Journal of Dentistry
Volume 35, Issue 8 , Pages 627-635 , August 2007

A review of the current literature on aetiology and measurement methods of halitosis

  • Annemiek M.W.T. van den Broek

      Affiliations

    • Department of Oral and Maxillofacial Surgery and Special Dental Care, Erasmus University Medical Centre, Rotterdam, The Netherlands
    • ,
  • Louw Feenstra

      Affiliations

    • Department of Otorhinolaryngology, Erasmus University Medical Centre, Rotterdam, The Netherlands
    • ,
  • Cees de Baat

      Affiliations

    • Department of Oral and Maxillofacial Surgery and Special Dental Care, Erasmus University Medical Centre, Rotterdam, The Netherlands
    • Corresponding Author InformationCorresponding author at: Department of Preventive and Restorative Dentistry, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Tel.: +31 24 3616410; fax: +31 24 3540265.

Received 14 February 2007 ,Revised 5 April 2007 ,Accepted 27 April 2007.

References 

  1. Tonzetich J, Ng SK. Reduction of malodor by oral cleansing procedures.. Oral Surgery, Oral Medicine, and Oral Pathology. 1976;42:172–181
  2. Tonzetich J. Production and origin of oral malodor: a review of mechanisms and methods of analysis. Journal of Periodontology. 1977;48:13–20
  3. Belluzzi A, Brignola C, Campieri M, Camporesi EP, Gionchetti P, Rizzello F, et al. Effects of new fish oil derivative on fatty acid phospholipid-membrane pattern in a group of Crohn's disease patients. Digestive Diseases Sciences. 1994;39:2589–2594
  4. Murata T, Fujiyama Y, Yamaga T, Miyazaki H. Breath malodor in an asthmatic patient caused by side-effects of medication: a case report and review of the literature. Oral Diseases. 2003;9:273–276
  5. Steinberg SM, Venuto RC, Kuruvila CK, Taylor DO, Anil Kumar MS, Groothuis JR, et al. Randomized, open-label preference study of two cyclosporine capsule formulations (USP modified) in stable solid-organ transplant recipients. Clinical Therapeutics. 2003;25:2037–2052
  6. Yaegaki K, Coil JM. Examination classification and treatment of halitosis; clinical perspectives. Journal of the Canadian Dental Association. 2000;66:257–261
  7. Meskin LH. A breath of fresh air. Journal of the American Dental Association. 1996;127:1282–1286
  8. Miyazaki H, Sakao S, Katoh Y, Takehara T. Correlation between volatile sulphur compounds and certain oral health measurements in the general population. Journal of Periodontology. 1995;66:679–684
  9. Taani DQ. Periodontal awareness and knowledge, and pattern of dental attendance among adults in Jordan. International Dental Journal. 2002;52:94–98
  10. Liu XN, Shinada K, Chen XC, Zhang BX, Yaegaki K, Kawaguchi Y. Oral malodor-related parameters in the Chinese general population. Journal of Clinical Periodontology. 2006;33:31–36
  11. Delanghe G, Ghyselen J, van Steenberghe D. Experiences of a Belgian multidisciplinary breath odour clinic. Acta Otorhinolaryngology Belgica. 1997;51:43–48
  12. Yaegaki K, Sanada K. Volatile sulfur compounds in mouth air from clinically healthy subjects and patients with periodontal disease. Journal of Periodontal Research. 1992;27:233–238
  13. Yaegaki K, Sanada K. Biochemical and clinical factors influencing oral malodor in periodontal patients. Journal of Periodontology. 1992;63:783–789
  14. Morita M, Wang H-L. Relationship of sulcular sulfide level to severity of periodontal disease and BANA test. Journal of Periodontology. 2001;72:74–78
  15. Morita M, Wang H-L. Relationship between sulcular sulfide level and oral malodor subjects with periodontal disease. Journal of Periodontology. 2001;72:79–84
  16. Morita M, Musinski DL, Wang H-L. Assessment of newly developed tongue sulfide probe for detecting oral malodor. Journal of Clinical Periodontology. 2001;28:494–496
  17. Kleinberg I, Wolff MS, Codipilly DM. Role of saliva in oral dryness, oral feel and oral malodour. International Dental Journal. 2002;52:236–240
  18. Hinode D, Fukui M, Yokoyama N, Yokoyama M, Yoshioka M, Nakamura R. Relationship between tongue coating and secretory-immunoglobulin A level in saliva obtained from patients complaining of oral malodour. Journal of Clinical Periodontology. 2003;30:1017–1023
  19. van Steenberghe D. Breath malodour: a step by step approach. Copenhagen: Quintessence Publishing; 2004;
  20. McNamara TF, Alexander JF, Lee M, Plains M. The role of microorganisms in the production of oral malodor. Oral Surgery, Oral Medicine, and Oral Pathology. 1972;34:41–48
  21. Persson S, Claesson R, Carlsson J. The capacity of subgingival microbiotas to produce volatile sulfur compounds in human serum. Oral Microbiology and Immunology. 1989;4:169–172
  22. Persson S, Edlund MB, Claesson R, Carlsson J. The formation of hydrogen sulfide and methyl mercaptan by oral bacteria. Oral Microbiology and Immunology. 1990;5:195–201
  23. Kleinberg I, Westbay G. Salivary and metabolic factors involved in oral malodor formation. Journal of Periodontology. 1992;63:768–775
  24. Wåler SM. On the transformation of sulfur-containing amino acids and peptides to volatile sulfur compounds (VSC) in the human mouth. European Journal of Oral Sciences. 1997;105:534–537
  25. Kleinberg I, Codipilly M. Modeling of the oral malodor system and methods of analysis. Quintessence International. 1999;30:357–369
  26. Sterer N, Greenstein RB-N, Rosenberg M. β-Galactosidase activity in saliva is associated with oral malodor. Journal of Dental Research. 2002;81:182–185
  27. Sterer N, Rosenberg M. Effect of deglycosylation of salivary glycoproteins on oral malodour production. International Dental Journal. 2002;52:229–232
  28. Schmidt NF, Missan SR, Tarbet WJ, Cooper AD. The correlation between organoleptic mouth-odor ratings and levels of volatile sulfur compounds. Oral Surgery, Oral Medicine, and Oral Pathology. 1978;45:560–567
  29. Tonzetich J, Coil JM, Ng W. Gas chromatographic method for trapping and detection of volatile gas compounds from human mouth air. Journal of Clinical Dentistry. 1991;2:79–82
  30. Goldberg S, Kozlovsky A, Gordon D, Gelernter I, Sintov A, Rosenberg M. Cadaverine as a putative component of oral malodor. Journal of Dental Research. 1994;73:1168–1172
  31. Amano A, Yoshida Y, Oho T, Koga T. Monitoring ammonia to assess halitosis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2002;94:692–696
  32. Loesche WJ, Kazor C. Microbiology and treatment of halitosis. Periodontology 2000. 2002;28:256–279
  33. Kato H, Yoshida A, Awano S, Ansai T, Takehara T. Quantitative detection of volatile sulphur compound-producing microorganisms in oral specimens using real-time PCR. Oral Diseases. 2005;11:67–71
  34. Donaldson AC, McKenzie D, Riggio MP, Hodge PJ, Rolph H, Flanagan A, et al. Microbiological culture analysis of the tongue anaerobic microflora in subjects with and without halitosis. Oral Diseases. 2005;11:61–63
  35. Washio J, Sato T, Koseki T, Takahashi N. Hydrogen sulfide-producing bacteria in tongue biofilm and their relationship with oral malodour. Journal of Medical Microbiology. 2005;54:889–895
  36. De Boever EH, De Uzeda M, Loesche WJ. Relationship between volatile sulfur compounds. BANA-hydrolizing bacteria and gingival health in patients with and without complaints of oral malodor. The Journal of Clinical Dentistry. 1994;4:114–119
  37. Claesson R, Edlund MB, Persson S, Carlsson J. Production of volatile sulfur compounds by various Fusobacterium species. Oral Microbiology and Immunology. 1990;5:137–142
  38. Tang-Larsen J, Claesson R, Edlund MB, Carlsson J. Competition for peptides and amino acids among periodontal bacteria. Journal of Periodontal Research. 1995;30:390–395
  39. Turng BF, Guthmiller JM, Minah GE, Falkler WA. Development and evaluation of a selective and differential medium for the primary isolation of Peptostreptococcus micros. Oral Microbiology and Immunology. 1996;11:356–361
  40. Higuchi Y, Yagi T. Liberation of hydrogen sulfide during the catalytic action of desulfovibrio hydrogenase under the atmosphere of hydrogen. Biochemical and Biophysical Research Community. 1999;255:295–299
  41. Langendijk PS, Hagemann J, van der Hoeven JS. Sulfate-reducing bacteria in periodontal pockets and in healthy oral sites. Journal of Clinical Periodontology. 1999;26:596–599
  42. Awano S, Gohara K, Kurihara E, Ansai T, Takehara T. The relationship between the presence of periodontopathogenic bacteria in saliva and halitosis. International Dental Journal. 2002;52:212–216
  43. Nakano Y, Yoshimura M, Koga T. Methyl mercaptan production by periodontal bacteria. International Dental Journal. 2002;52:217–220
  44. Kazor CE, Mitchell PM, Lee AM, Stokes LN, Loesche WJ, Dewhirst E, et al. Diversity of bacterial populations on the tongue dorsa of patients with halitosis and healthy patients. Journal of Clinical Microbiology. 2003;41:558–563
  45. Senpuku H, Tada A, Yamaga T, Hanada N, Miyazaki H. Relationship between volatile sulphide compounds concentration and oral bacteria species detection in the elderly. International Dental Journal. 2004;54:149–153
  46. Krespi YP, Shrime MG, Kacker A. The relationship between oral malodor and volatile sulfur compound-producing bacteria. Otolaryngology-Head and Neck Surgery. 2006;135:671–676
  47. Amir E, Shimonov R, Rosenberg M. Halitosis in children. The Journal of Pediatrics. 1999;134:338–343
  48. Poelmans J, Tack J, Feenstra L. Prospective study on the incidence of chronic ear complaints related to gastroesophageal reflux and on the outcome of antireflux therapy. Annals of Otology, Rhinology & Laryngology. 2002;111:933–938
  49. Ratcliff PA, Johnson PW. The relation between oral malodor, gingivitis, and periodontitis. A review. Journal of Periodontology. 1999;70:485–489
  50. Söder B, Johansson B, Söder PO. The relationship between foetor ex ore, oral hygiene and periodontal disease. Swedish Dental Journal. 2000;24:73–82
  51. Bosy A, Kulkarni GV, Rosenberg M, McCulloch CA. Relationship of oral malodor to periodontitis: evidence of independence in discrete subpopulations. Journal of Periodontology. 1994;65:37–46
  52. Stamou E, Kozlovsky A, Rosenberg M. Association between oral malodour and periodontal disease-related parameters in a population of 71 Israelis. Oral Diseases. 2005;11:72–74
  53. Rosenberg M. Bad breath and periodontal disease: how related are they?. Journal of Clinical Periodontology. 2006;33:29–30
  54. Koshimune S, Awano S, Gohara K, Kurihara E, Ansai T, Takehara T. Low salivary flow and volatile sulfur compounds in mouth air. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2003;96:38–41
  55. Quirynen M, van Eldere J, Pauwels M, Bollen CM, van Steenberghe D. In vitro volatile sulfur compound production of oral bacteria in different culture media. Quintessence International. 1999;30:351–356
  56. Kleinberg I, Codipilly DM. Cysteine challenge testing: a powerful tool for examining oral malodour processes and treatments in vivo. International Dental Journal. 2002;52:221–228
  57. Rösing CK, Jonski G, Rølla G. Comparative analysis of some mouthrinses on the production of volatile sulfur-containing compounds. Acta Odontologica Scandinavica. 2002;60:10–12
  58. Kostelc JG, Preti G, Zelson PR, Brauner L, Baehni P. Oral odors in early experimental gingivitis. Journal of Periodontal Research. 1984;19:303–312
  59. Quirynen M, Zhao H, van Steenberge D. Review of the treatment strategies for oral malodour. Clinical Oral Investigations. 2002;6:1–10
  60. van den Broek AMWT, Feenstra L, de Baat C. A review of the current literature on management of halitosis. Oral Diseases 2007; 13, in press.
  61. Attia EL, Marshall KG. Halitosis. Canadian Medical Association Journal. 1982;126:1281–1285
  62. Preti G, Clark L, Cowart BJ, Feldman RS, Lowry LD, Weber E, et al. Non-oral etiologies of oral malodor and altered chemosensation. Journal of Periodontology. 1992;63:790–796
  63. Tomas Carmona I, Limeres Posse J, Diz Dios P, Fernandez Feijoo J, Vazquez Garcia E. Extraoral etiology of halitosis. Medicina Oral. 2001;6:40–47
  64. Tangerman A. Halitosis in medicine: a review. International Dental Journal. 2002;52:201–206
  65. Kurihara E, Marcondes FK. Oral concentration of volatile sulphur compounds in stressed rats. Stress. 2002;5:295–298
  66. Queiroz CS, Hayacibara MF, Tabchoury CPM, Marcondes FK, Cury JA. Relationship between stressful situations, salivary flow rate and oral volatile sulfur-containing compounds. European Journal of Oral Sciences. 2002;110:337–340
  67. Calil CM, Marcondes FK. Influence of anxiety on the production of oral volatile sulphur compounds. Life Sciences. 2006;79:660–664
  68. Ermis B, Aslan T, Beder L, Unalacak M. A randomized placebo-controlled trial of mebendazole for halitosis. Archives of Pediatric and Adolescent Medicine. 2002;156:995–998
  69. Finkelstein Y, Talmi YP, Zohar Y, Ophir D. Endoscopic diagnosis and treatment of persistent halitosis after pharyngeal flap surgery. Plastic Reconstructive Surgery. 1993;92:1176–1178
  70. Miyahara H, Matsunaga T. Tornwaldt's disease. Acta Otolaryngology Supplement. 1994;517:36–39
  71. Lewis M, McClay JE, Schochet P. Lingual tonsillectomy for refractory paroxysmal cough. International Journal of Pediatric Otorhinolaryngology. 2000;53:63–66
  72. Tatli MM, San I, Karaoglanoglu M. Paranasal sinus computed tomographic findings of children with chronic cough. International Journal of Pediatric Otorhinolaryngology. 2001;60:213–217
  73. Kurul S, Kandogan T. Pharyngeal foreign body in a child persisting for three years. Emergency Medicine Journal. 2002;19:361–362
  74. Stoeckli SJ, Schmid S. Endoscopic stapler-assisted diverticuloesophagostomy for Zenker's diverticulum: patient satisfaction and subjective relief of symptoms. Surgery. 2002;131:158–162
  75. Candelli M, Rigante D, Marietti G, Nista EC, Crea F, Bartolozzi F, et al. Helicobacter pylori, gastrointestinal symptoms, and metabolic control in young type 1 diabetes mellitus patients. Pediatrics. 2003;111:800–803
  76. Ansai T, Takehara T. Tonsillolith as a halitosis-inducing factor. British Dental Journal. 2005;198:263–264
  77. Katz J, Shenkman A, Stavropoulos F, Melzer E. Oral signs and symptoms in relation to disease activity and site of involvement in patients with inflammatory bowel disease. Oral Diseases. 2003;9:34–40
  78. Santarelli L, Gabrielli M, Candelli M, Cremonini F, Nista EC, Cammarota G, et al. Post-cholecystectomy alkaline reactive gastritis: a randomized trial comparing sucralfate versus rabeprazole or no treatment. European Journal of Gastroenterology & Hepatology. 2003;15:975–979
  79. Adler I, Denninghoff VC, Alvarez MI, Avagnina A, Yoshida R, Elsner B. Helicobacter pylori associated with glossitis and halitosis. Helicobacter. 2005;10:312–317
  80. Gebara ECE, Faria CM, Pannuti C, Chehter L, Mayer MPA, Lima LAPA. Persistence of Helicobacter pylori in the oral cavity after systemic eradication therapy. Journal of Clinical Periodontology. 2006;33:329–333
  81. Rosenberg M, Gelernter I, Barki M, Bar-Ness R. Day-long reduction of oral malodor by a two-phase oil:water mouthrinse as compared to chlorhexidine and placebo rinses. Journal of Periodontology. 1992;63:39–43
  82. Greenman J, El-Maaytah M, Duffield J, Spencer P, Rosenberg M, Corry D, et al. Assessing the relationship between concentrations of malodor compounds and odor scores from judges. Journal of the American Dental Association. 2005;136:749–757
  83. Rosenberg M, Septon I, Eli I, Bar-Ness R, Gelernter I, Brenner S, et al. Halitosis measurement by an industrial sulphide monitor. Journal of Periodontology. 1991;62:487–489
  84. Zusho H, Asaka H, Okamoto M. Diagnosis of olfactory disturbance. Auris Nasus Larynx. 1981;8:19–26
  85. Saad S, Greenman J, Duffield J, Sudlow K. Use of n-butanol as an odorant to standardize the organoleptic scale of breath odour judges. Oral Diseases. 2005;11:45–47
  86. Oho T, Yoshida Y, Shimazaki Y, Yamashita Y, Koga T. Characteristics of patients complaining of halitosis and the usefulness of gas chromatography for diagnosing halitosis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2001;91:531–534
  87. Nachnani S, Majerus G, Lenton P, Hodges J, Magallanes E. Effects of training on odor judges scoring intensity. Oral Diseases. 2005;11:40–44
  88. Kozlovsky A, Gordon D, Gelernter I, Loesche WJ, Rosenberg M. Correlation between the BANA test and oral malodor parameters. Journal of Dental Research. 1994;73:1036–1042
  89. Rosenberg M. Clinical assessment of bad breath: current concepts. Journal of the American Dental Association. 1996;127:475–482
  90. Greenstein RB-N, Goldberg S, Marku-Cohen S, Sterer N, Rosenberg M. Reduction of oral malodor by oxidizing lozenges. Journal of Periodontology. 1997;68:1176–1181
  91. Tonzetich J. Direct gas chromatographic analysis of sulphur compounds in mouth air in man. Archives of Oral Biology. 1971;16:587–597
  92. Murata T, Yamaga T, Iida T, Miyazaki H, Yaegaki K. Classification and examination of halitosis. International Dental Journal. 2002;52:181–186
  93. Solis-Gaffar MC, Niles HP, Rainieri WC, Kestenbaum RC. Instrumental evaluation of mouth odor in a human clinical study. Journal of Dental Research. 1975;54:351–357
  94. Persson S. Hydrogen sulfide and methyl mercaptan in periodontal pockets. Oral Microbiology and Immunology. 1992;7:378–379
  95. Furne J, Majerus G, Lenton P, Springfield J, Levitt DG, Levitt MD. Comparison of volatile sulfur compound concentrations measured with a sulfide detector vs. gas chromatography. Journal of Dental Research. 2002;81:140–143
  96. Hunter CM, Niles HP, Vazquez J, Kloos C, Subramanyam R, Williams MI, et al. Breath odor evaluation by detection of volatile sulphur compounds—correlation with organoleptic odor ratings. Oral Diseases. 2005;11:48–50
  97. Aizawa F, Kishi M, Moriya T, Takahashi M, Inaba D, Yonemitsu M. The analysis of characteristics of elderly people with high VSC level. Oral Diseases. 2005;11:80–82
  98. Rosenberg M, Kulkarni GV, Bosy A, McCulloch CAG. Reproducibility and sensitivity of oral malodor measurements with a portable sulphide monitor. Journal of Dental Research. 1991;70:1436–1440
  99. Kozlovsky A, Goldberg S, Natour I, Rogatky-Gat A, Gelernter I, Rosenberg M. Efficacy of a 2-phase oil:water mouthrinse in controlling oral malodour, gingivitis, and plaque. Journal of Periodontology. 1996;67:577–582
  100. Quirynen M, Zhao H, Avondtroodt P, Soers C, Pauwels M, Coucke W, et al. A salivary incubation test for evaluation of oral malodor: a pilot study. Journal of Periodontology. 2003;74:937–944
  101. Phillips M, Cateneo RN, Greenberg J, Munawar MI, Nachnani S, Samtani S. Pilot study of a breath test for volatile organic compounds associated with oral malodor: evidence for the role of oxidative stress. Oral Diseases. 2005;11:32–34
  102. Sopapornamorn P, Ueno M, Shinada K, Vachirarojpisan T, Kawaguchi Y. Clinical application of a VSCs monitor for oral malodour assessment. Oral Health & Preventive Dentistry. 2006;4:91–97
  103. Sopapornamorn P, Ueno M, Shinada K, Vachirarojpisan T, Shinada K, Kawaguchi Y. Association between oral malodor and measurements obtained using a new sulfide monitor. Journal of Dentistry. 2006;34:770–774
  104. Loesche WJ, Bretz WA, Kerschensteiner D, Stoll J, Socransky SS, Hujoel P, et al. Development of a diagnostic test for anaerobic periodontal infections based on plaque hydrolysis of benzoyl-dl-arginine-naphthylamide. Journal of Clinical Microbiology. 1990;28:1551–1559
  105. Loesche WJ, Lopatin DE, Giordano J, Alcoforado G, Hujoel P. Comparison of the benzoyl-DL-arginine-naphthylamide (BANA) test, DNA probes, and immunological reagents for ability to detect anaerobic periodontal infections due to Porphyromonas gingivalis, Treponema denticola and Bacteroides forsythus. Journal of Clinical Microbiology. 1992;30:427–433
  106. Figueiredo LC, Rosetti EP, Marcantonio E, Marcantonio RAC, Salvador SL. The relationship of oral malodor in patients with or without periodontal disease. Journal of Periodontology. 2002;73:1338–1342
  107. Shimura M, Yasuno Y, Iwakura M, Shimada Y, Sakai S, Suzuki K, et al. A new monitor with a zinc-oxide thin film semiconductor sensor for the measurement of volatile sulfur compounds in mouth air. Journal of Periodontology. 1996;67:396–402
  108. Shimura M, Watanabe S, Iwakura M, Oshikiri Y, Kusumoto M, Ikawa K, et al. Correlation between measurements using a new halitosis monitor and organoleptic assessment. Journal of Periodontology. 1997;68:1182–1185
  109. Tanaka M, Anguri H, Nonaka A, Kataoka K, Nagata H, Kita J, et al. Clinical assessment of oral malodor by the electronic nose system. Journal of Dental Research. 2004;83:317–321
  110. Nonaka A, Tanaka M, Anguri H, Nagata H, Kita J, Shizukuishi S. Clinical assessment of oral malodour intensity expressed as absolute value using an electronic nose. Oral Diseases. 2005;11:35–36
  111. Minamide T, Mitsubayashi K, Jaffrezic-Renault N, Hibi K, Endo H, Saito H. Bioelectronic detector with monoamine oxidase for halitosis monitoring. The Analyst. 2005;130:1490–1494
  112. Toda K, Li J, Dasgupta PK. Measurement of ammonia in human breath with a liquid-film conductivity sensor. Analytical Chemistry. 2006;78:7284–7291
  113. Murata T, Rahardjo A, Fujiyama Y, Yamaga T, Hanada M, Yaegaki K, et al. Development of a compact and simple gas chromatography for oral malodor measurement. Journal of Periodontology. 2006;77:1142–1147
  114. Iwanicka-Grzegorek K, Lipkowska E, Kepa J, Michalik J, Wierzbicka M. Comparison of ninhydrin method of detecting amine compounds with other methods of halitosis detection. Oral Diseases. 2005;11:37–39
  115. Suzuki N, Yoshida A, Nakano Y. Quantitative analysis of multi-species oral biofilms by TaqMan real-time PCR. Clinical Medicine & Research. 2005;3:176–185
  116. American Dental Association . Products used in the management of oral malodor. Chicago: American Dental Association, Council on Scientific Affairs; 2003;
  117. Greenman J, Rosenberg M. Proceedings of the sixth international conference on breath odor. Oral Diseases. 2005;11:5–6
  118. Donaldson AC, Riggio MP, Rolph HJ, Bagg J, Hodge PJ. Clinical examination of subjects with halitosis. Oral Diseases. 2007;13:63–70
  119. Willis CL, Gibson GR, Holt J, Allison C. Negative correlation between oral malodour and numbers and activities of sulphate-reducing bacteria in the human mouth. Archives of Oral Biology. 1999;44:665–670

PII: S0300-5712(07)00090-5

doi: 10.1016/j.jdent.2007.04.009

Journal of Dentistry
Volume 35, Issue 8 , Pages 627-635 , August 2007

Article Tools