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   Table of Contents - Current issue
Coverpage
March-April 2020
Volume 12 | Issue 2
Page Nos. 95-186

Online since Saturday, March 28, 2020

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SYSTEMATIC REVIEWS  

Acceptability of Hall’s technique: A systematic literature review p. 95
Fabiha Jesmin, Aimi Kamarudin, Fadzlinda Baharin, Wan Muhamad Amir Wan Ahmad, Mahmud Mohammed
DOI:10.4103/jioh.jioh_312_19  
Aim: Hall’s technique (HT) has been established as a novel method for managing decayed primary molars. Despite good evidence of its effectiveness, the acceptability of HT among pedodontists, general dental practitioners, and undergraduate students are still noticeably low. The aim of this study was to review the available studies systematically by assessing the acceptability of HT under different experimental populations. Materials and Methods: A search was performed using three databases, Scopus, PubMed, and Google Scholar, published from 2003 to 2018. The keywords used in the search were “HT,” “preformed metal crown,” “acceptability,” and “primary molar.” After the relevant articles were found, the critical appraisal was made to select those that were suitable for the systematic review. The inclusion criteria of the study were surveys, clinical studies, no sample size restrictions, and only English language papers. Any conference abstracts, case reports, and unpublished data were excluded from this study. Results: On the basis of the keywords, 26 relevant articles were found and of those, 11 articles were selected for the systematic review. Conclusion: On the basis of the results of this study, it can be concluded that clinical trial can be an effective tool to assess the usage and acceptability of HT along with the questionnaire. Furthermore, there should be more questions, which can give information regarding the HT in children with special needs. Moreover, the study on the acceptability of HT could be conducted on other populations rather than Europe to evaluate the use rate of HT and its acceptability toward other regions.
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Photodynamic therapy in the treatment of periodontal diseases: A systematic review p. 102
Fatemah AlAhmari, Lujain Shaikh, Deema AlDhubaiban
DOI:10.4103/jioh.jioh_204_18  
Aim: Periodontal diseases remain a challenging clinical condition and hence existing literature showed no consensus on the best treatment option for disease control. The aim of this review was to provide a comprehensive overview of exciting clinical evidence on the effect of photodynamic therapy (PDT) in the treatment of periodontal diseases. Materials and Method: A literature review was performed using MEDLINE, PubMed, Wiley, ScienceDirect, and Scopus using the terms PDT, periodontal disease, laser, scaling and root planning, chronic periodontitis, and aggressive periodontitis. Results: Of a total of 149 articles appeared from various sources, 147 articles were screened and 36 were related to the research objective. Adjunctive therapy with PDT may promote additional clinical and microbiological outcomes. Conclusion: Little information is available with regard to PDT photosensitizers, wavelength, number of sessions, and duration. Therefore, large randomized control trials with longer follow-up are needed to assess the potential of PDT in the treatment of periodontal disease.
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ORIGINAL RESEARCH Top

Effect of drinking water habits and oral hygiene status in elementary school children: A Quasi experimental study Highly accessed article p. 109
Dini Setyowati, Dias R Cahyani, Roesanto Heroesoebekti, Aulia Ramadhani
DOI:10.4103/jioh.jioh_190_19  
Aim: To describe the effectiveness of drinking mineral water after consuming snacks in improving dental and oral hygiene of elementary school students. Materials and Methods: This was a quasi-experimental study with pretest–posttest control group design. The population of this study was 105 students selected from an elementary school in Surabaya, Indonesia. The sample size used in this research was 36 students aged 12 years old and have their first lower molars fully erupted. The sampling technique used was random sampling technique. The respondents were divided into three groups: Group 1 (eating only), Group 2 (eating and drinking), and Group 3 (eating, drinking, and gargling). Primary data were obtained from intraoral examination carried out by Debris Index (DI) with three-score category. The examination was only conducted in several tooth: posterior tooth (fully erupted tooth) and anterior tooth (upper and lower central incisors). Independent variable in this research was drinking 250 mL of mineral water, meanwhile the dependent variable was student’s DI. Statistical analysis was carried out using analysis of variance correlation test and using the Statistical Package for the Social Sciences (SPSS) software, version17. Results: Dental and oral hygiene status group is homogeneous (P = 0.484). A significant difference was observed between variables, such as eating and drinking with gargling group (P = 0.4250), the eating and drinking group (P = 0.2250), and the control group (P = 1.4833). Conclusion: Students who regularly drink water, especially with gargling habit, have a better oral hygiene than those who do not drink regularly.
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Periodontal health status and treatment needs of the community in Indonesia: A cross sectional study p. 114
Agus Susanto, Dyah N Carolina, Amaliya Amaliya, Indra M Setia Pribadi, Aldilla Miranda
DOI:10.4103/jioh.jioh_167_19  
Aim: Periodontal disease is an oral disease with a quite high prevalence in the world, especially in the developing countries such as Indonesia. The aim of this study was to evaluate the prevalence of periodontal disease, periodontal health status, and treatment needs of the community in Indonesia. Materials and Methods: This is a descriptive study with cross-sectional approach. A total of 400 participants were selected for the proposed research work from six Community Health Centre (Puskesmas) in Bandung City. The demographic and sociodemographic data obtained from the questionnaire were recorded, including age, gender, address, occupation, and smoking habits. The oral hygiene level was measured by using the Oral Hygiene Index simplified (OHI-S) and the Community Periodontal Index of Treatment Needs (CPITN). Data were analyzed using chi-squared test and multiple linear regression analysis. Results: The oral hygiene level was found good in 16.5%, fair in 68%, and poor in 15.5% of all the samples; the oral hygiene level in male tends to be worse than women. The CPITN score of code 1 was found in 1%, code 2 in 54.25%, code 3 in 43.25%, and code 4 in 1.5% of all the samples. In total, 1% treatment needs required oral hygiene instruction, 97.5% oral hygiene instruction and oral scaling prophylaxis, and 1.5% complex treatment. The frequency of brushing teeth and age were significantly associated with OHI-S score (P< 0.05), whereas age and sex (male and female) were significantly associated with CPITN score (P < 0.05) in multivariate analysis. Conclusion: In the study population, the number of patients who had gingivitis was 55.25% and who had periodontitis was 44.75%. The majority of them needs the primary and secondary levels of preventive program to reduce the initiation or progression of periodontal diseases.
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Effect of different white-spot lesion treatment on orthodontic shear strength and enamel morphology: In vitro study p. 120
Ari Triwardhani, Melisa Budipramana, Jusuf Sjamsudin
DOI:10.4103/jioh.jioh_206_19  
Aim: White-spot lesion treatment is required before fixed appliance insertion as caries prevalence increases during orthodontic treatment. The aim of this study was to analyze the effect of fluoride varnish, casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) varnish, and resin infiltration as white-spot lesion treatments on orthodontic shear strength and enamel morphology. Materials and Methods: This is an observational analysis study with posttest-only control group design and blind total sampling methods. Sixty bovine mandible incisors were cleaned and divided into five groups (n = 12). No treatment was applied on Group 1 (control), whereas the four other groups were immersed in demineralization solution for 96h before being stored in artificial saliva (Group 2), treated with fluoride varnish (Group 3), CPP-ACPF varnish (Group 4), and resin infiltration (Group 5). After bracket bonding with resin-modified glass ionomer on all samples, shear bond strength was evaluated. Adhesive remnant index (ARI) was observed by using a digital photo. Enamel morphology was evaluated using a scanning electron microscopy (SEM) before bracket bonding and after polishing. The Kruskal–Wallis test (P > 0.05) followed by Mann–Whitney U test was carried out (P < 0.05). Results: The shear strength in Groups 2 and 5 was slightly increased as compared with control group (P > 0.05), whereas it was significantly decreased in Groups 3 and 4 (P < 0.05). The ARI score was found to be highest after treatment with resin infiltration. Conclusion: Pretreatment with resin infiltration is recommended to be performed before bracket bonding on white-spot lesion; however, it may need to be reapplied after debonding and polishing to conceal enamel morphology damage formed after polishing.
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The prevalence of malocclusion traits in Saudi Arabia 2015–2019: An epidemiological cross sectional study p. 129
Fahad Alharbi
DOI:10.4103/jioh.jioh_200_19  
Background: Malocclusion is one of the most prevalent dental problems. The prevalence of malocclusion differs globally among various populations. It is essential to estimate its prevalence in order to allocate proper resources for preventive strategies and intervention plans. Aim: This study aimed to evaluate the status of malocclusion among school children in Al Kharj city, Saudi Arabia. Materials and Methods: This is a cross-sectional study. A group of 680 school children in Al Kharj city, Saudi Arabia, aged 11–14 years participated in the study. The occlusal parameters recorded in this study were molars relationship, overbite, crowding, midline diastema, anterior open bite, anterior crossbite, and posterior crossbite, using gloves, light source, mouth mirror, and ruler. Results: A Class-I molars relationship was observed in 84.9% of the total sample, whereas Class-II and -III molars relationships were observed in 9% and 6.2%, respectively. Normal overbite was found in 87.1%. The most widespread orthodontic problem was crowding (40.3%), followed by midline diastema (29.6%). A posterior crossbite was found in 3.8% of the sample, whereas 11.76% had an anterior crossbite. Conclusion: Crowding has the highest level of frequency among orthodontic problems. Class I, normal overjet, and normal overbite were frequent findings among Saudi adolescents in Al Kharj city.
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Approach for assessment of inferior alveolar canal to roots of mandibular second molar and mandibular cortex for ramadi city individuals, Iraq: A retrospective radiographic study p. 135
Mohanad A Hammad
DOI:10.4103/jioh.jioh_290_18  
Aims: To investigate the distances between inferior alveolar canal (IAC) to both mesial and distal roots of mandibular second molar (M2) and inferior mandibular cortex. Materials and Methods: This retrospective study was carried out on 110 patients (50 women and 60 men) aged between 20 and 50 years. Each patient took one panoramic image and one digital intraoral image for the right side at second molar area. Patients were evaluated by gender and age (coterie I = 54 and coterie II = 56). Data were analyzed by using the Statistical Package for the Social Sciences Statistics software, version 22.0 (IBM, Chicago, Illinois), and the mean values were compared using the compare means test. Results: The results showed no significant differences at P > 0.05 between men and women in the distances of M2 roots and mandibular cortex to IAC by both digital techniques. However, the roots of M2 of women (2.7 and 1.8 mm by digital panoramic, 2.6 and 2 mm by digital intraoral image) and of those aged less than 35 years (3.1 and 2.45 mm by digital panoramic, 3.1 and 2.56 mm by digital intraoral image) were near to the IAC. Conclusion: Preoperative investigations to know the degree of vicinity of roots of M2 and lower jaw canal by using of digital radiographic imaging (intraoral and panoramic) depending on their properties (image enhancement, measuring tools, and updating data) have high values to avoid a complications such as distress and numbness after dental procedures by direct damage or pushed toxic dental materials in this tunnel.
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Comparative evaluation of the efficacy of Triphala gel and chlorhexidine digluconate gel in management of patients with chronic gingivitis: A randomized clinical trial p. 140
Snehal R Ambhore, Ashvini M Padhye
DOI:10.4103/jioh.jioh_209_19  
Aim: To evaluate the efficacy of Triphala gel and chlorhexidine digluconate gel in the management of patients with chronic gingivitis. Materials and Methods: A total of 46 subjects diagnosed with mild to moderate chronic gingivitis were enrolled for this study after obtaining their informed consent. In their first visit, a detailed case history was recorded including gingival index, plaque index, and sulcus bleeding index at baseline; then full-mouth scaling and polishing was performed on the first visit by a single calibrated examiner. These subjects were then randomly allocated using computer-generated random numbering sequence method into two groups. Subjects in group A received Triphala gel (HiOra-GA gel, Himalaya Drug, Bengaluru, India) and group B received chlorhexidine digluconate gel (Hexigel, ICPA Health Products, Mumbai, India) for home application. The posttreatment follow-up examinations for gingival index, plaque index, and sulcus bleeding index changes were assessed after 14 days at second visit and 28 days at third visit and compared with baseline data. Results: The mean gingival, plaque, and sulcus bleeding index scores significantly decreased after 14- and 28-day intervals as compared to baseline scores with no significant difference in both the groups. Conclusion: Both Triphala gel and chlorhexidine digluconate gel were effective when used along with oral prophylaxis in the management of subjects with chronic gingivitis. Hence, Triphala gel can be considered as an alternative to chlorhexidine digluconate gel in the management of chronic gingivitis.
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Effect of exposure to variable degrees and durations of heat on dental Barr body identification in females: An in vitro cross-sectional study p. 145
Ghada Nabil El-Sarnagawy, Sarah Yasser
DOI:10.4103/jioh.jioh_239_19  
Aim: In developing countries DNA analysis techniques might be a slightly expensive forensic tool so the use of Barr body for gender determination could be a more economic method. The aim of this study is to evaluate the effect of exposure to variable degrees and durations of heat on dental pulp Barr bodies identification in human females. Materials and Methods: 130 premolars were divided equally into control and 12 study groups. The study groups were heated to different temperature degrees (100° c, 200° c and 300° c) for duration intervals (5, 15, 30 and 60 minutes), then the Barr body was examined in the pulp tissues using light microscope. Results: There was a significant decrease in the percentage of positive Barr body cells at 100°c, except in 5 and 15 minutes, and at 200° c groups except in 5min. Interestingly, at 200°c, Barr bodies could be identified only at 5 minutes duration. At 300°C, the pulp tissue could not be retrieved. Also, there was a significant negative correlation between the degree of heat exposure and the percentage of positive Barr body cells in the dental pulp (r = −0.73, P = < 0.001) and between the duration of exposure at each degree (100° c and 200° c) and the percentage of positive Barr body cells (r = −0.90, P = < 0.001) in 100 °c groups and in 200°c groups (r = −0.76, P = <0.001). Conclusion: Dental Barr bodies can be useful for gender determination up to 200°C at the time period of 5 min in vitro.
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A comparative evaluation of tear strength and tensile strength of autoclavable and non-autoclavable vinylpolysiloxane impression material: An in vitro study p. 153
Manu Gupta, Vinu T George, Dhanasekar Balakrishnan
DOI:10.4103/jioh.jioh_212_19  
Aim: To evaluate and compare the tear strength and tensile strength of autoclavable vinylpolysiloxane impression material Affinis with non-autoclavable Aquasil. Materials and Methods: In this study, a total of 80 specimens of two vinylpolysiloxane impression materials (Affinis and Aquasil) were evaluated. Twenty specimens each for evaluating tear strength and tensile strength were fabricated for both Affinis Regular body (Coltene Whaledent, Altstatten, Switzerland) and Aquasil Monophase (Dentsply DeTrey, Konstanz, Germany). The specimens were randomly selected and divided equally between control (no autoclave or no disinfection) and experimental groups (autoclave or disinfection). All the samples were tested after 24h using an Instron Universal Testing Machine (Instron 3366, Norwood, Massachusetts) and were loaded until failure. The differences in mean values were compared with control group and were analyzed using independent sample t test (P < 0.05). Results: The results showed that autoclaving had no significant effect on tear strength and tensile strength of Affinis, and disinfection had no significant effect on tear strength and tensile strength of Aquasil. However, the tear strength and tensile strength of Aquasil before disinfecting was significantly higher than that of Affinis before autoclaving. A similar pattern was observed for disinfected Aquasil compared to autoclaved Affinis. Conclusion: Owing to no statistically significant effect of autoclaving on the tested properties of Affinis and no statistically significant effect of disinfection on the tested properties of Aquasil, these materials can be sterilized via these methods to eliminate all disease-causing microorganisms.
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Comparison of cyclic fatigue resistance of three NiTi glide path files with different cross-sectional geometric characteristics: An in vitro experimental study p. 158
Abdulmohsen Alfadley
DOI:10.4103/jioh.jioh_191_19  
Aim: New nickel-titanium file systems with improved fatigue resistance are being introduced to the market. This study aimed to compare the cyclic fatigue resistance (CFR) of G1 (#12) file of G file system (Micro Mega, Besançon, France), ProGlider (Dentsply Maillefer, Ballaigues, Switzerland) single-file rotary pathfinding system, and the #13 file of the Flex Glide system (Neoendo, Gurugram, India). Materials and Methods: Each group had a sample size of 10 files. The cyclic fatigue test was conducted in an artificial stainless steel canal in a customized device. The artificial canal contained an inner diameter of 1.5 mm with 60° angle of curvature and 5 mm radius of curvature. The file tip was positioned at 18 mm with a stopper and then rotation began, synchronized with timing by a digital stopwatch (Timex, Middlebury, CT) to the thousandth of a second. The center of the curvature was located at 7 mm from the tip of the device. For each instrument, time to fracture and the number cycles to fracture (NCF) were recorded. The data were analyzed statistically. Results: ProGlider files had a significantly higher resistance to cyclic fatigue than G1 files, which in turn had significantly higher CFR than Flex Glide instruments (P < 0.05). The lengths of the fractured segment of ProGlider files and G1 files were significantly higher than the Flex Glide files. Conclusion: Thus, it can be inferred that the ProGlider files had the highest resistance to cyclic fatigue and can be advocated for glide path preparations in severely curved canals.
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Oral hygiene behavior of acrylic removable partial denture usage in Seuneubok District, West Aceh: A cross-sectional study p. 163
Liana Rahmayani, Pocut A Sofya, Poppy Andriany, Cut S Jingga
DOI:10.4103/jioh.jioh_177_18  
Aim: To evaluate the relationship of oral hygiene behavior and maintenance with gender, age, and duration of acrylic removable denture usage in Seuneubok District community, West Aceh. Materials and Methods: An analytic descriptive research was conducted with the sample of 97 people as research subjects. The subjects comprised 65 women and 32 men who were selected using purposive sampling technique and measured using questionnaire. The subjects signed informed consent and then continued by interviewing the questionnaire question. Pearson’s chi-squared test value was obtained at P ≤ 0.05 for the relationship between the behavior of maintaining oral hygiene in removable partial denture users between men and women. Results: The results showed that 14 subjects (15%) were good for maintaining dental and oral hygiene, 74 subjects (76%) were poor, and only 9 subjects (9%) were not good. It showed that the value of P was 0.038 (significant difference P ≤ 0.05) for the behavior relationship with the duration of removable partial dentures usage and P = 0.597 was associated with age. Conclusion: Community maintenance of oral hygiene was poor in studied population. There was a relationship between the behavior of maintaining oral hygiene with gender and duration of dentures usage, but there was no significant relationship with the age.
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Oral health status and self-perceived oral health satisfaction among residents in the largest care home in east coast Malaysia and its associated factors: A cross-sectional study p. 168
Farah N Mohd, Abdul H Said, Muhammad Z Yusof, Nor I Ismail, Nor M Musa
DOI:10.4103/jioh.jioh_253_19  
Aim: To Assess the oral health status among residents living in care home and to determine its association with their self-perceived oral health satisfaction. Materials and Methods: A cross-sectional study was conducted from July to August 2018 among 75 residents of Rumah Ehsan, Terengganu (the largest care home in east coast Malaysia). The oral health status of the residents was examined by one dental specialist based on two domains: the number of decayed, missing, and filled teeth (DMF-T) and the edentulous state. Their sociodemographic profile and self-perceived oral health status were collected through interviews. Multiple logistic regressions were used to determine factors associated with oral health satisfaction. Results: Unsurprisingly, majority of residents had high DMF-T score with median DMF-T score of 29.0 (interquartile range [IQR] = 12). On the contrary, majority of them (64%) perceived that they had good oral health status and 68% were satisfied with their current oral health status. There was no significant association between the actual oral health status and their perceived satisfaction. However, older age, Malay, and those eating dependently were less likely satisfied with their oral health status. Meanwhile, those who were dependent to the staff to brush their teeth were more likely satisfied with their oral health status. Conclusion: There was a discrepancy between actual and self-perceived oral health status among residents in care home. Hence, every effort is necessary to improve the awareness and knowledge among them in order to improve the oral health.
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Maximum mouth opening and its association with gender, age, height, weight, body mass index, and systemic disease in adult Saudi population: A cross-sectional study p. 173
Zuhair H Moosa, Abdulkarim G Slihem, Abdullah A Junaidallah, Abdulmalik A Alshathri, Abdulrahman K Abo Al Samh, Moustafa M Kandil
DOI:10.4103/jioh.jioh_254_19  
Aim: To analyse determine the maximum mouth opening (MMO) among adult patients seeking dental care in university dental clinics in Riyadh city, Saudi Arabia, and to find out the factors (gender, age, height, weight, body mass index [BMI]) and/or systemic disease associated with the MMO among the studied sample. Materials and Methods: This cross-sectional study was conducted on 391 adult patients aged over 21 years for a period of 2 months from February 2018 to April 2018. The MMO was measured by requesting the study participants to open his/her mouth maximally and then measuring inter-incisal length between upper and lower anterior teeth using Willis Bite Gauge. Descriptive statistics of frequency distribution, percentages, mean, and standard deviation values of MMO were calculated. Regression analysis was performed to identify predictor variables associated with the MMO. Results: Mean MMO and standard deviation of the sample was 46.15 mm and 8.49 mm. Male study subjects showed higher MMO of 48.35 ± 7.07 mm as compared with the female subjects’ MMO of 36.39 ± 7.35 mm. The MMO reduced with increasing age of the study subjects, and it showed significant differences across different age groups, gender, educational level, and health status. Weight and BMI showed significant differences with MMO. Presence of upper right and left third molars was also significantly related to MMO. Conclusion: In this study, reported MMO among the sample is lower than that reported in European and African population. Furthermore, MMO is affected by age, gender, educational level, weight, BMI, and presence of upper third molars in the sample.
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CASE REPORT Top

Odontoma in a young and anxious patient associated with unerupted permanent mandibular cuspid: A case report p. 182
Paola Martina Marra, Ludovica Nucci, Jamilian Abdolreza, Letizia Perillo, Angelo Itro, Vincenzo Grassia
DOI:10.4103/jioh.jioh_287_19  
Odontomas are among the most frequent odontogenic tumors of the jaws that generally appear as single or multiple teeth-like radiopaque lesions. As reported in the literature, they often interfere with tooth eruption and are usually discovered by routine panoramic radiographs. This case report shows a compound odontoma and the associated impaction of the underlying mandibular permanent right cuspid in an ASA II 10-year-old male Caucasian patient. Treatment plan involved surgical excision with histopathological analysis. No signs and symptoms were observed over 6 months of follow-up.
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