Determinants of Temperature Development during Dental Implant Surgery

Round 1

Reviewer 1 Report (Previous Reviewer 2)

Comments and Suggestions for Authors

This article uses in vitro animal models and polyurethane foam as a bone surrogate material to discuss the temperature generated during dental implant surgery. The results provide thorough thinking while drilling and inserting the implants in our clinic. I respect the authors' research results when translating them into clinical use. Although the experimental designs were similar to previous implant research, the animal experiments should follow for long periods of time to see the implant success rates associated with the heat generated while drilling or insertion. This might be the thinking when we read the article. I suggest that the authors improve their English editing. Plagiarism is less than 7%. The article may be ready for publication if the English editing is checked again.

Comments on the Quality of English Language

English editing may be improved or rechecked before publication. This article contains minor editing errors. The plagiarism rate is less than 7%. There is no inappropriate self-citation in this article.  

Author Response

This article uses in vitro animal models and polyurethane foam as a bone surrogate material to discuss the temperature generated during dental implant surgery. The results provide thorough thinking while drilling and inserting the implants in our clinic. I respect the authors' research results when translating them into clinical use. Although the experimental designs were similar to previous implant research, the animal experiments should follow for long periods of time to see the implant success rates associated with the heat generated while drilling or insertion. This might be the thinking when we read the article. I suggest that the authors improve their English editing. Plagiarism is less than 7%. The article may be ready for publication if the English editing is checked again.

RE: Thank you very much for your kind words! We have gone through the paper again trying to improve overall style and we added a section to the Discussion which states “An additional animal trial is currently conducted aimed at evaluating periimplant bone levels after osseointegration as a result of surgical trauma i.e. heat generation combined with mechanical stress.”

Reviewer 2 Report (New Reviewer)

Comments and Suggestions for Authors

Congratulations on completing your manuscript!

It's evident that you've put a tremendous amount of effort into your research and writing, and for that, you should be commended.

However, upon reviewing your work, it's apparent that there's an abundance of information that could benefit from either trimming down or being presented in a clearer, more digestible manner.

The density of the text makes it challenging for readers to navigate through, and some sections could be streamlined to enhance readability. Additionally, the tables are confusing with the cryptographic labels that makes the reader go back to the first one. while your conclusions are intriguing, they seem somewhat far-fetched and may require further refinement to align more closely with the evidence presented in your study.

Nonetheless, your dedication to the topic shines through, and with some revisions, your manuscript has the potential to make a significant contribution to the field.

In line 94, you effectively introduce the concept of perpendicular osteotomies, which serves as the cornerstone of your study. However, there seems to be a lack of clarity regarding the methodology employed to achieve this. It would greatly benefit the reader if you elaborated on the specific techniques or procedures utilized to perform these perpendicular osteotomies, as this information is crucial for understanding the methodology and results of your work.

Moreover, in line 96, you mention the rotational speed of 800RPM, yet the force exerted by the bur during bone drilling and the corresponding vertical velocity are not addressed. Both of these variables play pivotal roles in heat production during the drilling process. Providing insight into the force applied by the bur and its vertical velocity would enhance the comprehensiveness of your methodology, enabling a more thorough evaluation of the factors influencing heat generation in your experimental setup.

I would like to seek clarification regarding the citations referenced in the methods section, specifically on line 151, denoted as [43-46]. It appears unclear whether these citations are self-references. While discussing your previous work is pertinent, it might be more appropriate to reserve such discussions for the discussion section, as their inclusion within the methods section could be perceived as a form of self-citation without substantial context. Clarification on this matter would greatly enhance the clarity and coherence of your manuscript.

Figure 4 - you can't see DLC 2.8 - 191 40pcf 107.4°K value

Author Response

Congratulations on completing your manuscript! It's evident that you've put a tremendous amount of effort into your research and writing, and for that, you should be commended.

RE: Thanks much for your kind words!

However, upon reviewing your work, it's apparent that there's an abundance of information that could benefit from either trimming down or being presented in a clearer, more digestible manner. The density of the text makes it challenging for readers to navigate through, and some sections could be streamlined to enhance readability.

RE: We are aware that presenting a manuscript reporting on three different single experiments is challenging and we have gone through the text again trying to increase clarity and conciseness

Additionally, the tables are confusing with the cryptographic labels that makes the reader go back to the first one.

RE: The reviewer is correct in saying that it is complicated to keep track of the groups in this parametric study. However, we felt that introducing table 1 would be the best option for a concise presentation of group definitions. If desired, we could combine Tabs 2a and b to one table showing p-values for top and bottom measurements but we were afraid that this would even create greater confusion.

while your conclusions are intriguing, they seem somewhat far-fetched and may require further refinement to align more closely with the evidence presented in your study.

RE: We have reworded the Conclusion statement which now reads “Several factors seem to govern initial periimplant bone loss of which temperature development and mechanical stress can be controlled by the implant surgeon. Based on the findings of all study parts, it appears that the single steps of drill protocols as well as the final osteotomy diameters relative to the implant body are relevant factors in this context.”

Nonetheless, your dedication to the topic shines through, and with some revisions, your manuscript has the potential to make a significant contribution to the field.

RE: Thank you!

In line 94, you effectively introduce the concept of perpendicular osteotomies, which serves as the cornerstone of your study. However, there seems to be a lack of clarity regarding the methodology employed to achieve this. It would greatly benefit the reader if you elaborated on the specific techniques or procedures utilized to perform these perpendicular osteotomies, as this information is crucial for understanding the methodology and results of your work.

RE: We have reworded that sentence which now reads: “ Into theses perfectly squared blocks, perpendicular osteotomies were drilled using burs from a specific implant system (AlfaGate, Kfar Qara, Israel) and a surgical motor set at 800RPM (Mastersurg, KaVo, Biberach, Germany) with the contra-angle mounted in a modified drill press allowing for exact alignment.”

Moreover, in line 96, you mention the rotational speed of 800RPM, yet the force exerted by the bur during bone drilling and the corresponding vertical velocity are not addressed. Both of these variables play pivotal roles in heat production during the drilling process. Providing insight into the force applied by the bur and its vertical velocity would enhance the comprehensiveness of your methodology, enabling a more thorough evaluation of the factors influencing heat generation in your experimental setup.

RE: We have added the following sentence: “A dead weight of 1kg mounted on the handle of the drill press was used for standardizing the vertical velocity.”

I would like to seek clarification regarding the citations referenced in the methods section, specifically on line 151, denoted as [43-46]. It appears unclear whether these citations are self-references. While discussing your previous work is pertinent, it might be more appropriate to reserve such discussions for the discussion section, as their inclusion within the methods section could be perceived as a form of self-citation without substantial context. Clarification on this matter would greatly enhance the clarity and coherence of your manuscript.

RE: We understand the concerns of the reviewer and have eliminated these references; they had been cited as we have previously used the exact same setup and materials.The reference list has been updated

Figure 4 - you can't see DLC 2.8 - 191 40pcf 107.4°K value

RE: In addition to the Note already given in the figure legend, we have numerically added this value in the Fig. but would not like to change the scale of the y-axis as all other values would then not be discernable

Round 2

Reviewer 2 Report (New Reviewer)

Comments and Suggestions for Authors

Thank you fr taking in consideration my suggestions

Some minor issues

Line 96 remove the word dead

Figure4 is still misleading I accept your reply but you can maintain the graph but change the bar that goes up to 107º. check https://goodly.co.in/charts-large-small-values/

in table 2a and 2b remove te last line (DLC 2.8 - 40/20pcf - Irrigation)

 

Author Response

 

Thank you fr taking in consideration my suggestions

Some minor issues

 

Line 96 remove the word dead

RE: changed as suggested

 

Figure4 is still misleading I accept your reply but you can maintain the graph but change the bar that goes up to 107º. check https://goodly.co.in/charts-large-small-values/

RE: Thanks much for pointing us to this option! We have changed the figure according to your suggestion

 

in table 2a and 2b remove te last line (DLC 2.8 - 40/20pcf - Irrigation)

RE: we removed this line but also the first column (2.0 - 40pcf) from the tables

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 Authors

This piece of work needs additions, great additions in terms of Experiments primarily. When you execute more experiments, they could team-up to make a moderate publication. As you may know, form literature you study, from papers you read, a chart and a table are not sufficient results for a publication.

 

Keep working. 

Comments on the Quality of English Language

Vocabulary and language amelioration may take place

Reviewer 2 Report

Comments and Suggestions for Authors

This research use polyurethane foam materials to mimic alceloar bone to detect the heat generated during inserting implants. The results showed the greater insertion torque generated greater heat. But this biomaterials cannot reallyimic alveolar bone, because there are bone marrows and moistures in the alveolar bone. I personally think the bone marrows and liquids in the alveolar bone may reduce the thermal heat trauma during implant insertion.

There are many etiologies associated with peri-implantitis.How could the authors provide direct evidences related with the heat generated during implant insetion?

This is an intresting experimental modle to mimic and research the heat gernerate from implant insertion. Why did not use pig or other animal mandible or maxilla bone to do the experimental design? That will provide more better evidence to mimic human alveolar bone.

Can the authors transfer the heat collected in this research into clinical heat trauma in human？How many heat generated will cause damage during implannt insertion?I think may be this will provide more novalty in this paper.

Comments on the Quality of English Language

The English editing is well. Minor editing grammar errors were needed.

Reviewer 3 Report

Comments and Suggestions for Authors

The paper entitled “Implant design affects heat generation during the insertion process” by dr. Sekura deals with a novel implant design possibly reducing mechanical stress on cortical bone during insertion. The matter is undeniably interesting, although the methods used are too poor and  jeopardize the whole work: temperature development, frequency resonance analysis and removal torque performed in polyurethane foam are too far from any possible clinical relevance. The manuscript seems more a conference abstract than an original paper owing to the limited experimental setting. More experiments are necessary before the paper may be considered for publication.