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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
Original article / research
Full Version
Evaluation of Elastic Recovery of Elastomeric Impression Materials Subjected to Various Disinfection Methods: An In-vitro Study
Correspondence Address :
Dr. Rama Krishna Alla,
Professor, Department of Dental Materials, Vishnu Dental College, Bhimavaram-534202, Andhra Pradesh, India.
E-mail: rkdentalbiomaterials@gmail.com
Introduction: Disinfection of impressions is essential to prevent cross-contamination from the operatory to the laboratory. Various methods have been employed to disinfect the impressions. These disinfection methods should not alter the physical and mechanical properties of impression materials.
Aim: To evaluate the Elastic Recovery (ER) of elastomeric impression materials subjected to different disinfection methods.
Materials and Methods: This was an in-vitro study conducted at KIMS Dental College and Hospital, Amalapuram, Andhra Pradesh, India and Vishnu Dental College, Bhimavaram, Andhra Pradesh, India over a period of 5 months from August 2022 to December 2022. A total of 120 impressions were made using three different types of elastomeric impression materials: Poly Vinyl Siloxane (PVS), Vinyl Poly Ether Siloxane (VPES), and Poly Ether (PE). A metal die was made as per American Society for Testing and Materials (ASTM) D412 and International Organisation for Standardisation (ISO) Specification 4823, containing a lower and upper member. These impressions were trimmed to the dimensions of a stainless steel stencil, measuring at points with uniform thickness. The impressions were then subjected to autoclave and chemical disinfection using 5% Glutaraldehyde (Korsolex) and Ethanol-2-Propanol (Bacillol). The samples prepared were fixed in the tensile grips of a Universal Testing Machine (UTM) and subjected to tensile loading at a crosshead speed of 10 mm/minute until tearing. The distance between the break ends was measured using a digital Vernier Callipers, and ER was measured. One-way Analysis of Variance (ANOVA) followed by Tukey’s post-hoc tests were used to analyse the obtained study data.
Results: The PE impression material demonstrated more ER when subjected to different disinfection methods compared to the other materials. Significant differences were observed between the ER of impression materials with different disinfection methods (Autoclave: p<0.001, Korsolex: p<0.001, and Bacillol: p=0.007).
Conclusion: For better ER, PVS can be sterilised with Bacillol and Korsolex. Korsolex should be avoided for disinfecting PE. VPES performed better with autoclave and Korsolex.
Cross-contamination, Glutaraldehyde, Vinyl poly ether siloxane, Tear strength
An impression may serve as a harbour for various pathogens, posing a risk of indirectly spreading infectious diseases, including Human Immunodeficiency Virus (HIV), hepatitis, and herpes, to dental professionals and laboratory personnel. Therefore, dental professionals should follow specified disinfection methods to reduce the risk of cross-infection and the possible transmission of diseases (1). Dental impressions are disinfected using a variety of methods, such as autoclaving, chemical disinfection, microwave disinfection, etc. The most popular techniques are chemical disinfection and autoclaving. Alcohol, 2% glutaraldehyde, ethanol, propanol, sodium hypochlorite, and chlorhexidine are common chemical disinfectants used in dentistry (2).
During the disinfection procedure, the impression material should not undergo dimensional changes. However, numerous investigations have indicated that the mechanical and physical characteristics of the impression may be adversely affected by immersing the impression in the disinfectant or spraying it with the disinfectant. Disinfection methods that alter the volumetric shrinkage, surface texture, and elasticity of the impression material have been reported in the literature (3).
Recently, a hybrid elastomeric impression material, VPES, has been introduced by combining the favourable characteristics of both PVS and Polyether (PE) impression materials (4). Numerous researchers have investigated the physical and mechanical properties of these newly developed hybrid elastomeric impression materials (5),(6),(7). However, there is a research gap on the impact of various disinfection techniques on the physical and mechanical characteristics of the VPES impression material. Therefore, the present study aimed to investigate the impact of various disinfection methods on the ER of VPES impression material and compared them with PVS and PE impression materials. The present study is part of a larger project to assess the Dimensional Stability (DS) and ER of the elastic impression materials.
This was an in-vitro study conducted at KIMS Dental College and Hospital, Amalapuram, Andhra Pradesh, India and Vishnu Dental College, Bhimavaram, Andhra Pradesh, India over a period of 5 months from August 2022 to December 2022. The Institutional Ethical Committee (IEC) approval was obtained with the IEC No: 010/KIMSDENTAL/2020.
Sample size calculation: Sample size calculations were conducted using G*Power 3.1.9.7 software to determine the difference in ER between groups as the primary outcome. The calculations were based on an effect size of 0.31 (derived from the pilot study), an alpha level of 0.05, and a desired power of 80%. The estimated sample size required for the study was determined to be 118.
Study Procedure
Die preparation: A custom-made metal die was fabricated according to ASTM specification number D 412 (7), containing a lower and upper member with dimensions of 11.5 cm length×5 cm breadth×1 cm width.
This die was manufactured using Standard Triangular Language (STL) format with respective dimensions with a 4-axis Computerised Numerically Controlled (CNC) Milling Machine (Kent India Co., Ltd., Taiwan) and a coolant (CUT S, Servo, Indian Oil Corporation Ltd, Mumbai, India, Batch No. 082ITD0011). It had an hourglass-shaped recess cut to a thickness of 1 mm and dimensions of A 10 cm, B 4 cm, C 3 cm, D 3 cm (Table/Fig 1). The upper component comprised a metal lid that covered the lower part. It incorporated four escape holes to facilitate the overflow of excess material, ensuring a consistent 1 mm thickness of the specimen (Table/Fig 2)a,b. Additionally, the lid was equipped with two stops positioned diagonally on two corners to ensure stable alignment when placing the upper component onto the lower component (Table/Fig 2)a,b. A stainless-steel stencil (Table/Fig 3) of 1 mm thickness was also manufactured. Dimensions measuring the width of 4 mm, a semi-circular shaped projection placed at 10 mm away from the centre of the specimen on either side (Table/Fig 2). The samples were made at room temperature (27±2°C) with each elastomeric impression material (PVS, PE, VPES) (Table/Fig 4).
Sample preparation: All the elastomeric impression materials were of medium body (Monophase) consistency opted for the present study. The impression materials were manually dispensed and mixed in accordance with the manufacturer’s specified instructions. The mix was loaded into the lower member of the die, and the upper member was placed upon the lower member, and a constant weight of 5 lbs for 10 minutes was applied to the upper member. The mix was left for a few minutes and allowed to set, and after setting, the excess material was removed with a BP Blade. A thickness of 1 mm was measured for the sample with a digital Vernier calliper to rule out any discrepancies that occurred during sample preparation. The resultant samples were trimmed to the dimensions of a metal stencil. The metal stencil was dumbbell-shaped measuring at (1 mm Thickness, 4 mm Width×75 mm Length) provided with two semi-circular measuring marks on each side, positioned 20 mm apart from the centre.
A total of 120 samples were prepared, with 40 samples from each of the three different elastomeric impression materials. The 40 samples from each impression material were further divided into four groups, with 10 samples (n=10) in each group based on the disinfection methods.
Sample disinfection: The samples were subjected to three disinfection methods, including autoclaving, immersion in the disinfection solution, and spraying the disinfectant. The samples washed under running tap water were considered the control group. Ten samples (n=10) from each impression material were allocated to each disinfection method.
Autoclaving was performed at 121°C for 15 minutes at an atmospheric pressure of 12 Pounds per Square Inch (PSI). For the immersion disinfection method, the samples were immersed in the disinfection solution, Korsolex (5% Glutaraldehyde) Rapid, for 5 minutes. In the spraying method, the samples were sprayed with the disinfectant, Bacillol (10% Ethanol), for 20 seconds and left for 10 minutes.
Elastic Recovery (ER) measurement: After the disinfection process, the samples were washed under tap water and air blown to remove any disinfectant residues. Subsequently, the samples were subjected to tensile loading using the Universal Testing Machine (UTM) (AE-UTM-LC2, India) (Table/Fig 5). The samples were fixed in the pneumatic grips of the UTM and subjected to tensile load at a crosshead speed of 10 mm/min until the specimens tore. The torn samples were reattached using the metal stencil (Table/Fig 6), and the distance between the marked lines was measured two hours after the sample failure using a Digital Vernier Callipers with a resolution of 0.01 mm. The change in length (?L) was measured to calculate the percentage deformation, which helped in assessing the ER. The ER was measured with the formula:
ER=(Final length after 2 hours of specimen failure/Original length)×100
Statistical Analysis
The obtained data were analysed using the Statistical Package for the Social Sciences (SPSS) version 20.0 (IBM SPSS, IBM Corp., Armonk, NY, USA). One-way ANOVA was used for analysing the ER of the samples. Tukey’s post-hoc tests were conducted for inter group comparisons. A p-value less than 0.05 was considered statistically significant.
The mean ER of three elastomeric impression materials disinfected with different methods is described in (Table/Fig 7). Among the VPES group, the VPES control group showed a higher mean ER. A decrease in the ER was observed in the disinfected groups of VPES material compared to the control group. In the PVS impression material, disinfected with Korsolex, showed a higher ER followed by the control group and Bacillol groups. The autoclaved PVS material demonstrated a lower ER (2.640±1.151%). In the PE material, autoclaved PE material showed a higher ER (4.970±1.666%) compared to the other groups. For each of the three elastic impression materials, no significant differences (p=0.44, p=0.083, and p=0.689 for VPES, PVS, and PE, respectively) were observed in ER based on the type of disinfection (Table/Fig 7).
In comparisons based on the impression material within each type of disinfection, there were no significant differences between impression materials in the control group, while significant differences were noted with autoclave, Korsolex, and Bacillol (p<0.001, p<0.001, and p=0.007, respectively) (Table/Fig 8).
In inter group comparison, PE showed significant differences with VPES (p<0.001) and PVS materials (p=0.003) after subjecting autoclave disinfection. Korsolex disinfection demonstrated significant differences between the impression materials (VPES-PVS: p<0.001; VPES-PE: <0.001) except between PVS and PE. Bacillol disinfection displayed significant differences between VPES and PE materials (p=0.006) (Table/Fig 9).
Sterilisation and disinfection of impressions have become mandatory protocols for every dentist to prevent several cross infections that are caused by saliva (8),(9),(10). High-level disinfection involves the maximum elimination of all microorganisms from an object, except for a few bacterial spores. It entails using a sterilant to kill appropriate Mycobacterium species with a shorter contact time, according to Food and Drug Administration (FDA) guidelines (11).
In present study, the ER was considered another important parameter among the ideal requisites of an elastomeric impression material (12). Elastomer theory states that the impression removal from the oral cavity and the resulting gypsum model are closely related to an impression material’s shear modulus (13). According to the fracture mechanics theory, stresses at a weak or critical spot are those that cause an impression to fail. Thus, there is a connection between tear strength and modulus of elasticity (14).
The present study demonstrated no significant differences within the individual disinfection methods of the three impression materials. However, significant differences were observed between the materials subjected to different disinfection methods. Various disinfection techniques have been studied in the literature to determine their effect on the different properties of elastomeric impression materials (Table/Fig 10) (4),(12),(15),(16),(17),(18),(19),(20),(21),(22),(23),(24),(25),(26),(27),(28),(29),(30),(31).
The ER results of the present study were in accordance with Millar BJ and Sanjukta D (15). They found significant differences between the groups with autoclave and disinfection with Perform®-ID (an aldehyde-free chemical disinfectant solution containing potassium peroxomonosulphate) compared to the control group. Also, Lawson NC et al., evaluated the tensile ER of five PVS materials and one hybrid VPES elastomeric impression material and suggested that all the materials tested exceeded the elongations of 100% tension before failure (32).
The PVS is often considered the optimal elastic impression material due to its superior ER and minimal permanent deformation compared to other elastomers (12). The type and formulation of the elastomer, such as addition-cured silicones, condensation-cured silicones, polyethers, or vinyl polysiloxanes, could affect their elastic properties (33). In the present study, the ER of PVS and PE impression materials increased with disinfection by Korsolex and autoclaving, respectively. Similarly, Gothwal G et al., reported an increase in the ER of PVS following disinfection (12). However, the type of disinfectants used in their study was different from the present study.
According to Goldberg AJ, viscous flow and lack of ER led to permanent deformation in elastomeric impression materials (34). However, with prolonged polymerisation and cross-linking of the material, all three deformation factors like immediate elastic, delayed elastic, and viscous flow will eventually be diminished. A high strain rate resulted in better overall ultimate tensile strength and ER (35). The present study investigated the ER within 24 hours of the specimens being fabricated.
The VPES material has a quadra-functional hydrophilic feature consisting of a cross-linked polymer and a unique surface-active ingredient. The exceptional tear strength of the product is attributed to the polymer chain of the material and the surface-active agent responsible for making it equally wettable as polyether impression materials. This particular PVS modification makes it possible to record superb surface details even in humid environments. Modified PVS has extremely high tear strength due to its quadra-functional feature, which is unsurpassed by any other impression material (32).
The differences in the calculated measurements might be due to the cumulative effect of retarded ER, the shrinkage caused by continuous polymerisation, the evaporation of volatile constituents, and the viscoelastic nature (viscous flow) of the material that was tested [36,37]. In the present study, VPES has a lower ER with a minimal mean value when compared to the other materials (PVS and PE) when subjected to different methods of sterilisation disinfection. Further studies may focus on the impact of disinfection methods on the other physical and mechanical characteristics of elastomeric impression materials.
Limitation(s)
The present study was an in-vitro study conducted at room temperature, potentially differing from the oral environment. The absence of exposure to saliva during impression-making could introduce variability, given saliva’s potential influence on material properties. The impressions were not exposed to microbial flora, another factor that wasn’t considered in the study. Additionally, the study did not simulate the thermal changes impressions might undergo during transportation, which could impact their properties. Therefore, by addressing these limitations, future research can enhance understanding of the factors influencing impression material performance and contribute to improving the accuracy and reliability of dental impressions in clinical practice.
From the present study, it can be concluded that the PE impression materials showed higher ER when subjected to different disinfection methods compared to the PVS and VPES materials. No significant differences were observed between the disinfection methods of impression materials. However, significant differences were observed between the impression materials with individual disinfection methods.
DOI: 10.7860/JCDR/2024/70764.19700
Date of Submission: Mar 18, 2024
Date of Peer Review: Apr 08, 2024
Date of Acceptance: May 11, 2024
Date of Publishing: Aug 01, 2024
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? NA
• For any images presented appropriate consent has been obtained from the subjects. NA
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ETYMOLOGY: Author Origin
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