Quality of endodontic record-keeping and root canal obturation performed by final year undergraduate dental students: An audit during the COVID-19 pandemic

Galvin Sim Siang Lin; Wen Wu Tan; Daryl Zhun Kit Chan; Kah Hoay Chua; Teoh Chai Yee; Mohd Aizuddin Mohd Lazaldin

doi:10.1371/journal.pone.0275634

Peer Review History

Original SubmissionJune 21, 2022
3 Aug 2022 Decision Letter - Ove A. Peters, Editor PONE-D-22-17740Quality of Endodontic Record-keeping and Root Canal Obturation Performed by Final Year Undergraduate Dental Students: An Audit During the COVID-19 PandemicPLOS ONE Dear Dr. Lin, 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 submit your revised manuscript by Sep 17 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're 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. 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If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: The ms was reviewed by two content experts and requires minor changes as outlined in the reviewers' reports. [Note: HTML markup is below. Please do not edit.] 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: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. 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Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 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: The manuscript is structured, written in a concise manner and in standard English. The topic is interesting, sample size calculation is included in the study, the statistical analysis is appropriate and the results are presented with clarity. I would like to make the following two comments: a) there are no specifics about the status of the two investigators that assessed the PAs. It is important to know if they were undergraduate students, postgraduate students or faculty members. b) It would be preferable to include the p values in the manuscript. Reviewer #2: Thank you for submitting your manuscript to PLOS One for possible publication. Below please find my reviewer comments. Introduction Please add and explanation on why you assume that record keeping, and treatment quality would be different during the Covid-19 Pandemic than during other periods, as you have defined this as your investigated timeframe. Materials and Methods Endodontic record keeping: How were the 111 patient records selected from all available records from March 2020 to March 2022? E.g., Randomly selected or the first 111? Certain number per year? Please explain. Please check your tenses throughout the document, it should be past tense, e.g., NA score were excluded instead of will be excluded. Results Table 2 Legend: Instead of distribution this should be called documentation of records. You state that the only acceptable mishaps were no mishaps. Consequently, your results would be easier to read if you dichotomise into mishaps/no mishaps, instead of acceptable/unacceptable mishaps which could imply that there are such mishaps that are deemed acceptable. This is also true for Table 3 and the relevant section under “root canal obturation quality”. You state here that the “mishap quality” was “slightly lower” in posterior teeth. Please correct this statement. Discussion Again, you state that “root canal mishaps had the highest acceptability rate”. This conveys the message that mishaps can be acceptable. This should be reworded, for example that mishaps were the variable that occurred with the lowest frequency. Please discuss why there was such low compliance with post-obturation radiographs, and this is obviously of great importance to ensure that patients don’t leave the clinic before any treatment accidents such as overfilling into the IA canal are ruled out. Looking forward, did you consider providing students with a documentation template that they could copy/paste into their patient chart to create consistency in record keeping? Conclusion You introduce the category “moderately” satisfactory, while stating in M&M that only if all 4 parameters were graded as acceptable, then the overall case would be satisfactory. Please explain and introduce into M&M or change accordingly. ****** 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 ******** [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.] 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 PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0275634.r001
Revision 1
31 Aug 2022 Author Response Editor 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. Respond: The style requirements were checked. 2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information Respond: The phrase has been added: “No further consent from the patient is needed since written consent forms for patient folder confidentiality have been signed before receiving any dental care.” 3. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. Respond: The data availability statement has been addressed. 4. Please review your reference list to ensure that it is complete and correct. Respond: The reference list has been amended. Reviewer 1 1. The manuscript is structured, written in a concise manner and in standard English. The topic is interesting, sample size calculation is included in the study, the statistical analysis is appropriate and the results are presented with clarity. I would like to make the following two comments: a) there are no specifics about the status of the two investigators that assessed the PAs. It is important to know if they were undergraduate students, postgraduate students or faculty members. b) It would be preferable to include the p values in the manuscript. Respond: The authors would like to thank the reviewer for the constructive comments. (a): The words “senior faculty members” have been added. (b). p values were added to Table 3. Reviewer 2 1. Introduction Please add and explanation on why you assume that record keeping, and treatment quality would be different during the Covid-19 Pandemic than during other periods, as you have defined this as your investigated timeframe. Respond: The authors would like to thank the reviewer for the constructive feedback in improving the manuscript. Several points were added to the introduction: “In addition, strict measurements were implemented to reduce the amount of time and frequency of student-patient contact …… have an impact on students' record-keeping performance.” 2. Materials and Methods Endodontic record keeping: How were the 111 patient records selected from all available records from March 2020 to March 2022? E.g., Randomly selected or the first 111? Certain number per year? Please explain. Please check your tenses throughout the document, it should be past tense, e.g., NA score were excluded instead of will be excluded. Respond: All dental records and dental radiographs of patients who gave their consent and received endodontic treatments from March 2020 to March 2022 were retrieved which has been addressed in the manuscript. No specific sampling method was applied since all records were used in the study. The manuscript has been revised and changed the phrases accordingly to past tense. 3. Results Table 2 Legend: Instead of distribution this should be called documentation of records. You state that the only acceptable mishaps were no mishaps. Consequently, your results would be easier to read if you dichotomise into mishaps/no mishaps, instead of acceptable/unacceptable mishaps which could imply that there are such mishaps that are deemed acceptable. This is also true for Table 3 and the relevant section under “root canal obturation quality”. You state here that the “mishap quality” was “slightly lower” in posterior teeth. Please correct this statement. Respond: The word ‘distribution’ has been changed to ‘documentation’. The sentences have been revised: “Either ‘acceptable’ or ‘unacceptable’ was graded for adaptation, length, and taper. Meanwhile, mishap of root canal filling was evaluated as ‘present’ or ‘absent’. A root filling is defined as satisfactory only when all parameters were graded as acceptable with the absence of mishap.” Table 3 has been modified. The statement has been corrected in the result section. 4. Discussion Again, you state that “root canal mishaps had the highest acceptability rate”. This conveys the message that mishaps can be acceptable. This should be reworded, for example that mishaps were the variable that occurred with the lowest frequency. Please discuss why there was such low compliance with post-obturation radiographs, and this is obviously of great importance to ensure that patients don’t leave the clinic before any treatment accidents such as overfilling into the IA canal are ruled out. Looking forward, did you consider providing students with a documentation template that they could copy/paste into their patient chart to create consistency in record keeping? Respond: The sentence has been rephased. “The present results indicated that mishaps were the parameter that occurred with the lowest frequency, while acceptability rates of root canal taper, adaptation, and length were generally high (> 65%).” The reason for low compliance is discussed in the text: “One explanation for this could be the time restriction on clinical sessions imposed by the dental school…during the COVID-19 pandemic to establish a correlation with their endodontic record-keeping performance.” The sentence has been added: “One way to improve this is to provide dental students with a dental documentation template to record dental charts and establish a consistency in dental record-keeping among the students.” 5. Conclusion You introduce the category “moderately” satisfactory, while stating in M&M that only if all 4 parameters were graded as acceptable, then the overall case would be satisfactory. Please explain and introduce into M&M or change accordingly. Respond: The conclusion has been rephrased accordingly. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0275634.r002
20 Sep 2022 Decision Letter - Ove A. Peters, Editor Quality of Endodontic Record-keeping and Root Canal Obturation Performed by Final Year Undergraduate Dental Students: An Audit During the COVID-19 Pandemic PONE-D-22-17740R1 Dear Dr. Lin, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. 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 help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- 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. Kind regards, Ove A. Peters, DMD MS PhD Academic Editor PLOS ONE Additional Editor Comments (optional): The authors have satisfactorily addressed all comments, the ms is now acceptable. https://doi.org/10.1371/journal.pone.0275634.r003
Formally Accepted
26 Sep 2022 Acceptance Letter - Ove A. Peters, Editor PONE-D-22-17740R1 Quality of Endodontic Record-keeping and Root Canal Obturation Performed by Final Year Undergraduate Dental Students: An Audit During the COVID-19 Pandemic Dear Dr. Lin: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. 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. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Ove A. Peters Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0275634.r004

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