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LETTER TO THE EDITOR
Year : 2021  |  Volume : 8  |  Issue : 1  |  Page : 80-81

Cephalometric evaluation of skeletal base relationship in patients with cleft lip and palate in a tertiary hospital in South India


Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India

Date of Submission15-Nov-2020
Date of Acceptance18-Nov-2020
Date of Web Publication13-Jan-2021

Correspondence Address:
Dr. Isha Duggal
Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jclpca.jclpca_40_20

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How to cite this article:
Duggal I, Talwar A, Duggal R. Cephalometric evaluation of skeletal base relationship in patients with cleft lip and palate in a tertiary hospital in South India. J Cleft Lip Palate Craniofac Anomal 2021;8:80-1

How to cite this URL:
Duggal I, Talwar A, Duggal R. Cephalometric evaluation of skeletal base relationship in patients with cleft lip and palate in a tertiary hospital in South India. J Cleft Lip Palate Craniofac Anomal [serial online] 2021 [cited 2021 Jan 21];8:80-1. Available from: https://www.jclpca.org/text.asp?2021/8/1/80/306777



Sir,

We read with great interest the observational study by Johnson et al. published in the June–December 2020 issue of the Journal of Cleft Lip Palate and Craniofacial Anomalies.[1] This hospital-based study for evaluating the relationship between the skeletal base patterns and cephalometric characteristics in cleft lip and palate patients was indeed informative. However, we would like to express a few concerns regarding the study that needs further explanation and discussion:

  1. The authors state that “UCLP/BCLP patients recruited in the study were surgically treated at the appropriate age.” However, in the inclusion criteria, there is no mention about number of surgeries or a uniform surgical protocol followed by the operator(s), all of which can affect the treatment outcome[2]
  2. The mean age of patients with cleft is mentioned as 12.18 ± 2.77 years and 13.35 ± 1.99 years for the control group. Thus, the results largely apply to a prepubertal population which might be a limitation of the present study
  3. Furthermore, while the overall sample size is considerable, it seems to be inadequate (subgroups: >9 years, >12 years, >14 years, and 16 years where the sample size is < 6 patients) to derive a statistically significant conclusion and extrapolate the results to the general population
  4. It is noted in UCLP/BCLP assessment that tracing of point A is particularly difficult.[3] This difficulty is usually overcome by more number of observers doing/repeating the cephalometric measurements. Subsequently, inter/intra-rater reliability could have been incorporated in the present study[4]
  5. The study concludes that the mandible is retropositioned and retrognathic in cleft patients as determined by NPerp-Pog and Npog-FH. However, it would be pertinent if these values are correlated with the cranial base flexure and growth pattern of the individual to truly determine if the retrognathism is due to growth rotation or deficiency in mandibular length.[5]


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Johnson MK, Kuriakose MJ, Varma NS, Ajith VV, Subash P. Cephalometric evaluation of skeletal base relationship in patients with cleft lip and palate in a tertiary hospital in South India. J Cleft Lip Palate Craniofac Anom 2020;7:89.  Back to cited text no. 1
    
2.
Brattström V, Mølsted K, Prahl-Andersen B, Semb G, Shaw WC. The Eurocleft study: Intercenter study of treatment outcome in patients with complete cleft lip and palate. Part 2: Craniofacial form and nasolabial appearance. Cleft Palate Craniofacial J 2005;42:69-77.  Back to cited text no. 2
    
3.
Bongaarts CA, van't Hof MA, Prahl-Andersen B, Kuijpers-Jagtman AM. Identification of cephalometric landmarks in unilateral cleft lip and palate patients: Are there alternatives for point A, ANS, and PNS? Cleft Palate Craniofac J 2008;45:81-6.  Back to cited text no. 3
    
4.
Durão AR, Pittayapat P, Rockenbach MI, Olszewski R, Ng S, Ferreira AP, et al. Validity of 2D lateral cephalometry in orthodontics: A systematic review. Prog Orthod 2013;14:31.  Back to cited text no. 4
    
5.
Bhattacharya A, Bhatia A, Patel D, Mehta N, Parekh H, Trivedi R. Evaluation of relationship between cranial base angle and maxillofacial morphology in Indian population: A cephalometric study. J Orthod Sci 2014;3:74-80.  Back to cited text no. 5
    




 

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