Comment on: Effect of immediate delayed loadings of dental implants on the oral health-related quality of life in Saudi population. Experimental clinical trial

To the Editor

I have read with interest the study “Effect of immediate versus delayed loadings of dental implants on the oral health-related quality of life in Saudi population. Experimental clinical trial.” The study was nicely done and shed some light on patient acceptance for dental implants and the way it impacts their lives. Since the introduction of dental implants as a treatment option to replace hopeless or missing teeth, the time needed to complete implant restoration has been a continuous challenge. As such, immediate loading has been suggested for qualifying cases to expedite the process from the implant placement until delivery of prosthetic component. Hence, this treatment option may improve the quality of life for patients where they do not have to live with a missing tooth for a longer period of time.

However, several points have tracked my attention while reading this paper:

• 1) As I mentioned earlier, this study focuses on a specific niche of dentistry which is dental implants. In my opinion, this study may have a bigger impact and wider range of readers if it was published in a dental journal in general and dental implants specifically.

• 2) Under material and methods, the author has indicated collecting clinical and demographic parameters for study subjects. However, these data were not reported or analyzed in the manuscript. Therefore, the category of this study may have to be a survey rather than an “experimental clinical research”.

• 3) Patient randomization and number of participations in each category are not equal and not sure if they have enough power to draw any statistical significance.

• 4) Even that the author has indicated this study to be a prospective one, they have indicated that some cases were not included due to the missing data. This issue in particular is linked to retrospective studies or chart review rather than a prospective one.

• 5) Major component of the study was implementation of quality of life questions. It is not clear if this questionnaire was adopted from previous studies (no reference included) or created by the author which has to be validated first.

In the end, there were few points if addressed, it could have improved the study outcome and readers acceptance. However, it still provides some data for dental practitioners who treat patients with need for dental implants to read carefully and rely on to improve dental care.

Reply from the Author

The following are my responses to the correspondence:

• 1) The reason for submitting this paper in the current journal is the inclusion of oral health-related quality of life, which cannot be published in a dental journal in general or dental implants. Also, the authors chose the Saudi Medical Journal in particular because our population in this study are Saudis, and the data is local, important, and relevant to this particular community.

• 2) The study cannot be considered as a survey study because we have collected data according to the inclusion of both control and CMMLI group.

• 3) The study has employed a prospective design. The study has included 8 patients in group I, whereas 16 patients were included in the Group II due to the availability and accessibility of the data. Also, we have already mentioned this reason in the manuscript.

• 4) The justification for missing values is already provided in the previous response. Also, the findings have reported significant differences for both groups; therefore, there is no need to consider the missing values.

• 5) Lastly, the questionnaire has been created by the author, which is also cited in the manuscript.

• Many thanks.

Maha A. Bahammam

Department of Periodontology King Abdulaziz University Jeddah, Kingdom of Saudi Arabia