AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2690-1919/497
1Master Degree in Restorative and Esthetic Dentistry, Faculty of Dentistry, Sana’a University, Sana’a, Yemen.
2Professor in Restorative and Esthetic Dentistry, Faculty of Dentistry, Sana'a University, Yemen.
3Dean Faculty of Dentistry on 21 September University, Head of Restorative and Esthetic Dentistry Department, Dental Implant Consultant, Yemen
*Corresponding Author: Abdulwahab Ismail Al-Kholani, Dean Faculty of Dentistry on 21 September University, Sana'a Yemen.
Citation: Abdulrahman Ebrahim Al-Mansor, Ibrahim Zaid Al-Shami, Abdulwahab Ismail Al-kholani, (2025), The Efficiency of CBCT X-Ray in Detecting Caries Under Cemented and Uncemented Dental Fixed Prosthesis, J Clinical Research and Reports, 19(1); DOI:10.31579/2690-1919/497
Copyright: © 2025, Abdulwahab Ismail Al-Kholani. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 03 February 2025 | Accepted: 10 February 2025 | Published: 03 March 2025
Keywords: cone-beam computed tomography; CBCT; secondary caries; fixed prostheses; zirconia, porcelain-fused-to-metal; dental imaging; caries detection
Aim: This study aims to assess the efficiency of cone-beam computed tomography (CBCT) in detecting secondary caries under various types of fixed prostheses, including zirconia, e-max, porcelain-fused-to-metal, and acrylic CAD/CAM, and to evaluate whether dental cement acts as a barrier to caries detection.
Materials and Methods: An in vitro experimental study was conducted using 116 caries-free human premolar teeth, divided into four main groups based on the type of fixed prosthesis. Each group was further subdivided according to caries depth (0-1 mm, 1-2 mm, 2-3 mm). A pilot study was performed to establish the methodology, followed by CBCT imaging before and after cementation with glass ionomer cement. The images were analyzed using Ez3D-I software, and data were statistically evaluated using SPSS software.
Results: Significant differences in caries detection rates were observed before and after cementation for zirconia (100% to 58.33%, p = 0.002) and porcelain-fused-to-metal crowns (100% to 66.67%, p = 0.005). No significant differences were found for acrylic CAD/CAM and empress crowns. The study demonstrated excellent intraobserver reliability for caries and composite measurements.
Conclusion: CBCT is an effective tool for detecting secondary caries under cemented and uncemented dental fixed prostheses, particularly for zirconia and porcelain-fused-to-metal crowns. Early detection of secondary caries is crucial for preserving tooth structure and improving treatment outcomes. Given its non-invasive nature and superior imaging capabilities, CBCT should be integrated into clinical practice for enhanced diagnostic accuracy.
Cone-beam computed tomography (CBCT) has become an essential tool in dentistry for detecting caries beneath fixed prostheses. This imaging modality provides high-resolution, three-dimensional images, allowing for enhanced visualization of dental structures, which is crucial for accurate diagnosis and treatment planning in prosthodontics (Ludlow et al., 2013; Priyanka et al., 2016). CBCT has demonstrated superior sensitivity and specificity for caries detection compared to conventional radiography (Gowri et al., 2020; Alkhudhairy et al., 2018).
In addition to CBCT, other diagnostic aids such as ultrasound detectors, electric-based aids, and light-induced fluorescence are available. Recent advancements include deep learning applications for detecting proximal caries using intraoral photos (Emma et al., 2023). Early diagnosis of secondary caries is vital for preserving tooth structure and improving treatment outcomes, especially for patients requiring various types of crowns (Moataz et al., 2022).
The longevity of fixed dental prostheses (FDP) is typically around 10 years, with secondary caries being a leading cause of failure (Ali Alenezi et al., 2022). Despite advancements in materials and techniques, the need for removal due to secondary caries remains prevalent (Sharma et al., 2012). CBCT and intraoral preapical X-rays can detect caries without necessitating the removal of fixed prostheses (Farzaneh et al., 2022).
Various radiographic techniques, including periapical, bitewing, occlusal, panoramic, and CBCT imaging, are employed alongside clinical examinations to diagnose secondary caries and prevent prosthesis failure (Talaeipour et al., 2016). Conventional 2D radiographic techniques often fall short in detecting carious lesions located beneath restorations (Kandemir, 1997). CBCT offers a three-dimensional perspective, allowing for better evaluation of the region of interest (Elluru et al., 2017). Its advantages include reduced radiation dose and cost compared to medical CT (Khader et al., 2023).
Statement of the Problem
Evaluating secondary caries under fixed prostheses typically requires removal, which can lead to complications such as periodontal ligament breakdown and damage to both teeth and prostheses. CBCT may provide a solution by detecting secondary caries without the need for removal.
Justification
Secondary caries are a primary cause of fixed dental prosthesis failure. Early detection is crucial to prevent the spread of caries and subsequent failure without necessitating the removal of the prosthesis.
This study aims to assess the efficiency of CBCT in detecting secondary caries under various types of fixed prostheses (zirconia, e-max, porcelain-fused-to-metal, and acrylic CAD/CAM) and to evaluate whether dental cement acts as a barrier.
Specific Objectives
Pilot Study
A pilot study was conducted with four additional teeth (n=1 for each type) to prepare for the main experiment. Each tooth received a dental crown, and artificial buccal caries (2-3 mm deep) was created. The specimens underwent CBCT imaging before and after crown cementation with glass ionomer cement to identify potential irregularities in the study.
Study Design
This study was designed as an in vitro experimental study.
Place of Study
The research was conducted at the Laboratory of the Restorative Department, College of Dentistry, Sana’a University, Yemen, from May 2022 to August 2024.
Sample Grouping
A total of 116 caries-free human premolar teeth were selected, with 96 specimens and 20 control teeth. The main groups included:
Each main group was divided into three subgroups based on caries depth (0-1 mm, 1-2 mm, 2-3 mm). The control group consisted of 20 teeth, with 5 teeth for each type of FDP, prepared without artificial caries.
Materials
A table detailing the materials used in the study was included.
Methodology
Collection of Teeth
Caries-free premolars were collected from orthodontic patients in Sana’a, Yemen.
Sterilization
Teeth were sterilized with 10% formalin and 5.25% sodium hypochlorite, then stored in normal saline solution.
Preparation of Extracted Teeth
Teeth were fixed in a custom acrylic box for preparation. Each tooth was prepared according to aCAD emic standards using a high-speed handpiece and diamond bur. Artificial caries were created at the cervical third of the teeth, and cavities were filled with red wax to simulate the crown structure.
Procedures at the Dental Lab
Teeth were scanned using an ultra-high-speed 3D dental scanner, and crowns were designed using Exocad software. The crowns were fabricated using a dental milling machine for acrylic, empress, and zirconia crowns, and a metal laser melting machine for PFM crowns.
Procedures at the Dental X-Ray Center
CBCT imaging was performed using an X-Mind Trium machine. The imaging parameters included a small field of view (8 cm x 8 cm), 1 mm slice thickness, and an exposure time of 14 seconds. Images were reconstructed with Ez3D-I software, and data were evaluated by three observers (two specialists and one radiologist) using specific criteria for detecting caries and restorations.
CBCT Image Analysis
The mean grayscale feature in Ez3D-I software was utilized to detect carious lesions. Data was collected, tabulated, and analyzed using SPSS software.
This section presents the findings of the study derived from data analysis and interpretation. It begins with data screening, which includes coding and checking for missing data using SPSS. The sample profile is described, detailing the characteristics of the specimens or subjects in tabular form. Finally, the results of the comparative analysis are presented.
The SPSS software (Statistical Package for the Social Sciences, Version 26) was utilized to conduct the following statistical tests:
Frequency Distribution of Specimens by Group
Table 4.1 presents a comprehensive frequency distribution of specimens categorized by their respective groups. This organization is crucial for understanding the distribution and prevalence of different specimen types within the study.
Understanding Frequency Distribution
A frequency distribution summarizes how often each different value occurs in a dataset, providing a clear picture of the data's structure. In the context of specimens, this distribution reveals which groups are more common and which are less so, aiding in further analysis and decision-making.
Key Components of Frequency Distribution
| Group | Depth | Frequency | Percent |
| Zirconia | 0 to 1 | 8 | 8.33% |
| 1 to 2 | 8 | 8.33% | |
| 2 to 3 | 8 | 8.33% | |
| Acrylic CAD CAM | 0 to 1 | 8 | 8.33% |
| 1 to 2 | 8 | 8.33% | |
| 2 to 3 | 8 | 8.33% | |
| Impress | 0 to 1 | 8 | 8.33% |
| 1 to 2 | 8 | 8.33% | |
| 2 to 3 | 8 | 8.33% | |
| Porcelain fused to metal | 0 to 1 | 8 | 8.33% |
| 1 to 2 | 8 | 8.33% | |
| 2 to 3 | 8 | 8.33% | |
| Total | 96 | 100% |
Table 1: Frequency Distribution of Specimens by Group.
Interpreting Table 1
When analyzing Table 1, consider the following:
Caries Depth Analysis
Table 2 presents the percentage of caries depth appearance obtained from CBCT images according to the type of dental prosthesis. In the Zirconia crown group, statistically significant differences in caries depth were observed before and after cementation, with a p-value of 0.002, indicating a meaningful impact of cementation on caries detection. Before cementation, all 24 specimens (100%) exhibited caries. After cementation, the number of detected cases decreased to 14 specimens, representing 58.33%.
| Group | Depth | Before cementation | After cementation | P value1 | ||
| Detected | Not Detected | Detected | Not Detected | |||
| Zirconia | 0 to 1 | 8 (33.3%) | 0 (0.0%) | 0 (0.0%) | 8 (33.33%) | 0.000* |
| 1 to 2 | 8 (33.3%) | 0 (0.0%) | 6 (25.0%) | 2 (8.33%) | 0.157 | |
| 2 to 3 | 8 (33.3%) | 0 (0.0%) | 8 (33.33%) | 0 (0.0%) | 1.000 | |
| Total | 24 (100%) | 0 (0.0%) | 14 (58.33%) | 10 (41.67%) | 0.002* | |
| P value2 | 1.000 | 0.000* | ||||
| Acrylic CAD CAM | 0 to 1 | 8 (33.3%) | 0 (0.0%) | 8 (33.3%) | 0 (0.0%) | 1.000 |
| 1 to 2 | 8 (33.3%) | 0 (0.0%) | 8 (33.3%) | 0 (0.0%) | 1.000 | |
| 2 to 3 | 8 (33.3%) | 0 (0.0%) | 8 (33.3%) | 0 (0.0%) | 1.000 | |
| Total | 24 (100%) | 0 (0.0%) | 24 (100%) | 0 (0.0%) | 1.000 | |
| P value2 | 1.000 | 1.000 | ||||
| Impress | 0 to 1 | 8 (33.3%) | 0 (0.0%) | 8 (33.3%) | 0 (0.0%) | 1.000 |
| 1 to 2 | 8 (33.3%) | 0 (0.0%) | 8 (33.3%) | 0 (0.0%) | 1.000 | |
| 2 to 3 | 8 (33.3%) | 0 (0.0%) | 8 (33.3%) | 0 (0.0%) | 1.000 | |
| Total | 24 (100%) | 0 (0.0%) | 24 (100%) | 0 (0.0%) | 1.000 | |
| P value2 | 1.000 | 1.000 | ||||
| Porcelain fused to metal | 0 to 1 | 8 (33.3%) | 0 (0.0%) | 0 (0.0%) | 8 (33.33%) | 0.000* |
| 1 to 2 | 8 (33.3%) | 0 (0.0%) | 8 (33.3%) | 0 (0.0%) | 1.000 | |
| 2 to 3 | 8 (33.3%) | 0 (0.0%) | 8 (33.3%) | 0 (0.0%) | 1.000 | |
| Total | 24 (100%) | 0 (0.0%) | 16 (66.7%) | 8 (33.3%) | 0.005* | |
| P value2 | 1.000 | 0.000* | ||||
P value1: Wilcoxon Signed Ranks Test, P value2: Kruskal-Wallis Test, * P value ≤ 0.05
Table 2: Shows the percentage of caries depth appearance obtained from the CBCT image according to the type of dental prosthesis.
Overall Caries Appearance
Table 3 summarizes the significant differences in caries appearance observed before and after cementation across the various groups of dental prostheses. Before cementation, a total of 96 specimens (100%) exhibited caries, while after cementation, the number of detected cases decreased to 78 specimens, representing 81.25%. This reduction resulted in a statistically significant p-value of 0.000, indicating a meaningful impact of cementation on caries detection.
| Group | Before cementation | After cementation | P value | ||
| Detected | Not Detected | Detected | Not Detected | ||
| Zirconia | 24 (100%) | 0 (0.0%) | 14 (58.33%) | 10 (41.67%) | 0.002* |
| Acrylic CAD CAM | 24 (100%) | 0 (0.0%) | 24 (100%) | 0 (0.0%) | 1.000 |
| Impress | 24 (100%) | 0 (0.0%) | 24 (100%) | 0 (0.0%) | 1.000 |
| Porcelain fused to metal | 24 (100%) | 0 (0.0%) | 16 (66.7%) | 8 (33.3%) | 0.005* |
| Total | 96 (100%) | 0 (0.0%) | 78 (81.25%) | 18 (18.75%) | 0.000* |
Table 3: Comparison between caries appearance before and after cementation according to the types of dental prosthesis.
Reliability Analysis
Reliability analyses were conducted to assess the consistency of caries and composite measurements. One-way ANOVA tests confirmed no significant differences among the three readings, indicating excellent agreement in both measurements.
Reliability analyses were conducted to assess the consistency of caries and composite measurements. One-way ANOVA tests confirmed no significant differences among the three readings, indicating excellent agreement in both measurements.
The results of this study highlight the significant advantages of cone-beam computed tomography (CBCT) in the early detection of secondary caries beneath various types of fixed dental prostheses. The findings indicate that CBCT is particularly effective in identifying caries under zirconia and porcelain-fused-to-metal crowns, with statistically significant differences observed in caries detection rates before and after cementation. Specifically, the detection rate for zirconia crowns decreased from 100
In conclusion, this study confirms the efficiency of CBCT in detecting secondary caries under cemented and uncemented dental fixed prostheses. The significant differences in caries detection rates before and after cementation for zirconia and porcelain-fused-to-metal crowns highlight the importance of advanced imaging techniques in clinical practice. Early detection of secondary caries is crucial for preserving tooth structure and improving treatment outcomes, ultimately contributing to the longevity of fixed dental prostheses. Given the advantages of CBCT, including its non-invasive nature and superior imaging capabilities, it should be considered a valuable tool in the diagnostic arsenal of dental practitioners. Future research should focus on expanding the sample size and exploring the effectiveness of CBCT in detecting caries in a broader range of dental materials and clinical scenarios.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
