Introduction: The shift from hard tissue paradigm to soft tissue paradigm results in the establishment of numerous soft tissue cephalometric parameters to evaluate the facial esthetics in diagnosis and treatment planning. Objective: To evaluate the reliability and diagnostic acceptance of photograph based soft tissue cephalometrics. Materials & method: Thirty right profile photographs and lateral cephalograms were taken in natural head position (NHP) in patients around 14-30 years of age and assessed using Dolphin imaging software to evaluate the sagittal maxillary projection, mandibular projection and growth pattern in skeletal cephalometric analysis (SCA), radiographic based soft tissue cephalometrics (rSTCA), photograph based soft tissue cephalometrics (pSTCA). Kruskas-wallis and post hoc pairwise comparison tests were used to analyze the results. Result: Statistically significant concordance was observed with parameters N per pt A vs TVL to pt A’, N per Pog vs TVL to Pog’, hard tissue facial angle vs soft tissue facial angle between the skeletal cephalometric analysis (SCA), radiographic based soft tissue cephalometric analysis (rSTCA) & photograph based soft tissue cephalometric analysis (pSTCA). Conclusion: The study results suggested that the parameters taken in this study showed a positive correlation which supported the null hypothesis and reliability of photograph based soft tissue cephalometric analysis.
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