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We appreciate the comments raising several questions. We hope that our reply will prompt the readers to consider the best treatment option for each patient in the future.1.In the frontal view, a significant left deviation of the maxillary anterior teeth was observed. Thus, it was necessary to evaluate the displacement of the maxillary and mandibular anterior teeth relative to the body of the mandible, as well as the inclination of the maxillary occlusal cant for the diagnosis and treatment planning. The maxillary dental midline showed a left deviation of 3.0 mm, whereas the mandibular dental midline was coincident with the mandibular bony midline, and no tilting of the occlusal cant was observed by posteroanterior cephalometric analysis.2.Initially, we considered bilateral extraction of the first premolars to achieve proper canine guidance, symmetrical dental arch, and midline correction of the maxilla. However, we observed severe external root resorption in the left lateral incisor, predicting poor long-term prognosis.1Sameshima G.T. Sinclair P.M. Predicting and preventing root resorption: part II. Treatment factors.Am J Orthod Dentofacial Orthop. 2001; 119: 511-515Abstract Full Text Full Text PDF PubMed Scopus (171) Google Scholar However, the patient did not have concerns regarding the intraoral esthetic factors such as the symmetry, gingival contours, and shape and/or color of the teeth. We emphasized the importance of long-term preservation of the individual teeth, and after discussing the treatment alternatives, extraction of the left lateral incisor was performed. The patient did not have any demand for esthetic factors throughout the active treatment and retention period. There was no apparent change in the examination results of the periodontal tissues before and after treatment (Fig 1). The palatal sides of the maxillary left canine and first premolar were reshaped to gain proper guidance, which was revealed in the records of the mandibular kinesiograph after treatment (Fig 2).Fig 2Records of mandibular kinesiograph. A, Lateral border movement in pretreatment. B, Anterior border movement in pretreatment. C, Lateral border movement in post-treatment. D, Anterior border movement in post-treatment. BOP, bleeding on probing.View Large Image Figure ViewerDownload Hi-res image Download (PPT)3.We analyzed the sella nasion to maxillary incisor angle, the incisor mandibular plane angle, and the interincisal angle 5 times on different days using cranial base superimposition (Fig 3; copy of Fig 9 in the article). The sella nasion to maxillary incisor angle was 97.8° ± 0.2° at pretreatment and 106.4° ± 0.5° at posttreatment, whereas the incisor mandibular plane angle was 79.2° ± 0.3° at pretreatment and 85.3° ± 0.4° at posttreatment. In contrast, the interincisal angle was 142.1° ± 0.3° at pretreatment and 127.4° ± 0.4° at posttreatment. The standard deviation was larger in the posttreatment measurements than in the pretreatment ones, possibly because of root resorption after treatment.Fig 3Cranial base superimposition.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Canine substitution for missing lateral incisorAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 159Issue 1PreviewAn article published in July 2020 by Okihara and Onoto shows a case of a 21-year-old woman exhibiting maxillary anterior crowding, deviation of the maxillary midline, and deeply impacted mandibular second molars bilaterally with Class II malocclusion (Okihara H, Ono T. Correction of bilateral heavily impacted second molar with improved super-elastic nickel-titanium alloy wires. Am J Orthod Dentofacial Orthop 2020;158:114-25). Full-Text PDF