Evaluation of the cephalometric changes of Tweed triangle in patients with cleft lip and palate

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. 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. 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). 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.