Arash Farzan - Department of Orthodontics, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
Mahsa Delshad - DDS, Private Practice, Tehran, Iran
Nima Motamed - PhD in Biostatics, Department of Social Medicine, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran

Aim: Cephalometric analysis is a main part of diagnostics in orthodontics. Modern cephalometric analysis methods include using digital software or mobile applications. This study aimed to assess the validity and reliability of the CephNinjaPro application for linear and angular cephalometric measurements. Methods: In this cross-sectional study, ۳۰ randomly selected lateral cephalograms were digitized by a digital scanner. The required landmarks for five linear and eight angular measurements were identified on all cephalograms using a fine tip pen by an experienced orthodontist, and then rescanned. To assess the validity of manual versus digital landmark identification using the CephNinjaPro application, the landmarks were identified on scanned cephalograms in both the CephNinjaPro application and Dolphin software. The results were compared before and after landmark identification. The results of the Dolphin software and the CephNinjaPro application were also compared before and after landmark identification. Data were analyzed using the paired t-test and Wilcoxon test. Results: The results showed significant differences in the angles SNA (P<۰.۰۰۱), SNB (P<۰.۰۰۱), inter-incisal (P=۰.۰۰۱), and MP-SN (P<۰.۰۰۱), and the Ga (P<۰.۰۰۱) between the Dolphin software and CephNinjaPro application before landmark identification. Also, significant differences were observed in the Ga (P<۰.۰۰۱) and SN-MP (P<۰.۰۰۱) angle between the Dolphin software and CephNinjaPro application after landmark identification. Conclusion: The CephNinjaPro application has acceptable validity and reliability for most of the linear and angular cephalometric measurements from the clinical perspective. Nonetheless, interpretation of results regarding some measurements should be done with caution.

Linear Measurements, Angular Measurements, Cephalometric Analysis