Effects of Osseodensification Protocols on Insertion Torques and the Resonance Frequency Analysis of Conical-Shaped Implants: An In Vitro Study on Polyurethane Foam Blocks

Round 1

Reviewer 1 Report

The study is interesting and could lead to conclusions with practical implications, I appreciate the work of the authors and the way they carried out the research. The research is well documented and is carried out in accordance with scientific requirements.

I have some suggestion for this manuscript :

1.     My big concern about the obtained results is the practical applicability. In vivo, there are many variables that can influence the final result. In this case, you have taken into account the ideal situation that rarely occurs in practice. I would suggest to include more limitations of the study related to of the situations that occur in vivo.

2.     Considering the topicality of the title, I would suggest the introduction of more recent bibliographic references. I am sure that the references from 1994 or 2006 are valuable, but there are many current researches in the last 3-4 years.

Author Response

We are very thankful for the thorough review. The paper was revised in the light of the reviewers' useful suggestions and comments. We hope the revision meet your approval. 

Response to Reviewer #1 Comments

Comments1: - My big concern about the obtained results is the practical applicability. In vivo, there are many variables that can influence the final result. In this case, you have taken into account the ideal situation that rarely occurs in practice. I would suggest to include more limitations of the study related to of the situations that occur in vivo

Response: As suggested by the reviewer, we revised the manuscript accordingly (please see the limitation of the study in the Discussion section)

Comments2: - Considering the topicality of the title, I would suggest the introduction of more recent bibliographic references. I am sure that the references from 1994 or 2006 are valuable, but there are many current researches in the last 3-4 years.

Response: As suggested by the reviewer, more recent bibliography have been added.

Reviewer 2 Report

Dear Authors,

Your paper entitled "Effects of osseodensification protocol on insertion torques and resonance frequency analysis of implants with conical shape: an in vitro study on polyurethane foam blocks" brings useful information in the field of implant-based dentistry. It is well written, easy to follow and correctly conducted.

Please find below some recommendations for the further improvement of the paper.

In the Abstract section:

-please follow the Journal's recommendations - the Abstract should be a single paragraph, without headings

-the paper contains 11 keywords, while the recommended number is between 3 and 10.

In the Introduction section:

-please add study hypothesis in the end of the section.

In the Results section:

-line 238 - please consider "highest" instead of "higher"

-line 240 - please consider "lowest" instead of "lower".

In the Discussion section:

-please add comments on the verification/not of study hypothesis, in the end of this section.

In the References section:

-many of the references are quite old, please replace them if possible with newer ones.

Comments for author File: Comments.pdf

Minor editing of English language is required.

Author Response

We are very thankful for the thorough review. The paper was revised in the light of the reviewers' useful suggestions and comments. We hope the revision meet your approval. 

Response to Reviewer #2 Comments

Comment 1: Please find below some recommendations for the further improvement of the paper.

In the Abstract section:

-please follow the Journal's recommendations - the Abstract should be a single paragraph, without headings

-the paper contains 11 keywords, while the recommended number is between 3 and 10.

In the Introduction section:

-please add study hypothesis in the end of the section.

Response: As suggested by the reviewer, we revised the Abstract accordingly

Comment 2: In the Results section:

-line 238 - please consider "highest" instead of "higher"

-line 240 - please consider "lowest" instead of "lower".

In the Discussion section:

-please add comments on the verification/not of study hypothesis, in the end of this section.

In the References section:

-many of the references are quite old, please replace them if possible with newer ones.

Response: As suggested by the reviewer, we revised the Results section accordingly

Reviewer 3 Report

Pranno et al. presented with an interesting approach to preliminarily evaluate osseodensification. It is important to standardize everything before going in vivo or in clinical setting. I do not have further comments on this manuscript.

Author Response

Thank you for your comments. Your feedback is greatly appreciated.

Reviewer 4 Report

Find comments in the attached file.

Comments for author File: Comments.pdf

some minor corrections needed.

Author Response

As suggested by the reviewer, we revised the manuscript accordingly 

Reviewer 5 Report

1.     The introduction sets a clear background for the study. However, it could benefit from a more detailed discussion on the current state of research in osseodensification, perhaps referencing key studies or reviews in this area. Sentences such as ‘According to the literature, the attainment of primary functional stability is crucial for successful osseointegration, as it prevents microdisplacements between the implant and bone greater than 150 μm.’ has nothing to do with the main topic.

2.     More details should be added in the ‘methods’ part. First, what temperature of the saline which was used in simultaneous irrigation? Temperature is also an important factor that should be controlled. Second, The Fig1’ Image of 13×20×4 cm polyurethane foam blocks used.’ and the box showed the research used PFB (PCF 20) as material. But PFB (PCF 10) is more common to be used in researches to simulate bone density type IV. 

3.     The results section is well-articulated, but there's a need for a more thorough comparison with existing literatures. 

4.     Although in the end of ‘discussion’ part, authors mentioned the limitation ‘evaluate histology and parameters like BIC and BAFO’, for PFB model doesn’t support such experiment. But the transverse section can better observe the effect of osteocondensation drills.

5.     The conclusion succinctly summarizes key findings but could be more impactful by highlighting the potential changes this research might bring to clinical practice in implant dentistry.

Author Response

We are very thankful for the thorough review. The paper was revised in the light of the reviewers' useful suggestions and comments. We hope the revision meet your approval. 

Response to Reviewer #5 Comments

Comment 1: .     The introduction sets a clear background for the study. However, it could benefit from a more detailed discussion on the current state of research in osseodensification, perhaps referencing key studies or reviews in this area.

Response: As suggested the Discussion has been modified

Comment 2: Sentences such as ‘According to the literature, the attainment of primary functional stability is crucial for successful osseointegration, as it prevents microdisplacements between the implant and bone greater than 150 μm.’ has nothing to do with the main topic.

Response: As suggested by the reviewer, the sentence has been eliminated

Comment 3 : More details should be added in the ‘methods’ part. First, what temperature of the saline which was used in simultaneous irrigation? Temperature is also an important factor that should be controlled. Second, The Fig1’ Image of 13×20×4 cm polyurethane foam blocks used.’ and the box showed the research used PFB (PCF 20) as material. But PFB (PCF 10) is more common to be used in researches to simulate bone density type IV.

Response: The manuscript has been revised as suggested (please see methods section)

Comment 4: The results section is well-articulated, but there's a need for a more thorough comparison with existing literatures.

Response: The Discussion has been improved as suggested.

Comment 5: Although in the end of ‘discussion’ part, authors mentioned the limitation ‘evaluate histology and parameters like BIC and BAFO’, for PFB model doesn’t support such experiment. But the transverse section can better observe the effect of osteocondensation drills.

Response: As suggested, the limits of the study has been revised (please see discussion section).

Comment 6: The conclusion succinctly summarizes key findings but could be more impactful by highlighting the potential changes this research might bring to clinical practice in implant dentistry.

Response: The conclusion has been reviewed as suggested

Reviewer 6 Report

The paper has clear and fluid language. It has a clear clinical importance. The methodology/model used is simple, but consistent with the hypothesis. In particular, I congratulate the authors for choosing an alternative method to the use of animals. The unnecessary sacrifice of animals in similar work is widely observed in this field of research. The statistical analysis is adequate and the results are interesting. The discussion is well-founded and congruent with the conclusions.

Author Response

Thank you for your comments. Your feedback is greatly appreciated and will be instrumental in guiding our future research efforts.

Round 2

Reviewer 1 Report

The authors reviewed and completed the observations made. I agree with the publication.

Reviewer 5 Report

I agree that this paper should be accepted now