Magnetic Mallet and Laser for a Minimally Invasive Implantology: A Full Arch Case Report

Round 1

Reviewer 1 Report

This research topic is interesting for minimally invasive implants and surgical procedures. And the use of Magnetic Mallet and laser confirmed good prognostic results.

1. Are there any harmful effects of the Magnetic Mallet and diode laser used in this study?

It seems necessary to mention the adverse effects or problems reported in previous studies.

2. Figure 2 Are pictures available?

3. Were there any systemic diseases or problems other than those mentioned for elderly patients?

4. I wonder if you have checked the continuous follow-up after surgery.

Thank you.

Author Response

Dear reviewer,

Thank you for your kind review. We have improved the manuscript according to your suggestions.

Let me answer your questions:

1. There are no harmful aspects of the magnetic mallet and the diode laser described in this case report, nor there are in the previous studies: these are techniques without adverse effects, if used with the correct adjustments, those we have illustrated in the introduction.
2. I have add two figures with Sioxyl Solution (one sample and one clinical use)
3. There were no other systemic problems concerning the patient.
4. It is a quite recent case, we just have a clinical follow up for now: the implants are stable, the patient has had no problems and is satisfied.

We hope our article meets your expectations to be published in Applied Sciences.

Best regards,

Paolo Caccianiga

Reviewer 2 Report

dear authors, case presented is good but I suggest adding a discussion about oseodensification, comparing the technique used by you with conventional techniques, elaborate the systemic condition of patient in methodology and care taken to avoid any further problems , describe more about bone condition, PUT MORE CBCT IMAGES, also add magnetic mallet image, mention about insertion torque for implants and  describe about primary stability of implants .

Author Response

Dear reviewer,

Thank you for your kind review. We have improved the manuscript according to your suggestions: 

- We expanded the introduction on the magnetic mallet by pointing out the issue of condensation and consequently bone densification;
- The information on the patient's state of health and systemic problems are already in the materials and methods, as well as the precaution of administering antibiotic prophylaxis, we added that the intervention was performed in a conscious sedation regime;
- Cross sections from CBCT have been added;
- Information on bone density, implant insertion torque and primary stability has been added.

We hope our article meets your expectations to be published in Applied Sciences.

Best regards,

Paolo Caccianiga

Reviewer 3 Report

Hello dear authors!

Your work is interesting and clinically applied. However, I have a few questions that I would like to have answers.

1. What indications and contraindications should be considered when working with Magnetic Mallet

2. What was the rationale for choosing a specific drug for photodynamic therapy?

3. What was the point at all in the combination of lasers, if all the types you used sterilize the wound in the same way?

4. What was the protocol for managing postoperative pain and what drugs were chosen based on the health of the patient?

 

In the list of references it is necessary to clarify references 9 - 15, in which there are no imprints.

In general, the authors cite few works of the last 5 years, although the methods used are modern and constantly used by doctors.

 

Author Response

Dear reviewer,

Thank you for your kind review. We have improved the manuscript according to your suggestions.

Let me answer your questions: 

1. The indications for the use of the magnetic mallet are those indicated in the introduction, the contraindications are not indicated in any study;
2. No drug was used for photodynamic therapy, our protocol is dye-free, we only use hydrogen peroxide to hyper-oxygenate the periodontal tissues so that when the laser light hits the oxygen of the tissues it releases free radicals capable of eliminating the pathogenic bacteria, as described in the section of the OHLLT;
3. The two different types of lasers, diodes and erbium, have two different and complementary effects in this protocol, they are not interchangeable: the diode laser is a penetrating laser and is the one used with non-thermal adjustments in the decontamination protocol of post extraction alveoli, while the erbium laser is a non-penetrating, surgical laser, used to create holes in the bone and induce more bleeding, which leads to better and faster healing.
4. For the management of post-operative pain, in addition to the use of ATP38 for photobiomodulation, already described in the methods, we added that the patient was administered a dose of 550 mg of synflex as a precaution, subsequently she no longer needed these drugs. 

We hope our article meets your expectations to be published in Applied Sciences.

Best regards,

Paolo Caccianiga

Round 2

Reviewer 2 Report

congratulations 

Author Response

Dear reviewer,

Thank you for your kind review!

Faithfully,

Dr. Paolo Caccianiga