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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
Reviews
Full Version
Bonding of Fractured Fragments using Various Bonding Materials as a Treatment Modality in Cases of Vertical Root Fracture- A Systematic Review
Correspondence Address :
Pooja Chandak,
Postgraduate, Department of Conservative Dentistry and Endodontics,
Sharad Pawar Dental College, Wardha, Maharashtra, India.
E-mail: poojachandak1296@gmail.com
Introduction: Vertical Root Fracture (VRF) is third most common factor leading to extraction of root canal treated tooth. It has a longitudinal orientation. This occurs due to reduction in structural integrity and dehydration of dentine. Most common treatment includes extraction of the teeth. Other modality is amputation of involved root in molars. Various materials can also be used for bonding of the fragments.
Aim: To compare and evaluate the effectiveness of dentine bonding systems in re-attatchment of fractured root.
Materials and Methods: The present systematic review included a comprehensive search of last 10 years was performed in the systematic electronic database PubMed. In-vitro laboratory studies that evaluated the microtensile bond strength and fracture resistance of multiple dentine adhesive systems and compared them in human and/or animal teeth in which VRF had occurred were included. A total of 16 non duplicated studies were retrieved in the systematic search.
Results: Out of 16 studies four studies were included in the systematic review. One study assessed the bond strength of the adhesive using table top testing machine. Two studies assessed the microtensile bond strength using stereo microscope and one study assessed recurrence of the fracture using Instron Machine. The studies demonstrated large variability among methodology used for evaluation. In one study, acid phosphate monomer showed highest microtensile bond strength (p<0.05), and in another study Refracture (RF) occurred easily in samples bonded with Glass Ionomer Cement (GIC) as compared to those bound with Perma Bond and Gluma (p<0.0003).
Conclusion: From the present study’s analysis, dual cure adhesive resin cement either reinforced with polyethylene fibres or glass fibres, and glass ionomer cement may increase the fracture resistance of bonded tooth.
Adhesive systems, Longitudinal fractures, Re-attachment
Vertical Root Fracture has longitudinal orientation and originates from apex of the root and propagate to the coronal part of the tooth (1). It is third most common factor leading to extraction of root canal treated tooth (1). Changes occurring in Root Canal (RC) treated tooth are decreased stiffness and also leads to decreased fracture resistance. This occurs due to reduction in structural integrity and dehydration of dentine. In such cases endodontic crowns are better to be used instead of full crowns (2). Post and core is also the better restorative modality in cases of RC treated tooth (3).
The VRF leads to poor outcome of the tooth. Complete root or a part may be involved in the fracture (4). It may extend to only one or both sides of the root (4). Diagnosis of VRF is quite difficult. It is likely similar to the periodontal disease or the failed endodontic treatment (1). In multi-rooted teeth, fracture is commonly oriented in buccolingual direction. In anterior teeth also it is directed buccolingually (4). VRF can be classified as: initiating from the coronal tooth structure and one initiating from the apex. It can also be classified as complete and incomplete VRFs (4). VRF presents with multiple clinical features, thus making it difficult to diagnose. It presents delayed signs and symptoms. Clinical and radiographical features include deep periodontal pocket, pain, j-type radiolucency and sinus tract. Most common treatment includes extraction of the teeth (5). Other modality is amputation of involved root in molars. Bonding of the fragments can also be done (5). Sugaya T et al., developed the method which includes atraumatic intentional extraction followed by rotational replantation of the tooth (6). Adhesive resin are used to restore the tooth. Extraction of fragment helps to clear granules. Rotational replantation creates contact in the crack and healthy periodontal tissue (7). Various materials can be used for bonding of the fragments. It includes Methyl Methacrylate (MMA) based resin material, dual cure composites and GIC (7),(8),(9).
The purpose of this systematic review was to assess the success of dual cure composite with three adhesive systems [Clearfil SE Bond (SE), Tokuyama Bond Force (BF) and Clearfil DC Bond (DC)], MMA based adhesive resins, dual cure resin cement with polyethylene fibres and glass fibres, GIC, resin and Cyanoacrylate cement to bond fractured fragments. The hypothesis is none of the above bonding materials have successful results in treatment of VRF.
This systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The studies were selected according to the inclusion and exclusion criteria. All abstracts and full texts were reviewed. None of the manuscript author was contacted during this process. Disagreements between authors were evaluated and the studies were eliminated through discussion among researchers until a consensus was reached.
Inclusion criteria: The eligibility criteria considered in-vitro laboratory studies that evaluated the microtensile bond strength and fracture resistance of multiple dentine adhesive systems and compared them in human and/or animal teeth in which VRF has occurred. The studies in the review were included from year 1993-2013 and duration of systematic review was two months.
Exclusion criteria: Studies that considered extraction as a treatment option for VRF were excluded.
Search Strategy
A systematic search without restrictions was performed by two independent reviewers in the electronic database PubMed without restriction on year of publication. No filters or limits were applied in the searches. The selection of the descriptors was based on the most cited terms in previous publications related to this theme. The Boolean operators ‘AND’ and ‘OR’ were used to create the keywords search (Table/Fig 1). The keywords used were “VRF,” “re-attatchment of fragment”, “material for bonding”. The search details were “VRF (all fields) AND re-attatchment OR bonding (all field) AND bonding material (all field).”
Selection of the Studies
Two independent authors selected the studies, examining the retrieved titles and abstracts according to the search strategy. When it was not possible to judge the studies by title and abstract, full text was obtained for the final decision. This review included in-vitro studies. For this reason, the Patient Intervention Comparison Outcome (PICO) system was adapted: population (studies conducted in human/animal extracted teeth), intervention (evaluation of success of material used for the treatment), comparison (between the materials used), and outcomes (success rate of the material). Disagreements on inclusion criteria were solved by consensus with a third author following the predefined inclusion criteria. Studies that appeared to be duplicated in the database search were considered only once.
Quality Assessment of Studies
In second step full text of the chosen articles were read out for data extraction and quality assessment was done as per Oral Health Assessment Tool (OHAT) by two independent reviewers (PC, KR) (10),(11). In cases of difference between reviewers, the third senior reviewer (MC) clarified the discrepancy. Flow chart for this systematic review is shown in (Table/Fig 2).
In the beginning, 21 articles were selected which included bonding of fractured root fragment with the dentine adhesive. Five articles were excluded due to duplication. Out of remaining 16 articles, six studies were excluded due to wrong study design, no relevant result, no proper comparison of the adhesive system, different intervention and six more articles were excluded due to unavailability of full text. Hence, only four articles were selected (Table/Fig 2). Title, abstract, a scientific context based on bonding of fractured root fragment with dentine adhesive was included. Also, rationale, objectives hypothesis, methodology showing study type was incorporated. Intrusion, statistical analysis, evaluation period were also used and main results were extracted from each experimental study.
In this study, after quality assessment for risk of bias was done by three independent reviews and by OHAT tool, it was found that all studies included low risk of bias (Table/Fig 3) (7),(8),(9),(12).
Research question: Is bonding of the fractured fragment using various bonding material the effective treatment modality in cases of VRF?
Search findings and study characteristics: A total of 21 articles were found. After screening the titles and the abstracts of the identified studies, four studies were included in the full-text analysis. No additional relevant studies were found from hand searching. The four studies included were in-vitro studies. As the articles were heterogeneous in design/methodology and contained disparate data types, quantitative analysis was not possible and a qualitative systematic review was performed.
The initial screening of the retrieved studies was conducted using titles and abstracts. The corresponding full text was read when the results were unclear. The authors independently evaluated the studies and discussed the results until a decision was reached by consensus. The outcome of the included studies is mentioned in (Table/Fig 4). The performance of the included articles on the JBI The Joanna Briggs Institute Critical Appraisal tool (JBI) is presented in (Table/Fig 5) (13).
Tooth with VRF is difficult to treat with conventional treatment like root canal treatment. Multiple modalities are tried to preserve completely cracked tooth. These modalities include root resection in multi-rooted teeth and extraction in single rooted teeth (12). Root fracture reconstruction has been tried with various adhesive cements (12). This study aims in analysing various bonding or adhesive materials for their success in bonding the fractured root fragments and their ability to resist RF.
Waidyasekera K et al., in the study used different materials for bonding of fractured fragments: Dual cure resin composite Clearfil DC Core Automatrix, two-step self-etching adhesive Clearfil SE Bond, one step self-etching adhesive Tokuyama Bond Force or one step dual cure self-etching adhesive Clearfil DC Bond. The samples used for the study included bovine root fragments. The study was conducted to observe micro-tensile bond strength or ultimate bond strength of the materials used. The bond strength is affected by the dentine adhesive system to be used and water storage time. The result was statistically analysed by two-way ANOVA and Post-hoc test. Out of the above materials used Clearfil SE Bond showed highest microtensile bond strength of 59.7±7 irrespective of time for water storage. The initial micro-tensile bond strength was maintained even at one year of water storage of the specimens in case of Clearfil SE Bond. Tokuyama Bond Force showed reduction in the bond strength of 40.4±2.41 at six months of storage in water. Clearfil DC Bond showed least microtensile bond strength of 35.3±4.9. In case of resin material Clearfil DC Core Automatrix, the bond strength is affected only by the mode of curing. Water storage has no effect on the bond strength of resin. Resin incorporates well in dentinal tubules. It also infiltrates well in interfibrillar spaces and thus maintain the bond strength (8).
Nurrohman H et al., in their study evaluated micro-tensile bond strength (μTBS) of MMA based adhesive. The materials used were Super Bond (SB) C and B, M-Bond or M-Bond II. The bond strength was evaluated in cervical and the apical region. The results were obtained statistically using three-way ANOVA test. Two-way ANOVA test followed by Dunnett’s T3 Post-hoc test was carries out for each material. Value of significance kept was at α=0.05. As stated earlier the bond strength is affected by the dentine adhesive system to be used and water storage time. No significant difference was seen in μTBS of SB in cervical and apical region i.e. 21.0 and 22.1 at the end of one year. Water content of dentine in cervical region increases with increase in tubule diameter and density. The initiator in SB uptakes O2 and H2O. This leads to Free Radical Polymerisation (FRP) of monomers in resin. This stabilises bond strength of SB in various regions. A decrease in μTBS was found with of both self-etching systems M-Bond and M-Bond II with the mean value of 15.7 and 13.5 at the end of one year. This is due to increased content of hydrophilic like phosphoric acid monomers in MB and MB II primers. This results in increased water sorption. This decreases hydrolytic stability of the interface and thus decreased bond strength (7).
Kumar BS et al., conducted in-vitro study. They evaluated fracture resistance in vertically fractured root bonded with fibre reinforced composites. The teeth were intentionally fractured. They were rebounded with dual cure resin cement (RelyXU100), Dual cure resin cement and polyethylene fibre (Ribbond) and Dual cure resin cements and glass fibres (stick net). Vertical fracture resistance was calculated by one-way ANOVA and Tukey Post-hoc test. In fibre composites the mechanical properties depend on the direction of fibres in the matrix. Unidirectional and continuous fibres provide stiffness and strength to the material towards the fibre orientation. Thus ribbond showed higher resistance to fracture with the value of 328.1 N. This is because Ribbond fibres adhere to root dentine as well as the resin part. In comparison stick net fibres and RelyXU100 fibres forms clusters in canal space. In this system only resin part has the adhesion property with decreases the fracture resistance (12).
Friedman S et al., in their study calculated forces leading to RF of the already bonded fractured root fragments. In the study, he also evaluated the bonding strength and the fracture resistance of the material used for bonding. This is the in-vitro study. The samples were mounted in Instron Machine. The forces were made to exert vertically till the fracture occurred. The force fracturing the root (F), root surface area (A) was measured. The fractured fragments were attached with Ionos bone cement, Permabond 910 cynoacrylate adhesive and Gluma bonding system. The samples were then stored in wet sponge. The roots were RF one week later. The force required for RF of roots was measured. The values were statistically calculated by Kruskal-Wallis, one-way ANNOVA and Mann-Whitney u test. Thus the results showed that the RF force in the samples bonded with Ionos cement was less i.e., 15.09 lb as compared to samples bonded with Permabond with the value of 38.42 lb and Gluma with 31.13 lb. RF/A ratio was less for Ionos cement i.e., 22.11 mm2 in comparison to Permabond with 54.41 mm2 and Gluma with 41.21 mm2. The results with Permabond and Gluma were not statistically significant (9). Thus, the above hypothesis was proved to be wrong as dual cure composite resin with resin adhesive system, MMA based resin (SB C and B) showed significant results for bonding in cases of VRF.
Limitation(s)
The studies included in this systematic review did not have common materials to compare. Hence, it is difficult to give an appropriate conclusion. Studies with common parameter for comparison are required to come to proper conclusion. As these studies conducted were in-vitro, more in-vivo studies are required on the use of these materials in re-attatchment of VRF.
By reviewing the above studies, it is demonstrated that dual cure composite resin with resin adhesive system, MMA based resin (SB C and B) showed significant results for bonding in cases of VRF. Dual cure adhesive resin cement either reinforced with polyethylene fibres or glass fibre, and GIC can be used to increase the fracture resistance of bonded tooth.
DOI: 10.7860/JCDR/2022/50150.16303
Date of Submission: Apr 29, 2021
Date of Peer Review: Jul 03, 2021
Date of Acceptance: Jan 03, 2022
Date of Publishing: May 01, 2022
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? NA
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: May 03, 2021
• Manual Googling: Dec 02, 2021
• iThenticate Software: Jan 22, 2022 (20%)
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