Impact of mouthrinses on morning bad breath in healthy subjects

Background: During sleep, a proliferation of oral bacteria is responsible for the release of offending gases in morning breath even in healthy people. Thus, the aim of this study was to evaluate the bad breath‐inhibiting effect of four commercially available mouthrinses (0.03% triclosan, 0.12% chlor...

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Published inJournal of clinical periodontology Vol. 31; no. 2; pp. 85 - 90
Main Authors Carvalho, M. D., Tabchoury, C. M., Cury, J. A., Toledo, S., Nogueira-Filho, G. R.
Format Journal Article
LanguageEnglish
Published Oxford, UK Munksgaard International Publishers 01.02.2004
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Abstract Background: During sleep, a proliferation of oral bacteria is responsible for the release of offending gases in morning breath even in healthy people. Thus, the aim of this study was to evaluate the bad breath‐inhibiting effect of four commercially available mouthrinses (0.03% triclosan, 0.12% chlorhexidine gluconate, 0.05% cetylpyridinium chloride and essential oils) on morning breath when compared with a positive and a negative control. Method: A six‐step double‐blind, crossover, randomised study was conducted in 12 dental students with healthy periodontium, who refrained from mechanical plaque control during a 4‐day period. The subjects were instructed to rinse twice daily with the assigned product during each period. Fifteen‐day washout intervals were used. Before professional plaque and tongue coating removal (baseline), the morning breath was scored through volatile sulphur compounds (VSCs) level measured by a sulphide monitor. After 4 days, VSCs and plaque index (PI) were recorded. Results: Even in the absence of mechanical plaque control, there was a decrease in VSC level with the use of all mouthrinses, with the exception of an increase with the use of the negative control. The VSC formation was inhibited in descending order, by positive control (0.2% chlorhexidine), 0.12% chlorhexidine, triclosan and essential oils and cetylpyridinium chloride. Plaque formation was inhibited by chlorhexidine mouthrinses and essential oils. Conclusions: These findings suggest that mouthrinses can reduce morning bad breath, and that such a reduction is not attributable only to the reduction of supragingival plaque formation.
AbstractList Background: During sleep, a proliferation of oral bacteria is responsible for the release of offending gases in morning breath even in healthy people. Thus, the aim of this study was to evaluate the bad breath‐inhibiting effect of four commercially available mouthrinses (0.03% triclosan, 0.12% chlorhexidine gluconate, 0.05% cetylpyridinium chloride and essential oils) on morning breath when compared with a positive and a negative control. Method: A six‐step double‐blind, crossover, randomised study was conducted in 12 dental students with healthy periodontium, who refrained from mechanical plaque control during a 4‐day period. The subjects were instructed to rinse twice daily with the assigned product during each period. Fifteen‐day washout intervals were used. Before professional plaque and tongue coating removal (baseline), the morning breath was scored through volatile sulphur compounds (VSCs) level measured by a sulphide monitor. After 4 days, VSCs and plaque index (PI) were recorded. Results: Even in the absence of mechanical plaque control, there was a decrease in VSC level with the use of all mouthrinses, with the exception of an increase with the use of the negative control. The VSC formation was inhibited in descending order, by positive control (0.2% chlorhexidine), 0.12% chlorhexidine, triclosan and essential oils and cetylpyridinium chloride. Plaque formation was inhibited by chlorhexidine mouthrinses and essential oils. Conclusions: These findings suggest that mouthrinses can reduce morning bad breath, and that such a reduction is not attributable only to the reduction of supragingival plaque formation.
During sleep, a proliferation of oral bacteria is responsible for the release of offending gases in morning breath even in healthy people. Thus, the aim of this study was to evaluate the bad breath-inhibiting effect of four commercially available mouthrinses (0.03% triclosan, 0.12% chlorhexidine gluconate, 0.05% cetylpyridinium chloride and essential oils) on morning breath when compared with a positive and a negative control. A six-step double-blind, crossover, randomised study was conducted in 12 dental students with healthy periodontium, who refrained from mechanical plaque control during a 4-day period. The subjects were instructed to rinse twice daily with the assigned product during each period. Fifteen-day washout intervals were used. Before professional plaque and tongue coating removal (baseline), the morning breath was scored through volatile sulphur compounds (VSCs) level measured by a sulphide monitor. After 4 days, VSCs and plaque index (PI) were recorded. Even in the absence of mechanical plaque control, there was a decrease in VSC level with the use of all mouthrinses, with the exception of an increase with the use of the negative control. The VSC formation was inhibited in descending order, by positive control (0.2% chlorhexidine), 0.12% chlorhexidine, triclosan and essential oils and cetylpyridinium chloride. Plaque formation was inhibited by chlorhexidine mouthrinses and essential oils. These findings suggest that mouthrinses can reduce morning bad breath, and that such a reduction is not attributable only to the reduction of supragingival plaque formation.
Background: During sleep, a proliferation of oral bacteria is responsible for the release of offending gases in morning breath even in healthy people. Thus, the aim of this study was to evaluate the bad breath‐inhibiting effect of four commercially available mouthrinses (0.03% triclosan, 0.12% chlorhexidine gluconate, 0.05% cetylpyridinium chloride and essential oils) on morning breath when compared with a positive and a negative control. Method: A six‐step double‐blind, crossover, randomised study was conducted in 12 dental students with healthy periodontium, who refrained from mechanical plaque control during a 4‐day period. The subjects were instructed to rinse twice daily with the assigned product during each period. Fifteen‐day washout intervals were used. Before professional plaque and tongue coating removal (baseline), the morning breath was scored through volatile sulphur compounds (VSCs) level measured by a sulphide monitor. After 4 days, VSCs and plaque index (PI) were recorded. Results: Even in the absence of mechanical plaque control, there was a decrease in VSC level with the use of all mouthrinses, with the exception of an increase with the use of the negative control. The VSC formation was inhibited in descending order, by positive control (0.2% chlorhexidine), 0.12% chlorhexidine, triclosan and essential oils and cetylpyridinium chloride. Plaque formation was inhibited by chlorhexidine mouthrinses and essential oils. Conclusions: These findings suggest that mouthrinses can reduce morning bad breath, and that such a reduction is not attributable only to the reduction of supragingival plaque formation.
During sleep, a proliferation of oral bacteria is responsible for the release of offending gases in morning breath even in healthy people. Thus, the aim of this study was to evaluate the bad breath-inhibiting effect of four commercially available mouthrinses (0.03% triclosan, 0.12% chlorhexidine gluconate, 0.05% cetylpyridinium chloride and essential oils) on morning breath when compared with a positive and a negative control.BACKGROUNDDuring sleep, a proliferation of oral bacteria is responsible for the release of offending gases in morning breath even in healthy people. Thus, the aim of this study was to evaluate the bad breath-inhibiting effect of four commercially available mouthrinses (0.03% triclosan, 0.12% chlorhexidine gluconate, 0.05% cetylpyridinium chloride and essential oils) on morning breath when compared with a positive and a negative control.A six-step double-blind, crossover, randomised study was conducted in 12 dental students with healthy periodontium, who refrained from mechanical plaque control during a 4-day period. The subjects were instructed to rinse twice daily with the assigned product during each period. Fifteen-day washout intervals were used. Before professional plaque and tongue coating removal (baseline), the morning breath was scored through volatile sulphur compounds (VSCs) level measured by a sulphide monitor. After 4 days, VSCs and plaque index (PI) were recorded.METHODA six-step double-blind, crossover, randomised study was conducted in 12 dental students with healthy periodontium, who refrained from mechanical plaque control during a 4-day period. The subjects were instructed to rinse twice daily with the assigned product during each period. Fifteen-day washout intervals were used. Before professional plaque and tongue coating removal (baseline), the morning breath was scored through volatile sulphur compounds (VSCs) level measured by a sulphide monitor. After 4 days, VSCs and plaque index (PI) were recorded.Even in the absence of mechanical plaque control, there was a decrease in VSC level with the use of all mouthrinses, with the exception of an increase with the use of the negative control. The VSC formation was inhibited in descending order, by positive control (0.2% chlorhexidine), 0.12% chlorhexidine, triclosan and essential oils and cetylpyridinium chloride. Plaque formation was inhibited by chlorhexidine mouthrinses and essential oils.RESULTSEven in the absence of mechanical plaque control, there was a decrease in VSC level with the use of all mouthrinses, with the exception of an increase with the use of the negative control. The VSC formation was inhibited in descending order, by positive control (0.2% chlorhexidine), 0.12% chlorhexidine, triclosan and essential oils and cetylpyridinium chloride. Plaque formation was inhibited by chlorhexidine mouthrinses and essential oils.These findings suggest that mouthrinses can reduce morning bad breath, and that such a reduction is not attributable only to the reduction of supragingival plaque formation.CONCLUSIONSThese findings suggest that mouthrinses can reduce morning bad breath, and that such a reduction is not attributable only to the reduction of supragingival plaque formation.
Author Toledo, S.
Tabchoury, C. M.
Nogueira-Filho, G. R.
Cury, J. A.
Carvalho, M. D.
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/15016031$$D View this record in MEDLINE/PubMed
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Wáler, S. M. (1997b) The effect of some metal ions on volatile sulfur-containing compounds originating from the oral cavity. Acta Odontolgica Scandinavica 55, 261-264.
Nogueira-Filho, G. R., Toledo, S. & Cury, J. A. (2000) Effect of 3 dentifrices containing triclosan and various additives: an experimental gingivitis study. Journal of Clinical Periodontology 27, 494-498.
Addy, M. & Wade, W. (1995) An approach to efficacy screening of mouthrinses: studies on a group of French products. (I) Staining and antimicrobial properties in vitro. Journal of Clinical Periodontology 22, 718-722.
Kleinberg, I. & Westbay, G. (1990) Oral malodor. Critical Reviews in Oral Biology and Medicine 1, 247-259.
Tonzetich, J. (1976) Chromatographic separation of methionine, methionine sulphoxide, methionine sulphone, and their products of oral microbial metabolism. Annals Biochemistry 73, 290-300.
Van Steenberghe, D. (1997) Breath malodour. Current Opinion in Periodontology 4, 137-143.
Van Steenberghe, D., Avontroodt, P., Peeters, W., Pauwels, M., Coucke, W., Lijenen, A. & Quirynen, M. (2001) Effect of different mouthrinses on morning breath. Journal of Periodontology 72, 1183-1191.
Shapiro, S., Giertsen, E. & Guggenheim, B. (2002) An in vitro oral biofilm model for comparing the efficacy of antimicrobial mouthrinses. Caries Research 36, 93-100.
Kozlovsky, A., Gordon, D., Gelernter, I., Loesche, W. J. & Rosenberg, M. (1994) Correlation between the BANA test and oral malodor parameters. Journal of Dental Research 73, 1036-1042.
Sharma, N. C., Galustians, H. J., Oaquish, J., Galustians, A., Rustogi, K. N., Petrone, M. E., Chaknis, P., Garcia, L., Volpe, A. R. & Proskin, H. M. (1999) The clinical effectiveness of a dentifrice containing triclosan and a copolymer for controlling breath odor measured organoleptically twelve hours after toothbrushing. Journal of Clinical Dentistry 10, 131-134.
Wennström, J. L. (1988) Mouthrinses in "experimental gingivitis" studies. Journal of Clinical Periodontology 15, 511-516.
Schmidt, N. D. & Tarbet, W. J. (1978) The effect of oral rinses on organoleptic mouth odor ratings and levels of volatile sulfur compounds. Oral Surgery Oral Medicine Oral Pathology 45, 876-883.
Neiders, M. & Ramos, B. (1999) Operation of bad breath clinics. Quintessence International 30, 295-301.
Jenkins, S., Addy, M. & Newcombe, R. (1991) Triclosan and sodium lauryl sulphate mouthrinses. (II). Effects of 4-day plaque regrowth. Journal of Clinical Periodontology 18, 145-148.
Riep, B. G., Bernimoulin, J. P. & Barnett, M. L. (1999) Comparative antiplaque effectiveness of an essential oil and an amine fluoride/stannous fluoride mouthrinse. Journal of Clinical Periodontology 26, 164-168.
Rosenberg, M. (1996) Clinical assessment of bad breath: current concepts. Journal of the American Dental Association 127, 475-482.
Rosenberg, M. (1995) Bad breath: diagnosis and management. Harefuah 128, 513-516.
Axelsson, P. & Lindhe, J. (1987) Efficacy of mouthrinses in inhibiting dental plaque and gingivitis in man. Journal of Clinical Periodontology 14, 205-212.
Loesche, W. J. (1999) The effects of antimicrobial mouthrinses on oral malodor and their status relative to US Food and Drug Administration regulations. Quintessence International 30, 311-318.
Kornman, K. (1986) The microbiologic etiology of periodontal disease. Compendium of Continuing Education in Dentistry (Suppl. No.7), S173-175, S178.
Simonson, L. G., Goodman, C. H., Bial, J. J. & Morton, H. E. (1988) Quantitative relationship of Treponema denticola to severity of periodontal disease. Infectology and Immunology 56, 726-728.
Rosenberg, M., Septon, I., Eli, I., Brenner, S., Gelernter, I. & Gabbay, J. (1991b) Halitosis measurement by an industrial sulphide monitor. Journal of Periodontology 62, 487-489.
Dever, J. G. (1979) Oral hygiene in mentally handicapped children. A clinical trial using a chlorhexidine spray. Australian Dental Journal 24, 301-305.
Binney, A., Addy, M., McKeown, S. & Everatt, L. (1995) The effect of a commercially available triclosan-containing toothpaste compared to a sodium-fluoride-containing toothpaste and a chlorhexidine rinse on 4-day plaque regrowth. Journal of Clinical Periodontology 22, 830-834.
Young, A. R., Jonski, G., Rola, G. & Wáler, S. M. (2001) Effects of metal salts on the oral production of volatile sulfur-containing compounds (VSC). Journal of Clinical Periodontology 28, 776-781.
Talbott, K., Mandel, I. D. & Chilton, N. W. (1977) Reduction of baseline gingivitis scores with repeated prophylaxes. Journal of Preventive Dentistry 4, 28-29.
Persson, S. (1992) Hydrogen sulfide and methyl mercaptan in periodontal pockets. Oral Microbiology and Immunology 7, 378-379.
Addy, M., Willis, L. & Moran, J. (1983) Effect of toothpaste rinses compared with chlorhexidine on plaque formation during a 4-day period. Journal of Clinical Periodontology 10, 89-99.
Rosenberg, M., Gelernter, I., Barki, M. & Bar-Ness, R. (1992) Day-long reduction of oral malodor by a two-phase oil: water mouthrinse as compared to chlorhexidine and placebo rinses. Journal of Periodontology 63, 39-43.
Tonzetich, J. (1973) Oral malodor: an indicator of breath status and oral cleanliness. International Journal of Dentistry 28, 309-319.
Pitts, G., Gorgdon, C., Hu, L., Masurat, T., Pianotti, R. & Schumann, P. (1983) Mechanism of action of an antiseptic, anti-odor mouthwash. Journal of Dentistry Research 62, 738-742.
Silness, J. & Löe, H. (1964) Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontologica Scandinavica 22, 121-135.
Hull, P. S. (1980) Chemical inhibition of plaque. Journal of Clinical Periodontology 7, 431-442.
Niles, H. P., Vazquez, J., Rustogi, K. N., Williams, M., Gaffar, A. & Proskin, H. M. (1999) The clinical effectiveness of a dentifrice containing triclosan and a copolymer for providing long-term control of breath odor measured chromatographically. Journal of Clinical Dentistry 10, 135-138.
Yaegaki, K. & Suetaka, T. (1989) The effect of mouthwash on oral malodour production. Shigaku 76, 1492-1500.
Tonzetich, J. (1977) Production and origin of oral malodour: a review of mechanisms and methods of analysis. Journal of Periodontology 48, 13-20.
Delanghe, G., Ghyselen, J., Bollen, C., Van Steenberghe, D., Vandekerckhove, B. N. & Feenstra, L. (1999) An inventory of patients' response to treatment at a multidisciplinary breath odor clinic. Quintessence International 30, 307-310.
Rosenberg, M. (1992) Halitosis - the need for further research and education. Journal of Dental Research 71, 424.
Kozlovsky, A., Goldberg, S., Natour, I., Rogatky-Gat, A., Gelernter, I. & Rosenberg, M. (1996) Efficacy of a 2-phase oil: water mouthrinse in controlling oral malodour, gingivitis, and plaque. Journal of Periodontology 67, 577-582.
Miyazaki, H., Sakao, S., Katoh, Y. & Takehara, T. (1995) Correlation between volatile sulphur compounds and certain oral health measurements in the general population. Journal of Periodontology 66, 679-684.
Nachnani, S. (1997) The effects of oral rinses on halitosis. Journal California Dental Association 25, 145-150.
Addy, M. (1986) Chlorhexidine compared with other locally delivered antimicrobials. A short review. Journal of Clinical Periodontology 13, 957-964.
Ciancio, S. G. (1995) Chemical agents: plaque control, calculus reduction and treatment of dentinal hypersensitivity. Periodontology 2000 8, 75-86.
Bosy, A. & Geller, J. (1996) Oral Malodour-clearing the air. Alpha Omegan 89, 25-28.
Coli, J. M. & Tonzetich, J. (1992) Characterization of volatile sulphur compounds production at individual gingival crevicular sites in humans. Journal of Clinical Dentistry 3, 97-103.
Ratcliff, P. A. & Johnson, P. W. (1999) The relationship between oral malodor, gingivitis, and periodontitis. A Review. Journal of Periodontology 70, 485-489.
Delanghe, G., Ghyselen, J., Van Steenberghe, D. & Feenstra, L. (1997) Multidisciplinary breath-odour clinic. Lancet 350, 187.
Nogueira-Filho, G. R., Duarte, P. M., Toledo, S., Tabchoury, C. P. M. & Cury, J. A. (2002) Effect of triclosan dentifrices on mouth volatile sulphur compounds and dental plaque trypsin-like activity during experimental gingivitis development. Journal of Clinical Periodontology 29, 1059-1064.
Yaegaki, K. & San
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References_xml – reference: Dever, J. G. (1979) Oral hygiene in mentally handicapped children. A clinical trial using a chlorhexidine spray. Australian Dental Journal 24, 301-305.
– reference: Sharma, N. C., Galustians, H. J., Oaquish, J., Galustians, A., Rustogi, K. N., Petrone, M. E., Chaknis, P., Garcia, L., Volpe, A. R. & Proskin, H. M. (1999) The clinical effectiveness of a dentifrice containing triclosan and a copolymer for controlling breath odor measured organoleptically twelve hours after toothbrushing. Journal of Clinical Dentistry 10, 131-134.
– reference: Mandel, I. D. (1988) Chemotherapeutic agents for controlling plaque and gingivitis. Journal of Clinical Periodontology 15, 488-498.
– reference: Van Steenberghe, D. (1997) Breath malodour. Current Opinion in Periodontology 4, 137-143.
– reference: Ciancio, S. G. (1995) Chemical agents: plaque control, calculus reduction and treatment of dentinal hypersensitivity. Periodontology 2000 8, 75-86.
– reference: Young, A. R., Jonski, G., Rola, G. & Wáler, S. M. (2001) Effects of metal salts on the oral production of volatile sulfur-containing compounds (VSC). Journal of Clinical Periodontology 28, 776-781.
– reference: Kozlovsky, A., Gordon, D., Gelernter, I., Loesche, W. J. & Rosenberg, M. (1994) Correlation between the BANA test and oral malodor parameters. Journal of Dental Research 73, 1036-1042.
– reference: Rosenberg, M. (1995) Bad breath: diagnosis and management. Harefuah 128, 513-516.
– reference: Neiders, M. & Ramos, B. (1999) Operation of bad breath clinics. Quintessence International 30, 295-301.
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– reference: Simonson, L. G., Goodman, C. H., Bial, J. J. & Morton, H. E. (1988) Quantitative relationship of Treponema denticola to severity of periodontal disease. Infectology and Immunology 56, 726-728.
– reference: Loesche, W. J. (1999) The effects of antimicrobial mouthrinses on oral malodor and their status relative to US Food and Drug Administration regulations. Quintessence International 30, 311-318.
– reference: Miyazaki, H., Sakao, S., Katoh, Y. & Takehara, T. (1995) Correlation between volatile sulphur compounds and certain oral health measurements in the general population. Journal of Periodontology 66, 679-684.
– reference: Silness, J. & Löe, H. (1964) Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontologica Scandinavica 22, 121-135.
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  article-title: Chromatographic separation of methionine, methionine sulphoxide, methionine sulphone, and their products of oral microbial metabolism
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  year: 1992
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  article-title: Biochemical and clinical factors influencing oral malodor in periodontal patients
  publication-title: Journal of Periodontology
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  year: 1996
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  article-title: Clinical assessment of bad breath
  publication-title: Journal of the American Dental Association
– volume: 28
  start-page: 309
  year: 1973
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  article-title: Oral malodor
  publication-title: International Journal of Dentistry
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  start-page: 776
  year: 2001
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  article-title: Effects of metal salts on the oral production of volatile sulfur‐containing compounds (VSC)
  publication-title: Journal of Clinical Periodontology
– start-page: 3
  year: 1996
  end-page: 14
– volume: 71
  start-page: 424
  year: 1992
  article-title: Halitosis – the need for further research and education
  publication-title: Journal of Dental Research
– volume: 65
  start-page: 37
  year: 1994
  end-page: 46
  article-title: Relationship of oral malodor to periodontitis
  publication-title: Journal of Periodontology
– volume: 23
  start-page: 289
  year: 1978
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  article-title: A comparison between chlorhexidine and some quaternary ammonium compounds with regard to retention, salivary concentration and plaque‐inhibiting effect in the human mouth after mouth rinses
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Snippet Background: During sleep, a proliferation of oral bacteria is responsible for the release of offending gases in morning breath even in healthy people. Thus,...
Background: During sleep, a proliferation of oral bacteria is responsible for the release of offending gases in morning breath even in healthy people. Thus,...
During sleep, a proliferation of oral bacteria is responsible for the release of offending gases in morning breath even in healthy people. Thus, the aim of...
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StartPage 85
SubjectTerms Adult
Anti-Infective Agents, Local - therapeutic use
Cetylpyridinium - therapeutic use
Chlorhexidine - analogs & derivatives
Chlorhexidine - therapeutic use
clinical trial
Cross-Over Studies
Dental Plaque - prevention & control
Dental Plaque Index
Double-Blind Method
Female
Halitosis - metabolism
Halitosis - prevention & control
Humans
Male
morning breath
mouthrinses
Mouthwashes - therapeutic use
Oils, Volatile - therapeutic use
Sulfides - analysis
Sulfur Compounds - analysis
Triclosan - therapeutic use
VSC
Title Impact of mouthrinses on morning bad breath in healthy subjects
URI https://api.istex.fr/ark:/67375/WNG-VL79TCMK-1/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.0303-6979.2004.00452.x
https://www.ncbi.nlm.nih.gov/pubmed/15016031
https://www.proquest.com/docview/71741533
Volume 31
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