Photodynamic Therapy Effects on Oral Dysplastic Keratinocyte Cell Cultures: A Systematic Review

Round 1

Reviewer 1 Report

The paper provides a systematic literature search according to PRISMA protocol using a different PubMed, Cochrane Library, and ISI Web of Science databases. The main findings confirm the role of in vitro photodynamic therapy using several photosensitizer as a potential treatment for oral potentially malignant disorders. The concept of this work is valuable. The subject is important and scientifically relevant. The paper present interesting and promising results. All over presentation of the work is correct and careful.

I would recommend some minor corrections before publication. 

Please check line 60-62 and remove unnecessary text fraction.

Minor editing of English language required

Author Response

 

The paper provides a systematic literature search according to PRISMA protocol using a different PubMed, Cochrane Library, and ISI Web of Science databases. The main findings confirm the role of in vitro photodynamic therapy using several photosensitizer as a potential treatment for oral potentially malignant disorders. The concept of this work is valuable. The subject is important and scientifically relevant. The paper present interesting and promising results. All over presentation of the work is correct and careful.

I would recommend some minor corrections before publication.  

1. Please check line 60-62 and remove unnecessary text fraction.
   1. We would like to thank the reviewer for the valuable revision. The text fraction at lines 60-62 was an error and has been removed.

Reviewer 2 Report

I would like to congratulate the authors for the time and effort put on to perform this systematic review. 

However, I think that many details are missed in the methodology section.

It seems like many parts of the results sections should be moved to the methodology, or it was not reported at all like (inclusion and exclusion criteria, risk of bias, etc).

The results section looks like a literature review of the searched articles rather than a results section.

Why was there no meta-analysis??

The discussion is too limited.

A more concise conclusion is highly recommended. 

I am sorry to disappoint you on this occasion, but I will recommend rejection of this article this time, and my major concern to take this decision was the lack of meta-analysis, I think that it was possible to perform meta-analysis, besides, the authors did not mentioned this possibility and did not justify the lack of meta-analysis in this study.

 

Minor editing of English language required

Author Response

1. We thank the reviewer for valuable suggestions. Although the selection of articles was very thorough however, the extrapolated data had some heterogeneity, which led us not to perform the meta-analysis. In any case, we appreciate the referee's suggestion and since we plan to conduct further studies on malignant lesions, we will take these suggestions into consideration.

Reviewer 3 Report

Which number of researchers have participated in the search strategy item?

When there were disagreements regarding bias risks....., what was done?

 Moderate editing of English language required.

Author Response

1. Which number of researchers have participated in the search strategy item?
   1. We thank the reviewer for the kind suggestion. The phrases “The selection took different steps: after collecting all the initial results, three reviewers (DDS, AL, and AR) read the titles and abstracts, excluded duplicates, and ruled out all those articles that did not meet the inclusion criteria during this initial analysis. Then, two reviewers (DDS and AR) read the full texts of the remaining articles in depth to better evaluate the content” have been added.

 

2. When there were disagreements regarding bias risks....., what was done?
   1. We thank the reviewer for the fundamental improvement. The phrase “DDS and AR performed the bias analysis independently; a third author (AL) refereed the conflicts” has been added.

Reviewer 4 Report

This review analyzed photodynamic therapy effects on oral dysplastic keratinocyte cell cultures by collecting relative articles. This work was detailed and logical. However, I hope the authors could modify the follow information.

1. The introduction about PDT application in first paragraph was too tedious. Some part could be integrated, e.g. line 40-44.

 

2. The mechanism of PDT in page 2, line 63-69 should be transferred into page 1, line 37.

Comments for author File: Comments.pdf

Author Response

1. The introduction about PDT application in first paragraph was too tedious. Some part could be integrated, e.g. line 40-44.
   1. We thank the reviewer for the valuable hint. Line 40-46 have been changed: PDT has been used in diverse specialties from ophthalmology to gynecology, including diagnostics and numerous dental domains like endodontics, restorative dentistry, periodontology, and oral medicine. [3] [4] [5]–[7]. In this field, PDT has been increasingly studied for its potential role in the treatment of oral Potentially Malignant Disorders (OPMDs) such as oral leukoplakia (OL) and oral lichen planus (OLP)[8]–[10].
2. The mechanism of PDT in page 2, line 63-69 should be transferred into page 1, line 37.
   1. We thank the revisor for the valuable suggestion. The mechanism of PDT have been transferred in the first part of the introduction section.

 

Round 2

Reviewer 2 Report

The authors tried to improve the article, still, my concerns are the same, and were not answered or corrected.

1. It seems like many parts of the results sections should be moved to the methodology, or it was not reported at all like (inclusion and exclusion criteria, risk of bias, etc).

2. The results section looks like a literature review of the searched articles rather than a results section.

3. The authors should mention, in the main file,  why it was not possible to perform meta-analysis??

Minor editing of English language required

Author Response

-It seems like many parts of the results sections should be moved to the methodology, or it was not reported at all like (inclusion and exclusion criteria, risk of bias, etc). 

Thank you for your kind suggestion. We added the inclusion and exclusion criteria in the methodology section.  The risk of bias was described in section 2.1.

 

-The authors should mention, in the main file,  why it was not possible to perform meta-analysis??

Thank you for your valuable hint. We added in the main text the reason why we couldn't perform meta-analysis

Author Response File: Author Response.pdf

Round 3

Reviewer 2 Report

The authros answered all my questions and followed the suggesstions.

none