SCANNING VOL.
36, 640–647 (2014)
© Wiley Periodicals, Inc.
Effectiveness of Various Irrigation Activation Protocols and the
Self-Adjusting File System on Smear Layer and Debris Removal
İSMAIL DAVUT ÇAPAR1 AND HALE ARI AYDINBELGE2
1
Department of Endodontics, Faculty of Dentistry, İzmir Katip Çelebi University, İzmir, Turkey
2
Department of Endodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
Summary: The purpose of the present study is to
evaluate smear layer generation and residual debris after
using self-adjusting file (SAF) or rotary instrumentation
and to compare the debris and smear layer removal
efficacy of the SAF cleaning/shaping irrigation system
against final agitation techniques. One hundred and
eight maxillary lateral incisor teeth were randomly
divided into nine experimental groups (n ¼ 12), and root
canals were prepared using ProTaper Universal rotary
files, with the exception of the SAF instrumentation
group. During instrumentation, root canals were
irrigated with a total of 16 mL of 5% NaOCl. For final
irrigation, rotary-instrumented groups were irrigated
with 10 mL of 17% EDTA and 10 mL of 5% NaOCl
using different irrigation agitation regimens (syringe
irrigation with needles, NaviTip FX, manual dynamic
irrigation, CanalBrush, EndoActivator, EndoVac, pas-
sive ultrasonic irrigation (PUI), and SAF irrigation).
In the SAF instrumentation group, root canals were
instrumented for 4 min at a rate of 4 mL/min with 5%
NaOCl and received a final flush with same as syringe
irrigation with needles. The surface of the root dentin
was observed using a scanning electron microscope. The
SAF instrumentation group generated less smear layer
and yielded cleaner canals compared to rotary instru-
mentation. The EndoActivator, EndoVac, PUI, and SAF
irrigation groups increased the efficacy of irrigating
solutions on the smear layer and debris removal. The
SAF instrumentation yielded cleaner canal walls when
Contract grant sponsor: Scientific Research Projects Coordination
Center of Selcuk University, Konya, Turkey; Contract grant number:
11102018.
Conflicts of interest: None.
Address of reprints: İsmail Davut Çapar, Department of Endodontics,
Faculty of Dentistry, İzmir Katip Çelebi University, Izmir 35620, Turkey
E-mail: capardt@hotmail.com
Received 16 July 2014; revised 27 August 2014; Accepted with
revision 10 September 2014
DOI: 10.1002/sca.21171
Published online 6 October 2014 in Wiley Online Library
(wileyonlinelibrary.com).
compared to rotary instrumentation. None of the
techniques completely removed the smear layer from
the root canal walls. SCANNING 36:640–647, 2014.
© 2014 Wiley Periodicals, Inc.
Key words: CanalBrush, EndoActivator, EndoVac,
passive ultrasonic irrigation, self-adjusting file
Introduction
Removal of vital and necrotic pulp tissue, micro-
organisms, and their toxins from the root canal system is
critical for successful root canal therapy (Basmadjian-
Charles et al., 2002; Wong, 2004; Siqueira and
Rocas, 2008). Micro-computed tomography technology
has shown that current Ni–Ti rotary systems lead
to untreated dentin areas (Peters et al., 2001; Paque
et al., 2009; Paque et al., 2010). Traditional syringes
and metal needles of varying size and tip design
have delivered irrigants into the root canal space, but
because of the complexity of the root canal, there may be
untreated areas requiring cleaning following irrigation
(Williamson et al., 2009). Therefore, several mechanical
devices and techniques have been developed to further
improve the penetration and effectiveness of irrigation.
Devices and techniques for irrigation are classified as
either manual or machine assisted (Gu et al., 2009).
Repeated insertion of gutta-percha master cones into
the working length (WL), a technique called manual
dynamic irrigation (MDI), and the NaviTip FX (Ultra-
dent Products, Inc., South Jordan, UT) are used for
manual agitation of irrigants. MDI is a simple technique
and requires no additional devices (Susin et al., 2010).
The NaviTip FX is a brush-covered irrigation needle
designed for scrubbing the canal walls and agitating
the irrigation solution (Gu et al., 2009). Rotary brushes
are machine-assisted techniques for agitation that
can also be used manually and sonically (Salman
et al., 2010). Among them, the CanalBrush (Coltene
Whaledent, Langenau, Germany) is molded entirely
from polypropylene, which explains its high flexibility
 İ. D. Çapar and H. Ari Aydinbelge: Smear Layer Removal
(Gu et al., 2009). The EndoActivator system (Dentsply
Tulsa Dental Specialties, Tulsa, OK) uses sonic energy
with a flexible non-cutting polymer tip attached to a
vibrating handpiece. The EndoVac system (Discus
Dental, Culver City, CA) is an apical negative pressure
(ANP) irrigation device designed to deliver irrigating
solutions to the apical portion of the canal system
and suction out debris (Schoeffel, 2008). Continuous
passive ultrasonic irrigation (PUI) uses an ultrasonically
activated file inside the root canal with a continuous
irrigant supply from the handpiece. However, the use of
ultrasonic irrigation agitation may cause canal devia-
tion, apical zipping, and even root perforation, due to the
potential for continued prepping or cutting of the canal
walls (Klyn et al., 2010).
Root canal instrumentation generates the smear layer
that may also contain bacteria and their by-products.
This layer can prevent the penetration of intracanal
medicaments into dentinal tubules (Violich and
Chandler, 2010). It has also been shown that eliminating
the smear layer could increase the success of obturation
(Taylor et al., ’97).
The self-adjusting file system (SAF) system (Re-
Dent-Nova, Ra’nana, Israel) was introduced to achieve
complete three-dimensional root canal shaping, clean-
ing, and irrigation. It allows for continuous irrigation
during preparation and has beneficial effects for
activating final irrigation once the canal preparation
has been completed (Metzger et al., 2010b). The SAF
system is operated by vibrating a slightly abrasive lattice
using an in-and-out motion to remove dentin (Hof
et al., 2010). The continuous flow of the irrigating
solution through the file, combined with the vibrating
motion, may have an effect on the cleaning ability of the
file (Metzger et al., 2010a). Metzger et al. (2010a)
showed that using the SAF system combined with
NaOCl and EDTA resulted in a dentinal surface mostly
free of a smear layer in all parts of the root canal. Several
recent studies have shown that the use of the SAF
cleaning/shaping system enhanced the removal of
calcium hydroxide medicament from the artificial
groove models (Capar et al., 2013), residual gutta-
percha after retreatment (Abramovitz et al., 2012),
and biofilm bacteria from within the artificial groove
models (Lin et al., 2013), as well as increased pulp
tissue debridement (De-Deus et al., 2011) and the bond
strength of root fillings (De-Deus et al., 2013).
To the best of our knowledge, there are no data in the
literature comparing the SAF system with irrigation
agitation systems for smear layer removal. Thus, the aim
of the present study was to compare the SAF cleaning/
shaping irrigation system against final agitation techni-
ques (i.e., conventional syringe irrigation with needles,
NaviTip FX, and MDI, CanalBrush, EndoActivator,
EndoVac, and PUI), in terms of removing the smear
layer and debris, as well as to evaluate smear layer
formation and residual debris after using SAF or rotary
641
instrumentation. The null hypotheses were that there
would be no differences among the various irrigation
activation protocols in terms of root canal cleanliness,
and there would be no differences between SAF and
rotary instrumentation in terms of smear layer formation
and residual debris.
Materials and Methods
One hundred and eight maxillary lateral incisors with
single roots and round root canals were selected and
stored in distilled water at room temperature until use.
Teeth with previous root canal treatment, had a fractured
root, or were incompletely developed were excluded.
The selected teeth were decoronated, and the WL
was determined by using a size 15 K-file (Mani, Inc.,
Utsunomiya, Japan) pushed through the apex and pulled
back until the tip was flush with the root surface and
subtracting 1 mm. The root apices were covered with
a wax (Cavex set up regular, Cavex, Haarlem, the
Netherlands) to prevent the irrigants from passing freely
through the apical foramen during the irrigation
procedure. The roots were randomly divided into
nine experimental groups (n ¼ 12). One group was
instrumented with SAF, and the other groups were
instrumented with ProTaper Universal rotary files up
to size F4 instrument in the same manner (Dentsply,
Maillefer, Ballagiues, Switzerland).
SAF Instrumentation þ >Conventional Syringe
Irrigation (CSI)
The SAF system was used with an in-and-out
vibrating handpiece, combined with an RDT3 head
(ReDent-Nova, Ra’nana, Israel), at a frequency of 5,000
movements per minute and amplitude of 0.4 mm.
Irrigation with 5% NaOCl was applied through the
hollow file throughout the 4 min of operation. The
irrigant was continuously provided by a VATEA
peristaltic pump (ReDent-Nova, Ra’nana, Israel), at a
rate of 4 mL per minute. After instrumentation, the
canals were irrigated with 2 mL of distilled water, and
then 10 mL of 17% of EDTA was flushed into the canal
with an in-and-out motion using the 27-gauge conven-
tional needle and syringe and left in place for 1 min per
canal. All canals were then flushed with 10 mL of
NaOCl, which was left in place for 1 min per canal.
ProTaper Instrumentation (PI) þ CSI
Root canals were prepared to size F4 of the ProTaper
instrument using the following sequence: SX, S1, S2,
F1, F2, F3, and F4. During instrumentation, root canals
were irrigated with a total of 16 mL of 5% NaOCl. After
642 SCANNING VOL. 36, 6 (2014)
the last instrument, the canals were irrigated with 2 mL
of distilled water followed by varied irrigant agitation
protocols as described below.
To compare root canal debridement and smear layer
formation after use of SAF and rotary instrumentation,
root canals were irrigated in the same manner as the SAF
instrumentation group, using the 27-gauge conventional
needle and syringe. 10 mL of EDTA was flushed into the
canal with an in-and-out motion and left in place for
1 min per canal. All canals were then flushed with 10 mL
of NaOCl, which was left in place for 1 min per canal.
PI þ NaviTip FX (NFX)
Ten milliliter of EDTA was flushed into the canal
with the brush-covered 30-gauge NaviTip FX needle
using 45˚ clockwise and counter-clockwise movements
combined with back-and-forth strokes, for 1 min per
canal. Ten milliliter of NaOCl was activated using the
same method for 1 min.
PI þ Manual Dynamic Irrigation (MDI)
Ten milliliter of EDTA was flushed into the canal
using the 27-gauge conventional needle and syringe.
This solution was activated by using a number F4 gutta-
percha cone (Dentsply, Maillefer) for 1 min in each
canal. The frequency of activation was 100 push-pull
strokes per minute. The canals were then flushed with
10 mL of NaOCl and activated using the same method
for 1 min.
PI þ CanalBrush (CB)
Ten milliliter of EDTA was flushed into the canal
using the 27-gauge conventional needle and syringe and
activated using a CanalBrush operated on a contra angle
slow-speed handpiece at 600 rpm for 1 min. The brush
was used on the full WL with a gentle up-and-down
motion. The canals were then flushed with 10 mL of
NaOCl and activated using the same method for 1 min.
PI þ Continuous PUI
Ten milliliter of EDTA was agitated using a size
15 K-file (Acteon Group, Merignac, France) coupled to
the file-holding adapter of the handpiece of a Satalec P5
Newtron XS ultrasonic system (Acteon Group). The
ultrasonic file was placed into the canal 1 mm short of
the WL without touching the walls, enabling it to
vibrate freely. The ultrasonic file was activated at the
sixth power setting for 1 min, and the irrigants were
continuously delivered at a rate of 10 mL per minute
through the unit. Sequentially, 10 mL of NaOCl was
activated using the same method for 1 min.
PI þ EndoActivator
Ten milliliter of EDTA was flushed into the canal
using the 27-gauge conventional needle and syringe and
activated using the EndoActivator handpiece set at
10,000 cycles per minute, with a red (25/04) tip inserted
2 mm short of the WL for 1 min. The canals were then
flushed with 10 mL of NaOCl and activated using the
same method for 1 min.
PI þ EndoVac
The canals were first irrigated for 30 s with 2.5 mL
NaOCl using macro-cannulas. Canals were then
irrigated for three cycles using micro-cannulas inserted
into the full WL. The first cycle was 30 s of 2.5 mL
NaOCl followed by 30 s of soaking; the second cycle
was 1 min of 10 mL of EDTA followed by 1 min of
soaking; and the third cycle was 1 min of 5 mL NaOCl
followed by 1 min of soaking.
PI þ SAF Irrigation
The SAF file was operated in two cycles of 2 min
each, for a total of 4 min, at a rate of 5 mL per minute.
During the first minute of each cycle, NaOCl was used as
the irrigant, whereas EDTA was used during the second
minute. A total of 10 mL EDTA and 10 mL NaOCl
was used as the final irrigation in all groups. After final
irrigation, all specimens were irrigated with 2.5 mL
of distilled water to remove any remaining irrigation
solution.
For the scanning electron microscope (SEM)
examination, the access openings of the canal were
sealed with a temporary filling material (Cavit G; 3M
Espe, Seefeld, Germany) to prevent any debris from
getting into the canal. In addition, all roots were grooved
longitudinally on the buccal and lingual surfaces using a
diamond disk under copious water irrigation, avoiding
penetration into the root canal. The roots were then split
into two halves with a small chisel. Specimens were
dried at 50˚C in an incubator (Nüve Incubator EN 120;
Ankara, Turkey) for 24 h. After sputter coating the

specimens with gold to a thickness of 90 A, the surface
of the root dentin was observed using an SEM (Evo
LS10; Carl Zeiss, Oberkochen, Germany). The areas of
interest for each canal third of each specimen were
selected at 2, 5, and 8 mm from the root apex, and
magnifications of 200 and 1,000 were used to
 İ. D. Çapar and H. Ari Aydinbelge: Smear Layer Removal
evaluate the removal of debris and the smear layer,
respectively. Two calibrated and blinded independent
evaluators examined the SEM micrographs. Images
were divided into 100 frames with Adobe Photoshop
CS4 for counting the number of debris- and smear layer-
covered areas. The scoring system of Parente et al.
(2010) was modified as follows:
 Score 1: No smear layer or 5%, and most tubules
are patent.
 Score 2: Smear layer is evident in >5% to 35%;
when identified, dentinal tubule orifices may be
reduced in their dimensions, owing to partial or
complete occlusion by debris.
 Score 3: Smear layer is evident in >35% to 65% of
the canal surface.
 Score 4: Smear layer is evident in >65% to 95% of
the canal surface.
 Score 5: Smear layer covering >95% to 100% of
the canal surface.
Debris on the canal wall was evaluated using the
following scoring system:
 Score 1: Clean root canal or only a few small debris
particles in 5%.
 Score 2: Clumps of debris covering >5–35% of the
canal wall.
 Score 3: Clumps of debris covering >35–65% of
the canal wall.
 Score 4: Clumps of debris covering >65–95% of
the canal wall.
 Score 5: More than 95% of canal wall covered by
debris.
Statistical analyses of the data were performed using
the Kruskal–Wallis test and the Bonferroni-adjusted
Mann–Whitney U test. To compare the irrigation
groups, the data for the PI þ CSI were used as the CSI
Fig 1. Comparison of dentinal surfaces among groups based on debris and smear layer scores.
643
technique. The testing was performed at the 95% level
of confidence (p < 0.05). Cohen’s kappa coefficient was
used to calculate inter-reproducibility.
Results
The inter-examiner agreement was 95% for the smear
layer and 94% for debris removal (kappa test). Figure 1
presents the distribution of scores for removing debris and
the smear layer, based on the irrigant agitation protocols.
Debris and smear layer removal in the root canal
thirds for all groups are shown in Figures 2 and 3.
Comparison Between Instrumentation Groups
The SAF instrumentation group presented signifi-
cantly lower scores than the ProTaper instrumentation
with CSI for debris and smear layer removal (p < 0.05),
which means that the rotary instrumentation technique
generated more smear layer and left more debris in
the canal than the SAF instrumentation. Comparing
instrumentation groups at each root canal third revealed
that the SAF instrumentation group had lower amounts
of debris and smear layer at the apical third (p < 0.05).
At the middle third, the SAF instrumentation group
generated less smear layer than the rotary instrumenta-
tion group (p < 0.05), and there was no significant
difference between groups with respect to debris
removal (p > 0.05). At the coronal third, there was no
significant difference between the groups (p > 0.05).
Comparison Between Irrigation Groups With Respect
to Debris Removal
The CSI and NFX systems showed significantly
higher scores (p < 0.05) than the other irrigation
644 SCANNING VOL. 36, 6 (2014)
Fig 2. Representative SEM micrographs (200 magnification)
taken from canal thirds of root canals to evaluate debris removal.
In the apical third, rotary instrumentation with the CSI, and NFX,
MDI, and EA groups showed small debris particles, whereas the
CB, EV, PUI, SAF instrumentation, and SAF irrigation groups
showed no debris. In the middle third, all groups showed clean
canal surfaces. In the coronal third, the MDI group showed small
debris particles and the other groups showed clean canal surfaces.
SEM micrographs of the apical and coronal third for the PUI
group showed damage to the root canal wall due to contact by the
ultrasonic files.
agitation protocols (except for the CB group), which
means that these techniques left more debris in the canal
than the other techniques. Comparing debris removal at
each root canal third revealed that the MDI, EV, PUI,
and SAF irrigation systems had the least amount of
debris at the apical third, with no significant difference
Fig 3. Representative SEM micrographs (1,000 magnifica-
tion) taken from all canal thirds of root canals to evaluate smear
removal. In the apical third, ProTaper instrumentation with CSI,
and the NFX, CB, and MDI groups showed a thick smear layer
covering nearly all of the canal walls; the EA and EV groups
showed some dentinal tubules open and others covered by a thin
smear layer; the PUI, SAF irrigation, and SAF instrumentation
groups showed small amounts of smear layer and dentinal tubules
open. In the middle third, ProTaper instrumentation with CSI, and
the NFX, MDI, CB, and EA groups showed small amounts of
smear layer and some dentinal tubules open; the EV, PUI, SAF
instrumentation, and SAF irrigation groups showed most of the
dentinal tubules open and no smear layer. In the coronal third,
ProTaper instrumentation with the CSI, NFX, MDI, SAF
instrumentation, and SAF irrigation groups showed small
amounts of smear layer and some dentinal tubules open; the
CB, EA, EV, and PUI groups showed clean canal surfaces with
patent dentinal tubules.
 İ. D. Çapar and H. Ari Aydinbelge: Smear Layer Removal
among them. The CSI and NFX systems had the highest
debris score, with no significant difference between
them. At the middle third, SAF irrigation and EV
showed a statistically lower score than NFX. At the
coronal third, there was no significant difference among
the groups (p > 0.05).
Comparison Between Irrigation Groups With Respect
to Smear Layer Removal
The PUI system presented significantly lower scores
than the CSI, NFX, and MDI systems (p < 0.05). EV
showed a statistically lower score than the CSI and NFX
systems (p < 0.05). EA and SAF irrigation showed a
statistically lower score than CSI (p < 0.05). Comparing
the smear layer removal at each root canal third revealed
no significant differences among the groups (p > 0.05)
at the apical third. At the middle third, CSI, NFX,
and MDI had the highest scores, with no significant
difference among the three systems (p > 0.05). The EA
and EV systems recorded the lowest scores, followed by
PUI and SAF irrigation, with no significant difference
among the four systems (p > 0.05). At the coronal third,
EA, EV, and PUI showed statistically lower scores
compared to CSI (p < 0.05).
Discussion
One of the aims of the present study was to compare
the use of rotary nickel–titanium instruments and the
SAF cleaning/shaping irrigation system for cleaning
efficacy in root canals. The results revealed that the SAF
cleaning/shaping irrigation system produced cleaner
canal walls than rotary instrumentation. Therefore, the
null hypothesis that there would be no differences
between SAF or rotary instrumentation in terms of smear
layer formation and residual debris can be rejected. In the
SAF instrumentation group, we irrigated root canals with
NaOCl alone to standardize the enlargement protocol
with the continuous rotation group. However, Metzger
et al. (2010a) showed that the use of the SAF system
combined with NaOCl and EDTA resulted in less smear
layer and debris when compared to using NaOCl alone.
Moreover, to compare the SAF system to irrigation
agitation systems, we operated the SAF system after
instrumentation with the rotary system and we operated
the SAF with NaOCl and EDTA irrigation. We showed
that the SAF system exhibited similar effectiveness as
irrigation agitation systems. Similar to our findings,
previous studies revealed that, after root canal enlarge-
ment with rotary systems, using the SAF system
enhanced the removal of calcium hydroxide medicament
(Capar et al., 2014) and residual gutta-percha (Abramo-
vitz et al., 2012). This result revealed that after
instrumentation with rotary systems, the SAF system
645
could be used as an irrigation agitation device. The
scrubbing motion of the SAF file and continuous
irrigation during preparation seem to play a major role
in the efficacy of debris and smear layer removal.
Among the irrigation agitation protocols evaluated,
the CSI and NFX groups had significantly higher debris
scores (i.e., more debris left in the canal) than the EA,
EV, PUI, and SAF irrigation groups. Therefore, the null
hypothesis that there would be no differences among
the various irrigation activation protocols in terms of
root canal cleanliness can be rejected. These results
are compatible with results of previous studies (Lee
et al., 2004; McGill et al., 2008; Ribeiro et al., 2012). We
also did not find a significant difference among the NFX,
CB, and CSI systems. Inadequate cleaning of the root
canal walls using the NFX system can be explained by
the push–pull motion of the brush, which physically
displaces tissue; the friction created between the brush
bristles and canal walls precludes the flow of the solution
inside the canals (Ribeiro et al., 2012). Comparisons of
debris removal by the sonic and ultrasonic systems have
shown that PUI systems are more effective than sonic
systems in debris removal (Stamos et al., ’87; Sabins
et al., 2003), but using the EA for 1 min was as efficient
as ultrasonic cleaners in debris removal (Chye, 2008).
Similar to these findings, we found that the EA and PUI
systems used for 1 min had similar effects on debris and
smear removal. However, our SEM micrographs showed
damage to the root canal wall due to contact with
ultrasonic files but no damage from the EA system,
which had a flexible non-cutting polymer tip.
Our results showed that the EA, EV, PUI, and SAF
irrigation groups yielded lower smear layer scores (i.e.,
higher smear layer removal) compared to the CSI
system, in accordance with previous studies (Caron
et al., 2010; Abarajithan et al., 2011). The EV system
provides ANP, which results in effective cleaning of
dentinal surfaces by enabling irrigant suctioning with
volume and flow sufficient to remove the smear layers
and displace debris (Parente et al., 2010). Additionally,
EV providing ANP is reportedly the safest system with
regard to extruding irrigant beyond the apex (Mal-
entacca et al., 2012).
We found the use of CB, NFX, MDI, and CSI to have
a similar effect on smear removal, in agreement with
different studies (Garip et al., 2010; Parente et al., 2010;
Ribeiro et al., 2012). In contrast to our findings, Salman
et al. reported that the use of the CB system with a sonic
brush resulted in significantly cleaner canal walls than
the CSI system (Salman et al., 2010). Conflicting results
might be due to the different motions used with CB.
Insufficient cleaning with the MDI system may be
because the back-and-forth action of the corresponding
gutta-percha cones provides close contact between the
gutta-percha and the canal wall, causing debris to settle
back into the canal system after removal of the gutta-
percha cone (Parente et al., 2010).
646 SCANNING VOL. 36, 6 (2014)
Clinically, the tooth root is enclosed by the bone
socket and the canal behaves as a closed-end channel,
resulting in gas entrapment at its closed end (Tay
et al., 2010). Therefore, we used an ex vivo closed-end
canal model to imitate clinical conditions. To increase
the reliability of the results, our scoring method included
both qualitative and quantitative analyses. The scoring
system of Parente et al. (2010), which is simple and
direct, was modified by counting the number of frames
with debris and smear layer-covered areas. Two blinded
evaluators independently scored the specimens on the
SEM images.
With the exception of the SAF instrumentation
group, apical preparation was performed up to a size F4
file (40/0.06) to allow adequate penetration of solutions
to the apical third of each root canal (de Gregorio
et al., 2013). None of the techniques tested in this study
completely removed the smear layer from the apical
third of the root canal. This finding reflects the difficulty
associated with cleaning the apical third of root canals,
in agreement with the findings of previous studies
(Khedmat and Shokouhinejad, 2008; Goel and Tewari,
2009; Bolles et al., 2013).
Conclusions
Within the limitation of the present in vitro study,
it can be concluded that the agitation of irrigating
solutions with the EA, EV, SAF, and PUI techniques
produced cleaner canal walls compared to the CSI, MDI,
and NFX systems. The SAF cleaning/shaping irrigation
system provided similar performance as the agitation
systems and yielded cleaner canals compared to rotary
instrumentation.
Acknowledgment
This study was supported by Scientific Research
Projects Coordination Center of Selcuk University,
Konya, Turkey (Project no. 11102018).
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