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Assarzadeh H, Karrabi M, Fekrazad R, Tabarraei Y. Effect of Er:YAG Laser Irradiation and Acidulated Phosphate Fluoride Therapy on Re-Mineralization of White Spot Lesions. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2021; 22:153-161. [PMID: 34514061 PMCID: PMC8417547 DOI: 10.30476/dentjods.2020.86300.1187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/04/2020] [Accepted: 08/05/2020] [Indexed: 11/19/2022]
Abstract
Statement of the Problem: Studies on the efficacy of erbium laser for enhancement of enamel resistance to acid attacks and its effects on fluoride uptake by the enamel are limited. Purpose: This study sought to assess and compare the effects of erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation and application of acidulated phosphate fluoride (APF) gel
(alone and in combination) on remineralization of artificial white spot lesions (WSLs). Materials and Method: This in vitro, experimental study evaluated 90 buccal and lingual slabs of extracted human premolars. The specimens underwent pH cycling to induce WSLs. They were then randomly
divided into 6 groups of caries-free positive control (c+), negative control with WSLs (ws), 1.23% APF gel applied on the enamel (F), Er:YAG laser irradiation (80 mJ, 10 Hz, and 8 J/cm2)
of enamel (L), APF gel application followed by laser irradiation (FL), and laser irradiation followed by fluoride gel application (LF). The fluoride ion content of specimens was
measured before and after the intervention using a potentiometer. Data were analyzed by ANOVA (p< 0.05). Results: APF gel application before/after laser irradiation maximally increased the fluoride uptake by the enamel (p= 0.000). Application of APF gel in group F and laser irradiation in
group L increased fluoride uptake by the enamel, compared with groups 1 and 2 (p= 0.000). Laser- treated (L) and APF-treated (F) groups had no significant difference in this respect
(p= 0.945). Maximum fluoride concentration was noted in combined laser and fluoride groups (FL=332.07ppm and LF=341.27ppm) with no significant difference between the two (p= 1.000). Conclusion: Er:YAG laser irradiation changes the chemical composition of enamel and probably promote its remineralization, especially when combined with APF gel application,
which highlights its cariostatic potential.
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Affiliation(s)
- Hossein Assarzadeh
- Dept. of Oral and Prosthodontics, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Malihe Karrabi
- Dept. of Oral and Prosthodontics, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Reza Fekrazad
- Dept. of Periodontology, Dental Faculty, Laser Research Center In Medical Sciences, AJA University of Medical Sciences, Tehran, Iran.,Radiation Science Research Center, Laser Research Center in Medical Science, AJA University of Medical Sciences, Tehran, Iran.,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), University Scientific Education and Research Network (USERN), Tehran, Iran
| | - Yaser Tabarraei
- Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Guedes FR, Bonvicini JFS, de Souza GL, da Silva WHT, Moura CCG, Paranhos LR, Turrioni AP. Cytotoxicity and dentin composition alterations promoted by different chemomechanical caries removal agents: A preliminary in vitro study. J Clin Exp Dent 2021; 13:e826-e834. [PMID: 34512923 PMCID: PMC8412812 DOI: 10.4317/jced.58208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/15/2021] [Indexed: 01/09/2023] Open
Abstract
Background The use of chemomechanical agents for caries removal has been indicated as a non-invasive treatment option; however, their possible deleterious effects on the dental-pulp complex have been insufficiently studied. This study assessed the direct cytotoxicity of two chemomechanical caries removal agents (Brix 3000™ - BX and Papacarie Duo™ - PD) on pulp cells from deciduous teeth, as well as to assess the morphology and chemical compositions of the dentin surface after the application of these materials. Material and Methods The cells were seeded (50,000 cells/cm²) in a culture medium (DMEM with 10% fetal bovine serum - FBS). After 24 hours, the BX and PD materials were added to 1:20, 1:100, and 1:1000 dilutions. Non-exposed cells were considered as the control group. The viability test (MTT), Trypan Blue assay (TB), and cell morphology (Scanning Electron Microscopy - SEM) were performed after 24 hours of agent application. For the SEM and chemical (energy-dispersive X-ray spectrometry - EDS) dentin evaluation, 0.3-mm-thick dentin discs were obtained and divided into control group (no treatment) and surfaces covered with 37% phosphoric acid, BX, or PD. Data were compared by one-way ANOVA and Tukey's test (p<0.05). Results Decreases in cell viability and numbers of viable cells were observed for both materials, at all dilutions, when compared with the control group (p<0.05). The BX and PD materials did not cause visually perceptible changes, according to SEM, on the surfaces of dentin discs. The EDS analysis did not indicate a statistically significant difference in the levels of calcium (Ca) and phosphorus (P) between the materials and the control group (p>0.05). Conclusions Both materials showed cytotoxicity when in direct contact with the pulp cells from deciduous teeth, and the BX material presented lower cytotoxicity than the PD material. Moreover, both materials did not significantly change the dentin composition. Key words:Cell culture, cytotoxicity, dental pulp, papacarie, primary teeth.
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Affiliation(s)
- Fernanda-Rodrigues Guedes
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Uberlandia, Uberlandia, MG, Brazil
| | | | - Gabriela-Leite de Souza
- Department of Endodontics, School of Dentistry, Federal University of Uberlandia, Uberlandia, MG, Brazil
| | | | | | - Luiz-Renato Paranhos
- Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Uberlandia, Uberlandia, MG, Brazil
| | - Ana-Paula Turrioni
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Uberlandia, Uberlandia, MG, Brazil
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Ulusoy NB, Akbay Oba A, Cehreli ZC. Effect of Er,Cr:YSGG Laser on the Prevention of Primary and Permanent Teeth Enamel Demineralization: SEM and EDS Evaluation. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 38:308-315. [PMID: 32427554 DOI: 10.1089/photob.2019.4772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: To evaluate in vitro the effect of the erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser on resistance of primary and permanent human enamel to demineralization using water cooling and fluoride coapplication as variable parameters. Methods: Enamel specimens were prepared from extracted primary and permanent teeth (n = 225 each). The specimens were separated into 15 subgroups (n = 15/group) based on laser application at three different power settings (0.25, 0.50, and 0.75 W), laser application with and without water cooling, and application of acidulated phosphate fluoride (APF) gel before laser treatment. Morphological changes were assessed with scanning electron microscopy (SEM), and the specimens' chemical contents were determined with energy-dispersive X-ray spectroscopy. Results: In both the primary and permanent teeth, the highest Ca and P content was observed in the noncooled 0.75 W laser group (p < 0.05), irrespective of APF pretreatment (p > 0.05). The Ca and P content for the noncooled APF +0.75 W laser group was lower than that for the APF group and the noncooled 0.75 W laser group. For both dentitions, the F mass content for the APF+laser groups was significantly higher than laser-only groups (p < 0.05). Under SEM, both the primary and permanent enamel exhibited cracks, craters, and surface roughness without water cooling, consistent with increased power output. Conclusions: Er,Cr:YSGG laser application at 0.75 W without water cooling increased enamel resistance to demineralization. Compared with topical APF application, Er,Cr:YSGG laser application barely improved enamel resistance against demineralization, and coapplication did not result in a synergistic effect.
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Affiliation(s)
- Nur Burcu Ulusoy
- Department of Pediatric Dentistry, Kirikkale University, Kirikkale, Turkey
| | - Aylin Akbay Oba
- Department of Pediatric Dentistry, Kirikkale University, Kirikkale, Turkey
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Erkmen Almaz M, Ulusoy NB, Akbay Oba A, Erdem Ü, Doğan M. Thermal, morphological, and spectral changes after Er, Cr:YSGG laser irradiation at low fluences on primary teeth for caries prevention. Microsc Res Tech 2020; 84:150-159. [PMID: 33219723 DOI: 10.1002/jemt.23637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/06/2020] [Accepted: 10/22/2020] [Indexed: 11/10/2022]
Abstract
The aim of this study was to determine the temperature increase in the pulp chamber and possible thermal effects on molecular structure of primary teeth during the irradiation with Er,Cr:YSGG laser. Primary central incisors were divided into three groups (n = 20). Labial surfaces in each group were irradiated by Er,Cr:YSGG laser within different power and frequencies as following groups: I: 0.25 W, 20 Hz, II: 0.50 W, 20 Hz, III: 0.75 W, 20 Hz. A thermocouple was placed inside the pulp chamber so that the temperature increments were recorded during the enamel irradiation. Morphological changes of enamel surfaces were experimentally evaluated by SEM. Fourier-transform infrared spectroscopy and RAMAN analyses were carried out to determine the differentiations in the molecular structure. The experimental results obtained were analyzed statistically by means of one-way analysis of variance. Statistically significant differences were detected between groups (p < .05). Group III exhibited the highest values for the temperature parameters. Besides, the conical craters, cracks, and formation of ablation areas were observed for all the groups. Also, it was obtained that the hydroxyapatite lost the hydroxyl ions due to the thermal effect of the laser. Temperature rise throughout the Er,Cr:YSGG laser irradiation for prevention of primary enamel demineralization presented a positive correlation with the laser output power level. The formations of adverse morphological and spectral changes were detected on the surface of teeth after the laser application. On this basis, the Er,Cr:YSGG laser applications should be treated with much more caution considering enamel surface and pulpal tissues in primary teeth.
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Affiliation(s)
- Merve Erkmen Almaz
- Department of Pediatric Dentistry, Faculty of Dentistry, Kırıkkale University, Kırıkkale, Turkey
| | | | - Aylin Akbay Oba
- Department of Pediatric Dentistry, Faculty of Dentistry, Kırıkkale University, Kırıkkale, Turkey
| | - Ümit Erdem
- Scientific and Technological Research Application Center, Kırıkkale University, Kırıkkale, Turkey
| | - Mustafa Doğan
- Scientific and Technological Research Application Center, Kırıkkale University, Kırıkkale, Turkey
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Al-Maliky MA, Frentzen M, Meister J. Laser-assisted prevention of enamel caries: a 10-year review of the literature. Lasers Med Sci 2019; 35:13-30. [PMID: 31399861 DOI: 10.1007/s10103-019-02859-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 08/01/2019] [Indexed: 01/13/2023]
Abstract
Since the invention of lasers in dentistry, investigations in caries prevention by the use of laser radiation have been proposed. There are several mechanisms stated for this purpose such as photothermal and/or photochemical interaction processes with the enamel. Alone or in conjugation with topical fluoride application, this treatment modality may improve enamel acid resistance in high-caries-risk populations. Data collection was done by searching the keywords caries, prevention, and laser in PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar. Lasing protocols of the collected literature and their effectiveness as well as examination methods used to verify treatment outcomes have been evaluated. One hundred eighteen publications were found for the last 10 years. The wavelengths investigated for caries prevention are mainly located in the near and the mid-infrared spectral range. In the evaluated period of time, investigations using CO2; Er:YAG; Er,Cr:YSGG; Er:YLF; fundamental, second, and third harmonic generations of Nd:YAG; diodes; and argon ion lasers were found in the databases. Accounting for 39% of the literature, CO2 laser was the most examined system for this purpose. Reviewing the literature in this narrative review showed that all laser systems presented a positive effect in varying degrees. Laser irradiation could be an alternative or synergistic to topical fluoridation for enamel caries prevention with longer lasting effect. Further research should be focused on selecting proper laser settings to avoid damage to enamel and developing effective evidence-based clinical protocols.
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Affiliation(s)
- Mohammed Abbood Al-Maliky
- Department of Periodontology, Operative and Preventive Dentistry, Dental Faculty, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany. .,Center of Applied Medical Laser Research and Biomedical Optics (AMLaReBO), University of Bonn, Bonn, Germany. .,Department of Biomedical Applications, Institute of Laser for Postgraduate Studies, University of Baghdad, Baghdad, Iraq.
| | - Matthias Frentzen
- Department of Periodontology, Operative and Preventive Dentistry, Dental Faculty, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
| | - Jörg Meister
- Department of Periodontology, Operative and Preventive Dentistry, Dental Faculty, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany.,Center of Applied Medical Laser Research and Biomedical Optics (AMLaReBO), University of Bonn, Bonn, Germany
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Teutle-Coyotecatl B, Contreras-Bulnes R, Scougall-Vilchis RJ, Almaguer-Flores A, Rodríguez-Vilchis LE, Velazquez-Enriquez U, Alatorre JÁA. Effect of Er:YAG laser irradiation on deciduous enamel roughness and bacterial adhesion: An in vitro study. Microsc Res Tech 2019; 82:1869-1877. [PMID: 31373738 DOI: 10.1002/jemt.23354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/21/2019] [Accepted: 07/16/2019] [Indexed: 11/07/2022]
Abstract
Laser irradiation has been proposed as a preventive method against dental caries since it is capable to inhibit enamel demineralization by reducing carbonate and modifying organic matter, yet it can produce significant morphological changes. The purpose of this study was to evaluate the influence of Er:YAG laser irradiation on superficial roughness of deciduous dental enamel and bacterial adhesion. Fifty-four samples of deciduous enamel were divided into three groups (n = 18 each). G1_control (nonirradiated); G2_100 (7.5 J/cm2 ) and G3_100 (12.7 J/cm2 ) were irradiated with Er:YAG laser at 7.5 and 12.7 J/cm2 , respectively, under water irrigation. Surface roughness was measured before and after irradiation using a profilometer. Afterwards, six samples per group were used to measure bacterial growth by XTT cell viability assay. Adhered bacteria were observed using confocal laser scanning microscopy (CLSM) and a scanning electron microscopy (SEM). Paired t-, one-way analysis of variance (ANOVA), Kruskal-Wallis and pairwise Mann-Whitney U tests were performed to analyze statistical differences (p < .05). Before treatment, samples showed homogenous surface roughness, and after Er:YAG laser irradiation, the surfaces showed a significant increase in roughness values (p < .05). G3_100 (12.7 J/cm2 ) showed the highest amount of Streptococcus mutans adhered (p < .05). The increase in the roughness of the tooth enamel surfaces was proportional to the energy density used; the increase in surface roughness caused by laser irradiation did not augment the adhesion of Streptococcus sanguinis; only the use of the energy density of 12.7 J/cm2 favored significantly the adhesion of S. mutans.
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Affiliation(s)
- Bernardo Teutle-Coyotecatl
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO). Jesús Carranza esq. Paseo Tollocan, Colonia Universidad, Toluca, Estado de México, México, C.P. 50130
| | - Rosalía Contreras-Bulnes
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO). Jesús Carranza esq. Paseo Tollocan, Colonia Universidad, Toluca, Estado de México, México, C.P. 50130
| | - Rogelio José Scougall-Vilchis
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO). Jesús Carranza esq. Paseo Tollocan, Colonia Universidad, Toluca, Estado de México, México, C.P. 50130
| | - Argelia Almaguer-Flores
- Universidad Nacional Autónoma de México, Facultad de Odontología, Laboratorio de Genética Molecular, Circuito Escolar s/n, Ciudad Universitaria, Delegación Coyoacán, Mexico
| | - Laura Emma Rodríguez-Vilchis
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO). Jesús Carranza esq. Paseo Tollocan, Colonia Universidad, Toluca, Estado de México, México, C.P. 50130
| | - Ulises Velazquez-Enriquez
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO). Jesús Carranza esq. Paseo Tollocan, Colonia Universidad, Toluca, Estado de México, México, C.P. 50130
| | - Jesús Ángel Arenas Alatorre
- Universidad Nacional Autónoma de México, Instituto de Física, Circuito Escolar s/n, Ciudad Universitaria, Delegación Coyoacán, Mexico
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de los Angeles Moyaho-Bernal M, Contreras-Bulnes R, Rodríguez-Vilchis LE, Rubio-Rosas E, Scougall-Vilchis RJ, Centeno-Pedraza C. Morphological and chemical changes in human deciduous dentin after phosphoric acid, self-etching adhesive and Er: YAG laser conditioning. Microsc Res Tech 2018; 81:494-501. [DOI: 10.1002/jemt.23003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/27/2017] [Accepted: 01/26/2018] [Indexed: 11/10/2022]
Affiliation(s)
- María de los Angeles Moyaho-Bernal
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO); Jesús Carranza Esq. Paseo Tollocan, Col. Universidad, Toluca; Estado de México C.P, 50130 México
| | - Rosalía Contreras-Bulnes
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO); Jesús Carranza Esq. Paseo Tollocan, Col. Universidad, Toluca; Estado de México C.P, 50130 México
| | - Laura Emma Rodríguez-Vilchis
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO); Jesús Carranza Esq. Paseo Tollocan, Col. Universidad, Toluca; Estado de México C.P, 50130 México
| | - Efraín Rubio-Rosas
- Benemérita Universidad Autónoma de Puebla, Centro Universitario de Vinculación; Prolongación de la 24 Sur y Av. San Claudio, Ciudad Universitaria, Col. San Manuel, Puebla C.P, 72570 México
| | - Rogelio José Scougall-Vilchis
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO); Jesús Carranza Esq. Paseo Tollocan, Col. Universidad, Toluca; Estado de México C.P, 50130 México
| | - Claudia Centeno-Pedraza
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO); Jesús Carranza Esq. Paseo Tollocan, Col. Universidad, Toluca; Estado de México C.P, 50130 México
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Ţălu Ş, Contreras–Bulnes R, Morozov IA, Rodríguez-Vilchis LE, Montoya-Ayala G. Surface nanomorphology of human dental enamel irradiated with an Er:YAG laser. LASER PHYSICS 2015. [DOI: 10.1088/1054-660x/26/2/025601] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Ramalho KM, Hsu CYS, de Freitas PM, Aranha ACC, Esteves-Oliveira M, Rocha RG, de Paula Eduardo C. Erbium Lasers for the Prevention of Enamel and Dentin Demineralization: A Literature Review. Photomed Laser Surg 2015; 33:301-19. [DOI: 10.1089/pho.2014.3874] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Karen Müller Ramalho
- Department of Stomatology, School of Dentistry of the University of São Paulo (USP) Prof. São Paulo, SP, Brazil
| | - Chin-ying Stephen Hsu
- Department of Dentistry, Faculty of Dentistry, National University of Singapore (NUS), Singapore
| | - Patrícia Moreira de Freitas
- Department of Restorative Dentistry, School of Dentistry of the University of São Paulo (USP), São Paulo, SP, Brazil
| | - Ana Cecília Correa Aranha
- Department of Restorative Dentistry, School of Dentistry of the University of São Paulo (USP), São Paulo, SP, Brazil
| | - Marcella Esteves-Oliveira
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Rodney Garcia Rocha
- Department of Stomatology, School of Dentistry of the University of São Paulo (USP) Prof. São Paulo, SP, Brazil
| | - Carlos de Paula Eduardo
- Department of Restorative Dentistry, School of Dentistry of the University of São Paulo (USP), São Paulo, SP, Brazil
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