Factors Associated with the Proximity of the Incisive Canal to the Maxillary Central Incisor
Round 1
Reviewer 1 Report
The authors investigated the distances between the incisive canals and the incisor roots using cone-beam computed tomography (CBCT) on different face types.
· The authors should specify which point on the incisive canal they used to measure the distances to the incisor roots. It is not clear whether they measured the distances to the closest points on the incisor roots to the incisive canal, or to the centers of the incisor roots.
· The discussion section should evaluate the clinical significance of the results of the study. The authors should discuss how the results of the study could be applied to clinical practice.
· The conclusion sentence should be rewritten in a more academic style. The authors could state the main findings of the study and their clinical implications.
There are some minor grammatical challenges; academic editing is advised.
Author Response
We thank the Reviewer for performing a thorough review of our manuscript, and for making valuable suggestions for revision. We have responded to each item in the Reviewer’s critique and have modified the manuscript accordingly.
Reviewer 1:
- The authors should specify which point on the incisive canal they used to measure the distances to the incisor roots. It is not clear whether they measured the distances to the closest points on the incisor roots to the incisive canal, or to the centers of the incisor roots.
Thank you for your insightful comments and for bringing to our attention the need to clarify the measurement point on the incisive canal in our methodology.
We have revised the "Data Acquisition and Measurements" section in the Materials and Methods (page 3, line 111) with the following sentence: "The linear distance between the maxillary central incisor (MCI) root apex and the incisive canal (IC) on each side, defined specifically as the shortest linear distance between the lateral boundary of the MCI root and the lateral boundary of the IC cortical bone, was measured by tracing the center of the MCI root and IC cross-sections, based on the methodologies of previous studies."
For further clarification, we have added the following sentence to the description of Figure 3 (page 4, line 131): "This distance is specifically defined as the shortest linear distance between the lateral boundary of the maxillary incisor root and the lateral boundary of the incisive canal cortical bone."
- The discussion section should evaluate the clinical significance of the results of the study. The authors should discuss how the results of the study could be applied to clinical practice.
Thank you for your insightful comments and recommendations for improving the quality of our manuscript. We completely agree with your suggestion that the clinical significance of our study's results should be further highlighted in the discussion section.
In response to your comments, we have expanded the discussion section from lines 273 to 285 on pages 8–9, to better elaborate on the application of our study's results to clinical practice. In particular, we have provided further information on how a careful and thorough analysis of the incisive canal (IC) and maxillary central incisor (MCI) using cone beam computed tomography (CBCT) can guide treatment goals and improve the prognosis of orthodontic treatment in the maxillary anterior region.
We also discussed the associations between the vertical skeletal pattern, especially in dolichofacial type patients, and the distance between the MCI and IC. This would provide valuable insight for clinicians, particularly when treating malocclusion in Class II dolichofacial type patients. Furthermore, we emphasized the importance of taking special care and precautions for preventing intrusion into the IC during such treatments.
Finally, we stressed the benefits of a three-dimensional evaluation method for orthodontic diagnosis and the careful observation of the incisal roots during treatment to prevent possible complications, particularly in patients requiring maximum retraction.
We believe that these revisions present the clinical implications of our study more clearly, thereby making the findings more valuable for readers. We greatly appreciate your constructive feedback and hope that our revisions adequately address your concerns.
- Comments on the Quality of English Language
There are some minor grammatical challenges; academic editing is advised.
Thank you very much for your valuable feedback on our manuscript.
Regarding your comment on the quality of English language, we completely understand and appreciate your concern. In response to your suggestion, we have decided to seek professional help to rectify the language issues. We have now submitted the manuscript to a professional English editing service to ensure linguistic accuracy and clarity.
We hope that the revised manuscript now meets the high standards of your journal. We are very grateful for your time and effort in reviewing our work and your valuable feedback.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
The article describes a study based on cbct image analysis that aimed to determine the distance of the roots of maxillary central incisors from the incisive canal. The study was performed correctly, but I would ask the authors to address the following comments:
1) the study group consisted of 54 men and 104 women. In my opinion, the overwhelming (almost 2-fold) predominance of women in this group may affect the reliability of the assessment of the influence of patients' gender on the outcome of the study. Please justify the choice of such a study group.
2) In the "Materials and methods" section, please remove the descriptions of cephalometric points (lines 139-147 and 166-180) from the body of the manuscript. They are described in tables and there is no need to duplicate them in the text.
Please still check the manuscript content for linguistic correctness.
Author Response
We thank the Reviewer for providing a thorough review of our manuscript, and for making valuable suggestions for change. We have responded to each item in the Reviewer’s critique and have modified the manuscript accordingly.
Reviewer 1:
- the study group consisted of 54 men and 104 women. In my opinion, the overwhelming (almost 2-fold) predominance of women in this group may affect the reliability of the assessment of the influence of patients' gender on the outcome of the study. Please justify the choice of such a study group.
Thank you for your valuable comments concerning the sex imbalance in our study. We would like to clarify that the distribution of participants was not attributed to selective sampling, but rather reflects the natural occurrence of this condition in the study population. Specifically, we used patients who visited our affiliated hospital from April 2021 to October 2022.
We acknowledge that a potential bias in the results could be present owing to this imbalance. However, we have addressed this issue in several ways. First, we used t-tests to compare the means of the two groups. We believe that t-tests are robust against imbalances in group sizes, provided the assumptions of independence, normality, and equal variance are met.
Second, we have statistically adjusted for the influence of sex using multiple regression analysis, which allows for the simultaneous consideration of the effects of multiple explanatory variables, in this case including sex. This analysis enabled us to estimate the independent influence of each variable on the outcome. Thus, even with different sample sizes for men and women, this method allows us to elucidate how each group contributes to the results.
We greatly appreciate your thoughtful feedback, and we will continue to consider and scrutinize these issues in our future studies. We hope this response addresses your concerns.
In the "Materials and methods" section, please remove the descriptions of cephalometric points (lines 139-147 and 166-180) from the body of the manuscript. They are described in tables and there is no need to duplicate them in the text.
Please still check the manuscript content for linguistic correctness.
We greatly appreciate the reviewer's suggestion to remove the duplicated descriptions of the cephalometric points in our manuscript's "Materials and Methods" section. In line with this feedback, we have omitted the corresponding descriptions from the text (lines 139–147 and 166–180), as these are adequately detailed in the tables. Regarding the linguistic correctness of the manuscript, we have further scrutinized and revised the text to ensure clarity and accuracy of the language. Thank you for your thoughtful suggestions that have greatly improved the clarity and conciseness of our manuscript.
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Publication is acceptable in this form
