Requirements for Dental CAD Software: A Survey of Korean Dental Personnel

Round 1

Reviewer 1 Report

The authors aimed to evaluate the needs of dentists, dental technicians, dental hygienists, 27 and dental-related workers in terms of dental computer-aided design (CAD) software and artificial 28 intelligence (AI). It is great study. 

However, there are some comments:

Please improve the conclusion section of the abstract.

The introduction does not provide sufficient background and is not include all relevant references. It is also so short. Please improve it using more recent and relevant references. And also please mention the gaps in the study and the solutions you suggested for these gaps.

Methods: did the authors use a consent form for a survey evaluation method?

The discussion method is short. Please improve it using potent references and discussion comparing the previous studies.

Author Response

We are grateful to reviewer for the critical comments and useful suggestions that have helped us to improve our paper considerably. As indicated in the following responses, we have incorporated all these comments into the revised version of our paper.

Reviewer 1

1. Please improve the conclusion section of the abstract.

Response: We very much appreciate the reviewer’s comment and respect the reviewer’s insight. We have revised and improved the conclusion content in the abstract section.

Abstract Section

“….Dentists and dental hygienists considered design speed, convenience, and tooth library utilization as important factors, whereas dental technicians considered diversity of functions and compatibility with various equipment as important factors. The importance of specific survey items varied significantly based on age, dental personnel, and work experience groups. Dental personnel, such as dentists and dental technicians, assigned greater importance to certain factors, such as branding, functional diversity, design speed, and compatibility with CAM equipment, compared to other occupational groups.”

2. The introduction does not provide sufficient background and is not include all relevant references. It is also so short. Please improve it using more recent and relevant references. And also please mention the gaps in the study and the solutions you suggested for these gaps.

Response: Thank you for your suggestion for improving the quality of the manuscript. We have added additional references and content to provide sufficient background related to the present study. And we additionally wrote about the solutions mentioned by reviewer 1.

Introduction Section

“In the digital workflow for manufacturing dental prostheses, various types of dental CAD software have been reported to affect the quality of dental prostheses [25]. In addition, AI functions are being applied during the CAD work process to improve the design results of dental CAD software [26]. However, according to survey results, dentists still lack understanding of the digital workflow for manufacturing dental prostheses [27], and pre-dental students lack education on overall digital dentistry, including CAD software [28]. In addition, dental personnel, including dentists, need to understand various functions of dental CAD software to plan treatment appropriately for patients [29]. Therefore, through the present study, it is necessary to confirm the perceptions of various dental personnel about the functions required or considered important for dental CAD software.”

References

25. Akat, B., Şentürk, A., Ocak, M., Kiliçarslan, M.A., Özcan, M. Does cad software affect the marginal and internal fit of milled full ceramic crowns? Braz. Oral Res. 2022, 36, 42.
26. Thurzo, A., Urbanová, W., Novák, B., Czako, L., Siebert, T., Stano, P., Varga, I. Where is the artificial intelligence applied in dentistry? Systematic review and literature analysis. Healthcare 2022, 10, 1269.
27. Suganna, M., Kausher, H., Ali, A.B.M.R., Abed, M.M., Albishi, W.S., Al Hajji, F.A., Sultan, N.A. Knowledge on Applications of 3D Design and Printing in Dentistry Among Dental Practitioners in Saudi Arabia: A Questionnaire-Based Survey. Cureus 2022, 14, 8.
28. Sharab, L., Adel, M., Abualsoud, R., Hall, B., Albaree, S., de Leeuw, R., Kutkut, A. Perception, awareness, and attitude toward digital dentistry among pre-dental students: an observational survey. Bull. Natl. Res. Cent. 2022, 46, 1-7.
29. Kutkut, A., Okeson, J. Digital implant dentistry predoctoral program at University of Kentucky. J. Oral Implantol. 2022.

3. Methods: did the authors use a consent form for a survey evaluation method?

Response: We very much appreciate the reviewer’s comment and respect the reviewer’s insight. In the present study, all information that could identify the patient's personal information was deleted, and all information was deleted after obtaining the raw data. Therefore, due to this survey protocol, the present study was approved by the Clinical Trial Ethics Committee without the consent of the patient.

4. The discussion method is short. Please improve it using potent references and discussion comparing the previous studies.

Response: We very much appreciate the reviewer’s comment and respect the reviewer’s insight. We additionally wrote the content in the discussion section through discussions comparing previous studies.

Discussion Section

“According to previous studies on digital dentistry surveys [26, 27], it was found that dentists have a positive attitude towards dental CAD/CAM technology [26]. Additionally, CAD software for dentistry is increasingly popular among dentists [27]. However, various CAD software for dentistry can produce different quality designs for dental prostheses [25]. In the present study, the design quality of CAD software for dentistry was identified as the most important factor (Table 2, P < 0.05). Previous studies emphasized the importance of learning and ease of use of CAD software for dentistry for appropriate use in dental clinics [19-21]. Similarly, in the present study, work speed (learning) and ease of use were identified as very important factors in dental clinical practice (Table 2, P < 0.05). Previous studies described the digital implant dentistry Ph.D. program, which includes practical experience with CAD software and provides education on the basics and applications of CAD software for dentistry [29]. However, many dentists still have limited knowledge of 3D design in dentistry, indicating a need for educational improvement in this area [27]. Therefore, the results of this present study can be used as evidence for the education of digital dentistry.”

Author Response File: Author Response.docx

Reviewer 2 Report

Dear Authors,

The authors present original research. Although digital technology is not a recent field in dentistry, it is a well-documented unique workflow pathway.

Digital technology begins with the CAD procedure, and it has been improved until nowadays. This improvement follows the software upgrade. 

The authors should clarify and detail the sample, such as the habilitation degree of the professionals and the experience skills in digital technology. It is different from the knowledge working with i700 or first-generation advice. 

The discussion section should be improved in according with the previous suggestion.

Author Response

We are grateful to reviewer for the critical comments and useful suggestions that have helped us to improve our paper considerably. As indicated in the following responses, we have incorporated all these comments into the revised version of our paper.

Reviewer 2

1. The authors should clarify and detail the sample, such as the habilitation degree of the professionals and the experience skills in digital technology. It is different from the knowledge working with i700 or first-generation advice. The discussion section should be improved in according with the previous suggestion.

Response: Thank you for your comments. We appreciate your insights regarding the limitations of our study. As you noted, we only examined overall dental clinical experience and did not take into account the degree of habilitation of the professionals or their experience with digital technology.

We agree that the degree of habilitation of healthcare professionals and their proficiency with digital technology can significantly impact their clinical decision-making and patient outcomes. Future research should explore the impact of these factors on clinical decision-making and patient outcomes to better understand their real-world impact.

Furthermore, we agree that ignoring the experience and skills of healthcare professionals with digital technology could limit the potential benefits of these technologies in improving patient outcomes. It is important to consider the training and support needed for healthcare professionals to effectively use digital technologies in their clinical practice to optimize the benefits of these technologies.

In the revised discussion section, we have emphasized the need for future research to investigate the impact of the degree of habilitation and digital technology skills on clinical decision-making and patient outcomes. Thank you for your valuable feedback, which has helped us to improve our manuscript.

Discussion Section

“…. The limitations of the present study that only considered clinical experience without accounting for the professionals' degree of habilitation or digital technology skills are significant. The degree of habilitation of healthcare professionals can impact their clinical decision-making, as more highly trained professionals may have a greater knowledge base and more experience with complex cases. Additionally, the use of digital technology in healthcare is becoming increasingly prevalent, and the proficiency of healthcare professionals with such technology may impact the effectiveness of their clinical practice. Ignoring the experience and skills of healthcare professionals with digital technology could limit the potential benefits of these technologies in improving patient outcomes. Future research could investigate the impact of the degree of habilitation and digital technology skills on clinical decision-making and patient outcomes.”

Author Response File: Author Response.docx

Reviewer 3 Report

This work has been written with great care and its subject matter is very interesting and stimulating for readers. However, minor corrections in the following sections will make the presentation of the study more valuable.

Abstract: There should be a few more sentences in the findings section of this abstract. Sentences that give a little more detail should be added.

Introduction: Before the purpose of the study, the "niche" point, which indicates the difference of the study from other studies, should be specified.

Materials and methods: Well written.

Results: Well written.

Discussion: This section should be expanded a little more. Supported by the findings and compared with more studies.

Author Response

We are grateful to reviewer for the critical comments and useful suggestions that have helped us to improve our paper considerably. As indicated in the following responses, we have incorporated all these comments into the revised version of our paper.

Reviewer 3

1. Abstract: There should be a few more sentences in the findings section of this abstract. Sentences that give a little more detail should be added.

Response: Thank you for your comment on the abstract. We will revise the findings section to include a few more sentences that provide additional detail about the study results. We understand the importance of providing a clear and concise summary of our findings.

Abstract Section

“…. The results indicated significant differences in the importance of each category between the dental personnel groups (P < 0.05). The results revealed that design quality, design convenience and reproducibility, margin line setting, and automatic margin setting were considered most important in their respective categories (P < 0.05). There were also significant differences in the importance of certain items, such as branding importance and functional diversity, among different dental personnel groups (P < 0.05). Design speed and convenience were also found to be more important to dentists and dental hygienists compared to other dental personnel (P < 0.05).”

2. Introduction: Before the purpose of the study, the "niche" point, which indicates the difference of the study from other studies, should be specified.

Response: We appreciate your feedback on the introduction. We agree that it is important to provide a clear "niche" point that distinguishes our study from others in the field. We will revise the introduction to better highlight the unique contributions of our study.

Introduction Section

“In the digital workflow for manufacturing dental prostheses, various types of dental CAD software have been reported to affect the quality of dental prostheses [25]. In addition, AI functions are being applied during the CAD work process to improve the design results of dental CAD software [26]. However, according to survey results, dentists still lack understanding of the digital workflow for manufacturing dental prostheses [27], and pre-dental students lack education on overall digital dentistry, including CAD software [28]. In addition, dental personnel, including dentists, need to understand various functions of dental CAD software to plan treatment appropriately for patients [29]. Therefore, through the present study, it is necessary to confirm the perceptions of various dental personnel about the functions required or considered important for dental CAD software.”

References

25. Akat, B., Şentürk, A., Ocak, M., Kiliçarslan, M.A., Özcan, M. Does cad software affect the marginal and internal fit of milled full ceramic crowns? Braz. Oral Res. 2022, 36, 42.
26. Thurzo, A., Urbanová, W., Novák, B., Czako, L., Siebert, T., Stano, P., Varga, I. Where is the artificial intelligence applied in dentistry? Systematic review and literature analysis. Healthcare 2022, 10, 1269.
27. Suganna, M., Kausher, H., Ali, A.B.M.R., Abed, M.M., Albishi, W.S., Al Hajji, F.A., Sultan, N.A. Knowledge on Applications of 3D Design and Printing in Dentistry Among Dental Practitioners in Saudi Arabia: A Questionnaire-Based Survey. Cureus 2022, 14, 8.
28. Sharab, L., Adel, M., Abualsoud, R., Hall, B., Albaree, S., de Leeuw, R., Kutkut, A. Perception, awareness, and attitude toward digital dentistry among pre-dental students: an observational survey. Bull. Natl. Res. Cent. 2022, 46, 1-7.
29. Kutkut, A., Okeson, J. Digital implant dentistry predoctoral program at University of Kentucky. J. Oral Implantol. 2022.

3. Discussion: This section should be expanded a little more. Supported by the findings and compared with more studies.

Response: Thank you for your comment on the discussion section. We understand the importance of providing a thorough analysis and interpretation of our results in the context of previous research. We will expand the discussion section to more fully explore the implications of our findings and how they compare with other studies in the field. We will also make sure that our conclusions are well-supported by the evidence presented in the study. Thank you for your helpful feedback.

Discussion Section

“According to previous studies on digital dentistry surveys [26, 27], it was found that dentists have a positive attitude towards dental CAD/CAM technology [26]. Additionally, CAD software for dentistry is increasingly popular among dentists [27]. However, various CAD software for dentistry can produce different quality designs for dental prostheses [25]. In the present study, the design quality of CAD software for dentistry was identified as the most important factor (Table 2, P < 0.05). Previous studies emphasized the importance of learning and ease of use of CAD software for dentistry for appropriate use in dental clinics [19-21]. Similarly, in the present study, work speed (learning) and ease of use were identified as very important factors in dental clinical practice (Table 2, P < 0.05). Previous studies described the digital implant dentistry Ph.D. program, which includes practical experience with CAD software and provides education on the basics and applications of CAD software for dentistry [29]. However, many dentists still have limited knowledge of 3D design in dentistry, indicating a need for educational improvement in this area [27]. Therefore, the results of this present study can be used as evidence for the education of digital dentistry.”

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

Dear Authors, 

This reviewer does not accept a methodology with a profound flaw: the absence of information on the qualifications of the intervenients who pronounce on a topic. The intervenients need to know how to use and apply it to analyze the digital technology in the present manuscript! The authors do not responded positively to the proposed suggestions.

Author Response

We are grateful to reviewer for the critical comments and useful suggestions that have helped us to improve our paper considerably. As indicated in the following responses, we have incorporated all these comments into the revised version of our paper.

Reviewer 2

1. This reviewer does not accept a methodology with a profound flaw: the absence of information on the qualifications of the intervenients who pronounce on a topic. The intervenients need to know how to use and apply it to analyze the digital technology in the present manuscript! The authors do not responded positively to the proposed suggestions.

Response: Thank you for your feedback on our manuscript. We apologize for any confusion caused in our first revision response. We appreciate your concern regarding the qualifications of our intervenient and have taken steps to address this issue in our revised manuscript. Specifically, we have provided additional details about the intervenient qualifications and expertise in the field of digital dentistry.

We would like to assure you that the intervenient who participated in the present study consisted of highly qualified dental clinicians and dental university professors with extensive experience using the latest digital dental medical devices in dental clinics. In fact, many of these intervenient have published numerous research papers on digital dentistry.

In light of your feedback, we have added more detailed information on the intervenient qualifications and expertise in the Materials and Methods and Discussion sections of the manuscript. We hope these revisions address your concerns, and we welcome any further suggestions you may have to improve the manuscript. Thank you again for your valuable feedback.

Materials and Methods Section

“….The intervenient who participated in this study were selected based on their extensive expertise and experience in digital dentistry. The team consisted of dental clinicians and dental university professors who had a deep understanding of the latest digital dental medical devices and had used them extensively in dental clinics. They were also active researchers who had published many research papers related to digital dentistry…..”

Materials and Methods Section

“Understanding digital dentistry is increasingly important in clinical practice as digital technology continues to revolutionize the field [26, 27].  The present study emphasizes the importance of understanding digital dentistry for the successful implementation of digital workflows in dental clinics. As digital dental technology continues to advance, it is essential for clinicians and researchers to stay up to date with the latest innovations and understand how to properly utilize these tools to improve patient care. The intervenient who participated in this study were composed of dentists and dental college professors who had a high understanding of the latest digital dental medical devices and had extensive experience in digital dentistry, which is widely used in dental clinics. The inclusion of experts from diverse backgrounds allowed the survey to obtain a comprehensive and multidimensional analysis of digital technologies.”

Author Response File: Author Response.docx

Round 3

Reviewer 2 Report

Dear Authors,

The manuscript was improved. I suggest the fair use of "experience" and "habilitation" terms. Experience is measured in years, and Habilitation in skills by a third party ( like master's or Ph.D. degrees).

Author Response

We are grateful to reviewer for the critical comments and useful suggestions that have helped us to improve our paper considerably. As indicated in the following responses, we have incorporated all these comments into the revised version of our paper.

Reviewer 2

The manuscript was improved. I suggest the fair use of "experience" and "habilitation" terms. Experience is measured in years, and Habilitation in skills by a third party ( like master's or Ph.D. degrees).

Response: Thank you for your valuable feedback and for highlighting the importance of using accurate terminology in our manuscript. We have made the necessary modifications in the manuscript. We understand that "experience" should be used to refer to the number of years in a profession, while "expertise" should be used to describe the skills and knowledge acquired through formal education and training.

We agree that the degree of expertise of healthcare professionals can significantly impact their clinical decision-making and patient outcomes. Furthermore, the proficiency of healthcare professionals in using digital technology is becoming increasingly relevant in healthcare, and it can also affect their clinical practice. Therefore, we have revised our manuscript to include the significance of these factors and the need to investigate their impact on clinical decision-making and patient outcomes.

Once again, we appreciate your feedback and your contributions to improving the quality of our manuscript.

Discussion Section

“According to previous studies on digital dentistry surveys [26, 27], it was found that dentists have a positive attitude towards dental CAD/CAM technology [26]. Additionally, CAD software for dentistry is increasingly popular among dentists [27]. However, various CAD software for dentistry can produce different quality designs for dental prostheses [25]. In the present study, the design quality of CAD software for dentistry was identified as the most important factor (Table 2, P < 0.05). Previous studies emphasized the importance of learning and ease of use of CAD software for dentistry for appropriate use in dental clinics [19-21]. Similarly, in the present study, work speed (learning) and ease of use were identified as very important factors in dental clinical practice (Table 2, P < 0.05). Previous studies described the digital implant dentistry Ph.D. program, which includes practical experience habilitation with CAD software and provides education on the basics and applications of CAD software for dentistry [29]. However, many dentists still have limited knowledge of 3D design in dentistry, indicating a need for educational improvement in this area [27]. Therefore, the results of this present study can be used as evidence for the education of digital dentistry.

Understanding digital dentistry is increasingly important in clinical practice as digital technology continues to revolutionize the field [26, 27]. The present study emphasizes the importance of understanding digital dentistry for the successful implementation of digital workflows in dental clinics. As digital dental technology continues to advance, it is essential for clinicians and researchers to stay up to date with the latest innovations and understand how to properly utilize these tools to improve patient care. The intervenient who participated in this study were composed of dentists and dental college professors who had a high understanding of the latest digital dental medical devices and had extensive experience in digital dentistry, which is widely used in dental clinics. The inclusion of experts from diverse backgrounds allowed the survey to obtain a comprehensive and multidimensional analysis of digital technologies.

The present study found that the importance of certain survey items varied significantly by age, dental personnel, and work experience groups. These findings suggest that when choosing dental CAD software, it is important to consider individual needs and preferences based on specific demographics, as well as factors such as branding, functional diversity, and design speed and convenience. The main limitation of the current study was that the sample included Korean dental personnel only, thereby limiting the generalizability of the findings. Further studies in more diverse population are necessary to elucidate factors to be taken into consideration when using dental CAD software. The limitations of the present study that only considered clinical experience without considering the training level or digital technology skills of the participants are significant. The degree of habilitation expertise of healthcare professionals can impact their clinical decision-making, as more highly trained professionals may have a greater knowledge base and more experience better proficiency with complex cases. Additionally, the use of digital technology in healthcare is becoming increasingly prevalent, and the proficiency of healthcare professionals with such technology may impact the effectiveness of their clinical practice. Ignoring the experience and skills of healthcare professionals with digital technology could limit the potential benefits of these technologies in improving patient outcomes. Future research could investigate the impact of the degree of habilitation expertise and digital technology skills on clinical decision-making and patient outcomes.”

Author Response File: Author Response.docx