Reliability of Photogrammetric Landmarks to the Conventional Cephalogram for Analyzing Soft-Tissue Landmarks in Orthodontics

Background: Graber introduced facial photographs as an internal diagnostic aid. Facial photographs could serve as an important alternative assessment tool in the absence of equipment for cephalometric analysis. Objectives: The present study was aimed at assessing whether analyzing the photographs could have precision for assessing the landmarks appropriate for facial analysis. In addition, the relationship between frontal cephalogram and measurements on photographs was assessed. Materials and Methods: Twenty individuals including both males and females within the age range of 18 years to 28 years were enrolled in the study. Frontal facial photographs, as well as frontal cephalograms, were obtained for all the included study participants. Various soft-tissue vertical and horizontal landmarks were marked on both radiographs and photographs. The data were collected and subjected to statistical analysis. Results: The results showed a statistically insignificant difference between all the vertical and horizontal parameters on photographs and cephalograms. The reliability of the digital photographs was comparable to that of the cephalograms with nonsignificant differences in the recorded mean values using the one-way ANOVA test where the statistical significance level was kept at P <= 0.05. Conclusion: The present study concluded that photography is a cost-effective and reliable method for soft-tissue landmark identification, and allows recording the images of sufficient quantity for analysis. Low-cost and easily captured photographic images can replace costly radiographic procedures without causing any discomfort to the patients.