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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
Dentistry
Full Version
A Preliminary Study Of The Guided Tissue Regeneration Procedures For Adjacent Buccal Root Coverage Using Single Gtam-Tr6t Membrane
Correspondence Address :
Vandana.K.L.,Professor,Department ofPeriodontics College of DentalSciences Davangere,Karnataka.E.mail:vanrajs@hotmail.com
The purpose of this study was to assess the reliability of the GTR procedure in terms of root coverage, using material (GTAM-TR6T) in single and adjacent buccal recessions. One of the major therapeutic goals of periodontal treatment is to obtain root coverage in areas of localized or generalized gingival recession associated with aesthetic problems, dentinal hypersensitivity and root caries lesions. This study showed enhanced root coverage and attachment gain with a Titanium reinforced GTR (GTAM-TR6T) membrane in both single and adjacent buccal recessions. Therefore, a preliminary attempt to cover adjacent buccal recessions with single GTAM-TR6T (Augmentation material) has proved clinically successful.
Titanium reinforced augmentation material, adjacent gingival recessions, single membrane, root coverage
Introduction
One of the major therapeutic goals of periodontal treatment is to obtain root coverage in areas of localized or generalized gingival recession associated with aesthetic problems, dentinal hypersensitivity and root caries lesions.
Root coverage can be accomplished by using flaps, which can be free gingival grafts, connective tissue grafts, pedicle grafts or free mucosal autograft, followed by coronally displaced flap. The presence or the creation of significant amounts of keratinized tissue was the prerequisite for the success of any of these procedures.
Guided tissue regeneration (GTR) procedures provide a predictable reconstruction of periodontal tissues. In a study, 12 human recessions were treated using a membrane procedure, which consistently resulted in the reduction of the recession associated with corresponding attachment gain(1). At present, guided tissue regeneration (GTR) procedures using barrier membranes of expanded polytetrafluoroethylene (e-PTFE) have been introduced into the treatment of human isolated facial gingival recession. Koichi Ito et al (5) used titanium reinforced e-PTFE material for treating adjacent facial gingival recession. A Medline search revealed no data related to the treatment benefits of using single GTR membrane for root coverage of adjacent gingival recessions. The guided tissue angumentation material (GTAM) is the membrane of choice in ridge augmentation and implant therapy. Since the titanium reinforcement provides a good tent effect to facilitate periodontal regeneration, a first attempt was made for root coverage, uniquely for adjacent recessions using a single membrane. The aim of this preliminary study was to assess the clinical efficacy of titanium reinforced e-PTFE membrane (GTAM-TR6T) in the treatment of single and adjacent gingival recessions for a post operative period of 2 years.
Patient and Site Selection
The buccal recessions were selected in seven systemically healthy patients who presented at the Department of Periodontics, College of Dental Sciences, Davangere. All the 7 patients were males, whose age ranged from 26 to 32 years. The informed consent was obtained from the selected patients. A total of 11 sites included 3 single buccal recessions and 4 pairs of adjacent gingival recessions.
There was no loss of interdental bone or soft tissue, and patients were non smokers. The initial preparation before the surgical procedure consisted of scaling and root planing, and elimination of traumatic occlusion if required(Table/Fig 1). The patients exhibited acceptable plaque control during recall visits.
Surgical Procedures
The sites were treated with the technique described by Ito and Murai(6).A full thickness flap, including an intrasulcular incision and two releasing incisions, were elevated on the facial aspect of the alveolar process. A partial thickness dissection was carried out apical to the mucogingival junction. The exposed root surface was thoroughly planed by means of curettes(Table/Fig 2).
A microporous membrane Titanium reinforced guided tissue regenerative (GTAM-TR6T) membrane was trimmed and bent enough to cover the entire defect with one membrane in both single and adjacent recessions, and at least 2 mm of the buccal crest bone and the CEJ(Table/Fig 3).
The membrane was secured coronally by using a Teflon suture by means of a sling ligation. The flap was displaced coronally to cover the membrane and was ligated interdentally by means of Teflon sutures. Special care was taken not to displace or compress the membranes. No periodontal dressing was applied.
Post Operative Care
The patients were prescribed systemic Doxycycline Hydrochloride 100 mg twice on the first day and 100 mg/day for the next four days, along with 100 mg of Nimesulide given twice daily for 3 days. The patients were instructed to rinse 2 times daily with a 0.2% chlorhexidine digluconate for 4 weeks to prevent post surgical infection. Sutures were removed 10 days following the surgery.
The re-entry procedure was carried out 4 weeks following the initial surgery(Table/Fig 4). The membrane was exposed with a minimal flap reflection. The membrane was then dissected out carefully with gentle traction on its coronal margin.
The newly formed tissue was exposed(Table/Fig 5). The flap was repositioned to cover this tissue completely and was fixed with 4-0 silk sutures
The patients were recalled for professional tooth cleaning once in 3 months, for 24 months(Table/Fig 6)(Table/Fig 7).
Measurements
Probing depth, gingival recession, attachment level and the width of gingival recession were recorded with a PCP UNC-15 probe at the time of surgery (baseline) and 9 months and 24 months after surgery. All measurements were standardized using custom acrylic stents and were rounded off to the nearest millimeter.
Statistical Analysis
Means and standard deviations for both groups were calculated for each clinical parameter at the baseline and at 9 month and 24 month post operative examinations. Paired ‘t’ test was used to analyze mean difference between pre and post treatment values of each parameter. Differences at P < 0.05 were considered statistically significant. A linear regression analysis was also done.
Results
A total of 11 sites were treated with the guided tissue regeneration procedure.
The baseline and follow-up data are summarized in (Table/Fig 8) and the difference between the baseline and follow up values, along with the results of the significance test for differences between the means, are reported in (Table/Fig 9). (Fig.A1 to A7 ; B1 to B7)
A significant difference was noted in each case, both clinically and statistically in the amount of recession (P < 0.001) and probing attachment level (P < 0.01), and pocket depth reduction was noted (P < 0.05). The average width of the gingival recession was also significantly reduced (P < 0.01).
Discussion
Although most previous reports have indicated that isolated human facial gingival recession can be treated successfully through the use of GTR procedures with an e-PTFE membrane (1),(2),(3),(4) clinical reports of root coverage in the adjacent facial gingival recession, particularly long term observations, have been rare. A previous case report indicated that the GTR procedure with e-PTFE membranes is reliable for the treatment of adjacent facial gingival recession, consistently improving the soft tissue condition of the defect in terms of root coverage and attachment gain(6).
PiniPrato et al (2) have shown that the GTR procedure is of greater efficacy in situations where the recessions are very severe (more than 5 mm). In patients treated with the GTR procedure using e-PTFE membranes, follow-up is more complex because of the need for a second surgical procedure and more frequent visits.
The width of keratinized tissue was not taken into consideration in designing the surgical technique and no attempts were made to increase it in this study. The root surface was moderately planed to create an adequate space between the planed root surface and the titanium reinforced membrane, which was maintained during healing to provide enough room for the formation of adequate blood clot and the subsequent growth of newly formed tissue. The flap was gently positioned and sutured and no dressing was applied in order to prevent compression upon the membrane. The flap was positioned more coronally beyond the CEJ, to cover the membrane and the underlying tissues.
In the present study, the calculated average percentage of root coverage is 76.88%, whereas Koichi Ito et al (5) obtained an average root coverage of 74%. The differences between baseline and follow up in the recession reduction (2.9 1.8) and attachment gain (2.3 2.0) were statistically significant, which was similar to the findings of PiniPrato et al.(2) The width of the gingival recession measured at the level of CEJ was significantly reduced during the follow up period (0.9 0.8). The root coverage achieved after 6 months was stabilized throughout the study period. Therefore, it appears that the root coverage achieved using GT augmentation material (GTAM-TR6T) is successful clinically, in the treatment of both single as well adjacent recessions.
A new acellular dermal matrix (ADMA-Alloderm) has been recently introduced for use in dentistry, although it has been used for full-thickness burns, the revision of depressed scar and nasal reconstruction, facial defect repair, lip augmentation, and septal perforation repair. In dentistry, its uses include substitution for palatal donor tissue in soft tissue surgeries around natural teeth and implants to increase the zone of kertinized tissue, for tissue augmentation, and for root coverage. The intent of these procedures is principally to create a tissue barrier that is more resistant to further recession due to trauma. Other indications include soft tissue flap extension over bone graft, amalgam tattoo correction, and soft tissue defect repair.
ADMA is used as a barrier membrane in reconstructing non-spacemaking buccal dehiscences (7) and in ridge expansion procedures(8).
In this study, the aesthetic result obtained with the use of GTR was good. Therefore, it appears that GTR using GTAM-TR6T membrane is the preferable technique when adjacent facial gingival recession is present and the resolution of the aesthetic problem is necessary.
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