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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
Soft Tissue Ridge Augmentation Around Implant Using Modified Pouch Approach: A Case Report
Correspondence Address :
Dr Nishi Tanwar,
Professor, Department of Periodontology, Post Graduate Institute of Dental Sciences, Rohtak-124001, Haryana, India.
E-mail: aparna81112@gmail.com; nsh_tanwar@yahoo.co.in
Common clinical findings around dental implants are hard and soft tissue defects requiring interventions for functional and aesthetic purposes. Interventions include hard as well as soft tissue augmentation. Present case management included subepithelial connective tissue grafting with modification of lateral pouch graft procedure, avoiding the vertical incisions. To the best of our knowledge, this is the first case report of this modified procedure. A 24-year-old female patient was referred by the prosthodontist for soft tissue augmentation after implant placement with respect to #24. With the consent of patient, subepithelial connective tissue graft was placed using modified lateral pouch graft procedure. Patient was evaluated at three months. Adequate soft tissue thickness was obtained with satisfactory results. This modified pouch graft procedure is expected to provide better aesthetic results. This procedure can be best utilised for small horizontal ridge defects. This is a novel approach for soft tissue augmentation without using vertical incisions thus providing better aesthetic results. Further studies are suggested regarding the long term success of the procedure.
Alveolar ridge augmentation, Complications, Dental aesthetics, Dental implants
A 24-year-old female patient was referred by the prosthodontist for soft tissue augmentation after implant placement with respect to edentulous space of upper right first premolar. Implant was placed six months back along with bone grafting with respect to #24 for hard tissue augmentation. On intraoral examination, Seibert Class-I defect (horizontal ridge deficiency) (1) was found at the site [Table/Fig-1,2]. Adequate keratinised tissue thickness was present at the ridge defect site. Intraoral peri-apical radiograph (Table/Fig 3) was taken to assess osseo-integration of the implant, and to rule out any periodontal and peri-apical infection of the adjacent teeth. Periodontal tissue was healthy on clinical and radiographic examination [Table/Fig-3,4]. Soft tissue ridge augmentation procedure using subepithelial connective tissue with a modification of pouch graft approach was planned. Patient was informed about the procedure and consent was taken. Medical and dental history was non contributory. Full mouth scaling was done. Patient was recalled after one week for the procedure. After anaesthetising concerned area, sulcular incisions were made on the distal line angle of canine and mesial line angle of 2nd premolar using Bard Parker blade (#15C). Sub-epithilial tunnel was prepared using orban’s knife and periosteal elevator relieving all the underneath fibers. Sub-epithelial connective tissue graft of size 5×8 mm was retrieved from right-side of palate from premolar region (Table/Fig 5) using single incision technique. Graft was inserted in the tunnel (Table/Fig 4) and was secured with tooth anchored sutures using 5-0 prolene suture. Aftercare included antibiotics (Amoxicillin 500 mg thrice daily for five days) and analgesics (Ibuprofen 400 mg twice daily for three days) and chlorhexidine mouthwash 0.2% twice daily for two weeks. Suture removal was done after 10 days (Table/Fig 6). Patient was recalled at one month (Table/Fig 7) and three months [Table/Fig- 8,9]. Significant amount (3 mm) of soft tissue buldge was obtained at the concerned site. Patient was satisfied with the outcome. Results were stable till three months (Table/Fig 10). Patient is still on follow-up.
Hard and soft tissue deficiencies are common clinical findings around dental implant, included in the new classification of periodontal and peri-implant diseases and conditions under category “Peri-Implant soft and hard tissue deficiencies” (2). Very well evidenced contributing factor for tissue defects is tooth loss (3) leading to some physiological changes in hard as well as soft tissue of the alveolar bone. Majority of changes take place within first year (4). Reduction in buccal tissue volume, noted frequently, (5) is a physiologic phenomenon which can be explained on the basis of difference in thickness of buccal and lingual/palatal bony plates. Ridge concavity created as a result of volume loss, many times become reason of aesthetic concern for patient as well as clinician. Also, it is difficult to provide a good functional prosthesis on a deficient ridge. Ridge augmentation procedures are evolving as solution for ridge deficiency. Both hard as well as soft tissue augmentation can be performed in some deficient ridge cases. Various types of prosthesis such as maryland bridges can also be provided to compensate for deficient volume of ridge (6). Soft tissue augmentation procedures demonstrated for this purpose are: roll flap procedure, pouch graft procedure, interpositional graft procedure and onlay graft procedure. On the basis of short term evaluation of results in term of volumetric increase in edentulous ridge, Studer S et al., proposed these procedures as: roll flap 11procedure for single tooth ridge defect (minor horizontal and vertical loss) correction, submerged connective tissue graft for larger defects, onlay full thickness gingival graft for ridge augmentation with mucogingival problems (7). Studer SP et al., demonstrated superior results with the use of submerged connective tissue grafts compared to the use of full thickness graft (8).
Pouch graft procedure is used to correct Class-I ridge defects. Initial incision and dissection plane may vary (9),(10). When the dissection plane is lateral, one or two vertical incisions are made from either side of the defect.
This lateral plane dissection pouch graft procedure with one vertical incision was demonstrated by Kaldahl WB et al., (11). The procedure used in present case is although based on the same principle as of lateral pouch graft procedure but is a modification of this technique as approach was through adjacent gingival sulcus without any vertical incision.
As in this case, hard tissue augmentation was done prior to implant placement, option left to counter the ridge deficiency was soft tissue augmentation. It can be done at different time points for the implant, although a systematic review (12) revealed significant enhancement in soft tissue thickness and keratinised tissue width at three months regardless of procedural timings.
In present case, soft tissue ridge augmentation procedure was done three weeks before the second stage surgery using autogenous subepithilial connective tissue graft which is considered as gold standard. After three months, satisfactory results were obtained (Table/Fig 5) and were stable. However, one clinical trial reported analogous results using new xenograft materials (13), another reported better results with connective tissue graft (14).
In present case, surgical procedure was performed using sulcular incision avoiding any vertical incision. Vertical incisions should be avoided in the anterior region as it leads to scarring, compromising the aesthetics.
This modified technique can be used in Class-1 ridge defect with small edentulous span (involving one tooth). Advantages of this technique include better aesthetics and less postoperative complications due to adequate blood supply, minimum tissue trauma thereby imparting early uneventful healing. Limitation of this procedure can be stated as that this procedure may not be performed in larger edentulous span due to limited availability of connective tissue graft and also subepithelial tunnel cannot be prepared for long edentulous span.
This case report presents modification of lateral pouch graft procedure for soft tissue ridge construction in the maxillary premolar area having horizontal ridge defect. No vertical incision, good blood supply, less tissue trauma, use of autogenous graft contributed to the success of this procedure in terms of aesthetics, but limited availability of the connective tissue adds limitation to this procedure for long edentulous span. Further, long term follow-ups are advised for such cases to observe the dimensional stability.
We acknowledge Post Graduate Institute of Dental Sciences, Rohtak for providing all the facilities to conduct this research and Dr. Sujata Chahal from Department of Prosthodontics for referring and providing clinical details.
DOI: 10.7860/JCDR/2023/60808.18041
Date of Submission: Oct 15, 2022
Date of Peer Review: Jan 25, 2023
Date of Acceptance: Feb 20, 2023
Date of Publishing: Jun 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• 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: Oct 6, 2022
• Manual Googling: Feb 02, 2023
• iThenticate Software: Feb 18, 2023 (8%)
ETYMOLOGY: Author Origin
EMENDATIONS: 5
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