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Ruiz-Romero V, Jorba-Garcia A, Camps-Font O, Figueiredo R, Valmaseda-Castellón E. Accuracy of dynamic computer-assisted implant surgery in fully edentulous patients: An in vitro study. J Dent 2024; 149:105290. [PMID: 39106900 DOI: 10.1016/j.jdent.2024.105290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 07/12/2024] [Accepted: 08/03/2024] [Indexed: 08/09/2024] Open
Abstract
OBJECTIVES To compare miniscrew versus bone tracing registration methods on dental implant placement accuracy and time efficiency in edentulous jaws using a dynamic computer-assisted implant surgery (d-CAIS) system. METHODS Twelve fully edentulous maxillary models were allocated into two groups: miniscrew tracing (MST) group, where registration was performed by tracing four miniscrews; and bone tracing (BT) group, where registration was conducted by tracing maxillary bone fiducial landmarks. Six implants were placed on each model using the X-Guide® d-CAIS system. Pre- and postoperative cone-beam computed tomography (CBCT) scans were superimposed to evaluate implant placement accuracy. The time required for registration and the overall surgery time were also recorded. RESULTS Thirty-six implants were placed in each group. The MST group showed significantly lower mean angulation deviations (mean difference (MD): -3.33°; 95 % confidence interval (CI): -6.56 to -0.09); p = 0.044), 3D platform deviations (MD: -1.01 mm; 95 % CI: -1.74 to -0.29; p = 0.006), 2D platform deviations (MD: -0.97 mm; 95 % CI: -1.71 to -0.23; p = 0.010), and 3D apex deviations (MD: -1.18 mm; 95 % CI: -1.92 to -0.44; p = 0.002) versus the BT group. The overall surgery time was similar for both groups (MD: 6.10 min.; 95 % CI: -0.31 to 12.51; p = 0.06), though bone tracing required significantly more time compared with miniscrew registration (MD: 4.79 min.; 95 % CI: 2.96 to 6.62; p < 0.05). CONCLUSIONS Registration with MST increases the accuracy of implant placement with a d-CAIS system in edentulous jaws compared with the BT method, and slightly reduces the overall surgery time. CLINICAL SIGNIFICANCE Miniscrew tracing registration improves implant placement accuracy in comparison with bone tracing registration.
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Affiliation(s)
- Víctor Ruiz-Romero
- DDS, MS. Master of Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona Spain
| | - Adrià Jorba-Garcia
- DDS, MS. Master of Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona Spain
| | - Octavi Camps-Font
- DDS, MS, PhD. Associate Professor of Oral Surgery, Faculty of Medicine and Health Sciences, University of Barcelona (Spain). Researcher at the IDIBELL Institute, Barcelona Spain
| | - Rui Figueiredo
- DDS, MS, PhD. Associate Professor of Oral Surgery, Faculty of Medicine and Health Sciences, University of Barcelona (Spain). Researcher at the IDIBELL Institute, Barcelona Spain.
| | - Eduard Valmaseda-Castellón
- DDS, MS, PhD. Chairman of Oral Surgery. Faculty of Medicine and Health Sciences of the University of Barcelona (Spain), Researcher at the IDIBELL Institute, Barcelona Spain
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Jorba-García A, Ruiz-Romero V, Bara-Casaus JJ, Camps-Font O, Sánchez-Garcés MÁ, Figueiredo R, Valmaseda-Castellón E. The effect on the performance of a dynamic navigation system of superimposing a standard tessellation language (STL) file obtained with an intraoral scan on a cone beam computer tomograph (CBCT). An experimental in vitro study. J Dent 2024; 148:105150. [PMID: 38909646 DOI: 10.1016/j.jdent.2024.105150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/15/2023] [Accepted: 06/21/2024] [Indexed: 06/25/2024] Open
Abstract
OBJECTIVES To compare the accuracy and operative time of implant placement using a dynamic computer assisted implant surgery (dCAIS) system based on a cone beam computer tomography (CBCT) image, with and without superimposing a standard tessellation language (STL) file of an intraoral scan of the patient. METHODS Ten identical resin models simulating an upper maxilla with posterior edentulism were assigned to two groups. In the CBCT+STL group, a CBCT file and an intraoral STL file were superimposed and used for registration; in the CBCT group, registration was performed using CBCT images. Six implants were placed in each model using the Navident® dynamic navigation system. Anatomy registration was performed by tracing fiducial points on the CBCT or STL image, depending on the group. Preoperative and postoperative CBCT images were overlaid to assess implant placement accuracy. RESULTS Sixty implants were analyzed (30 implants in each group). 3D platform deviation was significantly lower (mean difference (MD): 0.17 mm; 95 % confidence interval (CI): 0.01 to 0.23; P = 0.039) in the CBCT+STL group (mean: 0.71 mm; standard deviation (SD): 0.29) than in the CBCT group (mean: 0.88 mm; SD: 0.39). The remaining accuracy outcome variables (angular deviation MD: -0.01; platform lateral deviation MD: 0.08 mm; apex global MD: 0.01 mm; apex depth MD: 0.33 mm) and surgery time (MD: 3.383 min.) were similar in both groups (p > 0.05). CONCLUSIONS The introduction of an intraoral scan (STL) seems to reduce deviations slightly in dental implant placement with dCAIS systems. However, the clinical repercussion of this improvement is questionable. CLINICAL SIGNIFICANCE Superimposing an intraoral scan on the CBCT image does not seem to increase the accuracy of dCAIS systems but can be useful when radiographic artifacts are present.
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Affiliation(s)
- Adrià Jorba-García
- Master of Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Researcher at the IDIBELL Institute, Barcelona, Spain
| | - Víctor Ruiz-Romero
- Master of Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Jose Javier Bara-Casaus
- Dental and Maxillofacial Institute at the University Hospital Sagrat Cor, Barcelona, Spain; Head of the department of oral and maxillofacial surgery, University Hospital of Mutua Terrassa, Terrassa, Spain
| | - Octavi Camps-Font
- Oral Surgery, Faculty of Medicine and Health Sciences, University of Barcelona, Spain; Researcher at the IDIBELL Institute, Barcelona, Spain
| | - Maria Ángeles Sánchez-Garcés
- Oral Surgery, Faculty of Medicine and Health Sciences, University of Barcelona, Spain; Researcher at the IDIBELL Institute, Barcelona, Spain
| | - Rui Figueiredo
- Oral Surgery, Faculty of Medicine and Health Sciences, University of Barcelona, Spain; Researcher at the IDIBELL Institute, Barcelona, Spain.
| | - Eduard Valmaseda-Castellón
- Oral Surgery, Faculty of Medicine and Health Sciences, University of Barcelona, Spain; Researcher at the IDIBELL Institute, Barcelona, Spain
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Xu Z, Zhou L, Han B, Wu S, Xiao Y, Zhang S, Chen J, Guo J, Wu D. Accuracy of dental implant placement using different dynamic navigation and robotic systems: an in vitro study. NPJ Digit Med 2024; 7:182. [PMID: 38971937 PMCID: PMC11227595 DOI: 10.1038/s41746-024-01178-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 06/26/2024] [Indexed: 07/08/2024] Open
Abstract
Computer-aided implant surgery has undergone continuous development in recent years. In this study, active and passive systems of dynamic navigation were divided into active dynamic navigation system group and passive dynamic navigation system group (ADG and PDG), respectively. Active, passive and semi-active implant robots were divided into active robot group, passive robot group and semi-active robot group (ARG, PRG and SRG), respectively. Each group placed two implants (FDI tooth positions 31 and 36) in a model 12 times. The accuracy of 216 implants in 108 models were analysed. The coronal deviations of ADG, PDG, ARG, PRG and SRG were 0.85 ± 0.17 mm, 1.05 ± 0.42 mm, 0.29 ± 0.15 mm, 0.40 ± 0.16 mm and 0.33 ± 0.14 mm, respectively. The apical deviations of the five groups were 1.11 ± 0.23 mm, 1.07 ± 0.38 mm, 0.29 ± 0.15 mm, 0.50 ± 0.19 mm and 0.36 ± 0.16 mm, respectively. The axial deviations of the five groups were 1.78 ± 0.73°, 1.99 ± 1.20°, 0.61 ± 0.25°, 1.04 ± 0.37° and 0.42 ± 0.18°, respectively. The coronal, apical and axial deviations of ADG were higher than those of ARG, PRG and SRG (all P < 0.001). Similarly, the coronal, apical and axial deviations of PDG were higher than those of ARG, PRG, and SRG (all P < 0.001). Dynamic and robotic computer-aided implant surgery may show good implant accuracy in vitro. However, the accuracy and stability of implant robots are higher than those of dynamic navigation systems.
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Affiliation(s)
- Zonghe Xu
- Fujian Provincial Engineering Research Center of Oral Biomaterial, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Lin Zhou
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Bin Han
- Fujian Provincial Engineering Research Center of Oral Biomaterial, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | | | - Yanjun Xiao
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Sihui Zhang
- Fujian Provincial Engineering Research Center of Oral Biomaterial, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Jiang Chen
- Fujian Provincial Engineering Research Center of Oral Biomaterial, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Jianbin Guo
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China.
| | - Dong Wu
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China.
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, 350001, China.
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Jorba-García A, Bara-Casaus JJ, Camps-Font O, Figueiredo R, Valmaseda-Castellón E. The influence of radiographic marker registration versus a markerless trace registration method on the implant placement accuracy achieved by dynamic computer-assisted implant surgery. An in-vitro study. J Dent 2024; 146:105072. [PMID: 38763387 DOI: 10.1016/j.jdent.2024.105072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 05/09/2024] [Accepted: 05/12/2024] [Indexed: 05/21/2024] Open
Abstract
OBJECTIVES This study aimed to compare the effect the radiographic marker registration (RMR) and markerless tracing registration (MTR) on implant placement accuracy using a dynamic computer-assisted implant surgery system (dCAIS). Additionally, this study aimed to assess the surgical time and whether the implant location influences the accuracy of the two registration methods. METHODS 136 dental implants were randomly allocated to the RMR or MTR group and were placed with a dCAIS in resin models. Preoperative and postoperative Cone Beam Computer Tomograms (CBCT) were overlaid and implant placement accuracy was assessed. Descriptive and multivariate analysis of the data was performed. RESULTS Significant differences (P < 0.001) were found for all accuracy variables except angular deviation (RMR:4.30° (SD:4.37°); MTR:3.89° (SD:3.32°)). The RMR had a mean 3D platform deviation of 1.53 mm (SD:0.98 mm) and mean apex 3D deviation of 1.63 mm (SD:1.05 mm) while the MTR had lower values (0.83 mm (SD:0.67 mm) and 1.07 mm (SD:0.86 mm), respectively). In the MTR group, implant placement in the anterior mandible was more accurate (p < 0.05). Additionally, MTR did not significantly increase the surgical time compared with RMR (P = 0.489). CONCLUSIONS MTR seems to increase the accuracy of implant placement using dCAIS in comparison with the RMR method, without increasing the surgical time. The operated area seems to be relevant and might influence the implant deviations. CLINICAL SIGNIFICANCE Considering the limitations of this in-vitro study, MTR seems to provide a higher accuracy in implant placement using dCAIS without increasing the surgical time. Furthermore, this method does not require radiographic markers and allows re-registration during surgery.
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Affiliation(s)
- Adrià Jorba-García
- Master of Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona Spain
| | - Jose Javier Bara-Casaus
- Director of the Dental and Maxillofacial Institute at the Hospital Universitari Sagrat Cor, Grupo Quirosalud. Barcelona (Spain). Head of the department of oral and maxillofacial surgery, University Hospital of Mutua Terrassa, University of Barcelona, Terrassa Spain
| | - Octavi Camps-Font
- Associate Professor of Oral Surgery, Faculty of Medicine and Health Sciences, University of Barcelona (Spain). Researcher at the IDIBELL Institute, Barcelona Spain
| | - Rui Figueiredo
- Professor of Oral Surgery, Faculty of Medicine and Health Sciences, University of Barcelona (Spain). Researcher at the IDIBELL Institute, Barcelona Spain.
| | - Eduard Valmaseda-Castellón
- Chairman of Oral Surgery, Faculty of Medicine and Health Sciences, University of Barcelona (Spain). Researcher at the IDIBELL Institute, Barcelona Spain
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Pei X, Weng J, Sun F, Ma Y, Iao S, Liu X. Accuracy and efficiency of a calibration approach in dynamic navigation for implant placement: An in vitro study. J Dent Sci 2024; 19:51-57. [PMID: 38303864 PMCID: PMC10829622 DOI: 10.1016/j.jds.2023.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/02/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose Computer-assisted dynamic navigation surgery could provide accurate implant placement. However, its low efficiency was always criticized by dental surgeons. The purpose of this study was to evaluate the accuracy and efficiency of a calibration approach with reflective wafers in dynamic navigation for implant placement. Materials and methods Eighty implants were placed in the standardized polyurethane mandibular models under dynamic navigation and divided into 2 groups according to the calibration methods (n = 40). The U-shaped tube (UT) group used a prefabricated U-shaped tube embedded with radiopaque markers. The reflective wafers (RW) group used a fixation with 3 round reflective wafers as markers. Postoperative cone beam computed tomography images were obtained for implants deviation analyses. The calibration time was used to evaluate the efficiency of the 2 methods. Results Significant differences were found in the trueness and efficiency between the 2 groups (P < 0.05). The 3D deviations at the implant platform and apex were smaller in UT group (0.89 ± 0.28 and 0.79 ± 0.30 mm, respectively) than in the RW group (0.99 ± 0.28 and 0.98 ± 0.30 mm, respectively). The angular deviation was larger in the UT group (2.16 ± 1.12°) than in the RW group (1.53 ± 0.88°). The calibration approach of RW group was more efficient than the UT group (2.05 ± 0.55 and 7.50 ± 0.71 min, respectively). Conclusion The calibration method of RW improved the efficiency significantly and achieved equivalent trueness with UT for dynamic navigation during implant placement.
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Affiliation(s)
- Xiyan Pei
- First Clinic Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Jinlong Weng
- First Clinic Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Feng Sun
- First Clinic Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Yu Ma
- First Clinic Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Siniong Iao
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaoqiang Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
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Tao B, Feng Y, Fan X, Lan K, Zhuang M, Wang S, Wang F, Chen X, Wu Y. The accuracy of a novel image-guided hybrid robotic system for dental implant placement: An in vitro study. Int J Med Robot 2023; 19:e2452. [PMID: 35946497 DOI: 10.1002/rcs.2452] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/31/2022] [Accepted: 08/08/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND This in vitro study aims to evaluate the accuracy of dental implant placement by a novel image-guided hybrid robotic system for dental implant surgery (HRS-DIS). METHODS The HRS-DIS with a 5 degree of freedom (DOF) serial manipulator and a 6 DOF Stewart platform was developed. To evaluate the accuracy of repeated drilling, the holes were prepared twice with a 2.2 mm drill. To evaluate the accuracy of dental implant placement, the entry, exit and angle deviations of dental implants were measured. RESULTS Twenty-four holes were prepared twice, and mean (±SD) of diameters were measured as 2.2 ± 0.02 mm. A total of 160 dental implants were placed in 32 phantoms by HRS-DIS. The mean (±SD) of the entry, exit and angle deviation were 0.8 ± 0.54 mm, 0.87 ± 0.54 mm and 1.0 1 ± 0.44°, respectively. CONCLUSIONS The results of the in vitro study preliminarily validated that the HRS-DIS could provide a high accuracy for dental implant surgery.
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Affiliation(s)
- Baoxin Tao
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yuan Feng
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Xingqi Fan
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Kengliang Lan
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Minjie Zhuang
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Shigang Wang
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Wang
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China.,Department of Oral Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojun Chen
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yiqun Wu
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
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Tao B, Feng Y, Fan X, Zhuang M, Chen X, Wang F, Wu Y. Accuracy of dental implant surgery using dynamic navigation and robotic systems: An in vitro study. J Dent 2022; 123:104170. [DOI: 10.1016/j.jdent.2022.104170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/21/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022] Open
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