Reviewer’s report  
 
Title: LONGITUDINAL STUDY OF GASTROOESOPHAGEAL REFLUX AND EROSIVE 
TOOTH WEAR  
 
Version: 0 Date: 01 May 2017  
 
Reviewer: Aurelio Mauro  
 
Reviewer's report:  
 
In this well conducted study authors wanted to evaluate the progression of erosive too th wear in 
a oligosymptomatic cohort of patients (57 patients with GERD symptoms < 2 per week) with 
positive pH -MII treated with a continous PPI (esomeprazolo 20 mg once) for one year. They 
observed in the majority of patients (74%) no progression of erosi ve tooth wear at one year (in 
59 patients and at 2 years in 12 patients). However, as the author stated in the discussion, there 
are no data of erosive tooth wear progression in a control group of patient without taking PPI due 
to decision of the Ethical r eview board. However personally I'm not agree with this decision 
because I don't think that oligo or asymptomatic patients without erosive esophagitis needs 
continuative PPIs; therefore the inclusion of control group of asymptomatic patients, without 
takin g PPI or taking PPI cyclically during the year, should have been included.  
Nonetheless I think that this paper illustrates something new in literature. However they have to 
discuss the clinical outcome of the study: is it feasible to prescribe longlife PPI s in oligo or 
asymptomatic patients just to avoid erosive tooth wear progression? I don't think so and it should 
be underlined in the discussion.  
It could be useful do describe the progression rate of erosive tooth wear dividing symptomatic 
and oligo sympt omatic patients.  
 
Minor comments:  
- How it was measured oesophagogastric junction distance for pH -MII catheter positioning? If 
it was with pull -through methods describe in the discussion that it is a limitation  
- Describe erosive esophagitis rate and gradin g 
- In background page 3 line 11 add "patients" at the end of the sentence  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not,  please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the m anuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of w ritten English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received r eimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or  lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from a n organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all  of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made avail able under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will  not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer’s report  
 
Title: LONGITUDINAL STUDY OF GASTROOESOPHAGEAL REFLUX AND EROSIVE 
TOOTH WEAR  
 
Version: 0 Date: 01 May 2017  
 
Reviewer: Aurelio Mauro  
 
Reviewer's report:  
 
In this well conducted study authors wanted to evaluate the progression of erosive too th wear in 
a oligosymptomatic cohort of patients (57 patients with GERD symptoms < 2 per week) with 
positive pH -MII treated with a continous PPI (esomeprazolo 20 mg once) for one year. They 
observed in the majority of patients (74%) no progression of erosi ve tooth wear at one year (in 
59 patients and at 2 years in 12 patients). However, as the author stated in the discussion, there 
are no data of erosive tooth wear progression in a control group of patient without taking PPI due 
to decision of the Ethical r eview board. However personally I'm not agree with this decision 
because I don't think that oligo or asymptomatic patients without erosive esophagitis needs 
continuative PPIs; therefore the inclusion of control group of asymptomatic patients, without 
takin g PPI or taking PPI cyclically during the year, should have been included.  
Nonetheless I think that this paper illustrates something new in literature. However they have to 
discuss the clinical outcome of the study: is it feasible to prescribe longlife PPI s in oligo or 
asymptomatic patients just to avoid erosive tooth wear progression? I don't think so and it should 
be underlined in the discussion.  
It could be useful do describe the progression rate of erosive tooth wear dividing symptomatic 
and oligo sympt omatic patients.  
 
Minor comments:  
- How it was measured oesophagogastric junction distance for pH -MII catheter positioning? If 
it was with pull -through methods describe in the discussion that it is a limitation  
- Describe erosive esophagitis rate and gradin g 
- In background page 3 line 11 add "patients" at the end of the sentence  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not,  please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the m anuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of w ritten English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received r eimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or  lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from a n organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all  of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made avail able under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will  not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer’s report  
 
Title: LONGITUDINAL STUDY OF GASTROOESOPHAGEAL REFLUX AND EROSIVE 
TOOTH WEAR  
 
Version: 0 Date: 01 May 2017  
 
Reviewer: Aurelio Mauro  
 
Reviewer's report:  
 
In this well conducted study authors wanted to evaluate the progression of erosive too th wear in 
a oligosymptomatic cohort of patients (57 patients with GERD symptoms < 2 per week) with 
positive pH -MII treated with a continous PPI (esomeprazolo 20 mg once) for one year. They 
observed in the majority of patients (74%) no progression of erosi ve tooth wear at one year (in 
59 patients and at 2 years in 12 patients). However, as the author stated in the discussion, there 
are no data of erosive tooth wear progression in a control group of patient without taking PPI due 
to decision of the Ethical r eview board. However personally I'm not agree with this decision 
because I don't think that oligo or asymptomatic patients without erosive esophagitis needs 
continuative PPIs; therefore the inclusion of control group of asymptomatic patients, without 
takin g PPI or taking PPI cyclically during the year, should have been included.  
Nonetheless I think that this paper illustrates something new in literature. However they have to 
discuss the clinical outcome of the study: is it feasible to prescribe longlife PPI s in oligo or 
asymptomatic patients just to avoid erosive tooth wear progression? I don't think so and it should 
be underlined in the discussion.  
It could be useful do describe the progression rate of erosive tooth wear dividing symptomatic 
and oligo sympt omatic patients.  
 
Minor comments:  
- How it was measured oesophagogastric junction distance for pH -MII catheter positioning? If 
it was with pull -through methods describe in the discussion that it is a limitation  
- Describe erosive esophagitis rate and gradin g 
- In background page 3 line 11 add "patients" at the end of the sentence  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not,  please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the m anuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of w ritten English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received r eimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or  lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from a n organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all  of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made avail able under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will  not be published.  
 
I agree to the open peer review policy of the journal  
assistant