Shear Bond Strength of Repaired CAD/CAM Resin-Based Composite Materials Submitted to Er:YAG Laser Treatments at Different Powers
, Burcu Oglakci 2, Zumrut Ceren Ozduman 2 and Evrim Eliguzeloglu Dalkilic 2
Round 1
Reviewer 1 Report
The paper is written clearly and fluently. Overall, the study could be of great interest. The level of English is good.
Introduction
The introduction is clear and complete.
I suggest making the following changes:
- Correct repetition "popularity" line 37 and 40.
- Lines 72-74: State the null hypothesis in one sentence.
Materials and methods
The materials and methods are well described and the subdivision into paragraphs makes the work reproducible.
I suggest reporting the following sentence in the results: the materials and methods section should not tend to contain numbers but only explain the sample selection, analysis and subdivision procedure:
"Based on the literature, the specimen size was determined with a power analysis12. In 78 the current study, minimum 15 specimens were needed for a medium effect size (d=0.50), 79 with 95% power and a 5% type 1 error installments".
Results
About the results, I suggest, if possible, to insert further tables in order to make the consultation of the paper more schematic.
I suggest describing Figure 1 and Figure 2 in more detail and comprehensively in order to corroborate the results obtained.
Discussion
The discussion was written appropriately and accurately; however, it would be advisable to also include the description of the most salient studies cited and the names of the authors as in line 290.
Conclusion
The conclusion should be shorter and written in a conversational way, avoiding lists.
Furthermore, it should be added that further in vitro and in vivo studies couled be essential to confirm the obtained results.
The paper is written clearly and fluently. Overall, the study could be of great interest. The level of English is good.
Author Response
Reviewing#1:
The paper is written clearly and fluently. Overall, the study could be of great interest. The level of English is good.
Introduction
The introduction is clear and complete. I suggest making the following changes:
- Correct repetition "popularity" line 37 and 40.
Response: Thanks for the reviewer for helpful feedback. We removed the repetition in line 40 and rearranged the sentence as below:
“In recent years, CAD/CAM resin-based composite materials have been preferred since…”
- Lines 72-74: State the null hypothesis in one sentence.
Response: Thanks for the reviewer for helpful feedback. We arranged the null hypothesis in one sentence.
“The research null hypothesis was that there would be no difference in SBS of repaired CAD/CAM resin-based composite materials among Er:YAG laser at different irradiation powers and other different surface pretreatments.“
Materials and methods
The materials and methods are well described and the subdivision into paragraphs makes the work reproducible.
I suggest reporting the following sentence in the results: the materials and methods section should not tend to contain numbers but only explain the sample selection, analysis and subdivision procedure:
"Based on the literature, the specimen size was determined with a power analysis12. In 78 the current study, minimum 15 specimens were needed for a medium effect size (d=0.50), 79 with 95% power and a 5% type 1 error installments".
Response: Thanks for the reviewer for helpful feedback. We moved this paragraph to the statistical analysis section. Because specimen size calculation is related to the statistical analysis.
Results
About the results, I suggest, if possible, to insert further tables in order to make the consultation of the paper more schematic.
I suggest describing Figure 1 and Figure 2 in more detail and comprehensively in order to corroborate the results obtained.
Response: Thanks for the reviewer for helpful feedback.We gave more detail regarding the results and added Table 3.
“When comparing the CAD/CAM materials, GB showed significantly higher SBS than SB for the ones with no treatment and treated with HF and 7W laser (p<0.05). SB showed significantly higher SBS than GB for the ones treated with bur, 3W and 5W laser (p<0.05).”
“Figure 1 shows the failure modes after SBS test for all tested groups For SB, the predominant mode of failure was an adhesive type except the specimens treated with bur. No pretreated specimens exhibited the highest frequency of adhesive type while the specimens treated with bur had the lowest frequency adhesive type. The specimens treated with bur had the highest rate cohesive failure type in restorative material (60%). The specimens treated with 7W laser showed adhesive type (46.66%) and mixed type in repair material (46.66%) at equal rates. Cohesive in repair material was observed for specimens treated with bur. Mixed type in restorative material was observed for the specimens treated with HF and 5W laser.
For GB, the predominant modes of failure were adhesive type and mixed type in repair material. The specimens treated with 3W and 5W lasers showed the highest rate adhesive type while the specimens treated with bur and HF exhibited the highest rate mixed type in repair material. Cohesive in repair material was observed for specimens treated with HF while cohesive in restorative material was found for no pretreated specimens. Mixed type in restorative material was observed for the specimens treated with HF and bur. “
“For both CAD/CAM resin-based composite materials, the groups were treated with no treatment (control) presented the smooth surfaces (Fig 2A/a, 2G/g). The groups treated with HF showed surface irregularities with peaks (Fig 2B/b, 2H/h) while the groups treated with bur showed deep parallel valleys (Fig 2C/c, 2I/i). With regard to the Er: YAG laser groups, for both CAD/CAM resin-based composite materials, the groups treated with 3W laser exhibited less intended surface appearance (Fig 2D/d, 2J/j). Greater microporosities were observed with 5W laser for SB (Fig 2E/e) while micro-scratches were seen for GB (Fig 2K/k). For GB, 7W laser caused more irregularities with peaks and valley (Fig 2L/l). “
Table 3. Failure mode analysis of fractured surfaces after shear bond strength test for all tested groups. (%)
|
|
adhesive |
Cohesive (Rest. Mat.) |
Cohesive (Repair Mat.) |
Mixed (Rest. Mat.) |
Mixed (Repair Mat.) |
TOTAL |
|
SB+no treatment |
80 |
0 |
0 |
0 |
20 |
100 |
|
SB+bur |
13,33 |
60 |
6,66 |
6,66 |
13,33 |
100 |
|
SB+HF |
46,66 |
0 |
0 |
26,66 |
26,66 |
100 |
|
SB+3W |
73,33 |
0 |
0 |
0 |
26,66 |
100 |
|
SB+5W |
53,33 |
13,33 |
0 |
13,33 |
20 |
100 |
|
SB+7W |
46,66 |
6,66 |
0 |
0 |
46,66 |
100 |
|
GB+no treatment |
33,33 |
0 |
0 |
33,33 |
33,33 |
100 |
|
GB+bur |
20 |
0 |
0 |
26,66 |
53,33 |
100 |
|
GB+HF |
20 |
0 |
13,33 |
6,66 |
60 |
100 |
|
GB+3W |
100 |
0 |
0 |
0 |
0 |
100 |
|
GB+5W |
86,66 |
0 |
0 |
0 |
13,33 |
100 |
|
GB+7W |
46,66 |
0 |
0 |
0 |
53,33 |
1O0 |
Discussion
The discussion was written appropriately and accurately; however, it would be advisable to also include the description of the most salient studies cited and the names of the authors as in line 290.
Response: Thanks for the reviewer for helpful feedback. We rewrote as below:
“Ataol et al. who investigated the effect of different surface pretreatments (Er, Cr: YSGG laser, HF etching, alumina blasting combined with silane) on the repair bond strength of ceramic CAD/CAM materials, indicated that the use of HF etching followed by silane application led to higher bond strength values.”
“The results obtained are opposite to those of Şişmanoğlu et al. They evaluated the repaired bond strength of different CAD/CAM resin-based composites with different surface pretreatment methods (HF etching, tribochemical silica coating, air abrasion) and reported that SB treated with HF showed similar bond strength than the ones with no surface pretreatment.”
“Erdemir et al. who evaluated the effect of different surface pretreatment methods (tribochemical silica coating, HF etching, 6W Er:YAG laser, diamond bur) on the repaired bond strength of lithium disilicate reinforced CAD/CAM ceramic material, reported that 6W laser irradiation produced lower bond strength than diamond bur.”
Conclusion
The conclusion should be shorter and written in a conversational way, avoiding lists.
Furthermore, it should be added that further in vitro and in vivo studies couled be essential to confirm the obtained results.
Response: Thanks for the reviewer for helpful feedback. We wrote this part as below:
“Despite the limitations of this study, it can be concluded that pretreatment of increasing Er: YAG laser irradiations led to similar bond strength to hydrofluoric acid and diamond bur for CAD/CAM resin-based composite materials. In addition, more powerful laser treatment is required to provide higher bond strength for restorative materials containing higher inorganic ceramic content. The results of 3D optic profilometer images confirmed the bond strength values. Further in vitro and in vivo studies could be essential to confirm the obtained results.”
Comments on the Quality of English Language
The paper is written clearly and fluently. Overall, the study could be of great interest. The level of English is good.
Author Response File: 
Author Response.docx
Reviewer 2 Report
Overall, the article presents an interesting investigation into the effects of different powers of Er:YAG laser irradiation on the shear bond strength (SBS) of repaired CAD/CAM resin-based composite materials. The study design and methodology were clearly presented, and the results provide valuable insights into the potential application of Er:YAG laser as a surface pretreatment method for composite resin repair. Based on the scientific merit and significance of the study, I recommend accepting this article for publication in the journal.
Author Response
Reviewing#2:
Overall, the article presents an interesting investigation into the effects of different powers of Er:YAG laser irradiation on the shear bond strength (SBS) of repaired CAD/CAM resin-based composite materials. The study design and methodology were clearly presented, and the results provide valuable insights into the potential application of Er:YAG laser as a surface pretreatment method for composite resin repair. Based on the scientific merit and significance of the study, I recommend accepting this article for publication in the journal.
Response: Thanks for the reviewer for helpful feedback.
Reviewer 3 Report
The article “Shear Bond Strength of Repaired CAD/CAM Resin-Based 2 Composite Materials Submitted to Er:YAG Laser at Different 3 Powers” is a very well written article and has some interesting results. However, the articles lack discussion part. The explanation leading to different strength for different surface treatment like HF, bur, 3W, 5W, 7W for the two materials, SB and GB is missing.
Line 232-234, it is stated that In the present study, after repair procedure, 10.000 thermocycles (5-55 °C) were submitted for aging of all specimens, which corresponds to a one-year clinical functions. The effect of aging and new samples is not compared in any of the results. Also, thermorecycling procedure is not reflected in “Preparations of the specimens” section (section 2.2.1). Moreover, the part of sentence, line 233, “..10.000 thermocycles (5-55 °C)..”, does 10.000 mean 10 or 10 thousand?
There are various places especially in the abstract where format correction are required, for example, space after full stop and colon.
There are various places especially in the abstract where format correction are required, for example, space after full stop and colon.
Author Response
Reviewing#3:
The article “Shear Bond Strength of Repaired CAD/CAM Resin-Based 2 Composite Materials Submitted to Er:YAG Laser at Different 3 Powers” is a very well written article and has some interesting results. However, the articles lack discussion part. The explanation leading to different strength for different surface treatment like HF, bur, 3W, 5W, 7W for the two materials, SB and GB is missing.
Response: Thanks for the reviewer for helpful feedback. We added the comparison of restorative materials in discussion section as below:
“These results are in line with the comparison of the CAD/CAM resin-based materials. For bur treated groups, SB showed higher bond strength values while for HF treated groups, GB showed higher bond strength.”
“When comparing the CAD/CAM resin-based materials, for 3W and 5W laser groups, SB exhibited higher bond strength while for 7W laser groups, GB showed higher bond strength.”
Line 232-234, it is stated that In the present study, after repair procedure, 10.000 thermocycles (5-55 °C) were submitted for aging of all specimens, which corresponds to a one-year clinical functions. The effect of aging and new samples is not compared in any of the results. Also, thermorecycling procedure is not reflected in “Preparations of the specimens” section (section 2.2.1). Moreover, the part of sentence, line 233, “..10.000 thermocycles (5-55 °C)..”, does 10.000 mean 10 or 10 thousand?
Response: Thanks for the reviewer for helpful feedback. We did not intend to investigate the effect of ageing on repair bond strength in this study. On further studies, we might focus on the ageing affect or different ageing methods. Our study design had a clinical scenario that fractures occured on new restorations right after cementation due to premature contacts etc. Afterwards, we completed the repair procedures on fresh CAD/CAM restorations and examined the long-term stability of repair bond strength. Besides, in material method section, we moved the ageing procedures to a new headings after specimen preparation headings. In line 233, we corrected 10.000 to 10,000 thermocycles to mean 10 thousand. In discussion part, we rearranged this paragraph as below:
“In clinical practice, for CAD/CAM resin-based composite restorations, the fractures may occur during milling process, internal defects of the block or parafunctional habits19. If premature occlusal contacts are present, the formation of cracks may be observed within block structure and lead to fracture and failures in the restoration. Thus, intraoral repair procedures could be needed10. Aging is a result of exposure of dental materials to different temperature, mechanical forces and chemical changes in the oral environment19. These aging processes may cause alteration of the restorative material and will also affect the SBS of repaired restorative materials20. While evaluating dental materials in vitro conditions, the use of thermocycling test method is assumed a reliable and important method for simulating intraoral conditions21. In the present study, after repair procedure, to investigate the long term-stability of the adhesion, 10,000 thermocycles (5-55 °C) were submitted for aging of all specimens, which corresponds to a one-year clinical functions22. Besides, aging procedure was not performed before repair procedure, because the shear bond strength of repaired fresh CAD/CAM restorations were intended to examine since in clinical practice, fractures can occur on new restorations right after cementation due to premature contacts etc. “
There are various places especially in the abstract where format correction are required, for example, space after full stop and colon.
Response: Thanks for the reviewer for helpful feedback. We checked and corrected the format and typos.
Comments on the Quality of English Language
There are various places especially in the abstract where format correction are required, for example, space after full stop and colon.
Author Response File: Author Response.docx
Round 2
Reviewer 1 Report
materials and methods are improved and the statistical methodology has been improved.
English has improved
Reviewer 3 Report
The comments provided by the authors in reposed to the following comments regarding discussion, does not seem to be answer to the question; as the reply does not cover the discussion.
