Authors' response.

Abstract

We thank the authors for taking an interest in our article and sending comments. We are happy to provide the following clarifications.1.The patients were selected from the database of 89 miniscrew-supported cases of different malocclusions treated over several years. All bimaxillary protrusion patients were treated by a similar predefined indirectly supported miniscrew anchorage protocol in our institute. Only bimaxillary protrusion cases that met the selection criteria mentioned in Material and methods section and having good-quality pretreatment and posttreatment radiographs were included in the study. These patients were consecutively started and finished, and their selection was not based on the results. We did not consider a control group because our objective was to evaluate the absolute control or anchorage loss, if any, with miniscrews and not relative to other methods of anchorage control, including a control sample.2.We did not consider the Frankfort horizontal plane as a reference plane for vertical tooth movement because of its unreliability.1Pancherz H. Gokbuget K. The reliability of the Frankfort horizontal in roentgenographic cephalometry.Eur J Orthod. 1996; 18: 367-372Crossref PubMed Scopus (16) Google Scholar Instead, the palatal plane and the mandibular plane were used as reference lines to measure vertical tooth movement of maxillary and mandibular teeth, respectively.2Yamada K. Kuroda S. Deguchi T. Takano-Yamamoto T. Yamashiro T. Distal movement of maxillary molars using miniscrew anchorage in the buccal interradicular region.Angle Orthod. 2009; 79: 78-84Crossref PubMed Scopus (80) Google Scholar, 3Park H.S. Yoon D.Y. Park C.S. Jeoung S.H. Treatment effects and anchorage potential of sliding mechanics with titanium screws compared with the Tweed-Merrifield technique.Am J Orthod Dentofacial Orthop. 2008; 133: 593-600Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar3.The observation is correct. There is a difference in tipping of the maxillary first molars by 2 different parameters, 1 angular and 1 linear, measured from 2 different reference systems. The linear measurements showed net mesial tipping of the maxillary molar (mesial movement at the crown tip was only 0.2 mm greater than at the apex) that was not clinically significant. The coefficient of variation for angular measurement was large, with a mean of −2.43 (SD, 3.12) for the maxillary molar, and these angular changes were not statistically significant. Due to this variation, the net distal tipping shown by this parameter may be clinically irrelevant. This may explain the difference between the 2 results.4.Definitely, placing miniscrew implants during the levelling and alignment stage will provide better anchorage control. Future anchorage studies should consider this suggestion when the methodology is designed. Indirectly loaded miniscrews for anchorage controlAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 151Issue 2PreviewWe read with great interest the article entitled “Quantitative and qualitative assessment of anchorage loss during en-masse retraction with indirectly loaded miniscrews in patients with bimaxillary protrusion” (Monga N, Kharbanda OP, Samrit V. Am J Orthod Dentofacial Orthop 2016;150:274-82). This article concluded that in clinical situations when directly loaded miniscrews are not preferable, indirect miniscrew anchorage could be a viable alternative to direct anchorage. However, we still have a few questions regarding this study. Full-Text PDF