Displaying publications 1 - 20 of 29 in total

Abstract:
Sort:
  1. Natarajan P, Choudhury M, Seenivasan MK, Jeyapalan K, Natarajan S, Vaidhyanathan AK
    J Pharm Bioallied Sci, 2019 May;11(Suppl 2):S402-S406.
    PMID: 31198377 DOI: 10.4103/JPBS.JPBS_48_19
    Aim: This study evaluated the relationship between missing posterior teeth and body mass index with regard to age and socioeconomic state in a sample of the suburban south Indian population.

    Materials and Methods: The 500 individuals of both males and females aged 40 years and older with missing posterior teeth and not rehabilitated with any prosthesis were gone through a clinical history, intraoral examination, and anthropometric measurement to get information regarding age, sex, socioeconomic status, missing posterior teeth, and body mass index (BMI). Subjects were divided into five groups according to BMI (underweight > 18.5 kg/m2, normal weight 18.5-23 kg/m2, overweight 23-25 kg/m2, obese without surgery 25-32.5 kg/m2, obese with surgery < 32.5 kg/m2). Multivariate logistic regression was used to adjust data according to age, sex, number of missing posterior teeth, and socioeconomic status.

    Results: People with a higher number of tooth loss were more obese. Females with high tooth loss were found to be more obese than male. Low socioeconomic group obese female had significantly higher tooth loss than any other group. No significant relation between age and obesity was found with regard to tooth loss.

    Conclusion: The BMI and tooth loss are interrelated. Management of obesity and tooth loss can help to maintain the overall health status.

    Matched MeSH terms: Tooth Loss
  2. Chan, Yoke Mun, Rahimah Abdul Kadir, Tengku Aizan Abdul Hamid, Tanti Irawati Rosli
    MyJurnal
    Loss of teeth can affect masticatory efficiency in older adults. This may result in avoidance or modifications in food
    choices and lead to lower intake of important nutrients among older individuals. The aim of this study was to determine
    the association between tooth loss and body mass index, BMI, among older adults in Kuala Pilah, Negeri Sembilan. A
    cross-sectional study was carried out on 428 older adults aged 50 years and above from selected villages in district of
    Kuala Pilah. Respondents were interviewed to collect information on their demographic characteristics. Number of tooth
    loss was determined through oral assessment, followed by anthropometric assessment to calculate the BMI of respondents.
    Findings showed that majority of the respondents were overweight and obese, 40.4% and 19.9% respectively, while only
    a small proportion was underweight, 3.9%. The proportion of edentulism (total tooth loss) was 18.3% and majority of
    the older adults had lost more than 12 teeth (77.1%) and less than 4 pairs of occluding posterior teeth (86.0%). Total
    and partial tooth loss was found to be not significantly associated with BMI. In relation to the arrangement of teeth,
    older adults with reduced number of posterior occluding pairs of teeth were more likely to experience unsatisfactory
    BMI (OR = 3.61, 95% CI: 1.48, 8.76). This may suggest that functional arrangement of the tooth in the oral cavity is more
    important than the number of tooth loss alone. Thus, maintaining an optimum number of teeth for chewing is essential
    for maintenance of ideal BMI.
    Matched MeSH terms: Tooth Loss
  3. Taiyeb Ali, T.B.
    Ann Dent, 1997;4(1):-.
    MyJurnal
    Endoseous Implant insertion for the replacement of missing teeth is the state of the art at present times. An understanding of the biology of the perimplant tissues is imperative for the overall success in the dental rehabilitation of a patient with fixture supported prosthesis. The dental implant tissue interface comprises bone, both cortical and cancellous bone; supracrestal connective tissue and the epithelial attachment. A comprehensive review of the response of bone during the postoperative or healing phase, the loading or remodelling phase and during the steady phase is described.
    Matched MeSH terms: Tooth Loss
  4. Radzi, Z., Yahya, N.A., Zamzam, N., Spencer, R.J.
    Ann Dent, 2004;11(1):-.
    MyJurnal
    Missing teeth can be due to hypodontia, trauma or extraction. In general, the options for treatment depend on the severity of the hypodontia and the severity of the malocclusion. Occasionally, the space from missing teeth has to be maintained for prosthetic replacement and require an orthodontic/restorative approach. It is very important to ensure the space maintained is adequate for aesthetic reason so that it can be replaced with a prosthesis after the orthodontic treatment is completed. This article discusses a new innovation and clinical technique for maintaining this space during orthodontic treatment by using an acrylic tooth with several modifications. This innovation will be illustrated using two cases.
    Matched MeSH terms: Tooth Loss
  5. Jaafar, N., Saub, R., Razak, I.A.
    Ann Dent, 1997;4(1):9-12.
    MyJurnal
    A pilot study was conducted on 135 sixteen-year-old students from three rural schools in Kelantan to establish the prevalence of orofacial pain and discomfort. About 44% reported to have experienced some oro-facial pain in the preceding four weeks. About 27% of those with pain, still experienced the pain at the time of clinical examination but only 8% have consulted professional help. Most of the pain encountered were only mild or moderate in nature. Only 7% and 10% respectively, reported that the pain affected their sleep and concentration to study. The main cause was toothache and sensitivity. The prevalence of discomfort was 22%, the most common causes being recurrent oral ulcers and bleeding gums. The impacts of orofacial pain was mainly manifested at the personal level, and very few affecting social functioning. However, untreated decay and missing teeth were very low (mean DT 0.47, mean MT 0.27), while filled teeth (mean Ff 2.9) was the main component of the DMFf (mean 3.66, sd ± 2.6). Severe periodontal disease and the prevalence of traumatised teeth was not a major public health problem. The high prevalence of pain merit further research. Therefore a larger study involving other age-groups in other states is planned.
    Matched MeSH terms: Tooth Loss
  6. Taiyeb Ali, T.B., Zain, R.B., Raja Latifah, Razak, I.A.
    Ann Dent, 1998;5(1):-.
    MyJurnal
    The prevalence of tooth loss amongst the elderly is generally very high. Hence mastication and subsequently nutrition is greatly affected leading to the impairment of their general health. Therefore denture construction is an important aspect in the rehabilitation of the oral and general health in most elderlies. However, poorly constructed dentures and lack of maintenance coupled with various other health and healthrelated problems of the elderly, for instance poor general health especially with immunocompromised states, multiple medication intake, xerostomia, reduced mobility, economic status, mental state and ignorance may all lead to discomfort and denture associated lesions in these elderly patients. No regional studies or data on denture-related lesions in the general population have been reported. Previous epidemiological studies of adults in Malaysia (1,2) and other local studies have not investigated lesions of the oral tissues associated with geriatric denture wearers although studies in developed countries, where prevalence of denture usage is high, have noted that denture-related lesions to be the most common group of oral mucosal lesions in the elderly (3-7). As has been reported in most developing countries, the proportion of elderly in Malaysia is also increasing. It has also been noted that the mean number of teeth present decreases as age increases; in those between 15 to 19 years, all 28 teeth are present, 35 to 44 years-old have 23 teeth whereas those above 65 years retain only 12 teeth. Edentulousness increases from 0% to 7.3% to 56.6% in these age groups respectively (2). It is anticipated that with the increasing population of the elderly in Malaysia and the improving economy, the proportion of denture wearers in the population will increase. In view of the lack of investigations in Malaysia focusing exclusively on this group of lesions, it is therefore the aim of this pilot investigation to highlight the prevalence of denture- related lesions in a representative population of the elderly living in the community, both in the urban and rural areas. It may also form a basis against which future studies can be compared.
    Matched MeSH terms: Tooth Loss
  7. Hamasha, Abed Al-Hadi, Almogbel, Lolowh, Alshehri, Abeer, Alssafia, Fatimah, Alghamdi, Hanan, Alajmia, Alanoud, et al.
    MyJurnal
    Upon reviewing the literature, the prevalence of many systemic conditions such as diabetes,
    hypertension, asthma and rheumatoid arthritis were reported to be high in Saudi Arabia. The relationship of these
    conditions with tooth loss among Saudi population was not investigated. Therefore, the aim of the present study
    is to explore the relationship between tooth loss and most common medical conditions among Saudi dental
    patient. The study participants were 250 patients who were randomly selected from the College of Dentistry
    database of King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Riyadh, Saudi Arabia.
    Participants were requested to answer self-administered questionnaires related to their demographic as well as
    general health questions concerned to the presence of systemic medical conditions. Missing teeth were
    determined after examining the orthopantogram radiographs and reviewing the Romexis and SALUD databases.
    Descriptive statistics, independent t-test and linear multiple regression model were performed using SPSS
    software. The mean number of missing teeth among the study population was 5.8 teeth per person. The mean
    number of missing teeth was higher among subjects with diabetes, hypertension, rheumatoid arthritis,
    cardiovascular diseases, or osteoporosis compared to healthy individuals. A multiple linear regression analysis
    model revealed that diabetes, hypertension and rheumatoid were significant predictors of missing teeth among
    Saudi population. These results highlight the importance of the effect of medical conditions on oral health.
    Matched MeSH terms: Tooth Loss
  8. Emrizal R, Nor Muhammad NA
    PeerJ, 2020;8:e9019.
    PMID: 32617187 DOI: 10.7717/peerj.9019
    Porphyromonas gingivalis is one of the major bacteria that causes periodontitis. Chronic periodontitis is a severe form of periodontal disease that ultimately leads to tooth loss. Virulence factors that contribute to periodontitis are secreted by Type IX Secretion System (T9SS). There are aspects of T9SS protein components that have yet to be characterised. Thus, the aim of this study is to investigate the phylogenetic relationship between members of 20 T9SS component protein families. The Bayesian Inference (BI) trees for 19 T9SS protein components exhibit monophyletic clades for all major classes under Bacteroidetes with strong support for the monophyletic clades or its subclades that is consistent with phylogeny exhibited by the constructed BI tree of 16S rRNA. The BI tree of PorR is different from the 19 BI trees of T9SS protein components as it does not exhibit monophyletic clades for all major classes under Bacteroidetes. There is strong support for the phylogeny exhibited by the BI tree of PorR which deviates from the phylogeny based on 16S rRNA. Hence, it is possible that the porR gene is subjected to horizontal transfer as it is known that virulence factor genes could be horizontally transferred. Seven genes (porR included) that are involved in the biosynthesis of A-LPS are found to be flanked by insertion sequences (IS5 family transposons). Therefore, the intervening DNA segment that contains the porR gene might be transposed and subjected to conjugative transfer. Thus, the seven genes can be co-transferred via horizontal gene transfer. The BI tree of UgdA does not exhibit monophyletic clades for all major classes under Bacteroidetes which is similar to the BI tree of PorR (both are a part of the seven genes). Both BI trees also exhibit similar topology as the four identified clusters with strong support and have similar relative positions to each other in both BI trees. This reinforces the possibility that porR and the other six genes might be horizontally transferred. Other than the BI tree of PorR, the 19 other BI trees of T9SS protein components also exhibit evidence of horizontal gene transfer. However, their genes might undergo horizontal gene transfer less frequently compared to porR because the intervening DNA segment that contains porR is easily exchanged between bacteria under Bacteroidetes due to the presence of insertion sequences (IS5 family transposons) that flank it. In conclusion, this study can provide a better understanding about the phylogeny of T9SS protein components.
    Matched MeSH terms: Tooth Loss
  9. Jaafar N, Razak IA, Nor GM
    Singapore Dent J, 1989 Dec;14(1):39-41.
    PMID: 2487474
    Although the patterns of dental disease is gradually changing, caries and periodontal disease still account for the most important reason for extractions in most countries. However their relative contributions towards overall tooth mortality figures varies. The aim of this study is to investigate the types of teeth usually associated with extractions due to caries or periodontal disease and its relation to the age at which the tooth was lost. The highest proportion of extractions due to caries occurred between 21 to 30 years of age while that for periodontal disease occurred between 41 to 50 years. For caries, the greatest proportion of extractions involved the posterior teeth. The most frequently extracted teeth due to caries are the molars, in particular the first permanent molar. However, for periodontal disease a slightly greater proportion of anterior teeth were lost than the posteriors. This trend is more marked in the lower jaw than the upper. Overall, extractions related to caries tend to increase posteriorly, while that for periodontal disease tend to increase anteriorly.
    Matched MeSH terms: Tooth Loss/etiology*; Tooth Loss/epidemiology
  10. Singh VP, Gan JY, Liew WL, Kyaw Soe HH, Nettem S, Nettemu SK
    Dent Res J (Isfahan), 2019 2 13;16(1):29-35.
    PMID: 30745916
    Background: Periodontitis is a public health concern since it is a major factor in tooth loss worldwide and has association with many systemic diseases. Sleep is a complex and essentially biological process and a critical factor for maintaining mental and physical health. Since inflammation is characteristic of both chronic periodontitis and sleep deprivation, few studies in recent years present the contradictory results regarding this potential association. The objective of the present study was to investigate the association between quality of sleep and chronic periodontitis.

    Materials and Methods: A total of 200 individuals participated in this study. All participants underwent a comprehensive clinical periodontal examination. Case-control were identified using the Centers for Disease Control and Prevention/American Academy of Periodontology case definitions for periodontal disease. The quality of sleep was assessed by Pittsburgh Sleep Quality Index. The univariate and multivariate logistic regression analysis was used to test the influence of variables (quality of sleep, age, sex, ethnicity, education, and socioeconomic status), in the occurrence of periodontitis. Odds ratio (OR) and respective confidence intervals (CIs) were calculated and reported. P =0.05 was considered statistically significant.

    Results: The prevalence of poor quality of sleep was 56.75% in cases (periodontitis group) and 43.24% in control group. There was positive association between quality of sleep and chronic periodontitis (OR = 3.04; 95% CI = 1.42-6.5; P = 0.004). In multivariate logistic regression analysis, only the age was significantly related to the periodontitis (OR = 1.11; 95% CI = 1.07-1.41; P < 0.001), other variables failed to reach the significant level.

    Conclusion: Poor quality of sleep was significantly associated with chronic periodontitis. Only the age was significantly related to periodontitis among the other covariable measured.
    Matched MeSH terms: Tooth Loss
  11. Masood M, Newton T, Bakri NN, Khalid T, Masood Y
    J Dent, 2017 Jan;56:78-83.
    PMID: 27825838 DOI: 10.1016/j.jdent.2016.11.002
    OBJECTIVES: To identify the determinants of OHRQoL among older people in the United Kingdom.

    METHODS: A subset of elderly (≥65year) participants from the UK Adult Dental Health Survey 2009 data was used. OHRQoL was assessed by means of the OHIP-14 additive score. The number of missing teeth; presence of active caries, dental pain, root caries, tooth wear, periodontal pockets>4mm, loss of attachment>9mm; having PUFA>0 (presence of severely decayed teeth with visible pulpal involvement, ulceration caused by dislocated tooth fragments, fistula and abscess); and wearing a denture were used as predictor variables. Age, gender, marital status, education level, occupation and presence of any long standing illness were used as control variables. Multivariate zero-inflated Poisson regression analysis was performed using R-project statistical software.

    RESULTS: A total of 1277 elderly participants were included. The weighted mean(SE) OHIP-14 score of these participants was 2.95 (0.17). Having active caries (IRR=1.37, CI=1.25;1.50), PUFA>0 (IRR=1.17, CI=1.05;1.31), dental pain (IRR=1.34, CI=1.20;1.50), and wearing dentures (IRR=1.30, CI=1.17;1.44), were significantly positively associated with OHIP-14 score. Having periodontal pockets>4mm, at least one bleeding site, and anterior tooth wear were not significantly associated with the OHIP-14 score.

    CONCLUSION: Whereas previous research has suggested a moderate relationship between oral disease and quality of life in this large scale survey of older adults, the presence of active caries and the presence of one or more of the PUFA indicators are associated with impaired oral health related quality of life in older adults, but not indicators of periodontal status. The implication of this is that whilst focussing on prevention of disease, there is an ongoing need for oral health screening and treatment in this group.

    Matched MeSH terms: Tooth Loss/epidemiology
  12. Kaur, Satvinder, MaykanathaN, Dhivyalosini, Lyn, Ng Kai
    MyJurnal
    This study aimed to assess the nutritional status (BMI), oral health behaviour, sugar consumption and the associated factors with dental caries among a group of 7 to 11 years old children in Kuala Lumpur, Malaysia. Three hundred and twelve students were recruited from February to July 2013. Information gathered were their socio-demographic characteristics, body mass index, sugar consumption, oral-health behaviour, oral hygiene index and decay-missing-filled teeth (dmft) index. Anthropometry measurements and sugar intake was measured using verified tools. Meanwhile, dmft was examined using the World Health Organization (WHO) criteria. 53.7% of the children were of the normal body weight with mean sugar consumption of 31.81±4.24 g/day. Prevalence of dental caries was reported at 44.6% (95% CI: 42.2, 53.3) with a mean (SD) dmft of 1.27(1.84). No association was found between dental caries and weight status distribution. Most children tend to brush their teeth 2 times or more in a day (75%), however, they spent lesser time in tooth brushing (5.4%) and do not practice flossing (78%). Regression analysis showed that age (p
    Matched MeSH terms: Tooth Loss
  13. Goh V, Hackmack PP, Corbet EF, Leung WK
    Aust Dent J, 2017 Jun;62(2):152-160.
    PMID: 27391220 DOI: 10.1111/adj.12440
    BACKGROUND: The current retrospective cross-sectional study investigated 5-18-year treatment outcomes in subjects who did not complete a recommended course of periodontal therapy.

    METHODS: Sixty-five subjects who voluntarily discontinued therapy were recalled. The subjects' demographic data and dental history since discontinuation of periodontal treatment were collected via questionnaires. The subjects' periodontal condition, radiographic data and individual tooth-based prognosis at pre-discontinuation and recall were compared.

    RESULTS: A total of 229 teeth had been lost over time, mainly due to periodontal reasons. Upper and lower molars were most frequently lost. Rate of tooth loss (0.38/patient per year) was comparable to untreated patients. Deterioration in periodontal health in terms of increased percentage of sites with bleeding on probing (BOP) and sites with probing pocket depths (PPD) of 6 mm or more at re-examination was observed. Positive correlations were found between tooth loss and: (i) years since therapy discontinued; (ii) percentage of sites with PPD of 6 mm or more at pre-discontinuation; and (iii) at re-examination. Percentage of sites with PPD of 6 mm or more at recall was positively correlated with periodontal tooth loss and negatively correlated with percentage of sites without BOP.

    CONCLUSIONS: Patients not completing a course of periodontal therapy are at risk of further tooth loss and deterioration in periodontal conditions over time.

    Matched MeSH terms: Tooth Loss/etiology*; Tooth Loss/therapy
  14. Goh V, Nihalani D, Yeung KWS, Corbet EF, Leung WK
    J Periodontal Res, 2018 Jun;53(3):324-333.
    PMID: 29105779 DOI: 10.1111/jre.12517
    BACKGROUND AND OBJECTIVE: Risk for deterioration in treated aggressive periodontitis (AgP) individuals remained unclear. This retrospective cohort study investigated 7-26 years of periodontal outcomes and oral health-related quality of life (OHRQoL) of young adults with advanced periodontitis.

    MATERIAL AND METHODS: Eighty-nine previously treated patients with AgP were re-examined. Clinical and radiographic parameters before treatment discontinuation and at re-examination were compared. OHRQoL at re-call was assessed with the short-form Oral Health Impact Profile (OHIP-14S).

    RESULTS: None of the subjects adhered to suggested periodontal therapy and maintenance after discharge. Mean percentage of sites with probing pocket depth (PPD) ≥6 mm at re-examination was 4.5 ± 5.9%. A total of 182 teeth had been lost over time. Tooth loss rate was 0.14/patient/year. From 68 subjects with documented favorable treatment outcomes, higher percentage of sites with PPD ≥6 mm at re-examination and higher radiographic proximal bone loss was associated with current smoking status. Patients with AgP with <20 teeth at re-call had worse OHRQoL than those with ≥20 teeth. Patients with higher full-mouth mean PPD also reported poorer OHRQoL.

    CONCLUSION: Treatment in patients with AgP who smoke and neglect proper supportive care, risk periodontal disease progression. Substantial tooth loss and higher full-mouth mean PPD led to poorer OHRQoL in this cohort.

    Matched MeSH terms: Tooth Loss/diagnosis; Tooth Loss/epidemiology; Tooth Loss/therapy*
  15. Wey MC, Loh S, Doss JG, Abu Bakar AK, Kisely S
    Aust N Z J Psychiatry, 2016 Jul;50(7):685-94.
    PMID: 26560842 DOI: 10.1177/0004867415615947
    OBJECTIVE: People with chronic schizophrenia have high rates of physical ill-health such as heart disease. However, there has been less attention to the issue of poor oral health including dental caries (tooth decay) and periodontal (gum) disease, although both have consequences for quality of life and systemic physical health. We therefore measured tooth decay and gum disease in Malaysians with schizophrenia.

    METHODS: We recruited long-stay inpatients with schizophrenia from June to October 2014. Four dental specialists assessed oral health using the decayed-missing-filled teeth index, the Community Periodontal Index of Treatment Needs and the Debris Index of the Simplified Oral Hygiene Index. Results were compared with the 2010 Oral Health survey of the general Malaysian population.

    RESULTS: A total of 543 patients participated (66.7% males, 33.3% females; mean age = 54.8 years [standard deviation = 16.0]) with a mean illness duration of 18.4 years (standard deviation = 17.1). The mean decayed-missing-filled teeth was 20.5 (standard deviation = 9.9), almost double that of the general population (11.7). Higher decayed-missing-filled teeth scores were associated with both older age (p tooth loss.

    CONCLUSION: Dental disease in people with schizophrenia deserves the same attention as other comorbid physical illness. The disparity in oral health is most marked for dental decay. Possible interventions include oral health assessments using standard checklists designed for non-dental personnel, help with oral hygiene, management of iatrogenic dry mouth and early dental referral.

    Matched MeSH terms: Tooth Loss/epidemiology*
  16. Jasmin B, Jaafar N
    Asia Pac J Public Health, 2011 Apr;23(2):203-8.
    PMID: 21159693 DOI: 10.1177/1010539510391234
    The aim of this study was to determine the dental health status and treatment needs of personnel in the Infantry Regiment of the Malaysian Territorial Army (TA).This cross-sectional study involved stratified and systematic random sampling with a total sample size of 300. Dental health status and treatment needs were assessed using the standard WHO oral assessment criteria (1997). The prevalence of caries experience was 96% (mean ± SD DMFT [decayed, missing, filled teeth] = 8.0 ± 5.5). Active decay prevalence was high (85%; mean ± SD = 3.6 ± 3.1) indicating high unmet treatment need. Missing teeth prevalence was high (69%; mean ± SD = 2.8 ± 3.7). Filled teeth prevalence was low (56%, mean ± SD = 1.5 ± 2.0). In all, 90% of participants required some form of dental treatment, of whom 85% required restorative treatment, 5% advanced restorative treatment, 36.7% extractions, and 45.3% prosthetic treatment. These findings suggest that there was a high need for dental treatment in the Infantry Battalions of Malaysian TA Regiments and the service must be made available to cater to the needs.
    Matched MeSH terms: Tooth Loss/epidemiology*
  17. Husein, A.
    MyJurnal
    The replacement of missing teeth with implant borne restorations has become a treatment modality accepted by the scientific community for fully and partially edentulous patients. Recent developments in oral implantology involve the use of immediate implant placement technique that significantly reduces waiting time. This case report describes the management of an anterior missing tooth using immediate implant. The result was good, which further validate the use of this technique for suitable patient management.
    Matched MeSH terms: Tooth Loss
  18. Awang, R.A.R., Arief, E.M., Hassan, A.
    MyJurnal
    Since the establishment of implant in dentistry, the use of removable partial denture in replacing missing teeth apparently becomes less popular. The situation is made worse by the renowned limitations of removable partial denture. One of the obvious limitations of removable partial denture, especially in replacing missing anterior teeth is the unsightly view of metal used for retentive clasp. This case report describes the use of spring loaded plunger attachments as an alternative way to achieve retention and at the same time improving the aesthetic of the prosthesis.
    Matched MeSH terms: Tooth Loss
  19. Wey, M.C., Wu, C.L., Wong, W.K., Zamri, R., Hagg, U.
    Malaysian Dental Journal, 2008;29(2):113-118.
    MyJurnal
    A case report of a 16 year old male oligodontia patient who presented with a Class I malocclusion on a skeletal I base. He had multiple missing teeth of upper lateral incisors and all premolars except for lower right first premolar. Treatment involved fixed appliance with the aid of mini-implants to mesialize posterior teeth in order to reduce the number of prosthodontic replacement of the remaining missing teeth planned for the future. The application of the mini-implants in the sequence of treatment is presented
    Matched MeSH terms: Tooth Loss
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links