Torque Range, a New Parameter to Evaluate New and Used Instrument Safety
, Marco Seracchiani, Alessandro Mazzoni, Andrea Del Giudice *, Gianluca Gambarini and Luca Testarelli
Round 1
Reviewer 1 Report
The paper titled “Torque range, a new parameter to evaluate new and used instrument safety” is an interesting work that compares operative torque and torque at failure of two different NiTi files. Nevertheless, this paper has some minor errors.
Minor errors:
1). In abstract. It must be rewritten to make it more understandable to the reader. In addition, references to tables must be deleted.
2). In references. The authors must read the instructions for authors. The number of the journal in parenthesis should be deleted.
Author Response
Response to Reviewer 1 Comments
Point 1:In abstract. It must be rewritten to make it more understandable to the reader. In addition, references to tables must be deleted.
Response 1: Abstract has been completely rewritten. Therefore, references to “table” in abstract have been deleted.
Point 2:In references. The authors must read the instructions for authors. The number of the journal in parenthesis should be deleted.
Response 2: Reference style has been changed as recommended.
Author Response File: 
Author Response.docx
Reviewer 2 Report
The present study is well presented, however, some minor points should be addressed as follows:
- Line 14. This in order to show....this sentence must be improved
- Line 31. RCT is an abbreviation for root canal treatments as stated above; therefore saying during a RCT is wrong
undergo to? I would leave to - Line 38. First time when you are mentioning Ni-Ti, the full name should be inserted (nickel-titanium)
- Line 41. T The
- Line 52. Each shouldn't be written with a capital letter
- Why are expressions such as operative torque and torque range written with capital letters?
- Introduction needs to be improved. There are to many paragraphs and text does not flow correctly
- Line 81. Write human teeth so that we do not read further to be sure what kind of teeth were used
- Where were the teeth kept?
- How did you prepare endodontic access? Who did perform it? Always the same person? Did you irrigate?
- How did you randomize the samples?
- Line 89. 121°C
- Figure legend should also include a statement of the results to ensure clarity.
- Line 133. Mean Values (Why capital letters?)
- Table 1 - not aligned properly
- The decimal separator should always be the same (use the dot)
- Line 154- motion, the
- Line 181. ...in accordance with part of the literature - mention those papers, please
- Lines 182, 190, 194, 212. ....double space
- Tables - it would be better to use this symbol ±
- Reference style- you do not need numbers in brackets
Author Response
Response to Reviewer 2 Comments
Point 1: Line 14. This in order to show...this sentence must be improved.
Response 1: Abstract has been rewritten.
Point 2: Line 31. RCT is an abbreviation for root canal treatments as stated above; therefore saying during a RCT is wrong.
undergo to? I would leave to
Response 2: Abbreviation has been corrected, Line 29; “to” has been deleted Line 29
Point 3: Line 38. First time when you are mentioning Ni-Ti, the full name should be inserted (nickel-titanium)
Response 3: Done Line 36
Point 4: Line 41. T The
Response 4: Done
Point 5: Line 52. Each shouldn't be written with a capital letter
Response 5: Done
Point 6: Why are expressions such as operative torque and torque range written with capital letters?
Response 6: Capital letters of expression such as Group, Operative Torque, Torque Range, Torsional Resistance and Mean Values were changed.
Point 7: Introduction needs to be improved. There are to many paragraphs and text does not flow correctly
Response 7: The whole introduction has been modified to keep it more fluent. Paragraphs have been reduced from 13 to 6.
Point 8: Line 81. Write human teeth so that we do not read further to be sure what kind of teeth were used
Response 8: Done
Point 9: Where were the teeth kept?
Response 9: According to Nawrocka A et al. Teeth were stored in saline solution and autclavated at 121°C before performing the ex vivo tests. “Nawrocka A, Łukomska-Szymańska M. Extracted human teeth and their utility in dental research. Recommendations on proper preservation: A literature review.Dent Med Probl. 2019 Apr-Jun;56(2):185-190. We added this information in the manuscript as follow “The selected teeth were cleaned of any organic tissue, stored in saline solution and then autoclaved at 121°C for 20 min” Line 147
Point 10: How did you prepare endodontic access? Who did perform it? Always the same person? Did you irrigate?
Response 10: We added these informations in manuscript as follow: “…performed to all the extracted teeth by the same operator. Afterwards, irrigation with Sodium Hypoclorite at 5% (NaOCl) was performed with a 30 gauge syringe.” Line 152
Point 11: How did you randomize the samples?
Response 11: We added this information in the manuscript as follow “…40 instruments were randomly divided, using simple randomization method, in four equal…” Line 135
Point 12: Line 89. 121°C
Response 12: Done
Point 13: Figure legend should also include a statement of the results to ensure clarity.
Response 13: Done
Point 14: Line 133. Mean Values (Why capital letters?)
Response 14: Done
Point 15: Table 1 - not aligned properly
Response 15: Done
Point 16:The decimal separator should always be the same (use the dot)
Response 16: Done
Point 17: Line 154- motion, the
Response 17: Changed
Point 18: Line 181. ...in accordance with part of the literature - mention those papers, please
Response 18: Done
Point 19: Lines 182, 190, 194, 212. ....double space
Response 19: Changed
Point 20: Tables - it would be better to use this symbol ±
Response 20: Done
Point 21: Reference style- you do not need numbers in brackets
Response 21: Done
Author Response File: Author Response.docx
Reviewer 3 Report
The topic of this article entitled “Torque Range, a New Parameter to Evaluate New and Used Instrument Safety.” is aimed to compare operative torque and torque at failure of two different NiTi files. I ask authors to add some key concepts. - The authors have reported test on extracted teeth, however, nothing has been reported on clinical procedure to manage patients, please give some clarifications. The authors must describe other type of tests to evaluate stress on different biomaterials, such as the three-points bending test, so to create some background to their work (for example, discuss: Marrelli, M.; Maletta, C.; Inchingolo, F.; Alfano, M.; Tatullo, M. Three-point bending tests of zirconia core/veneer ceramics for dental restorations. Int J Dent 2013, 2013, 831976.). - Authors should also give their point of view on nanotechnologies and nanomaterials on medical procedures and their clinical applications (for example, discuss: Barry M, Pearce H, Cross L, Tatullo, M., Gaharwar AK. Advances in Nanotechnology for the Treatment of Osteoporosis. Curr. Osteoporos Rep 2016, 14, 87–94.) A graphical abstract would be helpful to better explain your work. A slight improvement of comparation among different similar instruments would help readers to understand the novelty of your interesting work. Conclusions should report limitations of this study and potential applications of this research to future clinical applications.
Author Response
Response to Reviewer 3 Comments
The topic of this article entitled “Torque Range, a New Parameter to Evaluate New and Used Instrument Safety.” is aimed to compare operative torque and torque at failure of two different NiTi files. I ask authors to add some key concepts.
Point 1: The authors have reported test on extracted teeth, however, nothing has been reported on clinical procedure to manage patients, please give some clarifications.
Response 1: Clinical procedures to manage patients have been indicated: ”The surgical procedures were performed in accordance to Chiapasco’s “Manual of Oral Surgery” Line 148
Point 2: The authors must describe other type of tests to evaluate stress on different biomaterials, such as the three-points bending test, so to create some background to their work (for example, discuss: Marrelli, M.; Maletta, C.; Inchingolo, F.; Alfano, M.; Tatullo, M. Three-point bending tests of zirconia core/veneer ceramics for dental restorations. Int J Dent 2013, 2013, 831976.). - Authors should also give their point of view on nanotechnologies and nanomaterials on medical procedures and their clinical applications (for example, discuss: Barry M, Pearce H, Cross L, Tatullo, M., Gaharwar AK. Advances in Nanotechnology for the Treatment of Osteoporosis. Curr. Osteoporos Rep 2016, 14, 87–94.) A graphical abstract would be helpful to better explain your work.
Response 2: We apologize but in our humble opinion it is not worth discussing about zirconia core/veneer ceramics and nanotechnologies. Moreover different tests available for nickel titanium have been already cited in the manuscript. We are not able for this type of study, to produce a graphical abstract. Moreover, no published studies present this kind of images.
Point 3: A slight improvement of comparation among different similar instruments would help readers to understand the novelty of your interesting work.
Response 3: Comparison of the instruments has been written as follow: “M-Two rotary files (Sweden & Martina, Padova, Italy) are an endodontic file manufactured with traditional Nickel Titanium alloy without any heat treatment. The instruments present an “S shaped” cross sectional design with two active cutting blades along instrument surface. These rotary instruments are thought to be used in a sequence [16, 17]. The pitch is variable and increases from the tip to the handle. In order to carry out the study the M-Two 20 tip and 0.06 taper was selected.
The S One (Fanta Dental Co., Ltd, Shanghai, China) is a new NiTi rotary recently introduced in the market. This instrument has a similar S-Shaped cross sectional design of the M-Two. Moreover, the instrument present a new heat treatment recently produced by the manufacturer the AF-H wire [18]. This, according to manufactured internal studies, ensure a more bendable file and more flexural and torsional resistance compared to other instruments.”
Point 4: Conclusions should report limitations of this study and potential applications of this research to future clinical applications.
Response 4: Limitation of the studies and further clinical application have been indicated in the manuscript as follow:” Despite the limitation of the study performed on ex vivo samples, the torque range should be considered a crucial parameter for describing instrument safety: wider the range, safer the instrument. The S-One 20.06 exhibited a wider range than the M-Two 20.06, showing a better performance both before and after multiple usage. Torque range should represent a possible method of clinical evaluation of safety during RCT.”
Author Response File: Author Response.docx
Round 2
Reviewer 3 Report
This very interesting and highly impacting article can be published in Applied Science.