BibTex RIS Kaynak Göster

Phototherapy in Dentistry

Yıl 2016, Cilt: 7 Sayı: 1, 44 - 48, 23.03.2016

Öz

Low level laser therapy and photodynamic therapy are developing technologies in dentistry. This modern phototherapy approaches can be used for various purposes such as; disinfection, bio-stimulation, reduction of the inflammatory response, stimulation of DNA and RNA synthesis, promotion of cell adhesion and acceleration of wound healing. When the lasers are used properly during dental operations there would be less bleeding, swelling and discomfort.The main purpose of this review was to summarize the current literature about phototherapy approaches in dentistry and examine the methods of phototherapy applications.
Keywords: Photodynamic therapy, laser, biostimulation

Kaynakça

  • Sarkar P, Hirsch R. Photodynamic therapy. Carniol P SN. Clinical procedures in laser skin rejuvenation. New York: CRC Press; 2007: 173-180.
  • Prindeze NJ, Moffatt LT, Shupp JW. Mechanisms of action for light therapy: a review of molecular interactions. Exp Biol Med 2012; 237: 1241-1248.
  • Ishikawa I, Sasaki KM, Aoki A, Watanabe H. Effects of Er:YAG laser on periodontal therapy. J Int Acad Periodontol 2003; 5: 23-28.
  • de Paula Eduardo C, de Freitas PM, Esteves-Oliveira M, Aranha AC, Ramalho KM, Simoes A, et al. Laser phototherapy in the treatment of periodontal disease. A review. Lasers Med Sci 2010; 25: 781-792.
  • Konopka K, Goslinski T. Photodynamic therapy in dentistry. J Dent Res 2007; 86: 694-707.
  • Gursoy H, Ozcakir-Tomruk C, Tanalp J, Yilmaz S. Photodynamic therapy in dentistry: a literature review. Clin Oral Investig 2013; 17: 1113-1125.
  • Sarkar S, Wilson M. Lethal photosensitization of bacteria in subgingival plaque from patients with chronic periodontitis. J Periodontal Res 1993; 28: 204-210.
  • Bhatti M, MacRobert A, Henderson B, Shepherd P, Cridland J, Wilson M. Antibody-targeted lethal photosensitization of Porphyromonas gingivalis. Antimicrob Agents Chemother 2000; 44: 2615-2618.
  • Takasaki AA, Aoki A, Mizutani K, Schwarz F, Sculean A, Wang CY, et al. Application of antimicrobial photodynamic therapy in periodontal and peri-implant diseases. Periodontol 2000 2009; 51: 109-140.
  • Noble PB, Shields ED, Blecher PD, Bentley KC. Locomotory characteristics of fibroblasts within a three- dimensional collagen lattice: modulation by a helium/neon soft laser. Lasers Surg Med 1992; 12: 669-674.
  • Asencio-Arana F, Garcia-Fons V, Molina-Andreu E, Vidal- Martinez J, Martinez-Soriano F. Endoscopic enhancement of the healing of high-risk colon anastomoses by low-power helium-neon laser. An experimental study. Dis Colon Rectum 1992; 35: 568-573.
  • Cieplik F, Spath A, Leibl C, Gollmer A, Regensburger J, Tabenski L, et al. Blue light kills Aggregatibacter actinomycetemcomitans
  • photosensitizers. Clin Oral Investig 2014; 18: 1763-1769.
  • Dortbudak O, Haas R, Bernhart T, Mailath-Pokorny G. Lethal photosensitization for decontamination of implant surfaces in the treatment of peri-implantitis. Clin Oral Implants Res 2001; 12: 104-108.
  • Garcez AS, Nunez SC, Hamblim MR, Suzuki H, Ribeiro MS. Photodynamic therapy associated with conventional endodontic treatment in patients with antibiotic-resistant microflora: a preliminary report. J Endod 2010; 36: 1463- 1466.
  • Bago I, Plecko V, Gabric Panduric D, Schauperl Z, Baraba A, Anic I. Antimicrobial efficacy of a high-power diode laser, photo-activated disinfection, conventional and sonic activated irrigation during root canal treatment. Int Endod J 2013; 46: 339-347.
  • Verma SK, Maheshwari S, Chaudhari PK. Etiological factors of temporomandibular joint disorders. Natl J Maxillofac Surg 2012; 3: 238-239.
  • Hrnjak M, Kuljic-Kapulica N, Budisin A, Giser A. Stimulatory effect of low-power density He-Ne laser radiation on human fibroblasts in vitro. Vojnosanit Pregl 1995; 52: 539- 546.
  • AlGhamdi KM, Kumar A, Moussa NA. Low-level laser therapy: a useful technique for enhancing the proliferation of various cultured cells. Lasers Med Sci 2012; 27: 237-249.
  • Huang YY, Chen AC, Carroll JD, Hamblin MR. Biphasic dose response in low level light therapy. Dose Response 2009; 7: 358-383.
  • Karu T, Pyatibrat L, Kalendo G. Irradiation with He- Ne laser increases ATP level in cells cultivated in vitro. J Photochem Photobiol B 1995; 27: 219-223.
  • Wilden L, Karthein R. Import of radiation phenomena of electrons and therapeutic low-level laser in regard to the mitochondrial energy transfer. J Clin Laser Med Surg 1998; 16: 159-165.
  • Conlan MJ, Rapley JW, Cobb CM. Biostimulation of wound healing by low-energy laser irradiation. A review. J Clin Periodontol 1996; 23: 492-496.
  • Pourreau-Schneider N, Ahmed A, Soudry M, Jacquemier J, Kopp F, Franquin JC, et al. Helium-neon laser treatment transforms fibroblasts into myofibroblasts. Am J Pathol 1990; 137: 171-178.
  • Karu T. Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J Photochem Photobiol B 1999; 49: 1-17.
  • Neiburger EJ. Third molar impactions in early hominids. Am J Phys Anthropol 1995; 96: 93-95.
  • Kitsmaniuk ZD, DemochkoVb, Popovich VI. The use of low-energy lasers for preventing and treating postoperative and radiation-induced complications in patients with head and neck tumors]. Vopr Onkol 1992; 38: 980-986.
  • Kurumada F. A study on the application of Ga-As semiconductor laser to endodontics. The effects of laser irradiation on the activation of inflammatory cells and the vital pulpotomy. Ou Daigaku Shigakushi 1990; 17: 233-244.
  • Hargate G. A randomised double-blind study comparing the effect of 1072-nm light against placebo for the treatment of herpes labialis. Clin Exp Dermatol 2006; 31: 638-641.
  • Mier y Teran Armida M. Lasertherapy and its applications in dentistry. Pract Odontol 1989; 10: 10-16.
  • Turhani D, Scheriau M, Kapral D, Benesch T, Jonke E, Bantleon HP. Pain relief by single low-level laser irradiation in orthodontic patients undergoing fixed appliance therapy. Am J Orthod Dentofacial Orthop 2006; 130: 371-377.
  • Verma SK, Maheshwari S, Singh RK, Chaudhari PK. Laser in dentistry: An innovative tool in modern dental practice. Natl J Maxillofac Surg 2012; 3: 124-132.
  • Kawakami T, Ibaraki Y, Haraguchi K, Odachi H, Kawamura H, Kubota M, et al. The effectiveness of GaA1As semiconductor laser treatment to pain decrease after irradiation. Higashi Nihon Shigaku Zasshi 1989; 8: 57-62.
  • Basford JR. Low intensity laser therapy: still not an established clinical tool. Lasers Surg Med 1995; 16: 331-342. 34. Qadri T, Miranda L, Tuner J, Gustafsson A. The short- term effects of low-level lasers as adjunct therapy in the treatment of periodontal inflammation. J Clin Periodontol 2005; 32: 714-719.
  • Amorim JC, de Sousa GR, de Barros Silveira L, Prates RA, Pinotti M, Ribeiro MS. Clinical study of the gingiva healing after gingivectomy and low-level laser therapy. Photomed Laser Surg 2006; 24: 588-594.
  • Kreisler M, Christoffers AB, Willershausen B, d’Hoedt B. Effect of low-level GaAlAs laser irradiation on the proliferation rate of human periodontal ligament fibroblasts: an in vitro study. J Clin Periodontol 2003; 30: 353-358.
  • van Breugel HH, Bar PR. Power density and exposure time of He-Ne laser irradiation are more important than total energy dose in photo-biomodulation of human fibroblasts in vitro. Lasers Surg Med 1992; 12: 528-537.
  • Ozcelik O, Cenk Haytac M, Kunin A, Seydaoglu G. Improved wound healing by low-level laser irradiation after gingivectomy operations: a controlled clinical pilot study. J Clin Periodontol 2008; 35: 250-254.
  • AboElsaad NS, Soory M, Gadalla LM, Ragab LI, Dunne S, Zalata KR, et al. Effect of soft laser and bioactive glass on bone regeneration in the treatment of infra-bony defects (a clinical study). Lasers Med Sci 2009; 24: 387-395.
  • Doğan GE, Demir T, Orbak R. Effect of low-level laser on guided tissue regeneration performed with equine bone and membrane in the treatment of infrabony defects:a clinical study. Photomed Laser Surg. 2014 Apr;32(4):226-31. Doi: 10. 1089/pho.2013.3664.
  • Stein E, Koehn J, Sutter W, Wendtlandt G, Wanschitz F, Thurnher D, et al. Initial effects of low-level laser therapy on growth and differentiation of human osteoblast-like cells. Wien Klin Wochenschr 2008; 120: 112-117.
  • Nissan J, Assif D, Gross MD, Yaffe A, Binderman I. Effect of low intensity laser irradiation on surgically created bony defects in rats. J Oral Rehabil 2006; 33: 619-924.
  • Hakkı SS, Bozkurt B. Effects of different setting of diode laser on the mRNA expression of growth factors and type I collagen of human gingival fibroblasts. Lasers Med Sci 2012; 27:325-331.
  • Weber JB, Pinheiro AL, de Oliveira MG, Oliveira FA, Ramalho LM. Laser therapy improves healing of bone defects submitted to autologous bone graft. Photomed Laser Surg 2006; 24: 38-44.
  • Tanner AC, Socransky SS, Goodson JM. Microbiota of periodontal pockets losing crestal alveolar bone. J Periodontal Res 1984; 19: 279-291.
  • Adriaens PA, Edwards CA, De Boever JA, Loesche WJ. Ultrastructural observations on bacterial invasion in cementum and radicular dentin of periodontally diseased human teeth. J Periodontol 1988; 59: 493-503.
  • Allaker RP, Douglas CW. Novel anti-microbial therapies for dental plaque-related diseases. Int J Antimicrob Agents 2009; 33: 8-13.
  • Dickers B, Lamard L, Peremans A, Geerts S, Lamy M, Limme M, et al. Temperature rise during photo-activated disinfection of root canals. Lasers Med Sci 2009; 24: 81-85.
  • Bhatti M, MacRobert A, Meghji S, Henderson B, Wilson M. A study of the uptake of toluidine blue O by Porphyromonas gingivalis and the mechanism of lethal photosensitization. Photochem Photobiol 1998; 68: 370-376.
  • Bevilacqua IM, Nicolau RA, Khouri S, Brugnera A, Jr., Teodoro GR, Zangaro RA, et al. The impact of photodynamic therapy on the viability of Streptococcus mutans in a planktonic culture. Photomed Laser Surg 2007; 25: 513-518.
  • Prates RA, Yamada AM, Jr., Suzuki LC, Eiko Hashimoto MC, Cai S, Gouw-Soares S, et al. Bactericidal effect of malachite green and red laser on Actinobacillus actinomycetemcomitans. J Photochem Photobiol B 2007; 86: 70-76.
  • Soukos NS, Hamblin MR, Hasan T. The effect of charge on cellular uptake and phototoxicity of polylysine chlorin(e6) conjugates. Photochem Photobiol 1997; 65: 723-729.
  • Bhatti M, Nair SP, Macrobert AJ, Henderson B, Shepherd P, Cridland J, et al. Identification of photolabile outer membrane proteins of Porphyromonas gingivalis. Curr Microbiol 2001; 43: 96-99.

Diş Hekimliğinde Fototerapi

Yıl 2016, Cilt: 7 Sayı: 1, 44 - 48, 23.03.2016

Öz

Düşük seviyeli lazer tedavisi ve fotodinamik terapi diş hekimliğinde gelişmekte olan teknolojilerdir. Bu modern fototerapi yaklaşımları; dezenfeksiyon, biyostimulasyon, enflamatuar cevabın azaltılması, DNA ve RNA sentezinin stimüle edilmesi, hücre adezyonu ve yara iyileşmesinin hızlandırılması gibi çeşitli amaçlar için kullanılmaktadır. Lazerler diş hekimliği işlemleri sırasında doğru kullanıldığında daha az kanama, şişlik ve rahatsızlığa neden olur. Bu derlemenin ana amacı diş hekimliğinde fototerapi yaklaşımları hakkında güncel literatürü özetlemek ve fototerapi uygulama yöntemlerini incelemektir.
Anahtar kelimeler: Fotodinamik terapi, lazer, biostimülasyon

Kaynakça

  • Sarkar P, Hirsch R. Photodynamic therapy. Carniol P SN. Clinical procedures in laser skin rejuvenation. New York: CRC Press; 2007: 173-180.
  • Prindeze NJ, Moffatt LT, Shupp JW. Mechanisms of action for light therapy: a review of molecular interactions. Exp Biol Med 2012; 237: 1241-1248.
  • Ishikawa I, Sasaki KM, Aoki A, Watanabe H. Effects of Er:YAG laser on periodontal therapy. J Int Acad Periodontol 2003; 5: 23-28.
  • de Paula Eduardo C, de Freitas PM, Esteves-Oliveira M, Aranha AC, Ramalho KM, Simoes A, et al. Laser phototherapy in the treatment of periodontal disease. A review. Lasers Med Sci 2010; 25: 781-792.
  • Konopka K, Goslinski T. Photodynamic therapy in dentistry. J Dent Res 2007; 86: 694-707.
  • Gursoy H, Ozcakir-Tomruk C, Tanalp J, Yilmaz S. Photodynamic therapy in dentistry: a literature review. Clin Oral Investig 2013; 17: 1113-1125.
  • Sarkar S, Wilson M. Lethal photosensitization of bacteria in subgingival plaque from patients with chronic periodontitis. J Periodontal Res 1993; 28: 204-210.
  • Bhatti M, MacRobert A, Henderson B, Shepherd P, Cridland J, Wilson M. Antibody-targeted lethal photosensitization of Porphyromonas gingivalis. Antimicrob Agents Chemother 2000; 44: 2615-2618.
  • Takasaki AA, Aoki A, Mizutani K, Schwarz F, Sculean A, Wang CY, et al. Application of antimicrobial photodynamic therapy in periodontal and peri-implant diseases. Periodontol 2000 2009; 51: 109-140.
  • Noble PB, Shields ED, Blecher PD, Bentley KC. Locomotory characteristics of fibroblasts within a three- dimensional collagen lattice: modulation by a helium/neon soft laser. Lasers Surg Med 1992; 12: 669-674.
  • Asencio-Arana F, Garcia-Fons V, Molina-Andreu E, Vidal- Martinez J, Martinez-Soriano F. Endoscopic enhancement of the healing of high-risk colon anastomoses by low-power helium-neon laser. An experimental study. Dis Colon Rectum 1992; 35: 568-573.
  • Cieplik F, Spath A, Leibl C, Gollmer A, Regensburger J, Tabenski L, et al. Blue light kills Aggregatibacter actinomycetemcomitans
  • photosensitizers. Clin Oral Investig 2014; 18: 1763-1769.
  • Dortbudak O, Haas R, Bernhart T, Mailath-Pokorny G. Lethal photosensitization for decontamination of implant surfaces in the treatment of peri-implantitis. Clin Oral Implants Res 2001; 12: 104-108.
  • Garcez AS, Nunez SC, Hamblim MR, Suzuki H, Ribeiro MS. Photodynamic therapy associated with conventional endodontic treatment in patients with antibiotic-resistant microflora: a preliminary report. J Endod 2010; 36: 1463- 1466.
  • Bago I, Plecko V, Gabric Panduric D, Schauperl Z, Baraba A, Anic I. Antimicrobial efficacy of a high-power diode laser, photo-activated disinfection, conventional and sonic activated irrigation during root canal treatment. Int Endod J 2013; 46: 339-347.
  • Verma SK, Maheshwari S, Chaudhari PK. Etiological factors of temporomandibular joint disorders. Natl J Maxillofac Surg 2012; 3: 238-239.
  • Hrnjak M, Kuljic-Kapulica N, Budisin A, Giser A. Stimulatory effect of low-power density He-Ne laser radiation on human fibroblasts in vitro. Vojnosanit Pregl 1995; 52: 539- 546.
  • AlGhamdi KM, Kumar A, Moussa NA. Low-level laser therapy: a useful technique for enhancing the proliferation of various cultured cells. Lasers Med Sci 2012; 27: 237-249.
  • Huang YY, Chen AC, Carroll JD, Hamblin MR. Biphasic dose response in low level light therapy. Dose Response 2009; 7: 358-383.
  • Karu T, Pyatibrat L, Kalendo G. Irradiation with He- Ne laser increases ATP level in cells cultivated in vitro. J Photochem Photobiol B 1995; 27: 219-223.
  • Wilden L, Karthein R. Import of radiation phenomena of electrons and therapeutic low-level laser in regard to the mitochondrial energy transfer. J Clin Laser Med Surg 1998; 16: 159-165.
  • Conlan MJ, Rapley JW, Cobb CM. Biostimulation of wound healing by low-energy laser irradiation. A review. J Clin Periodontol 1996; 23: 492-496.
  • Pourreau-Schneider N, Ahmed A, Soudry M, Jacquemier J, Kopp F, Franquin JC, et al. Helium-neon laser treatment transforms fibroblasts into myofibroblasts. Am J Pathol 1990; 137: 171-178.
  • Karu T. Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J Photochem Photobiol B 1999; 49: 1-17.
  • Neiburger EJ. Third molar impactions in early hominids. Am J Phys Anthropol 1995; 96: 93-95.
  • Kitsmaniuk ZD, DemochkoVb, Popovich VI. The use of low-energy lasers for preventing and treating postoperative and radiation-induced complications in patients with head and neck tumors]. Vopr Onkol 1992; 38: 980-986.
  • Kurumada F. A study on the application of Ga-As semiconductor laser to endodontics. The effects of laser irradiation on the activation of inflammatory cells and the vital pulpotomy. Ou Daigaku Shigakushi 1990; 17: 233-244.
  • Hargate G. A randomised double-blind study comparing the effect of 1072-nm light against placebo for the treatment of herpes labialis. Clin Exp Dermatol 2006; 31: 638-641.
  • Mier y Teran Armida M. Lasertherapy and its applications in dentistry. Pract Odontol 1989; 10: 10-16.
  • Turhani D, Scheriau M, Kapral D, Benesch T, Jonke E, Bantleon HP. Pain relief by single low-level laser irradiation in orthodontic patients undergoing fixed appliance therapy. Am J Orthod Dentofacial Orthop 2006; 130: 371-377.
  • Verma SK, Maheshwari S, Singh RK, Chaudhari PK. Laser in dentistry: An innovative tool in modern dental practice. Natl J Maxillofac Surg 2012; 3: 124-132.
  • Kawakami T, Ibaraki Y, Haraguchi K, Odachi H, Kawamura H, Kubota M, et al. The effectiveness of GaA1As semiconductor laser treatment to pain decrease after irradiation. Higashi Nihon Shigaku Zasshi 1989; 8: 57-62.
  • Basford JR. Low intensity laser therapy: still not an established clinical tool. Lasers Surg Med 1995; 16: 331-342. 34. Qadri T, Miranda L, Tuner J, Gustafsson A. The short- term effects of low-level lasers as adjunct therapy in the treatment of periodontal inflammation. J Clin Periodontol 2005; 32: 714-719.
  • Amorim JC, de Sousa GR, de Barros Silveira L, Prates RA, Pinotti M, Ribeiro MS. Clinical study of the gingiva healing after gingivectomy and low-level laser therapy. Photomed Laser Surg 2006; 24: 588-594.
  • Kreisler M, Christoffers AB, Willershausen B, d’Hoedt B. Effect of low-level GaAlAs laser irradiation on the proliferation rate of human periodontal ligament fibroblasts: an in vitro study. J Clin Periodontol 2003; 30: 353-358.
  • van Breugel HH, Bar PR. Power density and exposure time of He-Ne laser irradiation are more important than total energy dose in photo-biomodulation of human fibroblasts in vitro. Lasers Surg Med 1992; 12: 528-537.
  • Ozcelik O, Cenk Haytac M, Kunin A, Seydaoglu G. Improved wound healing by low-level laser irradiation after gingivectomy operations: a controlled clinical pilot study. J Clin Periodontol 2008; 35: 250-254.
  • AboElsaad NS, Soory M, Gadalla LM, Ragab LI, Dunne S, Zalata KR, et al. Effect of soft laser and bioactive glass on bone regeneration in the treatment of infra-bony defects (a clinical study). Lasers Med Sci 2009; 24: 387-395.
  • Doğan GE, Demir T, Orbak R. Effect of low-level laser on guided tissue regeneration performed with equine bone and membrane in the treatment of infrabony defects:a clinical study. Photomed Laser Surg. 2014 Apr;32(4):226-31. Doi: 10. 1089/pho.2013.3664.
  • Stein E, Koehn J, Sutter W, Wendtlandt G, Wanschitz F, Thurnher D, et al. Initial effects of low-level laser therapy on growth and differentiation of human osteoblast-like cells. Wien Klin Wochenschr 2008; 120: 112-117.
  • Nissan J, Assif D, Gross MD, Yaffe A, Binderman I. Effect of low intensity laser irradiation on surgically created bony defects in rats. J Oral Rehabil 2006; 33: 619-924.
  • Hakkı SS, Bozkurt B. Effects of different setting of diode laser on the mRNA expression of growth factors and type I collagen of human gingival fibroblasts. Lasers Med Sci 2012; 27:325-331.
  • Weber JB, Pinheiro AL, de Oliveira MG, Oliveira FA, Ramalho LM. Laser therapy improves healing of bone defects submitted to autologous bone graft. Photomed Laser Surg 2006; 24: 38-44.
  • Tanner AC, Socransky SS, Goodson JM. Microbiota of periodontal pockets losing crestal alveolar bone. J Periodontal Res 1984; 19: 279-291.
  • Adriaens PA, Edwards CA, De Boever JA, Loesche WJ. Ultrastructural observations on bacterial invasion in cementum and radicular dentin of periodontally diseased human teeth. J Periodontol 1988; 59: 493-503.
  • Allaker RP, Douglas CW. Novel anti-microbial therapies for dental plaque-related diseases. Int J Antimicrob Agents 2009; 33: 8-13.
  • Dickers B, Lamard L, Peremans A, Geerts S, Lamy M, Limme M, et al. Temperature rise during photo-activated disinfection of root canals. Lasers Med Sci 2009; 24: 81-85.
  • Bhatti M, MacRobert A, Meghji S, Henderson B, Wilson M. A study of the uptake of toluidine blue O by Porphyromonas gingivalis and the mechanism of lethal photosensitization. Photochem Photobiol 1998; 68: 370-376.
  • Bevilacqua IM, Nicolau RA, Khouri S, Brugnera A, Jr., Teodoro GR, Zangaro RA, et al. The impact of photodynamic therapy on the viability of Streptococcus mutans in a planktonic culture. Photomed Laser Surg 2007; 25: 513-518.
  • Prates RA, Yamada AM, Jr., Suzuki LC, Eiko Hashimoto MC, Cai S, Gouw-Soares S, et al. Bactericidal effect of malachite green and red laser on Actinobacillus actinomycetemcomitans. J Photochem Photobiol B 2007; 86: 70-76.
  • Soukos NS, Hamblin MR, Hasan T. The effect of charge on cellular uptake and phototoxicity of polylysine chlorin(e6) conjugates. Photochem Photobiol 1997; 65: 723-729.
  • Bhatti M, Nair SP, Macrobert AJ, Henderson B, Shepherd P, Cridland J, et al. Identification of photolabile outer membrane proteins of Porphyromonas gingivalis. Curr Microbiol 2001; 43: 96-99.
Toplam 53 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Derlemeler
Yazarlar

Mükerrem Hatipoğlu

Osman Harorlı

Zeliha Aytekin

Yayımlanma Tarihi 23 Mart 2016
Gönderilme Tarihi 26 Ağustos 2015
Yayımlandığı Sayı Yıl 2016 Cilt: 7 Sayı: 1

Kaynak Göster

Vancouver Hatipoğlu M, Harorlı O, Aytekin Z. Phototherapy in Dentistry. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2016;7(1):44-8.

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