Reliability of landmark identification among orthodontic residents using traditional and indirect digital cephalometry

ABSTRACT

To determine the inter examiner reliability of landmark identification among Orthodontic Residents using Traditional and Indirect Digital Cephalometry and to determine the intra examiner reliability of landmark identification. A cross-sectional study of six months duration done at Orthodontics Department of KMDC. One conventional Lateral Cephalometric radiograph was randomly selected. Study subjects were 8 residents with mean age was 28.8 years, with a range of 27.5 to 31 years. Cephalometeric tracing was done and landmarks S or Sella, N or Nasion A or Point A, B or Point B, Pog or Pogonion, Gn or Gnathion, Go or Gonion, Me or Menton, Or or Orbitale, Ba or Basion, API or apex of upper incisor, APT or apex of lower incisor were identified using traditional method by an Orthodontic consultant and then tracing was scanned and digitized to obtain the Indirect Digital Cepha image. The same cepha was asked to trace by all 8 study subjects. Kappa statistics was applied to see the agreement between the residents for landmarks identification in conventional and indirect digital cephalograph. Results: The study subjects were 8 orthodontic residents [3 males and 5 females]. Residents had excellent agreement for landmark identification on the conventional and the indirect digital cephalogram. The value of agreement for inter-examiner and intra-examiner reliability was found to be 0.80 [CI 0.71, 0.89] and 0.83 [CI 0.79, 0.87] respectively. The reliability of landmark identification was good among residents for both the conventional and the indirect digital cephalometery