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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Case report
Full Version
Three Dimensional Analysis of Root Development and Bone Formation in an Immature Non Vital Permanent Molar using Regenerative Endodontic Procedure: A Case Report
Correspondence Address :
Shalini Garg,
Senior Professor, Department of Paediatric and Preventive Dentistry, SGT Dental College, Hospital and Research Centre, SGT University, Gurugram, Haryana, India.
E-mail: shaloosandeep@gmail.com
The Regenerative Endodontic Procedure (REP) is one of the latest biological procedures for successfully treating immature non vital teeth. Treating non vital immature teeth in children with associated bone resorption poses a challenge. In the present case, a 10-year-old male patient presented with an immature pulpally involved right permanent first molar, exhibiting a periapical radiolucency measuring 2×3.2×10.5 mm (distal root) and 4.4×5.2×10.5 mm (mesial root). The molar was non-surgically treated using a minimally invasive REP approach, aiming for anatomical healing and root completion. Mineral Trioxide Aggregate (MTA) was applied over a blood clot used as a scaffold. The radiolucency decreased significantly to a size of 0.9×1.3×0.2 mm (distal root) and 1×0.4×0.2 mm (mesial root). Continuous root formation was also observed, resulting in complete resolution of the Apical Bone Defect (ABD). The mesial and distal roots progressed from Nolla stage 8 (2/3rd of root formation) to Nolla stage 9 (root formation complete) over a twelve-month period. Three-dimensional (3D) analysis was employed to explain pathosis and the healing of lesions from every aspect. The present case demonstrates that REP may be the treatment of choice for managing non vital immature permanent posterior teeth with severe ABD in a paediatric patients, particularly when the surgical approach is contraindicated due to the presence of other developing structures. Furthermore, long-term follow-up is required, and the type of healing and root completion may vary depending on the stage of root formation, disinfection, and coronal seal achieved.
Computed tomography, Immature tooth, Regeneration
A 10-year-old male presented with a deep carious lesion in the right permanent mandibular first molar, involving the pulp. Over the course of nearly a year, he experienced occasional mild soft tissue swelling and dull pain, which resolved on its own. At the time of reporting, he had no swelling or pain. A periapical radiograph was taken using a Kodak RadioVisioGraph 5200 sensor (Carestream Dental), revealing a carious lesion radiolucency infiltrating the pulp space. The roots exhibited open apices, with Nolla stage 8 root development in the mesial root and Nolla stage 7 in the distal root (Table/Fig 1)a. All roots displayed bone rarefaction and periapical radiolucency with an irregular border, encompassing half of the mesial root and extending to the furcation area. A 3D analysis of the first molar was performed, generating transverse, axial, and sagittal sections (Table/Fig 2)a-c. Volumetric analysis of the lesion was also conducted (Table/Fig 3). The images depicted a Cone-beam Computed Tomography-Periapical Index (CBCT-PAI) 5+ D (4.4×5.2×10.5 mm) lesion size, along with apical destruction of cortical bone. Root canal length, dentine thickness, root canal lumen, bone margin, and periapical ABD were assessed and summarised in (Table/Fig 4). The final diagnosis was pulpally involved immature non-vital molar with apical periodontitis and bone resorption.
The REP was planned using a cell-free approach, employing a blood clot as a scaffold. The treatment adhered to the guidelines set by the American Association of Endodontics (AAE) (1). The procedure, along with its risks and benefits, was explained to the parents, and written informed consent was obtained.
Following one month of disinfection therapy using calcium hydroxide paste, the molar was treated again under a rubber dam. Apical bleeding was induced by gently irritating the tissue with a size 15K file in all canals. Once a blood clot formed, MTA was carefully placed over the clot in the coronal canal space. White MTA (ProRoot® et al., Tulsa Dental, Tulsa, OK) was applied over the blood clot, followed by glass ionomer (GC Fuji IX, Tokyo, Japan), and composite (3M, St. Paul, Minnesota, USA) to seal the access cavity.
During a three-month follow-up visit, the patient was asymptomatic (Table/Fig 1)b. The radiograph displayed evidence of healing and regression in radiolucency, as well as progress in tooth maturation (Table/Fig 1)c. After one year, both the mesial and distal root canals demonstrated maturation to Nolla stage 9 and bony healing (Table/Fig 1)d. Follow-up radiographs were taken (Table/Fig 2)d-f,(Table/Fig 3)b, revealing healing from CBCT-PAI 5+D (4.4×5.2×10.5 mm) (Table/Fig 5)a, (Table/Fig 5)b to CBCT-PAI 1 (1×0.4×0.2 mm). This indicated repair and anatomical healing with organised hard tissue (radiopaque) formation (2). The presence of periodontal ligament space in the healed area indicated anatomical healing. Three-dimensional measurements of root canal length, dentine thickness, root canal lumen, bone margin, and periapical ABD were taken, compared, and summarised in (Table/Fig 4). The follow-up demonstrated complete healing with root and bone formation.
The treatment of an immature, non-vital, carious infected molar with apical pathosis presents several challenges for a clinician (3).
Conventional apexification treatment of an immature molar tooth poses challenges to the tooth’s longevity (4). The use of blood clot in REP is now an established treatment for non-vital immature teeth (5),(6). However, REP may be challenging and unpredictable in severe cases of periapical pathology with significant bone resorption. It requires long-term follow-up, and the type of healing and root completion varies depending on the stage of root formation, disinfection, and achievement of a coronal seal.
In the present case, clinical signs and symptoms of radiolucent root size lesions in a permanent immature molar were reversed after cell-free REP. Three-dimensional analysis revealed standard resolution and complete healing of resorptive lesions, along with continued root formation until root completion. This demonstrates the promising success of REP in healing non-vital molars with severe bone defects. Disinfection, stem cells of the apical papilla, and blood clots as scaffolds have been reported to be responsible for pulp regeneration, dentin production, and root development. Recent literature reports cases treated with REP showing long-term success and healing with hard tissue.
For instance, Yang J et al., chose REP as a conservative treatment for immature dens invaginatus with a large periapical lesion, leading to the elimination of periapical pathology and closure of the open apex (7). Kim HC et al., demonstrated the success of REP through a single-visit pulp revascularisation procedure in teeth with dental anomalies, without the use of specific intracanal medicaments (8). Lui JN et al., showed the clinical effectiveness of REP in a tooth with resistant infection, leading to the formation of a reparative phenotype confirmed by histologic examination (9). Additionally, Petel R and Noy AF demonstrated the long-term survival of a hypoplastic immature permanent canine treated with successful REP, with a follow-up of 13 years (10).
The use of three-dimensional radiographic evaluation in the present case allowed for a close inspection of the buccal and lingual cortical plates, revealing complete healing of the resorptive lesions. This three-dimensional healing analysis enables clinicians to confidently select minimally invasive, biologically based endodontic treatment options like REP for severe cases of immature molar endodontics. Three-dimensional radiographic evaluation proves to be quantitatively valuable in measuring coronal-apical, mesiodistal, and buccolingual bone loss/fill (11),(12). It also aids in a better understanding the root canal morphology, showing regular anatomical root formation post-treatment (13),(14). Researchers have proposed a Computed Tomography (CT) protocol with a reduced radiation dose using various modifications (15). However, considering the additional cost associated, its usage should be limited based on necessity.
Cell-free REP using blood clot can be the treatment of choice to promote anatomical bone healing, continued root formation, and resolution of signs and symptoms for the treatment of non-vital, immature molars with severe apical periodontitis. Clinicians can consider REP as the treatment of choice for the management of non-vital, immature posterior teeth with large periapical lesions and apical bone pathology.
DOI: 10.7860/JCDR/2023/65665.18621
Date of Submission: May 30, 2023
Date of Peer Review: Jul 11, 2023
Date of Acceptance: Aug 08, 2023
Date of Publishing: Oct 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? No
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jun 02, 2023
• Manual Googling: Jul 21, 2023
• iThenticate Software: Aug 05, 2023 (11%)
ETYMOLOGY: Author Origin
EMENDATIONS: 8
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