Derleme
BibTex RIS Kaynak Göster

İntraoral Tarayıcı ve Cad / Cam Sistemlerinin Çocuk Diş Hekimliğinde Kullanım Alanları

Yıl 2022, Cilt: 11 Sayı: 1, 78 - 84, 17.01.2022
https://doi.org/10.54617/adoklinikbilimler.942853

Öz

İntraoral tarayıcılar (İOS), ağız içi yapıların dijital görüntüsünün hızlı ve doğru bir şekilde kaydedilmesini sağlayan cihazlardır. İntraoral tarayıcılarla birlikte bilgisayar destekli tasarım/bilgisayar destekli üretim (CAD/CAM) sistemleri kullanılarak hem süt hem daimî dişlerde minimal invaziv, hızlı ve etkili restorasyonlar gerçekleştirilmektedir. CAD/CAM sistemleri sadece diş restorasyonlarında değil cerrahi işlemlerde, travma durumunda splintleme işlemlerinde, yer tutucular da dahil olmak üzere çocuk hastaların her türlü tedavi prosedüründe kullanıldığı gösterilmektedir. İntraoral tarayıcı ve CAD/CAM kullanımı estetik ve konforu yükselterek hastanın tedavi adımlarını görsel bir şekilde izlemesini sağlar, çocuğun tedaviye uyumunu arttırabilir. Bu derlemede intraoral tarayıcı ve CAD/CAM sistemlerinin çocuk hastalarda kullanımından bahsedilmektedir.

Kaynakça

  • Rekow ED. Digital dentistry: The new state of the art - Is it disruptive or destructive? Dent Mater. 2020; 36(1): p. 9-24.
  • Cicciù M, Fiorillo L, D’Amico C, Gambino D, Amantia EM. 3D Digital Impression Systems Compared with Traditional Techniques in Dentistry. Materials. 2020; 13(8): p. 1982.
  • Strub J, Rekow E, Witkowski S. Computer-aided design and fabrication of dental restorations:current systems and future possibilities. J Am Dent Assoc. 2006; 137: p. 1289-96.
  • Blatz M, Conejo J. The Current State of Chairside Digital Dentistry and Materials. Dent Clin North Am. 2019; 63(2): p. 175-197.
  • Hickel R, Dasch W, Mehl A, Kremers L. CAD/CAM fillings of the future. Int Dent J. 1997; 47: p. 247-58.
  • Christensen G. Computerized restorative dentistry. J Am Dent Assoc. 2001; 132: p. 1301-3.
  • Mainjot A, Dupont N, Outkerk J, Dawael T, Sadoun M. From artisanal to CADCAM blocks: State of the art of indirect composite. J Dent Res. 2016; 95: p. 487-495.
  • Richert R, Goujat A, Venet L, Viguie G. Intraoral Scanner Technologies: A Review to Make a Successful Impression. Journal of Healthcare Engineering. 2017;: p. 1-9.
  • Pagano S, Moretti M, Marsili R, Ricci A, Barraco G, Cianetti S. Evaluation of the accuracy of four digital methods by linear and volumetric analysis of dental impressions. Materials. 2019; 12: p. 1958.
  • Cervino G, Fiorillo L, Arzukanyan AV, Spagnuolo G, Cicciu M. Dental restorative digital workflow:Digital smile design from aesthetic to function. Dent. J. 2019; 7(30).
  • Hacker T, Heydecke G, Reissmann D. Impact of procedures during prosthodontic treatment on patients’ perceived burdens. J Dent. 2015; 43(1): p. 51-57.
  • Oba A, Dulgergil C, Sonmez I.. Prevalence of dental anxiety in 7‐to 11‐year‐old children and its relationship to dental caries. Med. Princ Pract. 2009; 18(6): p. 453-457.
  • Grünheid T, McCarthy S, Larson B. Clinical use of a direct chairside oral scanner: an assessment of accuracy, time, and patient acceptance. Am J Orthod Dentofac Orthop. 2014; 146(5): p. 673-682.
  • Cave V, Keys W. Digital and conventional impressions have similar working times. Evid Based Dent. 2018; 19(3): p. 84-85.
  • Joda T, Bragger U. Patient-centered outcomes comparing digital and conventional implant impression procedures: A randomized crossover trial. Clin. Oral Implant. Res. 2016; 26: p. 185–189.
  • Yilmaz B, Abou-Ayash S. A digital intraoral implant scan technique using a combined healing abutment and scan body system. J. Prosthet. Dent. 2019; 123: p. 206-209.
  • Sakornwimon N, Leevailoj C. Clinical marginal fit of zirconia crowns and patients’ preferences for impresion techniques using intraoral digital scanner versus polyvinyl siloxane material. J. Prosthet. Dent. 2017; 118: p. 386–391.
  • Gjelvold B, Chrcanovic B, Korduner E, Collin-Bagewitz I, Kisch J. Intraoral digital impression technique compared to conventional impression technique. A randomized clinical trial. J Prosthodont. 2016; 25(4): p. 282-287.
  • Patel J, Winters J, Walters M. Intraoral Digital Impression Technique for a Neonate With Bilateral Cleft Lip and Palate. Cleft Palate Craniofac J. 2019; 56(8): p. 1120-1123.
  • Fleming P, Marinho V, Johal A. Orthodontic measurements on digital study models compared with plaster models: a systematic review. Orthod Craniofac Res. 2011; 14: p. 1-16.
  • Zilberman O, Huggare J, Parikakis K. Evaluation of the Validity of Tooth Size and Arch Width Measurements Using Conventional and Three dimensional Virtual Orthodontic Models. Angle Orthod. 2003; 73: p. 301-306.
  • Cicciù M, Fiorillo L, D'Amico C, Gambino D, Amantia E, Laino L, Crimi S, Campagna P, Bianchi A, Herford AS, Cervino G. 3D Digital Impression Systems Compared with Traditional Techniques in Dentistry: A Recent Data Systematic Review. Materials. 2020; 13(8).
  • Demirel A, Bezgin T, Akaltan F, Sarı S. Resin nanoceramic CAD/CAM restoration of the primary molar: 3-year follow-up study. Case Rep Dent. 2017.
  • Elisabeth D, Monnier-Da Costa A, Moussally C. Chairside CAD/CAM Composite Onlays for the Restoration Of Primary Molars. The Journal of Clinical Pediatric Dentistry. 2018; 42(5).
  • Santos G, Santos Jr G, Santos Jr M, Rizkalla A, Madani D. Overview of CEREC CAD/CAM chairside system. General Dentistry. 2013; 61(1): p. 36-40.
  • Davidovich E, Shay B, Mijiritsky E, Nuni E. An Innovative Treatment Approach Using Digital Workflow and CAD-CAM Part 1: The Restoration of Endodontically Treated Molars in Children. Int J Environ Res Public Health. 2020; 17(4): p. 1364.
  • Einhorn DuVall N, Wajdowicz M, Brewster J, Roberts H. Preparation ferrule design effect on endocrown failure resistance. J Prosthodont. 2019; 28: p. 237–242.
  • Bilgin M, Erdem A, Tanrıver M. CAD/CAM Endocrown fabrication from a polymer-infiltrated ceramic network block for primary molar: A Case Report. J Clin Pediatr Den. 2016; 40: p. 264-268.
  • Mourouzis P, Arhakis A, Tolidis K. Computer-aided Design and Manufacturing Crown on Primary Molars: An Innovative Case Report. International Journal of Clinical Pediatric Dentistry. 2019; 12(1).
  • Mittal H, Goyal A, Gauba K, Kapur A. Clinical Performance of Indirect Composite Onlays as Esthetic Alternative to Stainless Steel Crowns for Rehabilitation of a Large Carious Primary Molar. J Clin Pediatr. Dent. 2016; 40: p. 345–352.
  • Soni HK. Application of CAD-CAM for Fabrication of Metal-Free Band and Loop Space Maintainer. J Clin Diagn Res. 2017; 11(2): p. 14-16.
  • Moussally C, Fron-Chabouis H, Charriere A, Maladry L, Dursun E. Full-mouth Rehabilitation of Hypocalcified-type Amelogenesis Imperfecta With Chairside Computer-aided Design and Computer-aided Manufacturing: A Case Report. Operative Dentistry. 2019; 44(3): p. 145-158.
  • Esti D, Shlomi D, Israel T, Etinger M, Mijiritsky E. An Innovative Treatment Approach Using Digital Workflow and CAD-CAM Part 2: The Restoration of Molar Incisor Hypomineralization in Children. Int J Environ Res Public Health. 2020; 17(5): p. 1499.
  • Rozalio H, Johnny N, Akel H. Conservative anterior treatment with CAD-CAM technology and polymer-infiltrated ceramic for a child with amelogenesis imperfecta: A 2-year follow-up. The Journal of Prosthetic Dentistry. 2018; 119(5): p. 710-712.
  • Catherine M, Maxima D, Christine K, François V. Monolithic CAD/CAM Complete Overdentures for a Pedodontic Patient With Dentinogenesis Imperfecta and Limited Prosthetic Space: A Clinical Report. Int J Prosthodont. 2020; 33(3): p. 341-346.
  • Foucher F, Mainjot A. Polymer-Infiltrated-Ceramic-Network, CAD/CAM Restorations for Oral Rehabilitation of Pediatric Patients With X-Linked Ectodermal Dysplasia. Int J Prosthodont. 2018; 31(6): p. 610-612.
  • Hegap A. Management of mandibular fractures in children with a split acrylic splint: a case series. British Journal of Oral and Maxillofacial Surgery. 2012; 50(6): p. 93-5.
  • An J, Jia P, Zhang Y, Gong X, Han X, He Y. Application of biodegradable plates for treating pediatric mandibular fractures. Journal of Cranio-Maxillofacial Surgery. 2015; 43(4): p. 515-520.
  • Sezer B, Özveri Koyuncu B, Akay C, Günbay T. Splint Fixation with Circummandibular Wires for Pediatric Mandibular Fracture: Two Case Reports. EÜ Dişhek Fak Derg. 2010; 31: p. 113-117.
  • Jung-Woo L, Choi B, Namb O, Kwon Y. Minimal invasive treatment using patient-specific template for pediatric mandibular fracture: “Wing-splint” by CAD/CAM technology. Br J Oral Maxillofac Surg. 2016; 54(10): p. 1140-1141.
  • Mochizuki K, Tsujino K, Ohtawa Y, Yakushiji M, Nomura K, Ichinohe T, Kaneko Y. Dental care for physically or mentally challenged at public dental clinics. Bull Tokyo Dent Coll. 2007; 48(3): p. 135-42.
  • Noirrit E, Chabreron O, Nasr K, Esclassan R. A Contribution of CAD/CAM Treatment of a Dental Trauma in a Special Care Patient. Spec Care Dentist. 2018; 38(1): p. 55-57.
  • Wiedhahn K, Kerschbaum T, Fasbinder D. Clinical long-term results with 617 Cerec veneers: a nine-year report. Int J Comput Dent. 2005; 8(3): p. 233-46.
  • Murali R, Gnanashanmugam K, Rajasekar L, Kularashmi B, Saravanan B. A rare case of impacted supernumerary premolar causing resorption of mandibular first molar. J Pharm Bioallied. 2015; 7: p. 309.
  • Sukegawa S, Kanno T, Kawakami K, Shibata A, Takahashi Y, Furuki Y. Use of a piezosurgery technique to remove a deeply impacted supernumerary tooth in the anterior maxilla. Case Rep Dent. 2015; 11(1-4).
  • Kang S, Kim M. Single-tooth dento-osseous osteotomy with a computer-aided design/computer-aided manufacturing surgical guide. J Korean Assoc Oral Maxillofac Surg. 2016; 42(127).
  • Jo C, Bae D, Choi B, Kim J. Removal of Supernumerary Teeth Utilizing a Computer-Aided Design/Computer-Aided Manufacturing Surgical Guide. Journal of Oral and Maxillofacial Surgery. 2017; 75(5): p. 1-9.
  • Akhlef Y, Schwartz O, Andreasen J, Jensen S. Autotransplantation of teeth to the anterior maxilla: A systematic review of survival and success, aesthetic presentation and patient-reported outcome. Dent Traumatol. 2018; 34: p. 20–27.
  • Al-Rimawi A, ME, Schneider D, Politis C, Jacobs R. 3D Printed Temporary Veneer Restoring Autotransplanted Teeth in Children: Design and Concept Validation Ex Vivo. Int J Environ Res Public Health. 2019; 16(3): p. 496.

Use of Intraoral Scanner and Cad / Cam Systems In Pediatric Dentistry

Yıl 2022, Cilt: 11 Sayı: 1, 78 - 84, 17.01.2022
https://doi.org/10.54617/adoklinikbilimler.942853

Öz

Intraoral scanners are devices that allow the digital image of intraoral structures to be recorded quickly and accurately. Using computer aided design / computer aided manufacturing (CAD / CAM) systems with intraoral scanners are performed minimally invasive, fast and accurate restorations on both primer and permanent teeth. CAD/CAM systems are used not only in dental restorations, but also in surgical procedures, splinting in case of trauma, space maintainer and all kinds of treatment procedures for pediatric patients. The use of intraoral scanner and CAD / CAM increases aesthetics and comfort, allowing the patient to visually follow the treatment steps and can increase the child's compliance with the treatment. In this review, the use of intraoral scanner and CAD/CAM systems in pediatric patients is mentioned.

Kaynakça

  • Rekow ED. Digital dentistry: The new state of the art - Is it disruptive or destructive? Dent Mater. 2020; 36(1): p. 9-24.
  • Cicciù M, Fiorillo L, D’Amico C, Gambino D, Amantia EM. 3D Digital Impression Systems Compared with Traditional Techniques in Dentistry. Materials. 2020; 13(8): p. 1982.
  • Strub J, Rekow E, Witkowski S. Computer-aided design and fabrication of dental restorations:current systems and future possibilities. J Am Dent Assoc. 2006; 137: p. 1289-96.
  • Blatz M, Conejo J. The Current State of Chairside Digital Dentistry and Materials. Dent Clin North Am. 2019; 63(2): p. 175-197.
  • Hickel R, Dasch W, Mehl A, Kremers L. CAD/CAM fillings of the future. Int Dent J. 1997; 47: p. 247-58.
  • Christensen G. Computerized restorative dentistry. J Am Dent Assoc. 2001; 132: p. 1301-3.
  • Mainjot A, Dupont N, Outkerk J, Dawael T, Sadoun M. From artisanal to CADCAM blocks: State of the art of indirect composite. J Dent Res. 2016; 95: p. 487-495.
  • Richert R, Goujat A, Venet L, Viguie G. Intraoral Scanner Technologies: A Review to Make a Successful Impression. Journal of Healthcare Engineering. 2017;: p. 1-9.
  • Pagano S, Moretti M, Marsili R, Ricci A, Barraco G, Cianetti S. Evaluation of the accuracy of four digital methods by linear and volumetric analysis of dental impressions. Materials. 2019; 12: p. 1958.
  • Cervino G, Fiorillo L, Arzukanyan AV, Spagnuolo G, Cicciu M. Dental restorative digital workflow:Digital smile design from aesthetic to function. Dent. J. 2019; 7(30).
  • Hacker T, Heydecke G, Reissmann D. Impact of procedures during prosthodontic treatment on patients’ perceived burdens. J Dent. 2015; 43(1): p. 51-57.
  • Oba A, Dulgergil C, Sonmez I.. Prevalence of dental anxiety in 7‐to 11‐year‐old children and its relationship to dental caries. Med. Princ Pract. 2009; 18(6): p. 453-457.
  • Grünheid T, McCarthy S, Larson B. Clinical use of a direct chairside oral scanner: an assessment of accuracy, time, and patient acceptance. Am J Orthod Dentofac Orthop. 2014; 146(5): p. 673-682.
  • Cave V, Keys W. Digital and conventional impressions have similar working times. Evid Based Dent. 2018; 19(3): p. 84-85.
  • Joda T, Bragger U. Patient-centered outcomes comparing digital and conventional implant impression procedures: A randomized crossover trial. Clin. Oral Implant. Res. 2016; 26: p. 185–189.
  • Yilmaz B, Abou-Ayash S. A digital intraoral implant scan technique using a combined healing abutment and scan body system. J. Prosthet. Dent. 2019; 123: p. 206-209.
  • Sakornwimon N, Leevailoj C. Clinical marginal fit of zirconia crowns and patients’ preferences for impresion techniques using intraoral digital scanner versus polyvinyl siloxane material. J. Prosthet. Dent. 2017; 118: p. 386–391.
  • Gjelvold B, Chrcanovic B, Korduner E, Collin-Bagewitz I, Kisch J. Intraoral digital impression technique compared to conventional impression technique. A randomized clinical trial. J Prosthodont. 2016; 25(4): p. 282-287.
  • Patel J, Winters J, Walters M. Intraoral Digital Impression Technique for a Neonate With Bilateral Cleft Lip and Palate. Cleft Palate Craniofac J. 2019; 56(8): p. 1120-1123.
  • Fleming P, Marinho V, Johal A. Orthodontic measurements on digital study models compared with plaster models: a systematic review. Orthod Craniofac Res. 2011; 14: p. 1-16.
  • Zilberman O, Huggare J, Parikakis K. Evaluation of the Validity of Tooth Size and Arch Width Measurements Using Conventional and Three dimensional Virtual Orthodontic Models. Angle Orthod. 2003; 73: p. 301-306.
  • Cicciù M, Fiorillo L, D'Amico C, Gambino D, Amantia E, Laino L, Crimi S, Campagna P, Bianchi A, Herford AS, Cervino G. 3D Digital Impression Systems Compared with Traditional Techniques in Dentistry: A Recent Data Systematic Review. Materials. 2020; 13(8).
  • Demirel A, Bezgin T, Akaltan F, Sarı S. Resin nanoceramic CAD/CAM restoration of the primary molar: 3-year follow-up study. Case Rep Dent. 2017.
  • Elisabeth D, Monnier-Da Costa A, Moussally C. Chairside CAD/CAM Composite Onlays for the Restoration Of Primary Molars. The Journal of Clinical Pediatric Dentistry. 2018; 42(5).
  • Santos G, Santos Jr G, Santos Jr M, Rizkalla A, Madani D. Overview of CEREC CAD/CAM chairside system. General Dentistry. 2013; 61(1): p. 36-40.
  • Davidovich E, Shay B, Mijiritsky E, Nuni E. An Innovative Treatment Approach Using Digital Workflow and CAD-CAM Part 1: The Restoration of Endodontically Treated Molars in Children. Int J Environ Res Public Health. 2020; 17(4): p. 1364.
  • Einhorn DuVall N, Wajdowicz M, Brewster J, Roberts H. Preparation ferrule design effect on endocrown failure resistance. J Prosthodont. 2019; 28: p. 237–242.
  • Bilgin M, Erdem A, Tanrıver M. CAD/CAM Endocrown fabrication from a polymer-infiltrated ceramic network block for primary molar: A Case Report. J Clin Pediatr Den. 2016; 40: p. 264-268.
  • Mourouzis P, Arhakis A, Tolidis K. Computer-aided Design and Manufacturing Crown on Primary Molars: An Innovative Case Report. International Journal of Clinical Pediatric Dentistry. 2019; 12(1).
  • Mittal H, Goyal A, Gauba K, Kapur A. Clinical Performance of Indirect Composite Onlays as Esthetic Alternative to Stainless Steel Crowns for Rehabilitation of a Large Carious Primary Molar. J Clin Pediatr. Dent. 2016; 40: p. 345–352.
  • Soni HK. Application of CAD-CAM for Fabrication of Metal-Free Band and Loop Space Maintainer. J Clin Diagn Res. 2017; 11(2): p. 14-16.
  • Moussally C, Fron-Chabouis H, Charriere A, Maladry L, Dursun E. Full-mouth Rehabilitation of Hypocalcified-type Amelogenesis Imperfecta With Chairside Computer-aided Design and Computer-aided Manufacturing: A Case Report. Operative Dentistry. 2019; 44(3): p. 145-158.
  • Esti D, Shlomi D, Israel T, Etinger M, Mijiritsky E. An Innovative Treatment Approach Using Digital Workflow and CAD-CAM Part 2: The Restoration of Molar Incisor Hypomineralization in Children. Int J Environ Res Public Health. 2020; 17(5): p. 1499.
  • Rozalio H, Johnny N, Akel H. Conservative anterior treatment with CAD-CAM technology and polymer-infiltrated ceramic for a child with amelogenesis imperfecta: A 2-year follow-up. The Journal of Prosthetic Dentistry. 2018; 119(5): p. 710-712.
  • Catherine M, Maxima D, Christine K, François V. Monolithic CAD/CAM Complete Overdentures for a Pedodontic Patient With Dentinogenesis Imperfecta and Limited Prosthetic Space: A Clinical Report. Int J Prosthodont. 2020; 33(3): p. 341-346.
  • Foucher F, Mainjot A. Polymer-Infiltrated-Ceramic-Network, CAD/CAM Restorations for Oral Rehabilitation of Pediatric Patients With X-Linked Ectodermal Dysplasia. Int J Prosthodont. 2018; 31(6): p. 610-612.
  • Hegap A. Management of mandibular fractures in children with a split acrylic splint: a case series. British Journal of Oral and Maxillofacial Surgery. 2012; 50(6): p. 93-5.
  • An J, Jia P, Zhang Y, Gong X, Han X, He Y. Application of biodegradable plates for treating pediatric mandibular fractures. Journal of Cranio-Maxillofacial Surgery. 2015; 43(4): p. 515-520.
  • Sezer B, Özveri Koyuncu B, Akay C, Günbay T. Splint Fixation with Circummandibular Wires for Pediatric Mandibular Fracture: Two Case Reports. EÜ Dişhek Fak Derg. 2010; 31: p. 113-117.
  • Jung-Woo L, Choi B, Namb O, Kwon Y. Minimal invasive treatment using patient-specific template for pediatric mandibular fracture: “Wing-splint” by CAD/CAM technology. Br J Oral Maxillofac Surg. 2016; 54(10): p. 1140-1141.
  • Mochizuki K, Tsujino K, Ohtawa Y, Yakushiji M, Nomura K, Ichinohe T, Kaneko Y. Dental care for physically or mentally challenged at public dental clinics. Bull Tokyo Dent Coll. 2007; 48(3): p. 135-42.
  • Noirrit E, Chabreron O, Nasr K, Esclassan R. A Contribution of CAD/CAM Treatment of a Dental Trauma in a Special Care Patient. Spec Care Dentist. 2018; 38(1): p. 55-57.
  • Wiedhahn K, Kerschbaum T, Fasbinder D. Clinical long-term results with 617 Cerec veneers: a nine-year report. Int J Comput Dent. 2005; 8(3): p. 233-46.
  • Murali R, Gnanashanmugam K, Rajasekar L, Kularashmi B, Saravanan B. A rare case of impacted supernumerary premolar causing resorption of mandibular first molar. J Pharm Bioallied. 2015; 7: p. 309.
  • Sukegawa S, Kanno T, Kawakami K, Shibata A, Takahashi Y, Furuki Y. Use of a piezosurgery technique to remove a deeply impacted supernumerary tooth in the anterior maxilla. Case Rep Dent. 2015; 11(1-4).
  • Kang S, Kim M. Single-tooth dento-osseous osteotomy with a computer-aided design/computer-aided manufacturing surgical guide. J Korean Assoc Oral Maxillofac Surg. 2016; 42(127).
  • Jo C, Bae D, Choi B, Kim J. Removal of Supernumerary Teeth Utilizing a Computer-Aided Design/Computer-Aided Manufacturing Surgical Guide. Journal of Oral and Maxillofacial Surgery. 2017; 75(5): p. 1-9.
  • Akhlef Y, Schwartz O, Andreasen J, Jensen S. Autotransplantation of teeth to the anterior maxilla: A systematic review of survival and success, aesthetic presentation and patient-reported outcome. Dent Traumatol. 2018; 34: p. 20–27.
  • Al-Rimawi A, ME, Schneider D, Politis C, Jacobs R. 3D Printed Temporary Veneer Restoring Autotransplanted Teeth in Children: Design and Concept Validation Ex Vivo. Int J Environ Res Public Health. 2019; 16(3): p. 496.
Toplam 49 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Diş Hekimliği
Bölüm Derleme
Yazarlar

Çağla Akarçay 0000-0003-1857-5745

Kadriye Ulu Güzel 0000-0002-3129-8490

Yayımlanma Tarihi 17 Ocak 2022
Gönderilme Tarihi 25 Mayıs 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 11 Sayı: 1

Kaynak Göster

Vancouver Akarçay Ç, Ulu Güzel K. İntraoral Tarayıcı ve Cad / Cam Sistemlerinin Çocuk Diş Hekimliğinde Kullanım Alanları. ADO Klinik Bilimler Dergisi. 2022;11(1):78-84.