Residual periodontal pocket treatment with Er:YAG laser-assisted comprehensive periodontal pocket therapy: a retrospective study
Objectives Recently, the application of erbium-doped yttrium aluminum garnet (Er:YAG) laser has been increasing in periodontal therapy. In this retrospective study, we evaluated the safety and effectiveness of a novel pocket therapy using Er:YAG laser in combination with conventional mechanical scal...
Gespeichert in:
| Veröffentlicht in: | Clinical oral investigations 2022, Vol.26 (1), p.761-771 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 771 |
|---|---|
| container_issue | 1 |
| container_start_page | 761 |
| container_title | Clinical oral investigations |
| container_volume | 26 |
| creator | Aoki, Akira Mizutani, Koji Mikami, Risako Taniguchi, Yoichi Ohsugi, Yujin Meinzer, Walter Izumi, Yuichi Iwata, Takanori |
| description | Objectives
Recently, the application of erbium-doped yttrium aluminum garnet (Er:YAG) laser has been increasing in periodontal therapy. In this retrospective study, we evaluated the safety and effectiveness of a novel pocket therapy using Er:YAG laser in combination with conventional mechanical scaling and root planing treatment (Er:YAG laser-assisted comprehensive periodontal pocket therapy).
Methods
Forty sites in 29 elderly patients having residual periodontal pockets of ≥ 5 mm depth were treated by curette and Er:YAG laser from 2006 to 2009. After root debridement by curette, laser irradiation was performed on the root surfaces. Then, inflamed connective tissue on the inner gingival surface and on the bone surface/within extant bone defects was thoroughly debrided by curette and laser. Furthermore, in most cases, removal of the outer epithelium and coagulation of the blood clot in the pocket entrance were additionally performed with laser. Clinical parameters were evaluated before and 3, 6, and 12 months after treatment.
Results
With Er:YAG laser-assisted pocket therapy, debridement of pockets was thoroughly and safely performed, and favorable clinical improvements were observed in most cases, without any adverse side effects and complications. After 1 year, probing pocket depth significantly decreased from 6.4 ± 1.4 to 3.5 ± 1.3 mm (
p
|
| doi_str_mv | 10.1007/s00784-021-04054-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2622860514</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2622860514</sourcerecordid><originalsourceid>FETCH-LOGICAL-c342t-b29c88a4c79244e14cd34993e709ed2d24c6dd6feab27bfa4f2a42ebd76105d53</originalsourceid><addsrcrecordid>eNp9kD9PwzAQxS0EoqXwBRhQJGaD7Thx0q2qSkGqhIRgYLIc-0JT2iTYDqgbHx33D7AglruT7t17px9C55RcUULEtQsl45gwigknCcf5AepTHqc4FoIebmeG0zyjPXTi3IIQylMRH6NezJnIEkb76PMBXGU6tYxasFVjmtpv5ka_go-8BeVXUPvoo_LzaGKHz6NptFQOLFbOVc6DiXSzai3MoXbVO_zpMger2vUwUpEFbxvXgvYbrfOdWZ-io1ItHZzt-wA93Uwex7d4dj-9G49mWIdnPS5YrrNMcS1yxjlQrk3M8zwGQXIwzDCuU2PSElTBRFEqXjLFGRRGpJQkJokH6HLn29rmrQPn5aLpbB0iJUsZy1KSBFwDxHYqHf50FkrZ2mql7FpSIjfQ5Q66DNDlFrrMw9HF3rorVmB-Tr4pB0G8E7iwql_A_mb_Y_sFF6OQMg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2622860514</pqid></control><display><type>article</type><title>Residual periodontal pocket treatment with Er:YAG laser-assisted comprehensive periodontal pocket therapy: a retrospective study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Aoki, Akira ; Mizutani, Koji ; Mikami, Risako ; Taniguchi, Yoichi ; Ohsugi, Yujin ; Meinzer, Walter ; Izumi, Yuichi ; Iwata, Takanori</creator><creatorcontrib>Aoki, Akira ; Mizutani, Koji ; Mikami, Risako ; Taniguchi, Yoichi ; Ohsugi, Yujin ; Meinzer, Walter ; Izumi, Yuichi ; Iwata, Takanori</creatorcontrib><description>Objectives
Recently, the application of erbium-doped yttrium aluminum garnet (Er:YAG) laser has been increasing in periodontal therapy. In this retrospective study, we evaluated the safety and effectiveness of a novel pocket therapy using Er:YAG laser in combination with conventional mechanical scaling and root planing treatment (Er:YAG laser-assisted comprehensive periodontal pocket therapy).
Methods
Forty sites in 29 elderly patients having residual periodontal pockets of ≥ 5 mm depth were treated by curette and Er:YAG laser from 2006 to 2009. After root debridement by curette, laser irradiation was performed on the root surfaces. Then, inflamed connective tissue on the inner gingival surface and on the bone surface/within extant bone defects was thoroughly debrided by curette and laser. Furthermore, in most cases, removal of the outer epithelium and coagulation of the blood clot in the pocket entrance were additionally performed with laser. Clinical parameters were evaluated before and 3, 6, and 12 months after treatment.
Results
With Er:YAG laser-assisted pocket therapy, debridement of pockets was thoroughly and safely performed, and favorable clinical improvements were observed in most cases, without any adverse side effects and complications. After 1 year, probing pocket depth significantly decreased from 6.4 ± 1.4 to 3.5 ± 1.3 mm (
p
< 0.001, 3.0 mm reduction), and clinical attachment level significantly decreased from 7.5 ± 1.6 to 5.2 ± 1.9 mm (
p
< 0.001, 2.3 mm gain).
Conclusion
The results of this study indicate that Er:YAG laser-assisted therapy is useful for the treatment of residual pockets as a minimally invasive flapless surgery.
Clinical relevance
Er:YAG laser-assisted comprehensive pocket therapy reduces the necessity of more conventional surgical therapies.</description><identifier>ISSN: 1432-6981</identifier><identifier>EISSN: 1436-3771</identifier><identifier>DOI: 10.1007/s00784-021-04054-9</identifier><identifier>PMID: 34278521</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aluminum ; Blood coagulation ; Connective tissues ; Debridement ; Dental Scaling ; Dentistry ; Epithelium ; Follow-Up Studies ; Gum disease ; Humans ; Inflammation ; Laser Therapy ; Lasers ; Lasers, Solid-State - therapeutic use ; Medicine ; Original Article ; Periodontal Attachment Loss ; Periodontal Pocket - surgery ; Retrospective Studies ; Root Planing ; Yttrium</subject><ispartof>Clinical oral investigations, 2022, Vol.26 (1), p.761-771</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c342t-b29c88a4c79244e14cd34993e709ed2d24c6dd6feab27bfa4f2a42ebd76105d53</citedby><cites>FETCH-LOGICAL-c342t-b29c88a4c79244e14cd34993e709ed2d24c6dd6feab27bfa4f2a42ebd76105d53</cites><orcidid>0000-0002-2843-173X ; 0000-0002-1610-7430 ; 0000-0001-5936-1116 ; 0000-0003-2623-8255 ; 0000-0003-1398-0450 ; 0000-0002-5461-7298</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00784-021-04054-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00784-021-04054-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34278521$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aoki, Akira</creatorcontrib><creatorcontrib>Mizutani, Koji</creatorcontrib><creatorcontrib>Mikami, Risako</creatorcontrib><creatorcontrib>Taniguchi, Yoichi</creatorcontrib><creatorcontrib>Ohsugi, Yujin</creatorcontrib><creatorcontrib>Meinzer, Walter</creatorcontrib><creatorcontrib>Izumi, Yuichi</creatorcontrib><creatorcontrib>Iwata, Takanori</creatorcontrib><title>Residual periodontal pocket treatment with Er:YAG laser-assisted comprehensive periodontal pocket therapy: a retrospective study</title><title>Clinical oral investigations</title><addtitle>Clin Oral Invest</addtitle><addtitle>Clin Oral Investig</addtitle><description>Objectives
Recently, the application of erbium-doped yttrium aluminum garnet (Er:YAG) laser has been increasing in periodontal therapy. In this retrospective study, we evaluated the safety and effectiveness of a novel pocket therapy using Er:YAG laser in combination with conventional mechanical scaling and root planing treatment (Er:YAG laser-assisted comprehensive periodontal pocket therapy).
Methods
Forty sites in 29 elderly patients having residual periodontal pockets of ≥ 5 mm depth were treated by curette and Er:YAG laser from 2006 to 2009. After root debridement by curette, laser irradiation was performed on the root surfaces. Then, inflamed connective tissue on the inner gingival surface and on the bone surface/within extant bone defects was thoroughly debrided by curette and laser. Furthermore, in most cases, removal of the outer epithelium and coagulation of the blood clot in the pocket entrance were additionally performed with laser. Clinical parameters were evaluated before and 3, 6, and 12 months after treatment.
Results
With Er:YAG laser-assisted pocket therapy, debridement of pockets was thoroughly and safely performed, and favorable clinical improvements were observed in most cases, without any adverse side effects and complications. After 1 year, probing pocket depth significantly decreased from 6.4 ± 1.4 to 3.5 ± 1.3 mm (
p
< 0.001, 3.0 mm reduction), and clinical attachment level significantly decreased from 7.5 ± 1.6 to 5.2 ± 1.9 mm (
p
< 0.001, 2.3 mm gain).
Conclusion
The results of this study indicate that Er:YAG laser-assisted therapy is useful for the treatment of residual pockets as a minimally invasive flapless surgery.
Clinical relevance
Er:YAG laser-assisted comprehensive pocket therapy reduces the necessity of more conventional surgical therapies.</description><subject>Aged</subject><subject>Aluminum</subject><subject>Blood coagulation</subject><subject>Connective tissues</subject><subject>Debridement</subject><subject>Dental Scaling</subject><subject>Dentistry</subject><subject>Epithelium</subject><subject>Follow-Up Studies</subject><subject>Gum disease</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Laser Therapy</subject><subject>Lasers</subject><subject>Lasers, Solid-State - therapeutic use</subject><subject>Medicine</subject><subject>Original Article</subject><subject>Periodontal Attachment Loss</subject><subject>Periodontal Pocket - surgery</subject><subject>Retrospective Studies</subject><subject>Root Planing</subject><subject>Yttrium</subject><issn>1432-6981</issn><issn>1436-3771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kD9PwzAQxS0EoqXwBRhQJGaD7Thx0q2qSkGqhIRgYLIc-0JT2iTYDqgbHx33D7AglruT7t17px9C55RcUULEtQsl45gwigknCcf5AepTHqc4FoIebmeG0zyjPXTi3IIQylMRH6NezJnIEkb76PMBXGU6tYxasFVjmtpv5ka_go-8BeVXUPvoo_LzaGKHz6NptFQOLFbOVc6DiXSzai3MoXbVO_zpMger2vUwUpEFbxvXgvYbrfOdWZ-io1ItHZzt-wA93Uwex7d4dj-9G49mWIdnPS5YrrNMcS1yxjlQrk3M8zwGQXIwzDCuU2PSElTBRFEqXjLFGRRGpJQkJokH6HLn29rmrQPn5aLpbB0iJUsZy1KSBFwDxHYqHf50FkrZ2mql7FpSIjfQ5Q66DNDlFrrMw9HF3rorVmB-Tr4pB0G8E7iwql_A_mb_Y_sFF6OQMg</recordid><startdate>2022</startdate><enddate>2022</enddate><creator>Aoki, Akira</creator><creator>Mizutani, Koji</creator><creator>Mikami, Risako</creator><creator>Taniguchi, Yoichi</creator><creator>Ohsugi, Yujin</creator><creator>Meinzer, Walter</creator><creator>Izumi, Yuichi</creator><creator>Iwata, Takanori</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><orcidid>https://orcid.org/0000-0002-2843-173X</orcidid><orcidid>https://orcid.org/0000-0002-1610-7430</orcidid><orcidid>https://orcid.org/0000-0001-5936-1116</orcidid><orcidid>https://orcid.org/0000-0003-2623-8255</orcidid><orcidid>https://orcid.org/0000-0003-1398-0450</orcidid><orcidid>https://orcid.org/0000-0002-5461-7298</orcidid></search><sort><creationdate>2022</creationdate><title>Residual periodontal pocket treatment with Er:YAG laser-assisted comprehensive periodontal pocket therapy: a retrospective study</title><author>Aoki, Akira ; Mizutani, Koji ; Mikami, Risako ; Taniguchi, Yoichi ; Ohsugi, Yujin ; Meinzer, Walter ; Izumi, Yuichi ; Iwata, Takanori</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c342t-b29c88a4c79244e14cd34993e709ed2d24c6dd6feab27bfa4f2a42ebd76105d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Aluminum</topic><topic>Blood coagulation</topic><topic>Connective tissues</topic><topic>Debridement</topic><topic>Dental Scaling</topic><topic>Dentistry</topic><topic>Epithelium</topic><topic>Follow-Up Studies</topic><topic>Gum disease</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Laser Therapy</topic><topic>Lasers</topic><topic>Lasers, Solid-State - therapeutic use</topic><topic>Medicine</topic><topic>Original Article</topic><topic>Periodontal Attachment Loss</topic><topic>Periodontal Pocket - surgery</topic><topic>Retrospective Studies</topic><topic>Root Planing</topic><topic>Yttrium</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aoki, Akira</creatorcontrib><creatorcontrib>Mizutani, Koji</creatorcontrib><creatorcontrib>Mikami, Risako</creatorcontrib><creatorcontrib>Taniguchi, Yoichi</creatorcontrib><creatorcontrib>Ohsugi, Yujin</creatorcontrib><creatorcontrib>Meinzer, Walter</creatorcontrib><creatorcontrib>Izumi, Yuichi</creatorcontrib><creatorcontrib>Iwata, Takanori</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Clinical oral investigations</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aoki, Akira</au><au>Mizutani, Koji</au><au>Mikami, Risako</au><au>Taniguchi, Yoichi</au><au>Ohsugi, Yujin</au><au>Meinzer, Walter</au><au>Izumi, Yuichi</au><au>Iwata, Takanori</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Residual periodontal pocket treatment with Er:YAG laser-assisted comprehensive periodontal pocket therapy: a retrospective study</atitle><jtitle>Clinical oral investigations</jtitle><stitle>Clin Oral Invest</stitle><addtitle>Clin Oral Investig</addtitle><date>2022</date><risdate>2022</risdate><volume>26</volume><issue>1</issue><spage>761</spage><epage>771</epage><pages>761-771</pages><issn>1432-6981</issn><eissn>1436-3771</eissn><abstract>Objectives
Recently, the application of erbium-doped yttrium aluminum garnet (Er:YAG) laser has been increasing in periodontal therapy. In this retrospective study, we evaluated the safety and effectiveness of a novel pocket therapy using Er:YAG laser in combination with conventional mechanical scaling and root planing treatment (Er:YAG laser-assisted comprehensive periodontal pocket therapy).
Methods
Forty sites in 29 elderly patients having residual periodontal pockets of ≥ 5 mm depth were treated by curette and Er:YAG laser from 2006 to 2009. After root debridement by curette, laser irradiation was performed on the root surfaces. Then, inflamed connective tissue on the inner gingival surface and on the bone surface/within extant bone defects was thoroughly debrided by curette and laser. Furthermore, in most cases, removal of the outer epithelium and coagulation of the blood clot in the pocket entrance were additionally performed with laser. Clinical parameters were evaluated before and 3, 6, and 12 months after treatment.
Results
With Er:YAG laser-assisted pocket therapy, debridement of pockets was thoroughly and safely performed, and favorable clinical improvements were observed in most cases, without any adverse side effects and complications. After 1 year, probing pocket depth significantly decreased from 6.4 ± 1.4 to 3.5 ± 1.3 mm (
p
< 0.001, 3.0 mm reduction), and clinical attachment level significantly decreased from 7.5 ± 1.6 to 5.2 ± 1.9 mm (
p
< 0.001, 2.3 mm gain).
Conclusion
The results of this study indicate that Er:YAG laser-assisted therapy is useful for the treatment of residual pockets as a minimally invasive flapless surgery.
Clinical relevance
Er:YAG laser-assisted comprehensive pocket therapy reduces the necessity of more conventional surgical therapies.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34278521</pmid><doi>10.1007/s00784-021-04054-9</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-2843-173X</orcidid><orcidid>https://orcid.org/0000-0002-1610-7430</orcidid><orcidid>https://orcid.org/0000-0001-5936-1116</orcidid><orcidid>https://orcid.org/0000-0003-2623-8255</orcidid><orcidid>https://orcid.org/0000-0003-1398-0450</orcidid><orcidid>https://orcid.org/0000-0002-5461-7298</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1432-6981 |
| ispartof | Clinical oral investigations, 2022, Vol.26 (1), p.761-771 |
| issn | 1432-6981 1436-3771 |
| language | eng |
| recordid | cdi_proquest_journals_2622860514 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Aged Aluminum Blood coagulation Connective tissues Debridement Dental Scaling Dentistry Epithelium Follow-Up Studies Gum disease Humans Inflammation Laser Therapy Lasers Lasers, Solid-State - therapeutic use Medicine Original Article Periodontal Attachment Loss Periodontal Pocket - surgery Retrospective Studies Root Planing Yttrium |
| title | Residual periodontal pocket treatment with Er:YAG laser-assisted comprehensive periodontal pocket therapy: a retrospective study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T20%3A20%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Residual%20periodontal%20pocket%20treatment%20with%20Er:YAG%20laser-assisted%20comprehensive%20periodontal%20pocket%20therapy:%20a%20retrospective%20study&rft.jtitle=Clinical%20oral%20investigations&rft.au=Aoki,%20Akira&rft.date=2022&rft.volume=26&rft.issue=1&rft.spage=761&rft.epage=771&rft.pages=761-771&rft.issn=1432-6981&rft.eissn=1436-3771&rft_id=info:doi/10.1007/s00784-021-04054-9&rft_dat=%3Cproquest_cross%3E2622860514%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2622860514&rft_id=info:pmid/34278521&rfr_iscdi=true |