A Comparison of Cone Beam Computed Tomography and Periapical Digital Radiography for Evaluation of Root Canal Preparation
Round 1
Reviewer 1 Report
General comments The manuscript entitiled "Evaluation of root canal preparation using cone beam com-2 puted tomography versus periapical digital radiograph" aimed to evaluate the agreement between the two 8 processing methods using periapical digital radiograph or CBCT in assessment of root canal preparation. It's a interesting and pratical topic which may reconsider the accessibility to CBCT due to expenses, time-consuming, and relatively high radiation exposure. The present result revealed that no significant difference in the evaluation of root canal preparation between CBCT and periapical digital radiograph in vitro study. Therefore, it implied that periapical films have the potential to check the transportation point accurately in clinical use. There are still some specific points need to be address. 1. This is a in vitro study which the direction and position of object (tooth root) and x-ray can be fixed (standardized), however, in clinical conditions, the supporting tissues around a tooth, x-ray film deformation in oral mouth and the x-ray cone direction may vary from the operators and cause distortion of the images. Thus, authors should mention or talk about this issue. 2. The degree of root curvatures may have different shaping and resulting images either from CBCT or from periapical film. How did authors take it into consideration? 3. Figure 2 CBCT image showed the blurred outline, did authors do any image filtation and mediation? Seems 0.075 should present clearer image. 4. Again, if the resulting CBCT image showed blurr outlines, how could authors define the distance from two "points" definitely? 5. In this study, only one examiner to calculate the distance, I would recommend to perform by a single/double-blind exam which help to evaluate the correlations.
Author Response
Dear Reviewers,
Thank you so much for your comments.
The followings are my responses to your comments.
Reviewer 1
General comments:
The manuscript entitled "Evaluation of root canal preparation using cone beam computed tomography versus periapical digital radiograph" aimed to evaluate the agreement between the two processing methods using periapical digital radiograph or CBCT in assessment of root canal preparation. It is an interesting and practical topic which may reconsider the accessibility to CBCT due to expenses, time-consuming, and relatively high radiation exposure. The present result revealed that no significant difference in the evaluation of root canal preparation between CBCT and periapical digital radiograph in vitro study. Therefore, it implied that periapical films have the potential to check the transportation point accurately in clinical use. There are still some specific points need to be address.
Thank you so much for your comments.
- This is an in vitro study which the direction and position of object (tooth root) and x-ray can be fixed (standardized), however, in clinical conditions, the supporting tissues around a tooth, x-ray film deformation in oral mouth and the x-ray cone direction may vary from the operators and cause distortion of the images. Thus, authors should mention or talk about this issue.
Yes. I have mentioned these points at the end of the Discussion section.
- The degree of root curvatures may have different shaping and resulting images either from CBCT or from periapical film. How did authors take it into consideration?
Yes. I have mentioned this point in the Methods section. I have used the Schneider method for determination of root canal curvatures.
- Figure 2 CBCT image showed the blurred outline, did authors do any image filtration and mediation? Seems 0.075 should present clearer image.
Yes. I have used the voxel size of 0.075 mm for clearest image. Although the image is still blurred outline, the points could be defined appropriately. I have not used any mediations or filtration but the enhanced contrast tool of the software.
- Again, if the resulting CBCT image showed blurred outlines, how could authors define the distance from two "points" definitely?
The points first are defined carefully and then the distance is automatically appeared on the screen. In case of difficult in finding the shortest distance, three positions were chosen and the shortest distance was chosen.
- In this study, only one examiner to calculate the distance, I would recommend performing by a single/double-blind exam which help to evaluate the correlations.
Thank you for your recommendation. This is a single-blind exam because the examiner does not know which technique used for root canal preparation.
Author Response File: 
Author Response.docx
Reviewer 2 Report
The of publication of this paper is timely but report of gathered data should be significantly altered and paper be resubmitted before it is published.
I took the liberty to alter the title (A caparison of cone beam computed tomography and periapical digital radiography for evaluation of root canal preparation) and give an example of narrative alterations using the opening sentences of the abstract (below) - to make a point.
........ the aim of the present study is to compare cone beam computed tomography and periapical digital radiography for evaluation of root canal preparation. Nine extracted human molars were used in this study. Following access cavity preparation, mesio-buccal roots of maxillary and mesial roots of mandibular molars were prepared and the remaining roots were cut off. Three amalgam cavities were prepared on the coronal part on the teeth and filled with amalgam to be used as landmarks. Specimens were scanned using cone-beam computed tomography and periapical digital radiograph images were obtained before and after root canal preparation......
Author Response
Dear Reviewers,
Thank you so much for your comments.
The followings are my responses to your comments.
Reviewer 2
The of publication of this paper is timely but report of gathered data should be significantly altered and paper be resubmitted before it is published.
I took the liberty to alter the title (A comparison of cone beam computed tomography and periapical digital radiography for evaluation of root canal preparation) and give an example of narrative alterations using the opening sentences of the abstract (below) - to make a point.
........ the aim of the present study is to compare cone beam computed tomography and periapical digital radiography for evaluation of root canal preparation. Nine extracted human molars were used in this study. Following access cavity preparation, mesio-buccal roots of maxillary and mesial roots of mandibular molars were prepared and the remaining roots were cut off. Three amalgam cavities were prepared on the coronal part on the teeth and filled with amalgam to be used as landmarks. Specimens were scanned using cone-beam computed tomography and periapical digital radiograph images were obtained before and after root canal preparation......
Yes. I have changed the Title as your recommendation.
I have revised the sentences for easier understanding. The manuscript is reviewed by a native English speaker.
Author Response File: Author Response.docx
Reviewer 3 Report
In introduction it is appropriate to consider the clinical value of the research and expand the bibliography.
Line 50 insert in the sentence the limitations of cone beam use e.g. DOI 10.3390/dj8020051 and highlights the indication of its execution in specific clinical situations e.g. DOI 10.1155/2018/2514243
In figure 4 the computer desktop is visible.
lines 177 179 192 -metods'- Delete the apostrophe
In accordance with the title, in the Discussion it is necessary to describe more analytically the results obtained.
Author Response
Dear Reviewers,
Thank you so much for your comments.
The followings are my responses to your comments.
Reviewer 3
In introduction it is appropriate to consider the clinical value of the research and expand the bibliography.
Yes. I have added more bibliographies into the Introduction section.
Line 50 insert in the sentence the limitations of cone beam use e.g., DOI 10.3390/dj8020051 and highlights the indication of its execution in specific clinical situations e.g., DOI 10.1155/2018/2514243
Yes. I have used these two references in the Line 50.
In figure 4 the computer desktop is visible.
Yes, I have adjusted the image.
Lines 177 179 192 - methods' - Delete the apostrophe
Yes. I have deleted the apostrophe.
In accordance with the title, in the Discussion it is necessary to describe more analytically the results obtained.
Yes. I have added more sentences into the Discussion section.
Author Response File: Author Response.docx
Reviewer 4 Report
The work is well done , need to carry out in vivo comparisions.
Author Response
Dear Reviewers,
Thank you so much for your comments.
The followings are my responses to your comments.
Reviewer 4
The work is well done, need to carry out in vivo comparisons.
Thank you so much for your comment.
Author Response File: Author Response.docx
