Evaluation for the efficacy of haemocoagulase agent (botroclot) as a pulpotomy material as compared to ferric sulfate- an animal study.

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Grossly carious primary teeth should be restored and maintained which is the primary objective of “Pediatric dentistry”. Pulpotomy is done in the primary teeth where mechanical pulp exposure occurs during caries removal. All the functions of the radicular pulp are expected to be maintained by pulpotomy procedure. The main objectives are 1) managing reversible pulpal inflammation and keeping pulp in a vital condition. 2) maintain the function of the radicular pulp in deciduous teeth. Success of Pulpotomy procedure is dependent on many factors, and the ability of the pulpotomy medicament being hemostatic is one of the most vital factors to maintain the vitality of the radicular pulp. Considering the limitations of commonly used pulpotomy medicaments for primary teeth i.e. Formocresol and also the disadvantages associated with the hemostatic Ferric sulfate, the present study will be carried out using hemocoagulase (“botroclot”) which has shown improved hemocoagulant properties in the medical field and for healing the extraction socket wounds. The available solution of hemocoagulase agent converted in suitable Gel form will be tested for its tissue compatibility and hemocoagulant efficacy when used as pulpotomy material . The study will be conducted in two phases, I) Formulation of the gel and in vitro tests; II) Animal study to check histopathological effect on the pulp tissue as a pulpotomy agent." } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/13-48/v1", "name": "Evaluation for the efficacy of haemocoagulase agent (botroclot) as..." } } ] } Home Browse Evaluation for the efficacy of haemocoagulase agent (botroclot) as... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Karkare S and Thosar N. Evaluation for the efficacy of haemocoagulase agent (botroclot) as a pulpotomy material as compared to ferric sulfate- an animal study. [version 1; peer review: 1 approved with reservations] . F1000Research 2024, 13 :48 ( https://doi.org/10.12688/f1000research.134454.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol Evaluation for the efficacy of haemocoagulase agent (botroclot) as a pulpotomy material as compared to ferric sulfate- an animal study. [version 1; peer review: 1 approved with reservations] Swati Karkare https://orcid.org/0000-0001-8013-2609 1 , Nilima Thosar 1 Swati Karkare https://orcid.org/0000-0001-8013-2609 1 , Nilima Thosar 1 PUBLISHED 08 Jan 2024 Author details Author details 1 Pedodontics and Preventive Dentistry, DMIHER, Wardha, Maharashtra, India Swati Karkare Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Nilima Thosar Roles: Conceptualization, Project Administration, Supervision, Validation OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Deciduous teeth are thought to be best space maintainers; thus efforts are made to preserve these teeth for as long as possible. Grossly carious primary teeth should be restored and maintained which is the primary objective of “Pediatric dentistry”. Pulpotomy is done in the primary teeth where mechanical pulp exposure occurs during caries removal. All the functions of the radicular pulp are expected to be maintained by pulpotomy procedure. The main objectives are 1) managing reversible pulpal inflammation and keeping pulp in a vital condition. 2) maintain the function of the radicular pulp in deciduous teeth. Success of Pulpotomy procedure is dependent on many factors, and the ability of the pulpotomy medicament being hemostatic is one of the most vital factors to maintain the vitality of the radicular pulp. Considering the limitations of commonly used pulpotomy medicaments for primary teeth i.e. Formocresol and also the disadvantages associated with the hemostatic Ferric sulfate, the present study will be carried out using hemocoagulase (“botroclot”) which has shown improved hemocoagulant properties in the medical field and for healing the extraction socket wounds. The available solution of hemocoagulase agent converted in suitable Gel form will be tested for its tissue compatibility and hemocoagulant efficacy when used as pulpotomy material . The study will be conducted in two phases, I) Formulation of the gel and in vitro tests; II) Animal study to check histopathological effect on the pulp tissue as a pulpotomy agent. READ ALL READ LESS Keywords Pulpotomy, Primary Teeth, Ferric Sulfate, Hemocoagulase agent, Botroclot Corresponding Author(s) Swati Karkare ( [email protected] ) Close Corresponding author: Swati Karkare Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 Karkare S and Thosar N. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Karkare S and Thosar N. Evaluation for the efficacy of haemocoagulase agent (botroclot) as a pulpotomy material as compared to ferric sulfate- an animal study. [version 1; peer review: 1 approved with reservations] . F1000Research 2024, 13 :48 ( https://doi.org/10.12688/f1000research.134454.1 ) First published: 08 Jan 2024, 13 :48 ( https://doi.org/10.12688/f1000research.134454.1 ) Latest published: 08 Jan 2024, 13 :48 ( https://doi.org/10.12688/f1000research.134454.1 ) Introduction Deciduous teeth are thought to be best space maintainers; thus, efforts are made to preserve these teeth for as long as possible. Grossly carious primary teeth should be restored and maintained which is the primary objective of “Paediatric dentistry”. During cavity preparation mechanical exposure may occur frequently. The choice of a direct pulp covering material has been controversial when optimum pulp healing is considered. Haemorrhage control must be achieved before any pulp capping procedure. 1 – 3 All procedures are more important for maintaining pulp vitality. Many studies have shown that pulp healing is most compromised by uncontrolled bleeding. Sterile cotton pellet can be compressed on the exposure site until haemostasis occurs is the most common accepted clinical technique. Sometimes using cotton pellets soaked in sterile saline or other materials is also suggested. Other substitutes such as electro surgery or laser irradiations are not shown to be successful. 1 – 6 Pulpotomy A pulpotomy is a dental procedure that treats grossly carious primary teeth in children. This type of procedure is carried out when tooth decay reaches the pulp or there is mechanical exposure while cavity cutting. During a pulpotomy, the coronal pulp is removed and the pulp in the root canal is left intact. 1 – 3 , 6 All the functions of the radicular pulp are expected to be maintained by the pulpotomy procedure. The main objectives are managing reversible pulpal inflammation and keeping pulp in vital condition as well as maintaining the function of the radicular pulp in deciduous teeth. Many situations such as blood supply, amount of inflammation, hemorrhage control, exposure site disinfection, antibacterial efficacy and tissue compatibility of pulp covering materials and final restoration may affect the success of the procedure. 4 The most important factor in success is maintaining the vital radicular pulp. Several materials have been used in deciduous teeth, Ferric sulphate being one hemocoagulant material tried and compared with other materials. 4 Choosing the appropriate Pulpotomy agent is crucial. Ideal properties of pulpotomy material are as follows 5 • The material should be anti-bacterial, innocuous to pulp and surrounding structures. • The material should be able to cause advance repair of remaining pulp without interfering with the natural root resorption. • The material should not be toxic to pulp tissues. Ferric sulfate and haemocoagulase (botroclot) Ferric sulphate is extensively used in dentistry as a haemostatic agent (Astringent). It was primarily used in pulpotomy as an aid to haemostasis prior to the placement of calcium hydroxide . However, as an independent therapeutic agent, ferric sulphate pulpotomy has a success rate of 74–99%. Ferric sulphate is thought to react with the pulp tissue, forming a superficial protective layer of iron–protein complex. 2 , 3 Ferric Sulfate (FS) has agglutination effects due to a reaction between the blood in the pulp. 1 This reaction results in plugs that occlude the capillaries, thus control the bleeding. However, a common side effect of Ferric sulfate is chronic pulpal degradation, which can result in premature exfoliation of the pulpotomized tooth. Some studies have documented internal root resorption after FS pulpotomy. 2 Botroclot is a marketed preparation containing hemocoagulase, which is an enzyme having coagulant activity, isolated from the snake botrops atrox. This formulation is used in dental surgeries and other minor surgical wounds. A commercially available hemocoagulant “botroclot” is used widely in Medicine for the stoppage of hemorrhage at wound sites. In dentistry it has been tested at extraction sites of third molars for its efficacy and compared histopathologically for its effects. 3 A very small part of snake venom acquired from the snake found in Brazil “Bothrops-jararaca” or atrox which is a nontoxic systemic hemocoagulant (Botroclot). Available everywhere by various names such as Botroxobin which is a WHO accepted outcome and Botropase is a parenteral procoagulant. The formulation of “hemocoagulase agent (botroclot)” as a local application solution and its composition is (a) an aqueous mix of hemocoagulase extracted from “Bothrops atrox” or “Bothrops jararaca” 0.2 Cu/ml. (b) as a preservative “Chlorhexidine” 0.1% v/v and (c) for injection IPq.s water, as instructed in the composition booklet of the available solution bottle. The blood clotting properties of hemocoagulase are multifaceted. The creation of fibrin monomers is hastened, then it accelerates fibrin clot creation. It triggers Xa factor and thrombin is formed at the hemorrhage site. Its action on Factor XIIIa brings about stabilization of fibrin. Articles have proposed that this parenteral formulation performs as a prohealer, epithelization is enhanced, escalates lesion tensile strength and brings collagen in the curing of the lesion too. 6 Pulpotomy success is dependent on many factors, and the ability of the pulpotomy medicament being hemostatic is one of the most vital factors to improve success. Considering the limitations of commonly used pulpotomy medicaments for primary teeth i.e. Formocresol and the disadvantages associated with the hemostatic Ferric sulfate, a present study has thought of using hemocoagulase (“botroclot”) which has shown improved hemocoagulant properties in medical field and for healing of extraction socket wounds. 6 Rationale Internal resorption and furcation radiolucency was seen in pulpotomies performed with Ferric sulfate. 7 Also the exact amount of the medicament to be placed in the pulp chamber cannot be standardized with presently available Ferric sulfate as it is available in solution form and it can be used with a cotton pellet dipped in it, where one can not quantify it. To overcome the short falls of these hemostatic pulpotomy agent, Hemocoagulase agent (“botroclot”) needs to be tested and verified as better hemostatic pulpotomy material in gel form for primary teeth. Hemocoagulase agent (“botroclot”) has not been tried as a pulp therapy material either in primary or permanent teeth and its effect on the pulpal tissue has not been verified. It is a readily available, economic medicament that has been proved as a Heamocoagulant in other surgical fields needs to be tested in the concentration that is readily available or if it needs to be modified to make it suitable for Dental use as Pulpotomy agent. Research gap and scarce existing literature Ferric sulfate is tested as a pulpotomy material as it shows hemostatic qualities. It produces a metal protein mass at the pulp surface that acts as a barricade to irritating constituents of the sub-base. Although Ferric sulfate pulpotomies exhibited superior clinical success rates, it may show moderate to severe inflammatory changes histologically as shown in studies. 8 Ferric sulfate and laser have been tested for conservative pulp therapy to assess and histological changes were compared in the pulp. 9 It was found that the materials produced significant extraneous body and cell reactions that are inflammatory in the pulpal tissue. At 45 days follow up of all the samples, two models of laser group showed severe necrosis. Lasers are not cost effective and there is no control on penetration of the laser, which may lead to destruction of normal tissue along with the affected tissue. 9 Modern developments in dentistry are searching for more biocompatible and effective materials as the best medicament for primary teeth pulpotomies. There is limited scientific evidence which can illustrate the comparative efficacy of botroclot versus Ferric sulfate as an effective pulpotomy material. The present proposed research will be implemented to assess the efficacy of these two agents as pulpotomy materials. The available solution of hemocoagulase agent (“botroclot”) needs to be tested for its tissue compatibility and hemocoagulant efficacy when used as pulpotomy material specially for deciduous teeth in a more suitable form to be used as chairside. Aims To formulate haemocoagulase gel from botroclot solution and in vitro evaluation of pH, stability and adhesion of the new formulated gel. To evaluate efficacy of hemocoagulase agent (“boteroclot”) compared to ferric sulfate histologically in rats molars. Objectives 1. To evaluate the haemocoagulase gel for its pH, stability and adhesion by in vitro method in Phase I. 2. To evaluate histologically, the efficacy of hemocoagulase agent (“botroclot”) and “ferric sulfate” at 24 hours, 7 days, 15 days and 30 days in rat molars in Phase II. 3. To compare histologically, efficacy of hemocoagulase agent (“botroclot”) and “ferric sulfate” at 24 hours, 7 days, 15 days and 30 days in rat molars in Phase II. Research Question Phase I: Is hemocoagulase agent (“botroclot”) effective and has favorable reaction on the rat molar pulp? Phase II: Is hemocoagulase agent (“botroclot”) effective and superior as pulpotomy material compared to ferric sulfate in human primary molars? Protocol Methods Study materials Suitable consistency material (gel) from readily available haemocoagulase agent (botroclot) solution will be formulated. The preparation will be carried out in the research laboratory using Hydroxypropyl methylcellulose (HPMC) as excipient to change the consistency of the solution to gel. Formulation of gel – Phase I The weight quantity of HPMC will be dispersed accurately in purified water at 50° C. After that, 50 ml of haemocoagulase “botroclot” will be added and the mixture will be stirred continuously at a constant rate to form a uniform gel. 10 In vitro tests of the prepared gel will be performed as follows. 11 1. pH: The pH of the sample will be measured by using a pH meter calibrated at pH 7 and pH 4. 2. Viscosity: Viscosity of the sample will be measured by using a Brookfield viscometer, spindle no. 64 at 50rpm for HPMC gel at 24°C. 3. Adhesive strength test: i. The bio adhesive test will be performed by using a modified two arm balance method. ii. 0.5 gm of gel will be placed on the upper side of a lower plate which is fixed to base. iii. Then the upper plate will be placed over lower plate and upper plate will be stuck to one side of the balance. iv. 100 gm of preload (contact pressure) will be applied for 5 minutes. v. After removal of preload, weight will be added continuously in other side of the weighing balance till the plates will be detached from each other. vi. The weight required for the detachment of the glass plate will be considered as a bio adhesion force of applied gel. Dose calculation 1 ml haemocoagulase solution will be equivalent to 0.2 CU (Clotting Unit) About 5 drops used for hemcoagulase action. 1 drop = 0.06 ml, 5 drops = 0.3 ml 0.3 ml = 0.06 CU. and 0.6 ml = 0.12 CU The prepared gel formulation will have 50 ml of hemocoagulase solution. Upon adding HPMC, the weight of the gel would be around 55 gm (55 gm = 10 CU). To have effective hemocoagulase action, 0.5 mg to 1gm of gel will be used in the study. Comparison with other material Phase II Animal studies will be carried out with the newly developed material and it will be compared with ferric sulfate. The animals will be anesthetized and the pulpotomy procedure will be carried out in two molars of each rat under aseptic conditions. High speed handpiece will be used to access pulp chamber in maxillary and mandibular first molar. Upon pulp extirpation, haemocoagulase agent botroclot and ferric sulfate will be placed in teeth of the rats as per groups. Tissue reaction will be checked by histopathological evaluation at 24 hours, 7 days, 15 days and 30 days. Sources of the data The Albino Wistar rats to be studied will be selected from the “Animal House, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra”. For animal study, total 32 albino Wistar rats having weight 200 – 300 grams will be chosen randomly. All the animals will be divided in 2 groups and each group will have 16 animals. Methods of collection of data 1. In vitro evaluation of haemocoagulase agent (Botroclot) for pH, viscosity, adhesion and clotting. 2. In vivo pulp tissue reaction evaluation in rats by histopathological evaluation. Grouping of animals and methodology There will be two groups for animal trials which are as follows: Group A – Hemocoagulase agent “(botroclot)” preparation group (Test group). Group B – Ferric sulfate group. The animals will be cared as per CPCSA guidelines of ‘Animal Ethical Committee’. Pulp tissue reaction to the pulpotomy materials will be assessed by in vivo and in vitro methods. The follow up period will be 24 hours, 7 days, 15 days and 30 days. The teeth will be extracted at these intervals and histopathological assessment of the pulp tissue will be done. Statistical analysis The data will be subjected to a statistical analysis by using “Student t test” by using SPSS version 21.0 “(SPSS. Inc., Chicago, IL, USA)” with a p value set at 0.05. The statistical analysis of preclinical study results will be done using Two way “ANOVA”, Student’s paired “t-test”, Unpaired t-test, Multiple Comparison: Tukey test and Kruksal-Wallis test. A proprietary free software alternative is R or PSPP. Dissemination Hemocoagulase agent (botroclot) in a newer form which may exhibit good coagulant efficacy and can be utilized as a “pulpotomy” material for primary teeth. Based on clinical experiences, topical hemocoagulase may be an effective haemostatic agent after tooth extraction procedures including pulpotomy, which also reduces pain, swelling and improves wound healing. However, more clinical trials are required to explore the benefits of topical hemocoagulase solution in various dental procedures. The hemocoagulase may be equally beneficial as a local haemostatic agent compared to other chemical haemostatic agents like ferric sulfate. The other effective agent that is ferric sulfate is a commonly used astringent solution that has multiple uses in dentistry. It is widely used in dentistry as haemostatic agent. However, the evidence about its comparative effectiveness with heamogoacgulase as haemostatic agent in pulpotomy procedure has not been widely illustrated in the existing literature. Study status Animal study on going in vitro component completed. Ethical considerations The research Protocol is approved by institutional animal ethics committee of the respective institute . The approval number is DMIMS/IAEC/2020-21/41. Data availability Underlying data No data is associated with this article. References 1. Bandi M, Mallineni SK, Nuvvula S: Clinical applications of ferric sulfate in dentistry: A narrative review. J. Conserv. Dent. 2017; 20 (4): 278–281. PubMed Abstract | Publisher Full Text 2. Abirami K, Ramkumar H, Senthil D: Clinical and Radiographic Evaluation of the Efficacy of Formocresol, Allium sativum Oil, and Aloe barbadensis Gel as Pulpotomy Medicaments in Primary Molars: A Randomized Controlled Trial. Int. J. Clin. Pediatr. Dent. 2020 Oct; 13 (5): 518–522. PubMed Abstract | Publisher Full Text 3. Gupta G, Muthusekhar RM, Kumar SP: Efficacy of Hemocoagulase as a Topical Hemostatic Agent After Dental Extractions: A Systematic Review. Cureus. 2018 Mar 30; 10 (3): e2398. PubMed Abstract | Publisher Full Text 4. Olczak-Kowalczyk D, Samul M, Góra J, et al. : Ferric Sulfate and Formocresol pulpotomies in paediatric dental practice. A prospective-retrospective study. Eur. J. Paediatr. Dent. 2019 Mar; 20 (1): 27–32. PubMed Abstract | Publisher Full Text 5. Taha NA, Abdelkhader SZ: Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis. Int. Endod. J. 2018 Aug; 51 (8): 819–828. PubMed Abstract | Publisher Full Text 6. Shenoy K. V, Baliga M, Mahajan S, et al. : The Effects of Topical Hemocoagulase Solution on the Healing Process of Post-extraction Wounds: A Split Mouth Design. J. Maxillofac. Oral Surg. 2015 Sep; 14 (3): 586–593. PubMed Abstract | Publisher Full Text | Free Full Text 7. Smaïl-Faugeron V, Glenny AM, Courson F, et al. : Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst. Rev. 2018 May 31; 2018 : CD003220. Publisher Full Text 8. Sirohi K, Marwaha M, Gupta A, et al. : Comparison of Clinical and Radiographic Success Rates of Pulpotomy in Primary Molars using Ferric Sulfate and Bioactive Tricalcium Silicate Cement: An in vivo Study. Int. J. Clin. Pediatr. Dent. 2017 Jun; 10 (2): 147–151. PubMed Abstract | Publisher Full Text 9. Sivadas S, Rao A, Natarajan S, et al. : Pulpal Response to Ferric Sulfate and Diode Laser When Used as Pulpotomy Agent: An in vivo Study. J. Clin. Diagn. Res. 2017 Jun; 11 (6): ZC87–ZC91. PubMed Abstract | Publisher Full Text 10. Roy BG: Hydroxy Propyl Methyl Cellulose: Different Aspects in Drug Delivery. J. Pharm. Pharmacol. 2016 Aug 3; 4 : 381–385. Publisher Full Text 11. Singh S, Parhi R, Garg A: Formulation of topical bioadhesive gel of aceclofenac using 3-level factorial design. Iran. J. Pharm. Res. 2011; 10 (3): 435–445. PubMed Abstract Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 08 Jan 2024 ADD YOUR COMMENT Comment Author details Author details 1 Pedodontics and Preventive Dentistry, DMIHER, Wardha, Maharashtra, India Swati Karkare Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Nilima Thosar Roles: Conceptualization, Project Administration, Supervision, Validation Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 08 Jan 2024, 13:48 https://doi.org/10.12688/f1000research.134454.1 Copyright © 2024 Karkare S and Thosar N. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Karkare S and Thosar N. Evaluation for the efficacy of haemocoagulase agent (botroclot) as a pulpotomy material as compared to ferric sulfate- an animal study. [version 1; peer review: 1 approved with reservations] . F1000Research 2024, 13 :48 ( https://doi.org/10.12688/f1000research.134454.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 08 Jan 2024 Views 0 Cite How to cite this report: Singhal R. Reviewer Report For: Evaluation for the efficacy of haemocoagulase agent (botroclot) as a pulpotomy material as compared to ferric sulfate- an animal study. [version 1; peer review: 1 approved with reservations] . F1000Research 2024, 13 :48 ( https://doi.org/10.5256/f1000research.147510.r245723 ) The direct URL for this report is: https://f1000research.com/articles/13-48/v1#referee-response-245723 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 02 Sep 2024 Ruchi Singhal , PGIDS, Rohtak, India Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.147510.r245723 The present manuscript needs changes grammatically and at many places need rephrasing of sentences. Introduction: Instead of writing grossly carious, authors should use the term teeth which are pulpally involved. Authors have mentioned, "However, ... Continue reading READ ALL The present manuscript needs changes grammatically and at many places need rephrasing of sentences. Introduction: Instead of writing grossly carious, authors should use the term teeth which are pulpally involved. Authors have mentioned, "However, a common side effect of Ferric sulfate is chronic pulpal degradation, which can result in premature exfoliation of the pulpotomized tooth." Provide reference Dose calculation: How the dose was calculated. Any standard criteria or reference In phase II, it was mentioned that Tissue reaction will be checked by histopathological evaluation at 24 hours, 7 days, 15 days and 30 days. At what duration after pulpotomy, the tooth was extracted..clearly describe in detail. Is the rationale for, and objectives of, the study clearly described? Partly Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Pediatric Dentistry with special focus on preventive aspect and traumatology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Singhal R. Reviewer Report For: Evaluation for the efficacy of haemocoagulase agent (botroclot) as a pulpotomy material as compared to ferric sulfate- an animal study. [version 1; peer review: 1 approved with reservations] . F1000Research 2024, 13 :48 ( https://doi.org/10.5256/f1000research.147510.r245723 ) The direct URL for this report is: https://f1000research.com/articles/13-48/v1#referee-response-245723 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 26 Sep 2024 Dr. Swati Karkare , $usrAffiliation 26 Sep 2024 Author Response Answering to the comments by the reviewer as the main Author. 1) The term "Grossly carious " is used since pulpotomy is not indicated in teeth where the carious process ... Continue reading Answering to the comments by the reviewer as the main Author. 1) The term "Grossly carious " is used since pulpotomy is not indicated in teeth where the carious process has already involved the pulp. In that case one has to carry out Pulpectomy as one can not confirm the involvement of pulp damage if restricted to only coronal portion of the pulp. Very commonly, in grossly carious tooth, while doing excavation if the pulp is exposed traumatically, then Pulpotomy procedure is carried out. 2) The reference to the sentence is at the end of the last sentence of the paragraph, which is reference number 2. 3) Dose calculation is done as per Pharmaceutical guidelines where the solution of Botroclot was mixed with HPMC and at three different concentrations the efficacy was tested. 4) The tissue reaction was checked after extracting the teeth at 24 hr, 7 days, 15 days and 30 days post Pulpotomy, when the teeth were extracted. The follow up time mentioned is for extraction. After that the teeth were processed for histopathological evaluation. Answering to the comments by the reviewer as the main Author. 1) The term "Grossly carious " is used since pulpotomy is not indicated in teeth where the carious process has already involved the pulp. In that case one has to carry out Pulpectomy as one can not confirm the involvement of pulp damage if restricted to only coronal portion of the pulp. Very commonly, in grossly carious tooth, while doing excavation if the pulp is exposed traumatically, then Pulpotomy procedure is carried out. 2) The reference to the sentence is at the end of the last sentence of the paragraph, which is reference number 2. 3) Dose calculation is done as per Pharmaceutical guidelines where the solution of Botroclot was mixed with HPMC and at three different concentrations the efficacy was tested. 4) The tissue reaction was checked after extracting the teeth at 24 hr, 7 days, 15 days and 30 days post Pulpotomy, when the teeth were extracted. The follow up time mentioned is for extraction. After that the teeth were processed for histopathological evaluation. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 26 Sep 2024 Dr. Swati Karkare , $usrAffiliation 26 Sep 2024 Author Response Answering to the comments by the reviewer as the main Author. 1) The term "Grossly carious " is used since pulpotomy is not indicated in teeth where the carious process ... Continue reading Answering to the comments by the reviewer as the main Author. 1) The term "Grossly carious " is used since pulpotomy is not indicated in teeth where the carious process has already involved the pulp. In that case one has to carry out Pulpectomy as one can not confirm the involvement of pulp damage if restricted to only coronal portion of the pulp. Very commonly, in grossly carious tooth, while doing excavation if the pulp is exposed traumatically, then Pulpotomy procedure is carried out. 2) The reference to the sentence is at the end of the last sentence of the paragraph, which is reference number 2. 3) Dose calculation is done as per Pharmaceutical guidelines where the solution of Botroclot was mixed with HPMC and at three different concentrations the efficacy was tested. 4) The tissue reaction was checked after extracting the teeth at 24 hr, 7 days, 15 days and 30 days post Pulpotomy, when the teeth were extracted. The follow up time mentioned is for extraction. After that the teeth were processed for histopathological evaluation. Answering to the comments by the reviewer as the main Author. 1) The term "Grossly carious " is used since pulpotomy is not indicated in teeth where the carious process has already involved the pulp. In that case one has to carry out Pulpectomy as one can not confirm the involvement of pulp damage if restricted to only coronal portion of the pulp. Very commonly, in grossly carious tooth, while doing excavation if the pulp is exposed traumatically, then Pulpotomy procedure is carried out. 2) The reference to the sentence is at the end of the last sentence of the paragraph, which is reference number 2. 3) Dose calculation is done as per Pharmaceutical guidelines where the solution of Botroclot was mixed with HPMC and at three different concentrations the efficacy was tested. 4) The tissue reaction was checked after extracting the teeth at 24 hr, 7 days, 15 days and 30 days post Pulpotomy, when the teeth were extracted. The follow up time mentioned is for extraction. After that the teeth were processed for histopathological evaluation. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 08 Jan 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 Version 1 08 Jan 24 read Ruchi Singhal , PGIDS, Rohtak, India Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Singhal R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 02 Sep 2024 | for Version 1 Ruchi Singhal , PGIDS, Rohtak, India 0 Views copyright © 2024 Singhal R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The present manuscript needs changes grammatically and at many places need rephrasing of sentences. Introduction: Instead of writing grossly carious, authors should use the term teeth which are pulpally involved. Authors have mentioned, "However, a common side effect of Ferric sulfate is chronic pulpal degradation, which can result in premature exfoliation of the pulpotomized tooth." Provide reference Dose calculation: How the dose was calculated. Any standard criteria or reference In phase II, it was mentioned that Tissue reaction will be checked by histopathological evaluation at 24 hours, 7 days, 15 days and 30 days. At what duration after pulpotomy, the tooth was extracted..clearly describe in detail. Is the rationale for, and objectives of, the study clearly described? Partly Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Pediatric Dentistry with special focus on preventive aspect and traumatology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 26 Sep 2024 Dr. Swati Karkare, Answering to the comments by the reviewer as the main Author. 1) The term "Grossly carious " is used since pulpotomy is not indicated in teeth where the carious process has already involved the pulp. In that case one has to carry out Pulpectomy as one can not confirm the involvement of pulp damage if restricted to only coronal portion of the pulp. Very commonly, in grossly carious tooth, while doing excavation if the pulp is exposed traumatically, then Pulpotomy procedure is carried out. 2) The reference to the sentence is at the end of the last sentence of the paragraph, which is reference number 2. 3) Dose calculation is done as per Pharmaceutical guidelines where the solution of Botroclot was mixed with HPMC and at three different concentrations the efficacy was tested. 4) The tissue reaction was checked after extracting the teeth at 24 hr, 7 days, 15 days and 30 days post Pulpotomy, when the teeth were extracted. The follow up time mentioned is for extraction. After that the teeth were processed for histopathological evaluation. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Singhal R. Peer Review Report For: Evaluation for the efficacy of haemocoagulase agent (botroclot) as a pulpotomy material as compared to ferric sulfate- an animal study. [version 1; peer review: 1 approved with reservations] . F1000Research 2024, 13 :48 ( https://doi.org/10.5256/f1000research.147510.r245723) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-48/v1#referee-response-245723 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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