Journal of Dental Medicine

Background and Aims: Cleft lip and palate patients require orthodontic treatments during their childhood and adolescence. Tweed diagnostic triangle as well as cephalometric assessments provides important data regarding the skeletal patterns for the treatment and diagnostic purposes. The present study determined the cephalometric changes of Tweed triangle in the cleft lip and palate patients compared to normal patients.

Materials and Methods: In total, 101 cleft and palate patients as well as 95 normal individuals with the balanced age, gender and race were evaluated. All the cleft and palate patients had similar treatment histories. Radiographic clichés were obtained from both groups and the images were traced after identifying the anatomic landmarks. The studied landmarks included points, lines, and plans as well as dental and skeletal angles and distance ratios measured in radiographic images. The landmarks were statistically analyzed using Student t test.

Results: Significant differences were found between the cleft lip and palate patients and normal individuals regarding craniofacial complex morphology (P<0.001). Gender did not show significant effect on the cephalometic indices changes (except to IMPA and FMIA angles). Tweed angle changes were more in the males than that of females between normal and cleft lip and palate patients. Mandibular retrusion (decreased SNB), gonial angle opening, increased mandibular plan inclination and facial anterior height were similar in the normal and cleft lip and palate individuals while no significant differences were found between two groups regarding cranium indices (P>0.05).

Conclusion: In total, significant differences were observed between normal and cleft lip and palate individuals regarding Tweed diagnostic triangle area. These differences were decreased IMPA and increased FMA and FMIA angles. No significant differences were found in terms of other indices.

Background and Aims: In 1978 WHO (World health organization) formulated a histopathological definition for diagnosis of OLP (oral lichen planus). Previous studies showed that diagnosis of OLP with these criteria are not reproducible. In 2003 Van der Meij et al. represented new clinical and histopathologic definition for diagnosis of OLP known as modified WHO criteria. The purpose of this study was to evaluate the interobserver and intraobserver variability in the histopathological assessment of OLP based on the modified WHO criteria.
Materials and Methods: Fifty five microscopic slides which OLP and OLL (Oral Lichenoid Lesion) were recognized in their clinical differential diagnosis were given to 6 pathologists in two phases with 3 months interval. Each reviewing pathologist was asked to apply the modified WHO definition of OLP and to categorize each case as either OLP, or compatible with OLP. Then, the interobserver and intraobserver variability were assessed by calculation of repeatability coefficient and Kappa statistics.
Results: The results of this study demonstrated that interobserver variability based on modified WHO criteria was 0.77 (strong), while the intraobserver variability varied from 0.58 (moderate) to 0.82 (strong).
Conclusion: In the present study, the interobserver and intraobserver variability in the histopathologic assessment of OLP based on modified WHO criteria was stronger than previous studies which assessed WHO criteria. However, in order to propose the replacement of WHO criteria with modified WHO criteria, further studies with more cases and comparing the two methods is required.