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Sjöström, Mats
Publications (10 of 42) Show all publications
Lundberg, J., Al-Taai, N., Levring Jäghagen, E., Ransjö, M. & Sjöström, M. (2024). Skeletal stability after maxillary distraction osteogenesis or conventional Le Fort i osteotomy in patients with cleft lip and palate: a superimposition-based cephalometric analysis. Oral and Maxillofacial Surgery
Open this publication in new window or tab >>Skeletal stability after maxillary distraction osteogenesis or conventional Le Fort i osteotomy in patients with cleft lip and palate: a superimposition-based cephalometric analysis
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2024 (English)In: Oral and Maxillofacial Surgery, ISSN 1865-1550, E-ISSN 1865-1569Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose: The aim was to assess skeletal stability after maxillary advancement using either distraction osteogenesis (DO) or conventional Le Fort I osteotomy (CO) in patients with cleft lip and palate (CLP) or cleft palate (CP) utilising a new superimposition-based cephalometric method.

Method: This retrospective study included patients who were treated with DO (N = 12) or CO (N = 9). Sagittal and vertical changes after surgery, and skeletal stability at 18 months post-operatively were assessed with superimposition-based cephalometry, comparing lateral cephalograms performed pre-operatively (T0), post-operatively after CO or immediately after completed distraction in DO (T1), and at 18 months of follow-up (T2).

Results: The mean sagittal movements from T0 to T2 in the DO and CO groups were 5.9 mm and 2.2 mm, respectively, with a skeletal relapse rate of 16% in the DO group and 15% in the CO group between T1 and T2. The vertical mean movement from T0 to T2 in the DO and CO groups was 2.8 mm and 2.0 mm, respectively, and the skeletal relapse rate between T1 and T2 was 36% in the DO group and 32% in the CO group.

Conclusion: Sagittal advancement of the maxilla was stable, in contrast to the vertical downward movement, which showed more-extensive relapse in both groups. Despite more-extensive maxillary advancement in the DO group, the rates of skeletal relapse were similar.

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Distraction osteogenesis, Maxillary repositioning, Orthognathic surgery, Skeletal relapse, Cleft lip and palate
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-221090 (URN)10.1007/s10006-024-01227-0 (DOI)001163526500001 ()38363518 (PubMedID)2-s2.0-85185143089 (Scopus ID)
Funder
Umeå University, 396178205
Available from: 2024-02-19 Created: 2024-02-19 Last updated: 2024-03-20
Åkesson, F., Zamure-Damberga, L., Lundgren, S. & Sjöström, M. (2023). Alveolar bone remodeling in virtually planned, bone-grafted vs non-grafted guided flapless implant surgery in the anterior maxilla: a cross-sectional retrospective follow-up study. Oral and Maxillofacial Surgery, 27(1), 43-52
Open this publication in new window or tab >>Alveolar bone remodeling in virtually planned, bone-grafted vs non-grafted guided flapless implant surgery in the anterior maxilla: a cross-sectional retrospective follow-up study
2023 (English)In: Oral and Maxillofacial Surgery, ISSN 1865-1550, E-ISSN 1865-1569, Vol. 27, no 1, p. 43-52Article in journal (Refereed) Published
Abstract [en]

PURPOSE: In patients who underwent virtual planning and guided flapless implant surgery for teeth missing in the anterior maxilla, we compared buccal bone loss between those treated with and without autogenous bone augmentation.

METHODS: Of 22 patients with teeth missing because of trauma or aplasia, 10 (18 implant sites) were reconstructed with buccally placed bone graft harvested from the mandibular ramus, and 12 were non-reconstructed (16 sites). Baseline cone-beam computed tomography allowed for implant planning using the NobelClinician® software and was performed again at 1 year after functional loading. The marginal bone level was assessed radiographically at post-implant baseline and at follow-up.

RESULTS: At follow-up, buccal bone loss differed significantly between groups at the central level of the implant (p = 0.0005) but not at the coronal level (p = 0.329). The mean marginal bone level change was 0.6 mm, with no significant between-group difference (p = 0.876). The actual implant position often deviated in the vertical or sagittal plane by an average of 0.3-0.6 mm from the planned position.

CONCLUSION: Compared with non-reconstructed patients, reconstructed patients experienced significantly more buccal bone loss at the central level of implants. The groups did not differ at the coronal level or in marginal bone loss, possibly because of the more augmented bone at the central level among reconstructed patients. Differences between planned versus actual implant positions should be considered in situations of limited bone volume at the planned implant site.

Place, publisher, year, edition, pages
Springer, 2023
Keywords
Alveolar bone grafting, Buccal bone loss, Endosseous implants, Flapless guided surgery, Virtual implant planning
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-192610 (URN)10.1007/s10006-022-01048-z (DOI)000757141300001 ()35175458 (PubMedID)2-s2.0-85124742269 (Scopus ID)
Funder
Umeå University
Note

Published online: 17 February 2022

Available from: 2022-02-18 Created: 2022-02-18 Last updated: 2023-09-07Bibliographically approved
Danielsson, D., Hagel, E., Dybeck-Udd, S., Sjöström, M., Kjeller, G., Bengtsson, M., . . . Munck-Wikland, E. (2023). Brachytherapy and osteoradionecrosis in patients with base of tongue cancer. Acta Oto-Laryngologica, 143(1), 77-84
Open this publication in new window or tab >>Brachytherapy and osteoradionecrosis in patients with base of tongue cancer
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2023 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 143, no 1, p. 77-84Article in journal (Refereed) Published
Abstract [en]

Background: Base of tongue cancer incidence and patient survival is increasing why treatment sequelaebecomes exceedingly important. Osteoradionecrosis (ORN) is a late adverse effect of radiotherapyand brachytherapy (BT) could be a risk factor. Brachytherapy is used in three out of six health careregions in Sweden.

Aims: Investigate if patients treated in regions using BT show an increased risk for ORN and whetherbrachytherapy has any impact on overall survival.

Material and Methods: We used data from the Swedish Head and Neck Cancer Register between2008–2014. Due to the nonrandomized nature of the study and possible selection bias we comparedthe risk for ORN in brachy vs non-brachy regions.

Results: Fifty out of 505 patients (9.9%) developed ORN; eight of these were treated in nonbrachyregions (16%), while 42 (84%) were treated in brachy regions. Neither age, sex, TNM-classification/stage, p16, smoking, neck dissection, or chemotherapy differed between ORN and no-ORN patients.The risk for ORN was significantly higher for patients treated in brachy regions compared to nonbrachyregions (HR ¼ 2,63, p¼.012), whereas overall survival did not differ (HR ¼ 0.95, p¼.782).

Conclusions and Significance: Brachytherapy ought to be used cautiously for selected patients orwithin prospective randomized studies.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2023
Keywords
Brachytherapy, osteoradionecrosis, base of tongue cancer, head and neck cancer, sequelae
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-202166 (URN)10.1080/00016489.2022.2161627 (DOI)000906655700001 ()36595465 (PubMedID)2-s2.0-85145503455 (Scopus ID)
Funder
Stockholm County Council
Available from: 2023-01-04 Created: 2023-01-04 Last updated: 2023-06-19Bibliographically approved
Krämer, A., Sjöström, M., Apelthun, C., Hallman, M. & Feldmann, I. (2023). Post-treatment stability after 5 years of retention with vacuum-formed and bonded retainers: a randomized controlled trial. European Journal of Orthodontics, 45(1), 68-78
Open this publication in new window or tab >>Post-treatment stability after 5 years of retention with vacuum-formed and bonded retainers: a randomized controlled trial
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2023 (English)In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 45, no 1, p. 68-78Article in journal (Refereed) Published
Abstract [en]

Background: Retention after orthodontic treatment is still a challenge and more evidence about post-treatment stability and patients’ perceptions of different retention strategies is needed.

Objectives: This trial compares removable vacuum-formed retainers (VFR) with bonded cuspid-to-cuspid retainers (CTC) after 5 years of retention.

Trial design: A single centre two-arm parallel-group randomized controlled trial.

Methods: This trial included 104 adolescent patients, randomized into two groups (computer-generated), using sequentially numbered, opaque, and sealed envelopes. All patients were treated with fixed appliances in both jaws with and without tooth extractions. Patients in the intervention group received a VFR in the mandible (n = 52), and patients in the active comparator group received a CTC (n = 52). Both groups had a VFR in the maxilla. Dental casts at debond (T1), after 6 months (T2), after 18 months (T3), and after 5 years (T4) were digitized and analysed regarding Little’s Irregularity Index (LII), overbite, overjet, arch length, and intercanine and intermolar width. The patients completed questionnaires at T1, T2, T3, and T4.

Results: Post-treatment changes between T1 and T4 in both jaws were overall small. In the maxilla, LII increased significantly (median difference: 0.3 mm), equally in both groups. In the mandible, LII increased significantly in the group VFR/VFR (median difference: 0.6 mm) compared to group VFR/CTC (median difference: 0.1 mm). In both groups, overjet was stable, overbite increased, and arch lengths decreased continuously. Intercanine widths and intermolar width in the mandible remained stable, but intermolar width in the maxilla decreased significantly. No differences were found between groups. Regardless of retention strategy, patients were very satisfied with the treatment outcome and their retention appliances after 5 years.

Limitations: It was not possible to perform blinded assessments of digital models at follow-up.

Conclusions: Post-treatment changes in both jaws were small. Anterior alignment in the mandible was more stable with a bonded CTC retainer compared to a removable VFR after 5 years of retention. Patients were equally satisfied with fixed and removable retention appliances.

Trial registration: ClinicalTrials.gov (NCT03070444).Issue

Section:Randomized Controlled Trial (RCT)

Place, publisher, year, edition, pages
Oxford University Press, 2023
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-198630 (URN)10.1093/ejo/cjac043 (DOI)000840414200001 ()35968668 (PubMedID)2-s2.0-85146463354 (Scopus ID)
Available from: 2022-08-15 Created: 2022-08-15 Last updated: 2023-07-13Bibliographically approved
Terheyden, H., Raghoebar, G. M., Sjöström, M., Starch-Jensen, T. & Cawood, J. (2023). Preprosthetic surgery: narrative review and current debate. Journal of Clinical Medicine, 12(23), Article ID 7262.
Open this publication in new window or tab >>Preprosthetic surgery: narrative review and current debate
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2023 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 12, no 23, article id 7262Article in journal (Refereed) Published
Abstract [en]

This review describes the role of modern preprosthetic surgery. The atrophic edentulousjaw can cause severe functional impairment for patients, leading to inadequate denture retention,reduced quality of life, and significant health problems. The aim of preprosthetic surgery is to restorefunction and form due to tooth loss arising from congenital deformity, trauma, or ablative surgery.Alveolar bone loss is due to disuse atrophy following tooth loss. The advent of dental implants andtheir ability to preserve bone heralded the modern version of preprosthetic surgery. Their ability tomimic natural teeth has overcome the age-old problem of edentulism and consequent jaw atrophy.Controversies with preprosthetic surgery are discussed: soft tissue versus hard tissue augmentationin the aesthetic zone, bone regeneration versus prosthetic tissue replacement in the anterior maxilla,sinus floor augmentation versus short implants in the posterior maxilla—interpositional bone graftingversus onlay grafts for vertical bone augmentation. Best results for rehabilitation are achieved bythe team approach of surgeons, maxillofacial prosthodontists/general dentists, and importantly,informing patients about the available preprosthetic surgical options.

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
alveolar bone atrophy, alveolar bone loss, bone grafting, dental implants, edentulous jaw, preprosthetic oral surgery procedures
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-217031 (URN)10.3390/jcm12237262 (DOI)001116051600001 ()38068314 (PubMedID)2-s2.0-85179315072 (Scopus ID)
Available from: 2023-11-23 Created: 2023-11-23 Last updated: 2023-12-22Bibliographically approved
Kelk, P., Fasth, A., Lif Holgerson, P. & Sjöström, M. (2023). Successful complete oral rehabilitation of a patient with osteopetrosis with extensive pre-treatments, bone grafts, dental implants and fixed bridges: a multidisciplinary case report. BMC Oral Health, 23(1), Article ID 940.
Open this publication in new window or tab >>Successful complete oral rehabilitation of a patient with osteopetrosis with extensive pre-treatments, bone grafts, dental implants and fixed bridges: a multidisciplinary case report
2023 (English)In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 23, no 1, article id 940Article in journal (Refereed) Published
Abstract [en]

Background: Osteopetrosis comprises a group of inherited disorders that are rare and result in abnormal bone structure. Bone remodeling is extremely inhibited because osteoclasts are nonfunctional or lacking. This condition causes overgrowth of bone with disappearance of the bone marrow, leading to aplastic anemia; obstruction of nerve passages in the skull leads to blindness and often hearing impairment. In most cases, osteopetrosis results in oral complications such as tooth deformation, hypomineralization, and delayed or absent tooth eruption. The only curative treatment is hematopoietic stem cell transplantation (HSCT). The main treatment of the oral complications during childhood and adolescence consists in protecting the erupted teeth against caries disease through prophylactic treatment aimed at optimal oral hygiene through frequent regular dental visits throughout life. Many patients with osteopetrosis require major oral rehabilitation to treat complications of the disease. Improved results of HSCT increase the likelihood that dental professionals will encounter patients with osteopetrosis.

Case presentation: In this case report, we show that individuals with osteopetrosis who have severe oral complications can be treated successfully if they are treated for osteopetrosis at an early age. The boy had his dental care in pedodontics, and regular multidisciplinary meetings were held for future treatment planning. At the age of 15, he was then referred for rehabilitation. The initial evaluations revealed no further growth in the alveolar bone. The rehabilitation was done stepwise, with extraction of malformed and malpositioned teeth. Initially, the patient received a removable partial denture followed by reconstruction of the width of the alveolar process, titanium implants, temporary fixed bridges, and finally screw-retained titanium-ceramic bridges with titanium frames for the upper and lower jaws.

Conclusions: The three-year follow-up after loading indicated a stable marginal bone level and optimal oral hygiene as a result of frequent professional oral hygiene care. The patient showed no signs of symptoms from the temporomandibular joint and has adapted to the new jaw relation without any functional or phonetical issues.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Hematopoietic stem cell transplantation, Iliac crest bone graft, Oral rehabilitation, Osseo integrated implants, Osteopetrosis
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-217322 (URN)10.1186/s12903-023-03707-3 (DOI)38017429 (PubMedID)2-s2.0-85178240217 (Scopus ID)
Available from: 2023-11-30 Created: 2023-11-30 Last updated: 2023-12-14Bibliographically approved
Koskinen Holm, C., Johansson, L. C., Brundin, M. & Sjöström, M. (2023). Successful rehabilitation after multiple severe complications following orthognathic surgery: a case report. BMC Oral Health, 23(1), Article ID 909.
Open this publication in new window or tab >>Successful rehabilitation after multiple severe complications following orthognathic surgery: a case report
2023 (English)In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 23, no 1, article id 909Article in journal (Refereed) Published
Abstract [en]

Background. Complications of orthognathic surgery are quite rare, but they cause suffering in affected individuals.The range of complications is broad and includes both hard and soft tissue.

Case presentation: We here present a case of a fully healthy woman without signs of impaired healing capacity. Thepatient underwent bimaxillary orthognathic surgery and experienced multiple complications both peri- and postoperatively.During the post operative period, the patient also suffered from soft tissue complications after an orthopaedicinjury. Therefore, we referred the patient to her general practitioner for further medical investigation. Wealso present the result after restorative surgery and endodontic and prosthodontic treatment resulting in a successfulrehabilitation.

Conclusion: This case report clearly shows the need for a good collaboration between different odontologicaland medical fields to achieve a good and predictable result. In situations where normal healing processesdo not occur, in-depth analysis must be carried out.

Highlights: Orthognathic surgery affects soft and hard tissue which can result in adverse healing and complications.It is of great importance to follow up performed surgery to see late complications. Be restrictive with earlyre-operations when there are signs of necrosis. Always use a multidisciplinary approach when handling complicationsafter surgery.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Orthognathic surgery, Complications, Soft tissue, Vascularization, Necrosis
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-216976 (URN)10.1186/s12903-023-03644-1 (DOI)37993857 (PubMedID)2-s2.0-85177440778 (Scopus ID)
Available from: 2023-11-23 Created: 2023-11-23 Last updated: 2024-01-04Bibliographically approved
Ferreira, D. M. & Sjöström, M. (2022). 3-dimensional analysis of the pharyngeal airway in healthy adults, an insight. Dental, oral and maxillofacial research, 8, 1-11
Open this publication in new window or tab >>3-dimensional analysis of the pharyngeal airway in healthy adults, an insight
2022 (English)In: Dental, oral and maxillofacial research, E-ISSN 2633-4291, Vol. 8, p. 1-11Article in journal (Refereed) Published
Abstract [en]

Anatomical factors that narrow the upper airway predisposes for obstructive sleep apnea (OSA). Orthognathic surgery causes changes in the pharyngeal airway anda successful long-term treatment requires an understanding of all variables. This paper aims to describe the pharyngeal anatomy, factors that affects its dimension andconfiguration, discuss imaging of the pharynx with focus on computed tomography as well as normative volumetric data for healthy adults by 3-dimensional (3D)analysis.

The literature search was performed in PubMed with following MeSH terms: "pharynx", “diagnostic imaging", “tomography, x-ray computed”, "imaging, threedimensional"and "adult” together with “upper airway” and “pharyngeal airway”. Articles evaluating the upper airway in relation to a surgical procedure or to specificdisease were excluded. A total of 46 articles were included and analyzed.

As a fibromuscular tube, the size and shape of the pharynx is related to its mechanical intrinsic properties, surrounding anatomical structures and dynamic patientdependent factors, including breathing, gravity and postural changes, as well as technical aspects regarding imaging acquisition, processing and analysis by software.Even though 3D imaging allows cross-sectional and volumetric measurements, the current literature cannot present a consistent normative dimensional referencefor the pharyngeal airway.

Airway size should be considered when planning orthognathic surgery in order to minimize negative side-effects. 3D imaging might provide a range of informationconcerning pharyngeal size and shapes that can be used to analyze what type and extension of surgical movement is necessary to optimize the treatment. A standardprotocol for 3D assessment of the pharyngeal airway is still missing and clinical research with good quality and standardized criteria are needed.

Keywords
pharyngeal airway, imaging, computed tomography, cone-beam computed tomography, obstructive sleep apnea, orthognathic surgery
National Category
Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-192986 (URN)10.15761/DOMR.1000397 (DOI)
Funder
Umeå University
Available from: 2022-03-09 Created: 2022-03-09 Last updated: 2023-01-11Bibliographically approved
Sjöström, M., Danielsson, D., Munck-Wikland, E., Nyberg, J., Sandström, K., Thor, A., . . . Laurell, G. (2022). Mandibular resection in patients with head and neck cancer: acute and long-term complications after reconstruction. Acta Oto-Laryngologica, 142(1), 78-83
Open this publication in new window or tab >>Mandibular resection in patients with head and neck cancer: acute and long-term complications after reconstruction
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2022 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 142, no 1, p. 78-83Article in journal (Refereed) Published
Abstract [en]

Background: The treatment of head and neck cancer is an intensive multimodal treatment that has a great impact on the individual patient.

Aims/Objectives: This study aimed to evaluate acute and long-term complications associated with mandibular resections and reconstructions.

Material and Methods: We retrospectively retrieved data on complications and recurrences among patients that underwent mandibular resections and reconstructions for treating oral cavity cancer (n = 190 patients) and osteoradionecrosis (ORN, n = 72). Reconstructions included composite grafts (n = 177), soft tissue flaps (n = 61), or primary closure without any graft (n = 24).

Results: Forty-two patients that underwent reconstructions with composite grafts displayed serious complications (Clavien–Dindo ≥ IIIa). The complication rates were similar between patients treated for oral cavity cancer and patients treated for ORN. Patients that underwent a primary closure without any graft, had a significantly lower risk of complications compared to patients that underwent the other treatments. After hospitalization, 181 patients (69%) had at least one complication.

Conclusions: A majority of patients undergoing resection and reconstruction due to oral cancer/ORN suffered from postoperative complications regardless of indication, comorbidity status or reconstruction technique. The risk of Clavien–Dindo grade IIIa–V events was significantly lower for patients treated with primary closure without grafts. 

Significance: The results from this study clarifies the importance of in-depth analyse prior to decision of treatment for patients with head and neck cancer.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2022
Keywords
Head and neck cancer, mandible, resection, reconstruction, affecting factors, complications
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-191314 (URN)10.1080/00016489.2021.2021283 (DOI)000742276300001 ()35023428 (PubMedID)2-s2.0-85122852415 (Scopus ID)
Available from: 2022-01-13 Created: 2022-01-13 Last updated: 2024-05-07Bibliographically approved
Hasselby, H., Danielsson, K. & Sjöström, M. (2022). Oral Health in Patients with Osteopetrosis: A Literature Review. Clinics in surgery, 7(1), Article ID 3411.
Open this publication in new window or tab >>Oral Health in Patients with Osteopetrosis: A Literature Review
2022 (English)In: Clinics in surgery, ISSN 2474-1647, Vol. 7, no 1, article id 3411Article in journal (Other (popular science, discussion, etc.)) Published
Abstract [en]

Background: Osteopetrosis is a rare hereditary bone disease caused by mutated osteoclasts that are either in scarce abundance or have reduced efficiency. This condition leads to less bone resorption, and thus, denser, more fragile bones. Osteopetrosis leads to complications that can be severe and even fatal.

Aim: To summarize the current knowledge of (a) how Osteopetrosis affects the oral health, dentition, and facial skeleton of patients with different disease subtypes, and (b) which treatmentoptions are used worldwide to treat the different orofacial complications and provide symptomrelief in the oral cavity.

Methods: This review was based on published studies on oral health among patients witho steopetrosis that focused on diagnosis and treatment. Two searches were performed in PubMed, based on seven search terms: Osteopetrosis, oral, jaw, dental, craniofacial, mandible, and maxilla. After screening based on predefined inclusion and exclusion criteria; 30 articles were selected

.Results: All 30 articles were case studies, which have a low grade of evidence. Thus, the data studied were at high risk of bias. The 30 articles included 40 patients. The most common observed complication was osteomyelitis.

Conclusion: The data highlighted the importance of good oral hygiene and tissue-conservative treatment in preventing complications from infection. Osteomyelitis should be treated with acombination of surgery, antibiotics, and hyperbaric oxygen therapy. Follow up should continue throughout life to ensure successful treatment of this chronic disease.

Place, publisher, year, edition, pages
Remedy Publications, 2022
Keywords
Osteopetrosis, Oral status, Dental treatment complications
National Category
Medical and Health Sciences Dentistry
Identifiers
urn:nbn:se:umu:diva-192634 (URN)
Available from: 2022-02-21 Created: 2022-02-21 Last updated: 2022-03-09Bibliographically approved
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