The purpose of our study was to assess the reproducibility of linear and angular measurements of cephalogram tracings made with an online website-based platform CephX® vs. tracings made using the FACAD® computer software.

Thirty cephalometric radiographs were selected randomly to be used in this study. A total of 16 landmarks and 16 measurements (8 linear and 8 angular) were defined. We used paired t-test to compare mean differences between both methods. Concordance Correlation Coefficient (CCC) and Bland-Altman analyses were used to evaluate reproducibility of measurements. The level of statistical significance was set at P < 0.05.

We did not find a statistically significant mean difference between the two methods except for two angular measurements SNA, FMA and one linear measurement Pg to NB. The highest magnitude of the difference between sample means was 1.9° and 0.78 mm for the angular and linear measurements respectively. The SE value was less than 0.1° for the angular measurements and less than 0.3 mm for the linear measurements. All parameters except POG to NB showed moderate to almost perfect agreement (>0.90).

The measurements obtained by both softwares FACAD® and CephX® are reproducible. Although significant differences were detected for some measurements, all differences were not clinically significant.