Tooth-Derived Matrix Granules for Enhanced Bone Healing: Chemical Composition, Morphological Aspects, and Clinical Outcomes
, Mario Escobar 4, Inês Sofia Pimentel 3, João Caramês 5, Wim Teughels 6, Filipe Silva 1,2 and Bruno Henriques 1,2,7
Round 1
Reviewer 1 Report
The review paper entitled "Tooth-derived matrix granules for enhanced bone healing: chemical composition, morphological aspects, and clinical outcomes" is too short for a review paper and it has a low amount of references. Authors should be encouraged to increase the number of words and references and to resubmit the manuscript to the journal Ceramics MDPI. Authors should have in mind to highlight why is there a need for a review article on this topic. Also, the review needs to be systematic and explore recent literature on this topic. In addition, the authors should provide a critical point of view, giving the solutions to current challenges in the field.
Author Response
Our response: The authors acknowledge the reviewer for the comments. In fact, the authors prepared a concise review following a systematic approach for selection of studies. The number of words has been increased as suggested. Also, the authors emphasized the relevance of the present review and therefore a critical appraisal of previous studies was improved in the new version of the manuscript.
Revised text:
“A Medline bibliographical search of articles was carried out using the following search items: “tooth” OR “dentin” AND “granules” AND “chemical composition” OR “microscopy” OR “morphological” AND “bone healing” OR “bone regeneration” OR “bone repai”. The selection criteria involved articles published in the English language witin the last 15 years; in vitro studies; meta-analysis; and prospective cohort studies. Two of the authors (JCMS, MER) independently evaluated the titles and abstracts of potentially relevant studies. For this study, only papers focusing on chemical and morphological aspects of tooth-derived matrix granules were considered. The following variables were retrieved from the selected studies: authors’ names; publication year; purpose of the studies; chemical composition; chemical treatment; grinding process; microscopy; and in vivo outcomes. The strategy for search and selection of studies followed the method utilized by previous integrative reviews.”
“The current review emphasizes the effects of the chemical composition and morphological aspects of autologous tooth-derived matrix on the procedures for bone healing.”
“Thus, autogenous tooth-derived dentin matrix disclosed a structural and biological potential to serve as an alternative autograft to autogenous bone. In this context it must be emphasized that autogenous tooth-derived dentin matrix appear to be clinically suitable for different reconstruction or preservation procedure for enhanced bone healing.”
Yours sincerely,
Reviewer 2 Report
Dear Authors,
you made a good work! However, some improvements are mandatory before acceptance.
Comments for author File: 
Comments.pdf
Author Response
Our response: The authors appreciate the opportunity to improve the current manuscript. A revised version of the manuscript has been uploaded.
Reviewer 3 Report
Dear authors,
the article covers a very interesting topic.
Nevertheless I suggest some changes in order to improve the overall quality of the manuscript for the readers.
Line 30: The authors wrote 250-1300 microns. In line 220 the authors wrote 300 and 1200. Please adjust accordingly.
Line 40:
The readers could benefit of a sentence that could describe possible alternatives for ridge preservation and implant site development. For example, the implant site developement through forced eruption should be mentioned.
The authors could therefore add a sentence like:
“When possible, tooth forced eruption can be used as tissue regeneration procedure and implant site development technique. If orthodontic extrusion is not possible, alveolar ridge preservation […]”
To support this sentence you could use the following reference: Paolone MG, Kaitsas R, Paolone G, Kaitsas V. Lingual orthodontics and forced eruption: a means for osseous and tissue regeneration. Prog Orthod. 2008;9(2):46-57. PMID: 19350058.
Line 52-3:
The authors wrote:
“In dentistry, teeth are often extracted due to several issues such as advanced periodontitis, caries, orthodontic treatment, or wisdom teeth extraction indication.”
Add vertical fracture as cause for extraction.
Line 64:
The authors wrote:
“In this way, ATDM become a promising bone substitute considering its chemical composition and patient-based source.”
please rephrase in:
“ATDM could therefore be considered a promising bone substitute considering its chemical composition and patient-based source.”
Line 86-8:
Please add some references to support why filllings, calculus etc, shall be removed. You could cite for example for restorations:
Muduroglu R, Ionescu AC, Del Fabbro M, Scolavino S, Brambilla E. Distribution of adhesive layer in class II composite resin restorations before/after interproximal matrix application. J Dent. 2020 Dec;103:103494. doi: 10.1016/j.jdent.2020.103494. Epub 2020 Oct 5. PMID: 33031887.
and for calculus:
Lamont T, Worthington HV, Clarkson JE, Beirne PV. Routine scale and polish for periodontal health in adults. Cochrane Database Syst Rev. 2018 Dec 27;12(12):CD004625. doi: 10.1002/14651858.CD004625.pub5. PMID: 30590875; PMCID: PMC6516960.
Line 230: please correct Thun in Thus
Author Response
Dear authors,
the article covers a very interesting topic.
Nevertheless I suggest some changes in order to improve the overall quality of the manuscript for the readers.
Line 30: The authors wrote 250-1300 microns. In line 220 the authors wrote 300 and 1200. Please adjust accordingly.
Our response: The authors acknowledge the reviewer for the careful revision. The scale has been corrected in the new version of the manuscript.
Line 40:
The readers could benefit of a sentence that could describe possible alternatives for ridge preservation and implant site development. For example, the implant site developement through forced eruption should be mentioned.
The authors could therefore add a sentence like:
“When possible, tooth forced eruption can be used as tissue regeneration procedure and implant site development technique. If orthodontic extrusion is not possible, alveolar ridge preservation […]”
To support this sentence you could use the following reference: Paolone MG, Kaitsas R, Paolone G, Kaitsas V. Lingual orthodontics and forced eruption: a means for osseous and tissue regeneration. Prog Orthod. 2008;9(2):46-57. PMID: 19350058.
Our response: The authors agree with the reviewer suggestions and therefore the information has been added in the new version of the manuscript. Also, the reference was added.
Line 52-3:
The authors wrote:
“In dentistry, teeth are often extracted due to several issues such as advanced periodontitis, caries, orthodontic treatment, or wisdom teeth extraction indication.”
Add vertical fracture as cause for extraction.
Our response: That factor was added as suggested.
Line 64:
The authors wrote:
“In this way, ATDM become a promising bone substitute considering its chemical composition and patient-based source.”
please rephrase in:
“ATDM could therefore be considered a promising bone substitute considering its chemical composition and patient-based source.”
Our response: The sentence has been re-written.
Line 86-8:
Please add some references to support why filllings, calculus etc, shall be removed. You could cite for example for restorations:
Muduroglu R, Ionescu AC, Del Fabbro M, Scolavino S, Brambilla E. Distribution of adhesive layer in class II composite resin restorations before/after interproximal matrix application. J Dent. 2020 Dec;103:103494. doi: 10.1016/j.jdent.2020.103494. Epub 2020 Oct 5. PMID: 33031887.
and for calculus:
Lamont T, Worthington HV, Clarkson JE, Beirne PV. Routine scale and polish for periodontal health in adults. Cochrane Database Syst Rev. 2018 Dec 27;12(12):CD004625. doi: 10.1002/14651858.CD004625.pub5. PMID: 30590875; PMCID: PMC6516960.
Our response: References were cited in the corresponding sentences.
Line 230: please correct Thun in Thus
Our response: The word has been corrected. A revised version of the manuscript has been uploaded.
Yours sincerely,
Round 2
Reviewer 1 Report
Authors did not appropriatelly improved the review paper.
Author Response
The authors answered the comments provided by two reviewers. Also, the academic editor suggested some modifications that were performed in the new version of the manuscript. A new version of the manuscript has been uploaded.
Reviewer 2 Report
Dear Authors,
thank you for the corrections.
Author Response
The authors acknowledge the reviewer for the careful revision.
