AUCTORES
Globalize your Research
Case Report | DOI: https://doi.org/10.31579/2690-4861/127
*Corresponding Author: Rodrigo Soares de Andrade, Associate Professor, School of Dentistry, University Center of Patos de Minas (UNIPAM), Patos de Minas, Minas Gerais, Brazil.
Citation: Vitor C Rodrigues, Antônio A Sommer, RMA Pereira, ACS Santana, RSD Andrade. (2021) Amelogenesis Imperfecta from Diagnosis to Rehabilitation-A Case Report. International Journal of Clinical Case Reports and Reviews. 7(3); DOI: 10.31579/2690-4861/127
Copyright: © 2021 Rodrigo Soares de Andrade, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 19 March 2021 | Accepted: 18 May 2021 | Published: 21 June 2021
Keywords: amelogenesis imperfecta; clinical features; oral rehabilitation
During odontogenesis, enamel is normally synthesized as an extracellular matrix, a phenomenon known as amelogenesis. The failure of this process can lead to malformation of dental enamel, called Amelogenesis Imperfecta (AI). AI, by causing a qualitative and/or quantitative deficiency of dental enamel, presents characteristics such as hypersensitivity, unsatisfactory aesthetics, reduced vertical dimension, anterior open bite, plaque accumulation, and greater susceptibility to caries and gingivitis. Thus, our objective is to report a case of AI, describing the main characteristics of the disease, the diagnosis and the rehabilitative treatment plan, aiming to improve the patient's aesthetics and reestablishing the function of the stomatognathic system. Patient M.A.S.B., female, 5 years old, leucoderma, was admitted at the University of Patos de Minas Dental Clinic with a complaint of pain in the teeth. During the clinical interview, the person in charge reported that the child's teeth had the same defects as those of her mother and brother. During clinical examination it was observed: generalized loss of tooth structure, color change, rough surfaces and hypersensitivity. Treatment involved restorations with glass ionomer cement and composite resin, extraction of residual roots from the maxillary incisors, and confection of a functional and aesthetic space maintainer. Early diagnosis associated with the correct treatment plan is essential for a more conservative approach focused on preventing the effects of AI. In advanced cases, restoring function and aesthetics is paramount to improve the patient's quality of life.
Amelogenesis imperfecta (AI) is a group of hereditary alterations that exhibit anomalies in the primary enamel and permanent dentition [1]. It is considered a rare genetic alteration, since its frequency is depicted between 1:14000 and 1:700 [2]. However, in some populations where consanguineous marriages are customary, this frequency may be even higher [3]. Four main types are noted for AI, as: (i) hypoplastic, (ii) hypomineralized, (iii) hypomaturity, and (iv) hypoplastic-hypomaturity AI with taurodontism [1].
AI can be expressed in isolation, without any other non-oral symptoms, or as a phenotype of syndromic conditions, such as renal enamel syndrome (OMIM # 204690; FAM20A) and Jalili syndrome (OMIM # 217080; CNNM4). To date, more than 10 genes have been identified as being involved in the pathogenesis of AI [4].
The AI clinical characteristics depend on the type of the presented defect and on the stage of enamel formation, as: exaggerated dental sensitivity, compromised esthetics, loss of vertical dimension, plaque accumulation and, consequently, greater susceptibility to caries and gingivitis [5, 6, 7, 8]. Besides that, early teeth eruption, progressive resorption of roots and crowns, short roots and gingival hyperplasia, can also be associated with AI [5,9]. In addition, craniofacial features can be observed, such as the inverted curve of Spee, restricted maxillary arch, and anterior/posterior open bite. These are considered severe features and can be directly linked to issues in the patient's social life.
Rehabilitation in AI cases brings numerous challenges for dental surgeons because, besides involving an interdisciplinary approach, there is no guarantee of a relapse-free treatment. It is necessary to maintain case follow-up, respecting the stages in which the alteration is found and the age of the patient [5].
Based on the above, the purpose of this paper is to report a case of AI, describing the main characteristics of this disease, its diagnosis, and the rehabilitative treatment plan, aiming to improve the patient's aesthetics, in addition to restore the her stomatognathic system function.
M.A.S.B., 5 years old, female, leucoderma, was admitted at the University Center of Patos de Minas Dental Clinic, accompanied by her guardians, with pain in several dental elements. During the clinical interview, her mother reported dissatisfaction with the color and the quality of her daughter's teeth, claiming that they were yellowish and weak. In addition, she complained that the child had the same defects as her own and her brother's teeth. It was also reported that the patient had already received dental treatment, but due to the child's difficulty in understanding and accepting, it was unsatisfactory. The patient was submitted to clinical and radiographic exams, in addition to conditioning sections, oral hygiene instructions and treatment to restore aesthetics and function.
During the extraoral clinical examination no alteration was identified that would justify any dysfunction, whether muscular and/or articular. The intraoral examination revealed generalized loss of tooth structure, color change, rough surfaces, hypersensitivity and aesthetic impairment (Figures 1 and 2). Furthermore, the patient presented malocclusion and loss of vertical dimension. On panoramic radiography exam, it was possible to observe normal characteristics for both dentin and pulp, however, the absence of the enamel lamina was noticed (Figure 3).
Taking into consideration the clinical interview, the extra and intraoral clinical examination, the radiographic findings and the absence of systemic alterations that would justify dental enamel malformation, the most likely diagnostic hypothesis was AI. Based on this, the patient's plan, which is described in detail below, was elaborated aiming at the return of function and aesthetics, starting with the urgency and conditioning procedures of the patient, followed by environment adaptation and restorative phase.
The first treatment phase was dedicated to the urgencies and patient conditioning, since she was extremely afraid of the dentist, the instruments, and the noise of the high and low rotation motors:
The second treatment phase focused on eliminating infective foci and decreasing hypersensitivity:
The third treatment phase aimed at restoring the patient's function and aesthetics:
Fabrication of a functional and esthetic space maintainer (10th week).
Discussion
AI is a group of genomic origin disorders that affect both the structure and chemical composition of dental enamel [10]. In addition, it can be associated with morphological and/or biochemical changes in other parts of the human body [11].
During tooth development, the enamel is normally synthesized as an extracellular matrix and this phenomenon is defined as amelogenesis. It happens in two stages, where the first (secretory stage) is responsible for the production of the mineralized protein matrix, which will result in the adult enamel, and the second (maturation stage), responsible for the degradation of the matrix and the completion of mineralization [11, 12].
Some of these variations affected genes that encode structural enamel proteins (amelogenin, ameloblastin, c4orf26, enamelin), enzymatic proteins (kallikrein 4, MMP20), cellular proteins (WDR72, FAM83H, COL17A1), transcription factors (MSX2, DLX3) and cell receptor (ITGB6) [13].
There are several researchers who have set out to describe the forms of AI. Molecular defects, phenotypes, mode of inheritance and biochemical analysis are used as arguments to defend the most varied types of classification, with at least 13 models [5, 12, 14]. The most accepted classification in the literature, however, is divided into three main types (hypoplastic AI, hypomaturated AI, and hypocalcified AI) and is based on the stages of the enamel formation process [15]. In hypoplastic AI, a failure occurs during the secretory phase of amelogenesis and, as a result, the tooth enamel is thinner than normal. On radiography, it is possible to observe a contrast with the dentin [5, 13].
In hypocalcified AI, the failure happens during the beginning of mineralization and, therefore, the enamel has an adequate thickness, but it is softer, presents a yellow-orange coloration and, because the matrix is badly calcified, it is quickly lost. Radiographically, the enamel has less radiopacity than the dentin [5, 15]. Finally, in hypomaturation AI, the defect occurs in the maturation phase, with the enamel showing normal thickness, but much softer than normal. Its appearance varies from white to dark brown and, on radiography, it presents the same radiopacity as dentin [15, 16]. In the present case, it was observed that the patient, besides having cases in her family of AI, presented a friable enamel with yellowish coloration and, radiographically, a more radiopaque dentin than the enamel. Thus, based on her past history and these clinical and radiographic findings, we reached the diagnosis of hypocalcified amelogenesis imperfecta.
The primary discriminator for the AI classification is usually the phenotype, but some argue that the primary structure should be the mode of inheritance, since the molecular basis of all AI has already been established. Thus, in this classification model, the clinical and radiographic features would be the secondary discriminators of AI [11].
Because AI causes both aqualitative and quantitative deficiency of dental enamel, some clinical features and consequences become evident. Besides those already mentioned, it is possible to observe rough enamel texture, stained appearance, ogival palate, delayed eruption, dental impaction, presence of cavities in the teeth and diastemas [9, 17]. As a result of such characteristics, these patients have a significantly higher level of distress and social isolation than individuals without the condition, thus suffering a social impact on education, work, and interpersonal relationships [18, 19, 20].
In the case in question, we noticed that the patient, in the first sessions, presented great difficulty in relating to others, was introspective, resisted dental treatment, avoided eye contact, and did not smile. However, as the treatment progressed and her teeth were restored, we could notice a clear improvement in her behavior and relationships. The patient played, hugged and smiled a lot to show her new teeth. Thus, we ratify what is described in the literature and highlight the importance of rehabilitative and aesthetic treatment to improve the patient's self-esteem and interpersonal relationships.
For an adequate treatment plan elaboration, it is of fundamental importance not only to confirm the diagnosis of AI, but also to know how to identify both the type and severity of the disease. This requires differential diagnosis with dental fluorosis, molar-incisor hypomineralization, early carie lesions, dentinogenesis imperfecta type III and tetracycline staining [12, 21]. By diagnosing the presence of AI in family members of the presented case, the diagnosis became less challenging.
Close the diagnosis of AI is a very complex task, once it has an enormous clinical variability, presenting up to 14 subtypes [10, 15]. Therefore, a detailed information of the family history, as well as clinical and radiographic examinations to analyze the density and the thickness of the enamel layer, are extremely important to diagnose AI [21]. In addition, when possible, it is important to take deoxyribonucleic acid (DNA) samples, molecular genetics and a morphological analysis using electron microscopy scanning sections [22, 23, 24]. Based on the family history and both clinical and imaging examinations, it was already possible to identify the diagnostic hypothesis, however, to obtain confirmation, a genetic mapping was requested from the patient's family, which was not possible to be performed due to her scarce financial conditions.
In the past, the standard treatment for AI consisted, basically, in multiple extractions followed by the making of total prosthesis, generating psychological problems for patients, especially young ones [25]. Nowadays, thanks to advances in dental materials and greater technical and scientific knowledge on the part of professionals, the treatment modalities are varied and, to determine the best conduct to be employed, it is necessary to take into account the degree of AI severity, age and socioeconomic status of the patient [21, 26, 27]. However, regardless of the treatment plan chosen, the final objective is always the same: control the vertical dimension, improve aesthetics and eliminate dentin sensitivity, always preserving the dental structures as much as possible [14, 21, 24, 28].
Because the treatments are mostly lengthy and complex, the multidisciplinary follow-up, with periodontal, odontopediatric, orthodontic, endodontic and even psychological therapy, becomes essential for the success of the case [21, 26, 27]. Ideally, the diagnosis of AI should always be early so that it is possible to perform all steps of the treatment, which begins during childhood. In this initial phase, the treatment consists basically of oral hygiene orientation, topical fluoride application to reduce sensitivity, prevention of atrophy lesions and provisional restorations with glass ionomer cement (GIC) [7].
In the present case, when the family sought dental care for the patient, the oral problems caused by the AI were already advanced. Therefore, for the residual roots, it was necessary to resort to surgery; for the cavitated posterior teeth with active or inactive carie lesions, we performed the restoration with GIC; for the anterior teeth, which had already lost tooth enamel, a composite resin restoration was performed using celluloid matrix. In addition, following what is recommended in the literature, we performed oral hygiene orientations for both the child and the family and topical fluoride application.
For complications caused by AI ranging from mild to moderate, microabrasion, the application of fluoride varnish or amorphous casein-calcium phosphopeptide (CPP- ACP), are effective treatment options. The application of 37% phosphoric acid with pumice stone or 6% hydrochloric acid with silica can also be used for the treatment of mild to moderate AI [29]. In contrast, these treatments require frequent applications and do not produce totally satisfactory aesthetic results, becoming an inconvenient factor [30, 31].
An effective alternative to treat definitively the consequences of mild and moderate AI is the application of infiltrating resin. It presents low viscosity and, thus, is able to flow into the enamel porosity, hardening the tissue and improving aesthetics. Moreover, the application of the infiltrating resin is considered minimally invasive and less aggressive than conventional procedures [32, 33]. Because they have properties that confer greater aesthetic stability and functional conditions, such as the maintenance of disocclusion guides, ceramics are an excellent treatment option for more severe AI [7, 31, 34]. However, in order to have a good adaptation, a greater dental wear is necessary, a conduct that goes against what is recommended for the AI treatment [35].
Conclusion
The diagnosis of AI is challenging, so a very detailed interview and a thorough clinical examination, as well as complementary imaging exams associated with a good knowledge of the condition is necessary. Moreover, it is of fundamental importance to make an early diagnosis and a correct treatment plan, aiming at a more conservative approach and focusing on the prevention of the AI effects.Funding sources: NOT APPLICABLE
Conflict of Interest: None
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.
