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Amaral MF, Casatti CA, Naqvi AR, Debortoli CVL, Atili Brandini D. Histological changes in pulp-dentin complex in tooth subjected to traumatic occlusion and subluxation. Saudi Dent J 2024; 36:321-327. [PMID: 38420008 PMCID: PMC10897626 DOI: 10.1016/j.sdentj.2023.11.012] [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: 06/28/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 03/02/2024] Open
Abstract
Background This study evaluated the influence of traumatic occlusion in the dentin-pulp complex a molar teeth submitted to subluxation. Material and methods Ninety Wistar rats were divided into groups Naïve (N), Subluxation (S) and Subluxation with traumatic occlusion (STO) and submitted to histological analysis after 7 and 21 days. A quantitative analysis was submitted to one-way ANOVA and Tukey's post-hoc test, and Chi-square and Bonferronís post-hoc test. Results S and STO showed a significant increase in blood vessels area (p < 0.0005), amorphous fundamental substance (p < 0.0005) and reactionary dentin formation (p < 0.0005), as well as a decrease in the nuclear profile (p < 0.0005), odontoblast layer (p = 0.013 and p < 0.0005) by day 7 when compared with N. These changes normalized by day 21, except for the reactionary dentin (p < 0.0005) in both S and STO groups. Interestingly, the STO group exhibited significant changes in the increase of pulp calcification (p < 0.0005), presence of tubules with nuclei (p < 0.0005), and inflammatory infiltrate (p < 0.0005), as well reduction of nuclear profile (p < 0.0005), odontoblast layer (p < 0.0005) compared with N and S at day 21. Conclusions STO impaired the defence response and decreased pulp regeneration capacity by increasing the inflammatory infiltrate and pulp calcification, and decreasing the nucleated cell number in the odontoblast layer and central pulp.
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Affiliation(s)
- Marina Fuzette Amaral
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Cláudio Aparecido Casatti
- Department of Physiology and Morphology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Afsar Raza Naqvi
- Mucosal Immunology Lab, The University of Illinois at Chicago, College of Dentistry, Dept. of Periodontics, Chicago, IL, United States
| | | | - Daniela Atili Brandini
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
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Lisboa JL, Guimarães MO, Vieira-Andrade RG, Ferreira FM, Ramos-Jorge J, Zarzar PM. Factors associated with the survival of primary maxillary anterior teeth after intrusive luxation: a retrospective longitudinal study. Eur Arch Paediatr Dent 2023; 24:33-42. [PMID: 36114997 DOI: 10.1007/s40368-022-00752-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 09/02/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the survival rate of primary maxillary anterior teeth following intrusive luxation and identify associated factors. METHODS A retrospective longitudinal study was conducted at a primary dental trauma centre using 88 dental records of children with intrusive luxation between 2007 and 2018. The variables of interest were time the tooth remained in the alveolus, degree of intrusion, accentuated overjet, lip protection, visible plaque, compromised germ of the permanent successor, clinical signs of infectious and inflammatory processes, endodontic treatment, pulp canal obliteration, sex, age at the time of trauma, family income, mother's schooling, and immediate care. Descriptive, bivariate, and Cox regression analyses were performed (p < 0.05; 95% CI). RESULTS The 88 dental records of children with intrusive luxation included 128 teeth. Survival rate throughout the follow-up period was 65.6% (n = 84). Age older than three years and eight months (HR 2.28; 95% CI 1.04-4.99; p = 0.039), the development of an infectious process (HR 3.51; 95% CI 1.39-8.86; p = 0.008), development of an inflammatory process (HR 2.35; 95% CI 1.17-4.71; p = 0.016) and compromised germ of the permanent successor (HR 4.38; 95% CI 1.99-9.61; p < 0.001) were associated with a lower survival rate of intruded primary maxillary anterior teeth. CONCLUSION The survival rate during the follow-up period of intruded primary maxillary anterior teeth was considered high. A significantly lower survival rate was associated with age, the occurrence of an infectious process and inflammatory process, and the compromised germ of the permanent successor.
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Affiliation(s)
- J L Lisboa
- Department of Child and Adolescent, Oral Health, Federal University of Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte/MG, Brazil
| | - M O Guimarães
- Department of Child and Adolescent, Oral Health, Federal University of Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte/MG, Brazil
| | - R G Vieira-Andrade
- Department of Child and Adolescent, Oral Health, Federal University of Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte/MG, Brazil
| | - F M Ferreira
- Department of Child and Adolescent, Oral Health, Federal University of Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte/MG, Brazil
| | - J Ramos-Jorge
- Department of Child and Adolescent, Oral Health, Federal University of Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte/MG, Brazil
| | - P M Zarzar
- Department of Child and Adolescent, Oral Health, Federal University of Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte/MG, Brazil.
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Bulut E, Güçlü ZA. Evaluation of primary teeth affected by dental trauma in patients visiting a university clinic, part 2: dental injury types, treatment strategies, and complications. Clin Oral Investig 2023; 27:727-737. [PMID: 36502510 DOI: 10.1007/s00784-022-04820-3] [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: 03/11/2022] [Accepted: 11/26/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This article focuses on treatments and complications in patients presenting dental trauma in primary teeth. Treatment alternatives begin with the decision of performing a procedure under clinical settings or pharmacological techniques (PC) in young children. Correct diagnosis and treatment are crucial to maximize the chances of a favorable outcome. MATERIALS AND METHODS The files of 320 patients aged 0-9 years who presented to the Erciyes University Faculty of Dentistry Department for dental trauma management in primary teeth were evaluated in between 2018 and 2021 for 3-year period. The following information were extracted from patients' records: injury type, affected teeth, caries condition of the teeth, treatment preferences of the dentists. Additionally postoperative complications and their management were evaluated. RESULTS While 63.1% of the traumatized teeth were caries-free, 35.8% of the teeth had caries. The most frequent dental injuries was simple crown fractures (42.9%), followed by complicated crown fractures (38.5%). Treatments were mostly done in clinical conditions (67.9%) and mostly patients attend regularly to follow-up visits (85.6%). Clinicians prefer more radical treatments under sedation or GA (92.4% extraction of injured tooth). Coronal discoloration was the most common complication, and 35.3% had pulp necrosis for longer term results. CONCLUSION Follow-up decisions made after concussion in the primary teeth might be appropriate for the patient. Examination of the complication status of primary teeth with simple crown fracture injury revealed that 59.5% of patients did not have any complications. Follow-up decisions were found to be appropriate for crowns with coloration alone. CLINICAL RELEVANCE All options should be considered to provide the best care for children after primary tooth trauma; this can be achieved by being informed about the treatment and its consequences, and if necessary, a positive prognosis can be achieved with an interdisciplinary approach.
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Affiliation(s)
- Esra Bulut
- Department of Pediatric Dentistry, Faculty of Dentistry and Hospitals, Erciyes University, Melikgazi, Kayseri, 38039, Turkey
| | - Zeynep Aslı Güçlü
- Department of Pediatric Dentistry, Faculty of Dentistry and Hospitals, Erciyes University, Melikgazi, Kayseri, 38039, Turkey.
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Sancas MC, Pires PM, Primo LG. Conservative management of a horizontal root fracture in a primary maxillary central incisor: Case report. Dent Traumatol 2023; 39:82-87. [PMID: 36039396 DOI: 10.1111/edt.12788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 08/08/2022] [Accepted: 08/14/2022] [Indexed: 01/14/2023]
Abstract
Dental trauma occurs frequently in toddlers and the treatment protocols vary depending on each case. Thus, clinicians must not only plan the treatment but also consider any possible sequelae and characteristics related to the child and the family. The aim of this paper was to report a case of a three-year-old boy who had a horizontal root fracture in the middle third of the primary maxillary right incisor root (tooth 51) and crown discoloration of the primary maxillary left incisor (tooth 61) which were successfully treated with conservative management. The management was established in agreement with the family and was based on active surveillance. The clinical and radiographic follow-ups showed no changes besides pulp canal calcification of the left incisor throughout the eight years of follow-up. The pulps remained normal with no pathological signs throughout their life cycle and the permanent successors erupted normally, presenting an excellent result of the non-invasive approach adopted.
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Affiliation(s)
- Mariana Coutinho Sancas
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paula Maciel Pires
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Laura Guimarães Primo
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Santos BZD, Dutra RC, Santos ARSD, Casarin M, Goldfeder EM, Bosco VL, Cordeiro MMR. Immunohistochemistry of resorption and inflammation factors in the periodontal ligament of human deciduous teeth. Braz Oral Res 2022; 36:e056. [PMID: 36507743 DOI: 10.1590/1807-3107bor-2022.vol36.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 12/01/2021] [Indexed: 12/15/2022] Open
Abstract
The understanding of the biological mechanisms involved in root resorption in deciduous teeth is important to the future development of preventive measures and treatments of this condition. The aim of the present study was to compare the expression and immunostaining of iNOS, MMP-9, OPG and RANKL in the periodontal ligament (PDL) of deciduous teeth with physiologic root resorption (GI), inflammatory pathological root resorption (GII) and permanent teeth (GIII), the negative control. Teeth in GI (n = 10), GII (n = 10) and (GIII) (n = 10) were submitted to immunohistochemical analysis to determine the expression of iNOS, MMP-9, OPG, and RANKL. The immunostaining was analysed by optical density. Statistical analysis included one-way ANOVA, followed by Student-Newman-Keuls post hoc test (p < 0.05). The results showed that iNOS, MMP-9 and RANKL expression in the PDL was higher in GII compared to GI and GIII (p < 0.05). Moreover, RANKL expression was higher in GI compared to GIII (p < 0.001), while OPG immunolabelling was lower in GII compared to GI and GIII (p < 0.001). The PDL of deciduous teeth bearing inflammatory processed exhibited upregulation of resorption-associated factors as well as enzymes related to tissue degradation which, in turn explains the exacerbation and greater susceptibility of those teeth to root resorption process.
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Affiliation(s)
- Bianca Zimmermann Dos Santos
- Universidade Franciscana, School of Dentistry, Postgraduate Programme in Maternal and Child Health, Santa Maria, RS, Brazil
| | - Rafael Cypriano Dutra
- Universidade Federal de Santa Catarina - UFSC, Department of Health Science, Araranguá, SC, Brazil
| | | | - Maísa Casarin
- Universidade Federal de Pelotas - UFPel, Department of Semiology and Clinic, Pelotas, RS, Brazil
| | - Eliane Maria Goldfeder
- Universidade Federal de Santa Catarina - UFSC, Centre for Biological Sciences, Department of Morphological Sciences, Florianópolis, SC, Brazil
| | - Vera Lucia Bosco
- Universidade Federal de Santa Catarina - UFSC, Centre of Health Sciences, Department of Dentistry, Florianópolis, SC, Brazil
| | - Mabel Mariela Rodriguez Cordeiro
- Universidade Federal de Santa Catarina - UFSC, Postgraduate Programme in Dentistry, Department of Dentistry, Florianópolis, SC, Brazil
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Moccelini BS, Santos PS, Barasuol JC, Magno MB, Bolan M, Maia LC, Cardoso M. Prevalence of sequelae after traumatic dental injuries to anterior primary teeth: A systematic review and meta-analysis. Dent Traumatol 2022; 38:286-298. [PMID: 35276019 DOI: 10.1111/edt.12744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM Clinical and radiographic sequelae are common following traumatic dental injuries to primary teeth. The aim of this systematic review was to assess the prevalence of such sequelae. MATERIALS AND METHODS Searches were conducted in the PubMed, Scopus, Embase, Web of Science, and BBO/LILACS databases as well as the gray literature. The outcome of interest was the prevalence of the most common sequelae following traumatic dental injuries to anterior primary teeth. Observational studies that evaluated such sequelae were included. Data were extracted, and methodological quality was appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. The number of sequelae per tooth and the total number of teeth evaluated in each study were considered to calculate pooled prevalence rates with 95% confidence intervals (CI). The quality of the evidence was determined using the GRADE approach. RESULTS Twenty-five articles were included in this systematic review and meta-analysis. The prevalence of each complication in descending order was as follows: 39.7% crown discoloration (95% CI: 29.52-50.32), 24.3% pulp necrosis with infection (95% CI: 17.34-32.06), 16.2% periapical radiolucency (95% CI: 8.88-25.49), 15.9% premature tooth loss (95% CI: 9.93-23.15), 14.8% pulp canal obliteration (95% CI: 8.46-22.73), 11.9% pathological root resorption (95% CI: 7.68-16.98), 7.1% abscess/fistula (95% CI: 4.4-10.6), and 1.8% ankylosis (95% CI: 0.82-3.17). The certainty of the evidence was very low. CONCLUSIONS Crown discoloration was the most common sequela in injured primary teeth, but this should be interpreted with caution due to the very low certainty of the evidence. Considerable variation was found in the prevalence of each sequela.
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Affiliation(s)
| | - Pablo Silveira Santos
- Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | | | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michele Bolan
- Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariane Cardoso
- Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
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Lessa SV, Silva AMPD, Santos LAD, Vieira MS, Seabra LMAD, Ferreira DDC. Trauma in Primary Teeth at a Specialized Service Center: Retrospective Cohort. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Moccelini BS, de Alencar NA, Bolan M, Magno MB, Maia LC, Cardoso M. Pulp necrosis and crown discoloration: a systematic review and meta-analysis. Int J Paediatr Dent 2018; 28:432-442. [PMID: 29896799 DOI: 10.1111/ipd.12372] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The association between pulp necrosis and crown discoloration in traumatized primary teeth has not been clearly determined yet. AIM The study verified whether there is an association of pulp necrosis and crown discoloration in traumatized primary teeth through a systematic review and meta-analysis. METHODS A systematic literature search was conducted in PubMed/Medline, Lilacs/BBO, Scopus, Web of Science, Cochrane Library databases, and grey literature. A methodological quality assessment appraisal was independently conducted by two researchers. Random-effects models were employed, and heterogeneity was tested (I2 index/P ≤ 0.05). RESULTS Eight studies with low risk of bias were included in the analysis. A total of 1,494 traumatized primary teeth participated in the pooled meta-analysis. Diagnosis of pulp necrosis was evaluated in 1,414 teeth through clinical and/or radiographic analyses, and the analysis demonstrated a positive association (P = 0.0005/OR 8.37 [2.51, 27.90], I2 = 87%). Eighty teeth were diagnosed with pulp necrosis through endodontic access, and there was no statistically significant association (P = 0.36/OR 2.46 [0.36, 16.94], I2 = 54%). The pooled meta-analysis showed a positive association (P = 0.0003/OR 5.93 [2.24, 15.72], I2 = 83%). CONCLUSION The positive association between pulp necrosis and crown discoloration should be considered with caution once the diagnosis of pulp necrosis was performed by limited criteria.
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Affiliation(s)
- Bárbara Suelen Moccelini
- Department of Pediatric Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Nashalie Andrade de Alencar
- Department of Pediatric Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Michele Bolan
- Department of Pediatric Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mariane Cardoso
- Department of Pediatric Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Lauridsen E, Blanche P, Amaloo C, Andreasen JO. The risk of healing complications in primary teeth with concussion or subluxation injury-A retrospective cohort study. Dent Traumatol 2017; 33:337-344. [DOI: 10.1111/edt.12342] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Eva Lauridsen
- Resource Centre for Rare Oral Diseases; Department of Oral and Maxillo-Facial Surgery; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - Paul Blanche
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | - Catharina Amaloo
- Pediatric Dentistry and Clinical Genetics; Department of Odontology; University of Copenhagen; Copenhagen Denmark
| | - Jens O. Andreasen
- Resource Centre for Rare Oral Diseases; Department of Oral and Maxillo-Facial Surgery; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
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Lauridsen E, Blanche P, Yousaf N, Andreasen JO. The risk of healing complications in primary teeth with intrusive luxation: A retrospective cohort study. Dent Traumatol 2017; 33:329-336. [DOI: 10.1111/edt.12341] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Eva Lauridsen
- Resource Centre for Rare Oral Diseases; Department of Oral and Maxillo-Facial Surgery; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - Paul Blanche
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | - Nadia Yousaf
- School of Oral health Care; University of Copenhagen; Copenhagen Denmark
| | - Jens O. Andreasen
- Resource Centre for Rare Oral Diseases; Department of Oral and Maxillo-Facial Surgery; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
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Costa VPP, Goettems ML, Baldissera EZ, Bertoldi AD, Torriani DD. Clinical and radiographic sequelae to primary teeth affected by dental trauma: a 9-year retrospective study. Braz Oral Res 2016; 30:S1806-83242016000100702. [DOI: 10.1590/1807-3107bor-2016.vol30.0089] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 05/15/2016] [Indexed: 11/22/2022] Open
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