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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
Pulp Polyp Exhibiting a Unique Worm-shaped Presentation in an Ectopic Deciduous Tooth: A Novel Case Report
Correspondence Address :
Dr. Beshia Arnold,
H6, Sagar Living, No. 35, Reddykuppam Road, Kanathur, Chennai, Tamil Nadu, India.
E-mail: besh.arnld@gmail.com
Pulp polyp is a reactive lesion that occurs as a result of chronic long standing caries. Dental caries is common in children for a variety of reasons, including increased bacterial colonisation, frequent exposure to dietary sugars, improper bottle feeding technique, low community water fluoride levels, inadequate tooth brushing, and a lack of parental knowledge about oral health. Failure to treat such carious lesions during childhood will result in chronic long-term caries leading to pulpal necrosis or reactionary proliferations of pulpal tissue, known as pulp polyp. Apart from caries, trauma can also lead to hyperplastic behaviour of the pulp. Pulp polyps are most commonly found in the molars due to their abundant blood supply, whereas their presence in the anterior teeth is considered uncommon. Pulp polyp can cause anxiety among parents when they spot it in their child’s oral cavity. This is due to the unique clinical appearance, discomfort while having food and occasional bleeding, when irritated. This case report presents an unusual presentation of pulp polyp in an 11-year-old female patient with chief complaints of pain, discomfort, and bleeding on irritation. Its peculiar worm-shaped clinical appearance in the anterior attached gingival region imposed a diagnostic dilemma which on histological examination was confirmed to be pulp polyp and was subsequently excised. Therefore, this emphasises the fact that pulp polyps are not only limited to the occlusal surface of posterior teeth with a typical mushroom-shaped appearance, but also have a wide range of presentations regardless of their location and appearance.
Dental pulp diseases, Stomatognathic diseases, Tooth diseases
An 11-year-old female patient reported with a complaint of growth in the anterior gingival region for the past two years, which interfered with mastication and was associated with moderate intermittent pain and bleeding during brushing. She elicited a past dental history of carious deciduous anterior tooth 51 that had gone untreated for about four years despite intermittent pain. The patient did not reveal any history of trauma in the anterior gingival region. On intraoral examination, a linear bulbous growth curved on the end giving the appearance of a worm was evident on the attached gingiva about 1 cm above the gingival margin between the incisors of size approximately 2×1 cm and pink in colour. The base of the growth had a shell of hard tissue and calculus along with areas of inflammation. On palpation, the growth was tender, soft in consistency, and readily bled while lifting with the probe. The surface texture was smooth (Table/Fig 1). Correlating the clinical findings, a provisional diagnosis of inflammatory hyperplastic lesion was given.
Radiographic examination of 11, 21 revealed normal anatomical structures with irregular radiopacity corresponding to the base of the growth (Table/Fig 2). Considering the clinical and radiological findings, the following differential diagnoses were given- Irritational fibroma, pulp polyp, pyogenic granuloma, and peripheral giant cell granuloma. Laboratory investigations disclosed that haemoglobin was 12 g/dL, total leucocyte count was 7600 cells/cu mm, differential count of neutrophils was 31.13%, lymphocytes were 51.12%, eosinophils were 8.45%, monocytes were 8.65%, basophils were 0.65%, bleeding time was 1 minute 10 seconds and clotting time was 3 minutes 40 seconds. Afterwards, an excisional biopsy along with the hard tissue at the base of the growth was done (Table/Fig 3), (Table/Fig 4).
Histopathological examination of soft and hard tissue specimens revealed inflamed fibrovascular connective tissue associated with non keratinised stratified epithelium exhibiting numerous dilated capillaries and dense diffuse mixed inflammatory cells and dentin respectively (Table/Fig 5). Therefore, the final diagnosis of chronic hyperplastic pulpitis in an ectopic deciduous 51 was given. Follow-up after 2 weeks presented complete healing of the site (Table/Fig 6).
Pulp polyp, otherwise referred to as proliferative pulpitis, chronic hyperplastic pulpitis is a reactionary lesion of pulpal tissue that manifests as a proliferative granulation growth from the pulp occluding the carious defect with intact walls surrounding it. The colour of the pulp polyp may vary from cherry red of the granulation tissue to opaque whiteness of moist keratinised epithelium, depending on the duration, and presence of dilated blood vessels (1). In the presented case, it is assumed that the colour was pink due to the nearly two year process of epithelialisation to cover underlying granulation tissue. An unusual presentation regarding the size of the pulp polyp was reported by Faryabi J and Adhami S (2008) in which the pulp polyp enlarged beyond its cavity as a polypoid mass, interfering with the occlusion (2). Similarly, the presentation, in this case, is quite unique in terms of location, size, and shape. Its location in the anterior attached gingival region could be due to the ectopic malposition of a carious deciduous tooth in that region during the eruption of permanent central incisors, which later resorbed, leaving behind a thin shell of dentin that was detectable on the radiograph. The presence of a pulp polyp in such ectopic malposition tooth is new, and no reports have yet been published.
Dental caries might not be the only etiological factor of pulp polyp. Trauma to the primary anterior dentition especially primary maxillary anteriors can assault the pulp to have a hyperplastic behaviour (3). Studies were conducted to study the influence of sex hormones, such as estrogen, progesterone and androgen on pulpal lesions like pulp polyp in which they concluded the unique receptor-hormone interactions modify the physiologic character of these tissues (3). The presence of estrogen receptors (ER-?) and progesterone receptors (PR) in the pulp tissue were found, thus paving the way for the possibility of hormone influenced development of pulp polyp (4).
The defence cells in the pulp play a huge role in the pathogenesis of pulp polyp due to the difference in the amount of immune cells and mediators in carious lesion from time to time. The substantial amount of immunoglobulins (IgE), CD8+ T-cells, CD4+ T-cells, B-cells in an enlarged cavity would elicit a Type 1 hypersensitivity reaction to deal with the inflammation. However, in shallow cavities, only CD8+ T-cells are present exclusively (5).
The radiographic features of teeth with pulp polyp may vary from normal to periapical radiolucency, widening of Perioldontal Ligament (PDL) space, discontinuity in lamina dura, periapical rarefying osteitis, condensing osteitis, periapical granuloma, hypercementosis, and root resorption (6).
Another lesion which has a similar appearance to pulp polyp is the gingival polyp, distinguished by attachment, colour, friability. Pulp polyp has its origin from the centre of the tooth, friable whereas gingival polyp from the gingiva, non friable and occupies the carious cavity of adjacent teeth. Both of these have to be extirpated in case of managing permanent dentition (7).
A study conducted by Attar et al., concluded that cells isolated from pulp polyp have the potency to form Colony Forming Unit (CFU), the presence of cell surface markers panel (CD73, CD90, CD44, and CD166) and differentiating potential, culminating that dental pulp polyps have higher stem cell counts and pluripotency when compared to normal dental pulp (8).
Management of pulp polyp differs from primary to permanent dentition. In deciduous teeth, the treatment would be extraction of the deciduous teeth with placement of a space maintainer till underlying permanent teeth would erupt. In permanent teeth, endodontic therapy after excision of the polyp would be ideal. If necessary crown length is insufficient for crown luting, crown lengthening procedure should be carried out (1). However, bleeding could be a drawback in scalpel incision which can be avoided by using diode lasers that help to remove the polyp and assist vital pulp therapy in a bloodless and painless field. Later, the canal orifices should be disinfected by laser and low level laser therapy can be given to induce biomodulation (9).
From this case report, we can conclude that pulp polyp is not just limited to the carious tooth, but has a wide range of different presentations which should be unveiled by further evaluation to avoid misdiagnosis. Management will always be a concern in case of young permanent teeth which should be dealt carefully. The use of laser in treating pulp polyp has gained attention recently due to its benefits. Furthermore, studies are needed to know the nature of pulp in depth. Advancement in the field of dental pulp stem cell therapy can be beneficial in cancer therapies.
The authors acknowledge the patient, staff of the Department of Oral Medicine and Radiology, Department of Pedodontics, and Department of Oral Pathology for their cooperation.
DOI: 10.7860/JCDR/2022/56216.16549
Date of Submission: Mar 09, 2022
Date of Peer Review: Mar 31, 2022
Date of Acceptance: Apr 27, 2022
Date of Publishing: Jul 01, 2022
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• 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: Mar 15, 2022
• Manual Googling: Apr 26, 2022
• iThenticate Software: Jun 18, 2022 (15%)
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