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

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Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
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Aug 2018

Dr. Rajendra Kumar Ghritlaharey

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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.
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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.
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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 : 2010 | Month : June | Volume : 4 | Issue : 3 | Page : 2596 - 2600 Full Version

Management Of Acute Dental Trauma-Avulsion And Extrusive Luxation: A Case Report

Published: June 1, 2010 | DOI:

* (MDS)Professor , ** (MDS) Senior Lecturer, ***(MDS)Senior Lecturer, Dept of conservative dentistry and EndodonticsSurendera dental college & research institute Sri Ganganagar (Rajasthan)

Correspondence Address :
Dr. Munish Singla,(MDS),Professor,Dept. of conservativeDentistry and endodontics.
Surendera Dental College & Research institute,


This report presents a case of extrusive luxation and the avulsion of the maxillary left incisors with concomitant uncomplicated crown fractures in a 20 year old boy.The slightly extruded and avulsed teeth were repositioned in the sockets and were splinted for 2 weeks. Endodontic therapy was performed. After a follow up of 3 years, no root resorption and ankylosis was seen .The present case report showed that under the limited time of 30 minutes, ankylosis and root resorption like affects can be avoided for luxated and avulsed teeth.

Extrusive luxation and avulsion of teeth is an uncommon type of dental injury in the permanent dentition and usually involves the maxillary teeth (4),(5),(6),(7),(8).The shock and pain of the injury and the loss of a tooth which is needed for eating, speaking and smiling, often leads to emotional upheaval in the patients and their parents. The situation is compounded by the need for emergency treatment, to enhance the prognosis.

The longer the avulsed tooth is out of it’s socket, the less likely it will remain in a healthy functional state after replantation.

The following instructions should be given to the parent or the patient as soon as the dentist has been informed of the accident and in preparation for an imminent visit:

1. Wash the tooth in running water without brushing or cleaning it and examine it to be certain that the tooth is intact.
2. The patient should rinse his/her mouth and replace the tooth in it’s socket using gentle, steady, finger pressure. If the patient is cooperative, gently close the teeth together to force the tooth back into it’s original position.
3. Take the patient to the dentist immediately.

So, the present case report enlightens the good prognosis of avulsed and extruded teeth under limited time with a follow up of 3 years. Mangement of an avulsed permanent tooth often presents a challenge.

Case Report
A 20 year old boy was referred to the emergency department of Surendra Dental College and Research Institute, Sriganganagar, after suffering trauma to his maxillary teeth. The accident happened near the dental college and so, within 10 minutes, the patient was reached to the dental hospital. The accident was pre-informed to the doctors in emergency duty at the dental hospital. Full instructions were given from the hospital to the caller at the accident site.

The past medical history was unremarkable and he was not taking any medication and had no allergies. Initial examination of the facial bones and TMJ were within normal limits. Intraoral examination revealed the extrusive luxation of the maxillary left central incisor and the left lateral incisor was avulsed (Table/Fig 1).It was in the patient’s mouth. Lip and mucosal trauma was seen. The patient had spontaneous pain in the area of the maxillary incisors. The mandibular teeth revealed no signs of trauma.

Radiographs were taken, which showed that the root of the slightly extruded tooth was apically formed and the total avulsion of the maxillary left lateral incisor was confirmed (Table/Fig 2).

Repositioning of the maxillary incisors within the socket was planned immediately.

The left lateral incisor was rinsed in a physiological solution like saline for 2 minutes (Table/Fig 3). The debris was removed without damaging the periodontal ligament. The tooth was placed back into the socket by holding the crown gently. The maxillary left central incisor was repositioned in the socket with a surgical forcep and it was disoccluded (Table/Fig 4) Functional splinting was done for 2 weeks from the maxillary right canine to the left canine (Table/Fig 5) The positioning of both the teeth was confirmed with the help of radiographs (Table/Fig 6).

Antitetanus toxid (ATT) was given prophylactically, as it would provide immunity against tetanus. Antibiotics were prescribed for 7 days and the patient was encouraged to maintain good oral hygiene. Endodontic therapy of both the teeth was planned and was done (Table/Fig 7).

After two weeks, both the teeth were found to be stabilized and the splint was removed (Table/Fig 8).

The patient was kept under follow – up for 3 years. Of No signs of root resorption were seen radiographically during the follow up period (Table/Fig 9).


Dentoalveolar traumas are relatively frequent accidents and dramatic episodes can occur. The incidence of trauma involving permanent teeth is reported to be between 7% and 19% and typically affects teeth in the maxillary anterior segment (3).

The overall seriousness of the traumatic injury to the anterior teeth also focused on the aesthetic implications of the injury, because one of the greatest concerns of the patient was the immediate appearance of his traumatized teeth.

The emergency treatment and the clinical decisions must be made at the time of injury. Furthermore, there is need for long term follow up because of the high incidence of complications. The correct application of restorative techniques immediately after the trauma should improve short and long term outcomes.

Current efforts in the trauma literature of avulsion injury focuses on the following areas: Dry extra oral time, storage of the avulsed tooth, treatment of the periodontal ligaments, touching the cementum surface, splint treatment for prolonged time and treatment of the pulp canal to reduce the risk of inflammatory resorption. Treatment of the avulsed tooth’s root surface may also increase the probability of successful replantation. Toxins are usually not present initially in a great enough concentration to elicit an inflammatory response and hence, the necrotic pulp is not of immediate concern.

The current guidelines advice that avulsed teeth require a functional splint for 7–10 days, so asto allow for the functional or physiological movement of the root. A functional splint retains the tooth in the socket, but is flexible enough to allow functional stimulation of the peridontium. The results of recent studies have challenged the current guidelines for the management of avulsed teeth, with evidence that the type of splint and the duration of the splinting period are not significant variables in pulpal or periodontal healing (9).

Immediate surgical repositioning of the luxated tooth has been associated (10) with a high incidence of ankylosis, pulp necrosis and especially marginal bone loss (2). According to Ebeleseder et al (6), an advantage of the surgical technique is that it may be easily performed; more over, it returns the adjacent tissues to the original anatomic situation to allow repair and further allows fast and adequate endodontic access. The disadvantages of the surgical procedure would be more dependent on the professional’s care and skill than on the procedure itself (5).

According to Andreasen, (2) root resorption is less likely if the root canal of the reimplanted tooth is not filled prior to reimplantation, than if the pulp is left in the canal or is extirpated and the endodontic treatment is done.

The aesthetic and functional result was deemed satisfactory from the points of view of both the professional and the patient during the 3 years follow-up period. No signs of root resorption were seen radiographically. Clinical follow-up for this type of case is the most important and should be performed periodically.


Anca Silvia Valceanu , Stefan- loan Stratul : Multidisciplinary approach of complicated crown fractures of both superior central incisiors : a case report ; Dent Traumatol; 2008 : 24 : 482-86.
Andreasen FM, Andreasen JO. Luxation injuries. In : Andreasen JO, Andresen FM, editors. Text book and colour atlas of traumatic injuries to the teeth, 3rd edn. Copenhagen : Munksgaard Publishers; 1994.
Andrea Melo sense, Vivien T, Sakai etal, Management of a multiple dentoalveolar trauma in permanent dentition with avulsion of a canine – a 4 year follow up.jornal of endodontics; vol 34, issue 3: March 2008; 3336-39.
Andreasen JO. Etiology and pathogenesis of traumatic dental injuries: A clinical study of 1298 cases. Scand J Dent Res 1970; 78:329-42.
De Alenear AHG, Lustosa- Pereira A, etal. Intrusive luxation : a case report. Dent Traumatol 2007 ; doi : 10.1111.
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Louis I . Grossman, Seymour Oliet, Carlos E. Del Rio.Endodontic practice 11th ed 1991.
Mehmet Kemal Cahskan, Murat Gomel & etal, Surgical extrusion of intruded immature permanent incisors .case report and reviw of the literature, Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 86: 461-64.
Shiu- Yin Cho; Management of a traumatically extruded maxillary incisors: a case report, Hongkong Dent J 2009; 6: 49-50.
Skieller V. The prognosis for young teeth loosened after mechanical injuries.Acta Odontol Scand 1960; 18: 171-81.

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