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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
Case report
Full Version
The Charisma of 3D Imaging in Managing Endodontic Mishaps in Calcified Canal: A Case Report
Correspondence Address :
Ruchi Shah,
7, Taxashila Society, Opp. Zaver Nagar, Waghodia Road, Sumandeep Vidhyapeeth, Piparia, Vadodara, Gujarat, India.
E-mail: ruh006@gmail.com
Management of calcified canals is always challenging and is much more prone to mishaps such as perforations and ledge formations. The Two-dimensional (2D) imaging has a limitation, the 2D image of a Three-dimensional (3D) structure overlaps adjacent structures even over the root canals. This can create large confusion during treatment. Here, we are reporting a case where 2D imaging misled the treatment and 3D imaging evolved as a magical tool. A 32-year-old female, presented with complaints of pain, blackish discolouration and repeated sinus tract formation after her initial sitting of previous root canal treatment with upper right front tooth #11. On the radiograph, improper obturation and periapical radiolucency were evident. Hence, re-root canal treatment was advised and initiated. Gutta-percha was removed and radiographs were taken to ensure the removal of gutta-percha followed by working length estimation, which was satisfactory. After following all irrigation protocols, calcium hydroxide was placed as intracanal medicament but the patient came after two days with a draining pus sinus. The same happened with double antibiotic paste. Hence, Cone-beam Computed Tomography (CBCT) was advised. A buccal perforation and calcified unnegotiated canal were evident in all sections of CBCT. With the consent of the patient, the canal was again negotiated and guided with multiple angled radiographs. Intraoperative CBCT was advised with a master gutta-percha cone to verify the correct position of the canal. After verification, perforation was sealed with biodentine followed by obturation with crown placement in subsequent visits. Thus, 2D imaging can be misleading and 3D imaging is a guiding tool.
Biodentine, Buccal perforation, Calcification, Cone-beam computed tomography, Three-dimensional
A 32-year-old female patient presented with the chief complaint of mild dull aching pain associated with her right front tooth for five years and moderate throbbing pain with the same tooth for the last three months for which she was having analgesics twice or thrice a week. She was referred to the Department of Conservative Dentistry and Endodontics for its treatment. She had a history of root canal treatment three months back with the same tooth but had persistent pain and food lodgment with it. Also, there was a complain of blackish discolouration for seven to eight years. She did give a history of trauma in her childhood involving her right front tooth. The patient was examined after obtaining consent.
On oral examination, blackish discolouration was seen with tooth #11, with dislodged postendodontic restoration (Table/Fig 1)a. On vertical percussion and palpation of the adjacent tissue area, a positive response was obtained. On radiographic examination, coronally dislodged restoration was appreciated along with unsatisfactory obturation with voids and a periapical radiolucency suggesting periapical lesion with tooth #11 (Table/Fig 1)b. A diagnosis of a previously treated tooth with acute exacerbation of chronic periapical abscess was made with tooth #11.
The treatment plan included re-root canal treatment of #11 which was explained to the patient and after obtaining proper consent of the patient the treatment was initiated.
After anaesthetising the tooth and proper isolation, the gutta-percha was retrieved. Gutta-percha was softened with heated pluggers and retrieved using a conventional H-file. Single cone obturation was removed from the infected canal. Radiographically working length was established (Table/Fig 1)c. The canals were then irrigated with 3.25% Sodium Hypochlorite with a conventional irrigation technique. After relatively drying of the canal freshly mixed calcium hydroxide paste was placed as an intracanal medicament but on the radiograph, a hazy unevenly distributed radiopacity was observed after its placement (Table/Fig 1)d. The patient returned with pain and sinus tract opening after two days of placement of calcium hydroxide. After proper irrigation and drying of the canal, the double antibiotic paste was applied as an intracanal medicament this time. But patient returned the very next day with a larger sinus tract. Hence, Cone-beam Computed Tomography (CBCT) was advised to the patient to which she agreed.
All the scans were done using a CBCT machine (Kodak Carestream 9200, North America) and the sections thus obtained were analyzed using on-demand software (Kodak Carestream, North America). In the axial and sagittal sections of CBCT, buccal perforation was evident (Table/Fig 1)e. In coronal sections, a calcified canal was seen along with periapical radiolucency. In the sagittal section, the deviated buccal path of the canal created by the bur was seen along with a partially calcified canal along with periapical radiolucency.
The patient was informed of the condition and a newer treatment plan was designed and explained to the patient. The true canal was again negotiated with different angulated radiographs as the paralleling cone technique radiographs were misleading towards the buccal perforation as the correct canal path (Table/Fig 1)f.
Working length was again established and confirmed with help of multiple angulated radiographs (Table/Fig 1)g. Two orifices were appreciated.
Chemomechanical preparation was done with utmost care and calcium hydroxide was placed as an intracanal medicament as large periapical radiolucency was associated with the main canal. In the next sitting master cone, a gutta-percha radiograph was taken with different angulation (Table/Fig 1)h. Two orifices were appreciated clinically also (Table/Fig 1)i. As 2D radiography was misleading the treatment, an intraoperative CBCT scan with the master cone gutta-percha placed into the canal was advised (Table/Fig 2)a.
The axial and sagittal sections verified the correct path of the canal and gutta-percha. Master cone gutta-percha was placed in the canal (Table/Fig 2)b. Perforation repair was done by measuring the exact buccal perforation length with an inbuilt measurement tool in CBCT software (Table/Fig 2)c and the buccal perforation was repaired with biodentine (Septodent), a bioceramic repair material. After 12 minutes of the setting of biodentine, final obturation was carried out (Table/Fig 2)d. In subsequent visits, an all-ceramic crown was prepared and cemented to resolve the complaint of discolouration. On first year follow-up satisfactory healing was observed (Table/Fig 2)e,f.
Dystrophic pulpal calcification is seen widely in cases of trauma. They are defined as irregular biocalcification of pulp occurring during states of mineral imbalances (1). Many cases remain unnoticed and may be diagnosed accidentally during routine radiography (2). Clinically such cases of calcifications present with a slight change in the hue and value of the tooth. Yellowish and more dense whitish hue can be seen in such cases as the pulp chamber gets filled with reactionary and reparative dentine (3). Mostly, such cases do not require endodontic intervention, which is only indicated when pain is associated with necrotic pulp or a periapical lesion is associated with the same (4).
A similar case was reported, with buccal perforation in a calcified canal by Casadei A et al., who have also used guided CBCT and CAD/CAM in maxillary premolar (5). In a case reported by Alves R et al., surgical management of perforated obturated GP was carried out (6). The dynamic navigation system is the new era tool for managing such cases with more ease and perfection in which CBCT-guided software is the main equipment used (1).
In the above case, 2D radiography misled the treatment. The patient reported with the obturating material in the buccal perforation area and not the true canal, which was responsible for pain and sinus tract but it was not diagnosed with the conventional radiograph as the 2 vertical paths overlapped, one of the buccal perforation and another of the true canal. One of the other shortcomings of the case was not relying on the apex locator (RootZX mini) findings as the pretended canal (in real the perforation) was weeping and wet.
The use of low volume CBCT is increasing in diagnosing, planning and treating such difficult cases where radiographs have misled the treatment (7),(8). An intraoperative CBCT are rarely advised due to exposure concerns but it was necessary in this case (9).
In a review by Haridas H et al., in 2016, radiation exposure of a small volume CBCT image (ranging from 19-43 uSv) was compared with a panoramic radiograph (12-26 uSv) (10). Assouline SL et al., showed the importance and usefulness of a second intraoperative CBCT during maxillofacial surgeries (11). But its importance has not been appreciated yet, in the field of endodontics. For its use in endodontics, risks and advantages should be analysed before opting for an intraoperative CBCT, as in this case. All the aspects including the finances were also discussed with the patient. As the patient was financially sound, she agreed for obtaining a second intraoperative CBCT scan.
CBCT also guided the correct path of the canal after the chemomechanical preparation, using intraoperative CBCT with master cone gutta percha placed in the canal. Advances in bioceramic materials (e.g., biodentine, MTA) have increased the prognosis of the treatment in such difficult cases. Biodentine was preferred in this case over MTA due to its better handling properties, fast setting, and bio-sealing property (12),(13). One of the disadvantages of biodentine over MTA was its low radiopacity (14).
Mishaps during treating calcified canals are inadvertent but can be prevented by precise diagnosis and treatment planning. The 2D radiographs can be misleading as in this case and CBCT came out as a wonder guiding tool for not only diagnosing, and treatment planning but also for verifying the misguided path of the treatment and correcting the mishap.
DOI: 10.7860/JCDR/2022/58653.17074
Date of Submission: Jun 24, 2022
Date of Peer Review: Jul 18, 2022
Date of Acceptance: Aug 20, 2022
Date of Publishing: Oct 01, 2022
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jun 29, 2022
• Manual Googling: Aug 17, 2022
• iThenticate Software: Aug 18, 2022 (5%)
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