A Comparative Study to Evaluate the Effect of Honey and Zinc Oxide Eugenol Dressing for the Treatment of Dry Socket: A Double-Blind Randomized Controlled Trial

Round 1

Reviewer 1 Report

First of all, congratulations because performing clinical studies involves hard efforts.

 

I think it is important, in introduction, to speak about complication rates after dental extractions, to better understand how important dry socket it, so I find neccessary to know how many complications occur after a dental extraction, and how many complications appear after third molar surgery.

 

In lines 46-47: "Although dry socket can be encountered in any tooth, but most commonly it is associated with mandibular third molars". It is not well-writen, you should write although dry socket can be encountered in any tooth, it is associated more frequently after mandibular third molar extraction, being the extraction essential in dry socket beginning.

 

Do you think any type of anesthesia could affect in dry socket ? and any diseases as diabetes?

 

In terms of double-blind method, is it possible to blind Group 3, in comparison to groups 1 and 2??

 

In lines 136 and 137 you repeat "The patient was requested to note daily pain records on a 0-10 visual analog scale, it is important to check the paper before submissing it.

 

One of the most important aspects about dry socket is teeth position, which I consider mandatory to be written in a Table. Where is more common dry socket? Lower third molars, as you write in introduction? or other sites?

 

Line 230: mostly associated with mandibular third molar extraction. Please correct it.

I do not understand why you consider a small sample size if you have calculated it.

 

You have more limitations, as you can also evaluate healing in the post-operative. You should explain if, after performing the study, you would recommend yo use honey in comparison to  zinc oxide eugenol

 

Line 290: again, associated with mandibular third molar extraction. 

 

Author Response

Thank you, the response to reviewer comments is attached in the system

Author Response File: Author Response.docx

Reviewer 2 Report

This is a well-prepared and interesting paper that presents the findings of two different treatments of dry socket. I have a several concerns that need to be addressed.

1. Materials and methods should include detailed declaration of materials used, especially concerning “honey”. Please, provide description, certificate and product purity that was used in this study.
2. Figure 1 is superfluous, may be omitted.
3. Please check the data analysis – was the statistical test adequately chosen for comparison of three groups?
4. Results section – data from Tables 1, 2 and 3 may be collated to one main table, with columns showing Groups and rows showing VAS scores mean data, with asterisk to denote statistically significant results and name of statistical procedure used.
5. Conclusion – please omit first sentence, it is not a conclusion of this study.

 

Author Response

Thank you, the response to reviewer comments is attached in the system

Author Response File: Author Response.docx

Reviewer 3 Report

Dear Authors

the paper is well written and can be considered for publication in Applied Science

However, before acceptance, some topics need to be discussed

1) Authors should discuss the role of chlorexidine in managing such disease. Please cite DOI10.23805/JO.2019.12.01.20

2) Can dry socket be more frequent in systemic/immunocompromised patients? Please consider the following papers PubMed ID31781702; DOI10.1179/joc.1997.9.5.382

3) Can dry socket be more frequent in patient that underwent orthodontics? Please cite DOI10.1177/1721727X1201000208; PubMed ID26486206

After these concerns the paper can be acceptable for publication

Author Response

Thank you, the responses are attached in the system

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

I think in line 199, you should specify (with a Table), extractions type, because it is not the same dry socket treatment when a tooth is extracted, in comparison to multiple extraction. It is useful to readers to understand where dry socket appears (incisors, bicuspid, molars), if it appears in maxilla or mandible, because it seems to appear more frequently in mandible due to worse blood suply. 

 

In conclusions, I find mandatory to explain something about control group, if it is better to use honey or zinc oxide eugenol in comparison to saline irrigation, or there are not differences, because it is most expensive to use honey or other agent, or not?

Author Response

The point to point response to reviewer comments is attached in the system

Author Response File: Author Response.pdf