Cephalometric radiography has become a standard and invaluable means o
f obtaining diagnostic information for the management of malocclusion
and skeletal disharmony. However, concerns over radiographic exposure,
particularly in growing individuals, may limit its use, especially in
longitudinal analyses. Less invasive means of obtaining vital informa
tion would be desirable. A recently introduced system (Digigraph(TM),
Dolphin Imaging Systems; Valencia, Calif) provides sonically produced
representations of cranial landmarks and has been introduced by its ma
nufacturer as an alternative to standard cephalometric radiography. Th
e purpose of the study was to compare the validity and reproducibility
of cephalometric values generated sonically on a digital image analyz
er (Digigraph(TM)) with those obtained from standard cephalometric rad
iographs for 43 different measurements. Although 58.1% of the sonicall
y produced measurements showed significant correlation with radiograph
ically produced measurements, there were no trends observed for correl
ation, either in dental or skeletal structure classifications. Additio
nally, this study found the data generated from the digital image anal
yzer to be markedly variable, while the radiographically obtained data
were reproducible.