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Veneri F, Filippini T, Consolo U, Vinceti M, Generali L. Ozone therapy in dentistry: An overview of the biological mechanisms involved (Review). Biomed Rep 2024; 21:115. [PMID: 38912169 PMCID: PMC11190636 DOI: 10.3892/br.2024.1803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/03/2024] [Indexed: 06/25/2024] Open
Abstract
At low medically-relevant concentrations, ozone serves as an oxidant with a wide spectrum of antimicrobial activity and the ability to promote healing and reduce inflammation. Despite providing therapeutic benefits in a range of diseases, certain adverse effects and contraindications of ozone treatment must be considered. These are primarily related to toxicity from inhalation and systemic types of administration and can be avoided by following relevant guidelines and recommendations. Ozone therapy has been implemented in a number of fields of dentistry and the most commonly used formulations for the oral cavity are gaseous ozone, ozonized water and ozonized oil. The biological mechanisms underlying the molecular effects of ozone have been increasingly reported, but currently remain largely unknown. The aim of the present review was to provide an overview of the mechanisms involved in ozone interaction with dental tissues. The present review focused on relevant evidence regarding the effect of ozone on dental tissues, including periodontal structures, dental cells, enamel and dentine, considering in vitro studies in addition to animal and human studies. A variety of biological mechanisms acting through multiple biochemical target pathways were reported to be responsible for the therapeutic effects of ozone. The main beneficial effects of ozone occurred in the following domains: antimicrobial activity, remineralization and microstructural changes of hard dental tissues, immunomodulation and biostimulation of dental and periodontal cells. Additional research could provide further insights into the use of ozone, increase its use for broader clinical applications and assist in the selection of targeted protocols.
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Affiliation(s)
- Federica Veneri
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, I-41124 Modena, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, I-41125 Modena, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, I-41125 Modena, Italy
- School of Public Health, University of California Berkeley, Berkeley, CA 94704, USA
| | - Ugo Consolo
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, I-41124 Modena, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, I-41125 Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Luigi Generali
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, I-41124 Modena, Italy
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Vieira SM, Mima EGDO, Honório HM, Moher D, Drugowick LMH, Stabili MRG, Dovigo LN. A protocol for an overview of systematic reviews to map photodynamic inactivation evidence in different dental specialties. Photochem Photobiol Sci 2024; 23:387-394. [PMID: 38341812 DOI: 10.1007/s43630-023-00523-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/13/2023] [Indexed: 02/13/2024]
Abstract
This is a protocol for an overview to summarize the findings of Systematic Reviews (SR) dealing with Photodynamic Inactivation (PDI) for control of oral diseases. Specific variables of oral infectious will be considered as outcomes, according to dental specialty. Cochrane Database of Systematic Reviews (CDSR), MEDLINE, LILACS, Embase, and Epistemonikos will be searched, as well as reference lists. A search strategy was developed for each database using only terms related to the intervention (PDI) aiming to maximize sensitivity. After checking for duplicate entries, selection of reviews will be performed in a two-stage technique: two authors will independently screening titles and abstracts, and then full texts will be assessed for inclusion/exclusion criteria. Any disagreement will be resolved through discussion and/or consultation with a third reviewer. Data will be extracted following the recommendations in Chapter V of Cochrane Handbook and using an electronic pre-specified form. The evaluation of the methodological quality and risk of bias (RoB) of the SR included will be carried out using the AMSTAR 2 and ROBIS. Narrative summaries of relevant results from the individual SR will be carried out and displayed in tables and figures. A specific summary will focus on PDI parameters and study designs, such as the type and concentration of photosensitizer, pre-irradiation time, irradiation dosimetry, and infection or microbiological models, to identify the PDI protocols with clinical potential. We will summarize the quantitative results of the SRs narratively.
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Affiliation(s)
- Sâmmea Martins Vieira
- Department of Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá 1680, Araraquara, SP, CEP 14801-903, Brazil
| | - Ewerton Garcia de Oliveira Mima
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Collective Health, School of Dentistry, University of São Paulo (USP), Bauru, SP, Brazil
| | - David Moher
- Ottawa Hospital Research Institute, Centre for Journalology, Ottawa, Canada
| | - Lara Maria Herrera Drugowick
- State University of Campinas (UNICAMP), Institute of Mathematics, Statistics and Scientific Computing, Campinas, SP, Brazil
| | | | - Lívia Nordi Dovigo
- Department of Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá 1680, Araraquara, SP, CEP 14801-903, Brazil.
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Namba AM, Santos ELDS, Garcia MT, Ribeiro FDC, Figueiredo-Godoi LMA, Rossoni RD, Junqueira JC. Farnesol as a potentiator of antimicrobial photodynamic inactivation on Enterococcus faecalis. Photodiagnosis Photodyn Ther 2022; 39:102928. [DOI: 10.1016/j.pdpdt.2022.102928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 11/24/2022]
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Zan R, Topcuoglu HS, Hubbezoglu I, Gorler O, Altunbas D, Ayhan M. Effect of different irrigation activation methods on non-infected dentinal tubule penetration of medicaments: A CLSM study. Niger J Clin Pract 2022; 25:895-902. [DOI: 10.4103/njcp.njcp_1932_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Camacho-Alonso F, Salinas J, Sánchez-Siles M, Pato-Mourelo J, Cotrina-Veizaga BD, Ortega N. Synergistic antimicrobial effect of photodynamic therapy and chitosan on the titanium-adherent biofilms of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa: An in vitro study. J Periodontol 2021; 93:e104-e115. [PMID: 34541685 DOI: 10.1002/jper.21-0306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND To date, no studies on the combined use of photodynamic therapy (PDT) and chitosan against peri-implantitis have been published. The aim of this study was to evaluate the possible synergistic antimicrobial effect of PDT and chitosan on the titanium-adherent biofilms of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. METHODS A total of 60 titanium discs were included in this study. The discs were randomized into three bacterial contaminations (n = 20 discs per bacterium). After being cultured (incubated for 48 hours) they were randomized again into four different disinfection modalities (n = 5 discs per treatment): control (without treatment), PDT, chitosan 3 mg/mL, and PDT + chitosan 3 mg/mL. After the treatments, the colony forming units (CFU) were measured to determine antimicrobial effects, and field emission scanning electron microscopy (FESEM) was used to study cell morphology and titanium adherence. RESULTS For all the evaluated bacteria and all the variables studied the order from highest to lowest antimicrobial effectiveness was: PDT + chitosan 3 mg/mL > chitosan 3 mg/mL > PDT > control. Although, all disinfection methods were significantly effective when compared to control, the combined treatment of PDT + chitosan 3 mg/mL had the greatest antimicrobial effect against the three studied bacteria. CONCLUSIONS The combination of PDT and chitosan has a synergistic antimicrobial effect against the bacteria S. aureus, E. coli, and P. aeruginosa, all closely related to peri-implantitis. However, further in vivo studies are needed because this study provides data based on an in vitro scenario that might not be extrapolated to patients with peri-implantitis.
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Affiliation(s)
| | - Jesús Salinas
- Department of Animal Health, University of Murcia, Murcia, Spain
| | | | | | | | - Nieves Ortega
- Department of Animal Health, University of Murcia, Murcia, Spain
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Abdelkarim-Elafifi H, Parada-Avendaño I, Arnabat-Dominguez J. Photodynamic Therapy in Endodontics: A Helpful Tool to Combat Antibiotic Resistance? A Literature Review. Antibiotics (Basel) 2021; 10:1106. [PMID: 34572688 PMCID: PMC8468135 DOI: 10.3390/antibiotics10091106] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/05/2021] [Accepted: 09/09/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Antibiotic resistance has become a growing global problem where overprescription is a contributing factor for its development. In the endodontics field, complementary treatments, such as antimicrobial photodynamic therapy (aPDT), have been described to eliminate residual bacteria from the root canal space and reduce complications. The aim of this review is to describe the literature evidence up to now regarding the advantages, efficiency, and clinical outcomes of this therapy in endodontics as a possible tool to combat antibiotic resistance. METHODS A review of the literature from 2010 to 2021 was carried out using the PubMed and Web of Science databases. Two steps were taken: First, articles were compiled through the terms and MeSH terms "Photochesdmotherapy" and "endodontics." Then, a second search was conducted using "photodynamic therapy" and "antibiotic resistance" or "drug resistance, microbial." RESULTS A total of 51 articles were included for evaluation: 27 laboratory studies, 14 reviews, and 10 clinical studies. Laboratory studies show that aPDT achieves significant bacterial elimination, even against antibiotic-resistant species, and is also effective in biofilm disruption. Clinical studies suggest that aPDT can be considered a promising technique to reduce bacterial complications, and reviews about the issue confirm its advantages. CONCLUSION The benefits of aPDT in reducing complications due to its antibacterial effects means a possible decrease in systemic antibiotic prescription in endodontics. In addition, it could be an alternative to local intracanal antibiotic therapy, avoiding the appearance of possible antibiotic resistance, as no bacterial resistance with aPDT has been described to date.
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Affiliation(s)
| | - Isabel Parada-Avendaño
- Analysis and Design in Clinical Investigation, University of Barcelona, 08017 Barcelona, Spain;
| | - Josep Arnabat-Dominguez
- Faculty of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain;
- Idibell Institute, 08908 Barcelona, Spain
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Application of Selected Nanomaterials and Ozone in Modern Clinical Dentistry. NANOMATERIALS 2021; 11:nano11020259. [PMID: 33498453 PMCID: PMC7909445 DOI: 10.3390/nano11020259] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 12/14/2022]
Abstract
This review is an attempt to summarize current research on ozone, titanium dioxide (TiO2), silver (Ag), copper oxide CuO and platinum (Pt) nanoparticles (NPs). These agents can be used in various fields of dentistry such as conservative dentistry, endodontic, prosthetic or dental surgery. Nanotechnology and ozone can facilitate the dentist’s work by providing antimicrobial properties to dental materials or ensuring a decontaminated work area. However, the high potential of these agents for use in medicine should be confirmed in further research due to possible side effects, especially in long duration of observation so that the best way to apply them can be obtained.
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TIȘLER CE, BADEA ME, BUDURU S, KUI A, FLORIA M, POPESCU Ș, MITARIU M, NEGUCIOIU M. Biofilm Inactivation using Photodynamic Therapy in Dentistry: a review of literature. BALNEO RESEARCH JOURNAL 2020. [DOI: 10.12680/balneo.2020.353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Photodynamic therapy (PDT) is a therapy involving light and a photosensitising chemical substance, used in conjunction with molecular oxygen in order to elicit cell death (photo-toxicity) and thus ability to kill microbial cells, including bacteria, fungi and viruses. Photodynamic therapy is an alternative method of biofilm disruption and it is considered a new way of microorganism inactivation. It is also an additional procedure to reduce the infection rate in patients, caused by the increasing antimicrobials resistance of bacteria. The aim of this literature review was to evaluate the specific effects and the antibacterial effectiveness of photodynamic therapy using different types of photosensitizers (Erythrosine, Rose Bengal, Toluidine blue, Methylene blue, Ozone, Riboflavin, Curcumin, Chlorhexidine, SAPYR) and a visible light of a specific wavelength for each photosensitizer and to reveal the applications of PDT in periodontics, endodontics, prosthodontics and dental caries. Methods: A research of literature was performed in an attempt to find all the articles published on this topic in the last 10 years. The articles was searched by using a certain combination of different keywords (photodynamic therapy ) and (diode laser ) and (teeth) in PubMed database. Results: A total number of 83 articles were found. After applying inclusion and exclusion criteria, 35 articles were taken into consideration for our study and among them 4 were a manuscript, 3 was a review of literature, 1 was an in vivo evaluation and 27 were in vitro studies. Conclusion: Considering that none of the disinfection methods can completely remove the biofilm, PDT is a therapeutic tool complementary to conventional disinfection, with great applicability in dentistry. PDT showed significantly efficacy in reduction of biofilms. Exposure to light in the presence of a photosensitizing chemical substance helps in the reduction of microbes and the protocols could be recommended for clinical usage, but only together with ‘classic ‘ disinfection.
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Affiliation(s)
- Corina-Elena TIȘLER
- 1. Prosthodontic Department, "Iuliu Haţieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mîndra-Eugenia BADEA
- 2. Prevention in Dentistry Department, "Iuliu Haţieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Smaranda BUDURU
- 1. Prosthodontic Department, "Iuliu Haţieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andreea KUI
- 1. Prosthodontic Department, "Iuliu Haţieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela FLORIA
- 1. Prosthodontic Department, "Iuliu Haţieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ștefan POPESCU
- 1. Prosthodontic Department, "Iuliu Haţieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihai MITARIU
- 1. Prosthodontic Department, "Iuliu Haţieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Marius NEGUCIOIU
- 1. Prosthodontic Department, "Iuliu Haţieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Ex vivo assessment of synergic effect of chlorhexidine for enhancing antimicrobial photodynamic therapy efficiency on expression patterns of biofilm-associated genes of Enterococcus faecalis. Photodiagnosis Photodyn Ther 2018; 22:227-232. [PMID: 29709604 DOI: 10.1016/j.pdpdt.2018.04.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 04/17/2018] [Accepted: 04/23/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND It has clearly been demonstrated that Enterococcus faecalis, as a persistent microorganism, is the major agent in the etiopatogeny of endodontic infections. Recently, the limitations of conventional endodontic therapy have given rise to many attempts to introduce antimicrobial photodynamic therapy (aPDT) as an alternative treatment. The aim of this study was to analyze the ex vivo effect of aPDT in combination with 2.0% chlorhexidine (CHX) as a conventional therapy on colony count and expression patterns of genes associated with biofilm formation of E. faecalis. MATERIALS AND METHODS A total of 125 extracted human single-rooted teeth were divide into six groups (A-F; n = 20) and were incubated with E. faecalis. Group A- photosensitizer (indocyanine green [ICG]); B- diode laser; C- aPDT; D- 2.0% CHX; E- aPDT with photosensitizer modified by 2.0% CHX; and F- control group (no procedure was performed). Five remaining teeth were used to confirm the presence of E. faecalis biofilm via scanning electron microscope. Counts of colony forming units (CFUs) in each group were evaluated separately and quantitative real-time PCR (qRT-PCR) was then applied to monitor genes expression of fsrC, efa, and gelE involved in E. faecalis biofilm. RESULTS The results showed that none of the tested groups achieved eradication or inhibition of biofilm. On the other hand, aPDT + 2.0% CHX, 2.0% CHX, and ICG- mediated aPDT groups showed significantly less CFU/mL than ICG and diode laser groups. The group with the lowest CFU/mL count was the aPDT + 2.0% CHX, being statistically different from all other groups that could decrease the expression levels of efa, gelE, and fsrC genes 6.8-, 8.3-, and 12.1-fold, respectively. CONCLUSION Based on the results, the synergism effect of ICG-aPDT with 2.0% CHX leads to modulation of the virulence of E. faecalis strains biofilm model by suppressing the expression of the genes associated with biofilm formation.
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Ramazani M, Asnaashari M, Ahmadi R, Zarenejad N, Rafie A, Yazadani Charati J. The Effect of Final Rinse Agitation with Ultrasonic or 808 nm Diode Laser on Coronal Microleakage of Root-canal Treated Teeth. IRANIAN ENDODONTIC JOURNAL 2018; 13:108-113. [PMID: 29692845 PMCID: PMC5800451 DOI: 10.22037/iej.v13i1.17248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/21/2017] [Accepted: 12/02/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This in vitro study aimed at comparing the effect of agitating the final irrigant solutions of root canal by ultrasonic or using 808 nm Diode laser on the apical seal of canal. METHODS AND MATERIALS A total of 90 extracted human maxillary central incisors were prepared up to size #45 and were randomly assigned to 4 experimental groups (n=20) and two control groups (n=5) respectively, as follows: I): 3 mL of 5.25% NaOCl was agitated as final irrigant solution with ultrasonic for 30 sec. The ultrasonic tip was 1 mm shorter than the working length, II): 3 mL of 5.25% NaOCl was agitated as final irrigant with 808 nm Diode laser for 30 sec. Fiber tip, placed in 1 mm shorter from working length was spirally moved coronally, III): 3 mL of 17% EDTA was agitated as final irrigant with 808 nm Diode laser for 30 sec and was applied similar to group II, IV): 3 mL of 17% EDTA was stimulated as final irrigant with ultrasonic for 30 sec and was applied similar to I. Apical seal was assessed by Dual Chamber technique using Bovine Serum Albumin protein. Kruskal-Wallis and Mann Whitney tests were used with significance level lower than 0.05% for statistical analysis. RESULTS The average leakage in the negative control, positive control, and groups I, II, III, IV were: 0.00, 13.5±5.1, 1.72±2.9, 5.12±5.6, 3.36±3.7, 2.4±4.2, respectively. Statistical analysis showed significant difference between groups (P<0.05). There was a significant difference between groups 1 and 2 in terms of protein leakage. CONCLUSION Agitating 5.25% sodium hypochlorite solution as the final irrigant with ultrasonic is more effective in apical leakage reduction compared to other groups.
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Affiliation(s)
- Mohsen Ramazani
- Department of Endodontics, Sari Dental School, Mazandaran University of Medical Sciences;
| | - Mohammad Asnaashari
- Iranian Center For Endodontic Research , Research Institute of Dental Research, Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | | | - Nafiseh Zarenejad
- Restorative Dentistry, Sari Dental School, Mazandaran University of Medical Sciences, Sari, Iran;
| | - Alireza Rafie
- Department of Immunology, Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran;
| | - Jamshid Yazadani Charati
- Biostatistic Department, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
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