Retrograde Study Using Radiographic Comparison of Bone Fill Observed after Guided Tissue Regeneration by the Type of Periodontal Bone Defect
Round 1
Reviewer 1 Report (New Reviewer)
Comments and Suggestions for AuthorsDear Authors,
I write you in regard to your manuscript entitled Retrograde study using Radiographic comparison of bone fill observed after guided tissue regeneration by the type of peri-odontal bone defect.
- please, consider revising the title. Authors could use one main finding or the main conclusion as a title.
- in the abstract, if possible, start if with the gap that was described in line 24.
- please, describe more information about the subjects, like age, for example.
- please, add legends to the axis of the graphics.
- references must be placed among the lines 208-212.
- overall, the entire text must be deeply revised to achieve reading flow and more clarity. More references must be added along the text, mainly in the discussion.
Author Response
Dear reviwer,
Thank you for reviewing my article.
Information on the distribution of patient age has been added, and several recent papers on guided tissue regeneration have also been added as references. This article has already been proofread in English, and if it needs to be proofread again, we will consider it later.
Author Response File: 
Author Response.pdf
Reviewer 2 Report (New Reviewer)
Comments and Suggestions for AuthorsRetrograde study using Radiographic comparison of bone fill observed after guided tissue regeneration by the type of peri-odontal bone defect for Applied Sciences;
I believe that what we have here is an attempt to overview retrospectively patients after a GTR to check whether there is a difference in bone growt relative to the type of peri-odontal bone defect . Firstly, I need to criticise the selection of the references - most of the literature is published 5 years ago. Even though, some are incompqlete. Srivastava et al. and Rakmanee et al. would be helpful and inspirativne, though both papers are 6-7 ys old. Please, find some up-to-date references.
1) I miss the straightforward objective of this paper. Clear, unambiguous link between P0 d8sease and bony defects is appreciated.
2) 'author of text into parafraps is performed perfectly illogical and unskilled.s should work on their style. Some sentences are too long, with unnecessary 2prepositions or adjectives. This detracts the reader and diminishes the fluency. Subdivision or text into sections/ paragraphs is performed illogicaly and without a skill.
3) use of abbreviations throughout. In the instructions for authors,the authors are asked to define them first time they appear in each of three sections: the abstract; the main text; the first figure or table. When defined for the first time, the acronym/abbreviation/initialism should be added in parentheses after the written-out form.
Comments on the Quality of English LanguageSee above!
Author Response
Dear reviewer,
Thank you for reviewing my article.
Thank you for reviewing my article.
Information on the distribution of patient age has been added, and several recent papers on guided tissue regeneration have also been added as references. This article has already been proofread in English, and if it needs to be proofread again, we will consider it later.
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report (New Reviewer)
Comments and Suggestions for AuthorsDear Authors,
Thank you for addressing all comments and suggestions. Please, revise the text for one last check of the English and punctuation.
Author Response
I finally performed English proofreading on the entire sentence once more. Once again, thank you so much for reading my article.
Author Response File: Author Response.pdf
Reviewer 2 Report (New Reviewer)
Comments and Suggestions for AuthorsAt curret form, I do not have academic issues to be resolved.
Author Response
I finally performed English proofreading on the entire sentence once more. Once again, thank you so much for reading my article.
Author Response File: Author Response.pdf
This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsTitle:
Long-term comparison of bone healing after guided tissue regeneration according to type of periodontal bony defect
The topic of great interest and I enjoyed reading this article, however I have few concerns and suggestions
Title:
1. The title does not give any idea of study population, study setting and study design
Abstract:
1. The authors have mentioned about the background but however I feel they have some conclusive statements in the background like “Radiographic differences in bone filling before and after guided tissue regeneration were statistically significant using a t-test assuming equal variance.
2. The authors should mention at least 6-8 key words other than the one present in the title
Introduction:
1. Introduction is well written however, the authors need to add more details on the guided tissue regeneration
2. Line 33-37 need to cited with appropriate references
3. The reference style is not appropriate and it very unorganized
4. The authors start with reference 9, 14, 15
5. Reference style is not according to MDPI guidelines
6. Line 63-64 need to cited with appropriate references
Methodology:
1. Authors have not mention regarding IRB-Ethical clearance in this section
2. Informed consent is missing
3. Did the authors consider smoking or other habits in exclusion criteria’s? Should be mentioned explicitly
4. Was there any information on the post - operative care/ follow up for these patients who underwent surgeries?
Results: Results write up needs to elaborated
Discussion: Well presented
References:
1. Is not a correct way of presentation
2. Not according to MDPI guidelines
Comments for author File: Comments.pdf
Author Response
We've made changes based on your feedback, thank you.
Author Response File: 
Author Response.docx
Reviewer 2 Report
Comments and Suggestions for AuthorsThis study is a clinical study reporting values of GBR out of a sample of 80 patients. It is not clear that this study is retro or prospective? Authors are analysing a group of bone defects including multiple type wall bone loss treated by two different type of bone grafts and then analyzing everything in a single type of statistics. This analysis also assumes that all patients had reviewed only one type of defect and bone graft which is not the case in this study. Please consult to a biostatistician for proper method of analysis.
minor remaks:
- The sentences “If the patient has early recognition of gingivitis, ex- 32 cellent oral hygiene, or innate immunity to periodontal pathogens, alveolar bone loss may 33 be mild horizontally, but if the patient is unfortunate enough to have a morbidly obese 34 population, alveolar bone loss may be severe. “ - “The body's immune response to periodontal 35 pathogens leads to the loss of periodontal tissue, which in turn leads to alveolar bone loss, 36 resulting in difficulty in oral hygiene management and inability to achieve a complete 37 cure.
“ - “Three-wall bone defects and two- and 42 three-wall combined defects had a better response to healing compared to two-wall or 43 one-wall bone defects..
“ - “When periodontal tissue destruction extends from the multimolar to the periapical 45 region, it is impossible to treat with conventional non-surgical periodontal therapy. Anal- 46 ogizing the mechanism of periodontal disease development to the accumulation of path- 47 ogenic substances such as calculus, furcation involvement not only creates a narrow area 48 that is difficult to treat, but also facilitates the accumulation of these pathogenic sub- 49 stances.
“ are speculation without a relevant citation Remove/revise this sentence or add a direct proof citation. There are a lot of sentences in this manuscirpt. So please revise / remove or add proper citations.
Author Response
We've made changes based on your feedback, thank you.
Author Response File: Author Response.docx
Reviewer 3 Report
Comments and Suggestions for Authors
Comments:The information presented in the manuscript, Long-term comparison of bone healing after guided tissue regeneration according to the type of periodontal bony defect, is related to the reconstruction of the defects based on their anatomical location (maxillary, mandibular, furcation involvement, and intrabony defects). This manuscript has contained sufficient information, information is presented in a logical order, and the conclusions are generally supported by the data. Following minor corrections and proofreading are needed to further improve the readability and quality of the manuscript.
1. Please add more Keywords. More than 70 % of cited are before 2000. Please cite recent studies, as much as possible. The following studies can be cited to strengthen the literature.
ü www.sciencedirect.com/science/article/pii/S1385894722011135
ü www.sciencedirect.com/science/article/pii/S0272884219303566
2. At the end of the introduction part, there is a need to enlighten the novelty of the work and differentiate the current work compared to the literature.
3. The figures have been carelessly prepared. Work on it. Figures have no error bar. It is not mentioned the number of repeating tests in materials and methods.
4. What is the meaning/abbreviation of DFDBA and CEJ in line #127, and line# 132?
5. According to line #120, the total number of cases is 80, but according to the statement in line # 141, the total number of cases is 82. Please match the data. Or in other words please use the term 82 lesion instead of cases.
6. More Pie Graph can be used in Figure 1, such as classification-based on lesions and classification-based on graft used.
7. The length of the results section should be extended more. The result in each figure should be explained more. Especially detailed discussed in Figure 6.
8. In the discussion, there is written When performing the guided tissue regeneration procedure, the choice of the membrane is very important, and stated that absorbable membranes (dPTFE)) were primarily used in this study. The data relating to the use of dPTFE is missing in the experimental and results sections.
9. The authors concluded that were no differences in bone regeneration responsiveness to guided tissue re-324 generation in the maxilla and mandible. As different kinds of grafts have been used in this study, is there any link between different grafts and healing outcomes? This area is less discussed in this manuscript.
10. Conclusion is not comprehensive and not scientifically conclusive. Rewrite in scientific form.
Comments on the Quality of English LanguageRevising is neede
Author Response
We've made changes based on your feedback, thank you.
Author Response File: Author Response.docx
Reviewer 4 Report
Comments and Suggestions for AuthorsIt was evaluated the article “Long-term comparison of bone healing after guided tissue regeneration according to type of periodontal bony defect”. The primary goal was “to determine whether there is a significant difference in the amount of bone fill in guided tissue regeneration according to the location and shape of the lesion”.
When I read the title, I was very estimulated to read the whole text. However, I considered the approach large (quantity of bone graft in GRB according to location and shape) and the number of included patients very low.
- Please, include in the title that it is a retrospective study.
- “long-term” - this words are wrongly used (“2 years were finally selected”). Review it.
- large number of variables (“The bone lesions of the 80 final recruited patients were classified into maxillary, mandibular, furcation involvement, and intrabony defects, and the types of bone graft materials used were further analyzed”)
- How do the authors measured the “amount of bone fill in guided tissue regeneration” in a retrospective study? in order to find significant difference.
- References are not in a sequential order
- References must be updated. only 2 out of 31 refs used, are from 2018.
- IRB: there is a mistake or misunderstanding… “The research protocol of this study was reviewed and approved by the Research Ethics Committee, Kyungpook National University on 3rd january 2023 (approval number: KNUDH 2022-12-01-00).”
The IRB was approved this year. After less than 4 months, all data were collected, analyzed, and are ready to be published. Clarify it, please.
- There are methodological errors. Review it throughout.
- I do not suggest to mix DFDBA with xenograft biomaterials (Bio-Oss® and Legograft®). Different content and physical-chemical structure.
- Who were the operators? Was there calibration
- How many mg were used in each surgery? This part needs to be very well detailed.
Author Response
We've made changes based on your feedback, thank you.
Round 2
Reviewer 1 Report
Comments and Suggestions for AuthorsThe authors have just utilized English editing services to revise the manuscript without considering any of the previous comments.
Author Response
We've made changes based on your feedback
Author Response File: Author Response.docx
Reviewer 3 Report
Comments and Suggestions for AuthorsI could not find the comments have been addressed in the revised version.
Comments on the Quality of English Language
No comment.
Author Response
We've made changes based on your feedback
Author Response File: Author Response.docx
Reviewer 4 Report
Comments and Suggestions for AuthorsIt was evaluated the article “Long-term comparison of bone healing after guided tissue regeneration according to type of periodontal bony defect”. The primary goal was “to determine whether there is a significant difference in the amount of bone fill in guided tissue regeneration according to the location and shape of the lesion”.
It is the third round of evaluation.
- the references continue non-updated. Some old refs. were added. Please I sent the comment previously “only 2 out of 31 refs used, are from 2018”.
- I also continue considering the approach of the articles extremely large (large number of variables: The bone lesions of the final recruited patients were classified into maxillary, mandibular, furcation involvement, and intrabony defects, and the types of bone graft materials used were further analyzed”), and the content limited (there is a lack of content to respond the complexity raised). Moreover, the number of patients included is very low.
- I suggested to “include in the title that it is a retrospective study”. No modification was done in the title
- “long-term” - this words are wrongly used (“2 years were finally selected”). There is a scientific misunderstanding about the term “long term”.
- How do the authors measured the “amount of bone fill in guided tissue regeneration” in a retrospective study? in order to find significant difference. I did not receive response for that previous question.
- IRB: there is a mistake. “The research protocol of this study was reviewed and approved by the Research Ethics Committee, Kyungpook National University on 3rd january 2023 (approval number: KNUDH 2022-12-01-00).” Was all the study prepared in 4 months???
The IRB was approved this year. After less than 4 months, all data were collected, analyzed, and are ready to be published.
I did not receive responses for the questions below:
- There are methodological errors. Review it throughout.
- I do not suggest to mix DFDBA with xenograft biomaterials (Bio-Oss® and Legograft®). Different content and physical-chemical structure.
- Who were the operators? Was there calibration
- How many mg were used in each surgery? This part needs to be very well detailed.
Author Response
We've made changes based on your feedback
Author Response File: Author Response.docx
