The Role of Epigenetics in Periodontal and Systemic Diseases and Smoking: A Systematic Review
, Rosalie Salus Braun 2, Michelle Ordway 3, Iya Ghassib 4, Lena Larsson 5 and Farah Asa’ad 6,7Round 1
Reviewer 1 Report
The article entitled “The Role of Epigenetics in Periodontal and Systemic Diseases and Smokers: A Systematic Review” by Ismael Khouly, presents to systematically review the evidence for association of DNA methylation/histone modifications and periodontal diseases and systemic diseases/smoking. Although this work aims to developed a systematic review to thoroughly present the potential interactions between epigenetics and periodontal diseases, but lacks some deficiencies. The manuscript can be accepted if the following revisions be addressed.
- For future direction section, the specific area of research in the field should be proposed. Like experimental and clinical trials on the possible epigenetic association of short/long term interactions of biomaterials-gingival tissue.
- The updated references published in 2019-2020 should be mentioned in introduction and discussion parts.
- The manuscript English needs to be improved.
Author Response
First, we would like to thank you for the time reviewing this manuscripts and for your comments. Please see the following and updated manuscript including new changes following your suggestions/comments:1. Concern: For future direction section, the specific area of research in the field should be proposed. Like experimental and clinical trials on the possible epigenetic association of short/long term interactions of biomaterials-gingival tissue.
Our response: Thank you for the comment. This has been modified.
2. The updated references published in 2019-2020 should be mentioned in introduction and discussion parts.
Our response: Thank you for the comment. This has been modified and new references have been added.
3. The manuscript English needs to be improved.
Our response: The manuscript has been reviewed and modified as needed.
Reviewer 2 Report
This systematic review is well organized and formatted. The conclusions were carefully made.
The reviewer is not quite versed in reviewing such kind of papers but would suggest publication.
Author Response
We would like to thank you for the time reviewing this manuscripts and for your comments.
Reviewer 3 Report
Dear Co-Authors,
Kudos for contributing to the literature regarding the role of epigenetic in periodontal diseases and systematic health, further linking oral health to systemic health.
Overall well-designed study with rigorous methodology following PRISMA guidelines. The manuscript is well-written and informative, and discussion relevant.
Attached are some minor comments to further strengthen the manuscript.
Comment:
1. Have you considered using meta-analysis to further look at the effect of specific epigenetic mechanisms on periodontitis and specific systemic disease? Why or why not? Ex: Assess the effect of DNA methylation on CP/RA
2. In the discussion section, please include a short section, after 4.4 future research, on clinical relevance and elaborate on the clinical relevance of epigenetics on periodontal therapy. How can our understanding of epigenetics potentially enhance therapy and clinical decision making in addition to patient stratification?
Author Response
First, we would like to thank you for the time reviewing this manuscripts and for your comments. Please see the following and updated manuscript including new changes following your suggestions/comments:
1. Concern: Have you considered using meta-analysis to further look at the effect of specific epigenetic mechanisms on periodontitis and specific systemic disease? Why or why not? Ex: Assess the effect of DNA methylation on CP/RA
Our response: Thank you for the great comment. We actually planned to perform meta-analysis during our review protocol development. However, meta-analysis not be conducted as the methodology for assessing outcomes as well as the outcomes reported were inconsistent across included studies.
2. Concern: In the discussion section, please include a short section, after 4.4 future research, on clinical relevance and elaborate on the clinical relevance of epigenetics on periodontal therapy. How can our understanding of epigenetics potentially enhance therapy and clinical decision making in addition to patient stratification?
Our response: Thank you for the suggestion. A new section (4.5 Clinical relevance) has been added to discussion section.
