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Gokturk M, Yavan MA. Comparison of the short-term effects of tooth-bone-borne and tooth-borne rapid maxillary expansion in older adolescents. J Orofac Orthop 2024; 85:43-55. [PMID: 35612594 DOI: 10.1007/s00056-022-00401-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare the short-term effects of tooth-bone-borne and tooth-borne rapid maxillary expansion (RME) devices on dentofacial structures in older adolescents. METHODS The retrospective study reviewed pre- and posttreatment lateral and posteroanterior cephalometric images and orthodontic model records of patients who underwent maxillary expansion. Two groups were formed, in which the same upper jaw expansion protocol was applied with two different maxillary expansion devices: the first group consisted of 15 individuals treated with tooth-bone-borne (hybrid) RME (HRME; 9 girls and 6 boys; mean age, 16.9 ± 0.42 years) and the second group consisted of 15 individuals treated with tooth-borne (conventional) RME (CRME; 8 girls and 7 boys; mean age, 16.74 ± 0.54 years). Cephalometric and orthodontic model measurements were conducted on the records taken before and after treatment. RESULTS Significant skeletal and dental expansions were observed in both groups (p < 0.05). However, the increase in nasal width measurements in the HRME group (2.24 ± 0.61 mm) was significantly higher than the increase in the CRME group (1.12 ± 0.25 mm; p < 0.01). Buccal tipping of the premolars was significantly less in the HRME group (0.46 ± 0.35°) than in the CRME group (2.46 ± 0.63°; p < 0.01). The amount of tipping of the molars was higher in the HRME group (4.76 ± 0.88°) compared to the CRME group (2.9 ± 1.03°; p < 0.01). CONCLUSION Although the HRME device increase the nasal width in older adolescents to a greater extent, more dental side effects were seen at the maxillary first molars.
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Affiliation(s)
- Mustafa Gokturk
- Department of Orthodontics, Faculty of Dentistry, Adıyaman University, 02240, Adıyaman, Turkey
| | - Mehmet Ali Yavan
- Department of Orthodontics, Faculty of Dentistry, Adıyaman University, 02240, Adıyaman, Turkey.
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Krüsi M, Eliades T, Papageorgiou SN. Are there benefits from using bone-borne maxillary expansion instead of tooth-borne maxillary expansion? A systematic review with meta-analysis. Prog Orthod 2019; 20:9. [PMID: 30799516 PMCID: PMC6387979 DOI: 10.1186/s40510-019-0261-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/15/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The aim of the current systematic review was to compare the clinical effects of bone-borne or hybrid tooth-bone-borne rapid maxillary expansion (RME) with conventional tooth-borne RME in the treatment of maxillary deficiency. METHODS Nine databases were searched up to September 2018 for randomized clinical trials comparing bone-borne or hybrid tooth-bone-borne RME to conventional tooth-borne RME in patients of any age or sex. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE. RESULTS A total of 12 papers on 6 unique trials with 264 patients (42.4% male; average age 12.3 years) were finally included. Limited evidence indicated that bone-borne RME was associated with greater suture opening at the first molar post-retention (1 trial; MD 2.0 mm; 95% CI 1.4 to 2.6 mm; moderate evidence quality) compared to tooth-borne RME, while no significant differences could be found regarding tooth inclination, nasal cavity width, and root resorption (very low to low evidence quality). Hybrid tooth-bone-borne RME was associated with less buccal tipping of the first premolar (2 trials; MD - 4.0°; 95% CI - 0.9 to - 7.1°; moderate evidence quality) and lower nasal airway resistance post-retention (1 trial; MD - 0.2 Pa s/cm3; 95% CI - 0.4 to 0 Pa s/cm3; moderate evidence quality) compared to tooth-borne RME, while no significant difference could be found regarding skeletal maxillary width, molar inclination, and analgesic use (low to moderate evidence quality). The main limitations affecting the validity of the present findings were (a) imprecision due to the inclusion of few trials with limited sample sizes that precluded robust detection of existing differences and (b) methodological issues of the included trials that could lead to bias. CONCLUSIONS Limited evidence from randomized trials indicates that bone-borne or hybrid tooth-bone-borne RME might present advantages in terms of increased sutural opening, reduced tooth tipping, and lower nasal airway resistance compared to conventional tooth-borne RME. However, the limited number of existing studies and issues in their conduct or reporting preclude the drawing of definite conclusions. REVIEW REGISTRATION PROSPERO ( CRD42017079107 ).
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Affiliation(s)
- Marietta Krüsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
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Rice AJ, Carrillo R, Campbell PM, Taylor RW, Buschang PH. Do orthopedic corrections of growing retrognathic hyperdivergent patients produce stable results? Angle Orthod 2019; 89:552-558. [PMID: 30741574 DOI: 10.2319/061818-460.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To determine if posterior dental intrusion produces stable orthodontic and orthopedic corrections in growing retrognathic hyperdivergent patients. MATERIALS AND METHODS The sample included 14 subjects (five males and nine females), who were 13.4 ± 0.7 years pretreatment, treated for 3.5 years, and followed for 3.6 years posttreatment. During the initial orthopedic phase, 150 g NiTi coil springs were attached to two palatal miniscrew implants (MSIs) for maxillary intrusion; two buccal mandibular MSIs were used for posterior vertical control. Full orthodontic therapy was initiated to correct the malocclusions during the orthodontic phase. Patients were recalled a minimum of 1 year posttreatment (mean 3.6 ±1.6 years). Patients were compared to matched untreated controls. RESULTS Relative to the untreated controls, during treatment and retention, maxillary and mandibular molars underwent 2.8 mm and 3.7 mm of relative posterior intrusion, respectively. Maxillary incisors were extruded 1.3 mm and the mandibular incisors underwent 2.9 mm of relative intrusion. Overall orthopedic changes included a reduction in the mandibular plane angle (MPA; 3.3°), an increase in SN-Pg (2.4°), an increase in S-N-B (2.1°), and a 4.3 mm relative reduction in anterior facial height. The maxillary incisors, which showed 0.6 mm of intrusion (relative to controls), was the only dental or skeletal measure to show a statistically significant between-group posttreatment difference. CONCLUSIONS Except for maxillary incisor position, the substantial dental intrusion and associated orthopedic corrections that were produced during treatment remained stable post-treatment.
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Pereira JDS, Jacob HB, Locks A, Brunetto M, Ribeiro GLU. Evaluation of the rapid and slow maxillary expansion using cone-beam computed tomography: a randomized clinical trial. Dental Press J Orthod 2018; 22:61-68. [PMID: 28658357 PMCID: PMC5484271 DOI: 10.1590/2177-6709.22.2.061-068.oar] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 10/09/2016] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVE: The aim of this randomized clinical trial was to evaluate the dental, dentoalveolar, and skeletal changes occurring right after the rapid maxillary expansion (RME) and slow maxillary expansion (SME) treatment using Haas-type expander. METHODS: All subjects performed cone-beam computed tomography (CBCT) before installation of expanders (T1) and right after screw stabilization (T2). Patients who did not follow the research parameters were excluded. The final sample resulted in 21 patients in RME group (mean age of 8.43 years) and 16 patients in SME group (mean age of 8.70 years). Based on the skewness and kurtosis statistics, the variables were judged to be normally distributed and paired t-test and student t-test were performed at significance level of 5%. RESULTS: Intermolar angle changed significantly due to treatment and RME showed greater buccal tipping than SME. RME showed significant changes in other four measurements due to treatment: maxilla moved forward and mandible showed backward rotation and, at transversal level both skeletal and dentoalveolar showed significant changes due to maxillary expansion. SME showed significant dentoalveolar changes due to maxillary expansion. CONCLUSIONS: Only intermolar angle showed significant difference between the two modalities of maxillary expansion with greater buccal tipping for RME. Also, RME produced skeletal maxillary expansion and SME did not. Both maxillary expansion modalities were efficient to promote transversal gain at dentoalveolar level. Sagittal and vertical measurements did not show differences between groups, but RME promoted a forward movement of the maxilla and backward rotation of the mandible.
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Affiliation(s)
| | - Helder B Jacob
- Assistant Professor, Department of Orthodontics, The University of Texas Health Science Center at Houston School of Dentistry, Houston-TX, USA
| | - Arno Locks
- Federal University of Santa Catarina, Department of Orthodontics, Florianópolis, SC, Brazil
| | | | - Gerson L U Ribeiro
- Federal University of Santa Catarina, Department of Orthodontics, Florianópolis, SC, Brazil
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Aras I, Olmez S, Akay MC, Gunbay T, Aras A. The effects of maxillary expansion on the soft tissue facial profile. J Istanb Univ Fac Dent 2017; 51:1-10. [PMID: 29114424 PMCID: PMC5624139 DOI: 10.17096/jiufd.85884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 07/20/2016] [Indexed: 11/15/2022] Open
Abstract
Purpose The aims of this retrospective study were to evaluate the possible changes in soft tissue facial profile induced by orthopedic rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME), and to correlate them with the underlying hard tissue alterations. Materials and Methods 16 patients who received bone borne SARME and 25 patients who were subjected to RME using metal cast splint hyrax appliance were analyzed retrospectively. This research was conducted on lateral cephalometric radiographs taken on 2 occasions: before expansion (T1) and at the beginning of any further orthodontic treatment (T2). Investigated lateral cephalometric parameters consisted of Holdaway soft tissue measurements with some supplementary soft tissue, skeletal and dental assessments. Results The acquisition of T2 cephalograms which conforms to the initiation of further orthodontic treatment corresponded to 83.25±3.51 days for SARME and 85.68±4.37 days for RME after the expansion was completed. The only significant change in soft tissue profile of the SARME group was a decrease in upper lip thickness (p<0.05), whereas in the RME group, decrease in soft tissue facial profile angle and increase in H angle were found to be statistically significant (p<0.05 for each). For the RME group, the changes in soft tissue facial profile angle and H angle correlated only with the changes in SNB angle (p<0.05). Conclusion While bone-borne SARME did not seem to possess the potential to alter soft tissue profile, tooth-borne RME caused a more convex soft tissue profile related to a reduction in SNB.
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Affiliation(s)
- Isil Aras
- Department of Orthodontics, Faculty of Dentistry, Ege University Turkey
| | | | - Mehmet Cemal Akay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University Turkey
| | - Tayfun Gunbay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University Turkey
| | - Aynur Aras
- Department of Orthodontics, Faculty of Dentistry, Ege University Turkey
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Ugolini A, Doldo T, Ghislanzoni LTH, Mapelli A, Giorgetti R, Sforza C. Rapid palatal expansion effects on mandibular transverse dimensions in unilateral posterior crossbite patients: a three-dimensional digital imaging study. Prog Orthod 2016; 17:1. [PMID: 26746202 PMCID: PMC4706536 DOI: 10.1186/s40510-015-0114-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 12/20/2015] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this controlled study was to investigate indirect effects on mandibular arch dimensions, 1 year after rapid palatal expansion (RPE) therapy. Methods Thirty-three patients in mixed dentition (mean age 8.8 years) showing unilateral posterior crossbite and maxillary deficiency were treated with a RPE (Haas type) cemented on the first permanent molars. Treatment protocol consisted of two turns per day until slight overcorrection of the molar transverse relationship occurred. The Haas expander was kept on the teeth as a passive retainer for an average of 6 months. Study models were taken prior (T1) and 15 months on average (T2) after expansion. A control group of 15 untreated subjects with maxillary deficiency (mean age 8.3 years) was also recorded with a 12-month interval. Stone casts were digitized with a 3D scanner (3Shape, DK). Results In the treated group, both mandibular intermolar distance (+1.9 mm) and mandibular molar angulation (+9°) increased. Mandibular incisor angulation showed an increase of 1.9°. There was little effect on intercanine distance and canine angulation. Controls showed a reduction in transverse arch dimension and a decrease in molar and canine angulation values. Conclusions RPE protocol has indirect widening effects on the mandibular incisors and first molars.
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Affiliation(s)
- Alessandro Ugolini
- Department of Orthodontics, University of Siena, Siena, Italy. .,Functional Anatomy Research Center (FARC), Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico (LAFAS), Dipartimento di Scienze Biomediche per la Salute, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, Milan, Italy.
| | - Tiziana Doldo
- Department of Orthodontics, University of Siena, Siena, Italy
| | - Luis T Huanca Ghislanzoni
- Functional Anatomy Research Center (FARC), Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico (LAFAS), Dipartimento di Scienze Biomediche per la Salute, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, Milan, Italy
| | - Andrea Mapelli
- Functional Anatomy Research Center (FARC), Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico (LAFAS), Dipartimento di Scienze Biomediche per la Salute, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, Milan, Italy
| | | | - Chiarella Sforza
- Functional Anatomy Research Center (FARC), Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico (LAFAS), Dipartimento di Scienze Biomediche per la Salute, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, Milan, Italy
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Motro M, Schauseil M, Ludwig B, Zorkun B, Mainusch S, Ateş M, Küçükkeleş N, Korbmacher-Steiner H. Rapid-maxillary-expansion induced rhinological effects: a retrospective multicenter study. Eur Arch Otorhinolaryngol 2015; 273:679-87. [PMID: 25837986 DOI: 10.1007/s00405-015-3584-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 02/25/2015] [Indexed: 10/23/2022]
Abstract
Conventional dental-borne rapid maxillary expansion (RME) leads to a widening of the airways, followed by improved nasal breathing. Although combined skeletal-dental appliances are nowadays being inserted increasingly often and provide a force at the center of resistance in the nasomaxillary complex, no study exists so far that shows whether this treatment may improve the expansionary effect on the airways. In this study, low-dose computed tomography (CT) images from 31 patients (average age 14.63 ± 0.38 years) were examined retrospectively. Both records (T0 = before expansion and T1 = immediately after maximum expansion) were taken in a time interval of 25 days to avoid growth influence. Five patients were treated with Hyrax RME, 6 patients with Hybrid RME, and 20 patients with acrylic cap RME. The total airway volume increased highly significantly (mean +7272.6 mm(3); P < 0.001, power = 0.998), representing an average airway expansion of +11.54 % (2.35 %/mm activation). While the nasopharynx and oropharynx showed highly significant expansion (P < 0.000, power = 0.999), the airway at the laryngopharynx did not change significantly (P > 0.779, power = 0.05). Although the patients were significantly older in the Hybrid RME group (P = 0.006), the positive rhinological effects were comparable within all groups of different appliances (P > 0.316). Hybrid RME may, therefore, be an advisable procedure in patients with nasomaxillary impairment and pronounced patient's age.
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Affiliation(s)
- Melih Motro
- Department of Orthodontics, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
| | - Michael Schauseil
- Department of Orthodontics, Faculty of Dentistry, Marburg University, Marburg, Germany.
| | - Björn Ludwig
- Orthodontic praxis, Traben-Trarbach, Germany.,Department of Orthodontics, Faculty of Dentistry, Homburg University, Homburg, Germany
| | | | - Saskia Mainusch
- Department of Orthodontics, Faculty of Dentistry, Marburg University, Marburg, Germany
| | - Mustafa Ateş
- Department of Orthodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Nazan Küçükkeleş
- Department of Orthodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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Torres FC, Almeida RRD, Almeida-Pedrin RRD, Pedrin F, Paranhos LR. Dentoalveolar comparative study between removable and fixed cribs, associated to chincup, in anterior open bite treatment. J Appl Oral Sci 2013; 20:531-7. [PMID: 23138739 PMCID: PMC3881795 DOI: 10.1590/s1678-77572012000500007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Accepted: 08/02/2011] [Indexed: 12/01/2022] Open
Abstract
Objective The aim of this prospective study was to compare the dentoalveolar effects
produced by two types of palatal crib, removable (Rpc+C) and fixed (Fpc+C),
combined with chincup in growing patients with anterior open bite. Material and Methods Each group comprised 30 patients, in the mixed dentition phase, with similar
cephalometric characteristics and skeletal ages. Group 1 (Rpc+C) presented initial
mean age of 8.3 years and mean anterior open bite of 4.0 mm. Group 2 (Fpc+C)
presented initial mean age of 8.54 years and mean anterior open bite of 4.3 mm.
The evaluation period comprised 12 months between initial (T1) and second lateral
radiograph (T2). The T2-T1 changes were compared cephalometrically in the 2 groups
using the non-paired t-test. Results Vertical changes in the posterior dentoalveolar region were similar between the
groups (about 1 mm) and no significant differences were found in molar
mesialization. The Fpc+C group had in average 1.6 mm more improvement of the
overbite as a result of greater maxillary incisor extrusion (1.3 mm). Patients in
this group also presented less lingual tipping of maxillary incisors and more
mandibular incisors uprighting. Conclusions The Fpc+C combination was more efficient in the correction of the negative
overbite mainly due to greater extrusion of the maxillary incisors. However, the
Rpc+C appliance promoted better upper and lower incisor inclination, resulting in
a more adequate overjet.
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Affiliation(s)
- Fernando César Torres
- Department of Orthodontics, University of São Paulo City-UNICID, São Paulo, SP, Brazil.
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Gungor AY, Türkkahraman H, Baykul T, Alkis H. Comparison of the effects of rapid maxillary expansion and surgically assisted rapid maxillary expansion in the sagittal, vertical, and transverse planes. Med Oral Patol Oral Cir Bucal 2012; 17:e311-9. [PMID: 22143686 PMCID: PMC3448316 DOI: 10.4317/medoral.17389] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Accepted: 03/06/2011] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate and compare the effects of rapid maxillary expansion (RME) and surgically assisted RME (SARME) in the sagittal, vertical, and transverse planes. STUDY DESIGN Orthodontic records of 28 patients were selected retrospectively and divided into two treatment groups. Group 1 comprised 14 patients (4 boys, 10 girls, mean age 14.2 ± 0.74 years) who had been treated with RME. Group 2 comprised 14 patients (4 boys, 10 girls, mean age 19.6 ± 2.73 years) who had been treated with SARME. Measurements were performed on lateral and posteroanterior cephalograms and dental casts obtained before (T0) and after (T1) expansion. RESULTS Statistically significant differences were found in soft tissue convexity angle, anterior face height, and upper nasal width in group 1, and in U1-NA length and posterior face height measurements in group 2 (P<.05). In both groups significant increases were found in interpremolar, intermolar, maxillary, and lower nasal widths and in anterior lower face height (P<.01). Statistically significant intergroup differences were found in the ANB angle (P<.05) and maxillary intercanine (P<.01) measurements. CONCLUSION With both RME and SARME, successful expansion of maxillary dentoalveolar structures and nasal cavity and palatal widening were achieved. Sagittal plane effects of SARME were similar to those of RME on dental skeletal and airway measurements.
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Affiliation(s)
- A-Y Gungor
- Mustafa Kemal Universitesi, Tayfur SÖkmen Kampüsü Araştirma Hastanesi, Hatay 32100 Turkey.
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