article · The Angle Orthodontist
This study evaluated the accuracy and reliability of using Keynote presentation software to trace and analyse lateral cephalometric radiographs compared with dedicated software, Quick Ceph Studio. Digital radiographs from 49 patients at a dental radiology unit in Tanzania were imported and analysed in both programmes. Statistical assessments, including Bland-Altman plots and interexaminer reliability testing, determined the level of agreement between the two methods. Although most mean values from Quick Ceph Studio were higher, Bland-Altman plots indicated that nearly all measurements remained within acceptable limits of agreement, with exceptions found in only five linear variables. While interexaminer reliability for linear parameters was poor with one exception, all angular measurements demonstrated good to excellent agreement. The findings indicate that Keynote is clinically reliable and can be used interchangeably with dedicated cephalometric software.
Orthodontic treatment relies heavily on precise skull and facial measurements taken from radiographs. Specialist analysis software can be costly and difficult to access in lower-resource healthcare settings. Demonstrating that readily available presentation software like Keynote can reliably perform cephalometric tracing offers clinicians an accessible, low-cost alternative for diagnostic planning.
This research tests an applied alternative workflow for orthodontists and dental clinics seeking low-cost diagnostic methods. Because Keynote is an existing off-the-shelf presentation tool, the technique is immediately deployable in clinical practice without further software development. However, the abstract does not indicate a commercial pathway or productisation strategy, describing instead an accessible clinical workaround.
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Objectives: To evaluate the reliability and accuracy of Keynote for tracing and analyzing cephalograms in comparison to Quick Ceph Studio. Materials and Methods: This was a cross-sectional study, which utilized the lateral cephalometric digital images (radiographs) from 49 patients. The study site was the Dental Radiology unit in the School of Dentistry of the Muhimbili University of Health and Allied Sciences (MUHAS), in Dar es Salaam, Tanzania. Cephalograms were imported to Quick Ceph Studio and then to Keynote for analysis. Minimum, maximum, mean, standard deviation, and mean difference were used to describe the data. Agreement between the two techniques was assessed by the Bland-Altman plot, linear regression, and interexaminer reliability tests. A level of significance was considered at P < .05, and a 95% CI was estimated for the outcomes in the study groups. Results: The majority of the mean values obtained from Quick Ceph were greater (P < .05) than those obtained from Keynote. According to Bland-Altman plots, all measurements were within the limit of agreement except for only five linear variables. The interexaminer reliability test showed no agreement between the two instruments for all linear parameters except for the LAFH: TAFH, whereas all angular measurements revealed good to excellent agreement (ICC: 0.75 to 0.97) between the methods. Conclusions: The measurements obtained with the Keynote software were found to be clinically reliable since the limits did not exceed the maximum acceptable difference between the methods. The two software instruments were considered to be in agreement and can be used interchangeably.
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DOI: 10.2319/101724-864.1
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