Comparison of the Three-Dimensional Accuracy of Guided Apicoectomy Performed with a Drill or a Trephine: An In Vitro Study

Round 1

Reviewer 1 Report

Dear Authors, 

you made a great work! However, some improvements are suggested before publication. 

Comments for author File: Comments.pdf

Minor revisions suggested. 

Author Response

Dear Reviewer,

Please see our detailed responses below:

The paper is an in vitro study on the comparison of the three-dimensional accuracy of guided

apicoectomy performed with a drill or a trephine. The Authors made a great work in terms of methodology and the paper sounds scientific and well written. However, some improvements are mandatory before acceptance.

The abstract is well written, complete and summary in its various aspects. The keywords are complete and appropriate.

In the introduction I think it is extremely interesting to emphasize this observation: "Digitalization, in the form of routinely using CBCT in endodontic microsurgery cases, aids the establishment of the proper diagnosis and careful case assessment, allows the exact localization of the root end and the surrounding periapical lesion, and helps protect the adjacent vulnerable tissues [12,13]." From this point of view, it is interesting to evaluate some aspects, in particular how a 3D diagnosis technology considerably increases the possibility of performing retrograde surgery safely, and allows this treatment to be avoided when the surgical risks due to proximity to noble structures, or the root anatomy in the hypothetical section of the apical resection were disadvantageous, as underlined by: "Reda R, Zanza A, Bhandi S, Biase A, Testarelli L, Miccoli G. Surgical-anatomical evaluation of mandibular premolars by CBCT among the Italian population. Dent Med Probl. 2022 Apr-Jun;59(2):209-216 doi:10.17219/dmp/143546."

R: Thank you for this suggestion. The citation has been added with an explanatory sentence. 

Materials and methods are clear and well explained. Different aspects are analyzed with a dedicated statistical test. The authors did a great job in the explication of all the variables identified and included in the study.

Results are easy to understand and comprehensive. In the Results section: Table 1 is full of interesting information that deserves further study. In particular, I believe that in the results section it is possible to describe some of them, among the most interesting ones, in a much more precise and detailed way.

R: The most important findings from the table have been added to the text as well.

Discussion: this section is complete and evaluates the outcome of different papers present in literature. The overall is comprehensive, concise and complete in its various aspects. Also in this section with reference to this statement "AD can have a severe effect on the precision during the removal of the apical 3 mm, since the presence of lateral canals and ramification in the apical third are the common cause of persisting apical infection [40 ]." I think the suggestion above is adequate.

Please check if possible to use a more appropriate synonym of "stone model".

R:  Having consulted with a native speaker, we opted for ‘plaster model’. We hope you find this a proper choice.

Reviewer 2 Report

Dear authors, congratulations on the manuscript, the article is very interesting but I want to suggest some changes.

Line 44 :deepen and outline what these "several studies" are

line 214 " list and better explain the "several case reports and case series".

You must better describe the limitations of the study by describing them in a chapter and not as part of the discussion

The English is understandable and there are no syntax errors

Author Response

Dear Reviewer,

Please see our detailed responses below:

Line 44 :deepen and outline what these "several studies" are

R: A brief summary of the studies have been added with citations.

line 214 " list and better explain the "several case reports and case series".

R: We have given a brief summary of these studies with citations.

You must better describe the limitations of the study by describing them in a chapter and not as part of the discussion

R: The limitations have been separated as a chapter as requested, and this part has been rephrased to better express the limitations.

Round 2

Reviewer 2 Report

The authors took my advice and expanded on the unclear parts.

The limitations and conclusions  are accurate

I do not ask to make further changes, congratulations to the authors