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   Table of Contents - Current issue
Coverpage
September-October 2022
Volume 14 | Issue 5
Page Nos. 433-528

Online since Monday, October 31, 2022

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REVIEW ARTICLES  

Prevalence of orthodontic and prosthodontic treatment needs in differently abled population—A systematic review p. 433
Subbaiah Pradeep, Mysore Rajshekar Dakshayini, Honne Manjunathappa Thippeswamy, Nanditha Kumar
DOI:10.4103/jioh.jioh_311_21  
Aim: This systematic review assesses the severity and complexity of orthodontic treatment needs and prosthodontic requirements among differently abled population. Materials and Methods: An online search was conducted on Medline-PubMed, Cochrane database, and Embase databases from December 1980 to 2020. There were nine and five articles to determine the prevalence of malocclusion and prosthodontic treatment needs, after a thorough evaluation of the severity and complexity of orthodontic treatment needs and prosthodontic requirements for the differently abled population. Results: In this systematic review, the prevalence of orthodontic needs among individuals with special healthcare needs, specifically those with intellectual disability/Down syndrome/cerebral palsy, varied from 18.9% to 62.3%, and from 0% to 46.5% for prosthodontic treatment needs. Conclusions: This study concluded that differently abled individuals have orthodontic and prosthodontic needs far higher than their status. Malocclusion and missing teeth together can harm the individual’s “quality of life” in physical pain and social disabilities.
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Combination of hDPSCs and oxysterol in hyaluronic acid scaffolds for dental implant therapy: A narrative review Highly accessed article p. 440
Imam S Azhar, Veda S A Nariswari, Devy P Kusumawardhani, Mohammad A Maksum
DOI:10.4103/jioh.jioh_299_21  
Aim: The latest development of a dental therapy implant is the tissue engineering triad; one of them applies a combination of hDPSCs (human dental pulp stem cells) and oxysterol in media hyaluronic acid scaffolds. hDPSCs can produce osteoblasts in the bone repair process. Basic fibroblast growth factors and vascular endothelial growth factors are found in hDPSCs, and they can help speed up the vascularity and bone development. Oxysterol is an oxidized cholesterol product that can be found naturally in humans and animals. Oxysterol is an osteogenic factor that affects osteogenic differentiation by activating the liver X receptors and the Hh pathway signaling. Hyaluronic acid is a nonsulfate linear polysaccharide made up of disaccharide units of D-glucuronic acid and N-acetyl-d-glucosamine that occur naturally, which are linked by β-glycosidic bonds 1–3 and β-1–4. The hyaluronic acid scaffolds can be used for bone regeneration by increasing osteogenesis, osseointegration, and mineralization. The study aimed to describe the potential for combining hDPSCs and oxysterol in media hyaluronic acid scaffolds for dental implant therapy. Materials and Methods: Ideas and innovations were obtained based on the literature in journals and textbooks in the last 5 years (2016–2021) from PubMed, Google Scholar, and Web of Science databases. The review used the technique to find the similarity of the literature with the same keywords and then made conclusions. The theories that have been obtained are then summarized into a continuous series; thus, readers can more easily understand the ideas and innovations offered. Results: Pertaining to various literatures, there were 30 journals from PubMed, Google Scholar, and Web of Science databases. The case reports analyzed patients with inclusion criteria for dental implants and osseointegration. From the results of the review, it was found that the combination of these three ingredients has ingredients that can induce osseointegration. Conclusion: The combination of hDPSCs and oxysterol in media hyaluronic acid scaffolds can potentially provide bone regeneration in dental implant treatment.
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Breastfeeding and bottle-feeding as risk factors for dental caries and malocclusions in children with deciduous dentition: A scoping review p. 447
Jazmin M Amores-Esparza, Victoria Altamirano-Mora, Inés Villacís-Altamirano, Camila Montesinos-Guevara
DOI:10.4103/jioh.jioh_88_22  
Aim: To identify the available evidence on the effects that breastfeeding and/or bottle-feeding may have on the presence of early childhood caries (ECC) and malocclusion in children with deciduous dentition. Materials and Methods: A systematic search was carried out in different databases, including PubMed, Cochrane Library, Lilacs, and Epistemonikos, up to January 6, 2022. Studies were independently selected by two reviewers according to title, abstract, and full-text analysis. Disagreements were solved by a third reviewer. Results: A total of 1343 studies were found from the initial search, of which 42 studies were included in this study. Results are controversial, 14 studies concluded that prolonged breastfeeding and bottle-feeding at night increase the risk of caries, 7 studies mentioned that breastfeeding could be a protective factor for dental caries development in children under 6 years, 20 studies concluded that children who were breastfed for less than 6 months have a higher risk of developing malocclusions compared with children who were breastfed for a longer time and children who were bottle-fed compared with children who were breastfed had a higher prevalence of malocclusions, mainly anterior open-bite. Four studies found no significant association between breastfeeding and/or bottle-feeding with the development of dental caries and malocclusion. Conclusion: Most included studies concluded that the presence of ECC may be associated with bottle-feeding and prolonged breastfeeding, but reasons still need further development. Regarding malocclusions, most studies concluded that prolonged breastfeeding could be a protective factor for its development, whereas a high frequency and duration of bottle consumption could lead to deformations in the maxillary bone, mainly anterior open-bite. However, results are still controversial.
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The relationship between preterm birth and the presence of early childhood caries: A scoping review p. 454
Graciela I Santamaría-Jiménez, Karen Serrano-Arévalo, Camila Montesinos-Guevara
DOI:10.4103/jioh.jioh_63_22  
Aim: The rate of premature births in the past 20 years has increased up to 10 out of 100 births worldwide; birth conditions can change the dental structure and can eventually influence the susceptibility to dental caries in children. The aim of this scoping review is to summarize the available evidence on the relationship between preterm birth and the development of early childhood caries (ECC). Materials and Methods: A systematic search was performed in PubMed, Cochrane Database of Systematic Reviews, Lilacs, and Epistemonikos up to January 6, 2022. Two authors screened studies by title and abstract and by full text to select those that fulfilled the eligibility criteria (observational/randomized clinical trials/systematic reviews that assess dental caries in primary dentition and premature delivery in children between 1 and 6 years old with cavities in deciduous teeth and published in Spanish, English, and Portuguese. Studies combining deciduous and permanent teeth, and with patients that had dental trauma were excluded). Any disagreement between the two reviewers during the selection process was solved by discussion, and a third reviewer got involved in case of disagreement. Two reviewers independently extracted data from the included studies. Results: We identified 1480 studies from the initial search resulting in 17 studies included in this scoping review. Six studies were cross-sectional, three were cohort studies, five were case–control, two studies were systematic reviews, and one was a meta-analysis. In terms of the association between dental caries and prematurity, conclusions of the included studies are controversial. Nine studies concluded that there is no relationship; six studies demonstrated that there is a relationship, and two studies did not specify whether there is a relationship between dental caries and prematurity. Conclusion: We found that there is no conclusive evidence to demonstrate if there is a relationship between ECC and prematurity because of the high ambiguity of the evidence. It is necessary to carry out more prospective cohort studies with a larger sample size and a defined premature population who are followed up for a longer period when they have a complete deciduous dentition.
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ORIGINAL RESEARCH Top

Comparison of tensile and shear bond strengths of layering porcelain with VITA Suprinity after different surface treatment methods: An in vitro study p. 462
Arash Shishehian, Farnoush Fotovat, Banafsheh Poormoradi, Sara Khazaei, Maryam Farhadian, Hirbod Gilandoust
DOI:10.4103/jioh.jioh_75_22  
Background: For all-ceramic restorations to last a long time, the ceramic veneering and substructure need to have a strong sufficient bond. This research compared how two different surface treatments affected the tensile and shear bond strengths of zirconium-reinforced lithium silicate and porcelain (Suprinity). Materials and Methods: A total of 120 samples were divided into three groups at random: control(no surface treatment),aluminium oxide sandblasting, Erbium, Chromium-doped Yttrium, Scandium, Gallium, and Garnet (Er, Cr: YSGG) laser irradiation, and 60 samples to evaluate tensile bond strength and 60 samples to evaluate shear bond strength. By using one-way ANOVA and the post-hoc Tukey’s test, the tensile and shear bond strength between Suprinity and porcelain (VITA VM 11) was analyzed in all groups. Results: The maximum and minimum tensile bond strength was seen in sandblasting group (7.86 ± 2.22 Mpa) and control group (4.88 ± 1.58 Mpa), respectively (P < 0.001). The amount of shear bond strength in the laser group, sandblast group, and control group was (5.16 ± 1.66 Mpa),(5.00 ± 1.34 Mpa),(4.39 ± 1.54 Mpa) respectively (P = 0.252). In tensile and shear bond strength tests, most failures were cohesive in VITA VM 11 layering porcelain (65.0% vs. 66.7%) followed by mixed failures (33.3% vs. 20%). Conclusion: Suprinity and layering porcelain produced higher tensile bonds as a result of Al2O3 sandblasting and Er, Cr: YSGG laser irradiation. While no pure adhesive failure was seen, cohesive failure was predominant.
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Design and calibration of infrared thermography therapeutic device for temporomandibular disorder: An instrument accuracy study p. 468
Liana Rahmayani, Mustanir Yahya, Cut Soraya, Saumi Syahreza
DOI:10.4103/jioh.jioh_82_22  
Aim: To design a modification and calibration of the therapy device that is expected to be used in relieving the symptoms of temporomandibular disorders. Materials and Methods: The research type was an experimental study; the method was carried out by designing the addition of some modified components to the therapy device for the calibration of the sensors in terms of measuring the increase and decrease in the temperature repeatedly three times. The temperature increase and decrease time recorded was the duration every 30 min for each session. The data obtained were then processed using the interrater reliability statistical test with interclass correlation coefficient (ICC), to see whether a measuring instrument (device) has adequate and accurate stability. Results: The results of measurements were analyzed using interrater reliability statistical tests with ICC and measuring from the mean value of both the increase and decrease in temperature with the analysis of the Mann–Whitney test Asymp Sig. 2 (tailed) of 0.860, which means it can be assumed to be the same or not different. The result showed that the ICC single measures on the LM35 was 0.894, whereas the ICC single measures on the thermocouple was 0.887. The ICC value of single measures on the LM35 was 0.999, whereas the ICC value for single measures on thermocouples was 0.993. Conclusions: It can be concluded that there was no difference between the value of increased and decreased temperature using the LM35 sensor or thermocouple. It can be assumed that the results are the same and that the ICC value category for the LM35 sensor and the thermocouple is very reliable and has high stability.
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Knowledge, attitudes, and practices on oral health prevention associated with sociodemographic factors of adolescent students from a Peruvian-Swiss educational institution p. 475
Clifford Allen-Revoredo, Marysela Irene Ladera-Castañeda, Nancy Edith Córdova-Limaylla, Gissela Briceño-Vergel, Luis Adolfo Cervantes-Ganoza, César Cayo-Rojas
DOI:10.4103/jioh.jioh_120_22  
Aim: Adolescents experience a period in their lives when major variations in their development occur, in addition to establishing practices and attitudes that will play an important role in their general health care, which will have an impact on their well-being and life quality in the future. Therefore, the aim of this study was to determine how knowledge, attitudes, and practices on oral health prevention are related to sociodemographic factors of adolescent students in a Peruvian-Swiss Educational Institution. Materials and Methods: This observational and cross-sectional study in 154 adolescent students obtained by stratified random sampling was carried out during November to December 2021. A questionnaire validated by the Peruvian Association of Preventive and Social Dentistry (APOPS) was employed. For statistical analysis a Pearson’s chi-square test was applied, in addition to a logit model using odds ratio (OR) to evaluate knowledge, attitudes and practices on oral health prevention with the variables age, sex, academic level, family structure, educational level of parent or guardian, and nationality. A significance level of P < 0.05 was considered. Results: Of all the students, 44.81% presented insufficient knowledge, whereas 26.62% showed an unfavorable attitude and 1.95% reported incorrect practices. On the contrary, knowledge about oral health prevention was significantly associated with age group (P = 0.002), academic level (P = 0.004) and educational level of parent or guardian (P = 0.005). Attitude toward oral health prevention was significantly associated with age group (P = 0.045) and academic level (P = 0.044). Oral health prevention practice was not significantly associated with any factor. Finally, students whose parent or guardian had non-university higher education were significantly 67% less likely (OR = 0.33; confidence interval [CI]: 0.15–0.73) to have poor knowledge of oral health prevention than those whose parent or guardian had university higher education (P = 0.007). Conclusion: Knowledge and attitudes of the students about oral health prevention were associated with age and academic level. In addition, the educational level of parent or guardian was associated with knowledge, such that those students whose parent or guardian had non-university higher education were 67% less likely to have poor knowledge of oral health prevention than those whose parent or guardian had university higher education. Finally, the practice of oral health prevention was not associated with any of the sociodemographic factors considered in this study.
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The effect of implant length and diameter on primary stability of tilted implant on D4 bone density: An in vitro study p. 487
Muhammad I Baihaqi, Taufik Sumarsongko, Setyawan Bonifacius
DOI:10.4103/jioh.jioh_65_22  
Aim: To determine the effect of implant length and diameter on the primary stability of tilted dental implant and D4 bone density. Materials and Methods: Superline implant with different lengths (12 mm and 14 mm) and diameters (4 mm and 5 mm) as well as the path of placement inclinations (0°, 15°, 30°, 45°) were used in this true experimental study design with 48 samples and allocated into 16 groups with repeated three times (based on Federer’s formula). Artificial polyurethane bone blocks, 20 pounds per cubic foot (0.32 g/cm3), were prepared, and each implant was inserted following the manufacturer’s instruction. Primary implant stability was measured using Osstell tool. The procedure was repeated three times for each implant at four different 90° orientation or from buccal, lingual, mesial, and distal. The mean value for implant stability quotient (ISQ) was calculated using statistical analysis. Data distributed normally, and univariate analysis of variance was the statistical formula used to calculate any differences in the primary stability values of each group. Post hoc test was further utilized as a t-test to compare each group, which showed good scores for the primary stability. Results: The results of this study reveal that there was a significant difference in the primary stability of tilted implant at different lengths and diameters. Implants with a length of 14 mm and a diameter of 5 mm at 45° inclination resulted in the highest ISQ score with an average of 72.25. Implants with a length of 12 mm and a diameter of 4 mm at 15° inclination had the lowest ISQ score with an average of 63.58. Implants with an inclination of 45° showed no difference in the mean value of the primary stability against implants in the upright position (0°). Conclusion: The longer and wider the implants in the tilted position have better primary stability in D4 bone density.
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Impact of maturation time on the shear bond strength of an alkasite restorative material to pure tricalcium silicate based cement: An in-vitro experimental study p. 494
Arun Mayya, Ann Mary George, Anoop Mayya, Sonia Preshma D’souza, Shreemathi S Mayya
DOI:10.4103/jioh.jioh_326_21  
Aim: To evaluate the shear bond strength of pure tricalcium silicate-based cement (Biodentine) to Cention N between two maturation times of Biodentine, namely 12 minutes and 2 weeks. Materials and Methods: 30 acrylic blocks with a hole (3 mm in diameter and 1.5 mm in height) were prepared. Biodentine was mixed according to the manufacturer’s instructions and placed into the holes. The Samples were randomly divided into two groups. In group 1, Cention N was bonded to the Biodentine after 12 mins; in group 2, Cention N was bonded to Biodentine after 2 weeks. A plastic cylinder of height and diameter 2 mm was used to place Cention N over the Biodentine. A universal testing machine was used to measure the shear bond strength of the specimen. Data was analysed using SPSS V15.0. South Asia, Bangalore. Independent sample t-test was applied to compare the mean of the maximum compressive stress of the two groups. Result: Group 2 demonstrated significantly higher shear bond strength values compared to group 1. Lower shear bond strength testing values were observed when Cention N was bonded to an initially set Biodentine. Conclusion: The maturation period of Biodentine has a significant impact on its shear bond strength to Cention N. It is advisable to place the final overlying restoration after waiting for a duration of two weeks to allow the Biodentine maturation to take place.
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Comparative evaluation of enamel surface smoothness and operating time after debonding using four remnant adhesive removal techniques—An in vitro study p. 500
Lamis K Mohammed, Issam M Abdullah, Arkan M Al Azzawi, Hasan S Hasan, Kasem A Abeas
DOI:10.4103/jioh.jioh_102_22  
Aim: To compare and evaluate the effect of using four remnant adhesive removal techniques after bracket debonding on enamel surface smoothness and to assess the operating time spent in each one. Materials and Methods: Orthodontic adhesive material was removed from the buccal surface of 40 maxillary premolars after bracket debonding with four techniques as 10 teeth per each one: TCG = 10; TCPG = 10; EFG = 10; and EFPG = 10. The operating time required for the completion of each technique was recorded in seconds using a stopwatch, and the mean values of it were statistically calculated; ANOVA and least significant difference tests for means and significant difference of it were done. The enamel surface of two samples from each group in addition to the control group was evaluated by using scanning electron microscopy (SEM), and Enamel Damage Index (EDI) was used for assessing enamel surface damage by using ImageJ software. Results: Depending on the SEM evaluation and EDI, the results are as follows: EFPG was smooth enamel surface; EFG was an acceptable surface smoothness with very fine scratches; TCPG was surface with slightly coarse scratches, whereas TCG was surface with sever roughness and coarse scratches that can be seen by a naked eye. The operating time for cleanup with EFG was the lowest value among the four techniques (22.116 s) and significantly (P < 0.05) shorter than the TCPG and EFPG. Conclusions: The enhance finishing and polishing systems were considered as efficient techniques for removing the remnant adhesive materials after bracket debonding leaving a smooth surface with little or no scratches with the shorter operating time in EFG among the four techniques, whereas TCG was the worst one as it left the enamel surface with wide, deep grooves and scratches, and it is advised to stop and avoid using it anymore.
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Effect of chitosan and hydroxyapatite nanocomposite on dentin erosion: An in-vitro study p. 509
Ishwarya Gurucharan, D Roger Derick Isaac, M Madhana Madhubala, L Vijay Amirtharaj, Sekar Mahalaxmi, R Jayasree, TS Sampath Kumar
DOI:10.4103/jioh.jioh_50_22  
Aim: To evaluate the dentinal tubule occlusion and collagen stabilization potential of nanohydroxyapatite (nHAp) and nanochitosan (nCH) combination paste on eroded dentin surface. Materials and Methods: In this in-vitro study, nHAp was prepared using the microwave-accelerated wet chemical synthesis method and nCH was made by the ionic gelation technique. The particles were characterized separately under dynamic light scattering and made into a paste by mixing them at a ratio of 1:1, which was further analyzed using Fourier-transform infrared spectroscopy (FTIR). Dentin slabs were prepared from 32 extracted human molars and subjected to erosion by exposing to 3% citric acid for 5 min. They were divided into four groups by convenience sampling method (n = 15): group I-control (no treatment); group II-nHAp; group III-nCH; group IV-nHA–nCH paste. All dentin samples were treated according to their respective groups by the active application of pastes using microbrushes for 1 min everyday for 14 days. Later, the samples were subjected to FTIR and scanning electron microscopy and energy dispersive X-ray spectroscopy (SEM-EDX) analysis. Statistical analysis was done using one-way analysis of variance (P < 0.05). Results: SEM-EDX revealed complete occlusion of dentinal tubules in the nHA–nCH group with HAp deposits on the surface. The Ca/P ratio of various groups was significantly different from each other (control group-1.05, nHAp-1.64, nCH-1.14, and nHA–nCH-1.71) (P < 0.05). The FTIR spectra marked the presence of amide I peak in nCH and nHA–nCH groups, indicating collagen stabilization. Conclusion: The nHA–nCH paste shows a potential for tubular occlusion and stabilizes both the inorganic and organic components of eroded dentin, respectively.
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Students’ perceptions of their educational environment in a south Indian dental school—A cross-sectional study p. 518
Sravan K Yeturu, Vijay S Kumar, Kalyana C Pentapati, Nitin A Krishnan, Swagata Roy, Radhika S Babu
DOI:10.4103/jioh.jioh_34_22  
Aim: To compare the undergraduate dental students’ perceptions of their educational environment with academic achievement. Materials and Methods: This cross-sectional study used the shortened version of the “Dundee Ready Educational Environment Measure” (DREEM-17) and was administered to 200 students of a dental school in south India using a convenient sampling. DREEM-17 consists of 17 questions under five domains recorded on a Likert scale. Higher scores implied a better perception of the educational environment. Based on the results of university examinations, students were grouped as academic achievers and under-achievers. Independent sample t-test and analysis of variance with post-hoc test were used to evaluate significant differences with gender, academic year, and academic achievement. The relationship between academic achievement and the DREEM scores was evaluated with Poisson regression after adjusting for the academic year. Results: The final analysis included 183 students (91.5% response rate). The majority of the participants were females (92.3%) with a mean age of 20.84 ± 1.41 years. Only 16.9% were under-achievers. There was a significant difference in the total mean scores concerning the academic years (P < 0.001). Under-achievers, as compared to academic achievers, scored lower mean total DREEM (P = 0.005). Regression analysis showed that academic achievers perceived significantly higher DREEM scores after adjusting for the academic year (risk ratio = 0.96; 95% confidence interval = 0.95–0.98; P < 0.001). Conclusion: Academic achievers fared higher DREEM scores than under-achievers. The use of DREEM-17 as a tool for monitoring academic progress might facilitate the identification and implementation of timely interventions to modify any problematic educational situations.
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CASE REPORT Top

Surgical obturator as an immediate prosthesis post hemimaxillectomy of palatal squamous cell carcinoma: A case report p. 524
Ratri M Sitalaksmi, Muhammad D A Ari, Karina Mundiratri, Real A Au Sanjaya, Tasya R Pramesti, Agus Dahlan
DOI:10.4103/jioh.jioh_251_21  
Surgical management of oral squamous cell carcinoma results in significant defects in the oral and maxillofacial regions. This case study aims to support the formation of an intraoral defect profile, shorten recovery time, and improve the patient’s psychological aspects by inserting a postoperative surgical obturator. A 44-years-old male presented to Dental Hospital Universitas Airlangga at the referral from General Hospital Dr. Soetomo Head and Neck Surgery Department due to recurrent palatal squamous cell carcinoma. The patient required a surgical obturator to restore anatomical defect post-hemimaxillectomy. Multidiscipline discussion forums were performed to determine the plan for tissue removal, and the prosthodontist designed the surgical obturator. The design was made utilizing the retention of the remaining 17 and 27 teeth with Adams claps. In this case, mechanical retention was achieved by a wire, which was attached to the zygoma bone. The artificial teeth were arranged in the anterior area to improve aesthetic, while in the posterior region, the artificial teeth were not used to minimize the masticatory loading. Surgical obturator improved the masticatory function and psychology of the patient.
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