Impact of regenerative procedure on the healing process following surgical root canal treatment: A systematic review and meta-analysis

Nader Muthanna; Xiaoyue Guan; Fouad Alzahrani; Badr Sultan Saif; Abdelrahman Seyam; Ahmed Alsalman; Ahmed Es Alajami; Ang Li

doi:10.1371/journal.pone.0312751

Peer Review History

Original SubmissionJune 26, 2024
21 Aug 2024 Decision Letter - Fahad Umer, Editor PONE-D-24-25494Impact of Regenerative Procedure on The Healing Process Following Surgical Root Canal Treatment: A systematic review and meta-analysisPLOS ONE Dear Dr. Hussain, 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. I have identified some significant issues that need to be addressed before the paper can be considered for publication. The main concerns are as follows: Numerous grammatical errors throughout the manuscript Multiple spelling mistakes Inconsistent formatting Given these issues, I am recommending a Major Revision for your paper. In addition to addressing the reviewers' comments, please pay careful attention to the following: Thoroughly proofread the entire manuscript for grammatical and spelling errors. Ensure consistent formatting throughout the paper. Review all tables carefully for spelling, formatting, and accuracy. I encourage you to consider using a professional proofreading service if needed. Addressing these issues will significantly improve the quality and readability of your work. Please submit your revised manuscript along with a point-by-point response to the reviewers' comments and a detailed list of the changes you've made to address the language and formatting issues Please submit your revised manuscript by Oct 05 2024 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. 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). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. 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The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. We note that your Data Availability Statement is currently as follows: "All relevant data are within the manuscript and its Supporting Information files." Please confirm at this time whether or not your submission contains all raw data required to replicate the results of your study. Authors must share the “minimal data set” for their submission. PLOS defines the minimal data set to consist of the data required to replicate all study findings reported in the article, as well as related metadata and methods (https://journals.plos.org/plosone/s/data-availability#loc-minimal-data-set-definition). For example, authors should submit the following data: - The values behind the means, standard deviations and other measures reported; - The values used to build graphs; - The points extracted from images for analysis. Authors do not need to submit their entire data set if only a portion of the data was used in the reported study. If your submission does not contain these data, please either upload them as Supporting Information files or deposit them to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. For a list of recommended repositories, please see https://journals.plos.org/plosone/s/recommended-repositories. If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially sensitive information, data are owned by a third-party organization, etc.) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. If data are owned by a third party, please indicate how others may request data access. Additional Editor Comments: Dear Authors, I hope this email finds you well. I have received two reviews for your manuscript submitted to PLOS ONE. While both reviewers have suggested only minor changes to the content, I have identified some significant issues that need to be addressed before the paper can be considered for publication. The main concerns are as follows: Numerous grammatical errors throughout the manuscript Multiple spelling mistakes Inconsistent formatting Given these issues, I am recommending a Major Revision for your paper. In addition to addressing the reviewers' comments, please pay careful attention to the following: Thoroughly proofread the entire manuscript for grammatical and spelling errors. Ensure consistent formatting throughout the paper. Review all tables carefully for spelling, formatting, and accuracy. I encourage you to consider using a professional proofreading service if needed. Addressing these issues will significantly improve the quality and readability of your work. Please submit your revised manuscript along with a point-by-point response to the reviewers' comments and a detailed list of the changes you've made to address the language and formatting issues. If you have any questions or need clarification on any point, please don't hesitate to contact me. Best regards, Fahad [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. 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 ****** 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: 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 authors are commended for the thought process and a well written scientific manuscript. The current systematic review will be of good interest to the scientific community. There are some minor details that need modification to improve the overall quality of the manuscript. 1. There are several punctuation errors and some typographical errors all through the manuscript. The use of full stop, comma, semi colon and numbers are used in sentences which changed the context entirely. Advise is to seek a professional English language reviewer. 2. The formatting of the reference should be checked to ensure it matches the guidelines of the journal. 3. The last sentence of the paragraph states "However, The GTR procedure has no advantage in treating apical marginal lesions." - This statement may not be entirely true as the application of GTR in cases of marginal defects is dependent on the diagnosis and appropriate use of GTR technique. See the case series published in JOE, although a low level of evidence, it provides insight on the use of GTR in apical marginal lesions https://doi.org/10.1016/j.joen.2023.07.009 Reviewer #2: Introduction: GTR is comprehensively covered. Add more information about nonsurgical root canals and surgical root canal assessment criteria. Methods: Data Extraction: Give evidence for the criteria that you used to assess success and failure. Discussion: 2nd paragraph: What you met by possible issues? You did not discuss the slow resorption rate of bovine bone-derived hydroxyapatite, or whether it could affect the radiographic findings. ****** 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.0312751.r001
Revision 1
20 Sep 2024 Author Response Response to Reviewers Prof. Fahad Umer Academic Editor PLOS ONE 20 September 2024 Dear Academic Editor [Fahad Umer] Subject: Submission of revised manuscript No.: PONE-D-24-25494 Impact of Regenerative Procedure on The Healing Process Following Surgical Root Canal Treatment: A systematic review and meta-analysis We appreciate the opportunity to submit a revised revision of our manuscript. It is greatly appreciated that you and the other reviewers have devoted the time and effort necessary to offer valuable feedback on our manuscript. Also, we thank the reviewers for their insightful feedback regarding our paper. We have successfully implemented modifications to incorporate most of the reviewers' recommendations. We highlighted the modifications in the Revised Manuscript by the red color. We hope the revised version is appropriate for publishing and look forward to your response. Additional Editor Comments: The main concerns are as follows: Numerous grammatical errors throughout the manuscript Multiple spelling mistakes Inconsistent formatting Response: Thank you for raising these points. We have already hired a professional proofreader to thoroughly review all sections of the paper as recommended. Response to Reviewer #1: Thank you for taking the time to review our paper. Your feedback and suggestions have been valuable in improving the quality of our work. We have carefully addressed your point and made the necessary modifications as suggested. 1. There are several punctuation errors and some typographical errors all through the manuscript. The use of full stop, comma, semi colon and numbers are used in sentences which changed the context entirely. Advice is to seek a professional English language reviewer. Response: Thank you for raising this point. We have already hired a professional proofreader to thoroughly review all sections of the paper as recommended. 2. The formatting of the reference should be checked to ensure it matches the guidelines of the journal. Response: Thank you for raising this point. We have re-checked and downloaded the referencing style from the PLoS ONE website to ensure it matches the journal's guidelines. 3. The last sentence of the paragraph states "However, The GTR procedure has no advantage in treating apical marginal lesions." - This statement may not be entirely true as the application of GTR in cases of marginal defects is dependent on the diagnosis and appropriate use of GTR technique. See the case series published in JOE, although a low level of evidence, it provides insight on the use of GTR in apical marginal lesions https://doi.org/10.1016/j.joen.2023.07.009 Response: Thank you for your valuable suggestions. This sentence was written in the conclusion, so it is crucial to ensure that the conclusion accurately reflects the study's key findings. We have included this point in the discussion part as recommended. (P.15, Line 250). [However, a 2023 case series by Baruwa et al. found that endodontic microsurgery combined with GTR can be a highly effective treatment approach for treating apico-marginal lesions. It is important to note that proper diagnosis and procedures are crucial for achieving successful results.] Response to Reviewer #2: Thank you for taking the time to review our paper. Your feedback and suggestions have been valuable in improving the quality of our work. We have carefully addressed your points and made the necessary modifications as suggested. 1. Introduction: GTR is comprehensively covered. Add more information about nonsurgical root canals and surgical root canal assessment criteria. Response: Thank you for your valuable suggestions. We have included this point in the introduction part as recommended. (p.3, line 27). [Success in both RCT and SRCT relies on the absence of signs of infection and inflammation, along with radiography showing reduced periapical lesion size and normal growth of the periodontal ligament gap. The evaluation of healing after SRCT is commonly conducted using the criteria established by Rud et al. and Molven et al. on 2D imaging, which categorizes healing as complete, incomplete, uncertain, or unsatisfactory. On the other hand, the Modified PENN criteria have been used to evaluate healing on 3D imaging.] 2. Methods: Data Extraction: Give evidence for the criteria that you used to assess success and failure. Response: Thank you for raising this point. The success and failure were established based on the criteria described by Rud et al. and Molven et al. for 2D imaging and modified PENN's criteria described by Schloss et al. for 3D imaging. For statistical purposes, the outcomes were dichotomized into success and failure; this method of dichotomization has been described and used in many Randomized control trials. We clarified that in the Data Extraction section as recommended. (p.6, line 95). Here are some references that use the same dichotomization method: Schloss et al.[1], Parmer et al.[2], Dhamija et al.[3] [The clinical outcomes are evaluated by the presence or absence of signs of infection and inflammation. Radiographically, the healing assessment was determined by using the criteria established by Rud et al. or Molven et al. (complete, incomplete, uncertain, or unsatisfactory healing) for 2D imaging evaluation, whereas the modified PENN criteria established by Schloss et al. (complete, limited, uncertain, or unsatisfactory healing) were used for 3D imaging evaluation. The assessment of success and failure was determined based on a comprehensive evaluation of both clinical and radiological outcomes. For statistical purposes, the outcomes were also dichotomized into success and failure. The Success was assessed by the loss of clinical symptoms and the signs of (complete or incomplete healing) for 2D imaging and (Complete or Limited healing) for 3D imaging. Failure was assessed by the presence of clinical symptoms and/or the occurrence of (uncertain or unsatisfactory healing) for 2D and 3D imaging.] 3. Discussion: 2nd paragraph: What you met by possible issues? You did not discuss the slow resorption rate of bovine bone-derived hydroxyapatite, or whether it could affect the radiographic findings. Response: Thank you for raising this point. This point has been added to the discussion part as recommended. (p.14, line 217). [The slow resorption rate of bovine bone-derived hydroxyapatite is a critical advantage, as it enables better integration and acts as an effective osteoconductive grafting material during the natural healing process. This can ultimately lead to successful bone healing outcomes.] References 1. Schloss T, Sonntag D, Kohli MR, Setzer FC. A Comparison of 2- and 3-dimensional Healing Assessment after Endodontic Surgery Using Cone-beam Computed Tomographic Volumes or Periapical Radiographs. J Endod. 2017;43(7):1072-9. Epub 20170517. doi: 10.1016/j.joen.2017.02.007. PubMed PMID: 28527841. 2. Parmar PD, Dhamija R, Tewari S, Sangwan P, Gupta A, Duhan J, Mittal S. 2D and 3D radiographic outcome assessment of the effect of guided tissue regeneration using resorbable collagen membrane in the healing of through-and-through periapical lesions - a randomized controlled trial. Int Endod J. 2019;52(7):935-48. Epub 20190306. doi: 10.1111/iej.13098. PubMed PMID: 30758848. 3. Dhamija R, Tewari S, Sangwan P, Duhan J, Mittal S. Impact of Platelet-rich Plasma in the Healing of Through-and- through Periapical Lesions Using 2-dimensional and 3-dimensional Evaluation: A Randomized Controlled Trial. Journal of Endodontics. 2020;46(9):1167-84. doi: 10.1016/j.joen.2020.06.004. PubMed PMID: WOS:000572345400002. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0312751.r002
4 Oct 2024 Decision Letter - Fahad Umer, Editor PONE-D-24-25494R1Impact of Regenerative Procedure on The Healing Process Following Surgical Root Canal Treatment: A systematic review and meta-analysisPLOS ONE Dear Dr. Hussain 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 follow my comments Editors comments Introduction: It’s a bit prolix and can benefit from making it concise Statistical analysis Random effect model was not used so dis-include this. Results : Fig 1 : Prisma 2020 Use this flow chart RISMA 2020 flow diagram for new systematic reviews which included searches of databases, registers and other sources (https://www.prisma-statement.org/prisma-2020-flow-diagram) be mindful of formatting and font sizes. Table 1 is not required since it will be in Prisma flow diagram and will be redundant information. Discussion PENN is misspelled as PEEN Please pay close attention to these details and resubmit Conclusion Modify the conclusion to focus on the statistically significant GTR techniques Please submit your revised manuscript by Nov 18 2024 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. 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). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Fahad Umer Academic Editor PLOS ONE [Note: HTML markup is below. Please do not edit.] [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.0312751.r003
Revision 2
10 Oct 2024 Author Response Response to Reviewers Prof. Fahad Umer Academic Editor PLOS ONE 10 October 2024 Dear Academic Editor [Fahad Umer] Subject: Submission of revised manuscript No.: PONE-D-24-25494R1 Impact of Regenerative Procedure on The Healing Process Following Surgical Root Canal Treatment: A systematic review and meta-analysis We appreciate the opportunity to submit a revised revision of our manuscript. It is greatly appreciated that you and the other reviewers have devoted the time and effort necessary to offer valuable feedback on our manuscript. We have successfully implemented modifications to incorporate all of the Editor's recommendations. We utilized the track changes feature in the Word file of the revised manuscript. We hope the revised version is appropriate for publishing and look forward to your response. Editor Comments: Introduction: 1. It’s a bit prolix and can benefit from making it concise Response: Thank you for your suggestion regarding the text's verbosity. We have addressed this issue and made the necessary revisions to ensure the introduction is as concise as recommended. (P.3,4). Statistical analysis 2. Random effect model was not used, so dis-include this. Response: Thank you for raising this point. we have noted your suggestion and have removed any references to random effect as recommended. (P.7, Line 223). Results: Fig 1: Prisma 2020 3. Use this flow chart RISMA 2020 flow diagram for new systematic reviews which included searches of databases, registers and other sources (https://www.prisma-statement.org/prisma-2020-flow-diagram) be mindful of formatting and font sizes. Response: Thank you for your valuable suggestions. We used the RISMA 2020 flow diagram for new systematic reviews, which included searches of databases, registers, and other sources as recommended. 4. Table 1 is not required since it will be in the Prisma flow diagram and will be redundant information. Response: Thank you for your feedback regarding Table 1. We have removed it from the main manuscript as recommended. Instead, we have included it as supporting information. (P.8). Discussion 5. PENN is misspelled as PEEN Response: Thank you for pointing out the spelling error. We have corrected "PEEN" to "PENN" throughout the manuscript. We appreciate your attention to detail. (P.16, Line 285). Conclusion 6. Modify the conclusion to focus on the statistically significant GTR techniques Response: Thank you for your suggestion. We revised and rewrote the conclusion to emphasize the key statistically significant impacts of GTR procedures. (P.16, Line 289). Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0312751.r004
14 Oct 2024 Decision Letter - Fahad Umer, Editor Impact of Regenerative Procedure on The Healing Process Following Surgical Root Canal Treatment: A systematic review and meta-analysis PONE-D-24-25494R2 Dear Dr. Hussain, 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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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, Fahad Umer Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0312751.r005
Formally Accepted
18 Dec 2024 Acceptance Letter - Fahad Umer, Editor PONE-D-24-25494R2 PLOS ONE Dear Dr. Li, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, 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 customercare@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. Fahad Umer Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0312751.r006

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