Evaluation of the Predictability and Accuracy of Orthognathic Surgery in the Era of Virtual Surgical Planning

Round 1

Reviewer 1 Report

Dear Authors,

It is a really interesting topic, the study is well designed and analyzed.

Please provide a Moderate English revision.

1. The main topic addressed by the Authors is a protocol to validate the predictability in orthognathic surgery. In particular, the protocol analyzes the main and the standard cephalometric points (point a, point b, pogonion and more...).
2. The topic is interesting because add a more step in the valuation of orthognathic patient making it objectified so predictable. Moreover, the proposed method is easy to reproduce and therefore applicable even by less experienced in cephalometric field.
3. It adds the advantages related to the use of virtual surgical planning not only in pre operative phase but also in the post operative check up. In this way, it's possible to verify the clinical and biomechanical outcomes.
4. It could be interesting to analyze also the condylar area to verify the possible remodeling of it.
5. The conclusions are well described and resumed the main points addressed in this study.
6. The references are appropriate.
7. Tables and figures are appropriate

Author Response

Dear reviewer,

 

Thank you very much for your review and your comments. Regarding evaluation of the condylar area, we have another study ongoing where we are analyzing the changes that happen in the condyle (resorption/bone aposition) after bimaxillary surgery, however, due to the complexity of the analysis in a spherical object, we are still developing it and hope to submit it soon. 

 

Kind regards

Reviewer 2 Report

This paper evaluates the predictability of orthognathic planned virtually - retrospective study to analyze the predictability of orthognathic surgery

 

 

Dear authors, you are covering a very interesting topic, although this article is not very original in the scientific field it has high significance. With this said, the article could have significantly improved the quality of the presentation and needs improved scientific soundness.

 

Title – Correct the syntax of the title according to English grammar and possibly a better explanation of the study focus, no full stop in the title

Authors – Please reconsider if all the mentioned co—authors have contributed significantly to this paper. 9 authors

Abstract –the English syntax of the abstract is not satisfactory neither is the structure,

Introduction - The introduction could provide better background for this topic, including further relevant and recent references. Virtual planning is now conventional planning; however, it might be possible that the paradigm is not shifted in all clinical environments. It is surprising the authors have not mentioned 3D printing as a key advantage of virtual planning, that allows reproduction of virtual plan in a precise way. I do recommend mentioning this in the introduction. Virtual Three-Dimensional modeling and 3D printing of various biocompatible designs can have a clinical-dental application.

In the paragraph where authors mention “Several methods have been proposed to assess the accuracy of the postoperative outcome versus the 3D surgical planning” more references shall be cited. Lines -54-56

 

Materials and Methods

Rewrite this chapter with added sub-chapters for better structuring of the text. Reference some sources using Slicer as scientific tool in orthognathic surgery.

In this chapter the manuscript shall be clearer, and better presented in figures/schemes in a more-structured manner. Schematic figure for workflow would make the text more comprehensible and readable.

 

Results

The visuals are separated in separate subchapter, this is not suitable. For example, Figure 5 is mentioned in the text and shall be followed with figure 5 immediately as is referenced first time, unfortunately it is many pages bellow. Correct this please. Text has many errors that disturb the reader.

 

Discussion

This chapter shall be more focused and possibly shorter. Authors shall discuss 3D printing from virtual setup. For example Three-Dimensional Modeling and 3D Printing of Biocompatible Orthodontic Power-Arm Design 

Conclusions

Shall be more clear and based on the data presented in the results.

Data presented in this study shall be placed available in the public repository.

Author Response

Dear Reviewer,

 

Thank you very much for your comments. We have implemented all your suggestions.

We have changed the article title and the number of authors have been reduced. The abstract has been corrected and a clear conclusion has been added.  In the introduction we have also included information about 3D printing and other technologies, which has also been added in the discussion. However, since our article is mainly focused on virtual surgical planning and not all 3D technologies in orthognathic surgery, the information and discussion provided is limited because we consider this should be discussed in other articles. In materials and methods, sub-chapters have been added, as well as a resume scheme of the workflow followed for the analysis. In results, the figures have been positioned just below the paragraph where they are mentioned. Finally, the discussion has been shortened and the conclusion has been made more clear. 

Hope you find this revised version fine but please do not hesitate to reach out if you have further comments or suggestions.

We look forward to hearing from you.

Kind regards,

Marta 

Round 2

Reviewer 2 Report

Authors have sufficiently revised the manuscript.