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

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On Sep 2018

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"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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On Aug 2018

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Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
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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".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
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.

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.
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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.
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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)
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 : 2011 | Month : October | Volume : 5 | Issue : 5 | Page : 1123 - 1124 Full Version

Caution! We Are Erupting As Twins

Published: October 1, 2011 | DOI:

Corresponding Author. Senior Lecturer, Priyadarshini Dental College & Hospital, Tiruvallur-631203. Phone: 9942364100; E-mail: Reader, Tagore Dental College & Hospital, Vandalur, Chennai-600048. Phone: 9962439757; E-mail:

Correspondence Address :
R. Veerakumar, Reader
Priyadarshini Dental College & Hospital, Tiruvallur-631203.
Phone: 9843290444; E-mail:


The phenomenon of tooth fusion arises through union of two normally separated tooth germs, and depending upon the stage of development of the teeth at the time of union, it may be either complete or incomplete. On some occasions, two independent pulp chambers and root canals can be seen. Fusion occurs infrequently but could cause esthetic, spacing and a periodontal problem. The purpose of this article was to present a clinical case where fusion is present. The present article highlights the presence of a primary double tooth and also the fusion of permanent successors in the maxillary anterior region. These cases necessitate careful examination and treatment planning as they may be associated with anomalies in the succeeding permanent dentition.


Fusion, Dental anomalies, Primary teeth, Permanent teeth

The anomaly of co-joined teeth has been described in several different terms, such as Fusion, Gemination double teeth and Twinning. Fusion arises through the union of two normally separated tooth germs resulting in bifid crown and two root canals where as Gemination arises from an attempt at division of single tooth germ resulting in bifid crown with a single root or root canal (1), (2). Though it seems to be confusing clinically, a differential diagnosis can be made radiographically.

The etiology of double teeth may be attributed to evolution, trauma, heredity and environmental factors. Tooth germs in the same developmental stage and located close to each other are also postulated to have a high occurrence of adjacent anterior double teeth. Some researchers proposed that this alteration occurs as a result of physical forces that bring the developing teeth in contact, by causing necrosis of the epithelial tissue which usually separates them and finally leading to fusion. Others believed that fusion results from embryological persistence of the inter-dental lamina between 2 germs (3), (4).

Fused primary teeth occur more frequently in the mandibular incisors region than the maxilla. Incidence of this anomaly is approximately 0.1% in the permanent and 0.5% in the primary teeth. The present article describes a clinical case of double tooth, which causes delayed eruption of permanent successors which again resembles a double tooth.

Case Report

An 8½ year old boy reported with the complaint of missing front teeth. Intra oral examination revealed developmental disorders in maxillary teeth. A tooth with enlarged clinical crown was observed in the area of maxillary left incisors region and erupting maxillary right incisor was also observed(Table/Fig 1).

Parental history was negative to familial tendency to fused teeth. The intra oral periapical radiograph of maxillary left anterior region shows the following characteristics:

• Primary left central incisor and lateral incisors were fused.• Two separate pulp chambers and root canals were present. • The roots of fused primary teeth had not resorbed. • Surprisingly, the permanent central incisors also fused with the lateral incisors(Table/Fig 2).

The patient and the parent were informed about the delayed eruption of permanent central incisor. Extraction of fused teeth was carried out and periodic review was advised.


An interesting case of fusion between the maxillary primary central incisors and primary lateral incisors accompanied by fused permanent successors was presented in this case.

Prevalence of tooth fusion was estimated at 0.5% to 2.5% in the primary dentition, whereas prevalence in the permanent dentition seemed to be clearly lower than in the primary dentition (5). However, primary teeth anomalies can affect the permanent successors significantly which has been clearly demonstrated in this particular case. The presence of primary double tooth could also cause delayed resorption of root due to great root mass and increase area of root surface relative to the size of the permanent successor crown. This may lead to delayed or ectopic eruption of the permanent successor.

When fusion occurs, the clinician must be aware of following major dental concerns. First, since fused teeth are clearly wider than the surrounding teeth, esthetics may be a concern. In the present case, the esthetic view was not a problem in the primary dentition and the family was uninformed on the fusion teeth until the patient visited dental office.

Second, when normal teeth fuse, excess dental space can result which is not an issue in this case. Third concern relates to both esthetic and occlusion because of unerupted permanent maxillary anterior. This was the major concern for this particular patient. The fusion case reported have involved maxillary left primary maxillary central and lateral incisors, with complete union of the crown and two pulp canals and chamber. When fusion occurs in the primary dentition sometimes it may cause delayed eruption of permanent teeth. In this case the left permanent central incisor was not erupted due to this reason.

The final concern involves their surface contour fused teeth commonly exhibit labial and lingual grooves running vertically on the crown surface. These grooves are very pronounced in cases of incomplete fusion and are difficult to clean and considered to be caries prone zone (6). In present case there was a complete fusion. Although grooves were present on the teeth surface no caries was detected at the time of examination.

Thus, as per the patients concern of unerupted permanent maxillary anterior teeth, primary tooth is extracted and replaced by crowns after eruption of the permanent teeth. Periodic clinical follow-up was also advised to prevent caries, to check the erupting status of permanent teeth and to allow early intervention whenever pulp alterations and fractures occur.

Treatment of a fused tooth will depend on the clinical situation. Studies have shown that anomalies of primary dentition tendto repeat themselves in the permanent dentition (7). General preventive advice should be given to parent and the child, if it causes delayed eruption, it should be extracted and caries already exists, a restoration should be performed (8). Advanced treatment like sectioning and restoration, reconstruction with metalloplastic crown, amputation of one root, etc., greatly depends on location and extent of fusion.

Gellin also reported that proportion of permanent successor anomalies up to 50% following primary double tooth, including congenitally missing supernumerary and repeated double teeth formation (9). There fore, early diagnosis of the anomaly is considerable importance.


Dental fusion and germination are asymptomatic but both can result in a number of difficulties including tooth reduction in the permanent successors increased susceptibly to sub gingival bacterial plaque, aplasia or malformation of the permanent successors and impaction. The potential clinical problems associated with fusion require Orthodontic, Prosthetic, Cosmetic and Periodontal interventions also. Thus, to establish a right treatment to this anomaly, the early proper examination and knowledge to recognize this anomaly is a prerequisite.


Shafer WG.Developmental disturbances in shape of teeth. In. Shafer WG, Hine MK, Levy BM, Tomich C. A Text Book of Oral Pathology, 4th Ed. Philadelphia:W.B. Saunders Company, 1983; 38-9.
Duncan WK, Helpin ML. Bilateral fusion and Gemination: a literature analysis and case report. Oral Surg Oral Med Oral Pathol, 1987; 64: 82-87.
Milano M, Seybold SV, McCandless G, Cammarata R. Bilateral fusion of the mandibular primary incisors: Report of case. J Dent Child, 1999;66:280-82.
Hitchin A,Morris I. Geminated odontome –connation of the incisors in the dog: Its etiology and odontogeny. J Dent Res, 1966;45:575-83.
Hulsmann M, Bahr R, Grohmann U. Hemisection and vital treatment of fused teeth – literature review and case report. Endod Dent Traumatol.1997;13:253-58.
Alpoz AR, Munanoglu D,Oncag O. Mandibular bilateral fusion in primary dentition: Case report. J Dent Child(Chic), 2003;70:74-6.
Marinelli A, Giuntini V, Franchi L, Tollaro I, Baccetti T, Defraia E. Dental anomalies in the primary dentition and their repetition in the permanent dentition: a diagnostic performance study. Odontology, 2011 May 7 [Epub ahead of print).
Alvarez I, Creath CJ. Radiographic considerations for supernumerary tooth extraction: report of case. ASDC J Dent Child. 1995;62:141-44.
Gellin ME. The distribution of anomalies of primary anterior teeth and their effect on the permanent successors. Dent Clin North Am. 1984;28:69-80.

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