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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
Exudative Benign Cementoblastoma with Radiographic Rarities- A Case Report with Review of Literature
Correspondence Address :
Dr. Karthikeya Patil,
Professor and Head, Department of Oral Medicine and Radiology, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Bannimantapa, Mysuru, Karnataka, India.
E-mail: dr.karthikeyapatil@jssuni.edu.in
Cementoblastoma is a rare benign odontogenic neoplasm of mesenchymal origin. The benign cementoblastoma was previously classified as one of the cementoma neoplasias by the World Health Organisation’s (WHO) classification of odontogenic tumours. The benign cementoblastoma in 2005 has been added to the list of odontogenic tumours that involve “mesenchyme and/or odontogenic ectomesenchyme, with or without odontogenic epithelium”. It accounts for around 0.69-8% of all odontogenic tumours. The lesion usually is asymptomatic and slow growing causing cortical plate expansion of both buccal and lingual plates. Cementoblastoma has male predilection, commonly seen involving mandibular first molar diagnosed in early age. There are very few incidents of an infected cementoblastoma in the literature. Radiological examinations can reveal a blend of radiolucent and radiopaque mass presenting a wheel spoke pattern. The histopathological results for both cementoblastoma and osteoblastoma are comparable. The relationship of the lesion with the tooth is the distinguishing element. Hereby, authors present a case of infected cementoblastoma in a 51-year-old female patient involving impacted mandibular second molar, clinically aggressive with unique radiologic features. Cementoblastoma is usually an incidental finding while the present case was associated with an impacted tooth and was symptomatic with infection. The uniqueness of the present case was the complete involvement of the root structure and the cyst like expansion of the lesion instead of the usual thin radiolucent rim. Also, the lesion was infected with no dental caries associated with the tooth.
Dental cementum, Impacted, Odontogenic tumour
A 51-year-old female patient reported to the Dental Hospital with the chief complaint of swelling and pain on the left side of the face which she had noticed two months ago. The pain was moderate in intensity, intermittent in nature with no aggravating factors and relived on taking analgesics. The swelling was initially small which gradually grew to attain the present size. The patient had visited a dental practitioner with the same complaint two months ago where she got her tooth left mandibular first molar (36) extracted which was misdiagnosed as the cause for swelling and pain without prior diagnostic radiographs. The patient reported to our dental hospital since there was no relief form pain and swelling. The patient’s medical and family history were unremarkable.
Clinically, patient presented with an extraoral swelling in the left lower third of the face measuring around 5×6 cm in diameter with no remarkable surface changes (Table/Fig 1)a. On palpation, the swelling was well defined and hard in consistency and no signs of paraesthesia noted. Intraoral examination revealed obliteration of the left buccal vestibule in the region of 36 and 37, associated buccal cortical plate expansion with intact lingual cortical plate. Pus discharge was noted in the region of 37 which was clinically missing (Table/Fig 1)b.
Considering the above history and examination a provisional diagnosis of dentigerous cyst with respect to impacted 37 was given and differential diagnoses of infected residual cyst (in relation to 36) and odontogenic tumour with impacted teeth were considered. Orthopantomograph (OPG) revealed an impacted 37 with a radiopaque mass involving the entire root. Loss of complete root morphology and well circumscribed wide spacious concentric ring around the root which had fibrous root appearance was evident (Table/Fig 1)c which is rarely seen as compared to common spoke wheel appearance. Cone Beam Computed Tomography (CBCT) images of different sections, showed a well-defined radiolucent band inside the cortical border with a radiopaque mass at the centre accompanied by minor areas of radiolucency (Table/Fig 2)a,(Table/Fig 2)b,(Table/Fig 2)c.
There was no invasion of the lesion to the mandibular canal in all three sections- axial, coronal and sagittal. There was evidence of buccal cortical plate expansion and perforation of buccal cortical plate, giving more evidence of an aggressive matured benign cementoblastoma (Table/Fig 2)d.
Since, the lesion was infected, the patient was put on broad spectrum antibiotic coverage and routine haematological examination before surgical excision showed normal blood parameters. Excisional biopsy of the lesion along with the extraction of the associated 37 was done under general anaesthesia. The gross specimen consisted of a tooth along with bony tissue mass measuring 2.5×2×2 cm (Table/Fig 3)a. There was loss of the root morphology while the crown appeared normal. Microscopically, the sections showed basophilic masses with inflammatory infiltrate, fibrovascular connective tissue, areas of fibrosis and bony trabeculae lined by osteoblasts and association of the lesion with the root of the tooth, confirmed the diagnosis of cementoblastoma (Table/Fig 3)b.
The patient was advised periodic follow-up upto six months. The patient showed remarkable improvement in terms of healing and pain control in two months. Postoperative follow-up OPG taken at the end of six months showed complete resolution of the lesion with no recurrence (Table/Fig 3)c. Patient was advised for replacement of missing teeth. Schematic representation of the proposed staging of cementoblastoma based on root involvement with varied radiographic features (Table/Fig 3)d.
Cementoblastoma is a relatively rare and uncommon benign neoplasm of mesenchymal origin (1). Cementoblastoma accounts for around 0.69-8% of all odontogenic tumours (2). It is formed by the haphasard deposition of cementum like material by the proliferating cementoblast cells. The neoplasm usually presents as a slow growing bony hard swelling which is predominantly asymptomatic (3). Paraesthesia was also observed when the lesion involves the mandibular canal (4). The lesion has a slight male predilection usually occurring in the 2nd and 3rd decade of life. While there are cases reported in the literature in patients ranging between 10-72 years of both genders (4),(5). Few literature points to their equal gender predilection (6). A fully erupted mandibular permanent 1st molar is most commonly associated with the lesion. Nevertheless, the incidence of occurrence in the maxilla and primary dentition cannot be denied (7). The present case under discussion is unique in its presentation which is highlighted in (Table/Fig 4). Based on the literature survey very few cases have been reported involving impacted mandibular second molar (Table/Fig 5) (1),(2),(3), (5),(6),(7),(8),(9),(10),(11),(12),(13),(14),(15),(16),(17),(18),(19),(20),(21),(22),(23),(24),(25).
The lesion usually is asymptomatic and slow growing causing cortical plate expansion of both buccal and lingual plates (5). There are very few incidents of an infected cementoblastoma in the literature (5),(8),(9). The clinical examination in the present case revealed pus discharge in relation to unerupted 37 with intraoral sinus opening and 36 was missing. The present case seemed aggressive and more matured (considering the age at diagnosis) with the expansion of the buccal cortical plate and an extraoral swelling which the patient had noticed for the past two months.
Chrcanovic BR and Gomez RS, analysed 258 cases of cementoblastoma deriving the following result i.e, equal gender prevalence and higher prevalence was evident in the 2nd/3rd decades 9of life. The common site of occurrence is mandibular 1st molars. Lesions were frequently related with bone expansion (74.9%), clinical symptoms (70.2%), vital teeth (78%), and root resorption (59.8%). Less frequent observations included perforation of cortical bone (16.3%), inferior displacement of the mandibular canal (23.6%) (10).
The results of a radiological examination can present three stages i.e, initial, intermediate and mature stages. In the initial stage, the lesion is usually radiolucent. The intermediate stage manifests a blend of radiolucent and radiopaque mass. While a completely mature lesion displays a dense radiopaque mass surrounded by a radiolucent halo (26). Going through the radiographic data of case reports, it was observed that almost all the lesions were in the maturing stage and few were found to be in the intermediate stage. Therefore, lesions in their initial stage, seldom show any symptoms. Also, the case reports of cementoblastoma associated with infection or impacted tooth, are only a few (Table/Fig 5) (1),(2),(3), (5),(6),(7),(8),(9),(10),(11),(12),(13),(14),(15),(16),(17),(18),(19),(20),(21),(22),(23),(24),(25).
In the present case, the radiographic examination via orthopantomogram and CBCT images revealed an impacted 37 with a radiodense mass involving the entire root component from the cervical region to its apex showing a fibrous root appearance which was different from the regular wheel spoke pattern. The density of the cemental mass was obscuring the entire outline of the enveloped root resulting in loss of entire root morphology. The mass had invaded the root canal and had obliterated the periodontal ligament space. The tumour was considered to be in the matured stage since the central radiopaque mass involving the entire root was surrounded by a radiolucent band from the center to the periphery. The lesion was extensive enough to cause the expansion of mandible perforating the buccal cortical plate without any periosteal reaction. In the literature review most of the reported cases involved either apical 3rd or extended up to middle third of root which was different in the present case with the involvement of the entire root. Considering the unique radiographic features in the present case, a new classification for staging can be proposed based on the level of root involvement (Table/Fig 3)d.
1. Initial stage-Tumour involving apical third.
2. Intermediate stage-Tumour involving middle third of root.
3. Mature stage-Tumour involving entire root.
Cementoblastoma in its initial stage can be treated endodontically. While the intermediate and mature stages require extraction of the involved tooth (27).
Histopathological investigation gives similar findings for both cementoblastoma and osteoblastoma. The differentiating factor is through the association of the lesion to the tooth. In Cementoblastoma, the radiopaque mass is attached to the root of the associated tooth while in osteoblastoma the radiopaque mass is usually not in contact with the root of any tooth (13).
The present case of infected cementoblastoma associated with impacted tooth, had a history of extraction of the adjacent tooth. The chances of infection of cementoblastoma associated with an unerupted tooth, is highly unlikely (5). The lesion may have incurred the infection from an infected periapical lesion of the adjacent tooth or could be idiopathic. The probable cause of infection of cementoblastoma associated with an erupted tooth with no dental caries may be from the per coronal abscess or periodontal infection of the associated tooth or idiopathic.
The present case was a case of cementoblastoma with distinct clinical and radiological manifestations. The present case mandates the inclusion of cementoblastoma in the differential diagnosis of impacted/clinically missing tooth. Also, highlights the importance of radiographic investigation prior to arriving at a specific diagnosis and intervening with any surgical intervention. Radiographic investigation should be considered mandatory by all practitioners to avoid misdiagnosis and inaccurate treatment planning.
DOI: 10.7860/JCDR/2022/56579.16741
Date of Submission: Mar 23, 2022
Date of Peer Review: Apr 18, 2022
Date of Acceptance: May 30, 2022
Date of Publishing: Aug 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: Mar 26, 2022
• Manual Googling: Apr 18, 2022
• iThenticate Software: May 19, 2022 (6%)
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