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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
Original article / research
Full Version
Prevalence of Dental Anomalies in Maxillary Lateral Incisors: An Institutional Cross-sectional Study from Karnataka
Correspondence Address :
Dr. C Varalakshmi,
Reshmi Mansion, Near Income Tax Department, Via Sedam Road, Kalaburgi-585105, Karnataka, India.
E-mail: Mayvara3@gmail.com
Introduction: The majority of dental abnormalities are found in third molars, followed by permanent maxillary lateral incisors. The occurrence of these dental anomalies varies among different ethnic groups; hence, it is of prime importance for clinicians to know and understand the incidence of dental anomalies among the local population.
Aim: To analyse the prevalence of dental anomalies in relation to permanent maxillary lateral incisors in the Karnataka region.
Materials and Methods: A cross-sectional study was conducted in the Department of Conservative Dentistry and Endodontics of HKES’s S Nijalingappa Institute of Dental Science and Research, Kalaburgi, Karnataka, India from July 2022 to December 2022. A total of 1,116 subjects, aged between 15 and 50 years, were randomly screened. Each subject was clinically examined, and radiographs were taken for patients with dental anomalies. The five dental anomalies studied were congenitally missing permanent maxillary lateral incisors, peg laterals, dens in dente, talon’s cusp, and palato-gingival groove. Statistical analysis was performed using SPSS version 26. Descriptive statistics were estimated in terms of frequency and percentage.
Results: A total of 43 subjects were found to have anomalies associated with the maxillary lateral incisor, including peg-shaped laterals (1.25%-14), dens in dente (0.81%-09), congenitally missing (0.45%-05), talon’s cusp (0.27%-03), and palato-gingival groove (1.07%-12).
Conclusion: Anomalies in permanent maxillary lateral incisors were noted in 3.85% of the Karnataka population.
Developmental dental anamolies, Maxillary lateral incisors, Peg-shaped laterals
A deviation from normal is called an anomaly. Disturbance of epithelial and mesenchymal interactions can significantly alter normal odontogenesis, leading to the developmental anomaly of teeth (1). The existence of dental anomalies, such as changes in shape, size, or number, may depend on the developmental stage in which the alteration occurred (1).
Developmental anomalies can result from genetic variables, including inheritance, metabolism, and mutations, as well as environmental factors like physical, chemical, environmental, and biological factors, either individually or in combination (2). Morphological alterations are observed in both deciduous and permanent dentition. Permanent teeth are noted to have more anomalies than primary teeth (3),(4). Additionally, the prevalence of dental anomalies demonstrates location and jaw dependence. In the maxilla, dental abnormalities are more common and primarily affect the anterior teeth. Conversely, the mandible shows a higher prevalence of anomalies in the posterior region. The probable reason for the prevalence of these anomalies is the evolutionary change in jaw development (2).
Permanent maxillary lateral incisors exhibit the greatest degree of variation in crown size, shape, and form, after third molars (5),(6). Maxillary lateral incisors can display anomalies such as dens invaginatus, dens evaginatus/talon’s cusp, congenitally missing, palatogingival groove, Turner hypoplasia, gemination, fusion, macrodontia, microdontia, or peg laterals (7).
The morphogenic process becomes important to understand and treat conditions with a multidisciplinary approach. Since these anomalies predispose the tooth to caries, periodontal disease, as well as aesthetics and malocclusion (8),(9), it is crucial to understand if there are genetic correlations. Identifying and researching these anomalies helps in the timely detection of developmental disorders in individual teeth, which could indicate a potential risk of further positional or eruption abnormalities in other teeth. Therefore, the identification of these developmental anomalies is significant in establishing a strict follow-up protocol for early diagnosis and appropriate treatment. Additionally, anomalies can occur as part of a syndrome or disease, where they hold diagnostic and medical significance.
Given the impact these factors have on treatment outcomes, there is always room to supplement the available literature by using additional population cohorts. Numerous epidemiological studies have been conducted in various regions of the world to determine the prevalence of different forms of dental defects (6),(7),(10),(11),(12),(13). The findings indicate that dental abnormalities vary in frequency depending on geography and ethnicity (6),(7),(10),(11),(12),(13),(14). However, the existing studies on their prevalence show diverse outcomes, necessitating further research to help clarify the frequency and distribution of dental abnormalities. Understanding the pattern of such variation in the Indian sub-continental population is significant for local dental clinicians. Furthermore, there is limited literature on the frequency of dental anomalies in the Karnataka population that are unique to permanent maxillary lateral incisors, and there have been limited attempts to identify changes in current trends.
The significance of the current study was to assess the prevalence of dens invaginatus, peg laterals, congenitally missing teeth, talon’s cusp, and palatogingival groove in permanent maxillary lateral incisors among the population of the Karnataka region and recognise their current pattern. This information can help make appropriate modifications in diagnosis and treatment.
A cross-sectional study was conducted in the Department of Conservative Dentistry and Endodontics of HKES’s S Nijalingappa Institute of Dental Science and Research, Kalaburgi, Karnataka, India. After obtaining approval from the Institutional Ethical Committee board (HKES/SNIDSR/IEC/05/22) and informed consent from all participants, the study was carried out from July 2022 to December 2022.
Inclusion criteria: Individuals with regular and anomalous tooth morphology of permanent maxillary lateral incisors.
Exclusion criteria:
• Pregnant women.
• Maxillary permanent lateral incisors that have undergone endodontic treatment.
• Maxillary permanent lateral incisors with dental crowns.
• Maxillary permanent lateral incisors with dental restorations.
• Individuals undergoing radiation therapy.
• Impacted maxillary permanent lateral incisors.
• Ellis fracture.
• Tooth loss due to caries, periodontal disturbances, and extraction.
• Patients with significant systemic medical history.
A total of 1,116 patients of both genders, aged between 15 and 50 years, were randomly selected, resulting in the screening of 2,232 teeth.
A thorough clinical examination was performed under adequate lighting on a dental chair. After collecting demographic data, patients were clinically examined and recorded on a standard proforma. Relevant personal and family histories were also documented. Intra-oral pictures were taken when necessary. Only patients presenting with dental anomalies underwent radiographic examination. A standardised radiographic technique using Radio Visio Graphy (RVG) was employed, with an exposure time of 0.16 seconds and a vertical angulation of 40 degrees. The RVG sensor was placed intraorally using a sensor holder, and a paralleling technique was used for all anomalies except for missing permanent maxillary lateral incisors, for which standardised digital panoramic radiographs were used for evaluation.
Radiographic (2D) and orthopantomographic images were thoroughly observed as part of the radiographic examination, and findings were interpreted and recorded.
Each subject was evaluated to determine the prevalence of peg laterals, dens invaginatus, palatogingival groove, congenitally missing teeth, and dens evaginatus/talon’s cusp among the permanent maxillary lateral incisors.
Statistical Analysis
The findings of the present study were analysed using SPSS version 26. Descriptive statistics were estimated in terms of the frequency and percentage of each dental anomaly.
Among the 1,116 subjects examined, 602 (53.9%) were male and 514 (46.05%) were female. Anomalies were noted in 43 subjects (3.85%), with 24 being male and a mean age of 28.67±5.07 years, and 19 being female with a mean age of 25.31±3.59 years.
Out of the 1,116 subjects, peg laterals were seen in 14 (1.25%) individuals, with 6 (42.86%) having it unilaterally and 8 (57.14%) having it bilaterally. The prevalence of peg laterals was higher in males (0.72%, 8 subjects) compared to females (0.53%, 6 subjects) (Table/Fig 1),(Table/Fig 2).
Dens invaginatus was found in nine subjects (0.81%). It showed a predilection towards females with a prevalence of 0.53% (6 subjects), compared to males with a prevalence of 0.268% (3 subjects). Two subjects had bilateral cases of dens invaginatus, while seven had unilateral cases. According to Oehler’s classification, which is based on radiographic interpretation of the degree of invagination, seven subjects presented with Type-I invagination (5 female, 2 male), one subject (female) presented with Type-II, and one subject (male) had Type-III invagination (15).
Congenitally missing permanent maxillary lateral incisors were found in 5 (0.45%) subjects (2 females-0.18% and 3 males-0.27%). Among the 5 subjects, 3 (0.27%) had unilateral absence of maxillary lateral incisors, while 2 (0.18%) had bilateral absence. Talon’s cusp was found in 3 (0.27%) subjects (2 males and 1 female), unilaterally.
The prevalence of palatogingival groove was found to be 1.07% (12 subjects-4 females and 8 males). One subject had a bilateral palatogingival groove, while the remaining 11 subjects had unilateral cases palatogingival groove (Table/Fig 1),(Table/Fig 2).
Prevalence refers to the number of individuals with a particular condition in a population and can be considered as an indicator of disease status (16). In the current study, 3.85% of the 1,116 participants had abnormalities in the development of their permanent maxillary lateral incisors, including peg laterals, talon’s cusp, dens invaginatus, congenitally missing teeth, and palatogingival groove.
Comparing the findings of the current study with previous studies is important, as there may be significant variation in prevalence among different socio-ethnic groups, depending on factors such as regional variation, ethnicity, and sample size presents a comparative evaluation of the present study with previous similar studies (Table/Fig 3) (6),(7),(10),(11),(12),(13),(17),(18),(19),(20),(21).
The peg-shaped tooth, defined by Grahnén as the mesio-distal width at the incisal third of the tooth crown being shorter than the cervical width, usually affects the permanent upper lateral incisor (22). This shape leads to anterior diastemas, which pose functional and aesthetic concerns for the affected patients. In the present investigation, peg laterals were present in 14 patients, with a prevalence of 1.25%, which closely aligns with earlier studies (23),(24). Regarding the prevalence of unilateral and bilateral occurrences of peg laterals, the current study found a slightly higher prevalence of bilateral occurrence (0.71%; n=8) than unilateral (0.54%; n=6). These findings correlate with the study conducted by Hua F et al., and contrast with a study carried out by Lupinette GM et al., where a higher prevalence of unilateral peg laterals was observed in cases with the right lateral incisor compared to the left (24),(25).
The invagination of the enamel organ into the dental papilla during the developmental stage leads to a developmental malformation called Dens invaginatus. In the current study, the prevalence of Dens invaginatus was 0.81% (9 subjects), which is in agreement with the study by Shashirekha G and Jena A (1062 population) (7). Dens invaginatus may coexist alongside various dental anomalies, primarily dens evaginatus. There have been reports of peg-shaped laterals complicated by the presence of dens invagination (26). This variation predisposes the tooth to the development of dental caries, leading to pulpal necrosis and the development of a periradicular lesion, which becomes challenging for the clinician to treat. In the current study, Type-1 Dens invaginatus (based on Oehler’s classification) was the most prevalent morphology (7/9), which is in accordance with findings from prior studies by Alves Dos Santos GN et al., and Alkadi M et al., (27),(28). Regarding laterality, unilateral DI showed a higher prevalence, similar to the study by Alves Dos Santos GN et al., (27). A deep-grooved maxillary lateral incisor must be carefully examined, even in the absence of clinical symptoms, for the presence of dens invaginatus (29).
The most common congenitally missing permanent tooth in the aesthetic zone is the maxillary lateral incisors (30). The prevalence accounted for 0.45% (n=5) of subjects in this study, with 0.27% (n=3) unilateral and 0.18% (n=2) bilateral cases. The overall prevalence of congenitally missing lateral incisors in this study was lower than that reported in the Odisha population (G S Jen) with a prevalence of 1.6% of subjects. A similar study conducted by Arandi NZ on a sample of 2662 subjects found a prevalence of 1.91% of missing permanent maxillary lateral incisors in the studied population (12).
The presence of dens evaginatus in the anterior teeth is known as Talon’s cusp or eagle’s talon. In most instances, it is associated with clinical problems such as poor aesthetics and caries susceptibility. The present study found a prevalence of 0.27% for Talon’s cusp, while Sharma G et al., and Prabhu RV et al., found a personal prevalence of 0.06% and 0.36%, respectively, in permanent maxillary lateral incisors (19),(21).
The origin of the palatogingival groove is usually at the cingulum and extends on the root surface apically toward the Cementoenamel Junction (CEJ) and may terminate at the coronal/middle/apical third of the root surface. The infolding of the inner enamel epithelium, disturbance in the epithelial sheath of Hertwig, or an attempt to form a supernumerary root can be probable causes for the development of the palatogingival groove; however, the aetiology is not definitive. The highest predilection is seen with maxillary lateral incisors (31),(32). It can be seen as an independent entity or coexist with other developmental anomalies like dens invaginatus or dens evaginatus. The diagnosis and treatment are often dilemmatic and clinically challenging when the clinical presentation increases in severity and turns complex (33). The complicated root canal anatomy and the severe localised periodontitis may require a combined endodontic-periodontic treatment approach (34). In the present study, palatogingival grooves were present in 1.07% (n=12) of the subjects. The prevalence of palatogingival grooves (n=12) in this study was lower than that reported in studies by Fekonja A (2022) and Radhakrishnan R et al., (2012) (6),(35). Out of 200 dental outpatients evaluated in Benghazi, Libya,
Radhakrishnan R et al., identified a 1.68% prevalence of palatogingival grooves on their permanent maxillary lateral incisors (35), whereas Fekonja A found a 2.4% prevalence (6).
Limitation(s)
Although, 3D examinations of individuals would have allowed for more accurate data regarding other dental anomalies and morphologies, such as gemination, root dilacerations, concrescence, tooth fusion, and canal anomalies, this was not feasible in the current study.
Within the limitations of this study, it can be concluded that a total of 3.85% of the population were found to have maxillary lateral incisor anomalies. Early and accurate diagnosis plays a significant role in enabling the efficient management of consequences arising from these defects.
A deeper understanding of morphological variables in the local population provides reliable guidance for successful management.
We sincerely acknowledge Dr. Sangeeta and Dr. Supriya, Professor, Department of Conservative Dentistry and Endodontics, HKE’s S Nijalingappa Institute of Dental Science and Research, Kalaburgi, Karnataka, for their immense support in carrying out this study.
DOI: 10.7860/JCDR/2024/66233.18951
Date of Submission: Jun 24, 2023
Date of Peer Review: Aug 05, 2023
Date of Acceptance: Oct 17, 2023
Date of Publishing: Jan 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• 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
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