Advances in Dental Research最新文献

{"title":"Getting to Know \"The Known Unknowns\": Heterogeneity in the Oral Microbiome.","authors":"R A Burne","doi":"10.1177/0022034517735293","DOIUrl":"https://doi.org/10.1177/0022034517735293","url":null,"abstract":"<p><p>Technological advances in DNA sequencing have provided unprecedented insights into the composition of the oral microbiome in health and disease, and RNA-sequencing and metabolomics-related technologies are beginning to yield information on the activities of these organisms. Importantly, progress in this area has brought the scientific community closer to an understanding of what constitutes a health-associated microbiome and is supporting the notion that the microbiota in healthy sites assumes an active role in promoting health and suppressing the acquisition, persistence, and activities of overt and opportunistic pathogens. It is also becoming clear that a significant impediment to developing a conclusive body of evidence that defines a healthy microbiome and the mechanisms by which beneficial bacteria promote health is that an inherent characteristic of the most abundant members of the oral flora, those that potentially play the greatest roles in health and disease, is intraspecies genomic diversity. In particular, individual isolates of abundant commensal and pathogenic streptococci show tremendous variability in gene content, and this variability manifests in tremendous phenotypic heterogeneity. Analysis of the consequences of this diversity has been complicated by the exquisite sensitivity these bacteria have evolved to environmental inputs, inducing rapid and substantial fluctuations in behaviors, and often only within subpopulations of the organisms. Thus, the conditions under which the oral microbiota is studied can produce widely different results within and between species. Fortunately, continually diminishing costs and ongoing refinements in sequencing and metabolomics are making it practical to study the oral microbiome at a level that will create a sufficiently robust understanding of the functions of individual organisms and reveal the complex interrelationships of these microbes (\"the known unknowns\") in a way that researchers will be able to engage in the rational design of reliable and economical risk assessments and preventive therapies.</p>","PeriodicalId":7300,"journal":{"name":"Advances in Dental Research","volume":"29 1","pages":"66-70"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0022034517735293","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35756243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Carious Lesions: Why Do We Need Consensus on Terminology and Clinical Recommendations on Carious Tissue Removal?","authors":"J E Frencken,&nbsp;N P T Innes,&nbsp;F Schwendicke","doi":"10.1177/0022034516639272","DOIUrl":"https://doi.org/10.1177/0022034516639272","url":null,"abstract":"Although the prevalence of dental caries has decreased in many countries over the last 3 decades, it remains one of the most prevalent diseases worldwide, burdening billions of people (Marcenes et al. 2013) and generating significant global health care costs (Listl et al. 2015). How to manage carious lesions best is therefore a central concept in oral health care. The management should be guided by evidence-based recommendations, with patients at the center, founded on agreement among professionals, thereby easing clinical decision making. While the number of studies to support guidance is growing (Ricketts et al. 2013), there is disagreement around how to interpret the existing data. One of the underlying reasons for this disagreement is the use of different terms for describing more or less the same management strategies. There also continues to be a gap between research findings and clinical practice. The reasons for this are complex, but contributing factors are inconsistencies in clinical guidelines, dental education, national health care policies, and remuneration systems. To tackle these issues and provide a stepping-stone from which to improve the management of carious lesions, the International Caries Consensus Collaboration (ICCC) compiled expert consensus on terminology and recommendations for dealing with carious tooth tissue removal and managing cavitated carious lesions. The ICCC comprised 21 experts in cariology from 12 countries covering North and South America, Eastern and Western Europe, Asia and Australasia. 639272 ADRXXX10.1177/0022034516639272Advances in Dental ResearchConsensus on Caries Terminology and Carious Tissue Removal research-article2016","PeriodicalId":7300,"journal":{"name":"Advances in Dental Research","volume":"28 2","pages":"46-8"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0022034516639272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34321376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Carious Lesions: Consensus Recommendations on Terminology.","authors":"N P T Innes, J E Frencken, L Bjørndal, M Maltz, D J Manton, D Ricketts, K Van Landuyt, A Banerjee, G Campus, S Doméjean, M Fontana, S Leal, E Lo, V Machiulskiene, A Schulte, C Splieth, A Zandona, F Schwendicke","doi":"10.1177/0022034516639276","DOIUrl":"10.1177/0022034516639276","url":null,"abstract":"<p><p>Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided.Dental cariesis the name of the disease, and thecarious lesionis the consequence and manifestation of the disease-the signs or symptoms of the disease. The termdental caries managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm dentine; 2)stepwise removal-including stage 1,selective removal to soft dentine, and stage 2,selective removal to firm dentine6 to 12 mo later; and 3)nonselective removal to hard dentine-formerly known ascomplete caries removal(technique no longer recommended). Adoption of these terms, around managing dental caries and its sequelae, will facilitate improved understanding and communication among researchers and within dental educators and the wider clinical dentistry community. </p>","PeriodicalId":7300,"journal":{"name":"Advances in Dental Research","volume":"28 2","pages":"49-57"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34321377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal.","authors":"F Schwendicke,&nbsp;J E Frencken,&nbsp;L Bjørndal,&nbsp;M Maltz,&nbsp;D J Manton,&nbsp;D Ricketts,&nbsp;K Van Landuyt,&nbsp;A Banerjee,&nbsp;G Campus,&nbsp;S Doméjean,&nbsp;M Fontana,&nbsp;S Leal,&nbsp;E Lo,&nbsp;V Machiulskiene,&nbsp;A Schulte,&nbsp;C Splieth,&nbsp;A F Zandona,&nbsp;N P T Innes","doi":"10.1177/0022034516639271","DOIUrl":"https://doi.org/10.1177/0022034516639271","url":null,"abstract":"<p><p>The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal or control first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health should be prioritized, while in shallow or moderately deep lesions, restoration longevity becomes more important. For teeth with shallow or moderately deep cavitated lesions, carious tissue removal is performed according toselective removal to firm dentine.In deep cavitated lesions in primary or permanent teeth,selective removal to soft dentineshould be performed, although in permanent teeth,stepwise removalis an option. The evidence and, therefore, these recommendations support less invasive carious lesion management, delaying entry to, and slowing down, the restorative cycle by preserving tooth tissue and retaining teeth long-term. </p>","PeriodicalId":7300,"journal":{"name":"Advances in Dental Research","volume":"28 2","pages":"58-67"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0022034516639271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34321378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implant Surface Design Regulates Mesenchymal Stem Cell Differentiation and Maturation","authors":"B. Boyan, A. Cheng, R. Olivares-Navarrete, Z. Schwartz","doi":"10.1177/0022034515624444","DOIUrl":"https://doi.org/10.1177/0022034515624444","url":null,"abstract":"Changes in dental implant materials, structural design, and surface properties can all affect biological response. While bulk properties are important for mechanical stability of the implant, surface design ultimately contributes to osseointegration. This article reviews the surface parameters of dental implant materials that contribute to improved cell response and osseointegration. In particular, we focus on how surface design affects mesenchymal cell response and differentiation into the osteoblast lineage. Surface roughness has been largely studied at the microscale, but recent studies have highlighted the importance of hierarchical micron/submicron/nanosurface roughness, as well as surface roughness in combination with surface wettability. Integrins are transmembrane receptors that recognize changes in the surface and mediate downstream signaling pathways. Specifically, the noncanonical Wnt5a pathway has been implicated in osteoblastic differentiation of cells on titanium implant surfaces. However, much remains to be elucidated. Only recently have studies been conducted on the differences in biological response to implants based on sex, age, and clinical factors; these all point toward differences that advocate for patient-specific implant design. Finally, challenges in implant surface characterization must be addressed to optimize and compare data across studies. An understanding of both the science and the biology of the materials is crucial for developing novel dental implant materials and surface modifications for improved osseointegration.","PeriodicalId":7300,"journal":{"name":"Advances in Dental Research","volume":"28 1","pages":"10 - 17"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0022034515624444","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64931383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative Performance Analysis of a Novel Bone Level Tapered Implant","authors":"M. Dard, S. Kuehne, M. Obrecht, M. Grandin, J. Helfenstein, B. Pippenger","doi":"10.1177/0022034515624443","DOIUrl":"https://doi.org/10.1177/0022034515624443","url":null,"abstract":"Primary mechanical stability, as measured by maximum insertion torque and resonance frequency analysis, is generally considered to be positively associated with successful secondary stability and implant success. Primary implant stability can be affected by several factors, including the quality and quantity of available bone, the implant design, and the surgical procedure. The use of a tapered implant design, for instance, has been shown to result in good primary stability even in clinical scenarios where primary stability is otherwise difficult to achieve with traditional cylindrical implants—for example, in soft bone and for immediate placement in extraction sockets. In this study, bone-type specific drill procedures are presented for a novel Straumann bone level tapered implant that ensure maximum insertion torque values are kept within the range of 15 to 80 Ncm. The drill procedures are tested in vitro using polyurethane foam blocks of variable density, ex vivo on explanted porcine ribs (bone type 3), and finally in vivo on porcine mandibles (bone type 1). In each test site, adapted drill procedures are found to achieve a good primary stability. These results are further translated into a finite element analysis model capable of predicting primary stability of tapered implants. In conclusion, we have assessed the biomechanical behavior of a novel taper-walled implant in combination with a bone-type specific drill procedure in both synthetic and natural bone of various types, and we have developed an in silico model for predicting primary stability upon implantation.","PeriodicalId":7300,"journal":{"name":"Advances in Dental Research","volume":"28 1","pages":"28 - 33"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0022034515624443","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64931373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Critical Perspective on Mechanical Testing of Implants and Prostheses","authors":"E. Bonfante, Paulo G. Coelho, Paulo G. Coelho","doi":"10.1177/0022034515624445","DOIUrl":"https://doi.org/10.1177/0022034515624445","url":null,"abstract":"The degree of interplay among variables in dental implant treatment presents a challenge to randomized clinical trials attempting to answer questions in a timely, unbiased, and economically feasible fashion. Further adding complexity to the different scenarios is the varied implant designs and related bone response, area of implantation, implant bulk material, restoration, abutments and related screws, fixation mode (screwed, fixed, or a combination), and horizontal implant-abutment matching geometry. This article critically appraises the most common mechanical testing methods used to characterize the implant-prostheses complex. It attempts to provide insight into the process of construction of an informed database of clinically relevant questions regarding preclinical evaluation of implant biomechanics and failure mechanisms. The use of single load to failure, fatigue life, fatigue limit, and step-stress accelerated life testing is discussed with emphasis on their deliverables, weaknesses, and strengths. Fractographic analysis and challenges in the correlation between laboratory- and in-service-produced failures of dental ceramics, resin composites, and titanium are introduced. In addition, examples are presented of mechanical characterization studies used in our laboratory to assess some implant-supported rehabilitation variables.","PeriodicalId":7300,"journal":{"name":"Advances in Dental Research","volume":"28 1","pages":"18 - 27"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0022034515624445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64931413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Relevance of Integrated Developmental Research for Dental Implants","authors":"M. Dard","doi":"10.1177/0022034516630947","DOIUrl":"https://doi.org/10.1177/0022034516630947","url":null,"abstract":"The topic “clinical relevance of integrated developmental research for dental implants” was initially addressed at a multidisciplinary symposium during the 93rd General Session & Exhibition of the International Association for Dental Research on March 11, 2015, in Boston, Massachusetts, USA. The objective of this meeting consisted in discussing the optimal workflow for the development of a dental implant from the initial bench design to in vivo implantation at the clinical level. As a study case, attendees decided to share views on and confer about a new tapered implant. This special issue of Advances in Dental Research reflects the multiple outcomes of the discussions that took place during the above symposium and the multiple exchanges and chats that followed. The opening publication consists in a narrative review. The authors of the first paper, relying on undisputed clinical experience, describe that the relationship that exists among implant surface, primary stability, thread configuration, body shape, and type of bony bed has to be considered to lessen treatment times by decreasing the healing period during which osseointegration is established (Wilson et al. 2016). From this discussion, the concept of initial stability, which incorporates all the aforementioned parameters (including primary stability), clearly emerges. Consequently the 2 subsequent papers by Boyan et al. (2016) and Bonfante and Coelho (2016) deepen, respectively, the significance of implant surface and mechanical properties on osseointegration and their long-term maintenance. Boyan et al. (2016) insist on how surface design affects mesenchymal cell response and differentiation into the osteoblast lineage, as recent studies have highlighted the importance of hierarchical micro-/nanosurface roughness, as well as surface roughness in combination with surface wettability. Cell surface receptors recognize topographic and biological changes in the surface and downstream signaling pathways accordingly (i.e., the noncanonical Wnt5a pathway, which has been implicated in osteoblastic differentiation on titanium implant surfaces). Moreover, recently conducted studies on the differences in biological responses to implants based on sex, age, and clinical factors advocate for patient-specific implant designs. Bonfante and Coelho (2016) identify the complexity of investigating varied implant designs, related bone response, area of implantation, implant bulk material, restoration, abutments and related screws, fixation mode (screwed, fixed, or a combination), and horizontal implant-abutment matching geometry. They are concerned by the number of and interplay among variables in dental implant treatment and outline that this presents a challenge to clinical trials attempting to answer questions in a timely, unbiased, and economically feasible fashion. Their manuscript critically appraises the most common mechanical testing methods used to characterize the implant-prosthesis complex. It atte","PeriodicalId":7300,"journal":{"name":"Advances in Dental Research","volume":"28 1","pages":"2 - 3"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0022034516630947","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64931043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Osteotomy Preparation on Osseointegration of Immediately Loaded, Tapered Dental Implants","authors":"Andreas Stavropoulos, David L. Cochran, M. Obrecht, B. Pippenger, Michel Dard","doi":"10.1177/0022034515624446","DOIUrl":"https://doi.org/10.1177/0022034515624446","url":null,"abstract":"The aim of the present preclinical in vivo study was to evaluate whether a modified “drill-only” protocol, involving slight underpreparation of the implant site, may have an effect on aspects of osseointegration of a novel bone-level tapered implant, compared with the “standard drilling” protocol involving taping and profiling of the marginal aspect of the implant socket. In each side of the edentulated and completely healed mandible of 11 minipigs, 2 tapered implants (8 mm long × 4.1 mm Ø, BLT; Institut Straumann AG, Basel, Switzerland) were installed either with the drill-only or the standard drilling protocol. Significantly lower average insertion torque values were recorded for the standard drilling protocol group (52 ± 29 Ncm) compared with the drill-only group (70 ± 27 Ncm) (t test, P ≤ 0.05); no significant difference was observed between the 2 groups regarding implant stability, by means of resonance frequency analysis (75 ± 8 vs. 75 ± 6, respectively). Half of the implants were immediately loaded and the rest were submerged, providing observation times of 8 or 4 wk, respectively. Non-decalcified histological and histomorphometric analysis of the implants with surrounding tissues showed no significant differences between the 2 drilling protocols regarding the distance from the implant platform to the first coronal bone-to-implant contact (f-BIC), the total bone-to-implant contact (BIC) as a percentage of the total implant perimeter, and the bone density in an area extending 1 mm laterally from the implant (BATA) within 2 rectangular regions of interest (ROIs) 4 mm in height, representing the coronal (parallel-walled) and apical (tapered) aspect of the implant (ROI 1 and ROI 2, respectively) in non-submerged implants. In general, marginal peri-implant bone levels were at or slightly apical to the implant platform, and large amounts of bone-to-implant contact were observed. In contrast, immediately loaded implants placed with the drill-only protocol showed statistically significantly lower BIC values (66% ± 13.7%) compared with those installed with the standard drilling protocol (74.8% ± 11.2%) (P = 0.018). In addition, although marginal bone levels were in most of the immediately loaded implants at or slightly apical to the implant platform, some of the implants installed with the drill-only protocol showed marginal bone loss and crater formation. Thus, in this model system, even slight underpreparation of the implant socket appeared to compromise osseointegration of immediately loaded bone-level tapered implants.","PeriodicalId":7300,"journal":{"name":"Advances in Dental Research","volume":"28 1","pages":"34 - 41"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0022034515624446","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64931454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tapered Implants in Dentistry","authors":"T. G. Wilson, R. J. Miller, R. Trushkowsky, Michel Dard","doi":"10.1177/0022034516628868","DOIUrl":"https://doi.org/10.1177/0022034516628868","url":null,"abstract":"The most common approach to lessen treatment times is by decreasing the healing period during which osseointegration is established. Implant design parameters such as implant surface, primary stability, thread configuration, body shape, and the type of bone have to be considered to obtain this objective. The relationship that exists between these components will define the initial stability of the implant. It is believed implant sites using a tapered design and surface modification can increase the primary stability in low-density bone. Furthermore, recent experimental preclinical work has shown the possibility of attaining primary stability of immediately loaded, tapered dental implants without compromising healing and rapid bone formation while minimizing the implant stability loss at compression sites. This may be of singular importance with immediate/early functional loading of single implants placed in poor-quality bone. The selection of an implant that will provide adequate stability in bone of poor quality is important. A tapered-screw implant design will provide adequate stability because it creates pressure on cortical bone in areas of reduced bone quality. Building on the success of traditional tapered implant therapy, newer tapered implant designs should aim to maximize the clinical outcome by implementing new technologies with adapted clinical workflows.","PeriodicalId":7300,"journal":{"name":"Advances in Dental Research","volume":"28 1","pages":"4 - 9"},"PeriodicalIF":0.0,"publicationDate":"2016-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0022034516628868","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64931472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}