Determining Aligner-Induced Tooth Movements in Three Dimensions Using Clinical Data of Two Patients

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The paper describes a procedure for the quantification of the position changes of the individual crowns in the upper and lower jaws induced by aligner therapy.

Images are of high quality and even a graphical abstract is provided. 

The references are suitable.

The clinical relevance should be added. 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

 

1.      Revise the abstract to be more concise, emphasising the essential findings and their implications. For example:

2.      The introduction lacks a clear statement of the study’s novelty and importance in existing literature. Strengthen the introduction by explicitly stating what gap in the literature this study addresses and why it is significant. Mention specific shortcomings in current aligner studies and how this study aims to fill those gaps.

3.       Simplify the explanation of the scanner selection and aligner fabrication processes, ensuring the focus remains on why these methods were chosen. Provide clear subheadings and bullet points where appropriate.

4.      The case study only includes two patients, which may not be representative. Acknowledge the limitation of the small sample size in this section and discuss plans for future studies with larger cohorts to validate findings.

5.      There are too many figures. Simplify the figures and their descriptions. Add more explanatory text and legends to help readers understand the visual data.

6.      The discussion sometimes reiterates the results without deeply exploring their implications or limitations. Enhance the discussion by more thoroughly interpreting the results in the context of current orthodontic practices.

 

7.      The conclusion reiterates findings but does not sufficiently highlight the study’s contributions or future directions. Summarise the study's main contributions and propose specific areas for future research. Emphasise how these findings could influence clinical practices or further studies in orthodontics.

8.      The writing style is inconsistent, with some sections overly technical and others too simplistic. Aim for a consistent, clear, and professional writing style throughout. Maintain a balance between technical detail and readability.

9.      To expand the article, please cite the recent study, Instagram and clear aligner therapy: A content analysis of patient perspectives, Seminars in Orthodontics,2024,

 

 

Comments on the Quality of English Language

Minor editing of English language required

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The article presents an interesting and well-written study; however, several concerns and omissions need to be addressed before it can be considered for publication.

Firstly, I would like to see a photo of the PEEK model and, most importantly, the production process to evaluate the choice of the scanner. The description of the model and the production process is detailed, but including images would provide a better understanding and confirm the quality of the model used.

Additionally, it is unclear what type of MicroCT was used and what resolution it had. These details are important for assessing the precision and accuracy of the scans conducted. Information on these technical aspects must be provided for a complete evaluation.

There is an evident conflict of interest as some authors are affiliated with Bottmedical AG, the company that produces the aligners. This conflict of interest could affect the impartiality of the results presented. It would be advisable to address this point with greater transparency.

I also do not understand why the upper incisors appear so vertical in the scans. This result seems unusual and is not well explained in the text. Further details on the registration method and the validity of the obtained results are necessary to better understand this phenomenon.

Furthermore, the reference point for all the overlays is not clear. A clear definition of the reference points is essential to understanding the measurements and analyses of dental movements. It is recommended that a detailed explanation of how the reference points were chosen and used during the study be included.

In conclusion, although the article is well-written and methodologically sound, the aforementioned concerns must be addressed to ensure the transparency and reliability of the results. Without these crucial details, it is not possible to accept the article for publication.

Comments on the Quality of English Language

Minor error

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The paper has been considerably improved. 

Author Response

The paper has been considerably improved.

We are happy that we were able to satisfactorily address the reviewer’s concerns and thank the reviewer for helping to improve the manuscript.

Reviewer 2 Report

Comments and Suggestions for Authors

It is publishable

Comments on the Quality of English Language

Minor editing of English language required

Author Response

It is publishable.

We are pleased that we were able to response successfully to the reviewer’s comments.

Minor editing of English language required.

We have carefully checked the manuscript for English language issues.

Reviewer 3 Report

Comments and Suggestions for Authors

Thank you for your detailed responses and revisions. Despite the improvements, I have significant methodological concerns that need addressing. The Micro CT used has a pixel size of 35 µm, but the intraoral scanners have mean point distances ranging from 98 µm to 158 µm, raising concerns about data comparability and accuracy. The statistical analysis is thorough, but the practical implications of the resolution mismatch need further clarification. Methodological details, including the choice of not including images of the PEEK model and its production process, limit the ability to fully evaluate the reference model's quality. Additionally, the explanation regarding the vertical position of the upper incisors and overlay reference points needs further elaboration to ensure transparency and reproducibility. Given these concerns, I believe additional methodological rigour is required to ensure the reliability of your results.

Author Response

Please see the attachment

Author Response File: Author Response.pdf