Article in PDF
How to Cite
Citation Manager
Readers' Comments (0)
Audio Visual Article Statistics
Link
to PUBMED
Print this Article
Send to a Friend
Advertisers
Access Statistics Resources
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
Clinician's corner
Full Version
Definitive Impression Technique for Maxillary Defects in Patients with Reduced Mouth Opening- A Novel Approach
Correspondence Address :
Dr. Vinay Dutta,
Postgraduate Student, Department of Prosthodontics, Crown and Bridge,
Government Dental College and Hospital, Hanuman Nagar, Medical Chowk,
Nagpur, Maharashtra, India.
E-mail: vinay.bks@gmail.com
Palatal defects are categorised as a multicausal pathology, with its aetiology ranging from trauma and microbial infections to oncogenic origin. This by and large leads to surgical defects of the palatal tissues which warrants immediate treatment. Due to this, the patient faces a plethora of challenges, namely psychological, functional and social. These defects can be catered to by means of surgical closure or prosthetic therapy. Thereby, this uplifts the patient’s self-confidence and performance of day-to-day activities. However, surgical closure by free flaps is not feasible in all cases due to the dearth of favourable tissues or prevalent co-morbid conditions. So, this makes fabrication of a palatal obturator the treatment of choice to rehabilitate these cases. An obturator is a maxillofacial prosthesis which blocks the oro-nasal communication and thus ameliorates the mastication, phonation and aesthetic profile of the affected subject. For fabricating well-fitting obturator prosthesis, making an accurate impression with appropriate spatial orientation of the orofacial structures is imperative. Many obstacles come in the way of a prosthodontist while making impression in such cases due to the complexity of the supporting stomatognathic system in terms of compressibility and multitude of geometric planes of the tissues. These patients present with restricted mouth opening due to scarring of tissues or radiation therapy. In this article, the authors describes a technique which predominantly addresses most of the problems related to the impression making procedures in patients treated with maxillectomy experiencing limited mouth opening.
Maxillectomy, Obturator, Trismus
Any palatal defect, be it congenital, neoplastic or surgically induced is both physiologically and psychologically challenging to the patient. Normal routine activities perhaps mastication, deglutition and speech are compromised. This leads to social and psychological downfall of the patient. Hence, rehabilitation of these defects is mandatory which renders the individual capable to perform his daily activities (1). Surgical restoration is a viable option but is controversial and complex due to the compounded intraoral and facial anatomical orientation (2),(3). Surgical closure of these defects gives good results and lesser morbidity (4). However, this is not practicable at times due to the vast extent of the defect or any other comorbidities or complications secondary to radiotherapy, making palatal obturator the only option which restores the normal anatomy and function (5),(6).
The key step for success in maxillofacial cases is the accurate impression making which will aid in fabrication of a well-fitting prosthesis with no undue stress on the surrounding musculature and tissues (7). This can be achieved by the conventional and digital methodologies. Digital methodologies are fast-growing aids in prosthodontics and is promising in terms of accuracy and ease (8),(9). Digital approach may not be feasible in all cases where the defect is not accessible/limited mouth opening or when affordability is an issue (10).
Trismus among maxillectomy operated patients is common due to either scarring of the tissues or irradiation therapy (11). This does not permit for a surgical intervention to correct the limited mouth opening. Thus, forcing the prosthodontist to compromise on the extensions into the defect. For which a sectional tray can be used to make an impression in parts and reassemble it extraorally. This is a cumbersome procedure and is bound to have inaccuracies due to improper alignment of the trays (12). The following article describes a novel technique of making impression using a single custom tray.
IMPRESSION TECHNIQUE
- Preliminary impression was made using a suitable perforated stock tray with irreversible hydrocolloid impression material (ColteneColtoprint Alginate Powder, Alginate Impression Material, Coltene-whaledent) and cast was poured using die stone (Kalabhai Ultra Rock Die Stone, kalabhai) (Table/Fig 1).
- Modelling wax (MDM Link Modelling Wax, wax for modelling dentures, Mdm) was adapted all over the normal side of the palate and unwanted undercuts were blocked in the defect (to provide space for the final recording impression material) (Table/Fig 2).
- Tissue stops were carved out on the normal part of the palate (to ensure proper thickness of impression material).
- Custom tray was fabricated using auto-polymerising resin (Dpi Rr Cold Cure. Denture Base Material, Dpi) (Table/Fig 3).
- Holes were incorporated on the normal counterpart of the palate (to facilitate easy escape of excess material and also to enhance mechanical bonding of the impression material to the custom tray).
- The tray was tried in the patient’s mouth after all the wax was removed.
- Tray adhesive (Coltene Tray Adhesive, Tray Adhesive, Coltene-whaledent) was applied to the perforated part of the impression tray as per the manufacturer’s guidelines.
- The normal part of the palate was demarcated using an indelible pencil (Table/Fig 4).
- An assistant was made to mix addition silicon impression material, heavy body (Zhermack Elite P and P, Putty, Addition Silicone Impression Material, zhermack) and the tray recording the normal counterpart of the palate was loaded.
- Tray was placed in the patient’s mouth and necessary movements were made. The markings got transferred to the impression (Table/Fig 5).
- Any impression material extending to the defect part was cut based on the markings and discarded. Also, excess impression material along the vestibule was scraped off to reduce the bulk of the tray.
- The interdental areas recorded along the teeth containing segment was cut-off to facilitate easy placement and removal at later stages of impression making.
- Tray with addition silicon on one side was tried in the patient’s mouth, a mark was made on the patient’s face and then on the putty impression (acts as a repositioning guide) (Table/Fig 6).
- The defective part was moulded using green stick compound (Dpi Green Stick, Tracing Sticks, Dpi).
- It was ensured that no green stick compound extended over the addition silicon impression area.
- At the end, a final wash impression should be made all over using addition silicon impression material, light body (Zhermack Elite P and P, light body cartridge material, Addition Silicone Impression Material, zhermack) (Table/Fig 7). However, in this particular case, the medial wall of the defect had undercuts, which if recorded would create irritation to the respiratory epithelium (13) during placement and removal of the prosthesis. Since light body addition silicon impression is less viscous it would flow into the undercut. To avoid this, only green stick impression compound was used sequentially to develop the bulb portion of the defect.
- However, in other cases where such problems are not encountered, the impression of the entire defect and the normal counterpart can be made with light body addition silicon impression material by a single wash.
- Cast was poured using die stone (Kalabhai Ultra Rock Die Stone, kalabhai) (Table/Fig 8).
For an obturator to function adequately, the soft tissues should be recorded functionally as per the compressibility and resistance of the tissues and the teeth anatomically. Spatial orientation of the hard and soft tissues becomes a prime factor in determining the success of a prosthesis. The vertical extension or bulb portion of the obturator plays a major role in rendering the prosthesis functionally and vocationally effective (14). It was found that in contrast to high bulb obturators, low bulb obturators produced a hypernasal speech among patient (15). So, it can be inferred that the height of the bulb should not be compromised to facilitate easy impression making in patients with trismus.
The above-mentioned technique majorly addresses the issues pertaining to impression making among individuals with limited mouth opening. Hence, it is indicated in patients with trismus and severe gag reflex. It can also be followed as a definitive impression procedure in individuals with normal mouth opening.
This impression technique provides for a better record of tissues as per their respective histological makeup. The patient’s comfort will not be compromised as only a single tray is used. It mitigates the drawback of disorientation of the two trays as used in conventional or sectional technique resulting in minimal errors. Putty index developed on the normal counterpart contributes to superoinferior, mesiodistal and anteroposterior orientation of the tray and thus reduces the rotation of the tray. The marking over the patient’s face acts as a repositioning guide for the sequential impression making procedures. The demerit of this technique is that, it is time consuming and necessitates the use of a wide range of materials.
Different authors have come up with several other new techniques for recording palatal defects which can be used based on the need and convenience of the clinician (Table/Fig 9) (10),(16),(17),(18),(19).
This technique emphasised on the three-dimensional record of the defect by a simple method thereby minimising the errors and enhancing the success of prosthodontic rehabilitation in palatal defects. A proper knowledge of the various impression materials and an amalgamation with the right techniques would result in accurate impressions. Modifications in the procedure are necessary as per the patient’s considerations and comfort.
DOI: 10.7860/JCDR/2022/52775.16043
Date of Submission: Dec 02, 2021
Date of Peer Review: Jan 11, 2022
Date of Acceptance: Feb 01, 2022
Date of Publishing: Mar 01, 2022
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? NA
• 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: Dec 03, 2021
• Manual Googling: Jan 27, 2022
• iThenticate Software: Feb 11, 2022 (5%)
Etymology: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com