We thank Dr Sen Yilmaz for his interest in our article.
We said “cone-beam computed tomography” in the title because that is what we used to make the measurements. There was no way other than the use of CBCT to create a lateral cephalogram for each side of the head independently. This step increased the accuracy, since it removed the superimposition of bilateral structures. It also allowed for increasing the sample size.
We agree with Dr Sen Yilmaz that direct measurements on the 3D CBCT images are the closest thing to the actual dimensions. However, this method would render our study incomparable with previous studies that reported on maxillary dentition distalization because of the huge difference in the measurement methodology. Therefore, since our aim was to present the clinical results of the modified palatal anchorage plate, we opted to use a more conventional method of evaluation to demonstrate the difference between the palatal plate and the other distalization devices. Hence, we used CBCT-derived lateral cephalograms.
We considered the report of Moshiri et al of higher accuracy with “CBCT-derived lateral cephalograms” than with “conventional lateral cephalograms,” even though their CBCT-derived 2-dimensional images were not split into right and left sides as we did in our study. We wanted to prevent superimposition of the bilateral structures. Moreover, Shokri et al concluded that the measurements obtained from “CBCT-derived lateral cephalograms” were comparable with direct skull measurements in all 3 planes and were more reliable than “conventional lateral cephalometric” measurements.