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J. Indian bot. Soc. e-ISSN:2455-7218, ISSN:0019 - 4468 Vol. 97 (1&2) 2018 :79-88
Received on Feruary 16, 2018 Accepted on Feruary 20, 2018www.indianbotsoc.org
POTENTIAL APPLICATION OF NATURAL PRODUCTS IN PREVENTION AND TREATMENT OF ORAL DISEASES: A
REVIEW
PRATIMA VISHWAKARMADepartment of Microbiology, Purvanchal Institute of Dental Sciences, GIDA,
Gorakhpur-273209, Uttar [email protected] of online publication: 3oth June 2018
Microbial populations colonizing the teeth and gums are the major group of pathogens responsible for oral and dental infections, including periodontal diseases, gingivitis, pericoronitis, endodontitis, peri-implantitis, and post extraction infections (Tanner and Stillman 1993). Dental caries is one of the most prevalent chronic diseases of people worldwide. The disease process may involve enamel , dent in and cement , caus ing deca lc i f ica t ion of these t i s sues and d i s i n t eg ra t i on o f i t (Ka rp in sk i and Szkaradkiewicz 2013). The elimination of microorganisms is one of the most important steps in endodontic therapy because bacteria and their metabolic products are considered to be the primary etiologic agents of pulpar and periradicular disease of more than 750 species of bacteria that inhabit the oral cavity, a few numbers is implicated in oral diseases. The development of dental caries involves acidogenic and aciduric Gram-positive bacteria (mutans Streptococci, Lactobacilli and Actinomycetes). Periodontal diseases have been linked to anaerobic Gram-negative bacter ia (Porphyromonas gingival is , Actinobacillus, Prevotella and Fusobacterium) (Palombo 2011, Martos et al. 2013).
Dental biofilms are produced by bacterial communities with large biodiversity and high
11densities (near about 10 cell/g of wet weight). During the first 24 h of colonization, oral
streptococci compose 60% to 90% of the supragingival plaque biomass (Ogawa et al. 2011). Mutans Streptococci are biofilm-forming bacteria and are considered to be the primary etiologic agents of human dental caries.
GOOD BACTERIA AND BACTERIA ASSOCIATED WITH YOUNG ONES
Healthy mouths contains Streptococcus, Actinomyces, Veillonella, Fusobacterium, Porphromonas, Prevotella, Treponema, N i s ser ia , Haemoph i l i s , Eubac te r ia , Lactobacterium, Capnocytophaga, Eikenella, L e p t o t r i c h i a , P e p t o s t re p t o c o c c u s , Staphylococcus, and Propionibacterium in high quantity (Avila et al. 2009). The oral cavity of new born is free from bacteria but rapidly normal flora will be colonized such as Streptococcus salivarius within 8 hrs. As these microorganisms colonise the dental surface and gingiva, colonization of Streptococcus sanguis and Streptococcus mutans are formed on the teeth. Other strains of Streptococci adhere strongly to the cheeks and gums but not to the teeth (Sowmya 2016).
BACTERIA ASSOCIATED WITH ORAL PROBLEMS
Anaerobic bacteria in the oral cavity include: Actinomyces , Arachnia , Bacteroides , B i f i d o b a c t e r i u m , E u b a c t e r i u m , Fusobacterium, Lactobacillus, Leptotrichia,
Oral disease is one of the major problems throughout the world affecting about all ages, either children or old age peoples. Now a days excess use of chemicals and drugs for treatment of various microbial diseases results in drug resistance among them. Essential oils possesses different medicinal application viz., antibacterial, antiviral, antifungal, antioxidant and many more. The main aim of this review is to highlight the effect of essential oil on harmful oral bacteria which causes various oral infections.
Keywords: Bacteria, Dental Caries, Essential Oil, Oral Care, Secondary Metabolites
P e p t o c o c c u s , P e p t o s t re p t o c o c c u s , Propionibacterium, Selenomonas, Treponema and Veillonella (Sutter 1984). Bacteria accumulate on both the hard and soft oral tissues in biofilms. The bacteria associated with periodontal diseases are predominantly Gram-negative anaerobic bacteria and may include A. actinomycetemcomitans, P. gingivalis, P. intermedia, B. forsythus, C. rectus, E. nodatum, P. micros, S. intermedius and Treponema sp (Lovegrove 2004).
Streptococcus mutans is the main bacteria which initiates dental caries while different genera of Lactobacillus help in further caries development. Caries can also be caused by other bacteria, including members of the Viridans Streptococci, Streptococcus mutans, S.mitis, S. sanguis, S. milleri, S. salivarius. Enterococci (Enterococcus faecal is ) Staphylococcus (S.aureus, S.epidermidis, S. asaccharolyticus) Lactobacilli (L. acidophilus, L. salivarius, L. casei, L. plantarum, L. fermentum, L. cellobiosus, L. brevis and L. buchneri), Diptheroids (Corynebacterium, Propionobacterium), Neisseria (N. sicca, N. subflava), Haemophilus (H. aphrophilus, H. parainfluenzae, H. paraprophilus, H. haemolyticus and H. segnis), Actinobacillus actinomyce-temcomitan and Helicobacter pylori (Khan and Khan 2007, Karpinski and Szkaradkiewicz 2013)
R E A S O N F O R S E L E C T I O N O F ALTERNATIVE THERAPY
Antibiotic resistance is documented to be a serious problem that affects the choice of appropriate antibiotic therapy and increases the probability of unfavorable infection outcome. One of the proposed methods to cope with multidrug-resistant (MDR) bacteria is the use of alternative antibacterial treatments, which include natural antimicrobial substances such as plant essential oils (Kon and Rai 2012).
NATURAL PRODUCTS FOR DENTAL CARES
Herbal products have recently undergone more thorough investigation for their potential in
preventing oral diseases, particularly plaque-related diseases, such as dental caries. It is well known that Streptococcus mutans and other cariogenic bacteria are the major etiological agents in dental caries. Insoluble glucans synthesized by S. mutans increase the pathogenicity of oral biofilm by promoting the adherence and accumulation of cariogenic bacteria on tooth surface (Da Silva et al. 2012, Hays 2006).
Essential oils are complex volatile compounds, naturally synthesized by various parts of the plant during the secondary metabolism of plants (Akthar et al. 2014). Essential oil-containing mouth rinse demonstrates a significant reduction in dental plaque, gingivitis and enhances overall gingival health (Feng et al. 2009). Essential oil-containing mouth rinses can be beneficial , safe components of daily oral health routines, representing an efficient and without side effect alternative to prevent and control oral infections (Cecchini et al. 2012).
Several studies have been done to evaluate the antimicrobial activity of natural products against oral microorganisms. Shapiro et al. (1994) evaluated the antimicrobial activity of some botanical oils, against facultative anaerobic oral bacteria and stated that Australian tea tree oil, peppermint oil and sage oil are the most potent essential oils and also found thymol and eugenol as potent essential oil components. Takarada et al. (2004) investigated the antibacterial effects of various essential oils viz., manuka oil, tea tree oil, eucalyptus oil, lavandula oil and romarinus oil against fol lowing oral bacter ia viz . , Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum , Streptococcus mutans and Streptococcus sobrinus. Among the essential oils tested, manuka oil and tea tree oil in particular had strong antibacterial activity against periodontopathic and cariogenic bacteria. Hammer et al. (2003) evaluated the ant icar iogenic act ivi ty of Melaleuca alternifolia (tea tree) oil against 161 isolates of
J. Indian bot. Soc. 97 (1&2) 2018 :80Natural products in prevention and treatment of Oral diseases
S.No. Plant Family Bacteria MIC/MBC Reference
1. Aloysia gratissima (Gillies
& Hook) Troncoso
Verbenaceae Streptococcus mutans 125–250 µg/ml(MIC),
250–500 µg/ml (MBC)
Galvão et al.(2012)
2. Aloysia triphylla (L’H´
er.) Britton
Verbenaceae Streptococcus mutans 125–250 µg/ml (MIC),
125–250 µg/ml (MBC)
Galvão et al.(2012)
3. Alpinia speciosa (Pers.)
Burtt &
Smith
Zingiberaceae Streptococcus mutans 125–250 µg/ml (MIC),
250–500 µg/ml (MBC)
Galvão et al.(2012)
4. Baccharis
dracunculifolia DC
Asteraceae Streptococcus mutans 62.5–125 µg/ml (MIC),
250–500 µg/ml (MBC)
Galvão et al.(2012)
5. Baccharis
dracunculifolia DC
Asteraceae Streptococcus mutans 6% (MIC) Pereira et al. (2016)
6. Bidens sulphurea (Cav.)
Sch. Bip
Asteraceae Streptococcus mutans
Streptococcus mitis
250 µg /ml and
31.25 µg /ml (MIC)
respectively
Aguair et al.(2013)
7. Cinnamomum
osmophloeum Kaneh.
Lauraceae E. coli, P. aeruginosa, E.
faecalis, S. aureus, S.
epidermidis, MRSA, K.
pneumoniae, Salmonella sp., and
V. parahemolyticus
500, 1000, 250, 250,
250, 250, 1000, 500,
and 250 microg/ml,
respectively
Chang et al. (2001)
8. Cinnamomum
zeylanicum Blume
Lauraceae Streptococcus mutans 250–500 µg/ml (MIC),
500–1000 µg/ml (MBC)
Galvão et al.(2012)
9. Citrus hystrix DC. Rutaceae S. mutans 2.12 mg/ml Wongsariya et al.
(2014)
10. Citrus hystrix DC. Rutaceae P. gingivalis 1.06 mg/ml Wongsariya et al.
(2014)
11. Coriandrum
sativum L.
Apiaceae Streptococcus mutans 31.2–62.5 µg/ml (MIC),
62.5–125 µg/ml (MBC)
Galvão et al.(2012)
12. Cymbopogon
citratus (DC)
Poaceae Streptococcus mutans 125–250 µg/ml (MIC),
250–500 µg/ml (MBC)
Galvão et al.(2012)
13. Cymbopogon
martini (Roxb.)
Poaceae Streptococcus mutans 125–250 µg/ml (MIC),
250–500 µg/ml (MBC)
Galvão et al.(2012)
14. Cymbopogon
winterianus Jowitt
Poaceae Streptococcus mutans 125–250 µg/ml (MIC),
250–500 µg/ml (MBC)
Galvão et al.(2012)
15. Cyperus articulatus
Vahl
Cyperaceae Streptococcus mutans 125–250 µg/ml (MIC),
250–500 µg/ml (MBC)
Galvão et al.(2012)
16. Dracocephalum foetidum
Bunge
Lamiaceae methicillin-resistant
Staphylococcus aureus strain
26-2592 µg/ml (MIC) Lee et al. (2007)
17. Elyonurus muticus
Spreng
Poaceae Streptococcus mutans 125–250 µg/ml (MIC),
125–250 µg/ml (MBC)
Galvão et al.(2012)
18. Eucalyptus camaldulensis
Dehnh.
Myrtaceae Streptococcus mutans and
Streptococcus pyogenes
2 mg/ml (MBC) Rasooli et al. (2009)
19. Eugenia florida
DC.
Myrtaceae Streptococcus mutans 125–250 µg/ml (MIC),
250–500 µg/ml (MBC)
Galvão et al.(2012)
20. Eugenia uniflora L. Myrtaceae Streptococcus mutans 125–250 µg/ml (MIC),
250–500 µg/ml (MBC)
Galvão et al.(2012)
21. Glycyrrhiza glabra L. Fabaceae Streptococcus mutans,
Actinomyces viscosus and
Enterococcus faecalis
12.5 mg/ml (MIC) Sedighinia et al.
(2012)
22. Glycyrrhiza glabra L. Fabaceae Escherishia coli and
Staphylococcus aureus
35 mg/ml (MIC) Sedighinia et al.
(2012)
23. Glycyrrhiza glabra L. Fabaceae Streptococcus sanguis 30 mg/ml (MIC) Sedighinia et al.
(2012)
24. Lavandula spica L. Lamiaceae Enterococcus fecalis,
Escherichia coli Staphylococcus
aureus, and Candida albicans
32, 128, 32, 8 (MIC)
respectively
Thosar et al. (2013)
25. Lippia alba (Mill.)
N.E. Brown
Verbenaceae Streptococcus mutans 125–250 µg/ml (MIC),
250–500 µg/ml (MBC)
Galvão et al.(2012)
26. Lippia sidoides
Cham.
Verbenaceae Streptococcus mutans 62.5–125 µg/ml (MIC),
125–250 µg/ml (MBC)
Galvão et al. (2012)
Table 1: Antimicrobial activity of some essential oil against oral bacteria
Pratima Vishwakarma J. Indian bot. Soc. 97 (1&2) 2018 :81
oral bacteria. MIC90 values were found to be 1.0% (v/v) for Actinomyces spp., Lactobacillus spp., Streptococcus mitis and Streptococcus sanguis and 0.1% (v/v) for Prevotella spp. Isolates of Porphyromonas, Prevotella and Veillonella had the lowest MICs and MBCs w h i l e i s o l a t e s o f S t r e p t o c o c c u s , Fusobacterium and Lactobacillus had the highest. Shayegh et al. (2008) evaluated the
antimicrobial activity of Mentha piperita and Cuminum cyminum essential oils against microbes associated with supragingival dental plaque and found that M. piperita was more effective followed by C. cyminum. Prabhakar et al. (2009) had evaluated anti microbial efficacy of Curry leaves, Garlic and Tea tree oil mouthwashes against Streptococcus mutans and Lactobacillus and found that these three
J. Indian bot. Soc. 97 (1&2) 2018 :82
27.
a � � � � � � � � � � � � � � � � � � � �
(Maiden & Betche)
Cheel
Myrtaceae Enterobacter aerogenes,
Escherichia coli, Klebsiella
pneumoniae, Proteus mirabilis,
Salmonella choleraesuis, Shigella
flexneri, Bacillus subtilis, Listeria
monocytogenes, Staphylococcus
aureus, S. saprophyticus and S.
xylosus
0.25 % (MIC) Harkenthal et al.
(1999)
28. Melaleuca alternifolia
(Maiden & Betche)
Cheel
Myrtaceae Enterococcus fecalis, Escherichia
coli Staphylococcus aureus and
Candida albicans
64, 2, 1, 0.5 µg /ml
(MIC) respectively
Thosar et al.
(2013)
29. Mentha piperita L. Lamiaceae Streptococcus mutans 250–500 µg/ml (MIC),
250–500 µg/ml (MBC)
Galvão et
al.(2012)
30. Mentha piperita L. Lamiaceae Enterococcus fecalis, Escherichia
coliÆ { � � � � � � � � � � � � � � � � � � � and
Candida albicans
32,1,2, 0.5(MIC)
respectively
Thosar et al.
(2013)
31. Mentha spicata L. Lamiaceae Streptococcus mutans and
Streptococcus pyogenes
4 mg/ml (MBC) Rasooli et al.
(2009)
32. Mikania glomerata
Spreng.
Asteraceae Streptococcus mutans 62.5–125 µg/ml
Streptococcus mutans
(MIC), 125–250 µg/ml
(MBC)
Galvão et
al.(2012)
33. Ocimum americanum
L.
Lamiaceae Streptococcus mutans,
Lactobacillus casei and Candida
albicans
0.04% (MIC),
Thaweboon and
Thaweboon
(2009)
34. Rosmarinus officinalis
L.
Lamiaceae Streptococcus mutans and
Streptococcus pyogenes
2000 ppm and 4000
ppm respectively
Rasooli et al.
(2008)
35. Salvia rosifolia SM. Lamiaceae methicillin-resistant
Staphylococcus aureus strain
125 µg /ml Ozek et al.
(2010)
36. Siparuna
guianenses Aubl.
Monimiaceae Streptococcus mutans 62.5–125 µg/ml (MIC),
125–250 µg/ml (MBC)
Galvão et
al.(2012)
37. Syzygium
aromaticum (L.)
Merr. & L. M. Perry
Myrtaceae Streptococcus mutans 62.5–125 µg/ml (MIC),
125–250 µg/ml (MBC)
Galvão et
al.(2012)
38. Thymus eriocalyx
(Ronniger) Jalas,
Rech.f.
Lamiaceae Streptococcus mutans and
Streptococcus pyogenes
2000 ppm and 4000
ppm respectively
Rasooli et al.
(2008)
39. Thymus vulgaris L. Lamiaceae Enterococcus fecalis, Escherichia
coli Staphylococcus aureus, and
Candida albicans
32, 2, 32, 16 (MIC)
respectively
Thosar et al.
(2013)
40. Vitex agnus-castus L. Lamiaceae Streptococcus mutans, Lactobacillus casei
15.6 µg /ml (MIC) Gonçalves et al.
(2017)
41. Vitex agnus-castus L. Lamiaceae Streptococcus mitis 31.2 µg /ml(MIC) Gonçalves et al.
(2017)
42. Ziziphus joazeiro
Mart.
Rhamnaceae Streptococcus mutans 250–500 µg/ml (MBC),
500-1000 µg/ml (MBC)
Galvão et
al.(2012)
Natural products in prevention and treatment of Oral diseases
botanicals possesses good antimicrobial activity against the tested microbes in children. Antimicrobial activity is one of the important medicinal properties associated with garlic which makes it a potential anticariogenic agent in protecting against Streptococcus mutans, which is acidogenic, aciduric and cariogenic in the oral cavity (Kudva et al. 2012). Ocimum
americanum can also be used as oral health care products for reducing the pathogenic microorganisms in the oral cavity. Thaweboon and Thaweboon (2009) evaluated MCC (minimum cida concentrat ion) of O. americanum against three oral bacteria viz., Streptococcus mutans, Lactobacillus casei and Candida albicans and found it to be 0.08%,
J. Indian bot. Soc. 97 (1&2) 2018 :83
S.No. Plants Active constituents Reference
1. Achillea ligustica All. linalool, viridiflorol, � � pinene, 1,8-cineole and
terpinen-4-ol
Maggi et al. (2009)
2. Bidens sulphurea (Cav.)
Sch. Bip
Germacrene D, trans-caryophyllene, � � elemene and
bicyclogermacrene
Aguair et al.(2013)
3. Cinnamomum
osmophloeum Kaneh.
Cinnamaldehyde Chang et al. (2001)
4. Cinnamomum
pubescens Kochummen
1,6-octadien-3-ol,3,7-dimethyl, cinnamaldehyde
and 1-phenyl-propane-2,2-diol diethanoate
Abdelwahab et al.
(2010)
5. Citrus hystrix DC. Citronellal Wongsariya et al. (2014)
6. Cocos nucifera L. Monolaurin and monoglycerides Naseem et al. (2017)
7. Cymbopogon citratus
(DC.)
Geraniol and Citral Tofiño-Rivera et al.
(2016)
8. Dracocephalum foetidum
Bunge
n-Mentha-1,8-dien-10-al, limonene, geranial, and
neral
Lee et al. (2007)
9. Etlingera elatior (Jack)
R.M.Sm.
� � pinene and 1-dodecene Abdelwahab et al.
(2010)
10. Eucalyptus camaldulensis
Dehnh.
1,8-Cineole, � � Pinene, iso-Leptospermone and (E)-
Caryophyllene
Gakuubi (2016)
11. Eucalyptus citriodora
Hook.
Citronellal and citronellol
Mulyaningsih et al.
(2011)
12. Eucalyptus globules
Labill.
Aromadendrene, 1,8-cineole and
globulol
Mulyaningsih et al.
(2010), Mulyaningsih et
al. (2011)
13. Lavandula
Stoechas L.
alpha-fenchone, 1,8-cineole, camphor and
viridiflorol in the leaves; and alpha-fenchone,
myrtenyl acetate, a-pinene,
camphor and 1,8-cineole in flowers
Kirmizibekmez et al.
(2009)
14. Lippia alba (Mill.) N.E.
Brown
Geraniol and Citral Tofiño-Rivera et al.
(2016)
15. Melaleuca alternifolia
(Maiden & Betche) Cheel
Terpinen-4-ol Loughlin et al. (2008),
LaPlante (2007)
16. Melaleuca alternifolia
(Maiden & Betche) Cheel
terpinol-4 and 1,8-cineol Salvatori et al. (2017)
17. Mentha spicata L. Carvone and limonene Snoussi et al. (2015)
18. Salvia rosifolia SM. a-pinene, 1,8-cineole, b-pinene, b-caryophyllene
and caryophyllene oxide
Ozek et al. (2010)
19. Sesamum indicum L. sesamin, sesamolin and sesaminol Naseem et al. (2017)
20. Thymus vulgaris L. Thymol, rho-cymene and g-terpinene Tohidpour et al. (2010)
21. Vitex agnus-castus L. 1,8-cineole, (E)-� � farnesene, (E) caryophyllene,
sabinene and � � terpinyl acetate
Gonçalves et al. (2017)
Table 2: List of active compounds of plants responsible for antimicrobial activity against oral bacteria
Pratima Vishwakarma
0.3% and 0.08% v/v, respectively. Maggi et al. (2009) evaluated the antimicrobial activity of Achillea ligustica on 6 microbial strains and showed that it is quite strong against the cariogenic Gram-positive Streptococcus mutans, suggesting that it can be a valid candidate for anti-cariogenic formulations. Chaudhari et al. (2012) evaluated nine pure essential oils viz., wintergreen oil, lime oil, cinnamon oil, spearmint oil, peppermint oil, lemongrass oil, cedarwood oil, clove oil and eucalyptus oil against Streptococcus mutans and stated that Cinnamon oil showed highest activity against Streptococcus mutans followed by lemongrass oil and cedarwood oil. Wintergreen oil, lime oil, peppermint oil and spearmint oil showed no antibacterial activity. D i f f e r e n t p l a n t s p e c i e s p o s s e s s i n g antimicrobial activity are presented in Table 1.
Essential oils are aromatic in nature because of a mixture of multifarious chemical substances that belong to different chemical families, including terpenes, aldehydes, alcohols, esters, phenolic, ethers and ketones. Essential oils generally have 2-3 major components at fairly high concentrations (20-70%) compared to other components present in trace amount. Most essential oils are composed of terpenes, terpenoids and other aromatic and aliphatic constituents with low molecular weights. Terpenes or terpenoids are synthesized within the cytoplasm of the cell through the mevalonic acid pathway (Akthar et al. 2014, Swamy et al. 2016). List of different active constituents isolated from different plant species possessing antimicrobial activity are given in Table 2.
M E C H A N I S M O F A C T I O N O F ESSENTIAL OILS
There are fewer reports on the mechanisms of action of essential oils or their purified components on microorganisms. It results in sequential inhibition of a common biochemical pathway, inhibition of protective enzymes and use of cell wall active agents to enhance the uptake of other antimicrobials (Bassolé and Juliani 2012). Essential oils primarily
destabilize the cellular architecture, leading to the breakdown of membrane integrity and increased permeability, which disrupts many cellular activities, including energy production (membrane-coupled), membrane transport, and other metabolic regulatory functions. The disruption of the cell membrane by essential oils may assist various vital processes such as energy conversion processes, nutrient processing, the synthesis of structural macromolecules and the secretion of growth regulators (Nazzaro et al. 2013). It can affect both the external envelope of the cell and the cytoplasm. The hydrophobicity of the major antibacterial compositions of essential oil enables them partition in the lipids of the cell membranes and mitochondria, disturbing their structures, changing their functions and rendering them permeably. Subsequently, the active components can lead to disrupt the synthesis of some macromolecules, such as DNA, RNA, protein or polysaccharides and then cause the death of the cells (Zhang et al. 2017). Changes in the hydrophobicity, surface charge and membrane integrity with the
+subsequent K leakage from E. coli and S. aureus were observed after exposure to essential oils (Lopez-Romero et al. 2015).
CONCLUSION
Poor oral health imparts profound effect on general health of peoples. Peoples having oral issues experiences several problems viz., problem during eating and chewing, severe pain and also bad odor. Increasing resistance of microorganism to drugs and chemicals is becoming a serious problem throughout the world which increases the interest of researcher towards some alternative remedies which are cost effective and also possesses no adverse effects on people's health. Essential oils are plant volatiles which contains various secondary metabolites which have many medicinal importance. It also possesses antimicrobial activity against oral microbes and works on cell membrane. It disrupt the cell structure which results in leakage of the contents of cell and finally leads to cell death. It
J. Indian bot. Soc. 97 (1&2) 2018 :84Natural products in prevention and treatment of Oral diseases
also checks the cell membrane synthesis pathway and blocks its growth process.
The author wish to thank the Principal, Purvanchal Institute of Dental Sciences for providing necessary lab facilities to carry out this work. I am also thankful to Prof NN Tripathi, Dept of Botany, DDU Gorakhpur University for his appropriate guidance and support.
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