Design of Unilateral Complete Presurgical Nasoalveolar Molding (PNAM) Corrector Based on Feature Points Extraction of Complex 3D Surface

Round 1

Reviewer 1 Report

The authors wrote an interesting paper that aimed to find an automated process to reduce production costs and time of NAM equipment. Here are some ways to improve the paper.

1. As mentioned above, the research question dealt with reduction of production costs and time. However, the methodology and discussion did not mention anything about this. At this point, creating another experiment to align it with the research question may be difficult. To pacify this, it would be prudent to restructure or phrase the research question to coincide with the findings of the study.

2. Some old references were cited.

3. The schema in figure 1 does not coincide with the description.

4. Limitations and recommendations for future research need to be added in the last part of the discussion.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

General comments: Very interesting topic. The authors describe an algorithm to design presurgical nasoalveolar molding (PNAM) corrector using Gaussian function after feature point extraction. It definitely helps to eliminate the subjective factor in designing the PNAM appliance and helps to streamline the process using computer assisted designing. The paper is good but it needs few minor corrections.

 

Specific comments:

 

·      Line 192 & 193: Never heard of term “incisor mastoid” in the anatomy of maxillary ridge? Is it referring to central incisor tooth?

 

·      Line 195: “the position of the eruption of the deciduous cusps” Is it referring to eruption of the deciduous cuspids (canines)?

 

·      Line 203: Which deciduous teeth is being referenced here? Canine?

 

·      Line 228: Not clear what is chapter 2

 

·      Line 238-240: Not clear what is being referenced here exactly. The description for both points I and C looks similar.  “point C is located on the intersection point of the malleolar frenum and alveolar ridge, point I is located on the intersection point of the malleolar frenum and alveolar ridge” What is malleolar frenum? Also in line 194, point C is described as following “C: The point of intersection of the alveolar crest and the extension line of the healthy lateral buccal frenum”. Would recommend to stay consistent throughout the paper so that there is no confusion.

 

·      Line 266-269 and Line 270-272- Repetition of texts

 

·      Number 2.3 in Section 2.3 has been used twice. (Section: Phased design of PNAM appliance): What is the basis of designing whole treatment cycle into 8 stages and 1 week for each stage?

 

Results and discussion:

 

·      Line 441-445. Looks like there is repetition of texts. Hard to understand what is being said.

 

·      Line 447: Not clear what is being said here? “the smaller and longer the value, the more similar the length.”

 

·      Line 463 & 465: It describes low and high LS and MS. What is considered low vs high? Is there a cutoff point that is being used to differentiate high vs low LS and MS values?

 

·      Line 463: Model 8 is being referred as samples with low LS and MS when in fact it has the highest LS and MS in figure 5.

 

·      How was the sample size decided?

 

·      Little confusing. What’s the study design being used in the study to show the improvement of algorithm design results? So, patients who got clinical correction were also designed to get PNAM using the algorithm? Did patients get both the devices to wear or the actual clinical correction results are just being compared to the PNAM design using algorithm on paper?

 

·      What does clinical correction results include? How long did they wear the appliance for? As presented previously in the paper the algorithm designed appliance is for 8 weeks. Was the duration of wear for clinically designed appliance also 8 weeks?

 

·      What does PP`/mm stand for? Is it distance between points PP` in millimeters?

 

·      Would recommend to keep the evaluating indicator labels consistent in the tables and text. For example, in table #1 |1-t| was used and in table # 2 LS was used. Also, in tables and figures PP`/mm was used but in discussion the term width has been used a lot.

 

·      Please report the p-values of t-tests comparing the clinical correction with algorithm correction to see if there is significant statistical difference.

 

·      Figure 5: What does the label “Correct the result” stand for? Clinical correction done by dentists?

 

·      Line 488:489: No p-values were shared comparing the clinical results with algorithm design to able support the term “significantly greater”. It might be misleading to say that without any statistical analysis.

 

·      Line 493-495: LS in algorithm design is higher than clinical correction even in sample # 1, 4 & 10 it’s just not in sample # 5 & 9. May need to correct that.

 

·      Line 496-497: The authors again comment about the significance of MS without presenting any p-values of any statistical analysis.

 

·      Discuss any limitations for this approach? Any recommendations to improve on the topic for future research?

Author Response

Please see the attachment.

Author Response File: Author Response.docx