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Li Z, Su Z, Liu H, Bai Y, Shen Y, Pan C. Phase-locked µPIV analysis of flow dynamics in a simulated root canal with different laser-activated irrigations. Lasers Med Sci 2024; 39:112. [PMID: 38656634 DOI: 10.1007/s10103-024-04051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To measure the dynamic characteristics of the flow field in a complex root canal model activated by two laser-activated irrigation (LAI) modalities at different activation energy outputs: photon-induced photoacoustic streaming (PIPS) and microshort pulse (MSP). METHODS A phase-locked micro-scale Particle Image Velocimetry (µPIV) system was employed to characterise the temporal variations of LAI-induced velocity fields in the root canal following a single laser pulse. The wall shear stress (WSS) in the lateral root canal was subsequently estimated from the phase-averaged velocity fields. RESULTS Both PIPS and MSP were able to generate the 'breath mode' of the irrigant current under all tested conditions. The transient irrigation flush in the root canal peaked at speeds close to 6 m/s. However, this intense flushing effect persisted for only about 2000 µs (or 3% of a single laser-pulse activation cycle). For MSP, the maximum WSS magnitude was approximately 3.08 Pa at an activation energy of E = 20 mJ/pulse, rising to 9.01 Pa at E = 50 mJ/pulse. In comparison, PIPS elevated the WSS to 10.63 Pa at E = 20 mJ/pulse. CONCLUSION Elevating the activation energy can boost the peak flushing velocity and the maximum WSS, thereby enhancing irrigation efficiency. Given the same activation energy, PIPS outperforms MSP. Additionally, increasing the activation frequency may be an effective strategy to improve irrigation performance further.
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Affiliation(s)
- Zhibo Li
- Key Laboratory of Fluid Mechanics of Ministry of Education, Beihang University, 100191, Beijing, People's Republic of China
| | - Zheng Su
- Department of VIP Dental Service, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China
| | - He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Yuhao Bai
- Department of Stomatology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
| | - Chong Pan
- Key Laboratory of Fluid Mechanics of Ministry of Education, Beihang University, 100191, Beijing, People's Republic of China.
- Tianmushan Laboratory, Yuhang District, 311115, Hangzhou, People's Republic of China.
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Yu M, Li Y, Zhao M, Huang Z, Zhou N, Jin H. Computational fluid dynamics investigation on the irrigation of a real root canal with a side-vented needle. BMC Oral Health 2024; 24:321. [PMID: 38461300 PMCID: PMC10924978 DOI: 10.1186/s12903-024-03966-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/01/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND Root canal therapy is one of the main treatments for root canal diseases, and effective irrigation is the key to successful treatment. Side-vented needle is one of the commonly used needle types in clinic. In the real root canal, due to the influence of the curvature of the root canal, the irrigation flow field in different needle directions shows obvious differences. At the same time, changes in root canal curvature and working depth will lead to changes in irrigation efficiency and the flow field. Both the mainstream of the irrigation flow and the shear stress near the wall changes significant. Consequently, either the replacement in the root canal or the removal efficiency of the smear layers is apparently modified. MATERIALS AND METHODS In this paper, the permanent root canal of the maxillary first molar prepared until 15/04 were scanned by micro-CT, and then imported into the software for 3D reconstruction. The key parameters of flushing efficiency of 30G side needle at different working depths of 4.75 mm, 5 mm, 5.25 mm and 5.5 mm were compared. Meanwhile, the simulated models with different curvatures of 0°, 5°, 10°, 20° and 30° based on the real root canal were reconstructed to investigate the curvature effect on the irrigation efficiency. RESULTS The results show that moderate working depth (such as 4.75 mm and 5.25 mm in present paper) helps to improve the replacement capacity of irrigation flow. At the same time, the apical pressure decreased as the working depth increased. The curvature of the root canal seriously affects the removal depth of the smear layers of the root canal. A root canal with a large curvature (especially 20° and 30°) can significantly improve the difficulty of irrigation. CONCLUSIONS (1) Moderate working depth helps to improve the displacement capacity, the ERD of the irrigation flow is generally improved at the working depths of 4.75 mm and 5.25 mm, and the apical pressure will decrease with the increase of working depth. (2) The large curvature of the root canal can significantly improve the difficulty of irrigation. The curvature of the root canal can severely influence the removal depth of the smear layer on the wall. It can be found both the span and the depth of the ESS for little curvatures (5° and 10°) root canals are higher than those for large curvatures (20° and 30°).
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Affiliation(s)
- Mingzhou Yu
- School of Aeronautics and Astronautics, Zhejiang University, Hangzhou, 310027, People's Republic of China
- Aerosol Science and Technology Laboratory, China Jiliang University, Hangzhou, 310018, People's Republic of China
| | - Yi Li
- Aerosol Science and Technology Laboratory, China Jiliang University, Hangzhou, 310018, People's Republic of China
| | - Mengdie Zhao
- Aerosol Science and Technology Laboratory, China Jiliang University, Hangzhou, 310018, People's Republic of China
| | - Zhengqiu Huang
- Aerosol Science and Technology Laboratory, China Jiliang University, Hangzhou, 310018, People's Republic of China
| | - Na Zhou
- Aerosol Science and Technology Laboratory, China Jiliang University, Hangzhou, 310018, People's Republic of China.
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People's Republic of China.
| | - Hanhui Jin
- School of Aeronautics and Astronautics, Zhejiang University, Hangzhou, 310027, People's Republic of China.
- State Key Laboratory of Clean Energy Utilization, Zhejiang University, Hangzhou, 310027, People's Republic of China.
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Alkahtany MF, Almadi KH. Canal disinfection using photo-chemically activated micro-bubble emulsion, Emblica officinalis, and Nd: YAP laser on smear layer and push-out bond strength of resin-based root canal sealer to the radicular dentin. Photodiagnosis Photodyn Ther 2024; 45:103981. [PMID: 38242188 DOI: 10.1016/j.pdpdt.2024.103981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 01/21/2024]
Abstract
AIMS Evaluation of the effects of the latest root canal disinfectants i.e., Micro-bubble emulsion (MBE), Neodymium-doped yttrium aluminum perovskite (Nd: YAP), Emblica officinalis (E. officinalis) on the removal of smear layer (SL) and push out bond strength (PBS) of resin-based root canal sealer to the radicular dentin. METHODS The coronal portion of sixty single-rooted human mandibular premolar teeth was precisely sectioned at the cementoenamel junction. The canals were prepared to utilize ProTaper universal rotary files till F3. All the study specimens were divided into four groups based on the disinfection regime (n = 15) Group 1: 5.25% NaOCl, Group 2: MBE, Group 3: Nd: YAP laser and Group 4: E. officinalis extract. All the canals were then finally irrigated using 17% EDTA solution as a final disinfecting agent. SL removal assessment was performed on five samples from each group using a scanning electron microscope (SEM). Ten samples from each group were then filled with root canal filling material and the roots were sectioned. Push-out test and failure mode analysis were performed using the universal testing machine (UTM) and stereomicroscope respectively. The mean scores of PBS and SL removal were compared using a one-way analysis of variance (ANOVA) and Post Hoc Tukey's HSD test p = 0.05. RESULTS Group-2 (MBE + EDTA) coronal section (1.50 ± 0.23) exhibited the most effective eradication of SL from the canal space. The apical third of Group-1 (NaOCl+EDTA) (2.68 ± 0.82) samples demonstrated the least effective removal of SL from the radicular canal. The maximum score of PBS of AH plus sealer to the canal dentin was exhibited by the coronal section of Group-2 (MBE + EDTA) (9.55 ± 0.45 MPa) samples. However, the apical third of Group-1 (NaOCl+ EDTA) specimens (5.16 ± 0.32 MPa) demonstrated the minimum EBS. CONCLUSION MBE+ EDTA displayed better smear layer removal and bond integrity of AH plus sealer to the root canal dentin. Nd: YAP+ EDTA laser and E.officinalis displayed comparable outcomes to that of control NaOCl+ EDTA.
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Affiliation(s)
- Mazen F Alkahtany
- Department of Restorative Dental Sciences, Division of Endodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Khalid H Almadi
- Department of Restorative Dental Sciences, Division of Endodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
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S. DPA, Solete P, Jeevanandan G, Syed AA, Almahdi S, Alzhrani M, Maganur PC, Vishwanathaiah S. Effect of Various Irrigant Activation Methods and Its Penetration in the Apical Third of Root Canal-In Vitro Study. Eur J Dent 2022; 17:57-61. [PMID: 35189642 PMCID: PMC9949917 DOI: 10.1055/s-0041-1742122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the irrigant penetration using iohexol dye with four irrigation techniques. METHODOLOGY Single-rooted premolars were recently extracted and preserved in physiological saline solution. All the samples were standardized to 16 mm. Standard endodontic access was prepared using endoaccess bur (Dentsply Maillefer, Switzerland). The initial patency was established using #10 k file (Mani, Utsunomiya, Tochigi, Japan) to the working length. The cleaning and shaping were performed using the file system ProFit S3 in the following sequence: P0 (orifice enlarger), PF1 (yellow), PF2 (red) #25, and PF3 (blue) #30. The samples were randomly allocated in concealed opaque envelopes into four groups. This was performed by a trained dentist. Fifteen samples were allocated to one group. The groups were divided as follows: Group A-conventional needle (CN), Group B-side-vented needle (SVN), Group C-manual dynamic agitation (MDA), and Group D-EndoActivator (EA). The radiopaque dye irrigant agitation/activation was performed by one operator to prevent operator bias. Following irrigation using the different techniques, digital radiographs were taken, and the measurement was taken from the apical foramen to the point where the dye had penetrated apically for each tooth and the data were entered into an Excel sheet for all the four groups. RESULTS Comparing the four groups, there was a statistically significant difference among the four groups (p < 0.05), thus, favoring the alternate hypothesis. EA had resulted in better penetration of the irrigant compared with the other three groups (p < 0.05). CONCLUSION It was evident that irrigant penetration was best achieved with the use of an EA followed by MDA, SVNs, and then the CN when the preparation was done till size 30 (PF3 #30) using ProFit S3 rotary file system.
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Affiliation(s)
- Delphine Pricilla Antony S.
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Pradeep Solete
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Ganesh Jeevanandan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Science, Chennai, Tamil Nadu, India,Ganesh Jeevanandan, BDS, MDS, PhD Department of Pediatric and Preventive Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical ScienceChennai, Tamil NaduIndia
| | - Ather Ahmed Syed
- Division of Pedodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Samaher Almahdi
- Division of Pedodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | | | - Prabhadevi C. Maganur
- Division of Pedodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Satish Vishwanathaiah
- Division of Pedodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia,Address for correspondence Satish Vishwanathaiah, BDS, MDS, FICD, FPFA Division of Pedodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan UniversityJazanKingdom of Saudi Arabia
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Liapis D, De Bruyne MAA, De Moor RJG, Meire MA. Postoperative pain after ultrasonically and laser-activated irrigation during root canal treatment: a randomized clinical trial. Int Endod J 2021; 54:1037-1050. [PMID: 33595920 DOI: 10.1111/iej.13500] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 12/18/2022]
Abstract
AIM To compare the intensity of postoperative pain after primary root canal treatment of asymptomatic teeth when using ultrasonically (UAI) or laser-activated irrigation (LAI). METHODOLOGY In this superiority randomized clinical trial (ClinicalTrials.gov ID: NCT03981237) with parallel design, fifty-six patients with an asymptomatic tooth in need of primary root canal treatment were enrolled. After chemo-mechanical canal preparation using rotary instruments and NaOCl irrigation, teeth were randomly assigned to two groups and patients were blinded to the final irrigation protocol. In the UAI group (n = 28), 60s activation with an Irrisafe tip was done per canal. In the LAI group (n = 28), NaOCl was activated with a pulsed Er:YAG (2940 nm) laser, equipped with a conical tip, with settings of 50 µs, 20 mJ at 15 Hz for 60 s. Patients recorded their pain intensity 6, 24, 48 and 72 h after treatment on a 100 mm visual analogue scale (VAS), as well as their analgesic consumption. Pain levels and incidence were compared across groups using the Mann-Whitney U-test and chi-square test. RESULTS Overall, mean postoperative pain intensity was low, with the majority of patients having no or minimal pain 24 h postoperatively. At 6 h postoperatively, pain intensity and incidence were significantly higher in the UAI group compared to the LAI group (P < 0.05). For the other time intervals, no significant differences in postoperative pain incidence or intensity were found. The frequency of analgesic intake did not differ significantly between the two groups. Neither of the activation methods resulted in any adverse effects. CONCLUSIONS Ultrasonically and laser-activated irrigation resulted in low and comparable levels of postoperative pain in asymptomatic patients receiving primary root canal treatment.
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Affiliation(s)
- D Liapis
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - M A A De Bruyne
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - R J G De Moor
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - M A Meire
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
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Pereira TC, Boutsioukis C, Dijkstra RJB, Petridis X, Versluis M, de Andrade FB, van de Meer WJ, Sharma PK, van der Sluis LWM, So MVR. Biofilm removal from a simulated isthmus and lateral canal during syringe irrigation at various flow rates: a combined experimental and Computational Fluid Dynamics approach. Int Endod J 2020; 54:427-438. [PMID: 32990985 PMCID: PMC7894139 DOI: 10.1111/iej.13420] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 01/22/2023]
Abstract
Aim (i) To quantify biofilm removal from a simulated isthmus and a lateral canal in an artificial root canal system during syringe irrigation with NaOCl at different concentrations and delivered at various flow rates (ii) to examine whether biofilm removal is further improved by a final high‐flow‐rate rinse with an inert irrigant following irrigation with NaOCl. (iii) to simulate the irrigant flow in these areas using a computer model (iv) to examine whether the irrigant velocity calculated by the computer model is correlated to biofilm removal. Methodology Ninety‐six artificial root canals with either a simulated isthmus or lateral canal were used. A dual‐species in vitro biofilm was formed in these areas using a Constant Depth Film Fermenter. NaOCl at various concentrations (2, 5 and 10%) or adhesion buffer (control) was delivered for 30 s by a syringe and an open‐ended needle at 0.033, 0.083, or 0.166 mL s−1 or passively deposited in the main root canal (phase 1). All specimens were subsequently rinsed for 30 s with adhesion buffer at 0.166 mL s−1 (phase 2). The biofilm was scanned by Optical Coherence Tomography to determine the percentage of the remaining biofilm. Results were analysed by two 3‐way mixed‐design ANOVAs (α = 0.05). A Computational Fluid Dynamics model was used to simulate the irrigant flow inside the artificial root canal system. Results The flow rate during phase 1 and additional irrigation during phase 2 had a significant effect on the percentage of the remaining biofilm in the isthmus (P = 0.004 and P < 0.001). Additional irrigation during phase 2 also affected the remaining biofilm in the lateral canal significantly (P ≤ 0.007) but only when preceded by irrigation at medium or high flow rate during phase 1. The effect of NaOCl concentration was not significant (P > 0.05). Irrigant velocity in the isthmus and lateral canal increased with increasing flow rate and it was substantially correlated to biofilm removal from those areas. Conclusions The irrigant flow rate affected biofilm removal in vitro more than NaOCl concentration. Irrigant velocity predicted by the computer model corresponded with the pattern of biofilm removal from the simulated isthmus and lateral canal.
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Affiliation(s)
- T C Pereira
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.,Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - R J B Dijkstra
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - X Petridis
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M Versluis
- Physics of Fluids group, Technical Medical (TechMed) Center and MESA+ Institute for Nanotechnology, University of Twente, Enschede, The Netherlands
| | - F B de Andrade
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - W J van de Meer
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - P K Sharma
- Department of Biomedical Engineering, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - L W M van der Sluis
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M V R So
- Conservative Dentistry Department, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre-Rio Grande do Sul, Brazil
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Funk B, Kirmayer D, Sahar-Heft S, Gati I, Friedman M, Steinberg D. Efficacy and potential use of novel sustained release fillers as intracanal medicaments against Enterococcus faecalis biofilm in vitro. BMC Oral Health 2019; 19:190. [PMID: 31429746 PMCID: PMC6700812 DOI: 10.1186/s12903-019-0879-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 08/06/2019] [Indexed: 12/15/2022] Open
Abstract
Background Enterococcus faecalis is a bacterium frequently isolated after failed root canal therapy. This study analyzed the antibacterial and antibiofilm effects in vitro of sustained-release fillers (SRF) containing cetylpyridinium chloride (CPC) against vancomycin resistant E. faecalis. Methods First, the solidification capability was tested by introducing liquid SRF into phosphate buffered saline, followed by 30 s of vortexing. The antimicrobial effects of SRF-CPC against static monospecies biofilms were analyzed with a metabolic assay. Inhibition of biofilm formation was tested by exposing daily refreshed E. faecalis suspensions to SRF-CPC for 9 weeks. To evaluate the effects of SRF-CPC against preformed biofilms, biofilms were grown for 1, 3 and 7 days, and then treated with SRF-CPC for 24 h. Biofilm kill time was tested by applying SRF-CPC to a 3-day-old biofilm and measuring its viability at different time points. All experiments were compared to Placebo SRFs and to untreated control biofilms. Data were analyzed with two-way ANOVA followed by Tukey’s test. Results were considered significant at P < 0.05. Results The liquid SRF solidified within seconds and no structural changes were observed after 30 s of vortexing at maximum speed. SRF-CPC inhibited E. faecalis biofilm formation for 7 weeks and significantly reduced its viability in weeks 8 and 9. Mature biofilms grown for 1, 3 and 7 days were destructed by SRF-CPC in less than 24 h. Fifty percent of a 3-day-old biofilm was destructed in 2 h and complete destruction occurred in less than 12 h. (P < 0.05 in all cases, compared to SRII-Placebo). Conclusions SRF-CPC’s physical properties and long-lasting anti-biofilm effects make it a promising coadjuvant medication for endodontic therapy. Electronic supplementary material The online version of this article (10.1186/s12903-019-0879-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bernhard Funk
- The Institute of Dental Sciences, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - David Kirmayer
- The Institute of Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sharonit Sahar-Heft
- Department of Endodontics, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Irith Gati
- The Institute of Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Michael Friedman
- The Institute of Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Doron Steinberg
- The Institute of Dental Sciences, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.,Faculty of Dentistry, Hebrew University - Hadassah, PO Box 12272, 91120, Jerusalem, Israel
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