Clinical Efficacy of Anterior Ceramic Materials in Resin-Bonded Fixed Dental Prostheses with Different Bridge Designs—A Systematic Review and Meta-Analysis

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The methodology is robust, and the work is well-structured, I only have a few minor suggestions for the authors.

I would not include abbreviations in the title, for greater clarity for readers.

The impact and clarity could be enhanced expanding the rationale considering the clinical context and decision-making process, justifying the selection of materials and designs in more detail, deepening the discussion of clinical implications and limitations, clearly motivating the aim of this study.

The manuscript lacks discussion on how these materials compare to alternative restorative approaches. There is no mention of the clinical decision process, when should a dentist choose Resin Bonded Fixed Dental Prostheses over other restoration types?
The authors should expand the rationale of the study by discussing alternative restorative strategies, highlighting their advantages and limitations, explaining why these specific materials were chosen over others motivating the aim of this systematic review.

Author Response

Please see the attachment. I have uploaded the file, which contains a point-by-point response to the reviewer's comments, as well as the revised manuscript reflecting the changes. I sincerely appreciate the reviewer's valuable feedback and thoughtful suggestions, which have helped improve the manuscript. Thank you for your time and consideration.

 

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

A very interesting systematic review for RBFPD in the anterior area. The subject is very popular and can be very extended since new materials, new adhesives are now in market and many of the presented materials have almost disappeared from market (Inceram Alumina,Inceram Zirconia etc). Many generations of zirconia are now in market with the main drawback of difficulty to etch the surface compared to metal and glass-ceramics.

Introduction: It should be commented that selection of RBFPD might have some limitations, or points of special attention as bruxism and overall treatment plan in extended restorations requiring incease of OVD, loss of posterior support and periodontal status. Moreover strict recalls are necessary for long term survival. The factors that influence tooth mobilty (as it is commented in discussion part) can influence de-cementation of such sensitive prosthetics as RBFPD. Moreover, explain if only 9 articles are enough for a systematic review.

Discussion: A little more analysis in the adhesive techniques and literature of the last decade for zirconia bonding which are basically the material of selection in most cases nowadays. Special attention that the studies involed in this review include older techniques and classic materials as Panavia EX,21,2.0 which are almost extinct from the market. MDP is of course required for reliable attention but check recent literature that shows diferences between MDP-primers and MDP-resin cements. It seems that MDP-primers can have higher concentration of MDP and so this might be a benefit for strong adhesion requirements.

Conclusions: Should be more condensed the comments for materials should be ommitted.   

Author Response

Please see the attachment. I have uploaded the file, which contains a point-by-point response to the reviewer's comments, as well as the revised manuscript reflecting the changes. I sincerely appreciate the reviewer's valuable feedback and thoughtful suggestions, which have helped improve the manuscript. Thank you for your time and consideration.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

Dear authors, thank you for submitting the manuscript "Clinical efficacy of anterior ceramic materials in RBFDPs with differetn bridge designs - A systematic review and meta-analysis". I carefully read and here is my feedback:

-English grammar should be improved.

-iThenticate report is 28%, which is very high, please reduce it. Here are a few of the similar articles:  https://doi.org/10.18332/tid/132411, https://doi.org/10.3389/fmed.2021.723790 , and https://doi.org/10.2340/actadv.v104.18477  (please note this is a must).

-Make sure you follow journal's abstract template with 250 words. It seems too long.

-For the introduction, it would be useful to create a table in which what clinical scenarios a RBFDPs can be useful.   -Also mention that RBFDPs can be done with chairside CAD/CAM systems, a recommended reference is: PMID: 32483533.   -For the discussion section, It would be useful if you create a table with the main prosthetic challenges described in the literature.   -Describe the limitations of your review at the end of the manuscript.   -Based on the results, mention what other review you would like to perform.   -Conclusion seems to long, you either reduce or create bullet points.   -Review the style of the references. I see some with full capital letters and different styles. Also, I see very old references example from 1990, check if you can update them. Comments on the Quality of English Language

needs improvement

Author Response

Please see the attachment. I have uploaded the file, which contains a point-by-point response to the reviewer's comments, as well as the revised manuscript reflecting the changes. I sincerely appreciate the reviewer's valuable feedback and thoughtful suggestions, which have helped improve the manuscript. Thank you for your time and consideration.

Author Response File: Author Response.pdf

Reviewer 4 Report

Comments and Suggestions for Authors

This review paper is interesting and may add potentially novel information to the current literature. However, the authors should address the following issues to improve the quality of the manuscript:

• The abstract should start with a short background statement. The abstract can be non-structured (check authors' guidelines).
• Since this paper has a meta-analysis part, null hypothesis/hypotheses should be added to the end of the introduction section.
• Adherence to PRISMA and registration in PROSPERO are appreciated from the authors side.
• MeSH terms used in each database should be tabulated and added under search strategy.
• Reasons of exclusion should be mentioned at each level of search process.
• Tables are not clear. Authors may consider different orientation and resolution for clarity.
• Figure 2: Authors should rationalize why those studies fall in low risk category.
• Limitations and directions for future research should be added in the discussion section.
• Conclusions should be more concise and summarized in bullet points.
• All abbreviations should be listed at the end of the article above references section.

Author Response

Please see the attachment. I have uploaded the file, which contains a point-by-point response to the reviewer's comments, as well as the revised manuscript reflecting the changes. I sincerely appreciate the reviewer's valuable feedback and thoughtful suggestions, which have helped improve the manuscript. Thank you for your time and consideration.

Author Response File: Author Response.pdf