Torque Requirements and the Influence of Pilot Holes on Orthodontic Miniscrew Microdamage
Round 1
Reviewer 1 Report
Overall, the paper is very well written with sound experimental design.
- It is unclear why a standard 0.9mm pilot hole drill was used. Pilot hole size could influence bone microdamage. Therefore, a more thorough investigation of pilot hole influence on microdamage would be to explore different pilot hole sizes with the various cortical bone thicknesses. I suggest adding a paragraph to the discussion addressing this point, and justifying why a standard 0.9mm hole was selected for the study design.
- Please increase the size of the image scale bar in Figures 1, 2 and 3. It is hard to see the numbers on the scale bar.
- With regards to the Pearson Correlation, I would like to see the correlation graphs for maximum insertion torque and total damage area, as well as diffuse damage area, where association was detected. There is always interest in the insertion torque limits to protect against bone microdamage. Adding these graphs to show insertion torque numbers relative to the microdamage will be informative. This would also make for a good paragraph within the discussion.
Author Response
Reviewer 1:
Comments:
- It is unclear why a standard 0.9mm pilot hole drill was used. Pilot hole size could influence bone microdamage. Therefore, a more thorough investigation of pilot hole influence on microdamage would be to explore different pilot hole sizes with the various cortical bone thicknesses. I suggest adding a paragraph to the discussion addressing this point, and justifying why a standard 0.9mm hole was selected for the study design.
Response:
Introduction paragraph 3: This technique was also used to visualise the clinically insignificant microdamage caused by a 0.9 mm pilot hole in varied cortical bone thicknesses.[21]
- Please increase the size of the image scale bar in Figures 1, 2 and 3. It is hard to see the numbers on the scale bar.
Response:
Figures 1, 2 and 3 have been amended.
- With regards to the Pearson Correlation, I would like to see the correlation graphs for maximum insertion torque and total damage area, as well as diffuse damage area, where association was detected. There is always interest in the insertion torque limits to protect against bone microdamage. Adding these graphs to show insertion torque numbers relative to the microdamage will be informative. This would also make for a good paragraph within the discussion.
Response:
There was an association between the maximum insertion torque and total damage area as well as diffuse damage area. The Pearson correlation coefficient (denoted by r) measures the strength of the linear association between the two variables. The r values for total damage area and diffuse damage area were 0.49 and 0.31, respectively. When interpreting the magnitude of r, which measures the strength of the correlation, values of r between 0.3-0.5 are “moderate”. With both values for maximum insertion torque compared to total damage area and diffuse damage area being of “moderate” strength correlation, we do not believe that addition of these graphs would provide any further valuable information to this paper.
Author Response File: 
Author Response.docx
Reviewer 2 Report
Dear authors,
I have appreciated the work and the present study is interesting. The paper is interesting and fundamental to obtain an improvement in the research aimed to better survival and success rate OMI. By the way, my main concerns about the work are:
- In table 1,the highest torque value obtained in the present study happened with pilot hole ( 21.38 ±4.19) that suggests that there is a minimal effect on the insertion torque but in the conclusions there is no such effect. why this conclusion? it shouldn't be "a minimal effect on the insertion torque" .
Best Regards
Author Response
Reviewer 2:
- In table 1,the highest torque value obtained in the present study happened with pilot hole ( 21.38 ±4.19) that suggests that there is a minimal effect on the insertion torque but in the conclusions there is no such effect. why this conclusion? it shouldn't be "a minimal effect on the insertion torque" .
Response:
Conclusion paragraph: “no effect” has been changed to “minimal effect”
Author Response File: Author Response.docx
