Combination of strontium chloride and photobiomodulation in the control of tooth sensitivity post-bleaching: A split-mouth randomized clinical trial

Danielle da Silva Pompeu, Brennda Lucy Freitas de Paula, Antônia Patricia Oliveira Barros, Samir Costa Nunes, Alexandra Melo Pingarilho Carneiro, Jesuína Lamartine Nogueira Araújo, Cecy Martins Silva, Danielle da Silva Pompeu, Brennda Lucy Freitas de Paula, Antônia Patricia Oliveira Barros, Samir Costa Nunes, Alexandra Melo Pingarilho Carneiro, Jesuína Lamartine Nogueira Araújo, Cecy Martins Silva

Abstract

Objective: This split-mouth randomized controlled clinical trial assessed the effect of 10% strontium chloride in combination with photobiomodulation (PBM) for the control of tooth sensitivity (TS) post-bleaching.

Methods: The upper/lower, right and left quadrants of fifty volunteers were randomized and allocated to four groups (n = 25): PLACEBO-placebo gel + simulation of PBM; Placebo + PBM; STRONTIUM-10% strontium chloride + simulation of PBM; and PBM + STRONTIUM-10% strontium chloride + PBM. All groups received tooth bleaching treatment with 35% hydrogen peroxide. For the PBM treatment, the laser tip was positioned in the apical and cervical regions of the teeth bleached in the respective hemi-arch. The laser system was operated in continuous mode, using 1.7 J of energy. A dose of 60 J/cm2 was applied to each point for 16 seconds under 808 nm near-infrared light (100mW of power), with a point area of 0.028 cm2. TS was assessed during a 21-day follow-up, using the modified visual analogue scale.

Results: In the intragroup assessment, the Friedman test indicated that PBM + STRONTIUM promoted the greatest reduction in TS after the second week of treatment (p ≤ 0.05). The Wilcoxon-Mann-Whitney test indicated that the groups Placebo + PBM, STRONTIUM, and STRONTIUM + PBM did not differ statistically (p ≥ 0.05) in the first and third weeks of treatment The group PLACEBO exhibited the greatest TS in the first three days after each bleaching session.

Conclusion: The combination of 10% strontium chloride with PBM was effective in reducing post-bleaching TS; however, the combination of 10% strontium chloride with PBM was effective in reducing post-bleaching TS; however, it did not differ from the individual use of Placebo + PBM or STRONTIUM groups assessed after 21 days of follow-up.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Flow diagram showing patient recruitment…
Fig 1. Flow diagram showing patient recruitment and follow-up.
Adapted from the CONSORT flow diagram.

References

    1. Kwon SR, Wertz PW. Review of the mechanism of tooth whitening. J Esthet Restor Dent. 2015; 27(5): 240–257. 10.1111/jerd.12152
    1. Cardenas AFM, Maran BM, Araújo LCR, de Siqueira FSF, Wambier LM, Gonzaga CC, et al.. Are combined bleaching techniques better than their sole application? A systematic review and meta-analysis. Clin Oral Investig. 2019; 23(10): 3673–3689. 10.1007/s00784-019-03042-4
    1. Bortolatto J, Pretel H, Floros M, Luizzi A, Dantas A, Fernandez E, et al.. Low concentration H2O2/TiO_N in office bleaching: A randomized clinical trial. J Dent Res. 2014; 93(7): 66S–71S. 10.1177/0022034514537466
    1. Kothari S, Gray AR, Lyons K, Wen Tan X, Brunton PA. Vital bleaching and oral-health-related quality of life in adults: A systematic review and meta-analysis. J Dent. 2019; 84: 22–29. 10.1016/j.jdent.2019.03.007
    1. Lin KY, Chung CH, Ciou JS, Su PF, Wang PW, Shieh DB, et al.. Molecular damage and responses of oral keratinocyte to hydrogen peroxide. BMC Oral Health. 2019; 19(1): 10. 10.1186/s12903-018-0694-0
    1. Park HJ, Kwon TY, Nam SH, Kim HJ, Kim KH, Kim YJ. Changes in bovine enamel after treatment with a 30% hydrogen peroxide bleaching agent. Dent Mater J. 2004; 23: 517–521. 10.4012/dmj.23.517
    1. Soares DG, Basso FG, Hebling J, de Souza Costa CA. Concentrations of and application protocols for hydrogen peroxide bleaching gels: effects on pulp cell viability and whitening efficacy. J Dent. 2014; 42(2): 185–198. 10.1016/j.jdent.2013.10.021
    1. De Souza Costa CA, Riehl H, Kina JF, Sacono NT, Hebling J. Human pulp responses to in-office tooth bleaching. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109(4): e59–e64. 10.1016/j.tripleo.2009.12.002
    1. da Costa Poubel LA, de Gouvea CVD, Calazans FS, Dip EC, Alves WV, Marins SS, et al.. Pre-operative use of dexamethasone does not reduce incidence or intensity of bleaching-induced tooth sensitivity. A triple-blind, parallel-design, randomized clinical trial. Clin Oral Investig. 2019; 23(1): 435–444. 10.1007/s00784-018-2452-8
    1. Wang Y, Gao J, Jiang T, Liang S, Zhou Y, Matis BA. Evaluation of the efficacy of potassium nitrate and sodium fluoride as desensitizing agents during tooth bleaching treatment—A systematic review and meta-analysis. J Dent. 2015; 43(8): 913–923. 10.1016/j.jdent.2015.03.015
    1. Rezende M, Loguercio AD, Kossatz S, Reis A. Predictive factors on the efficacy and risk/intensity of tooth sensitivity of dental bleaching: A multi regression and logistic analysis. J Dent. 2016; 45: 1–6. 10.1016/j.jdent.2015.11.003
    1. Nanjundasetty JK, Ashrafulla M. Efficacy of desensitizing agents on postoperative sensitivity following an in-office vital tooth bleaching: A randomized controlled clinical trial. J Conserv Dent. 2016; 19(3): 207–211. 10.4103/0972-0707.181927
    1. Martins LM, Lima E Souza LA, Sutil E, da Silva LM, Silva J, Reis A, et al.. Clinical Effects of Desensitizing Prefilled Disposable Trays in In-office Bleaching: A Randomized Single-blind Clinical Trial. Oper Dent. 2020; 45(1): E1–E10. 10.2341/18-149-C
    1. Mehta D, Venkata S, Naganath M, LingaReddy U, Ishihata H, Finger WJ. Clinical trial of tooth desensitization prior to in-office bleaching. Eur J Oral Sci. 2013; 121(5): 477–481. 10.1111/eos.12067
    1. Pierote JJA, Prieto LT, Dias CTDS, CÂmara JVF, Lima DANL, Aguiar FHB, et al.. Effects of desensitizing products on the reduction of pain sensitivity caused by in-office tooth bleaching: a 24-week follow-up. J Appl Oral Sci. 2020; 28: e20190755. 10.1590/1678-7757-2019-0755
    1. Silva RC, Alencar CM, Silva BHRE, Paula BLF, Barros APO, Silveira ADS, et al.. A clinical, randomized, double-blind study on the use of nano-hydroxyapatite and arginine during at-home tooth bleaching. J Clin Diagn Res. 2018; 12(12): ZC01–ZC05. 10.7860/JCDR/2018/37325.12340
    1. Markowitz K, Kim S. The role of selected cations in the desensitization of intradental nerves. Proc Finn Dent Soc. 1992; 88 (1): 39–54. .
    1. Low SB, Allen EP, Kontogiorgos ED. Reduction in dental hypersensitivity with nano-hydroxyapatite, potassium nitrate, sodium monoflurophosphate and antioxidants. Open Dent J. 2015; 9: 92–97. 10.2174/1874364101509010092
    1. de Paula B, Alencar C, Ortiz M, Couto R, Araújo J, Silva C. Effect of photobiomodulation with low-level laser therapy combined with potassium nitrate on controlling post-bleaching tooth sensitivity: clinical, randomized, controlled, double-blind, and split-mouth study. Clin Oral Investig. 2019; 23(6): 2723–2732. 10.1007/s00784-018-2715-4
    1. Alencar CM, De Paula BLF, Araújo JLN, Alves EB, De Albuquerque Jassé FF, Silva CM. Effect of low-level laser therapy combined with 5000 parts per million fluoride dentifrice on post-bleaching sensitivity: A clinical, randomized, and double-blind study. J Esthet Restor Dent. 2018; 30(4): 352–359. 10.1111/jerd.12386
    1. Moosavi H, Arjmand N, Ahrari F, Zakeri M, Maleknejad F. Effect of low-level laser therapy on tooth sensitivity induced by in-office bleaching. Lasers Med Sci. 2016; 31: 713–719. 10.1007/s10103-016-1913-z
    1. Wakabayashi H, Hamba M, Matsumoto K, Tachibana H. Effect of irradiation by semiconductor laser on responses evoked in trigeminal caudal neurons by tooth pulp stimulation. Lasers Surg Med. 1993; 13(6): 605–610. 10.1002/lsm.1900130603
    1. Favaro–Pipi E, Ribeiro DA, Ribeiro JU, Bossini P, Oliveira P, Parizotto NA, et al.. Low level laser therapy induces differential expression of osteogenic genes during bone repair in rats. Photomed Laser Surg. 2011; 29(5): 311–317. 10.1089/pho.2010.2841
    1. Silveira PC, Silva LA, Freitas TP, Latini A, Pinho RA. Effects of low-power laser irradiation (LPLI) at different wavelengths and doses on oxidative stress and fibrogenesis parameters in an animal model of wound healing. Lasers Med Sci. 2011; 26(1): 125–131. 10.1007/s10103-010-0839-0
    1. Kimura Y, Wilder-Smith P, Yonaga K, Matsumoto K. Treatment of dentine hypersensitivity by lasers: a review. J Clin Periodontol. 2000; 27(10): 715–721. 10.1034/j.1600-051x.2000.027010715.x
    1. Tay LY, Kose C, Loguercio AD, Reis A. Assessing the effect of a desensitizing agent used before in-office tooth bleaching. J Am Dent Assoc. 2009; 140(10): 1245–1251. 10.14219/jada.archive.2009.0047
    1. Mushashe AM, Coelho BS, Garcia PP, Rechia BN, da Cunha LF, Correr GM, et al.. Effect of different bleaching protocols on whitening efficiency and enamel superficial microhardness. J Clin Exp Dent. 2018; 10(8): e772–e775. 10.4317/jced.54967
    1. Yang Z, Zou M, Lin X, Yang X, Li N, Wang K. Novel method to measure enamel surface porosity with hydrogen peroxide bleaching. Am J Dent. 2009; 22(5): 283–9. .
    1. Soares DG, Ribeiro AP, Lima AF, Sacono NT, Hebling J, de Souza Costa CA. Effect of fluoride-treated enamel on indirect cytotoxicity of a 16% carbamide peroxide bleaching gel to pulp cells. Braz Dent J. 2013; 24(2): 121–127. 10.1590/0103-6440201302161
    1. de Melo Alencar C, Castro da Silva R, Nogueira Araújo JL, Silva da Silveira AD, Martins Silva C. A clinical, randomized, double-blind study on the use of toothpastes immediately after at-home tooth bleaching. Am J Dent. 2017; 30(5): 267–271. .
    1. Kobler A, Kub O, Schaller HG, Gernhardt CR. Clinical effectiveness of a strontium chloride- containing desensitizing agent over 6 months: a randomized, double-blind, placebo-controlled study. Quintessence Int. 2008; 39(4): 321–5. .
    1. Turner L, Shamseer L, Altman DG, Weeks L, Peters J, Kober T, et al.. Consolidated standards of reporting trials (CONSORT) and the completeness of reporting of randomized controlled trials (RCTs) published in medical journals. Cochrane Database Syst Rev. 2012; 14(11): MR000030. 10.1002/14651858.MR000030.pub2
    1. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013; 27: 2191–2194. 10.1001/jama.2013.281053
    1. Gerritsen AE, Allen PF, Witter DJ, Bronkhorst EM, Creugers NH. Tooth loss and oral health-related quality of life: a systematic review and meta-analysis. Health Qual Life Outcomes. 2010; 8: 126. 10.1186/1477-7525-8-126
    1. Reis A, Tay LY, Herrera DR, Kossatz S, Loguercio AD. Clinical effects of prolonged application time of an in-office bleaching gel. Oper Dent. 2011; 36(6): 590–596. 10.2341/10-173-C
    1. Pedreira De Freitas AC, Botta SB, Teixeira F de S, Salvadori MC, Garone-Netto N. Effects of fluoride or nanohydroxiapatite on roughness and gloss of bleached teeth. Microsc Res Tech. 2011; 74(12): 1069–1075. 10.1002/jemt.20996
    1. Espíndola-Castro LF, Celerino PRRP, Nascimento TA, Monteiro GQM, Correia TC. Evaluation of the effect of tooth polishing on color stability after in-office bleaching treatment. Rev Odontol UNESP. 2020; 49: e20200023. 10.1590/1807-2577.02320
    1. Kielbassa AM, Maier M, Gieren AK, Eliav E. Tooth sensitivity during and after vital tooth bleaching: A systematic review on an unsolved problem. Quintessence Int. 2015; 46(10): 881–97. 10.3290/j.qi.a34700
    1. Parreiras SO, Szesz AL, Coppla FM, Martini EC, Farago PV, Loguercio AD, et al.. Effect of an experimental desensitizing agent on reduction of bleaching-induced tooth sensitivity: A triple-blind randomized clinical trial. J Am Dent Assoc. 2018; 149(4): 281–290. 10.1016/j.adaj.2017.10.025
    1. Lesaffre E, Philstrom B, Needleman I, Worthington H. The design and analysis of split-mouth studies: what statisticians and clinicians should know. Stat Med. 2009; 28(28): 3470–3482. 10.1002/sim.3634
    1. Martini EC, Parreiras SO, Szesz AL, Coppla FM, Loguercio AD, Reis A. Bleaching-induced tooth sensitivity with application of a desensitizing gel before and after in-office bleaching: a triple-blind randomized clinical trial. Clin Oral Investig. 2020; 24(1): 385–394. 10.1007/s00784-019-02942-9
    1. Pihlstrom BL, Barnett ML. Design, operation, and interpretation of Clinical Trials. J Dent Res. 2010; 89(8): 759–772. 10.1177/0022034510374737
    1. Mussttaf RA, Jenkins DFL, Jha AN. Assessing the impact of low level laser therapy (LLLT) on biological systems: a review. Int J Radiat Biol. 2019; 1–24. 10.1080/09553002.2019.1524944
    1. Sommer AP. Revisiting the Photon/Cell Interaction Mechanism in Low-Level Light Therapy. Photobiomodul Photomed Laser Surg. 2019; 37(6): 336–341. 10.1089/photob.2018.4606
    1. Gibson M, Sharif MO, Smith A, Saini P, Brunton PA. A practice-based randomised controlled trial of the efficacy of three interventions to reduce dentinal hypersensitivity. J Dent. 2013; 41(8): 668–674. 10.1016/j.jdent.2013.06.003
    1. Mehta D, Jyothi S, Moogi P, Finger WJ, Sasaki K. Novel treatment of in-office tooth bleaching sensitivity: a randomized, placebo-controlled clinical study. J Esthet Restor Dent. 2018; 30(3): 254–258. 10.1111/jerd.12374
    1. Bender I. Pulpal Pain Diagnosis—A Review. J Endod. 2000; 26(3), 175–179. 10.1097/00004770-200003000-00012
    1. White M. Mediators of inflammation and the inflammatory process. J Allergy Clin Immunol. 1999; 103(3): S378–S381. 10.1016/s0091-6749(99)70215-0
    1. De Oliveira Duque CC, Soares DG, Basso FG, Hebling J, de Souza Costa CA. Influence of enamel/dentin thickness on the toxic and esthetic effects of experimental in-office bleaching protocols. Clin Oral Investig. 2017; 21(8): 2509–2520. 10.1007/s00784-017-2049-7
    1. Durgalakshmi D, Ajay Rakkesh R, Kesavan M, Ganapathy S, Ajithkumar TG, Karthikeyan S, et al.. Highly reactive crystalline-phase-embedded strontium-bioactive nanorods for multimodal bioactive applications. Biomater Sci. 2018; 6(7): 1764–1776. 10.1039/c8bm00362a
    1. Saeki K, Marshall GW, Gansky SA, Parkinson CR, Marshall SJ. Strontium effects on root dentin tubule occlusion and nanomechanical properties. Dent Mater. 2016; 32(2): 240–251. 10.1016/j.dental.2015.11.020
    1. Huang M, Hill RG, Rawlinson SC. Strontium (Sr) elicits odontogenic differentiation of human dental pulp stem cells (hDPSCs): a therapeutic role for Sr in dentine repair? Acta Biomater. 2016; 38: 201–211. 10.1016/j.actbio.2016.04.037
    1. Sato C, Rodrigues FA, Garcia DM, Vidal CM, Pashley DH, Tjäderhane L, et al.. Tooth bleaching increases dentinal protease activity. J Dent Res. 2013; 92(2): 187–192. 10.1177/0022034512470831
    1. Cavalli V, Arrais CA, Giannini M, Ambrosano GM. High-concentrated carbamide peroxide bleaching agents effects on enamel surface. J Oral Rehabil. 2004; 31(2): 155–159. 10.1111/j.1365-2842.2004.01138.x
    1. Bistey T, Nagy IP, Simó A, Hegedus C. In vitro FT-IR study of the effects of hydrogen peroxide on superficial tooth enamel. J Dent. 2007; 35(4): 325–330. 10.1016/j.jdent.2006.10.004
    1. Byers MR, Dong WK. Autoradiographic location of sensory nerve endings in dentin of monkey teeth. Anat Rec. 1983; 205(4): 441–454. 10.1002/ar.1092050409
    1. Rezende M, De Geus JL, Loguercio AD, Reis A, Kossatz D. Clinical evaluation of genotoxicity of in-office bleaching. Oper Dent. 2016; 41(6): 578–586. 10.2341/15-207-C
    1. Dedhiya MG, Young F, Higuchi WI. Mechanism for the retardation of the acid dissolution rate of hydroxapatite by strontium. J Dent Res. 1973; 52(5): 1097–1109. 10.1177/00220345730520051901
    1. Ross MR: Hypersensitive teeth: effect of strontium chloride in a compatible dentifrice. J Periodontol 1961; 32: 49–53. 10.1902/jop.1961.32.1.49
    1. Majji P, Murthy KR. Clinical efficacy of four interventions in the reduction of dentinal hypersensitivity: A 2-month study. Indian J Dent Res. 2016; 27(5): 477–482. 10.4103/0970-9290.195618
    1. Nammour S, Zeinoun T, Namour A, Vanheusden A, Vescovi P. Evaluation of Different Laser-Supported Surgical Protocols for the Treatment of Oral Leukoplakia: A Long-Term Follow-Up. Photomed Laser Surg. 2017; 35(11): 629–638. 10.1089/pho.2016.4256
    1. Vitale MC, Sfondrini MF, Croci GA, Paulli M, Carbone L, Gandini P, et al.. Diode Laser-Assisted Surgical Therapy for Early Treatment of Oral Mucocele in a Newborn Patient: Case Report and Procedures Checklist. Case Rep Dent. 2018; 2018: 3048429. 10.1155/2018/3048429
    1. Sfondrini MF, Calderoni G, Vitale MC, Gandini P, Scribante A. Is laser conditioning a valid alternative to conventional etching for aesthetic brackets? Eur J Paediatr Dent. 2018; 19(1): 61–66. 10.23804/ejpd.2018.19.01.11
    1. Rezazadeh F, Dehghanian P, Jafarpour D. Laser effects on the prevention and treatment of dentinal hypersensitivity: a systematic review. J Lasers Med Sci. 2019; 10(1): 1–11. 10.15171/jlms.2019.01
    1. Anders JJ, Lanzafame RJ, Arany PR. Low-Level Light/Laser Therapy Versus Photobiomodulation Therapy. Photomed Laser Surg. 2015; 33(4): 183–184. 10.1089/pho.2015.9848
    1. Hamblin MR. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophys. 2017; 4(3): 337–361. 10.3934/biophy.2017.3.337
    1. Frozanfar A, Ramezani M, Rahpeyma A, Khajehahmadi S, Arbab HR. The effects of low level laser therapy on the expression of collagen type I gene and proliferation of human gingival fibroblasts (Hgf3-Pi 53): in vitro study. Iran J Basic Med Sci. 2014; 16(10): 1071–4. .
    1. De Freitas LF, Hamblin MR. Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy. IEEE J Sel Top Quantum Electron. 2016; 22(3): 7000417. 10.1109/JSTQE.2016.2561201
    1. Fonseca AS, Moreira TO, Paixão DL, Farias FM, Guimarães OR, de Paoli S, et al.. Effect of laser therapy on DNA damage. Lasers Surg Med. 2010; 42(6): 481–488. 10.1002/lsm.20921
    1. Passarella S, Karu T. Absorption of monochromatic and narrow band radiation in the visible and near IR by both mitochondrial and non-mitochondrial photoacceptors results in photobiomodulation. J Photochem Photobiol B. 2014; 140: 344–358. 10.1016/j.jphotobiol.2014.07.021
    1. Keshri GK, Gupta A, Yadav A, Sharma SK, Singh SB. Photobiomodulation with Pulsed and Continuous Wave Near-Infrared Laser (810 nm, Al-Ga-As) Augments Dermal Wound Healing in Immunosuppressed Rats. PLoS One. 2016;11(11): e0166705. 10.1371/journal.pone.0166705
    1. Gordon MW. The correlation between in vivo mitochondrial changes and tryptophan pyrrolase activity. Arch Biochem Biophys. 1960; 91(1): 75–82. 10.1016/0003-9861(60)90457-4
    1. Bagis S, Comelekoglu U, Sahin G, Buyukakilli B, Erdogan C, Kanik A. Acute electrophysiologic effect of pulsed gallium–arsenide low energy laser irradiation on configuration of compound nerve action potential and nerve excitability. Lasers Surg Med. 2002; 30(5): 376–380. 10.1002/lsm.10057
    1. Pesevska S, Nakova M, Ivanovski K, Angelov N, Kesic L, Obradovic R, et al.. Dentinal hypersensitivity following scaling and root planing: comparison of low-level laser and topical fluoride treatment. Lasers Med Sci. 2010; 25(5): 647–650. 10.1007/s10103-009-0685-0
    1. Matsumoto K, Kimura Y. Laser therapy of dentin hypersensitivity. J Oral Laser Appl. 2007;7(1):7–25.
    1. Calheiros APC, Moreira MS, Gonçalves F, Aranha ACC, Cunha SR, Steiner-Oliveira C, et al.. Photobiomodulation in the Prevention of Tooth Sensitivity Caused by In-Office Dental Bleaching. A Randomized Placebo Preliminary Study. Photomed Laser Surg. 2017; 35(8): 415–420. 10.1089/pho.2017.4282
    1. Diniz A, Lima S, Tavarez R, Borges AH, Pinto S, Tonetto MR, Loguercio AD, Bandéca MC. Preventive Use of a Resin-based Desensitizer Containing Glutaraldehyde on Tooth Sensitivity Caused by In-office Bleaching: A Randomized, Single-blind Clinical Trial. Oper Dent. 2018; 43(5): 472–481. 10.2341/17-020-C
    1. Maghaireh GA, Alzraikat H, Guidoum A. Assessment of the effect of casein phosphopeptide-amorphous calcium phosphate on postoperative sensitivity associated with in-office vital tooth whitening. Oper Dent. 2014; 39(3): 239–247. 10.2341/12-527-C
    1. Machado LS, de Oliveira FG, Rocha EP, dos Santos PH, Briso AL, Sundefeld ML, et al.. Clinical trial evaluating color change and tooth sensitivity throughout and following in-office bleaching. Int J Periodontics Restorative Dent. 2013; 33(2): 209–215. 10.11607/prd.1410
    1. Esposito P, Varvara G, Murmura G, Terlizzi A, Caputi S. Ability of healthy and inflamed human dental pulp to reduce hydrogen peroxide. Eur J Oral Sci. 2003; 111: 454–456. 10.1034/j.1600-0722.2003.00062.x
    1. Younger J, McCue R, Mackey S. Pain outcomes: a brief review of instruments and techniques. Curr Pain Headache Rep. 2009; 13(1): 39–43. 10.1007/s11916-009-0009-x
    1. Reed MD, Van Nostran W. Assessing pain intensity with the visual analog scale: A plea for uniformity. J Clin Pharmacol. 2014; 54(3): 241–244. 10.1002/jcph.250

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다