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Thomas DC, Manfredini D, Patel J, George A, Chanamolu B, Pitchumani PK, Sangalli L. Sleep bruxism: The past, the present, and the future-evolution of a concept. J Am Dent Assoc 2024; 155:329-343. [PMID: 38363252 DOI: 10.1016/j.adaj.2023.12.004] [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: 09/09/2023] [Revised: 12/26/2023] [Accepted: 12/26/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND The concept of sleep bruxism (SB) has evolved exponentially over the past several decades. Many theories and hypotheses have been proposed as to the definition, pathophysiology, and management of SB, from the early 1960s through the present. The role of peripheral factors, such as dental occlusion, in the pathogenesis of SB has been discarded. TYPES OF STUDIES REVIEWED The authors searched several electronic databases (ie, PubMed, Google Scholar, Web of Science, Embase, and Ovid MEDLINE) for studies on bruxism. The search was conducted from January 1961 through May 2023 and yielded 4,612 articles, of which 312 were selected for comprehensive review after eliminating duplicates and nonfocused articles. RESULTS There has been an evident progressive shift from the role of peripheral factors, such as dental occlusion, to more central factors, such as the involvement of a central pattern generator as well as the autonomic nervous system, in the genesis of bruxing movements. There is continued robust interest in the dental community to elucidate the contributing factors involved in SB. CONCLUSIONS AND PRACTICAL IMPLICATIONS The neurophysiology of SB appears to be leaning more toward central rather than peripheral factors. There is increasing evidence of the role of the autonomic nervous system, genetics, and comorbidities in the genesis of SB. The scientific literature seems to refute the role of dental occlusion in the causation of bruxing movements. As per the literature, there has been a paradigm shift in the definition and genesis of SB and its possible dental implications and management, which also highlights the need for succinct scientific studies in this regard.
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Conti PCR, Cunha CO, Conti ACDCF, Bonjardim LR, Barbosa JS, Costa YM. Secondary bruxism: A valid diagnosis or just a coincidental finding of additional masticatory muscle activity? A narrative review of literature. J Oral Rehabil 2024; 51:74-86. [PMID: 37688286 DOI: 10.1111/joor.13592] [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: 10/07/2022] [Revised: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023]
Abstract
INTRODUCTION Bruxism is defined as a repetitive masticatory muscle activity that can manifest it upon awakening (awake bruxism-AB) or during sleep (sleep bruxism-SB). Some forms of both, AB and SB can be associated to many other coexistent factors, considered of risk for the initiation and maintenance of the bruxism. Although controversial, the term 'secondary bruxism' has frequently been used to label these cases. The absence of an adequate definition of bruxism, the non-distinction between the circadian manifestations and the report of many different measurement techniques, however, are important factors to be considered when judging the literature findings. The use (and abuse) of drugs, caffeine, nicotine, alcohol and psychoactive substances, the presence of respiratory disorders during sleep, gastroesophageal reflux disorders and movement, neurological and psychiatric disorders are among these factors. The scarcity of controlled studies and the complexity and interactions among all aforementioned factors, unfortunately, does not allow to establish any causality or temporal association with SB and AB. The supposition that variables are related depends on different parameters, not clearly demonstrated in the available studies. OBJECTIVES This narrative review aims at providing oral health care professionals with an update on the co-risk factors and disorders possibly associated with bruxism. In addition, the authors discuss the appropriateness of the term 'secondary bruxism' as a valid diagnostic category based on the available evidence. CONCLUSION The absence of an adequate definition of bruxism, the non-distinction between the circadian manifestations and the report of many different measurement techniques found in many studies preclude any solid and convincing conclusion on the existence of the 'secondary' bruxism.
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Affiliation(s)
- Paulo Cesar R Conti
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
- Bauru Orofacial Group, University of São Paulo, Bauru, Brazil
| | - Carolina Ortigosa Cunha
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
- Bauru Orofacial Group, University of São Paulo, Bauru, Brazil
| | - Ana Cláudia de Castro F Conti
- Bauru Orofacial Group, University of São Paulo, Bauru, Brazil
- Department of Orthodontics and Pediatric Dentistry, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Leonardo R Bonjardim
- Bauru Orofacial Group, University of São Paulo, Bauru, Brazil
- Department of Biologic Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Yuri Martins Costa
- Bauru Orofacial Group, University of São Paulo, Bauru, Brazil
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Yanez-Regonesi F, Eisa E, Judge S, Carlson C, Okeson J, Moreno-Hay I. Diagnostic accuracy of a portable device (Bruxoff®) to measure sleep bruxism. J Oral Rehabil 2023; 50:258-266. [PMID: 36648354 DOI: 10.1111/joor.13416] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 10/05/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND Diagnosis of sleep bruxism (SB) challenges clinicians every day due to multiple forms of assessment tools available, including self-reported questionnaires, clinical examinations, portable devices and laboratory polysomnography (PSG). PSG has become the gold standard for evaluating SB, but it can be limited due to cost and restricted accessibility which often is characterised by long waiting times. Hence, there is a need for the development of a reliable method that can assess SB in a simple and portable manner, which would offer acceptable sensitivity and specificity to evaluate SB. OBJECTIVE The objective of this study was to investigate reliability and validity of the Bruxoff® device for the diagnosis of SB compared to the PSG. METHODS Forty-nine subjects underwent one night of polysomnographic study with simultaneous recording with the Bruxoff® device. Rhythmic masticatory muscle activity (RMMA) index was scored according to published criteria. Pearson correlation, Bland-Altman plot and receiver operating characteristic (ROC) curve outcomes were used to quantify the agreement between both methods. RESULTS Receiver operating characteristic analysis showed an acceptable accuracy for the Bruxoff® with sensitivity of 83.3% and specificity of 72% when the cut-off was set at two events per hour. Pearson correlation analysis showed a nearly significant correlation between PSG and Bruxoff® for RMMA index (r = .282 p = .071) and for total SB episodes per night (r = .295 p = .058). Additionally, the Bland-Altman plot revealed a consistent and systematic difference in the measurement of events between devices. CONCLUSION The Bruxoff® device appears to be a promising diagnostic method for clinical use, but further study is needed.
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Affiliation(s)
- Fernanda Yanez-Regonesi
- Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Elfatih Eisa
- Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Stephanie Judge
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Charles Carlson
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Jeffrey Okeson
- Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Isabel Moreno-Hay
- Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
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Rodríguez-Pena K, Salgado-Peralvo ÁO, Kewalramani N, Suárez-Quintanilla JA, Suárez-Quintanilla JM. Selective serotonin reuptake inhibitors as a risk factor for dental implant failure: a retrospective clinical study. Br J Oral Maxillofac Surg 2022; 60:1347-1352. [PMID: 36411146 DOI: 10.1016/j.bjoms.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 09/23/2022] [Indexed: 12/31/2022]
Abstract
The trend in recent decades in Europe and the United States points to an exponential increase in the consumption of antidepressant drugs and, in particular, selective serotonin reuptake inhibitors (SSRIs). This retrospective study aimed to investigate whether there is an association between SSRI intake and dental implant (DI) failure or survival and, secondarily, to investigate the influence of other systemic and local factors. This retrospective cohort study was done in accordance with the the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for observational studies. A total of 170 patients received 573 DIs between 2014 and 2020.The reported DI failure rate was 6.11% (n = 35 DIs). Of these 18.31% failed in patients treated with SSRIs while 4.38% failed in patients who were not prescribed SSRIs (p < 0.001). Specifically, use of these drugs was associated with a hazard ratio rate of DI failure that was 4.53 times higher (95% CI: 1.93 to 10.61), and in the multivariate analysis, a 3.70 times higher adjusted risk was found. A lower DI survival rate at 90 months' follow up was also observed in these patients compared with those not taking them (84.30% vs 96%, respectively; p = 0.00014). With the limitations of the present study it can be affirmed that there is a relation between the intake of SSRIs and DI failure, as well as a lower survival rate in these patients.
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Affiliation(s)
- Karen Rodríguez-Pena
- Department of Surgery and Medical-Surgical Specialties, Faculty of Dentistry, University of Santiago de Compostela, Spain
| | | | - Naresh Kewalramani
- Department of Nursery and Stomatology, Faculty of Dentistry, Rey Juan Carlos University, Madrid, Spain
| | | | - José-María Suárez-Quintanilla
- Department of Surgery and Medical-Surgical Specialties, Faculty of Dentistry, University of Santiago de Compostela, Spain
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The Relationship between the Plasma Concentration of Electrolytes and Intensity of Sleep Bruxism and Blood Pressure Variability among Sleep Bruxers. Biomedicines 2022; 10:biomedicines10112804. [PMID: 36359324 PMCID: PMC9687451 DOI: 10.3390/biomedicines10112804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Plasma sodium plays a major role in regulating blood pressure (BP). An augmented variability of BP is considered a risk factor for the development of arterial hypertension, which is prevalent among patients with suspected sleep bruxism (SB). The aims of this study were to assess the plasma concentration of electrolytes and their effect on the intensity of SB and BP variability among sleep bruxers. A total of 51 patients were enrolled in this prospective, observational study. A single full-night polysomnographic examination was conducted in the Wroclaw Medical University Sleep Laboratory, Poland, and based on the guidelines of the American Academy of Sleep Medicine, the results were analyzed. The monitoring of ambulatory BP was performed the next day, and the plasma levels of sodium, potassium, magnesium, and calcium were measured. The mean age of the studied group was 33.9 ± 11.2 years, and the mean bruxism episode index (BEI) was 4.94 ± 3.53. The study revealed statistically significant differences in the plasma concentrations of sodium in the SB group. A decreased sodium concentration was observed in the group of mild bruxers (2 ≤ BEI < 4) (139.7 ± 1.4 vs. 142.8 ± 3.2, p = 0.002) and severe bruxers (BEI ≥ 4) (140.5 ± 2.0 vs. 142.8 ± 3.2, p = 0.016) compared to nonbruxers (BEI < 2). A statistically significant positive linear correlation was found between plasma sodium concentration and daytime systolic BP variability (r = 0.32, p < 0.05) as well as between plasma sodium concentration and nighttime diastolic BP variability (r = 0.31, p < 0.05). The preliminary results suggest the probable relationship between the lower plasma concentration of sodium and increased intensity of SB and BP variability among suspected sleep bruxers.
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Wallem A, Felipe-Spada N, Tomàs-Aliberas J. Influence of selective serotonin reuptake inhibitors (SSRIs) in the development of bruxism. Cranio 2022:1-7. [PMID: 36101968 DOI: 10.1080/08869634.2022.2120277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To identify the relationship between the use of selective serotonin reuptake inhibitors (SSRIs) as pharmacological treatment and the development of bruxism. METHODS A systematic literature search was performed in PubMed and Scopus databases, which included articles written within the last 30 years. The working hypothesis was that there is a significant association between using SSRIs as an antidepressant medication and developing bruxism. RESULTS A total of four articles were included in the systematic review. All the articles are related to SSRI antidepressants and bruxism. CONCLUSION The results indicate that there is an apparent association between SSRI drug treatment and the development of bruxism. The methods of evaluation and analysis were different in each article and cannot be considered conclusive; however, there is sufficient information to elucidate the impact of SSRI drugs on the development of bruxism.
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Affiliation(s)
- Andrea Wallem
- Department of TMJ, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Natalia Felipe-Spada
- Department of TMJ, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jordi Tomàs-Aliberas
- Department of TMJ, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
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L T Thayer M, Ali R. The dental demolition derby: bruxism and its impact - part 1: background. Br Dent J 2022; 232:515-521. [PMID: 35459823 PMCID: PMC9033581 DOI: 10.1038/s41415-022-4143-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 09/28/2021] [Indexed: 11/08/2022]
Abstract
Bruxism may lead to changes or damage to the oral and perioral tissues. Bruxism may occur during sleep or when awake. Many patients will not require active management; however, for some, intervention is required. Control of bruxism may be difficult, if not impossible, but the need exists for preservation of the dentition and quality of life. A prediction of risk to the tissues for the planning of interventions is difficult and relies upon evidence of past damage and assessment of future risks. Treatment options may need to be imaginative and rescuable. This series of papers will review the aetiology of bruxism, its impacts and treatment strategies for persistent bruxers who are at risk of, or suffering, tissue damage.
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Affiliation(s)
- Mark L T Thayer
- Consultant and Honorary Lecturer in Oral Surgery, Liverpool University Dental Hospital, Pembroke Place, Liverpool, L3 5PS, UK.
| | - Rahat Ali
- Consultant in Restorative Dentistry, Liverpool University Dental Hospital, Pembroke Place, Liverpool, L3 5PS, UK
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Han K, Wang C, Zhong Z, Xu M, Zou X, Yu B, Wang K, Yao D. Characterisation of the relationships between rhythmic masticatory muscle activities and limb movements in patients with sleep bruxism. J Oral Rehabil 2019; 46:399-408. [PMID: 30588653 DOI: 10.1111/joor.12760] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/25/2018] [Accepted: 12/18/2018] [Indexed: 02/02/2023]
Affiliation(s)
- Kangning Han
- Jiangxi Mental Hospital Nanchang University Jiangxi China
- Queen Mary College Nanchang University Jiangxi China
- School of Pharmaceutical Sciences Nanchang University Jiangxi China
| | - Chuanying Wang
- Jiangxi Mental Hospital Nanchang University Jiangxi China
- Queen Mary College Nanchang University Jiangxi China
- School of Pharmaceutical Sciences Nanchang University Jiangxi China
| | - Zhijun Zhong
- Jiangxi Mental Hospital Nanchang University Jiangxi China
- School of Pharmaceutical Sciences Nanchang University Jiangxi China
| | - Miao Xu
- Jiangxi Mental Hospital Nanchang University Jiangxi China
- School of Pharmaceutical Sciences Nanchang University Jiangxi China
| | - Xueliang Zou
- Jiangxi Mental Hospital Nanchang University Jiangxi China
| | - Bin Yu
- Jiangxi Mental Hospital Nanchang University Jiangxi China
| | - Kelun Wang
- Center for Sensory‐Motor Interaction, Department of Health Science & Technology Aalborg University Aalborg Denmark
| | - Dongyuan Yao
- Jiangxi Mental Hospital Nanchang University Jiangxi China
- School of Pharmaceutical Sciences Nanchang University Jiangxi China
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Gupta B, Acharya A, Singh S, Brazzoli S, Ghorab M, Malik S, Pelekos G, Rossouw E. Evaluation of jawbone morphology and bone density indices in panoramic radiographs of selective serotonin reuptake inhibitor users: a preliminary study. Dentomaxillofac Radiol 2019; 48:20170360. [PMID: 30004255 PMCID: PMC6398908 DOI: 10.1259/dmfr.20170360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 06/18/2018] [Accepted: 01/01/1900] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES: To assess the influence of selective serotonin reuptake inhibitor (SSRI) use on jawbone and bone mineral density by retrospective analysis of panoramic radiographs. METHODS: Radiographic and clinical records were sourced from the Division of Orthodontics and TMJD, Eastman Institute for Oral Health, University of Rochester. Randomly selected adults (20-65 years) were categorized into: "Active" (with history of SSRI use of >6 months) and a "Control" group. Panoramic indices: Klemetti index (KI), panoramic mandibular index, antegonial notching index, condylar pathology, mandibular cortical width (MCW) and mean ramus height were recorded. Frequency-weighted Χ2 tests and multinomial regression controlling for age and gender were applied to categorical indices (KI, condylar pathology, antegonial notching index). Multivariate generalized linear modeling was applied to mean ramus height, MCW and panoramic mandibular index. Multiple regression analyses determined: (a) panoramic indices that best predicted SSRI use, and (b) independent predictors of KI category. RESULTS: 64 SSRI users and 48 Controls were assessed. SSRI users had significantly higher odds of having worse KI status than normal [mildly to moderately eroded cortex: odds ratio (OR) = 2.926, 95% CI (1.07-8.04) and severely eroded cortex: OR = 19.86, 95% CI (3.91-100.69)], more frequent flat condylar anatomy (right side: p = 0.009, left side: p < 0.001) but greater ramus height (p = 0.001) and mandibular cortical width (p = 0.032). Age, gender, SSRI use each significantly impacted KI. Only SSRI use significantly impacted condylar pathology, ramus height and MCW. KI category (OR = 1.3) was the best panoramic predictor of SSRI use. Conversely, KI category C3 was significantly predicted by SSRI use (OR = 31.2, p = 0.002), female gender (17.5, p = 0.006), and severe antegonial notching (OR = 1289, p < 0.001). CONCLUSIONS: SRRI use was significantly associated with worse panoramic morphometric indices: KI, condylar pathology, ramus height, and MCW, where KI was its strongest predictor. Worse KI was independently predicted by SSRI use.
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Affiliation(s)
- Bhumija Gupta
- Eastman Institute for Oral Health, University Of Rochester, Rochester, NY, USA
| | | | - Shilpa Singh
- Eastman Institute for Oral Health, University Of Rochester, Rochester, NY, USA
| | - Stefania Brazzoli
- Eastman Institute for Oral Health, University Of Rochester, Rochester, NY, USA
| | - Mohamed Ghorab
- Eastman Institute for Oral Health, University Of Rochester, Rochester, NY, USA
| | - Shaima Malik
- Eastman Institute for Oral Health, University Of Rochester, Rochester, NY, USA
| | - George Pelekos
- The Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Emile Rossouw
- Eastman Institute for Oral Health, University Of Rochester, Rochester, NY, USA
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Gahr M, Connemann BJ, Schönfeldt-Lecuona C, Freudenmann RW, Stein JM, Hawlik AK. Psychiatrists' and dentists' knowledge and attitudes regarding adverse drug reactions of psychotropic drugs. Psychiatry Res 2018; 266:323-327. [PMID: 29628219 DOI: 10.1016/j.psychres.2018.03.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/06/2018] [Accepted: 03/07/2018] [Indexed: 11/19/2022]
Abstract
Psychotropic drugs may induce impairments in the mouth, jaw and face area. Currently, appropriate pharmacoepidemiologic data are missing. Therefore, a questionnaire-based telephone survey of two non-representative samples of psychiatrists and dentists was conducted. Most of the psychiatrists (79.7%) and dentists (76.5%) indicated that psychotropic drugs may induce dental adverse drug reactions (ADR); in both samples there was an approximately equally sized, relevant proportion of participants who did not believe in the risk of dental ADR of psychotropic drugs (psychiatrists 20.3%; dentists 23.5%). About one third of the participants of both samples (psychiatrists 34.9%; dentists 35.9%) felt that dental ADRs of psychotropic drugs are a serious health problem. The majority of both groups (psychiatrists 97.8%; dentists 97.0%) had never reported a dental ADR. Most psychiatrists and dentists appeared to be aware of the risk of dental ADRs by psychotropic drugs. A relevant proportion of participants of both groups considered psychotropic drugs to be irrelevant regarding dental ADRs; therefore, there may be information needs in both groups. The willingness to report dental ADRs of psychotropic drugs was low in both groups; the evaluation of the actual relevance of this drug-related risk is impeded by the absence of reports of suspected ADRs.
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Affiliation(s)
- Maximilian Gahr
- Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany.
| | - Bernhard J Connemann
- Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | - Carlos Schönfeldt-Lecuona
- Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | - Roland W Freudenmann
- Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | - Jamal M Stein
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH) Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Anna-Katharina Hawlik
- Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
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