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PubMed2001

A clinical comparison of different film systems for radiotherapy portal imaging.

Portal films are an important tool for verification of the shaping and positioning of external radiation fields to the target volume in radiotherapy. One limitation of port films is their inherent lack of contrast, which is due to the low attenuation of the exposing megavoltage radiation by the tissues being imaged. Recently, Kodak introduced a new portal film-cassette system, Kodak EC-L, with much improved contrast compared with conventional film. The aim of this study was to determine if the enhanced contrast of the Kodak EC-L system actually provides better clinical results. To simulate clinical use, port films were taken using an anthropomorphic phantom that was artificially shifted and/or rotated by a predetermined distance. Identical images were taken using a conventional port film system (AGFA-Gevaert Curix MR4 in lead-lined cassette) and the Kodak EC-L system. Twelve different operators (6 physicists and 6 radiation therapists) were asked to diagnose the problem from a total of 20 port films (10 per treatment site), allowing for direct comparison of the 2 types of films. While the diagnosis of the field displacement improved using the Kodak film, it did not speed-up the decision-making process. It was also found that experienced operators were more accurate at evaluating the films. The results indicate that, for the situations studied (head and neck, pelvis), the Kodak system exhibits better contrast and leads to improved decision making.

Humans↗
PubMed1995

Quality of portal verification images using GLP7 film.

RATIONALE AND OBJECTIVES: To improve portal verification radiographs, we tested the application of GLP7 film. METHODS: The quality of the portal verification radiograph using the XV cassette-GLP7 film combination and the XL cassette-GLP7 film combination was investigated. The XV cassette-XV2 film combination and the SA cassette-GS screen-XTL film combination also were used for comparison. RESULTS: The characteristic curves showed that the relative speeds were 0.32 and 0.47 for the XV-GLP7 and XL-GLP7 combinations and that the average gradients were 1.93, 2.14, and 1.32 for the XV-GLP7, XL-GLP7, and XV-XV2 combinations, respectively. In the experiment using Burger's phantom, the smallest visible volumes were 11.8, 11.3, 28.7, and 19.6 mm3 for the XV-GLP7, XL-GLP7, XV-XV2, and SA-GS-XTL combinations, respectively. In the lower dosage treatment in the clinic, there were no marked differences between the GLP7 film and XV2 film. However, in the higher dosage treatment, the GLP7 film had a better quality than did the XV2 film. CONCLUSION: Portal verification radiographs using GLP7 film are of sufficient quality for clinical use.

Humans↗
PubMed1997

In vivo study of approximal caries depth on storage phosphor plate images compared with dental x-ray film.

The aim of this in vivo study was to compare approximal caries depth on storage phosphor plate images to conventional film. A Soredex Digora imaging plate was placed in a film bite-wing positioner behind a Kodak Ektaspeed Plus film package without lead foil. The effect of scattered radiation on film without lead foil with a storage phosphor plate at the back was studied in a separate in vitro experiment. Compared with film protected by lead foil, the film showed higher density, but comparable contrast. For the in vivo study, clinical bite-wing exposures were made with the setup described above, with exposure settings for Ektaspeed Plus film. A four-point scale was chosen for approximal caries depth: 0 = no caries; 1 = caries in enamel; 2 = caries reaching dentino-enamel junction; 3 = caries into dentin. The bite-wing film images were shown to a panel of four experts. Sixty surfaces were selected for observer performance, based on identical scorings of the experts consensus classification. Next, six dentists evaluated both film and storage phosphor plate images with the same four point scale. Analysis of variance revealed a significant observer and image modality effect without an interaction effect. In conclusion, caries depth on storage phosphor plate images was underestimated compared with film-based images.

Dental Caries↗
PubMed2001

Sensitometric evaluation of a new F-speed dental radiographic film.

OBJECTIVE: To compare a new experimental Kodak (Eastman Kodak, Rochester, NY, USA) F-speed dental X-ray film with Ektaspeed Plus and Ultra-speed. METHODS: The three types of film were exposed and processed under standardized conditions. Values of base plus fog, speed, and film contrast were derived. Resolution was compared by a line-pair plate. RESULTS: Under these experimental conditions, the speed of the new film was just into the F-speed range, and a little over twice as fast as Ultra-speed. The Ektaspeed Plus emulsion was somewhat slower than previously recorded when it was first introduced, but around the centre of the E-speed range. Ektaspeed Plus and the new F-speed film had almost identical film contrasts, the F-speed film having slightly greater contrast in the higher density range. Ultra-speed contrast was marginally greater in the lower density range, but was overtaken by both of the other emulsions at higher densities. All three emulsions had low values of base plus fog. Both E- and F-speed films resolved 10 line-pairs per millimetre well, though both emulsions were inferior to Ultra-speed. CONCLUSIONS: The new F-speed film, since marketed as Insight, provides a further saving in radiation exposure, with no evident deterioration in film contrast or resolution.

Absorptiometry, Photon↗
PubMed2001

Sensitometric properties of Agfa Dentus OrthoLux, Agfa Dentus ST8G, and Kodak Ektavision panoramic radiographic film.

OBJECTIVES: The purpose of this study was to compare the sensitometric properties of and visualization of anatomical structures with Agfa OrthoLux green-sensitive panoramic radiographic film, Agfa ST8G green sensitive panoramic radiographic film, and Kodak Ektavision green-sensitive panoramic radiographic film used in combination with an Agfa Ortho Regular 400 imaging screen, Kodak Ektavision imaging screen, and Kodak Lanex Regular imaging screen. METHODS: The density response and resolution of panoramic radiographic film/intensifying screen combinations was evaluated by means of Hunter and Driffield curves, modulation transfer functions, and noise-equivalent number of quanta. Image clarity of selected anatomical structures was rated independently by 6 oral and maxillofacial radiologists. RESULTS: The ISO speed for the Agfa OrthoLux panoramic radiographic film combinations was the fastest, and the ISO speed for the Kodak Ektavision green-sensitive panoramic radiographic film combinations was the slowest. The average gradient for the Agfa ST8G systems was relatively steep in comparison with those for the other film/screen combinations. The modulation transfer functions for the Kodak Ektavision film were higher than those for the other films, irrespective of the screen combination used, and those for Agfa OrthoLux film were slightly higher than those for Agfa ST8G film. The noise-equivalent number of quanta for the Agfa ST8G film/screen combinations was lower than those for the other film/screen combinations. The noise-equivalent number of quanta for the Kodak Ektavision film/screen combinations was well within the high-frequency range, whereas Agfa OrthoLux combined with either the Kodak Ektavision imaging screen or the Kodak Lanex Regular imaging screen produced a noise-equivalent number of quanta similar to those of the Kodak Ektavision film/screen combinations in the low-frequency range. Agfa OrthoLux was perceived to provide clearer images of the selected anatomical details than Agfa ST8G, and the Agfa OrthoLux/Agfa Ortho Regular 400 combination was not significantly different from the Kodak Ektavision/Kodak Lanex Regular combination in terms of perceived image quality. CONCLUSION: Agfa OrthoLux is an improvement over Agfa ST8G in film speed, spatial resolution, granularity, and perceived diagnostic image quality. The Agfa OrthoLux/Agfa Ortho Regular 400 combination did not exceed the Kodak Ektavision film/Kodak Ektavision imaging screen combination in resolution, granularity, or perceived image quality.

Algorithms↗
PubMed1999

An application of GafChromic MD-55 film for 67.5 MeV clinical proton beam dosimetry.

The purpose of this study is to explore the use of GafChromic MD-55 (RC) film for 67.5 MeV clinical proton beam dosimetry at the Crocker Nuclear Laboratory, University of California, Davis. Several strips of RC film 6 cm x 6 cm in dimension were irradiated at a depth of 18.2 mm corresponding to the middle of a 24 mm spread-out Bragg peak (SOBP). The films were irradiated to a proton dose in the range of 0.5 Gy to 100 Gy. The beam profiles were also measured at the middle of the 24 mm SOBP. The Bragg peak was measured by using a wedge shaped phantom made of Lucite. The Bragg peak measured with RC film was compared with diode and ionization chamber measurements. After background subtraction, the calibration of the dose response of RC film showed, to a maximum deviation of 10%, a linear increase of optical density (OD) with dose from 0.5 to 100 Gy. The uniformity of OD over a single sheet of film showed a variation of +/-6%. The distal-fall off between 90% and 20% measured with GafChromic film for the Bragg peak was 1.3 mm as compared to 1.1 mm for a diode measurement and 1.4 mm for an ionization chamber measurement. The FWHM of the Bragg peak was 7.5 mm when measured with GafChromic film, 5.3 mm when measured with a diode and 8.1 mm as measured by an ionization chamber. The peak/plateau ratio with GafChromic film was 3.3 as compared to 3.7 with a diode and 3.2 with an ionization chamber. In conclusion, GafChromic MD-55 film may be a useful and convenient detector for dose measurement and quality assurance programmes of proton beams.

Cyclotrons↗
PubMed2002

Investigation of Kodak extended dose range (EDR) film for megavoltage photon beam dosimetry.

We have investigated the dependence of the measured optical density on the incident beam energy, field size and depth for a new type of film, Kodak extended dose range (Kodak EDR). Film measurements have been conducted over a range of field sizes (3 x 3 cm2 to 25 x 25 cm2) and depths (d(max) to 15 cm), for 6 MV and 15 MV photons within a solid water phantom, and the variation in sensitometric response (net optical density versus dose) has been reported. Kodak EDR film is found to have a linear response with dose, from 0 to 350 cGy, which is much higher than that typically seen for Kodak XV film (0-50 cGy). The variation in sensitometric response for Kodak EDR film as a function of field size and depth is observed to be similar to that of Kodak XV film; the optical density varied in the order of 2-3% for field sizes of 3 x 3 cm2 and 10 x 10 cm2 at depths of d(max), 5 cm and 15 cm in the phantom. Measurements for a 25 x 25 cm2 field size showed consistently higher optical densities at depths of d(max), 5 cm and 15 cm, relative to a 10 x 10 cm2 field size at 5 cm depth, with 4-5% differences noted at a depth of 15 cm. Fractional depth dose and profiles conducted with Kodak EDR film showed good agreement (2%/2 mm) with ion chamber measurements for all field sizes except for the 25 x 25 cm2 at depths greater than 15 cm, where differences in the order of 3-5% were observed. In addition, Kodak EDR film measurements were found to be consistent with those of Kodak XV film for all fractional depth doses and profiles. The results of this study indicate that Kodak EDR film may be a useful tool for relative dosimetry at higher dose ranges.

Film Dosimetry↗
PubMed2005

Post-irradiation colouration of Gafchromic EBT radiochromic film.

Gafchromic EBT (International Specialty Products, NJ, USA), radiochromic film is one of the newest radiation-induced auto-developing x-ray analysis films available for therapeutic radiation dosimetry in radiotherapy applications. Part of any radiochromic film product which undergoes a polymerization reaction for automatic darkening is an associated post-irradiation colouration whereby the film continues to darken after irradiation has ceased. The Gafchromic EBT film has been shown to produce an approximate 6% to 9% increase in post-irradiation optical density within the first 12 h of irradiation within the 1 Gy to 5 Gy dose range. This is compared to approximately 13%, 15% and 19% for MD-55-2, XR type T and HS radiochromic film, respectively. It is also shown that the EBT film's post-irradiation growth stabilizes to within 1% within the first 6 h. Thus EBT provides a reduced post-irradiation growth effect. However, to increase the accuracy of the film analysis, it is recommended that films be left for a significant period (at least 6 h) before the analysis is performed to provide a high level of accuracy. Also, calibration films must be read out with the same post-irradiation time to further enhance the accuracy of dosimetry.

Artifacts↗
PubMed2005

Practical and dosimetric implications of a new type of packaging for radiographic film.

Recently, Kodak introduced new light-tight packages (vacuum packaging, aluminium layer under black polyethylene and different paper) for their oncology films (EDR-2, X-Omat V and PPL-2). In order to avoid additional uncertainty and to ensure transferability of previously published results, we assessed in this study the effect of the old and new packages on the dosimetric response of EDR-2 radiographic film. Therefore, sensitometric measurements were performed for different film assemblies (new envelope + new paper, old envelope + old paper, new envelope without paper and old envelope without paper). In addition, to assess possible effects of the package on the film depth-dose response, packaged films were irradiated in parallel geometry, and central depth-dose curves were retrieved. For the perpendicular geometry, on the other hand, the effect of the package was assessed at large depth for a high intensity-modulated inverse-pyramid beam. The results of the sensitometric measurements reveal no difference between the packages. However, the white colour of the paper in both the packages induces a dose-dependent increase in optical density (0-0.12) of the film. The depth-dose curves show better reproducibility for the new package and the new paper improves the accuracy of film dosimetry, but despite the company's effort to evacuate the air out of the new envelope, it remains necessary to clamp the films in the phantom for the parallel irradiation geometry. At 5 cm depth, the films irradiated in parallel geometry show an under-response of 3-5% compared to films irradiated perpendicularly. Finally, even at locations of large photon scatter, no filtration effect from the aluminium layer incorporated in the new envelope has been observed for perpendicular irradiation geometry.

Dose-Response Relationship, Radiation↗
PubMed2006

Evaluation of a new self-developing instant film for imaging and dosimetry.

Radiation sensitive films are standard dosimetric tools in radiation therapy. Films are used for machine quality assurance (QA) and treatment planning software evaluation. With the advent of intensity modulated radiation therapy (IMRT), simple and fast imaging technology is needed for patient-specific verification of radiation fields. Conventional radiographic films are often used. Radiochromic films, e.g. Gafchromic films, were recently introduced to the market. But these films have some disadvantages. JP Laboratories have developed a prototype radiochromic film, called SIFID (self-developing, instant film for imaging and dosimetry) with superior performance such that SIFID is unaffected by ambient light for months, stable up to 90 degrees C and can be archived. SIFID is made of polymerisable diacetylene. The film develops blue colour instantly upon absorbing radiation. We evaluated the film for radiation therapy applications. Our preliminary data demonstrate its feasibility as a dosimetric tool for IMRT QA as well as for other applications.

Colorimetry↗
PubMed1996

Dosimetric characteristics of an improved radiochromic film.

Recently, a new model of radiochromic film has been developed for medical applications to provide a higher sensitivity and better uniformity of response than existing models (i.e., MD-55). Dosimetric characteristics including sensitivity, linearity, reproducibility, uniformity, and dependence on energy and time have been studied experimentally. The characteristics of the new films were compared with those of model MD-55. For these investigations, the two films were exposed to ionizing radiation in the dose range from 1-72 Gy, using gamma-rays from a 60Co teletherapy unit and 6- and 18-MV x rays from a linear accelerator. The response of the exposed film was measured with a helium-neon laser densitometer. The results indicated that the sensitivity of the improved film was about 40% greater than that of MD-55 film. Moreover, the response of the improved film was found to be uniform within 4% only in one direction of the film. The orthogonal direction indicated a nonuniformity of up to 15%, similar to that of model MD-55. Less than 5% energy dependence in the megavoltage photon range was observed for the new film. Complete dosimetric characteristics of the new film are presented.

Film Dosimetry↗
PubMed2006

Optical density variations in CT films and their effect on image quality.

It was recently reported that optical density (OD) variations were observed in CT films printed with a laser camera, depending on the printing format and the frame position within the film. The purpose of the present study was to investigate if these variations are common to both laser and dry-film printers and if the different OD settings along with day-to-day and frame-to-frame variations may affect the image quality. Eight laser and five dry-film printers installed at 12 different CT facilities were tested. For each one, the SMPTE test pattern was printed on all frames of a film using the same printing format. The ODs of the 0%, 10%, 40% and 70% patches of the 11-step greyscale of the SMPTE patterns were measured with a densitometer in all frames, while all films were examined on a viewing box to assess subjectively the image quality by visual inspection of the test pattern. A wide range of OD settings and variations were recorded. Frame-to-frame variations in the same film of up to 0.19, 0.15 and 0.21 OD, were observed for contrast index (CI, the OD difference of patches 10% and 70%), speed index (SI, the OD of patch 40%) and maximum OD (OD(max), the OD of patch 0%), respectively. The variations were not always of the same magnitude, nor always followed the same pattern, even for printers of the same model. Considering all films and frames, the CI ranged from 1.26 to 1.74, the SI from 0.68 to 1.43 and the OD(max) from 2.5 to 3.11 OD, well beyond the proposed settings and tolerances of 1.55+/-0.15, 1.15+/-0.1 and 2.45+/-0.1 given in the literature for CI, SI and OD(max), respectively. Despite these large differences, the various problems that were identified in image quality from the visual inspection of the films could not be directly attributed to OD settings, as films with similar CI, SI and OD(max) presented quite different image quality levels. Therefore, for routine quality control, thorough visual inspection of the SMPTE test pattern provides all the necessary information about the imaging chain status.

Computer Peripherals↗
PubMed2004

Feasibility study of custom hip stem design based on X-ray films.

The hip stem design based upon X-ray films requires sufficient information in order to customize for the patient. If the errors are resulted from rotating angles, more X-ray films may carry out the solution. The present study aimed to realize the improvement of multiple X-ray films for hip stem design. Eight X-ray films were taken from a volunteer. The characteristic length of X-ray film was input into cosine function to derive the relative rotating angle of each X-ray film. The combinations of 2, 4, 6, and 8 X-ray films that included true AP view and lateral view were obtained to construct the corresponding stem. CT images were used to construct femur and stem model to verify the rotating angle of femur in each X-ray film. A quantitative comparison was made between the hip stems for the fill ratio, fit gap and contact area. The results showed that the markers on the body surface would result in error and were unable to provide reference to the rotating angle of femur. The contact area and fill ratio of the stems designed by 6 or 8 X-ray films would get closer to that by CT images. It is concluded that the rotation of the femur could be determined from the length of femoral neck as well as the distance between the tips of medial and lateral condyles. The use of 6 or more X-ray films for custom-made hip stem as a source of design is recommended in this study.

Feasibility Studies↗
PubMed2000

Physicomechanical properties of biodegradable poly(D,L-lactide) and poly(D,L-lactide-co-glycolide) films in the dry and wet states.

The objective of this study was to investigate the mechanical properties (% elongation and puncture strength) of poly(D,L-lactide) (PLA) and poly(D,L-lactide-co-glycolide) (PLGA) films as a function of exposure time to an aqueous medium and to correlate the mechanical properties to the degradation/erosion of the polymer as a function of the type of polymer [PLA, weight-average molecular weight (M(W)) 270,300, or PLGA 50:50, M(W) 56,500], the type of plasticizer [(triethyl citrate (TEC) or acetyltributyl citrate (ATBC)], and the exposure time to pH 7.4 phosphate buffer. The glass transition temperature of the films was measured by differential scanning calorimetry (DSC), the molecular weight by size exclusion chromatography (SEC), and the polymer erosion and hydration gravimetrically. The mechanical properties were strongly affected by the type of polymer and plasticizer. PLGA films showed a faster loss of mechanical integrity. TEC, the water-soluble plasticizer, leached from the films, resulting in major differences in the mechanical properties (flexibility) when compared with films plasticized with the more permanent, water-insoluble ATBC. A significant difference in M(W) decrease was seen between plasticizer-free and plasticizer-containing PLA films, but not for PLGA films. Plasticized PLA films, which were above their glass transition temperature in the rubbery state, showed a faster decrease in M(W) than plasticizer-free PLA ones, which were in the glassy state. The plasticizer addition to the lower M(W) PLGA did not enhance the polymer degradation; the plasticizer-free PLGA was already in the rubbery state. Major differences between the two polymers were also seen in the mass loss and the water uptake studies. After 4 weeks, the mass loss was between 2.6 and 7.0% and the water uptake between 10.1 and 21.1% for PLA films, whereas for PLGA films, the mass loss was between 40.3 and 51.3% and the water uptake between 221.9 and 350.6%. 2000 Wiley-Liss, Inc.

Biocompatible Materials↗
PubMed2004

Photochromism of novel molybdate/alkylamine composite thin films.

Novel inorganic/organic composite films of molybdates with photochromic properties have been prepared by self-assembly using alkylammonium ions as a supramolecular template. Both 1-hexadecylammonium/polyoxomolybdate (C16-Mo) and 1-octadecylammonium/polyoxomolybdate (C18-Mo) composite films have been successfully fabricated. The elemental analysis and thermal gravimetric analysis show that the main product in the C16-Mo film was (C16H33NH3)4Mo8O26. The X-ray diffraction (XRD) results indicate that the composite films were lamellar in nature. The IR, Raman and X-ray photoelectron spectroscopy (XPS) results show that the polyoxomolybdate anions present as MoO6 octahedra and that the Mo species exists as Mo6+ in the freshly prepared films. The alkyl chains in the 1-hexadecylammonium chains were linear and the alkyl groups are an all-trans configuration. Upon UV irradiation of the C16-Mo films, some Mo6+ was reduced to Mo5+, some -NH3+ became -NH2 with a concomitant increase in the concentration of -OH groups on the molybdate moieties, and the films were colored. Thus, the photochromism of the films involves the reduction of Mo6+ to Mo5+, coupled with a proton transfer from 1-hexadecylammonium ions to an oxygen atom at the Mo site. In contrast to thin films of transition-metal oxides, which all show photochromism in the blue region of the electromagnetic spectrum, these composite films show photochromism in the violet region with the greatest absorbance change at 472 nm.

Journal Article↗
PubMed2003

Neural differentiation of midbrain cells on various protein-immobilized polyethylene films.

The effect of surface modification of polyethylene (PE) film on differentiation of midbrain (MB) cells obtained from rat embryos was determined by their micromass culture system. When cultured on untreated PE film, cell differentiation was suppressed to approximately two-thirds of that observed in a control culture dish. On the contrary, type I collagen-immobilized PE film increased differentiated foci of the MB cells more than did the untreated PE film. RGDS (Arg-Gly-Asp-Ser) peptide immobilization onto PE film resulted in almost the same differentiation activity as the collagen immobilized PE film. Bovine serum albumin (BSA) immobilization onto PE film enhance the differentiation activity more than did the untreated PE film, but not up to the levels of collagen- and RGDS-immobilized PE. The number of differentiated foci of the MB cells on untreated PE film were increased by the addition of the condition medium prepared from the collagen-immobilized PE film. However, the number of foci was not increased by the addition of other condition media obtained from control dish, untreated, BSA-, and RGDS-immobilized PE. On the other hand, none of these condition media enhanced a differentiation of the neuronal cell line of PC12 cells, suggesting that some factors effectively differentiate midbrain cells, composed of neuronal epithelial and mesenchymal cells, but not the PC12 cells secreted in the condition media prepared from collagen-immobilized PE. In addition, it is probable that neural growth factor was not secreted in these condition media, which could not induce the differentiation of PC12 cells.

Animals↗
PubMed2006

Construction of antibacterial multilayer films containing nanosilver via layer-by-layer assembly of heparin and chitosan-silver ions complex.

Antibacterial multilayer films containing nanosilver were prepared via layer-by-layer fashion. PET film was aminolyzed with 1,6-hexanediamine to introduce amino groups on PET film surface; chitosan-silver nitrate complex and heparin were alternately deposited onto an aminolyzed PET film surface, and subsequently, the silver ions within the multilayer films were reduced with ascorbic acid to form silver nanoparticles. UV-visible spectroscopy and transmission electron microscopy confirmed the formation of well-dispersed nanosilver particles with sizes (10-40 nm) that depended on the initial concentration of silver ions in chitosan solution and the pH of ascorbic acid solution. The chitosan/heparin multilayer films were possessed of bactericidal effect on Escherichia coli (E. coli), and this antibacterial effect could be significantly enhanced by the incorporation of silver nanoparticles into the multilayer films. The multilayer films containing nanosilver were not only effective as antibacterial but also as anticoagulant coating. And cell toxicity evaluation suggested that the multilayer films containing nanosilver did not show any cytotoxicity. The multilayer films containing nanosilver may have good potentials for surface modification of medical devices, especially for cardiovascular implants.

Animals↗
PubMed2004

Sol-gel preparation and in vitro test of fluorapatite/hydroxyapatite films.

Fluorapatite/hydroxyapatite (FA/HA) films have been demonstrated to be a good alternative to pure hydroxyapatite (HA) ones in medical applications because of their bioactivity and relatively low solubility. In this study, Ca(NO(3))(2), P(2)O(5), and HPF(6) were used to prepare FA/HA films on Ti6Al4V substrate with the use of a sol-gel method. The F contents in the films could be tailored by adjusting the amount of HPF(6) added. The in vitro evaluation of the films was carried out in both SBF9# solution and TRIS buffer solution. The films with appropriate F contents showed a better ability to induce calcium phosphate deposition on their surfaces than either pure HA film and FA/HA films with even higher F content, as well as smaller dissolution amounts than HA film in TRIS buffer solution. Hence, the FA/HA films obtained in this work integrate both good bioactivity and stability, and could be a better choice for bioactive film on titanium alloys to produce high-quality implants.

Apatites↗