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An Evaluation of the Reproducibility of Landmark Identification Using Scanned Cephalometric Images

The analysis of cephalometric lateral skull X-rays is critically dependent on the accurate location of carefully defined anatomical and constructed landmarks. Errors in landmark identification, both systematic and random, are a significant source of error (Baumrind and Frantz, 1971a,b; Midtgård et al., 1974; Cohen, 1984; Houston et al., 1986), so that the methodology used to identify and record landmarks must be meticulous. Three techniques are commonly used to identify and record landmarks in cephalometric studies.These are: