Researchers at the University College of London Eastman Dental Institute have found that the chairside picture archiving and communications system (PACS) can eliminate the need for hand tracing when conducting orthodontic cephalometric analysis. Their findings appear in the European Journal of Orthodontics.

The researchers sought to compare PACS with hand tracing and on-screen digitization using a commercial program (Dolphin Imaging Plus™, version 10.0). They selected 100 digital lateral cephalometric radiographs and analyzed them using the Eastman analysis. Both angular and linear measurements were recorded, and a single operator traced each radiograph twice, using PACS, hand tracing, and Dolphin Imaging.

PACS was found to be more repeatable than Dolphin for measuring the angle between the upper incisors and the maxillary plane, but less repeatable than hand tracing for measuring percentage lower anterior face height. The researchers also found statistically significant systematic differences between PACS, hand tracing, and Dolphin when measuring lower incisor inclination; however, all three methods agreed on average, and differences between the methods were all within clinically acceptable limits.

According to the researchers, the use of PACS at the chairside allows orthodontists the freedom to analyze digital cephalograms at the same appointment as when the digital radiograph is taken.