Proposal for a Paradigm Shift in Personalized Medicine for Patients with a Maxillary Edentulous Jaw by ENT Specialist and Dentist Cooperation
Round 1
Reviewer 1 Report
Dear Authors,
Thank you for giving me the opportunity to review this article. The authors evaluate postoperative maxillary sinus complications associated with dental implant treatment. Furthermore, they propose a new paradigm for personalized evidence-based decision-making. I think the manuscript is well-written and covers an interesting topic indeed.
However, I have a few comments:
Introduction:
Please include a paragraph about
Page 2 Line 56: Please include a statement on the dental causes of peri-implantitis that may play an important role, e.g. periodontal disease, lack of follow-up, inadequate plaque control, mucositis, and malposition of the implant.
page 3 figure 3: please make the letters of the caption in the figures bigger and create a more suitable layout
Page 3 Section; 2. Identification of the possible causal/risk factors for maxillary sinusitis after implant surgery with or without sinus augmentation
Please add a paragraph that considers dental causes, addressing the following topics: poor oral hygiene, persistent/recurrent periodontitis, preoperative imaging modality/planning, influence of the surgical technique (extrasinusal surgical technique (classical or sinus slot technique) or intrsinusal approach.
Page 6 Figure 5: Please add arrows to figure 5 for a better overview and direct visualization of pathologies.
Discussion:
New Concept and Figure 6: The proposed concept also lacks simple dental management, which simply rejects implantation because there are various prosthetic options, that also achieve satisfactory results, especially in the maxilla, without resorting to surgical methods. Please explain why this has been omitted or modify the concept.
Page 8 Line 234: Please also address other imaging modalities. Address the possibility of low-dose DVTs that further minimize radiation exposure. or dental MRI, which allows simultaneous visualization of soft and hard tissue using black-bone MRI sequences and may therefore be an interesting option, especially in sinus pathologies.
Therefore will be worthwhile to discuss if MRI and low-dose CBCT can be used to evaluate this aspect with an improved benefit-risk ratio. I think that citing these references can further enhance the paper.
1. Al-Haj Husain A, Sekerci E, Schönegg D, Bosshard FA, Stadlinger B, Winklhofer S, et al. Dental MRI of Oral Soft-Tissue Tumors-Optimized Use of Black Bone MRI Sequences and a 15-Channel Mandibular Coil. J Imaging. 2022;8(5).
2. Al-Haj Husain A, Döbelin Q, Giacomelli-Hiestand B, Wiedemeier DB, Stadlinger B, Valdec S. Diagnostic Accuracy of Cystic Lesions Using a Pre-Programmed Low-Dose and Standard-Dose Dental Cone-Beam Computed Tomography Protocol: An Ex Vivo Comparison Study. Sensors (Basel). 2021;21(21).
Author Response
August 1, 2022
Editor, the Journal of Personalized Medicine
Dear Editor in chief, Professor Keiso Takahashi
Manuscript ID: jpm-1844758
Dear Prof. Keiso Takahashi:
Please find attached the revised version of our manuscript, entitled “Proposal for a Paradigm Shift in Personalized Medicine for Patients with a Maxillary Edentulous Jaw by ENT and Dentist Cooperation”, which we are resubmitting to the Journal of Personalized Medicine (Special Issue “Precision Medicine for Oral Diseases”). We have extensively revised our manuscript according to the reviewers’ comments, and added content above 3000 words according to your suggestions. We stated the response to reviewer 1 by words in red, and the response to reviewer 2 by words in blue of the revised manuscript. We believe that these revisions have strengthened our manuscript, and we would like to thank you and the reviewers for your valuable and helpful comments.
We trust that the revised version is satisfactory and suitable for publication in the Journal of Personalized Medicine. We thank you for consideration of our manuscript, and we hope to hear from you soon.
Yours sincerely,
Yuh Baba, MD, PhD, Professor
Department of General Clinical Medicine,
Ohu University School of Dentistry
31-1 Misumido, Tomita-machi,
Koriyama 963-8611, JAPAN
Tel: +81-(0)24-932-9331
Fax:+81-(0)24-933-7372
E-mail: [email protected]
- The following is a point-by-point response to the reviewer 1.
Comment 1. Page 2 Line56: Please include a statement on the dental causes of peri-implantitis, and add a paragraph that consider dental causes addressing the following topics: poor oral hygiene, persistent/recurrent periodontitis etc to Page 3 Section 2.
Answer 1.Thank you for your useful comments and suggestions. We moved the statement on the dental causes of peri-implantitis from introduction section to section 2, because you had also asked us to add dental causes in section 2. Please see the sentence “Dental causes such as poor oral hygiene ~ after implant surgery.” from Page 3 Line 79 to Page 3 Line 84. Furthermore, we added reference 10 about peri-implantitis.
Comment 2. Page 3 figure 3: Please make the letters of the caption in the figures bigger and create a more suitable layout.
Answer 2. Thank you for your useful comments and suggestions. We made letters of the caption in the figure 3 bigger and create a more suitable layout. Please see the revised Figure 3 in the inferior part of Page 3.
Comment 3. Please add arrows to figure 5 for better overview and direct visualization of pathologies.
Answer 3. Thank you for your useful comments and suggestions. We add white arrow to Figure 5. Please see the revised Figure 5 in the upper part of Page 6.
Comment 4. Please modify new concept and figure 6, because there are various prosthetic option, and add a paragraph addressing the surgical technique such as sinus slot technique.
Answer 4. Thank you for your useful comments and suggestions. We agreed that there are other various prosthetic options such as dentures, implant-supported over dentures, and sinus slot technique. Therefore, we revised figure 6, and added the following sentence “Patients with refractory disorders ~ as an alternative method [31].” from Page 8 Line 246 to Page 8 Line 249.
Comment 5. Please address other preoperative imaging modalities/planning.
Answer 5. Thank you for your useful comments and suggestions. We agreed that low-dose DVTs and dental MRI are promising alterative diagnostic evaluations for pathologies in the maxillary sinus. Therefore, we added the following sentence “Promising alterative ~the natural ostium of the maxillary sinus.” from Page 9 Line 268 to Page 9 Line 272.
Author Response File: 
Author Response.docx
Reviewer 2 Report
Dear authors,
The Paradigm Shift is not clearly defined in the manuscript. So, what exactly is this Paradigm Shift?
Please remove unnecessary spacing, so that the titles should remain on the same page as the text.
There is no clear structure of the manuscript: introduction, aims, material and methods, results, discussion, and conclusions.
It seems like a background article, showing many clinical situations.
Please add clinical relevance.
Please add the limitations and strengths of the manuscript.
Figure 1: where does the data come from?
Figure 6. Please explain more in detail than just “Here, we propose 226 an evaluation and management protocol based on sinonasal CT findings (Figure 6).”
In conclusion the paradigm is not clearly presented, as well conclusions are not sustained by the results.
Author Response
August 1, 2022
Editor, the Journal of Personalized Medicine
Dear Editor in chief, Professor Keiso Takahashi
Manuscript ID: jpm-1844758
Dear Prof. Keiso Takahashi:
Please find attached the revised version of our manuscript, entitled “Proposal for a Paradigm Shift in Personalized Medicine for Patients with a Maxillary Edentulous Jaw by ENT and Dentist Cooperation”, which we are resubmitting to the Journal of Personalized Medicine (Special Issue “Precision Medicine for Oral Diseases”). We have extensively revised our manuscript according to the reviewers’ comments, and added content above 3000 words according to your suggestions. We stated the response to reviewer 1 by words in red, and the response to reviewer 2 by words in blue of the revised manuscript. We believe that these revisions have strengthened our manuscript, and we would like to thank you and the reviewers for your valuable and helpful comments.
We trust that the revised version is satisfactory and suitable for publication in the Journal of Personalized Medicine. We thank you for consideration of our manuscript, and we hope to hear from you soon.
Yours sincerely,
Yuh Baba, MD, PhD, Professor
Department of General Clinical Medicine,
Ohu University School of Dentistry
31-1 Misumido, Tomita-machi,
Koriyama 963-8611, JAPAN
Tel: +81-(0)24-932-9331
Fax:+81-(0)24-933-7372
E-mail: [email protected]
Comment 1. What exactly is this paradigm shift?
Answer 1. We wish to thank reviewer 2 for critical comment. We added the following sentence about the definition of this paradigm shift “Furthermore we emphasize ~ in addition to maxillary sinus pathologies.” from Page 1 Line 21 to Page 1 Line 25 in abstract.
Comment 2. Please remove unnecessary spacing, so that the titles should remain on the same page as the text.
Answer 2. Thank you for your useful comments and suggestions. We revised that the title of “3.4.1” remains on the same page as the text. Please see Page 7 Line 193.
Comment 3. There is no clear structure of the manuscript: introduction, aims, material and methods, results, discussion, and conclusions. It seems like a background article.
Answer 3. We apologize for misleading the reviewer 2. This manuscript is not original article but review article. Therefore, the manuscript is constructed by introduction, section 2 (Identification of risk factor for maxillary sinusitis after implant surgery), section 3 (traditional paradigm), discussion (proposal for new paradigm), and conclusions. Thus, we revised from “In this study” to “In this review article”. Please see Page 1 Line 17 in abstract.
Comment 4. Please add clinical relevance and strengths of the manuscript.
Answer 4. Thank you for your useful comments and suggestions. We completely agreed with your comment 4. Therefore, we added the following sentence “Under this new paradigm ~ maxillary implantation at our institution (unpublished data).” from Page 8 Line 249 to Page 8 Line 251.
Comment 5. Please add the limitations of the manuscript.
Answer 5. We agreed with your comment. We added the following sentence “This proposal has some limitations ~ under this new paradigm” from Page 8 Line 253 to Page 9 Line 260.
Comment 6. Figure 1: Where does the data come from?
Answer 6. Please see references 5, 6, and 7. These publications were written by working group of trouble investigation of the Japanese academy of maxillofacial implants. The data of Figure 1 comes from previous reports (ref.5, 6, 7).
Comment 7. Please explain more in detail than just “Here propose an evaluation and management protocol based on sinonasal CT findings (Figure 6).”
Answer 7. We completely agreed with your comment. Therefore, we added the following sentence “When there is normal lesion ~ after recovery from these illness.” from Page 8 Line 241 to Page 8 Line 246.
Comment 8. In conclusion the paradigm is not clearly presented, as well conclusions are not sustained by the results.
Answer 8. Thank you for your useful comments and suggestions. We added the following sentence “Under this new paradigm, there was no patient with chronic rhinosinusitis which might need FESS after maxillary implantation at our institution (unpublished data).” from Page 8 Line 249 to Page 8 Line 251 in discussion, as we stated in comment 4. Furthermore, we added the following sentence “further work ~ more clinical relevance” from Page 9 Line 295 to Page 9 Line 298 in conclusion section. We intend to state that the clinical outcome under this new proposal is superior to that under traditional paradigm in the next original clinical research article after increasing the number of participants under this new paradigm.
Author Response File: Author Response.docx
Round 2
Reviewer 2 Report
the article is intersting and ot is writtne in an appropriate manner for the publication
