Accuracy and reliability of 2 artificial intelligence platforms for cephalometric analysis compared with a semiautomatic computer program

Introduction: Web-based platforms offer cephalometric tracing using artificial intelligence (AI) with varying performance levels. This study assessed the accuracy, reliability, and time efficiency of cephalometric tracings performed with the AI Web-based platforms WebCeph (Assemble Circle, Seoul, South Korea) and CephX (ORCA Dental AI, Las Vegas, Nev) in both their automated and corrected forms. Methods: Fifty pretreatment lateral cephalograms of patients were randomly selected and traced using AI platforms WebCeph and CephX in both their automated and landmark-corrected forms, along with the Dolphin Imaging software (version 13.01; Dolphin Imaging and Management Solutions, Chatsworth, Calif) as the “gold standard.” Twelve parameters involving sagittal, vertical, dental, and soft-tissue dimensions were selected. The time required for each analysis was measured using a stopwatch. Intersystem comparisons were performed using ordinary least squares linear regression models, with Dolphin Imaging software as the reference. The intraclass correlation coefficient was used to determine the agreement among systems. A significance level of P <0.05 was applied, and 95% confidence intervals were calculated for all outcomes. Clinically relevant differences were defined as angular discrepancies greater than 2° or linear discrepancies exceeding 2 mm. Results: The AI systems in their corrected form showed similar results to those of Dolphin Imaging software. If a 14% error is accepted, they were accurate and reliable in 11 of 12 parameters. Moreover, it was possible to reduce the tracing time by 46% compared with Dolphin Imaging software. The automated systems demonstrated low reliability and accuracy for cephalometric analysis. CephX and WebCeph are still not suitable for assessing soft-tissue parameters. Conclusions: CephX and WebCeph platforms for cephalometric tracing are valuable diagnosis tools only when landmark correction is applied.