Objective: The current study aimed to accurately assess the digital wise superimposition of the lateral cephalometric images through the reloading of definite pre-treated images anatomical landmarks expressed points on the follow up ones.
Methods: Sixty-one pre and follow up orthodontic cases cephalometric images were superimposed using fiji software multi point tools. Linear and angular measurements between anatomical landmarks expressed points were obtained on the pre and follow up images to assess the accuracy of the superimposition used method by a radiologist and orthodontist.
Results: Intra and inter-observer reliability was more than 0.99. Pre and follow up linear and angular measurements showed no statistically significant difference (p > 0.05), except for C-D linear measurements that showed statistically significant difference (p < 0.05). Mann-Whitney test of the absolute measurement error (AME) difference between the linear and angular comparable measurements showed no significant difference (p > 0.05).
Conclusion: The current study concluded that reloading points that define specific landmarks from pre on follow up cephalometric radiographs can be considered as an accurate superimposition method for assessing the maxillofacial growth pattern and treatment changes follow up.