Advanced radiation-induced hyposalivation may lead to tooth fracture, dental abscess, tooth loss, or osteoradionecrosis. https://doi.org/10.1177/0022034521990653 (2021). Required film mount information would include all of the following except the: A dentist may delegate to a dental assistant which of the following procedures? 2. Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Postal number 590, P.O. Radiographically, dental caries is essentially a process of demineralization leading to density changes within the enamel or dentine and hence detectable using radiographic imaging. PMC All anonymized data were revalidated by two clinicians (SV, MH). An imbalance in the continuum with a net demineralization over time results in the initiation of caries lesions. 2 This highlights the need for regular radiographic assessment of dental caries if an individual is . The training and optimization process were carried out using the Keras library in the Colaboratory Jupyter Notebook environment22. Secondly, there are several approaches to detect caries on PR(s) such as object detection, semantic segmentation or instance segmentation. Jaw fractures. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. What appears most radiolucent on a dental radiograph? Englander and colleagues demonstrated the role of saliva in neutralizing the decrease in plaque pH after exposure to fermentable carbohydrate. The cropped data consisting of carious M3(s) and non-carious M3(s) were de-identified and anonymized prior to further analysis. 2003-2023 Chegg Inc. All rights reserved. : Data collection, statistical analysis, writing the article. Firstly, the use of depthwise separable convolutions and the inverted residual with linear bottleneck reduced the number of parameters and the amount of memory constraint while retaining a high accuracy18. The model achieved an AUC of 0.90 (Fig. Public Health 97, 15541559. Before Currently, there is a shift toward early detection and minimal intervention dentistry (MID). Deep learning for caries lesion detection in near-infrared light transillumination images: A pilot study. 6 ). There are several caries classification systems, and the American Dental Association Caries Classification System is as follows: Sound surface: Healthy sound enamel with no detectable lesion with normal glossy surface. Radiography is useful for detecting dental caries because the carious process causes tooth demineralization. Dental caries is a preventable, reversible, multifactorial, complex biofilm disease that progresses with time. Furthermore, prospective studies are required to evaluate the diagnostic accuracy of deep learning models against clinicians in a clinical setting. Film fogging can best be detected on stored radiographic film by, The function of the raised embossed dot on the surface of the film is to determine the, Which of the following tissues is considered to be the most radioresistant, To reduce cross contamination the most appropriate way to store exposed radiographs prior to processing is in, _________ is the time between exposure to radiation and time the effect becomes visible. A vertical left premolar bitewing showing interproximal contacts and crestal bone levels. 1 st Edition. Dental assistant registration after September 1, 2006. Article By reusing these learned weights on other tasks, the need to re-learn these low-level features in new data sets is eliminated, which greatly reduces the amount of data and timed required to converge such a deep neural network20. Analog films are still being used in clinical practice; however, it is recommended that no dental radiographic film with speeds lower than E- or F-speed shall be used for intraoral radiography, as the dose is essentially halved from the older D-speed to E-plus or F-speeds. 63, 341346. Alcaraz and colleagues showed dose reduction using direct digital sensors in comparison with the analog films. How does the lamina dura appear on a dental image? 634 . Using the " E" speed film can reduce the radiation exposure to the patient by: Steam autoclave, chemical vapor, & dry heat. Gudkina J, Amaechi BT, Abrams SH, Brinkmane A, Jelisejeva I. Eur J Dent. Early childhood caries (ECC) is defined as the presence of one or more decayed, missing, or filled tooth surfaces in any primary tooth in a child under six years of age or younger [].According to the 2018 Korean Children's Oral Health Survey, >60% of children aged five years have experienced dental caries, and the prevalence of ECC has shown an increasing trend since 2016 []. Because radiographs are a 2-dimensional representation of a 3-dimensional tooth structure, it is not always possible to determine caries extension to the pulp chamber or pulp horn because of anatomic variations and presence of radiopaque restorations in the crowns. The present third molars (M3(s)) on PR(s) were classified and labeled as carious M3 and non-carious M3 based on electronic medical records (EMR). Another study compared the detection accuracy of proximal caries and crestal bone loss using EOBWR or IOBWR and concluded that although EOBWR has promise, clinicians should be aware of the false positive diagnoses of proximal caries and crestal bone loss when using EOBWR. In the early days, the focus of radiographic imaging was on the periapical areas of teeth, as the investigation was based on pain or infection, which was the late stage of dental caries that had led to cavitation and pulp exposure with tracking of bacteria through pulpal blood vessels to the periapical region causing an inflammatory process. <>/MediaBox [ 0 0 720 540]/Parent 2 0 R/Resources <>/Font <>/ProcSet [ /PDF /Text /ImageB /ImageC /ImageI]>>/StructParents 0/Tabs /S/Type /Page>> Sci Rep 11, 12609 (2021). Factors that increase somatic exposure to the patient include: Extracted teeth containing amalgam restorations should not be autoclaved because: A radiographic image is produced on a panoramic film by the use of: The embossed dot should face up when mounting. Submitted to Oral Surg Oral Med Oral Pathol oral Radiol, 2020). The difference between the crest of one photon wave & the next is called: A visual dental health inspection is performed by: A dental assistant who does not expose or process x-rays must be registered I'n the state of Texas. Cite this article. CAS There are multiple theories for their pathogenesis but contributing factors include a combination of a sugar-rich diet, anatomy, oral cavity microbiome, poor dental hygiene, hyposalivationand time 1,2. Phosphor plates may be compared with analog films in terms of flexibility and is suitable for pediatric and special needs patients. Other non-invasive techniques for detection of early caries have been developed and investigated such as Quantitative Light-induced Fluorescence (QLF), DIAGNOdent (DD), Fibre-optic Transillumination (FOTI) and Electrical Conductance (EC). This model is characterized by depthwise separable convolutions and an inverted residual with linear bottleneck. Lesions are classified based on the depth of demineralization detected on the approximal surface. Define pOH. Although PEIR resembles dental caries on radiographs, there is little evidence to support that hypothesis. 92, 103260. https://doi.org/10.1016/j.jdent.2019.103260 (2020). Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Friedman, J. W. The prophylactic extraction of third molars: A public health hazard. Adding interactivity to courses is easier than you think when faculty partner with students. Classification of caries in third molars on panoramic radiographs using deep learning, https://doi.org/10.1038/s41598-021-92121-2. Consent for release of privileged information must be: A herringbone or tire track pattern on a radiograph is a result of: On a processed radiograph, dental caries appear as: Film holders are not necessary with the paralleling technique. S.V. The inherent low-contrast resolution of plain radiographs makes it impossible to determine the full extent of dentin involvement. A dental assistants registration may be revoked for all of the following except: The dental assistant is solely responsible for any acts or procedures performed I'n the dental office. Initial or advanced dental caries (a.k.a. Right premolar bitewing showing carious lesions (E1, E2) in the maxillary right premolars. Radiographic detection of dental caries and the methods used for detection have changed over the years. Tooth decay is asymptomatic in its early stages. <> Taking the numerous interactions between all those factors into account, it might be challenging to make the correct decision during an average presurgical consultation. {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Weerakkody Y, Zhang L, et al. Studies that used the receiver operating characteristic as a measure of diagnostic accuracy were not included. 2007 Sep-Oct;32(5):504-9. doi: 10.2341/06-148. Grad-CAM: Visual explanations from deep networks via gradient-based localization. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Your email address will not be published. How Long Does It Take To Electronically Send Transcripts? The right column illustrates the overlay. This is seldom possible because few of the drains now in use are radiopaque. Caries classification on third molars using PR(s) is flawed by limited and varying accuracy of individual examiners leading to inconsistent decisions and consequently suboptimal care9. Your email address will not be published. Dental caries forms through a complex interaction over time between acid-producing bacteria and fermentable carbohydrate, and many host factors, including teeth and saliva. The diameter of the X-ray beam exiting from from the round come BID should be: Filmless and no processing solutions, the system uses radiation from a tubehead, And the image is captured on a sensor, A foreshortened image on a dental radiograph is most likely caused by, If a film produces a milky and not transparent look, this error is known as, Dental radiographs are part of the dental record therefore, they are, Legal documents that belong to the dentist & kept in the patient dental record for 5 years, The embossed dot should face up when mounting, A radiographs that had not been properly washed will, The aluminum filter in the X-ray tubehead reduces the dose of radiation received by the patient by, Absorbing low penetration long wavelengths, How many minutes should you manually develop to a radiograph and at what temperature, Radiation units and measurement are measured by, Both A & B, Amount of x-ray energy produced by an x-ray unit, Amount absorbed by the body, The difference between the crest of one photon wave and then next is called, Which of the following anatomical structures would appear radiopaque on a processed radiograph, Factors that increase somatic exposure to the patient include. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2008 Feb. SBU Yellow Report No. : Study design, statistical analysis, writing the article. In conclusion, a convolutional neural network (CNN) was developed that achieved a F1 score of 0.86 for caries classification on third molars using panoramic radiographs. On the other hand, bitewing radiographs capture the crown and a third of the root of the maxillary and mandibular teeth with its accompanying interalveolar bone ( Fig. The aim of this study is to train a CNN-based deep learning model for the classification of caries on third molars on PR(s) and to assess the diagnostic accuracy. <> Class activation map for non-carious third molars. Sandler, M., Howard, A., Zhu, M. L., Zhmoginov, A. 91, 103226. https://doi.org/10.1016/j.jdent.2019.103226 (2019). Cantu, A. G. et al. Active lesions are shiny/glossy and smooth to touch; inactive/arrested lesions are frosty/matte in luster with a roughened surface. applied U-net with VGG-16 as an encoder, on near-infrared transillumination images (NITS)10 with a reported AUC between 0.836 and 0.856. The second molar is frequently disrupting the eruption path of the third molar, evoking it to only erupt partially or not at all, which can adversely affect periodontal health of the second molar. PubMed Histogram equalization is a method for adjusting image intensities to enhance the contrast and this can increase the prediction accuracy19. J. Dent. Sci. An automated decision-making tool for third molar removal may have the potential to aid patients and surgeon to make the right choice6. Which statement best describes the duties of the SBDE: The benefits of digital radiography include: Reduction of radiation exposure for the patient, reduction I'n storage space, greater diagnostic capability & high resolution with color enhanced image quality. Thank you for visiting nature.com. Comparing the accuracy of panoramic and intraoral radiography in the diagnosis of proximal caries. Accurate interpretation of carious lesions starts with accurate radiographic depiction of adjacent contact points of teeth using bitewing radiography. Early childhood caries (ECC) is a very widespread multifactorial disease that constitutes a public health problem in both developing and industrialized countries [1,2].According to the American Association of Pediatric Dentistry (AAPD), ECC is defined by the presence of one or more carious tooth surfaces (with or without cavities), the absence of one or more deciduous teeth and/or one or more . White, Stuart C., and Michael J. Pharoah. Vinayahalingam, S., Xi, T. & Berg, S. Automated detection of third molars and mandibular nerve by deep learning. approximal: occur between teeth. Some examples of radiopaque substances other than barium sulfate, as suggested by the authors, include acetrizoate sodium, iobenzamic acid, iopanoic acid, and iopentol. Dental caries is a complex biofilm disease that creates prolonged periods of low pH in the mouth, resulting in a net mineral loss from the teeth. 100, 103425. https://doi.org/10.1016/j.jdent.2020.103425 (2020). Abdinian, M., Razavi, S. M., Faghihian, R., Samety, A. This forms a promising foundation for the further development of automatic third molar removal assessment. Grieco P, Jivraj A, Da Silva J, Kuwajima Y, Ishida Y, Ogawa K, Ohyama H, Ishikawa-Nagai S. Ann Transl Med. HHS Vulnerability Disclosure, Help 3. Small occlusal lesions, buccal and lingual pit cavities, are better studied clinically, as radiography plays a small role in the detection of these lesions. endobj & Chen, L. C. MobileNetV2: Inverted Residuals and Linear Bottlenecks. Learn about the program, timeline and how you can participate. Diagnostic Imaging: Oral and Maxillofacial. A thiol-containing agent, like Amifostine, has been used for its radioprotective properties in the prevention of radiation-induced changes by scavenging free radicals. https://doi.org/10.1177/0022034519871884 (2019). This study has been conducted in accordance with the code of ethics of the world medical association (Declaration of Helsinki). 2020 Mar 17;20(6):1659. doi: 10.3390/s20061659. Alkurt MT, Peker I, Bala O, Altunkaynak B. Oper Dent. Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. If all settings stay the same, what happens when KvP, Ma, & exposure time is increased? The classification accuracy and the area-under-the-curve (AUC) were calculated. Also, the potential bias in these algorithms with possible risks of limited robustness, generalizability and reproducibility has to be assessed in future studies using external datasets and is a necessary step to further implement deep learning successfully in daily clinical practice. Slider with three articles shown per slide. 2 ) and are used in clinical practice to evaluate interproximal caries; crestal bone height in the interproximal region; calculus; and periodontal disease. Which of the following anatomical structures would appear radiopaque on a processed . Bitewing radiographs are obtained for examination of interproximal surfaces as well as crestal bone levels. Radiopaque structures appear light or white in a radiographic image. Neural Netw. The detection of pathologies associated with third molars on PR is the first step in the automation of M3 removal diagnostics. Google Scholar. What exposure error is eliminated if the central ray is directed between the interproximal areas? 3 0 obj Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Radiopaque volumes of material have white appearance on radiographs, compared with the relatively darker appearance of radiolucent volumes. The two types of digital systems include: Instant viewing, less radiation exposure to the patient, remote consultation, images sent by email. Effects of healthcare policy and education on reading accuracy of bitewing radiographs for interproximal caries. https://doi.org/10.1109/Jbhi.2019.2919916 (2020). Oral Maxillofac Surg. The purpose of this report was to respond to aspects of the RTI/UNC systematic review relating to the radiographic diagnosis of dental caries. gum disease) Tooth infection. A registered dental assistant may fill out & sign a patient's work excuse without prior authorization from the dentist. Akkaya N, Kansu O, Kansu H, Cagirankaya LB, Arslan U. Dentomaxillofac Radiol. The accumulated PR(s) were acquired with a Cranex Novus e device (Soredex, Helsinki, Finland), operated at 90kV and 10mA, using a CCD sensor. Background. OSHA requires employers, including those I'n the health cRe profession to: Establish guidelines & carry out procedures to protect employees, maintain employee exposure incident records for the duration of employment plus 30 years, provide protective equipment to staff. Certain types of dental caries are difficult to visualize intraorally, and therefore, the diagnosis need to be made based solely on the radiographs. PSP with 60kVp and 0.07-second exposure time had higher sensitivity and lower patient radiation dose for detection of cavitated and noncavitated lesions, but the difference was not significant ( P >.05). The right column illustrates the overlay. Learn. Teeth: what radiologists should know. A dental assistant who does not expose or process x-rays must be registered I'n the state of Texas. Neutral? Unable to load your collection due to an error, Unable to load your delegates due to an error. 98, 12271233. Mandibular Tori Subpontic Hyperostosis August 2016 References Koenig. The varying shades of gray on a processed radiograph is termed: True. Detection and diagnosis of dental caries using a deep learning-based convolutional neural network algorithm. Moderate caries lesion: Moderate mineral loss with loss of tooth surface integrity/anatomy with deeper demineralization. The carious lesion (the demineralized area of the tooth that allows greater infiltration of x-rays) is darker (i.e., Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. The following condition does not harbor bacteria that could lead to contamination; A licensed hygienist is able to legally perform any act that a registered dental assistant can perform, Adopt&enforce rules necessary to ensure compliance of rules to protect the public health safety I'n the practice of dentistry. Privileged information that cannot be disclosed: -Info between dentist and patient as relating to dental treatment. Alkali production has potential in changing the pH of the oral biofilm, which impacts demineralization. Being able to detect dental caries on radiographs is an essential skill needed for providing comprehensive dental treatment. The prevalence of carious lesions in third molars is reported to range between 2.5% and 86%4. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Disinfection is the partial elimination of active growth stage . May lead to bacterial contamination of the existing soap Mandibular central incisor periapical radiograph. , , Saliva helps modulate both the composition of the biofilm and the recovery of the biofilm pH after sugar challenge. The decision whether to remove a third molar or not, can only be made by considering these clinical data with the necessary radiological information, that are present on preoperative panoramic radiographs (PRs)3. CAS Radhiyah, A., Harsono, T. & Sigit, R. Comparison study of gaussian and histogram equalization filter on dental radiograph segmentation for labelling dental radiograph. Diagnostic accuracy of cone beam computed tomography compared with panoramic radiography. Alterations in Fluid Balance and Filtration and Resulting Edema Formation, Interactive Approach to Learning Musculoskeletal Imaging, Cervical Cancer: A Female Reproductive System Pathology Case Study, Pediatric Malnutrition (Failure to Thrive) Part A: Cardiac, Pulmonary, Gastrointestinal, & Social, Hepatoblastoma: Liver Pathology Case Study, Anatomy of the Thyroid & Surrounding Structures, Islet Cell Tumor of the Pancreas: A Pathology Case Study, Rhabdomyosarcoma: A Musculoskeletal Pathology Case Study. Which Is More Stable Thiophene Or Pyridine. 10 0 obj In cases of disagreement, the cropped PR(s) were excluded. The Innovators in Education Showcase highlights our most recent faculty and student developers and lets attendees see live demonstrations of the projects. Res. Write a statement that will free the memory allocated in the statement you wrote above. L.L. In cases of diseased third molar, where pain or pathology are obvious, there is a general consensus that surgical removal is indicated3. endobj <> Ravikiran Ongole, Praveen B N. Textbook of Oral Medicine, Oral Diagnosis and Oral Radiology. Most of periapical radiolucencies are the result of inflammation such as pulpal disease due to infection or trauma. M.H. endobj The left column shows the cropped carious M3s. The reported AUC ranged from 0.730 to 0.856 in these studies. >"n moderate occlusal caries. Shao, L., Zhu, F. & Li, X. Corresponding values for conventional radiography were 63% and 93% at the buccal line angle, 61% and 93% at the lingual line angle, and 44% and 95% at the mid-gingival floor, respectively. The systematic review was commissioned as part of the NIH Consensus Development Conference on Diagnosis and Management of Dental Caries Throughout Life. Visual examination and intraoral radiographs are still vital in diagnosis of dental caries. Classification of caries in third molars on panoramic radiographs using deep learning. Watch completed modules to see examples of the information and interactions used to keep students engaged. J. Enamel, Dentin, Cementum and bone: Enamel: is the most radiopaque structure. They can lead to a severe toothache, infection and tooth loss. Intraoral radiography has been an integral part of the diagnostic arsenal for more than 100years. Moutselos, K., Berdouses, E., Oulis, C. & Maglogiannis, I. Recognizing Occlusal Caries in Dental Intraoral Images Using Deep Learning. Clean & disinfect the outside of the container. This module will introduce students to a larger number of radiographic examples of caries than typically covered in lecture. Class activation map for carious third molars. Taking every prudent measure or precaution to prevent occasionally and non-occupationally exposed persons from excessive radiation reverts to which concept? Recent guidelines recommend the removal of pathologically erupting third molars in order to prevent future complications1,2. Home | About | Contact | Copyright | Privacy | Cookie Policy | Terms & Conditions | Sitemap. T.M. Although considerable attention has been placed on a few bacterial species as the cause of dental caries (eg, S mutans , Lactobacillus ), there is general agreement today that the dental biofilm exists as a complex ecosystem that can shift from a neutral pH to a more acidic ecosystem. Thyroid. Box 9101, 6500 HB, Nijmegen, the Netherlands, Shankeeth Vinayahalingam,Steven Kempers,Lorenzo Limon,Dionne Deibel,Stefaan Berg&Tong Xi, Artificial Intelligence, Radboud University, Nijmegen, The Netherlands, Shankeeth Vinayahalingam,Steven Kempers&Lorenzo Limon, Department of Oral and Maxillofacial Surgery, Universittsklinikum Mnster, Mnster, Germany, Shankeeth Vinayahalingam&Marcel Hanisch, Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, the Netherlands, You can also search for this author in : Supervision, writing article, article review. It is challenging to make an early diagnosis of . What is the purpose of the wedge x-ray test? Oral Maxillofac Surg. The use of deep neural networks might bring us a more reliable, faster and reproducible way of diagnosing pathology, and can therefore reduce the number of unnecessary third molar removals15. (Assume 25C^{\circ} \mathrm{C}C. The .gov means its official. applied a pre-trained GoogLeNet Inception v3 CNN network on periapical radiographs achieving accuracies up to 0.898. x_K0,7IkYq PubMed Visual and radiographic examination are the most common adjunct methods in routine clinical practice for detecting caries lesions . Waiting to see if you can arrest these caries may be all for not, as they are likely more advanced than meets the eye. Developing time is determined by the developer temperature, All these settings affect the quality of the x-ray. At the time the article was created Henry Knipe had no recorded disclosures. In this study, an accuracy of 0.87 and an AUC of 0.90 was achieved for caries classification on third molars on PR(s). Direct-acting cholinergic parasympathomimetic agents, such as Pilocarpine hydrochloride , or muscarinic agonist, like Cevimeline, are used for treatment of xerostomia. Radiation units & measurement are measured by: Hazardous products moved from one container to another do not need to have a warning label or sticker affixed to them. Google Scholar. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The image sharpness on a processed radiograph is termed: Taking every prudent measure or precaution to prevent occupationally & nonoccupationally exposed persons from excessive radiation refers to which concept? The sensitivity and specificity of film, CCD and PSP for the detection of both dentin and enamel caries, were 55% and 100%; 45% and 100%; and 55% and 100%, respectively. the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in In comparison, previous studies have stated an AUC of 0.768 for caries detection on PR(s) by clinicians17. These elements are more concentrated in enamel than in dentin, making enamel more radiopaque than dentin. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. https://doi.org/10.2105/AJPH.2006.100271 (2007). What is significant about the temperature absolute zero? Studies have shown that the median time for caries penetrating the enamel to form is 6.1 months. The lack of lubrication and buffering action from saliva, increased salivary pH (acidic), and increased colonization of acidogenic bacteria (especially S mutans ) all lead to caries of smooth surfaces, and this is termed radiation caries, although it not directly caused by radiation. Dentin surrounds the root canal and pulp chamber, the most radiolucent tooth structures and which contain the neurovascular elements of the tooth (13). The https:// ensures that you are connecting to the By submitting a comment you agree to abide by our Terms and Community Guidelines. Blurred and incomplete PR(s) were excluded from further analysis. ), The collar on a lead apron reduces the dose of radiation to the, The beam of radiation for a panoramic radiograph is a narrow silt, Which tissue is considered to be radiobiologically critical, When compared to the actual length of the tooth, the elongated image will appear, One of the advantages of being able to enhance a digital image is that, The purpose of this film is to record a major portion of the maxilla or mandible on one film, preventing cross contamination when exposing dental films can be achieved by the use of, Film placed backwards in the mouth has the appearance of (incorrect film placement), Solution exposure to air &light with the manual processing technique can be avoided by using, Lead and silver are heavy solutions and are very toxic, Developing time is determined by the developer temperature, The optimium condition for processing in a manual processor is to develop for 10 minutes at 68-70 degrees, When using the panoramic machine there is no need to wrap the unit, The following statements are true about panoramic X-rays except, Produce enlarged image that is more accurate than a full mouth series, Some of the advantages of digital radiographs include, Instant viewing, less radiation exposure to patient; remove consultation, images sent by email, Whether using the manual or automatic processing techniques, improper handling can result in. uBEATS makes a teachers job easier by giving a simple, easy way to offer advanced content. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. When the outside of the biopsy specimen bottle shows visible contamination, what should be done?
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