In response to the article “Soft-tissue Cephalometric Norms of Kashmiri Population with Normal Occlusion and Well-balanced Faces”

We read this article with keen interest as it claimed to be first of its kind to establish soft tissue cephalometric norms of Kashmiri population. We would like to compliment Kalgotra et al for the same. However, we have following questions:

• While going through the article (on p. 304, line 3) we find author stating that “A total of 102 subjects falling in the age group of 19 to 25 years were selected from random and representative sample of 5317.” This means that the sample size was selected with the age range of 7 years among adult Kashmiri population. Contradictory to this (on p. 305, lines 15-17) authors stated that “Out of a sample of 5317 people, 102 who fulfilled the criteria were selected, with an age group of 18 to 32 years.” This means that the sample size was selected with the age range of 15 years.

• This whooping difference of more than twice the age range mentioned in the article of a population based study is baffling and this self-contradiction of authors is untenable and seems abstruse.

• While going through Figure 1, by original author, (p. 305) we were staggered to find that a research article which is dedicated for “cephalometric norms with normal occlusion and well balanced faces” is being illustrated by a figure which is depicting a cephalogram with proclination as well as anterior open bite and is still exhibiting a balanced soft tissue profile.

  Such a diagrammatic representation of a well-balanced soft tissue profile is unjustifiable, seems ethereal and it creates confusion among the readers while flipping and going through the figures of the journal.

• Whereas the authors have proclaimed to take into account minute details for reliable cephalometric evaluation, for example, examiner fatigue (p. 305, para 2), but the authors have failed to include an important parameter for checking the reliability of their cephalometric tracings, that is, the intra-operator error, ¹ which is assessed by retracing the cephalograms and repeating each measurement on 2 occasions. ² The differences are further assessed by routinely used methods, ³ for example, Dahlberg’s formula ⁴ and intraclass correlation coefficient.

  With due respect to the authors, as far as we understand, the reliability of the observations and results of this study seems questionable with the above-mentioned queries.