Response to Letter to the Editor on "Comparative Analysis of Tear Strength Across Different Types of Maxillofacial...

We appreciate the reader's comments on our systematic review and meta-analysis evaluating mechanical properties of maxillofacial silicone materials. The points raised highlight important aspects of clinical translation, methodological heterogeneity, patient-centered outcomes, and future research opportunities. In response, we clarify that our analysis extended beyond tear strength to include tensile strength, elongation percentage, and surface roughness, providing a broader mechanical perspective. The heterogeneity observed across studies was anticipated and managed using random-effects modeling, I² statistics, and meta-regression, with the intent not only to synthesize existing data but also to expose the variability in current methodologies. This variability underscores the urgent need for standardized testing protocols and more homogeneous study designs. While patient-reported and economic outcomes were beyond the scope of our review, we acknowledge their critical importance for real-world applications. Our findings should therefore be understood as both a synthesis of available mechanical evidence and a call to the field to conduct more comprehensive, standardized, and clinically relevant investigations.No Level Assigned This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .