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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
Redefining Immediate Implant Aesthetics with Socket-shield Technique: A Case Report
Correspondence Address :
D Preetha,
Off. Old Mahabalipuram Road, Thalambur Road, Near Navalur, Chennai-600130, Tamil Nadu, India.
E-mail: preethadivakaran97@gmail.com
Tooth loss has been a longstanding issue, prompting the exploration of various treatment modalities. Dental Implants have emerged as one such biocompatible treatment modality for replacement of missing teeth. Following tooth extraction preservation of facial alveolar bone and soft-tissue architecture is critical for achieving optimal aesthetic outcomes in the anterior maxilla. Physiologic post-extraction remodelling, particularly resorption of the buccal plate, often compromises aesthetic results even with immediate implant placement. Conventional extraction and implant protocols may not completely prevent these dimensional changes. The Socket-shield Technique (SST) is a biologically driven approach that aims to preserve the periodontal ligament-bundle bone complex through intentional retention of the buccal root fragment, thereby limiting post-extraction hard and soft-tissue collapse. Hereby, the authors described the clinical application of SST with immediate implant placement in a 27-year-old male patient presenting with repeated fracture of a composite restoration in a previously endodontically treated maxillary left central incisor (21). Clinical and radiographic follow-up demonstrated preservation of the facial bone contour, stable peri-implant soft-tissues and favourable aesthetic outcomes. Within the limitations of a single case, SST appears to be a viable option for managing aesthetically demanding anterior maxillary implant sites when performed with careful case selection and surgical precision.
Alveolar bone loss, Bundle bone, Decoronation, Root retention, Tooth extraction
A 27-year-old systemically healthy male patient reported with the chief complaint of replacing the composite restoration in relation to 21. The tooth had been endodontically treated one year earlier following trauma, with a composite restoration placed due to limited remaining coronal structure. The patient had a history of repeated fracture of the composite restoration in 21. The patient underwent restoration in 21 before reporting to the Department as the tooth is located in the aesthetic zone. But the patient expressed dissatisfaction with aesthetics and wanted a fixed replacement, particularly in the maxillary anterior aesthetic zone where post-extraction tissue remodelling is critical.
Patient was systemically healthy and had no history of Gastro Oesophageal Reflux Disease (GERD). Patient had a dental history of multiple restoration in cervical region in mandibular teeth and root canal treated 11. The patient had also undergone uneventful extraction of 12 and 22 following trauma and implant placement of the same teeth one year prior, which were stable and intact. Patient had no complaints about 11, 12 and 22. Patient had poor oral hygiene maintenance with severe calculus and stains. So patient was advised and explained ways to improve oral hygiene for better prognosis after the treatment.
Preoperative Evaluation
Intraoral examination revealed a composite restoration in relation to tooth 21. The tooth was asymptomatic and exhibited no signs of mobility. Clinically adequate bone height was confirmed with probing pocket depth of less than 3 mm (Table/Fig 1)a, (Table/Fig 1)b. Intraoral periapical radiographic examination demonstrated an adequately obturated root canal, no crestal or interdental bone loss in relation to 21, an intact buccal cortical plate and sufficient bone volume for immediate implant placement (Table/Fig 1)c making the site favourable for a socket-shield-based approach.
Clinical and radiographic findings revealed absence of mobility, no crestal, interdental bone loss and periapical pathology. SST was selected to preserve the buccal alveolar bone and maintain soft-tissue
architecture, thereby minimising post-extraction ridge resorption and enhancing long-term aesthetic stability in the anterior maxilla.
Surgical Procedure
The patient was explained about the procedure and written informed consent was obtained. The procedure was carried out under local anaesthesia following strict aseptic protocol. The existing restoration was removed. Removal of Gutta-percha which was used for obturating is done using Gates Glidden drill and the tooth was decoronated at the level of the gingiva (Table/Fig 2)a. The palatal root segment was sectioned and resected, while the buccal root portion was preserved as per the socket-shield protocol (Table/Fig 2)b.
The resected palatal root segment was atraumatically removed without disturbing the buccal fragment (Table/Fig 3). The retained buccal root segment was reduced to approximately 1.5-2 mm thickness and trimmed to the level of the crestal bone, ensuring stability and absence of mobility.
The retained buccal root fragment was then carefully reduced and contoured to form a stable buccal shield, ensuring it was immobile and flush with the crestal bone (Table/Fig 4).
An osteotomy site was prepared palatal to the buccal shield and a Minimally Invasive Surgery (MIS) dental implant measuring 4.2×13 mm was placed, achieving adequate primary stability (Table/Fig 5)a, (Table/Fig 5)b. As the horizontal jumping distance exceeded 1.5 mm, bone graft material was placed in the peri-implant gap to promote optimal bone healing and implant integration (Table/Fig 6).
Implant Stability and Provisionalisation
Primary implant stability was evaluated using Resonance Frequency Analysis (RFA), yielding an Implant Stability Quotient (ISQ) value of 63 (Table/Fig 7). A screw-retained provisional crown was delivered immediately to support peri-implant soft-tissue contours and preserve gingival architecture during healing (Table/Fig 8). Following stability assessment, an implant abutment was placed (Table/Fig 9).
Postoperative Evaluation
At the one-month follow-up visit, clinical examination revealed healthy peri-implant soft-tissues with satisfactory gingival contour and emergence profile (Table/Fig 10)a. Radiographic evaluation confirmed appropriate implant positioning and favourable peri-implant bone response (Table/Fig 10)b. Healing was uneventful and the patient reported no discomfort or functional impairment.
The SST was first introduced by Hürzeler MB et al., who demonstrated in a proof-of-principle study that intentional retention of a buccal root fragment during immediate implant placement may preserve the buccal bone plate and limit post-extraction ridge alterations (1). In the same study through a preclinical model, Hürzeler MB et al., also demonstrated preservation of the periodontal ligament-bundle bone complex and formation of mineralised tissue between the implant surface and retained root fragment (1).
Maintenance of facial bone and peri-implant soft-tissue contours remains a major challenge in implant rehabilitation of the anterior maxilla. Following tooth extraction, dimensional changes of the alveolar ridge have been consistently demonstrated, with marked horizontal and vertical bone reduction, particularly affecting the buccal aspect (2),(3). These alterations are more pronounced in the anterior maxilla due to the thin buccal cortical plate.
Animal studies have validated the biologic concept of SST. In a preclinical dog model, the retained root fragment remained attached to the buccal bone via a periodontal ligament, with maintenance of the buccal bone plate observed (4). Similarly, animal studies on root retention concepts have shown maintenance of surrounding alveolar bone and reduced resorption following retention of root structures (5).
Human histological evidence has further supported these findings. Bäumer D et al., demonstrated the formation of cementum-like tissue in direct contact with the implant surface adjacent to the retained root fragment without signs of inflammation or fibrous encapsulation (6). In addition, clinical studies by Siormpas KD et al., reported favourable outcomes of SST with high implant survival rates and maintenance of peri-implant tissues over a follow-up period of up to five years (7).
The concept of SST has been incorporated into Partial Extraction Therapies (PET), which include root submergence, pontic shield and proximal SSTs aimed at preserving alveolar ridge architecture (8),(9).
Long-term clinical data have demonstrated stable peri-implant bone levels and volumetric tissue stability following SST (10). Case-based reports have also shown favourable aesthetic outcomes and soft-tissue stability in the anterior maxilla (11). Modifications in surgical technique have been proposed to improve clinical applicability and simplify the procedure (12).
Systematic reviews have concluded that SST is a promising technique for ridge preservation, although it remains technique-sensitive and dependent on appropriate case selection (13). Comparative analyses suggest that SST provides favourable or comparable outcomes in maintaining facial bone thickness and soft-tissue contours when compared with conventional immediate implant placement approaches (14).
Despite these encouraging findings, complications such as shield exposure, root fragment mobility and infection have been reported, often related to surgical technique or case selection. Careful patient selection and precise surgical execution are therefore critical.
Delayed implant placement may reduce surgical complexity but is associated with greater ridge dimensional changes and may require additional augmentation procedures. In contrast, SST aims to preserve native tissues by maintaining the root-periodontal ligament complex.
Long-term follow-up with clinical and radiographic evaluation is essential to monitor peri-implant tissue stability. Patient compliance and oral hygiene maintenance also play a critical role in long-term success.
From a clinical perspective, SST should be performed by experienced clinicians within a prosthetically driven treatment approach. Adjunctive procedures such as immediate provisionalisation may further support soft-tissue contour preservation in selected cases.
In the present case, SST combined with immediate implant placement and provisionalisation resulted in preservation of facial contour and peri-implant tissue stability, consistent with previously reported histological and clinical findings.
The SST is a biologically sound and clinically effective approach for implant placement in the aesthetic zone of the anterior maxilla. By preserving the buccal root fragment and associated periodontal ligament, SST limits post-extraction alveolar resorption and supports stable peri-implant soft-tissue architecture. Within the limitations of a single case report, SST demonstrated favourable aesthetic and functional outcomes. Meticulous case selection and precise surgical execution are essential for predictable results.
Acknowledgement
The authors acknowledged the clinical and technical staff for their assistance during the procedure.
DOI: 10.7860/JCDR/2026/87414.24285
Date of Submission: Jan 13, 2026
Date of Peer Review: Feb 07, 2026
Date of Acceptance: May 12, 2026
Date of Publishing: Sep 01, 2026
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: Jan 28, 2026
• Manual Googling: May 07, 2026
• iThenticate Software: May 09, 2026 (8%)
ETYMOLOGY: Author Origin
EMENDATIONS: 8
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