Methods: Profile photographic pictures of 50 patients (27 males 23 females) were taken. The patients were instructed to slightly tighten their teeth and to reach primary contact with their lips. All the digital pictures were analyzed with cephalometric software (Viewbox 3.0.0.107) by custom soft tissue analysis. The landmark identification was performed twice in four different methods: three of them computerized and one classic using a manual cephalometric roller. All the measurements were angular in order to overcome the nonstandard system.
Results: When comparing between the two readings in each method, a high correlation was found between the readings in each method. (Values between 0.95 to 0.99). Regarding the distance of values from the average value, there were no significant differences between the three computerized methods and a small significant difference in the manual group (statistics - Bonferroni model).
Conclusions: 1. Reproducibility in landmark identification using computerized tools or tangents proved to be accurate. 2. Using computerized tools for landmark identification is better compared to a manual technique.