Aim: To evaluate the reliability of the automatic cephalometric analysis in relation to the semi-automatic method. Methods: Fifty lateral cephalometric radiographs were selected and two dental surgeons performed the Steiner and Tweed analyses independently using the semi-automatic method on the Radiocef Studio 2® software suite (Radiomemory, Belo Horizonte, MG, Brazil), and the automatic method on the Kodak Dental Imaging Software (Carestream Health, Rochester, NY, USA). After thirty days, 30% of the sample was re-evaluated to assess intra-observer agreement. Ten angular and linear measurements of both analyses were selected, averaged for both observers and compared using Student's t-test with a significance level of 5% (α=0.05). Intra and inter-observer agreement were assessed through Intraclass Correlation Coefficient. Results: Intra-observer reproducibility was excellent for all measurements and inter-observer reproducibility was excellent for most of them. Significant differences (p<0.05) were found between automatic and semi-automatic methods for all measurements. Most of the measurements were significantly higher (p<0.05) with the automatic method. Conclusion: Semi-automatic cephalometric analysis can not be replaced with a completely automatic method.
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