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Aim <p>This study aimed to evaluate the reliability and agreement of a&#xa0;semi-automated evaluation of the electronic cast–radiograph evaluation (E-CRE) model score, as developed by the American Board of Orthodontics (ABO), compared to manual measurements.</p> Methods <p>A&#xa0;total of 67&#xa0;study models of patients who had completed orthodontic treatment were available, both as digital scans and as plaster models. Manual and digital evaluations followed the E‑CRE guidelines, assessing six criteria: alignment, marginal ridges, buccolingual inclination, occlusal relationships, overjet and root angulation, which was assessed visually on panoramic radiographs. The digital models were graded using a&#xa0;semi-automated software tool in OnyxCeph<sup>3</sup>™ Lab (version&#xa0;3.5, Image Instruments GmbH, Chemnitz, Germany), while the plaster models were scored manually using the ABO measurement gauge. In addition, 20&#xa0;models were scored manually and digitally by a&#xa0;second observer to assess interobserver reliability.</p> Results <p>The interobserver reliability was excellent for digital measurements (intraclass correlation coefficient [ICC] 0.94–1.00) and higher compared to those for manual measurements (ICC 0.90–0.97). The reliability between digital and manual measurements was very high, with correlation coefficients ranging from 0.95 to 0.99. However, the digital evaluation produced slightly higher scores for alignment than the manual measurement (mean difference: +0.93).</p> Conclusion <p>Semi-automated evaluation of ABO E‑CRE scores using OnyxCeph<sup>3</sup>™ is highly reliable and involves less interpersonal variance than manual grading. However, scores measured digitally were on average 0.79 point higher than those measured manually (scores below 30&#xa0;are considered as acceptable treatment outcome).</p>

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Semi-automated evaluation of the American Board of Orthodontics electronic cast-radiograph evaluation for assessing orthodontic treatment outcome

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月6日

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  • Gina Marie Georgi,
  • Melika Khanloo,
  • Cita Nottmeier,
  • Alice von Laffert,
  • Christian Hirsch,
  • Linus Schwake,
  • Till Koehne

摘要

Aim

This study aimed to evaluate the reliability and agreement of a semi-automated evaluation of the electronic cast–radiograph evaluation (E-CRE) model score, as developed by the American Board of Orthodontics (ABO), compared to manual measurements.

Methods

A total of 67 study models of patients who had completed orthodontic treatment were available, both as digital scans and as plaster models. Manual and digital evaluations followed the E‑CRE guidelines, assessing six criteria: alignment, marginal ridges, buccolingual inclination, occlusal relationships, overjet and root angulation, which was assessed visually on panoramic radiographs. The digital models were graded using a semi-automated software tool in OnyxCeph3™ Lab (version 3.5, Image Instruments GmbH, Chemnitz, Germany), while the plaster models were scored manually using the ABO measurement gauge. In addition, 20 models were scored manually and digitally by a second observer to assess interobserver reliability.

Results

The interobserver reliability was excellent for digital measurements (intraclass correlation coefficient [ICC] 0.94–1.00) and higher compared to those for manual measurements (ICC 0.90–0.97). The reliability between digital and manual measurements was very high, with correlation coefficients ranging from 0.95 to 0.99. However, the digital evaluation produced slightly higher scores for alignment than the manual measurement (mean difference: +0.93).

Conclusion

Semi-automated evaluation of ABO E‑CRE scores using OnyxCeph3™ is highly reliable and involves less interpersonal variance than manual grading. However, scores measured digitally were on average 0.79 point higher than those measured manually (scores below 30 are considered as acceptable treatment outcome).