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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
Hemisection for the Successful Preservation of Hopeless Teeth: A Case Report
Correspondence Address :
Dr. Akansha Tilokani,
Postgraduate Student, Department of Conservative Dentistry and Endodontics, Kalinga Institute of Dental Sciences, Bhubaneswar-751024, Odisha, India.
E-mail: akansha.tilokani@gmail.com
Hemisection is conservative way of preserving tooth , which is defined as the surgical procedure that involves removal of a weakened root and compromised crown portion which may be affected by periodontal, endodontic, or structural failures. It aims to efficacious atternative modality in the extraced to save multirooted teeth. This treatment option should be considered when caries, resorption, perforation, or periodontal damage is confined to one root, whereas the other root is healthier. As long as, Expected results can be achieved with this treatment by following the proper diagnostic, endodontic, surgical, prosthetic, and maintenance procedures are followed, this treatment can produce. Present study describes the successful treatment two patients with severely damaged mandibular molars through hemisection. The procedure was successfully and the remaining portion of the tooth was restored with a prosthesis. The patients were followed-up for several months, and the outcome was satisfactory, with no recurrence of symptoms. Hemisection can be an effective treatment option for preserving a damaged tooth, and this case report demonstrates its successful application in a clinical setting.
Furcation, Hyaluronic acid, Platelet-rich fibrin, Retreatment, Root resection
Case 1
A 53-year-old male patient presented to the Department of Conservative Dentistry and Endodontics since how long with a chief complaint of food lodgment and pain in the lower right back tooth region. The patient experienced intermittent dull aching pain which aggravated on chewing since 2 weeks. A periodontal pocket measuring 8-10 mm was detected on the buccal and distal surfaces of the right mandibular first molar (46), along with grade-II furcation involvement (1), without mobility. The tooth had a positive response to both horizontal and vertical percussion.
Radiographic examination revealed evidence of decay extending subgingivally at the distal aspect and a distinct radiolucency in the furcation region and involving the distal root (Table/Fig 1)a. The extent of decay rendered the tooth non-restorable on the distal aspect, leading to a diagnosis of hence the symptomatic apical periodontitis was the diagnosis made clinically. Initially, extraction and prosthetic rehabilitation were indicated due to the poor prognosis of the tooth. However, the patient was reluctant to lose the tooth. Therefore, an alternative approach was considered, since the tooth was firm with extensive crown damage at the distal aspect and grade-II furcation (1). Thus hemisection of the distal root after endodontic therapy followed by a prosthetic replacement was was hence planned.
Conventional root canal treatment was performed on 46 after scaling and root planing in endodontic phase. Following endodontic access, working length was determined, bio-mechanical preparation was done, and obturation was performed (Table/Fig 1)b,c. The procedure was performed under 2% lignocaine and 1:200,000 adrenaline. A sulcular incision was given by using No. 15 BP Blade from 45 to 47 to elevate a full-thickness mucoperiosteal flap, using with a periosteal elevator (Table/Fig 1)d. Reflection of the flap, followed by the debridement of underlying bony defects was done. A vertical cut was made faciolingually towards the bifurcation area using a tapered fissure carbide bur (169L), and the distal root was atraumatically extracted [Table/Fig-1e,f]. Socket preservation was performed using BioOss Bovine Xenograft along with Platelet-Rich Fibrin (PRF), and an immediate post-operative radiograph was taken (Table/Fig 1)g,h.
Subsequently, the buccal and lingual flaps were approximated to cover the grafts and the mesial root of 46 with a 3-0 Mersilk non-absorbable sutures. After placing the sutures, a Coe-PakTM surgical dressing was applied after sutures were placed. Follow-up recall after three months revealed good bone healing without mobility of the mesial root (Table/Fig 1)i. The restoration of the hemisected tooth was planned, with a metal ceramic fixed partial denture with on 45, the mesial root of 46, and 47. Radiographs were taken after six and 12 months displayed bone formation in the preserved socket, along with dissolution of the periapical radiolucency involving the mesial root (Table/Fig 1)j,k.
Case 2
A 38-year-old female presented to the Department of Conservative Dentistry and Endodontics with a chief complaint of severe and spontaneous pain in the lower right mandibular molar area, which had been ongoing for past 2-3 days. The patient gave history of root canal treatment on 46, eight months ago. Clinical examination revealed a fractured composite restoration, painful response to tender on percussion, no swelling, and no response to the cold test. Periodontally, no deep pocket was found, but there was grade-II furcation involvement (1). Radiographic examination revealed previous root canal treatment with apical radiolucency on the mesial root extending to the furcation area and radiopaque root canal filling (Table/Fig 2)a. Hence, the diagnosis of formerly treated tooth with symptomatic apical periodontitis was made. Re-endodontic treatment was planned followed by the hemisection of the mesial root, Due to the furcation involvement and the extensive damage around the root.
On access, four obturated canals were identified while doing access, protaper universal NiTi. ProTaper universal NiTi rotary files (Tulsa Dental, Tulsa, OK) were used to remove the root fillings. The working length was estimated using an electronic apex locator (Dentsply) and periapical radiographs, followed by the obturation with gutta-percha and sealed with AH Plus sealer (Table/Fig 2)b.
The mesial root was hemisected, as described in Case 1 (Table/Fig 2)c-e. However, the socket was preserved with BioOss bovine Xenograft along with 1% Hyaluronic acid (Table/Fig 2)f-h, and an immediate post-operative radiograph was taken (Table/Fig 2)i. A follow-up radiograph after three months revealed adequate healing (Table/Fig 2)j. The restoration of the hemisected tooth was planned with a fixed partial denture with 45, distal root of 46. Radiographs taken after six and 12 months showed good healing (Table/Fig 2)k,l.
Hemisection is multidisciplinary approach which incorporates the concepts from prosthodontics, oral surgery, endodontics, periodontics, and restorative dentistry (2). It is a surgery in which the healthy crown and related root of a multi-rooted tooth are left in place at the furcation, keeping their integrity within the socket (3). Weine has classified the following reasons for tooth hemisection as follows: if only one root has vertical bone loss, furcation involvement, close proximity of adjacent teeth’s roots are too close together, root exposure due to dehiscence endodontic failure, and vertical root fracture (4). This case report presents two cases where hemisection was chosen as an alternative to tooth extraction.
Resective therapy has been used for over a century to treatment of furcation defects. Park suggested that hemisection of molars with a questionable prognosis can maintain the teeth without a detectable bone loss over the long term (5). Shafiq MK et al., also concluded that hemisection of a mandibular molar can be a viable treatment option when decay is restricted to one root and the remaining portion of the tooth can serve as an abutment (6).
In both cases presented, hemisection was chosen to save teeth that would have otherwise been extracted. In the first case, extensive tooth structure loss on the distal aspect and a large periapical lesion made the tooth unsuitable for a successful post-endodontic restoration. Hemisection was planned to discard the compromised aspect of the tooth. On the contrary, the second report was a case of endodontic re-treatment where the mesial root was compromised due to involving the furcation area with a questionable prognosis of 5the mesial root. Finally, a fixed prosthesis was planned involving the adjacent bicuspid to retain functionality.
In both cases, the extraction socket was preserved in both the cases to minimise post-extraction bone loss which aid in serving good function and aesthetic after prosthetic rehabilitation. Steps taken for successful socket preservation included using atraumatic extraction techniques to minimise damage to the alveolar bone, using a barrier membrane and Steps taken for successful socket preservation included using atraumatic extraction techniques to minimise damage to the alveolar bone, using a barrier membrane and bone grafting material (7).
Hemisection is a well-documented treatment choice for grade-II and grade-III furcation involvement and mandibular teeth with advanced vertical bone loss in one root (8). Yuh DY et al., literature review shows high survival rates of root-resected molars were 91.1% (9) and long-term survival rates of approximately 93% were reported by Carnival G et al., over a 10-year follow-up (10). A similar case to ours was reported by Gupta P et al., where hemisection was used to save an advanced endo-perio involved tooth with socket preservation using PRF. The case showed favourable outcomes with healing of the periapical lesion and healthy periodontal condition up to one year of follow-up (11).
The use of PRF in the first case was based on its well-known property of releasing growth factors and the widespread use of Choukroun’s PRF (12). In the second scenario, hyaluronic acid was combined with xenograft to preserve the socket after hemisection. Hyaluronic acid is essential for collagen production, which promotes better ridge preservation, especially in damaged extraction sockets (13).
By following strict case selection criteria, hemisection can be considered as a reliable treatment option for molar teeth that were previously deemed unsalvageable.
Hemisection is a conservative treatment modality for teeth that present with both periodontal and endodontic issues, as it allows for the preservation of the healthy segment of the tooth. The success of this procedure depends on factors such as the strength of the surrounding bone, the planned restoration, and regular maintenance and care. In our cases, the use of hemisection combined with socket preservation resulted in positive outcomes and satisfactory results.
DOI: 10.7860/JCDR/2023/62922.18303
Date of Submission: Jan 17, 2023
Date of Peer Review: Apr 19, 2023
Date of Acceptance: May 05, 2023
Date of Publishing: Aug 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jan 24, 2023
• Manual Googling: Apr 13, 2023
• iThenticate Software: May 04, 2023 (15%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6
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