Review History


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Summary

  • The initial submission of this article was received on May 7th, 2024 and was peer-reviewed by 4 reviewers and the Academic Editor.
  • The Academic Editor made their initial decision on June 18th, 2024.
  • The first revision was submitted on July 3rd, 2024 and was reviewed by 1 reviewer and the Academic Editor.
  • A further revision was submitted on September 2nd, 2024 and was reviewed by 2 reviewers and the Academic Editor.
  • The article was Accepted by the Academic Editor on September 9th, 2024.

Version 0.3 (accepted)

· Sep 9, 2024 · Academic Editor

Accept

Dear authors,

We are pleased to inform you that your manuscript titled "Effect of bioceramic-based and resin-based sealers on postoperative discomfort following root canal therapy: a systematic review and meta-analysis" has been accepted for publication in PeerJ. After thorough review and consideration by the editorial board and peer reviewers, we believe that your research makes a significant contribution to the field of Endodontics.

·

Basic reporting

Noi comments

Experimental design

All suggested improvemnets are addressed.

Validity of the findings

No comments

Reviewer 3 ·

Basic reporting

The current version seems acceptable.

Experimental design

The current version seems acceptable.

Validity of the findings

The current version seems acceptable.

Additional comments

The current version seems acceptable.

Version 0.2

· Jul 22, 2024 · Academic Editor

Minor Revisions

Dear authors,

I believe that your submission would benefit from minor revisions. Please try to address all the reviewer comments to avoid further rounds of revision.

Thanks

Reviewer 3 ·

Basic reporting

More details of study Ates 2018 should be provided in the result section to avoid the misunderstanding.

Experimental design

no comment

Validity of the findings

no comment

Additional comments

The previous question of "In discussion, the authors stated “This review explored how various root canal sealers in single-visit endodontic treatment”, which may be misleading. Were all the studies included conducting preparing, obturation in single-visit?" was yet addressed.

Version 0.1 (original submission)

· Jun 18, 2024 · Academic Editor

Minor Revisions

Dear authors,
Based on feedback from four external peer reviewers, I have decided to request minor revisions to the manuscript. There are several typos throughout the text that need to be addressed. Please carefully consider all the reviewers' questions and comments to avoid multiple rounds of revisions. I have a particular concern regarding your study's PubMed search strategy. Could you explain why only one MeSH term was used and how the search strategy was developed?

·

Basic reporting

no comments

Experimental design

no comments

Validity of the findings

no comments

Additional comments

1. The introduction effectively outlines various causes of postoperative discomfort, including physical trauma during treatment, inflammation, bacterial extrusion, and iatrogenic factors such as instrument selection, working length determination, and choice of root canal sealer.
2. By referencing relevant studies, it establishes a solid foundation for the importance of addressing postoperative discomfort in RCT.
3. Overall, the introduction effectively establishes the importance of addressing postoperative discomfort in RCT, provides a clear overview of the factors contributing to this discomfort, and introduces relevant assessment tools and obturation techniques.
4. It sets a strong foundation for the subsequent discussion in the article.
5. The data sources section provides a detailed description of the methodology employed in identifying and selecting research articles for the review.
6. The use of PICOS criteria for screening potential articles indicates a systematic approach to ensure the relevance and quality of the included studies.
7. The involvement of multiple reviewers in independently evaluating titles and abstracts adds rigor to the screening process and minimizes bias.
8. The outcomes measured, namely mean post-operative pain scores and analgesic intake, are clearly defined, aligning with the objectives of the review. This ensures consistency in the evaluation of the selected studies and facilitates the comparison of results across different publications.
9. The utilization of electronic databases such as PubMed MEDLINE and the Directory of Open Access Journals (DOAJ) for the literature search enhances the comprehensiveness of the review.
10. The inclusion of articles published between January 2000 and August 2022 without language restrictions further broadens the scope of the search, increasing the likelihood of capturing relevant studies.
11. The use of specific keywords and MeSH terms in combination with Boolean operators for the advanced search highlights a structured approach to retrieving relevant literature.
12. This strategy enhances the efficiency of the search process and improves the accuracy of identifying eligible articles.
13. The data extraction section outlines the systematic process employed for extracting relevant information from the selected studies.
14. It emphasizes the importance of transparency and rigor in collecting data to ensure the reliability and validity of the review findings.
15. The involvement of two independent reviewers in the data selection process, along with open dialogue to address any questions or concerns, enhances the reliability of data extraction.
16. The use of a comprehensive verification checklist helps ensure consistency in extracting relevant information across studies.
17. The inclusion of studies conducted in various parts of the world adds diversity to the evidence base, enhancing the generalizability of the findings.
18. Despite differences in geographic location and study population, all included studies reached a consistent conclusion regarding the lack of notable distinction in postoperative pain levels between the two types of sealers.
19. The results section effectively summarizes the findings of the review, highlighting the methodological approach to study selection, the characteristics of the included studies, and the consensus among the literature regarding postoperative pain outcomes associated with different types of sealers.
20. The discussion section provides a comprehensive analysis of the relationship between root canal sealers and postoperative pain, as well as the implications of the study findings for clinical practice.
21. The review explores the complexities of postoperative pain in endodontic procedures, acknowledging the potential impact of patient anxiety and physiological changes at the cellular level.
22. The discussion highlights the three potential outcomes at the start of endodontic therapy, ranging from no symptoms to intense pain/swelling requiring unscheduled clinical visits.
23. This contextualization sets the stage for understanding the significance of identifying factors that may contribute to postoperative discomfort.
24. The section delves into the mechanisms underlying postoperative endodontic pain, emphasizing the role of local inflammatory responses and biochemical mediators such as reactive oxygen species (ROS).
25. It discusses how root canal sealers, including bioceramic-based sealers (BCS) and resin-based sealers (RBS), may contribute to postoperative discomfort through the release of ROS and activation of trigeminal nociceptors and pain-sensitive sensory receptors.
26. This detailed exploration of molecular pathways provides valuable insights into the physiological basis of postoperative pain in endodontic procedures.
27. The discussion also underscores the importance of selecting the appropriate sealer and applying it correctly to minimize postoperative pain and discomfort.
28. By comparing the frequency of postoperative pain associated with BCS and RBS, the study sheds light on the potential impact of sealant type on patient outcomes. This analysis contributes to the growing body of evidence aimed at optimizing treatment protocols and improving patient comfort in endodontic practice.
29. Overall, the discussion effectively synthesizes the findings of the meta-analysis, contextualizes them within the existing literature, and provides insights into the potential clinical implications of the study results.
30. It underscores the complexity of factors influencing postoperative pain in endodontic procedures and highlights the importance of evidence-based decision-making in selecting root canal sealers to optimize patient comfort and outcomes.

·

Basic reporting

No comments

Experimental design

No comments
PRISMA flowchart is present and review question is correctly mentioned
Sufficient methodology provided.

Validity of the findings

Since the authors have mentioned certain limitations of the review. Kindly mentions how to overcome these limitations.
Kindly add few more points in conclusion

Reviewer 3 ·

Basic reporting

In introduction, the authors described resin-based sealers as good biocompatibility, however, they also declared their potential for producing residual monomers and cytotoxicity. Thus from line 92 to line 99, the consecution of section should be reorganized.
The English writing should be improved. For example, from line 377 to line 379, the sentence was not smooth which should be modified.
The “Survey and methodology” section was too prolix, which should be modified to be more concise.
For instance,From line 118 to 126, the description for “PICO” was too repetitive, which may be altered as:“Population: participants with non-surgical root canal treatment on permanent teeth
Intervention: root canal treatment done using bioceramic sealers
Comparison: root canal treatment done using resin-based sealers
Outcomes: post-operative pain scores and post-operative analgesic use.”
Please shorten the paragraph of “Selection of studies” and “Data extraction” which seemed to be too lengthiness.

Experimental design

I noticed that the initial search retrieved more than seven thousands results, which seem too many and may cause the screening progress difficult. Thus the search strategy should be modified, especially for the Pubmed.

Validity of the findings

In table 3, the “characteristics of selected studies” may altered as “characteristics of included studies”. It showed that the sample size of the study by Ates, 2018 was 160, however, the total number of participants in the forest plot (Fig 4) in this study was 72, was there an error?

Additional comments

In discussion, the authors stated “This review explored how various root canal sealers in single-visit endodontic treatment”, which may be misleading. Were all the studies included conducting preparing, obturation in single-visit?

Reviewer 4 ·

Basic reporting

This section is ok

Experimental design

The design is perfect

Validity of the findings

The findings is helpful for clinicians

Additional comments

I think this manuscript is OK in whole.sections

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