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Authors’ response

American Journal of Orthodontics and Dentofacial Orthopedics, 2021-07-01, Volume 160, Issue 1, Pages 6-6, Copyright © 2021 American Association of Orthodontists

Thank you for taking an interest in our article and for your thoughtful comments. We agree with your thoughts regarding the shortcomings of our published method; the report was one of our initial attempts at using nasoalveolar molding aligners, and we have been making efforts to refine, simplify, and optimize our approach since then.

Thank you for sharing your experience with scanning infants at your center. The limitation of acquiring a traditional impression was highlighted in our discussion. We concur that acquiring intraoral scans would be a safer and more efficient approach, and since the preparation of our manuscript, we have moved toward acquiring intraoral scans instead of traditional impressions. Although our success rate with scanning infants is not yet 100%, our current protocol is to attempt scanning at the first visit, and if we are unable to capture an adequate scan, we acquire a traditional impression. In our limited experience scanning infants, the most challenging patients are those with wide clefts (>9 mm). We successfully scanned infants with the 3-Shape Trios and the Carestream CS3600 scanners (Carestream Dental, Atlanta, Ga). However, we have not attempted to scan with the I-Tero Element (Align Technologies, San Jose, Calif) because of its larger sensor size. With practice, experience, and the inevitable introduction of new smaller sensors, the success rate is expected to increase.

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Thank you again for sharing your experience with us and the readers. In agreement with your comments, we advocate for a transition toward a fully digital approach for nasoalveolar molding treatment in the near future.