Staging of Orthodontic Tooth Movement in Clear Aligner Treatment: Macro-Staging and Micro-Staging—A Narrative Review
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsThank you for the opportunity to review this manuscript. In general terms, the topic could be interesting for the journal’s readers. However, I have several aspects that need to be clarify in this review.
1. Introduction: it seems so necessary to stablish the scientific rationale for this review. In this sense, it could be useful to justify one narrative review in comparison with a systematic review.
What is the new input with this review?
2. Methods: Although is a narrative review. It could be useful to explain the methods used to analyze the main aspects described in this narrative review.
Please explain the main characteristics that will be analysed in this review (as a guide for the journal’s readers
3. Discussion: please mention the limitations of this narrative review in terms of the solidity of their conclusions in comparison with other kind of literature reviews
Please mention recommendations for the research and practice as derived of this narrative review
Author Response
Comments 1: Thank you for the opportunity to review this manuscript. In general terms, the topic could be interesting for the journal’s readers.
Response 1: Thank you very much for your words and for dedicating your time to improving the quality of our article. Following your recommendations, we have attached the responses to your analysis and the justified changes.
Comments 2: Introduction: it seems so necessary to stablish the scientific rationale for this review. In this sense, it could be useful to justify one narrative review in comparison with a systematic review.
Response 2: Thank you for pointing this out. We have added a final paragraph in the introduction to justify a narrative review of the topic. We believe it is the best option for an initial approach to staging since there are not many specific articles on the topic, and it may be more comfortable for readers who want to begin exploring staging with clear aligners.
Comments 3: What is the new input with this review?
Response 3: This review establishes a starting point in the evolution of research into the staging of the orthodontic tooth movement with clear aligners. In addition, it allows creating a classification of the different types of staging to facilitate the organization of treatment for orthodontists. We have clarified these ideas in the section "aim and objectives".
Comments 4: Methods: Although is a narrative review. It could be useful to explain the methods used to analyze the main aspects described in this narrative review. Please explain the main characteristics that will be analysed in this review (as a guide for the journal’s readers.
Response 4: Agree, we have created a new methods section where the methodology we have applied to collect the information from the narrative review is explained.
Comments 5: Discussion: please mention the limitations of this narrative review in terms of the solidity of their conclusions in comparison with other kind of literature reviews. Please mention recommendations for the research and practice as derived of this narrative review.
Response 5: Thank you for pointing this out. We have added an extra section with “limitations of this study” to indicate aspects to improve in the future and lines of research that may be interesting to advance the field.
Reviewer 2 Report
Comments and Suggestions for Authors
This manuscript presents a detailed narrative review on the staging of orthodontic tooth movement using clear aligners, focusing on the concepts of macro-staging and micro-staging. The authors aim to address the lack of comprehensive literature on this topic and provide new terminology to enhance digital planning for orthodontists.
The article is well-written, but I suggest making a few revisions before publication.
Please see below.
Title
· Add "narrative review" to the title to avoid misleading readers.
Abstract
· Please rewrite the abstract following this structure: Aim, Materials and Methods, Results, and Conclusions.
Introduction
· Provide an overview of aligners.
· Discuss indications, contraindications, advantages, and disadvantages.
· Include perspectives from doctors and patient preferences.
· These topics should be addressed to expand the introduction, which is currently too brief and lacking in detail.
· Emphasize the rationale for this study.
Definition and Concept
· Add "Align Technology, CA, US" in parentheses where it first appears in the text.
Basic Principles of Clear Aligners
· Well explained.
Macro-Staging and Micro-Staging
· Macro-Staging should be a subsection under Macro-Staging and Micro-Staging. Instead of section 5, it should be 4.1, with Micro-Staging as 4.2. Adjust all other subsections accordingly.
· The figures are high quality and provide valuable insights. Well done. The cases are well-documented.
· The information in the Macro-Staging and Micro-staging sections is sufficient, well-structured, and well-presented.
Limitations
· Add a final section or subsection discussing the limitations of this study.
Conclusions
· The conclusions are satisfactory.
Additional Recommendations
Even though this is a narrative review, I recommend adding information about the databases used for gathering information, the search terms used, the search strategy, and the period during which the search was conducted (Material and Methods).
Best regards!
Author Response
Comments 1: The article is well-written, but I suggest making a few revisions before publication.
Response 1: Thank you very much for your words and for dedicating your time to improving the quality of our article. Following your recommendations, we have attached the responses to your analysis and the justified changes.
Comments 2: Add "narrative review" to the title to avoid misleading readers.
Response 2: We have updated the title of the manuscript to: “Staging of orthodontic tooth movement in clear aligner treatment. Macro-staging and micro-staging. A narrative review.”
Comments 3: Please rewrite the abstract following this structure: Aim, Materials and Methods, Results, and Conclusions.
Response 3: Thank you for pointing this out. We have restructured the sections of the manuscript into the following blocks: "Introduction," "Aim and Objectives," "Methods," "Results and Discussion" (where the rest of the numbered subsections appear), and "Conclusions."
Comments 4: Introduction. Provide an overview of aligners. Discuss indications, contraindications, advantages, and disadvantages. Include perspectives from doctors and patient preferences. These topics should be addressed to expand the introduction, which is currently too brief and lacking in detail. Emphasize the rationale for this study.
Response 4: Agree. We have, accordingly, expanded the introduction by adding the advantages offered by clear aligners and the more challenging movements to achieve according to systematic reviews. We believe these changes provide a more solid initial section to introduce the narrative review following your recomendations. However, we also do not want to dwell too much on this point to avoid taking up the reader's time with generic issues, especially since the rest of the manuscript is lengthy and may become "heavy" for an initial read if we overly develop the initial points.
Also, we have added a final paragraph in the introduction that we believe emphasizes and justifies the need for this narrative review and the benefits of studying it for the reader.
Comments 5: Add "Align Technology, CA, US" in parentheses where it first appears in the text.
Response 5: Already done.
Comments 6: Macro-Staging should be a subsection under Macro-Staging and Micro-Staging. Instead of section 5, it should be 4.1, with Micro-Staging as 4.2. Adjust all other subsections accordingly.
Response 6: You are right. We have introduced the different sections within "Results and discussion", subnumbering each point. Specifically, the macro-staging and micro-staging subsections are 4.3.1 and 4.3.2, respectively. For the subdivisions of these we have added a fourth number at the end, but we are not sure if it may be slightly confusing for the reader and it might be better to replace the last digit with a letter (for example, instead of 4.3.2.1 put 4.3. 2.a). We are waiting for your recommendation to maintain this structure or modify it.
Comments 7: Add a final section or subsection discussing the limitations of this study.
Response 7: Thank you for pointing this out. We have added an extra section with “limitations of this study” to indicate aspects to improve in the future and lines of research that may be interesting to advance the field.
Comments 8: Even though this is a narrative review, I recommend adding information about the databases used for gathering information, the search terms used, the search strategy, and the period during which the search was conducted (Material and Methods).
Response 8: Agree, in the methods section we have explained how we have collected the information for the narrative review.
Round 2
Reviewer 1 Report
Comments and Suggestions for AuthorsAccepted
Author Response
Dear reviewer,
Thank you very much for accepting our comments
kind regards
Reviewer 2 Report
Comments and Suggestions for AuthorsI have examined the revised version of the manuscript entitled "Staging of Orthodontic Tooth Movement in Clear Aligner Treatment: Macro-Staging and Micro-Staging – A Narrative Review." Most revisions have appropriately addressed the initial recommendations; however, the abstract remains overly general and lacks a coherent structure.
Please revise the abstract to adhere to the conventional format of Aim, Materials and Methods, Results, and Conclusions, as was initially advised.
Kind regards!
Author Response
Dear reviewer,
Thank you very much for your comments, and we have made the changes to the abstract following your recommendations
Kind regards.
