Clear Aligner Treatment as a Safe Method for Treating Occlusal Trauma in Elderly Patients

Round 1

Reviewer 1 Report

The manuscript is entitled "Clear aligner treatment as a safe method for treating occlusal trauma in elderly patients."

 

The manuscript is focused on the interdisciplinary treatment of a 65-year-old patient with an improper zirconium oxide-based prosthetic crown. The manuscript is well written, and the treatment outcome is favorable. The manuscript can be accepted.

Author Response

Dear Reviewer, thank you for such a good comment. Best regards, Authors

Reviewer 2 Report

Discreet work, need for enrichment of iconographic material, photographs are missing. Improve the quality and increase the share of the discussion. Altogether sufficient.

Comments for author File: Comments.pdf

Author Response

Dear Reviewer,

thank you very much for your specific comments. We added pictures, improved the abstract, added suggested reference. We know, that the changes after treatment are descrete, that is why we thought the process and effects will be more visible on scans and 3D models. But you are absolutely right - the photos are mandatory in case reports.

 

We would also like to provide answers on your questions:

• Q: Why was an expensive and lengthy orthodontic treatment chosen when it would have been sufficient to manufacture a new adequate prosthesis on element 2.1 with a considerable saving of time and costs?

A: Making a new crown would involve the need to remove the old one, and thus with the risk of tooth fracture during the procedure and, consequently, tooth loss, and it would not improve the positioning of the root, the density of the bone structure, the crown on the protruding tooth would still transfer abnormal forces to the periodontium. The old crown has already changed the setting of the teeth in the opposing arch and influenced the setting of the entire tooth and periodontium - also the root, not only the crown. The shortest possible orthodontic treatments was selected, with gentle forces, which was also supposed to improve periodontium structures, not only aesthetics.

 

• Q: Why was the OPT exam chosen to evaluate the periodontal impact of occlusal trauma knowing full well that it is not the main diagnostic exam

A: Periapical photograph was also taken, but the technician took them at the wrong angle, in the wrong projection, and so they are unsuitable for publication. The described treatment was provided basically just to help the patient, only after the treatment was completed, the authors came up with the idea to describe this case, and that it could be interesting - therefore (taking into account the previous x-rays therapy exposure of the patient) during the treatment, the patient was not sent for re-photographs, considering it clinically unnecessary.

Once again thank you very much for your effort and time, we- the authors-  appreciate this very much. Thanks to you our article has a chance to be better.

 

Best regards,

Authors

 

Reviewer 3 Report

The aligner treatment of this case report, especially in the elderly, is an issue that will attract the attention of the reader.

My suggested corrections to the manuscript are listed below.

Abstract:

·      The sentence on line 9 should start with "the case report" instead of "the article".

·      This section should be expanded with a little more detail.

·      Information about the follow-up period of the patient should be given in the summary.

Introduction: This chapter is well written, but a bit long. It should be simplified so that the reader is not distracted.

Narrative: Is there a periapical radiograph of the patient's 21st tooth? If there is, it should be added between the figures.

Patient perspective: Well written.

Discussion: No reference is given in the paragraph between lines 303-317. A reference should be added about the sentence indicating judgment in lines 313.-314.

Conclusion: This part should be rewritten in connection with the case report.

References: References should be corrected in a single format and in accordance with journal writing rules. Also references 3, 4, 11, 12, 15-17 are very old. Possible ones should be revised with new references.

No major problems with English were detected.

Author Response

Dear Reviewer,

thank you very much for your specific comments. We added every changes and improvements that you suggested.

Answering on your question- periapical photograph was taken, but the technician took them at the wrong angle, in the wrong projection, and so they are unsuitable for publication. The described treatment was provided basically just to help the patient, only after the treatment was completed, the authors came up with the idea to describe this case, and that it could be interesting - therefore (taking into account the previous x-rays therapy exposure of the patient) during the treatment, the patient was not sent for re-photographs, considering it clinically unnecessary.

Once again thank you very much for your effort and time, we- the authors-  appreciate this very much. Thanks to you our article has a chance to be better.

Best regards,

Authors