Frequency and Demographic Analysis of Odontogenic Tumors in Three Tertiary Institutions: An 11-Year Retrospective Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Comments are in the pdf

Comments for author File: Comments.pdf

Comments on the Quality of English Language

Comments are in the pdf

Author Response

Apr 22, 2024

We would like to thank you, the reviewer, for your careful review of our manuscript and helpful comments to improve it. We submit here a revised version of the manuscript addressing each comment. Changes are highlighted in the manuscript in yellow.

Reviewer #1:

• Abstract: no, they are not the most encountered pathologies in the oral cavity

Comment: Thank you for your comment. We have changed the sentence to “Although OTs are relatively common in the jaws” for accuracy. The change is highlighted in the manuscript.

• Keywords: Keywords must be in alphabetical order

Comment: The keywords were rearranged alphabetically as “ameloblastoma, biopsy, odontoma, odontogenic tumors, odontogenic myxoma, tertiary hospitals”. The change is highlighted in the manuscript.

• Keywords: Remove the keyword oral pathology

Comment: The oral pathology keyword was removed

• Introduction: Also from odontogenic ectomesenchyme

Comment: The authors agree and added “the proliferation of odontogenic epithelial and odontogenic ectomesenchyme remnants.” The change is highlighted in the manuscript.

• Introduction: The Middle East was removed.
• Table 1: You had mentioned that primordial odontogenic tumor was included in the 2014 WHO blue book. Can u confirm this?

Comment: Mosqueda et al. described POT in 2014, incorporated it into the WHO book in 2017, and remained in 2022. The introduction clearly states and references this.

• Results: Any case showed malignant transformation on follow up?

Comment: This is clearly stated in the follow-up table result section. One ameloblastic fibroma recurred as ameloblastic fibrosarcoma after one year of follow-up.

• Result: Any errors in diagnosis that was found during histopathological examination of he slides ? Especially primordial odontogenic tumour as this was defined only in 2014 and your study includes cases from 2010

Comment: There were a few errors and reclassifications of tumors based on the 2022 WHO classification found upon review and confirmed by two pathologists. We have mentioned this in the methodology. The POT case was diagnosed in 2015 after the POT description in the literature.

• Table 3: Histopathology subtypes could be mentioned with %

Comment: The authors would like to thank the reviewer for the comment and wish to keep the details for table 4 for simplicity reasons.

• Table 3: complex compound %

Comment: The authors thank the reviewer for the comment. We added these details in Table 4 and highlighted the change in the manuscript.

• Discussion: don’t make speculations without any evidence

Comment: The authors would like to thank the reviewer for the comment. We changed the sentence and added, “The variation in frequency may be attributed to the lack of well-established diagnostic criteria for odontogenic malignancy. Hence, there is a need for stringent diagnostic protocols to reduce the frequency range and ensure accurate diagnosis.” Instead. The change was highlighted in the manuscript.

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for submitting this work.  I think that it is of general medical interest and it provides a good presentation of clinical and demographic data regarding patients with odontogenic tumors.  I have some suggestions:

1) Please consider including more photomicrographs of each of the tumor types, to demonstrate the histologic spectrum of each of the entities you discuss.

2) In your list of inclusion criteria, please change "Patients with histologic features of..." to "tumors with histologic features of..."  P 5 line 79.

3) Your work states that you are emphasizing treatment options for these tumors, and so I would suggest adding some clinical surgical images (from the OR, or radiographs or photos of gross specimens).  

Author Response

Apr 22, 2024

We would like to thank you, the reviewer, for your careful review of our manuscript and helpful comments to improve it. We submit here a revised version of the manuscript addressing each comment. Changes are highlighted in the manuscript in yellow.

Reviewer #2:

Thank you for submitting this work.  I think that it is of general medical interest and it provides a good presentation of clinical and demographic data regarding patients with odontogenic tumors.  I have some suggestions:

• Please consider including more photomicrographs of each of the tumor types to demonstrate the histologic spectrum of each you discuss.

Comment: The authors would like to express gratitude to the reviewer for their comment. The primary objective of this study is to report the frequency and demographics of specific lesions. To achieve this, we have provided illustrations of the typical features of each entity, which we rely on to make a diagnosis. We believe that discussing the histological spectrum of such lesions is beyond the scope of this paper.

• In your list of inclusion criteria, please change "Patients with histologic features of..." to "tumors with histologic features of..."  P 5 line 79.

Comment: The change was made and highlighted in the manuscript.

• Your work states that you are emphasizing treatment options for these tumors, and so I would suggest adding some clinical surgical images (from the OR, or radiographs or photos of gross specimens). 

Comment: The authors express their gratitude to the reviewer for their comments. As our paper is retrospective in nature, the primary treatment data was sourced from the medical record, and obtaining images of OR or gross presentation wasn't possible. Nevertheless, we have included a figure to depict instances of ameloblastoma recurrence. The changes made to the manuscript have been highlighted.