Yıl: 2023 Cilt: 8 Sayı: 1 Sayfa Aralığı: 871 - 875 Metin Dili: İngilizce DOI: 10.33808/clinexphealthsci.1215298 İndeks Tarihi: 07-01-2024

Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials

Öz:
Objective: The aim of this in vitro study is to evaluate the micro-gap changes in three dimensions after thermodynamic loading between hybrid abutment crowns made of different materials and implants with internal conical connection. Methods: A total of 10 morse cone connection implants (Straumann Bone Level Implant, Institut Straumann AG, Basel, Switzerland) were used. In this study, two study groups were formed using lithium disilicate glass-ceramic (LD) and polymethyl methacrylate (PMMA) in hybrid abutment-crown production (n=5). Hybrid abutment-crowns were fabricated by CAD/CAM system. Hybrid abutment crowns were designed and manufactured digitally. A 4-month of clinical cycle was applied to the samples in the chewing simulator. The micro-gap at the implant- abutment interface was visualized with micro-CT before and after thermodynamic loading. Micro-gap change was determined using these obtained images. For comparisons, independent t-test was used. Results: When comparing the micro-gap volumes before and after aging, no significant difference was observed between the LD and PMMA groups. The micro-gap increase after loading was 0.68 ±0.209 in the LD group and 0.45 ±0.373 in the PMMA group. Although the increase was higher in the LD group, there is no statistically significant difference between two groups. Conclusion: he micro-gap in the interface of implants and hybrid abutment crowns increased after aging. Hybrid abutment-crown material affected the micro-gap increase, but it was not statistically significant.
Anahtar Kelime: Micro-gap hybrid abutment-crown implant-abutment connection

Serum Amylase Levels Can Predict Hospitalization and Operation Rates

Öz:
Objective: The levels of serum amylase is an indicator of several diseases.Therefore, a routine amylase test is frequently requested in hospital emergency admissions. This research aims to evaluate the hospitalization and surgery rates of patients with high amylase levels.Methods: A retrospective clinical study was performed on 64,909 patientsaged 53.30±19.45 years who had a serum amylase test at hospital admissionin the emergency ward between 2011 and 2015. Age, gender, serum amylase levels, diagnosis, hospitalization, and surgery status of the patients wereobtained from the electronic medical records. The diseases were classifiedinto seven groups according to the International Statistical Classification ofDiseases and Related Health Problems codes. The patients were divided intothree groups with respect to amylase levels– group 1 (<125 U/L), group 2(125–375 U/L), and group 3 (>376 U/L). The results were statistically analyzedusing the SPSS commercial tool package version 21.0. The χ2 test and Fisher’sexact probability test were adapted for categorical variables, while Student’st-test was performed for the unpaired data of continuous variables.Results: The hospitalization rate increased 2.4-fold and 4.7-fold and the surgeryrate increased 1.6-fold and 1.4-fold in group 2 and group 3 compared to group1, respectively. The hospitalization rate of the patients (N=571) in group 3 was59.4%. Among them, only 93 patients were diagnosed with acute pancreatitis.Conclusion: Elevated serum amylase levels can predict hospitalization andsurgery status.
Anahtar Kelime:

Serum Amilaz Aktivitesi, Hastaneye Yatış ve Operasyon Oranlarını Öngörebilir

Öz:
Amaç: Serum amilaz düzeyi birçok hastalığın göstergesidir. Bu yüzden, rutin amilaz testi hastaneye acil başvurularda sıklıkla istenmektedir. Bu araştırmanın amacı, yüksek amilaz düzeyine sahip hastalarda hastaneye yatış durumu ve cerrahi riskleri değerlendirmektir. Yöntemler: Acil serviste serum amilaz testi yapılmış, 53,30±19,45 yaşında 64909 hasta ile retrospektif klinik çalışma yapıldı. Yaş, cinsiyet, serum amilaz miktarı düzeyi, tanı, hastaların hastaneye yatış ve operasyonel durumlarına ait bilgiler tıbbi kayıtlar (Probel, Hastane İşletim Sistemi) kullanılarak elde edildi. Hastalıklar, ICD 10 kodlarına göre yedi grupta sınıflandırıldı. Serum amilaz düzeyleri amilaz konsantrasyonlarına göre üç gruba ayrıldı; Grup 1 (< 125 U/L), Grup 2 (125-375 U/L) and Grup 3 (> 376 U/L). Sonuçlar istatistiksel olarak SPSS ticari paket programı (versiyon 21,0) kullanılarak analiz edildi. Kategorik değişkenler için χ2 ve Fisher kesin olasılık testi; sürekli değişkenlerin eşleştirilmemiş verileri için ise Student t testi kullanıldı. Bulgular: Hastaneye yatış ve ameliyat oranlarının Grup 2 ve Grup 3’te Grup 1’e göre sırasıyla 2,4 ve 4,7 ve 1,6 ve 1,4 arttığı saptandı. Amilaz değeri 376 U/L üzerinde olan hastaların (N=571) hastaneye yatış oranları %59,4 idi. Bu hastalardan yalnızca 93’ünde akut pankreas iltihabı vardı. Sonuç: Yüksek serum amilaz düzeyi hastaneye yatış ve ameliyatı öngörmede kullanılan parametrelerden biri olabilir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Pieper-Bigelow C, Strocchi A, Levitt MD. Where does serum amylase come from and where does it go? Gastroenterol Clin North Am 1990; 19: 793-810.
  • 2. Byrne MF, Mitchell RM, Stiffler H, Jowell PS, Branch MS, Pappas TN, et al. Extensive investigation of patients with mild elevations of serum amylase and/or lipase is low yield. Can J Gastroenterol 2002; 16: 849-54. [CrossRef]
  • [1] Singla S, Kumar L, Rathee M. Know your implant connections. Afr J Oral Health. 2018;6(2): 1-7. DOI:10.4314/ajoh.v6i2.162380
  • 3. Vissers RJ, Abu-Laban RB, McHugh DF. Amylase and lipase in the emergency department evaluation of acute pancreatitis. J Em Med 1999; 17: 1027-37. [CrossRef]
  • [2] Goodacre CJ, Kan JY, Rungcharassaeng K. Clinical complications of osseointegrated implants. J Prosthet Dent. 1999;8(5): 537- 552. DOI: 10.1016/s0022-3913(99)70208-8
  • 4. Matull WR, Pereira SP, O’donohue JW. Biochemical markers of acute pancreatitis. J Clin Pathol 2006; 59: 340-4. [CrossRef]
  • [3] Sailer I, Sailer T, Stawarczyk B, Jung RE, Hämmerle CH. In vitro study of the influence of the type of connection on the fracture load of zirconia abutments with internal and external implant-abutment connections. Int J Oral Maxillofac Implants. 2009;24(5):850-858. DOI:10.5167/uzh-26251
  • 5. Frulloni L, Patrizi F, Bernardoni L, Cavallini G. Pancreatic hyperenzymemia: Clinical significance and diagnostic approach. JOP 2005; 6: 536-51.
  • [4] Gupta S, Gupta H, Tandan A. Technical complications of implant-causes and management: A comprehensive review. Natl J Maxillofac Surg. 2015;6(1):3-8. DOI: 10.4103/0975- 5950.168233
  • 6. Bindu CM, Vidya Shankar P, Shetty HV, Gupta D. Serum amylase in patients with chronic kidney disease. IJCRR 2013; 5: 10-5.
  • [5] Koutouzis, T. Implant-abutment connection as contributing factor to peri-implant diseases. Periodontology. 2019;81(1):152–166. DOI: 10.1111/prd.12289
  • 7. Berk JE, Shimamura J, Fridhandler L. Tumor associated hyperamylasemia. Am J Gastroenterol 1977; 68: 572-7.
  • [6] Liu Y, Wang J. Influences of microgap and micromotion of implant-abutment interface on marginal bone loss around implant neck. Arch Oral Biol. 2017;83:153-160. DOI: 10.1016/j. archoralbio.2017.07.022
  • 8. Sudo K, Kanno T. Properties of the amylase produced in carcinoma of the lung. Clin Chem Acta 1976; 73: 1-12. [CrossRef]
  • [7] Caricasulo R, Malchiodi L, Ghensi P, Fantozzi G, Cucchi A. The influence of implant-abutment connection to peri-implant bone loss: A systematic review and meta-analysis. Clin Implant Dent Relat Res. 2018;20(4):653-664. DOI: 10.1111/cid.12620
  • 9. Jasdanwala S, Babyatsky M. A critical evaluation of serum lipase and amylase as diagnostic tests for acute pancreatitis. Integr Mol Med 2015; 2: 189-95.
  • [8] Schmitt CM, Nogueira-Filho G, Tenenbaum HC, Lai JY, Brito C, Döring H, Nonhoff J. Performance of conical abutment (Morse Taper) connection implants: a systematic review. J Biomed Mater Res A. 2014;102(2):552-574. DOI: 10.1002/jbm.a.34709
  • 10. Kazmierczak SC, Catrou PG, Van Lente F. Diagnostic accuracy of pancreatic enzymes evaluated by use of multivariate data analysis. Clin Chem 1993; 39: 1960-5.
  • [9] Canullo L, Penarrocha-Oltra D, Soldini C, Mazzocco F, Penarrocha M, Covani U. Microbiological assessment of the implant-abutment interface in different connections: cross- sectional study after 5 years of functional loading. Clin Oral Implants Res. 2015;26(4):426-434. DOI: 10.1111/clr.12383
  • 11. Batra HS, Kumar A, Saha TK, Misra P, Ambade V. Comparative study of serum amylase and lipase in acute pancreatitis patients.Indian J Clin Biochem 2015; 30: 230-3. [CrossRef]
  • [10] Priest G. A current perspective on screw-retained single- implant restorations: a review of pertinent literature. J Esthet Rest Dent. 2017;29(3):161-171. DOI: 10.1111/jerd.12283
  • 12. Lankisch PG, Burchard-Reckert S, Lehnick D. Underestimation of acute pancreatitis: patients with only a small increase in amylase/lipase levels can also have or develop severe acute pancreatitis. Gut 1999; 44: 542-44. [CrossRef]
  • [11] Huang Y, Wang J. Mechanism of and factors associated with the loosening of the implant abutment screw. J Ethet Restor Dent. 2019;31(4):338-345. DOI: 10.1111/jerd.12494
  • 13. Muniraj T, Dang S, Pitchumoni CS. Pancreatitis or not?--elevated lipase and amylase in icu patients. J Crit Care 2015; 30: 1370-5. [CrossRef]
  • [12] Edelhoff D, Schweiger J, Prandtner O, Stimmelmayr M, Güth JF. Metal-free implant-supported single-tooth restorations. Part I: Abutments and cemented crowns. Quintessence Int. 2019;50(3):176-184. DOI: 10.3290/j.qi.a41906
  • 14. Lankisch PG, Doobe C, Finger T, Lübbers H, Mahlke R, Brinkmann G, et al. Hyperamylasaemia and/or hyperlipasaemia: incidence and underlying causes in hospitalized patients with non-pancreatic diseases. Scand J Gastroenterol 2009; 44: 237-41. [CrossRef]
  • [13] Edelhoff D, Schweiger J, Prandtner O, Stimmelmayr M, Güth JF. Metal-free implant-supported single-tooth restorations. Part II: Hybrid abutment crowns and material selection. Quintessence Int. 2019;50(4):260-269. DOI: 10.3290/j.qi.a42099
  • 15. Weaver DW, Busuito MJ, Bouwman DL, Wilson RF. Interpretation of serum amylase levels in the critically ill patient. Crit Care Med 1985; 13: 532-3. [CrossRef]
  • [14] Zembic A, Kim S, Zwahlen M, Kelly JR. Systematic review of the survival rate and incidence of biologic, technical, and esthetic complications of single implant abutments supporting fixed prostheses. Int J Oral Maxillofac Implants. 2014;29:99-116. DOI: 10.11607/jomi.2014suppl.g2.2
  • 16. Gilbert EH, Lowenstein SR, Koziol-Mclain J, Barta DC, Steiner J. Chart reviews in emergency medicine research: Where are the methods? Ann Emerg Med 1996; 27: 305-8. [CrossRef]
  • [15] Qutub OA, Basunbul GI, Binmahfooz AM. Influence of abutment material on the shade of dental implant restorations in the esthetic zone: a single case report. Clin Cosmet Investig Dent. 2019;11:73-80. DOI: 10.2147/CCIDE.S199635
  • 17. Lott JA. The value of clinical laboratory studies in acute pancreatitis. Arch Pathol Lab Med 1991; 115: 325-6.
  • [16] Tribst JPM, Dal Piva AMO, Özcan M, Borges ALS, Bottino MA. Influence of Ceramic Materials on Biomechanical Behavior of Implant Supported Fixed Prosthesis with Hybrid Abutment. Eur J Prosthodont Restor Dent. 2019;27(2):76-82. DOI: 10.1922/ EJPRD_01829Tribst07
  • 18. Sutton PA, Humes DJ, Purcell G, Smith JK, Whiting F, Wright T, et al. The role of routine assays of serum amylase and lipase for the diagnosis of acute abdominal pain. Ann R Coll Surg Engl 2009; 91: 381-4. [CrossRef]
  • [17] Glauser R, Zembic A, Hämmerle CH. A systematic review of marginal soft tissue at implants subjected to immediate loading or immediate restoration. Clin Oral Implants Res. 2006;17(2):82-92. DOI: 10.1111/j.1600-0501.2006.01355.x
  • 19. Gomez D, Addison A, De Rosa A, Brooks A, Cameron IC. Retrospective study of patients with acute pancreatitis: Is serum amylase still required? BMJ Open 2012; 2: E001471. [CrossRef]
  • [18] Yazigi C, Kern M, Chaar MS, Libecki W, Elsayed A. The influence of the restorative material on the mechanical behavior of screw-retained hybrid-abutment-crowns. J Mech Behav Biomed Mater. 2020;111:103988. DOI: 10.1016/j. jmbbm.2020.103988
  • 20. Engert V, Vogel S, Efanov SI, Duchesne A, Corbo V, Ali N, et al. Investigation into the cross-correlation of salivary cortisol and alpha-amylase responses to psychological stress. Psychoneuroendocrinology 2011; 36: 1294-302. [CrossRef]
  • [19] Adolfi D, Tribst JPM, Adolfi M, Dal Piva AMO, Saavedra GSFA, Bottino MA. Lithium Disilicate Crown, Zirconia Hybrid Abutment and Platform Switching to Improve the Esthetics in Anterior Region: A Case Report. Clin Cosmet Investig Dent. 2020;12:31-40. DOI: 10.2147/CCIDE.S234980
  • 21. Vineetha R, Pai KM, Vengal M, Gopalakrishna K, Narayanakurup D. Usefulness of salivary alpha amylase as a biomarker of chronic stress and stress related oral mucosal changes - A pilot study. J Clin Exp Dent 2014; 6: e132-7. [CrossRef]
  • [20] Al-Zordk W, Elmisery A, Ghazy M. Hybrid-abutment- restoration: effect of material type on torque maintenance and fracture resistance after thermal aging. Int J Implant Dent. 2020;6(1):24. DOI: 10.1186/s40729.020.00220-y
  • 22. Nakajima K, Muneyuki T, Munakata H, Kakei M. Revisiting the cardiometabolic relevance of serum amylase. BMC Res Notes 2011; 4: 419. [CrossRef]
  • [21] Oh TJ, Yoon J, Misch CE,Wang HL. The causes of early implant bone loss: myth or science. J Periodontol. 2002;73(3):322-333. DOI: 10.1902/jop.2002.73.3.322
  • [22] Broggini N, McManus LM, Hermann JS, Medina R, Schenk RK, Buser D. Peri-implant inflammation defined by the implant- abutment interface. J Dent Res. 2006;85(5):473-478. DOI: 10.1177/154.405.910608500515
  • [23] Coelho AL, Suzuki M, Dibart S, DA Silva N, Coelho PG. Cross- sectional analysis of the implant-abutment interface. J Oral Rehabil. 2007;34(7):508-16. DOI: 10.1111/j.1365- 2842.2007.01714.x
  • [24] Ricomini Filho AP, FernandesFS, Straioto FG, da Silva WJ, Del BelCury AA. Preload loss and bacterial penetration on different implant-abutment connection systems. Braz Dent J. 2010;21(2):123-129. DOI: 10.1590/ s0103.644.0201000.020.0006
  • [25] Blum K, Wiest W, Fella C, Balles A, Dittmann J, Rack A, Maier D, Thomann R, Spies BC, Kohal RJ, Zabler S, Nelson K. Fatigue induced changes in conical implant-abutment connections. Dent Mater. 2015;31(11):1415-1426. DOI: 10.1016/j. dental.2015.09.004
  • [26] Rack T, Zabler S, Rack A, Riesemeier H, Nelson K. An in vitro pilot study of abutment stability during loading in new and fatigue- loaded conical dental implants using synchrotron-based radiography. Int J Oral Maxillofac Implants. 2013;28(1):44-50. DOI: 10.11607/jomi.2748
  • [27] Elsayed A, Wille S, Al-Akhali M, Kern M. Effect of fatigue loading on the fracture strength and failure mode of lithium disilicate and zirconia implant abutments. Clin Oral Implants Res. 2018;29(1):20-27. DOI: 10.1016/j.prosdent.2020.09.059
  • [28] Nouh I, Kern M, Sabet A, Aboelfadl A, Hamdy A, Chaar M. Mechanical behavior of posterior all-ceramic hybrid- abutment-crowns versus hybrid – abutments with separate crowns: a laboratory study. Clin Oral Impl Res. 2019;30(1):90- 98. DOI: 10.1111/clr.13395
  • [29] Karl M, Graef F, Wichmann MG, Heckmann SM. The effect of load cycling on metal ceramic screw-retained implant restorations with unrestored and restored screw access holes. J Prosthet Dent. 2008;99(1):19-24. DOI: 10.1016/S0022- 3913(08)60004-9
  • [30] Karl M, Kelly JR. Influence of loading frequency on implant failure under cyclic fatigue conditions. Dent Mater. 2009;25(11):1426-1432. DOI: 10.1016/j.dental.2009.06.015
  • [31] Tribst JPM, Piva AMDOD, Borges ALS, Bottino MA. Influence of crown and hybrid abutment ceramic materials on the stress distribution of implant-supported prosthesis. Rev Odontol UNESP. 2018;47(3):149–154. DOI:10.1590/1807-2577.04218
  • [32] Vahey BR, Sordi MB, Stanley K, Magini RS, Novaes de Oliveira AP, Fredel MC, Henriques B, Souza JCM. Mechanical integrity of cement – and screw-retained zirconium-lithium silicate glass- ceramic crowns to Morse taper implants. J Prosthet Dent. 2018;120(5):721-731. DOI: 10.1016/j.prosdent.2018.01.028
APA Çetin T, BASKIN Y, Aslan Y, YİĞİTBAŞI T, Büyükuslu N, ÇALIBAŞI KOÇAL G, ÜSTÜNER F, ŞENTÜRK B, ELLİDOKUZ H (2023). Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials. , 871 - 875. 10.33808/clinexphealthsci.1215298
Chicago Çetin Tuğçe,BASKIN Yasemin,Aslan Yılmaz Umut,YİĞİTBAŞI Türkan,Büyükuslu Nihal,ÇALIBAŞI KOÇAL Gizem,ÜSTÜNER Füsun,ŞENTÜRK Banu Arslan,ELLİDOKUZ Hülya Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials. (2023): 871 - 875. 10.33808/clinexphealthsci.1215298
MLA Çetin Tuğçe,BASKIN Yasemin,Aslan Yılmaz Umut,YİĞİTBAŞI Türkan,Büyükuslu Nihal,ÇALIBAŞI KOÇAL Gizem,ÜSTÜNER Füsun,ŞENTÜRK Banu Arslan,ELLİDOKUZ Hülya Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials. , 2023, ss.871 - 875. 10.33808/clinexphealthsci.1215298
AMA Çetin T,BASKIN Y,Aslan Y,YİĞİTBAŞI T,Büyükuslu N,ÇALIBAŞI KOÇAL G,ÜSTÜNER F,ŞENTÜRK B,ELLİDOKUZ H Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials. . 2023; 871 - 875. 10.33808/clinexphealthsci.1215298
Vancouver Çetin T,BASKIN Y,Aslan Y,YİĞİTBAŞI T,Büyükuslu N,ÇALIBAŞI KOÇAL G,ÜSTÜNER F,ŞENTÜRK B,ELLİDOKUZ H Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials. . 2023; 871 - 875. 10.33808/clinexphealthsci.1215298
IEEE Çetin T,BASKIN Y,Aslan Y,YİĞİTBAŞI T,Büyükuslu N,ÇALIBAŞI KOÇAL G,ÜSTÜNER F,ŞENTÜRK B,ELLİDOKUZ H "Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials." , ss.871 - 875, 2023. 10.33808/clinexphealthsci.1215298
ISNAD Çetin, Tuğçe vd. "Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials". (2023), 871-875. https://doi.org/10.33808/clinexphealthsci.1215298
APA Çetin T, BASKIN Y, Aslan Y, YİĞİTBAŞI T, Büyükuslu N, ÇALIBAŞI KOÇAL G, ÜSTÜNER F, ŞENTÜRK B, ELLİDOKUZ H (2023). Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials. Clinical and Experimental Health Sciences, 8(1), 871 - 875. 10.33808/clinexphealthsci.1215298
Chicago Çetin Tuğçe,BASKIN Yasemin,Aslan Yılmaz Umut,YİĞİTBAŞI Türkan,Büyükuslu Nihal,ÇALIBAŞI KOÇAL Gizem,ÜSTÜNER Füsun,ŞENTÜRK Banu Arslan,ELLİDOKUZ Hülya Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials. Clinical and Experimental Health Sciences 8, no.1 (2023): 871 - 875. 10.33808/clinexphealthsci.1215298
MLA Çetin Tuğçe,BASKIN Yasemin,Aslan Yılmaz Umut,YİĞİTBAŞI Türkan,Büyükuslu Nihal,ÇALIBAŞI KOÇAL Gizem,ÜSTÜNER Füsun,ŞENTÜRK Banu Arslan,ELLİDOKUZ Hülya Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials. Clinical and Experimental Health Sciences, vol.8, no.1, 2023, ss.871 - 875. 10.33808/clinexphealthsci.1215298
AMA Çetin T,BASKIN Y,Aslan Y,YİĞİTBAŞI T,Büyükuslu N,ÇALIBAŞI KOÇAL G,ÜSTÜNER F,ŞENTÜRK B,ELLİDOKUZ H Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials. Clinical and Experimental Health Sciences. 2023; 8(1): 871 - 875. 10.33808/clinexphealthsci.1215298
Vancouver Çetin T,BASKIN Y,Aslan Y,YİĞİTBAŞI T,Büyükuslu N,ÇALIBAŞI KOÇAL G,ÜSTÜNER F,ŞENTÜRK B,ELLİDOKUZ H Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials. Clinical and Experimental Health Sciences. 2023; 8(1): 871 - 875. 10.33808/clinexphealthsci.1215298
IEEE Çetin T,BASKIN Y,Aslan Y,YİĞİTBAŞI T,Büyükuslu N,ÇALIBAŞI KOÇAL G,ÜSTÜNER F,ŞENTÜRK B,ELLİDOKUZ H "Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials." Clinical and Experimental Health Sciences, 8, ss.871 - 875, 2023. 10.33808/clinexphealthsci.1215298
ISNAD Çetin, Tuğçe vd. "Assessment of Micro-Gap in Hybrid Abutment-Crowns Fabricated with Different Materials". Clinical and Experimental Health Sciences 8/1 (2023), 871-875. https://doi.org/10.33808/clinexphealthsci.1215298