, RV changes were comparable between protocols. IMBF may influence the degree of RL and RV changes.
Angle Orthod
· 2025 May · PMID 40306697
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OBJECTIVES: To evaluate root development after forced eruption of impacted maxillary canines before or after complete root development of the contralateral canine. MATERIALS AND METHODS: A total of 50 patients (21 male,...OBJECTIVES: To evaluate root development after forced eruption of impacted maxillary canines before or after complete root development of the contralateral canine. MATERIALS AND METHODS: A total of 50 patients (21 male, 29 female; mean age: 12.4 years) with unilateral impaction of maxillary canines were classified to "Immature group" with incomplete root development of the contralateral canine or "Mature group" with complete root development of the contralateral canine. Volume, total length, crown length, root length, and root/crown ratio (R/C) of the impacted canine and the contralateral canine were measured in the posttreatment cone-beam computed tomography images. RESULTS: In the immature group, total length and root length of impacted canines were 0.68 mm and 0.51 mm shorter than contralateral canines, respectively (P < .05). In the mature group, volume, total length, root length, and R/C of impacted canines were 37.90 mm3, 2.43 mm, 2.53 mm, and 0.26 smaller, respectively, than contralateral canines (P < .001). Crown length also showed a statistically significant difference between impacted canines and contralateral canines (P < .05). When differences between impacted canines and contralateral canines were compared between the immature and mature groups, all variables showed statistically significant differences, with the mean difference in total length and root length being 1.75 mm and 2.02 mm larger, respectively, in the mature group, (P < .001). CONCLUSIONS: Regardless of treatment timing, total length and root length of impacted canines were shorter than those of contralateral canines. Forced eruption of the impacted canine undertaken before root development of the contralateral canine showed better root development in both linear and volumetric measurements.
Burnett I, Gandhi V, Alshami L
… +2 more, Patel J, Nandakumar J
Angle Orthod
· 2025 May · PMID 40306691
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OBJECTIVES: To assess case outcomes using the American Board of Orthodontics (ABO) Objective Grading System (OGS) in patients treated with lower incisor extraction. MATERIALS AND METHODS: Discrepancy indices (DI) were us...OBJECTIVES: To assess case outcomes using the American Board of Orthodontics (ABO) Objective Grading System (OGS) in patients treated with lower incisor extraction. MATERIALS AND METHODS: Discrepancy indices (DI) were used to stratify patients into mild, moderate, and complex categories and overjet, overbite, and buccal occlusion were examined. Nineteen subjects were included in the study, among which 52.6% were females. RESULTS: The average (SD) age was 28.5 (15.1) years, and the average (SD) DI was 15.2 (8.6) with an even distribution of mild, moderate, and complex cases. The mean post-treatment OGS was 31, with 52.6% of the patients achieving passing ABO clinical scores. 31.6% achieved normal post-treatment overjet. A total of 52.6% achieved normal post-treatment overbite, and 84.2% achieved normal post-treatment buccal occlusion. CONCLUSIONS: An increase in overbite and overjet, and a decrease in buccal occlusion measurement, were found after lower incisor extraction treatment. The ABO-OGS scores obtained were high, indicating that they may not pass the ABO criteria established.
Angle Orthod
· 2025 Apr · PMID 40300781
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OBJECTIVES: To investigate the possible association between the presence of extreme premolar rotations (135° to 180° rotated premolars) and other dental anomalies within the dental anomaly pattern (DAP). MATERIALS AND ME...OBJECTIVES: To investigate the possible association between the presence of extreme premolar rotations (135° to 180° rotated premolars) and other dental anomalies within the dental anomaly pattern (DAP). MATERIALS AND METHODS: Thirty-two healthy subjects exhibiting at least one premolar rotated 135° to 180° were identified from the archives of a university orthodontic clinic. Inclusion criteria were: presence of a rotated premolar, availability of panoramic radiographs, dental study casts, and intraoral photographs. The concomitant occurrence of additional dental anomalies was evaluated based on the DAP, including tooth agenesis, infraocclusion of deciduous molars, peg-shaped lateral incisors, palatally-displaced canines and transpositions. Comparisons were made to a randomly selected control group (n = 96) without this anomaly, using chi-square statistics. RESULTS: The experimental group displayed a higher prevalence of dental anomalies compared to the control group. Forty-seven percent of patients in the experimental group exhibited dental agenesis, whereas only 8% of the control group had dental agenesis (P < .001). Infraocclusion of deciduous molars (22% vs 5%; P = .005) and canine impaction (16% vs 3%; P = .035) were also observed more frequently in patients in the experimental group. CONCLUSIONS: These findings reveal significant associations between the presence of extreme premolar rotations and the occurrence of other dental anomalies, namely dental agenesis, infraocclusion of deciduous molars, and palatally-displaced canines. These observations suggest a shared genetic origin for these anomalies.
Liu Y, Valkenburg C, Jonkman REG
… +1 more, Slot DE
Angle Orthod
· 2025 Apr · PMID 40247151
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OBJECTIVES: To analyze, appraise, and synthesize papers in which authors have compared the effects of chemotherapeutic toothpaste (CTP) and regular toothpaste (RTP) on plaque scores (PSs), gingival scores (GSs), and blee...OBJECTIVES: To analyze, appraise, and synthesize papers in which authors have compared the effects of chemotherapeutic toothpaste (CTP) and regular toothpaste (RTP) on plaque scores (PSs), gingival scores (GSs), and bleeding scores (BSs) in orthodontic patients wearing fixed appliances (FAs). MATERIALS AND METHODS: PubMed-MEDLINE, Cochrane-CENTRAL, and Embase databases were searched with predefined search terms until April 2024 for controlled or randomized controlled clinical trials aligning with the aim. In the eligible papers, risk of bias was evaluated, data of interest were extracted, and a descriptive analysis was performed. If possible, meta-analyses and subanalyses on specific factors were conducted. The quality of evidence and strength of the recommendation were rated. RESULTS: In our search and selection, we obtained five papers describing eight comparisons. Potential risk of bias was assessed as some concerns to high, and heterogeneity was considered substantial. Descriptive analysis revealed no significant difference in PS and BS, with an improvement in GS favoring CTP. Meta-analyses of the end scores showed CTP significantly reduced PS (standardized mean difference [SMD] = -0.26; 95% confidence interval [CI] = -0.52, -0.01; P = .04). However, no significant effects were observed on GS and BS. These findings were supported by the subanalyses on CTP with chlorhexidine (CHX; PS: mean difference [MD] = -5.12; 95% CI = -10.08, -0.15; P = .04). The quality of evidence was graded as very low, and strength of the recommendation was judged as very weak. CONCLUSIONS: For orthodontic patients with FAs, very weak certainty exists in recommending CTP (eg, with CHX) over RTP for use with toothbrushing. CTP may have a very small effect on PS and a small effect on GS.
Angle Orthod
· 2025 Apr · PMID 40242890
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OBJECTIVES: To identify the rotational fulcrum (RF) and to evaluate the skeletal and dentoalveolar effects after rapid palatal expansion (RPE) with tooth-borne and tooth-bone-borne (MARPE) appliances. MATERIALS AND METHO...OBJECTIVES: To identify the rotational fulcrum (RF) and to evaluate the skeletal and dentoalveolar effects after rapid palatal expansion (RPE) with tooth-borne and tooth-bone-borne (MARPE) appliances. MATERIALS AND METHODS: 31 patients were selected (MARPE group: n = 14, age 16.2 ± 2 years; hyrax group: n = 17, age 14.7 ± 0.8 years) with RPE indication and having cone-beam computed tomography before (T1) and after RPE (T2) and after 6 months of retention (T3). RESULTS: In the MARPE group, the RF was at or above the frontozygomatic suture (FZS), whereas in the hyrax group, it was at or below the FZS. The skeletal response rates were 70% (2°) and 33% (1.09°); alveolar response rates, 18% (0.52°) and 20% (0.68°); and dental response rates, 12% (0.35°) and 47% (1.54°) in the MARPE and hyrax groups, respectively, with a significant difference between groups in skeletal (P = .005) and dental (P < .001) regions. After retention, no significant difference was found between groups. CONCLUSIONS: Although MARPE resulted in a higher RF in the coronal view, both techniques effectively corrected transverse discrepancies with similar stability. Considering the between-group differences in relation to skeletal and dentoalveolar response, MARPE should be used for cases in which minimal compensatory tooth movement is desired.
Angle Orthod
· 2025 May · PMID 40231547
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OBJECTIVES: To evaluate the position of the chin of untreated male and female Class I growing subjects. MATERIALS AND METHODS: A sample of 51 growing Class I subjects, 29 male and 22 female, from 7 to 16 years of age, wa...OBJECTIVES: To evaluate the position of the chin of untreated male and female Class I growing subjects. MATERIALS AND METHODS: A sample of 51 growing Class I subjects, 29 male and 22 female, from 7 to 16 years of age, was studied. The total number of 359 lateral cephalograms included at least one cephalogram for each subject taken in the early mixed dentition (younger than 10 years), one in late mixed dentition (between 10 and 12 years), and one in the permanent dentition phase (older than 12 years old). RESULTS: Descriptive statistics for the X component (horizontal) and Y component (vertical) of the cephalometric landmark Gnathion (Gn) were recorded. Student t-tests showed no differences between male and female growing subjects for the X component (horizontal), but significant differences for the Y component (vertical). CONCLUSIONS: Displacement of the mandible over the timeframe studied differs between male and female untreated subjects. Although most of the orthodontic literature addresses such differences as an anteroposterior phenomenon, this study found that the difference is mainly due to the vertical, and not horizontal, component of such displacement.
Angle Orthod
· 2025 Apr · PMID 40204282
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OBJECTIVES: To evaluate the accuracy and reliability of an automated landmark identification (ALI) system and the impact of ALI errors on cephalometric measurements on cone-beam computed tomography (CBCT) images. MATERIA...OBJECTIVES: To evaluate the accuracy and reliability of an automated landmark identification (ALI) system and the impact of ALI errors on cephalometric measurements on cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS: Thirty-one landmarks were identified on 76 CBCT images using Invivo7 software (Anatomage, San Jose, Calif). Ground truth was established by averaging landmark coordinates from two calibrated human examiners. The accuracy of the ALI system was assessed by the mean absolute error (MAE, mm) across coordinate axes, the mean error distance (mm), and the successful detection rate (SDR) for each landmark. Interexaminer reliability between the ALI and manual landmark location was evaluated. Eighteen cephalometric measurements were computed from 25 landmarks. Accuracy of measurements from the ALI system was assessed with the MAE and successful measurement rates (SMR). RESULTS: The ALI system closely matched human examiners in landmark identification, with an average MAE of 0.94 ± 0.99 mm. Across all three coordinate axes, 87% of the landmarks had <2 mm MAE. ALI average MAE for conventional linear and angular cephalometric measurements were 1.35 ± 1.33 mm and 0.89 ± 0.89 degrees, respectively. Only one measurement, Intercondylar Width, showed MAE >3 mm. CONCLUSIONS: The ALI system showed clinically acceptable accuracy and reliability for the majority of cephalometric landmarks and measurements. Clinicians are advised to critically evaluate ALI landmarks with substantial errors, to fully utilize the capabilities of commercial software effectively.
Pilgrim C, Major PW, Perez-Garcia A
… +1 more, Flores-Mir C
Angle Orthod
· 2025 Mar · PMID 40147480
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OBJECTIVES: To describe parent perspectives on effective patient-provider communication (PPC) during orthodontic consultations for their children. MATERIALS AND METHODS: Qualitative description guided the study design. P...OBJECTIVES: To describe parent perspectives on effective patient-provider communication (PPC) during orthodontic consultations for their children. MATERIALS AND METHODS: Qualitative description guided the study design. Parents of children who recently underwent an orthodontic consultation and were fluent in English were purposefully selected. Interviews continued until data saturation was achieved. Data were analyzed using inductive, manifest thematic analysis. RESULTS: Fifteen parents, including 10 females and five males, participated. Four themes were inductively developed. Parents attributed several characteristics to effective PPC, including inclusivity, clarity, honesty, and comprehensiveness's. Specifically, they emphasized the importance of involving children and staff members in the consultation process, delivering honest and justifiable diagnoses and treatment plans, and adopting a holistic approach that considered all phases of the therapeutic process and various dimensions such as tasks, finances, and relationships between patients and care providers. CONCLUSIONS: The findings underscore the significance of care provider-related factors in PPC. These findings also emphasize the need for a collaborative and inclusive approach between orthodontic patients and care providers to foster effective PPC. Subsequent researchers should delve into the perspectives of pediatric patients, particularly adolescents, and care providers regarding effective PPC.
Angle Orthod
· 2025 Mar · PMID 40107298
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OBJECTIVES: To investigate the influence of attachment position and torque overcorrection on stress distribution and tooth displacement trends during arch expansion in clear aligner therapy (CAT). MATERIALS AND METHODS:...OBJECTIVES: To investigate the influence of attachment position and torque overcorrection on stress distribution and tooth displacement trends during arch expansion in clear aligner therapy (CAT). MATERIALS AND METHODS: Dental and skeletal models were obtained from an adult volunteer with angle Class I and mild crowding. Attachments were designed on the buccal, lingual, and buccolingual surfaces of the first molar. Different overcorrection torques were designed on the first molar. The displacement and stress of the whole arch were analyzed using a three-dimensional finite element analysis model. RESULTS: Crown buccal tipping was observed during arch expansion, while the lingual attachment showed more buccal crown and lingual root movement. Based on the trend of displacement, 1.5° of buccal root torque overcorrection without attachments could lead to bodily movement, 1.8° with a lingual attachment, 0.5° with a buccal attachment, and 0.9° with a buccolingual attachment. CONCLUSIONS: Arch expansion is primarily achieved by teeth tipping despite attachments placed on the buccal or lingual side of teeth in CAT. Appropriate overcorrection of buccal root torque could contribute to the achievement of bodily movement.
Guo F, Wang C, Han L
… +3 more, Li H, Lei L, Mei L
Angle Orthod
· 2025 Mar · PMID 40098284
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OBJECTIVES: To evaluate the accuracy of Invisalign ClinCheck in predicting open gingival embrasures (OGEs) and to identify predictors of OGEs in adult extraction cases. MATERIALS AND METHODS: Fifty-seven adult patients t...OBJECTIVES: To evaluate the accuracy of Invisalign ClinCheck in predicting open gingival embrasures (OGEs) and to identify predictors of OGEs in adult extraction cases. MATERIALS AND METHODS: Fifty-seven adult patients treated with Invisalign and four first premolar extractions were included in this retrospective study. OGEs were measured in maxillary and mandibular anterior regions using posttreatment intraoral photographs (actual OGEs) and the final step from the first treatment plan in ClinCheck (predicted OGEs). Prediction performance indicators including precision, sensitivity, specificity, false positive rate, false negative rate, and accuracy were evaluated at each tooth site. Predictors of OGEs (age, crowding, crown morphology, tooth movement, tooth site, treatment duration, and attachment design) were analyzed using binary logistic regression. RESULTS: Incidence of actual OGEs was like that of the ClinCheck predicted OGEs in the maxillary and mandibular anterior regions. The predictability of ClinCheck was satisfactory in both the maxilla and mandible, with accuracy rates of 94.0% and 86.0%, respectively. The most accurate prediction was for the maxillary central incisors, achieving a precision of 100% and an accuracy of 96.6%. The most significant predictors of OGEs included patient age at initial consultation, anterior crowding, tooth crown morphology, and type of tooth movement. CONCLUSIONS: Invisalign ClinCheck predicted OGEs in adult patients treated with four premolar extractions. The accuracy of the prediction was satisfactory, 94% in the maxilla and 86% in the mandible, demonstrating great potential for clinical application.
Angle Orthod
· 2025 Mar · PMID 40096851
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OBJECTIVES: To evaluate the reliability and accuracy of Keynote for tracing and analyzing cephalograms in comparison to Quick Ceph Studio. MATERIALS AND METHODS: This was a cross-sectional study, which utilized the later...OBJECTIVES: To evaluate the reliability and accuracy of Keynote for tracing and analyzing cephalograms in comparison to Quick Ceph Studio. MATERIALS AND METHODS: This was a cross-sectional study, which utilized the lateral cephalometric digital images (radiographs) from 49 patients. The study site was the Dental Radiology unit in the School of Dentistry of the Muhimbili University of Health and Allied Sciences (MUHAS), in Dar es Salaam, Tanzania. Cephalograms were imported to Quick Ceph Studio and then to Keynote for analysis. Minimum, maximum, mean, standard deviation, and mean difference were used to describe the data. Agreement between the two techniques was assessed by the Bland-Altman plot, linear regression, and interexaminer reliability tests. A level of significance was considered at P < .05, and a 95% CI was estimated for the outcomes in the study groups. RESULTS: The majority of the mean values obtained from Quick Ceph were greater (P < .05) than those obtained from Keynote. According to Bland-Altman plots, all measurements were within the limit of agreement except for only five linear variables. The interexaminer reliability test showed no agreement between the two instruments for all linear parameters except for the LAFH: TAFH, whereas all angular measurements revealed good to excellent agreement (ICC: 0.75 to 0.97) between the methods. CONCLUSIONS: The measurements obtained with the Keynote software were found to be clinically reliable since the limits did not exceed the maximum acceptable difference between the methods. The two software instruments were considered to be in agreement and can be used interchangeably.