Computer-Guided Surgery for Dental Implant Placement: A Systematic Review

Round 1

Reviewer 1 Report

In general, I do not like to evaluate together static and dynamic surgery. They are completely different between them. They are not different outcomes but different interventions (PICOS). I suggest to rewrite the review without considering navigation surgery. Moreover, this review without meta analysis is a no sense. Maybe, you can consider this paper as a "Narrative review". I defer to the editor.

INTRODUCTION

In general the introduction is too long and not focalized on the main topic of this review. For example, lines from 69 to 76, and 81-83 could be removed. Moreover, I would like a bit more scientific language.

Reference 2 is not appropriated. For example, you can use one of the follows or both:

Tallarico, M. & Meloni, S. Retrospective Analysis on Survival Rate, Template-Related Complications, and Prevalence of Peri-implantitis of 694 Anodized Implants Placed Using Computer-Guided Surgery: Results Between 1 and 10 Years of Follow-Up. The International journal of oral & maxillofacial implants 32, 1162–1171 (2017).

Tallarico, M., Meloni, S. M., Canullo, L., Caneva, M. & Polizzi, G. Five-Year Results of a Randomized Controlled Trial Comparing Patients Rehabilitated with Immediately Loaded Maxillary Cross-Arch Fixed Dental Prosthesis Supported by Four or Six Implants Placed Using Guided Surgery. Clinical Implant Dentistry and Related Research 18, 965–972 (2016).

Lines 48-50 can be reduced in just one sentence.

Lines 52-54 "Static guided surgery ... which can be used to support...". I thin this is a typing error. Guided surgery the template can not be used to support but it is supported by...

MATERIALS AND METHODS

Lines 105-106 "This systematic review has been prepared according to the PRISMA 105 guidelines [16]." must to be reported at the beginning of the materials and methods.

The SEARCH STRATEGY (string) must to be more detailed. For example, applying the restrictions (RCT, CCT, English and Spanish languages) I found 35 manuscript. Without restriction 459.

Lines 97-98. Prospective and retrospective study should be included if with control group. I mean, you should replace it with cohort study.

In the criteria the authors report "using a tooth-supported guide". What about dynamic guided surgery?

In the materials and methods, the authors must to report the planned analysis. In the result section, the results. Any discussion in the appropriate section. Planned methods and analysis must to be rewritten. Lines 135 to 139 must to be moved in the results/discussion section.

Did the authors require missing data to the authors?

Quality of evidence, line 148, "two different outcomes". There are not two different outcomes, but they are two different intervention. As I wrote in my general comment, this is very complicated. I suggest to follow the inclusion criteria and only consider the static guided surgery.

Most of the discussion must to be moved in the result section. In the result section, the authors must to report data of the included manuscript, according to the outcomes. Please follow the PRISMA guidelines and provide the check list.

Discussion must to be reduced (moving most of the initial part in the result section, and avoiding bullet list in this section.

Conclusions must to be shortened. 

Author Response

Dear reviewer, thank you very much for your quick response and great comments about our work. We have made the corrections that you indicated. Change tracking is active in Word so you can see the changes made. We also attach in bold the response to the comments that you attached to us. Thank you very much for your attention and we remain at your disposal in case you have any additional suggestions about our work.

In general, I do not like to evaluate together static and dynamic surgery. They are completely different between them. They are not different outcomes but different interventions (PICOS). I suggest to rewrite the review without considering navigation surgery. Moreover, this review without meta analysis is a no sense. Maybe, you can consider this paper as a "Narrative review". I defer to the editor.

Static and dynamic guided surgery as well as freehand implant placement constitute, in the opinion of the authors, different ways of performing the same intervention (dental implant placement). We have tried to compare the placement of dental implants (INTERVENTION) with three different types of surgery (COMPARISON): static guided surgery, dynamic guided surgery and freehand surgery. With this we have tried to evaluate the different results obtained with these procedures. The authors consider that eliminating dynamic guided surgery from this work reduces its quality, so we do not consider its elimination. On the other hand, a systematic review is the orderly and explicit evaluation of the literature based on a clear research question, together with a critical analysis according to different tools and a qualitative summary of the evidence. For this reason, the authors consider that this work meets the requirements to be called a systematic review since it meets the defining criteria and, in addition, follows the PRISMA guidelines. In any case, we leave it up to the editor to call our work Systematic Review or Narrative Review.

Translation to English has been performed by Central Languages Service of our institution by a certified translator (Elena Patricia Hernández Rivero).

INTRODUCTION

In general the introduction is too long and not focalized on the main topic of this review. For example, lines from 69 to 76, and 81-83 could be removed. Moreover, I would like a bit more scientific language.

Lines 69-76 have been removed.

Lines 81-83 are secondary objectives of this paper so the authors think removing them reduces the quality of work.

Reference 2 is not appropriated. For example, you can use one of the follows or both:

Tallarico, M. & Meloni, S. Retrospective Analysis on Survival Rate, Template-Related Complications, and Prevalence of Peri-implantitis of 694 Anodized Implants Placed Using Computer-Guided Surgery: Results Between 1 and 10 Years of Follow-Up. The International journal of oral & maxillofacial implants 32, 1162–1171 (2017).

Tallarico, M., Meloni, S. M., Canullo, L., Caneva, M. & Polizzi, G. Five-Year Results of a Randomized Controlled Trial Comparing Patients Rehabilitated with Immediately Loaded Maxillary Cross-Arch Fixed Dental Prosthesis Supported by Four or Six Implants Placed Using Guided Surgery. Clinical Implant Dentistry and Related Research 18, 965–972 (2016).

We added the first reference

Lines 48-50 can be reduced in just one sentence.

Done

Lines 52-54 "Static guided surgery ... which can be used to support...". I thin this is a typing error. Guided surgery the template can not be used to support but it is supported by...

It was a mistake, it has been changed

MATERIALS AND METHODS

Lines 105-106 "This systematic review has been prepared according to the PRISMA 105 guidelines [16]." must to be reported at the beginning of the materials and methods.

Changed

The SEARCH STRATEGY (string) must to be more detailed. For example, applying the restrictions (RCT, CCT, English and Spanish languages) I found 35 manuscript. Without restriction 459.

We do not apply the restrictions directly in the search since we consider that there may be articles that meet the criteria but may be erroneously classified by their metadata in the database, therefore we do the general search without filters (if the number of articles that appear is affordable) and from those items that come out we select those that meet our inclusion criteria. In this way we reduce the risk of losing jobs that are not properly classified. The last search was made in July 2021 so many new articles may have been published.

Lines 97-98. Prospective and retrospective study should be included if with control group. I mean, you should replace it with cohort study.

We only included clinical trials.

In the criteria the authors report "using a tooth-supported guide". What about dynamic guided surgery?

This has been corrected, because the criteria was that guided surgery was used, not a guide.

In the materials and methods, the authors must to report the planned analysis. In the result section, the results. Any discussion in the appropriate section. Planned methods and analysis must to be rewritten. Lines 135 to 139 must to be moved in the results/discussion section.

We have rewritten those lines

Did the authors require missing data to the authors?

Yes, if there were missing data the authors were contacted to obtain them, the problem was that in most cases we never obtained a response from the authors.

Quality of evidence, line 148, "two different outcomes". There are not two different outcomes, but they are two different intervention. As I wrote in my general comment, this is very complicated. I suggest to follow the inclusion criteria and only consider the static guided surgery.

The word was mistaken, the correct word is “comparisons” this has been corrected.

Most of the discussion must to be moved in the result section. In the result section, the authors must to report data of the included manuscript, according to the outcomes. Please follow the PRISMA guidelines and provide the check list.

Discussion must to be reduced (moving most of the initial part in the result section, and avoiding bullet list in this section.

We have moved the initial part of the discussion to the results section.

We made a list in this section because we considered that it would make it more understandable and visible. We have removed the bullet list in the discussion.

PRISMA guidelines have been followed throughout all the paper.

Conclusions must to be shortened. 

Conclusions are according to objectives.

 

Reviewer 2 Report

This is well written article that synthesises the available literature to confirm the benefits of guided implant placement. 

The structure and logical presentation made this an easy paper to read and assimilate the data. I could not detect any spelling or grammatical errors. This is a minor comment, but lines 69-73 are a repetition of the basic point that implants need to be placed accurately , which is an accepted principle. While it doesn't detract from the paper those three sentences do not add very much and could be removed or reduced.  

Comments for author File: Comments.pdf

Author Response

Dear reviewer, thank you very much for your quick response and great comments about our work. We have made the corrections that you indicated. Change tracking is active in Word so you can see the changes made. We also attach in bold the response to the comments that you attached to us. Thank you very much for your attention and we remain at your disposal in case you have any additional suggestions about our work

This is well written article that synthesises the available literature to confirm the benefits of guided implant placement. 

The structure and logical presentation made this an easy paper to read and assimilate the data. I could not detect any spelling or grammatical errors. This is a minor comment, but lines 69-73 are a repetition of the basic point that implants need to be placed accurately , which is an accepted principle. While it doesn't detract from the paper those three sentences do not add very much and could be removed or reduced.  

Lines 69-73 have been removed.

 

Round 2

Reviewer 1 Report

Dear author, thanks to provide a revisited version, with several improvements.