Thank for giving me an opportunity to review your excellent study.
This is a study showing that rheumatic diseases are risk factor of complications following orthognathic surgery. There are few studies focusing on the risk rheumatic diseases in perioperative management in oral and maxillofacial surgery. I think that this study is so important, but lacks some important data as follows:
Introduction
No comments.
Materials and methods
Page 6: Other post-operative adverse events, such as neurosensory disturbances (hypoesthesia, paresthesia, or dysesthesia of the inferior alveolar nerve and/or infraorbital nerve) and new-onset TMJ complications were only recorded at the end of the 24-month follow-up period because they are normal findings in the early postoperative period in most patients.
• Please add the detailed way of diagnosis of neurosensory disturbances such as SW test.
Page 6: All surgeries were executed by a single surgical team and prophylactic antibiotics were administered for a period of 1 week starting on the day of surgery to prevent infection.
• Was this antibiotic administration for prevention of SSI for patients with rheumatic diseases or all patients in your hospital?
Results
• Surgical factors such as blood loss and operation time may affect the complications. Please add the details of surgical factors and show the differences between two groups.
• Please describe the details of infection. Were those early or late-onset?
• Did you continue or stop immunosuppressant before and after surgery? Please add the details of drug holiday in this study.

Additionally, please add the details of diagnostic imaging (such as panoramic x-ray or CT) before and after surgery.
This study includes many patients with class II deformity especially in rheumatic diseases group. Did you evaluate the morphological changes of TMJ before surgery? Did you experience patients who suffered from postoperative condylar resorption in patients with rheumatic diseases? I think that many oral and maxillofacial surgeons want to know the relationship between rheumatic diseases and condylar resorption before and after surgery.

Thank you for your revisions.