PONE-D-19-30284

Finite Element Analysis of a One-piece Zirconia Implant in Anterior Single Tooth Implant Applications

PLOS ONE

Dear Dr. Bencharit,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please, address all the comments made by the reviewers, specially those pointed out by Reviewers #1 and #3.

We would appreciate receiving your revised manuscript by Jan 06 2020 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter.

To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'.

Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out.

We look forward to receiving your revised manuscript.

Kind regards,

Antonio Riveiro Rodríguez, PhD

Academic Editor

PLOS ONE

Journal requirements:

1. When submitting your revision, we need you to address these additional requirements.

Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at

http://www.journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and http://www.journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

2. In your methods section you write that the study used CBCT scans from an implant clinic database with patient identifiers removed. Please provide the name of the database and clarify whether the data were anonymized or de-identified before you accessed them.

- In your data availability statement you write, "All relevant data are within the paper." Please ensure you have provided the individual data points used to create the figures and determine means, medians and variance measures presented in the results, tables and figures and provided details of the database from which the underlying images were obtained such that other researchers can replicate the analyses (http://journals.plos.org/plosone/s/data-availability#loc-faqs-for-data-policy).

3. Please amend either the abstract on the online submission form (via Edit Submission) or the abstract in the manuscript so that they are identical.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: N/A

Reviewer #3: No

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: This article numerically investigates one-piece zirconia implant in anterior single tooth implant applications. The paper presented in a poor quality. The results are NOT clearly explained. The structure of the paper does NOT follow any specific method. From reviewer's point of view, the article is required more than a major revision. In the following, there are comments that are appropriate to reinforce the article.

- Some of the most important research results should be mentioned at the end of this section.

- The paper needs keywords.

- The subtitles should be numbered.

- The quality of the figures should be increased.

- The graphs should be presented in a standard way.

- The reviewer is unable to follow the paper goal.

- The figures need captures.

Reviewer #2: The scientific paper propose a detailed FE-based numerical analysis of one-piece zirconia implant concerning three clinically simulated models.

The authors present a very interesting study. This manuscript is well structured using a rich introduction concerning state of the art with respect to scientific literature overview.

The abstract is correct synthesised in order to understand the study goals and the principal obtained results. I would like to recommend this paper for publication in the journal “PLOS ONE“. The major drawbacks are itemized below:

Line 81: It is suggested to replace "The Authors" by "Marcián et al.".

Line 149: "direcrtion" ?

The type of the strain (true strain, equivalent strain, elastic strain, etc. ?) used in the entire manuscript should be specified.

Quality of the figures 3a-3b in pdf version of a manuscript is very poor. The values in legends are illegible.

Conclusions are not adequately supported by the data presented. It is suggested to add more conclusions based on the results found.

Reviewer #3: This is an interesting study, in which force transmission to bone was investigated in loaded Zir and Ti implants using finite element analysis models. Authors showed that loaded Zir implant transmit less force to bone compared to similar Ti implant, which is presumably to the differences in the stiffness between these two materials.

The experimental procedure is described in sufficient details. However, the statistical analysis is missing in the paper. It is not clear, how many experiments were made and how the differences in the transmission force were assessed.

Data on the force transmission should be presented as mean+/-SD (S.E.M).

In the results section, there are several sentences like “Strain on the implant surface for Ti-6Al-4V averaged at 4.00x10-4 and 1.78x10-4, respectively. These values were higher 69.39% and 62.32 respectively, than Zir which averaged at 1.94x10-4 and 9.33x10-5…”. Such constructions are little confusing, because it is not clear what is taken as 100 %. In this case, values for Ti are about two times higher than those for Zir, and therefore the difference could be estimated as about 100 %. This text, as well as similar passages in other places, should be rephrased. It is not necessary to mention the differences in %, because it can be estimated by readers themselves.

Minor comments

The quality of graphs is low, text is difficult to read. The resolution of figures should be improved.

I would recommend writing Ti6Al4V with the numbers in lowercase; the abbreviation Ti-6Al-4V is confusing, because the numbers seem to be related to wrong atoms.

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6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step.

PONE-D-19-30284R1

Finite Element Analysis of a One-piece Zirconia Implant in Anterior Single Tooth Implant Applications

PLOS ONE

Dear Dr. Bencharit,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please, take into consideration the comments made by Reviewer 1, and address the recommendations made by the reviewer. 

We would appreciate receiving your revised manuscript by Mar 07 2020 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter.

To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'.

Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out.

We look forward to receiving your revised manuscript.

Kind regards,

Antonio Riveiro Rodríguez, PhD

Academic Editor

PLOS ONE

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: (No Response)

Reviewer #2: All comments have been addressed

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: N/A

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The paper still needs a major revision. It should be mentioned that the author should addressed and replied to the reviewer comments carefully, because the comments are just to improve the paper. In the following, there are comments that are appropriate to reinforce the article.

**Abstract**

- Abstract is too long.

- Some of the most important research results should be mentioned at the end of this section.

- The authors mentioned “This FEA modeling was completed on the basis to aid in conducting and validating future clinical studies”. The reviewer think this is not a result.

**Keywords**

- Each paper needs keywords. The keywords are the main technical words that used in paper. For example, you can use following keywords: Finite element analysis; One-piece Zirconia Implant; titanium alloy; Zir implant.

**Conclusion**

- This section should be rewritten. It is suggested to use at least 11 line to explain the conclusion. Reader usually check the abstract and conclusion.

**General comments**

- The subtitles should be numbered.

- The quality of the figures should be increased.

- The legend of figure 3 is not clear. Most of the paper use figures with wide of 3.5 inch, or 7 inch. It is recommended to check the quality of figures in this size in your paper.

- The graphs should be presented in a standard way, meaning that the format of the legend, horizontal and vertical axis should be clear with high quality. If you are working with EXEL, please go to the dimension part and use 3.5inx3.5in for your graph. A standard file is attached for instance.

- The figures need captures.

- In vertical axis of the graphs, unite for stress is MPa, and it is not MPA.

Reviewer #2: (No Response)

Reviewer #3: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

Reviewer #3: Yes: Oleh Andrukhov

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step.

Finite Element Analysis of a One-piece Zirconia Implant in Anterior Single Tooth Implant Applications

PONE-D-19-30284R2

Dear Dr. Bencharit,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication.

Shortly after the formal acceptance letter is sent, an invoice for payment will follow. To ensure an efficient production and billing process, please log into Editorial Manager at https://www.editorialmanager.com/pone/, click the "Update My Information" link at the top of the page, and update your user information. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

With kind regards,

Antonio Riveiro Rodríguez, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Please, revise the manuscript prior to its publication. English language should be revised. Some corrections are needed, e.g.: 

(Line 21, Abstract) Please, replace "...around Monolithic Yttria-Zirconia..." with "...around monolithic yttria-zirconia..."

(Line 38, Abstract) Please, replace "...differently then Ti implants." with "...differently than Ti implants."

(Line 299, Conclusions) Please, replace "In general Zir implants behaves more..." with "In general, Zir implants behave more..."

(Lines 308-309) Please, replace "Zir implants may be considered for not only for its esthetic properties, but also the stress modulation properties of the material." with "Zir implants may be considered not only due to its esthetic properties, but also due to the stress modulation properties of the material."