Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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On Sep 2018

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Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

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Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

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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)
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.
On April 2011

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
On Jan 2020

Important Notice

Year : 2009 | Month : February | Volume : 3 | Issue : 1 | Page : 1353 - 1356 Full Version

Prosthodontic Rehabilitation of Weakened Root Canals: A Case Report

Published: February 1, 2009 | DOI:

*M.D.S.,Lecturer,Department of Prosthodontics,VSPM’s Dental College & Hospital,Nagpur.**M.D.S.,Senior Resident,Department of Prosthodontics, PGIMER,Chandigarh,***M.D.S.,Professor,Dept of Prosthodontics,GovernmentDental College&Hospital,Nagpur.

Correspondence Address :
Dr. Saee Deshpande,I-7 Sagar Palace,Laxminagar,Nagpur–22,(India).Ph.No Mob.+91-9225213204,


This paper highlights the fact that many anterior teeth requiring restoration are severely weakened, having wide flared canal spaces and thin dentinal walls, and are at a high risk of getting fractured. Traditionally, such teeth would be restored using metal posts, but this procedure has often been unsuccessful, because of lack of retention or root fracture. The canal can be reinforced using a new post system involving intraradicular composite resin polymerization with light transmitting posts, rendering the defective endodontically treated root capable of supporting a post and core, and thereby ensuring continued function of the badly damaged tooth.


intra-radicular rehabilitation, weakened root canals, post and core

In clinical practice, endodontically treated teeth often have significant coronal and radicular compromise of the tooth structure. The factors responsible for this compromise include extensive carries, fracture, trauma to an immature tooth, iatrogenic and pulp pathology, as well as endodontic treatment (1). In addition, loss of water content in dentin after endodontic therapy can reduce tooth resilience, and can subsequently increase the probability of fracture. The post-endodontic restoration of such teeth is commonly accomplished using intra-radicular restorations or post and core, to retain the coronal portion of the tooth before the placement of a single or multi-unit fixed partial denture. Factors such as location and quantity of the remaining healthy dentinal structure and the internal configuration and morphology of the root, affect the choice of post system. Also, the principals for retention of the posts such as length, diameter and surface configuration should be considered (2),(3),(4).

For many years, cast posts were most commonly used for the treatment of endodontically treated teeth with wide canals. Their disadvantages include catastrophic root fractures in teeth with reduced remaining dentinal thickness, shadowing and graying of the root and discolouration at the tooth’s gingival margins.

In the past decade, other post systems including prefabricated aesthetic posts, have gained popularity. Endodontically treated teeth with weak canals i.e. remaining dentinal thickness <2mm, should be ideally reinforced before post placement. Light polymerized composite resin can be used for this purpose. Composite resin absorbs and distributes forces in a more uniform manner as compared to metals, and increases resistance to fracture, thus providing improved prognosis. An adhesive bonding system used with these resins is based on its ability to create micromechanical retention, which has an added advantage for a weakened root (3),(4).

In various clinical situations, when the post does not allow light transmission, it is only possible to light polymerise the resin within the intraradicular space to a maximum depth of 2-3 mm, due to the limited effect of trans-illumination within the composite resin. However, introduction of commercially available light transmitting posts allow light polymerization by transillumination, that effectively polymerises the composite along the entire length of the radicular preparation (4). Luminex aesthetic post system (Dentatus, USA) has been developed specifically for the purpose of rehabilitating such weak teeth, and it involves the use of light transmitting post, composite resin reinforcement of the canal and subsequent rehabilitation.
Following is a case report, which describes the step by step procedure of post and core restoration of a maxillary central incisor with weakened root, with the above mentioned system.

Case Report

A 20 year old girl reported to the Department of Prosthetic Dentistry, GDC and H, Nagpur, with the complaint of an unaesthetic smile due to discoloured and fractured upper front teeth (Table/Fig 1).
She gave a history of trauma on her front teeth 2 years back. She then visited a dentist who treated her conservatively, only with antibiotics and analgesics. On presentation,, an intraoral periapical radiograph was taken, which showed periapical radiolucency with a maxillary central incisor, along with a flared canal due to internal resorption (Table/Fig 2).
The tooth tested negative on vitality testing. Root canal treatment of that tooth was carried out, and an apical seal was established using MTA. After 6 weeks, it was decided that the tooth could undergo post-endodontic restoration (Table/Fig 3).
Since the remaining dentinal thickness was very less, it was decided that the root canal would require a reinforcement. Also, as the tooth was a central incisor, it was prudent to select an aesthetic post system. Luminex aesthetic post system (Dentatus, USA) (Table/Fig 4) was selected, since it combined both the objectives. Gutta percha from the canal was removed carefully using pesos reamer, without disturbing the apical third of the filling.
A radiograph was taken to ensure the adequacy of the canal preparation, and a matching diameter light transmitting plastic post was selected. The canal was etched with 35% phosphoric acid (EtchRite, Pulpdent ,USA) for 15 sec, was rinsed with an endodontic irrigation syringe, and was dried. A thin coat of dentin bonding agent (Excite, Ivoclar Vivadent) was applied using a microapplication brush and was light cured for 20 sec. A flowable composite resin was placed into the canal. The plastic light transmitting post was centred, and the resin was cured for 40 sec. The post was taken out, an identical diameter glass fibre post was first coated with a silane coupling agent (Monobond-S, Ivoclar Vivadent). The post was then cemented into the canal with dual cure resin cement (Wetbond Embrace, Pulpdent, USA), which was cured for another 40 sec (Table/Fig 5), (Table/Fig 6) Core build up was done using hybrid composite resin (Charisma, Heraues Kulzer, Inc) in an incremental pattern, and this was light-cured every time for 20 sec.
Next, the central incisor was prepared to receive all ceramic crown (Cergo, Degudent, USA). Gingival retraction was done using a knitted cord (Ultradent Products Inc., Salt Lake City, Utah) soaked in Aluminium chloride (ViscoStat Clear, Ultradent Products Inc) (Table/Fig 7) .
Definitive impressions of the prepared maxillary anterior teeth were obtained using vinyl polysiloxane impression material (Aquasil Putty and XLV, Dentsply, USA). Working casts were generated from Type IV die stone (Ultrarock, Klabhai Dental, India). The restorations were subjected to a bisque trial to verify the colour and the contour. The final restorations were surface treated with hydrofluoric acid (Pululpdent USA) and silane coupling agent, and were then cemented using dual cure resin cement (Wetbond Embrace, Pulpdent) (Table/Fig 8)(Table/Fig 9). Informed consent of patient was taken for the publication of the images.


Failure in endodontically treated teeth is more likely due to restorative failure than the endodontic treatment itself. Thus, it is important to plan the treatment with respect to the endodontic technique and the feasibility of successful restoration as well. Also, post selection affects the stress patterns in the root canal. For a weakened root, the use of cast post can concentrate the wedging forces at the weakened coronal portion of the root canal. The use of prefabricated post entails the obturation of large defects with the cementing medium, thus creating a weak link between the entire post-core-crown-tooth complex. Thus, for a flared canal, it is important that lost dentin is rebuilt with a strong substitute. Composite resin bonds well to the dentinal wall after the acid etching and the tooth bonding procedure, and serves to reinforce the weakened root. The use of light transmitting post along with light curing composite resin facilitates complete polymerisation to the depths of the canal. The placement of identical size fibre/metal post and composite core build up ensures optimum resistance and retention form. This technique has advantages like reinforced root strength as light-cured composites internally reinforce the root structure, providing maximum sheer load support and retention. There is also improved control since light-curing composites are easy to control, are more adaptive and safer than auto-cured composites that may prematurely harden.

Also, centered canal position, superior aesthetics and technique versatility are its additional advantages. Thus, even badly mutilated teeth need not necessarily be extracted.

They can be restored with this technique to best serve the needs of the patient.


. LA Conclaves, LPV Vansan, SM Paulino, MS Neto, Fracture resistance of weakened roots restored with a transilluminating post and adhesive restorative materials. Journal of Prosthetic Dentistry 2006; 96:339-44.
. William A. Saupe, Alan H. Gluskin, Ryle A. Radke, Jr. A Comparative Study of Fracture Resistance between Morphological Dowel and Cores and a Resin Reinforced Dowel System in the Intradicular Restoration of Structurally Compromised Roots. Quintessence International 1996; 27:483-91.
. Lui, J.L Composite Resin Reinforcement of Flared Canals Using Light-Transmitting Plastic Posts. Quintessence International 1995;25: 320-25.
. Robbins JW. Guidelines for restoration of endodontically treated teeth. Journal of American Dental Association 1990; 120:558-62.

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