An Evaluation of the Demineralizing Effects of Various Acidic Solutions

Round 1

Reviewer 1 Report

In this manuscript the authors present the evaluation of six demineralizing acidic solutions to induce artificial carious lesions in human teeth and they searched the creation of white spot lesions after 30 minutes, 1 hour, 24 hours and 96 hours of demineralization. They indicated that for a short period of time no change was appreciated, but the demineralization of enamel and dentin were visible after 24 hours. This is a very interesting manuscript, but some points should be addressed.

1). Describe the meaning of the acronyms used in the manuscript since first mention in the text. For example, ÄE first appears in the abstract, but its meaning is indicated up to the Materials and Methods section (page 3).

2). To clarity reading, the authors should include in the introduction section a paragraph describing the carious effects on the human tooth. For example, what is a natural carious lesion? What are its characteristics? What is its origin?. Also compare it with the obtained results.

3). To include or highlight the tooth data related to healthy teeth. For comparison, it would also be very appropriate to include the data in the case of a carious tooth.

4). In the results section, it is necessary to comment on the photographs shown in figures 1 to 6 and highlight their importance on supporting objective of the manuscript and the conclusions, since they were included without mentioning anything in this regard. One suggestion in this direction is to name this section Results and Discussions instead of just Results, and rewrite it accordingly.

Author Response

Thank you for the revision of the article and for the excellent questions. All the comments were very useful and helped us to increase the quality of the manuscript. We have revised the paper and we have made the changes suggested by you. A detailed point by point response is below:

1). Describe the meaning of the acronyms used in the manuscript since first mention in the text. For example, ÄE first appears in the abstract, but its meaning is indicated up to the Materials and Methods section (page 3).

1). We corrected this aspect and verified all of the acronyms to be explained when they are first mentioned

2). To clarity reading, the authors should include in the introduction section a paragraph describing the carious effects on the human tooth. For example, what is a natural carious lesion? What are its characteristics? What is its origin?. Also compare it with the obtained results.

2). This paragraph was included in the introduction section:

Dental caries is a multifactorial chronic disease caused by the interaction of four major factors: microorganisms, substrate, host factors and time[3]. It is caused by the action of organic acids, produced during the metabolism of carbohydrates by aciduric bacteria[4]. Glycolysis (acid production) lowers the pH of the surrounding area and leads to the demineralization of the dental tissue[5]. The acidic environment eventually causes a cavity on tooth surfaces[6].

3). To include or highlight the tooth data related to healthy teeth. For comparison, it would also be very appropriate to include the data in the case of a carious tooth.

3). The data obtained in this study is compared to the initial situation, which is the healthy tooth structure: In the Results and Discussion section, the healthy enamel is presented in Figure 1 (a) and the rest of the demineralized sites were compared to this one. The ΔE values were calculated using the results obtained the spectrophotometric readings in the initial situation and the demineralized ones. In Table (3), the DIAGNODentTM pen readings contains the initial values too. Figure (10) shows the radiologic aspect of the initial, healthy tooth compared to the demineralized one.

4). In the results section, it is necessary to comment on the photographs shown in figures 1 to 6 and highlight their importance on supporting objective of the manuscript and the conclusions, since they were included without mentioning anything in this regard. One suggestion in this direction is to name this section Results and Discussions instead of just Results, and rewrite it accordingly.

4). The authors decided to change this section to Results and Discussion, as suggested. More structural changes were made and all of the results were explained clearly.

Hoping you will favorably reconsider this work for publication, we remain with very best regards.

Sincerely,
Dr Agnes Kolumban (Szekely)

Reviewer 2 Report

Dear Editor,

dear Authors,

 

In the present manuscript an effort was made to examine the effect of different acidic agents on the demineralization of tooth enamel. The study seems to be interesting, but I have some concerns as they are listed below:

 

Abstract

-Mention the six different demineralizing solutions used in a short way.

-The phrase "The photographs show relevant step-by-step images that make the study easy to 23 understand for every reader" should be excluded from the text.

 

Introduction

-Check and correct the formula of hydroxyapatite.

- Too much information regarding the explanation of demineralization process was spent. Furthermore, previous reports associated with the current research are absolutely missing. The manuscript should be enriched with such literature data in details. The topic of the present study should be placed in the context of the existing scientific progress. If not, a lack of novelty might be considered.

-  A short description of the study should be placed in the last paragraph. What was the significance of the expected results?

 

Materials and methods

- Refer to the temperature of storage before and after the experimental demineralization.

- Describe the experimental conditions using the spectrophotometer (e.g. wavelength range, reflectance or absorbance mode, black or white background). Did you use an integrating sphere? If so, what was the angle of the light direction to the tooth? What was the software retrieving the color data? Were the data retrieved relative to the illuminant D65 standard or something else?

- Provide the SEM parameters used for the measurements.

 

Results

- The Figures 1-5, 6 and 10 should be commented at least on the basis of the description given in discussion section.

- Table 3: Check the chemical formulas.

 

Discussion

The description of the experimental data should be moved to the results section. Herein, they must be further discussed in comparison to the previous studies.       

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Dear Authors

Thank you for submitting the manuscript. The topic analyzed is interesting. However, there are several areas regarding research problems, methodology, or discussion that need modification or further detail.  Please see list below.

-The writing should be improved. There are some errata in the text that need edit. Please review the manuscript.

Introduction:

-Please introduce the purpose of the work and the null hypothesis at the end of the Introduction section. (See instructions for authors)

Material and Methods

-Please discuss how the authors determined that sample size was adequate. Was a power analysis performed?

-The authors have used 30 teeth. How many teeth did you included in each acidic treatment?

Results

-The authors show the images obtained by photographs and SEM. However, the explanation is in the Discussion section. Please edit.

Discussion

-This section is very poor. The results obtained must be discussed and compared with the relevant available literature.

- The authors have introduced in this section most of the results. Please edit. They must be included in the Results section

-Please introduce the limitations of the study in the Discussion section.

-Please describe the impact of the study results on clinical practice.

Conclusions

The conclusions must be concise according to the results obtained in the study.

References

-I miss more updated references

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Round 2

Reviewer 3 Report

Dear authors,

Thank you very much for your responses. Certainly, the paper has been improved.

However, some corrections and clarifications are still required

Please see list below.

Introduction:

-The authors have introduced the alternative hypothesis and not the null hypothesis. Please edit.

Material and Methods

-Please, introduce that it is a pilot study

Discussion

-The authors say that the the limitations of the study have been introduced in the Results-Discussion section. However, I have not found them. Perhaps, you have another version of the manuscript. Please, introduce this paragraph.

Author Response

Please see the attachment. 

Author Response File: Author Response.pdf