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Lee EYN, Sua ZY, Bhatia S, Kohli S, Rossi-Fedele G, Doğramacı EJ, Nagendrababu V. Oral health-related quality of life and perceptions of patients following primary root canal treatment or non-surgical retreatment. AUST ENDOD J 2024. [PMID: 38924249 DOI: 10.1111/aej.12868] [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: 01/03/2024] [Revised: 05/12/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
This retrospective cohort study compared the effect of primary root canal treatment (RCT) with root canal retreatment (Re-RCT) on patient-reported outcomes in Kuala Lumpur, Malaysia. Forty randomly selected adults participated (RCT n = 20; Re-RCT n = 20). The impact their dentition had on the Oral Health Impact Profile-14 (OHIP-14) was assessed by calculating the prevalence of oral health impact, and the severity score. Focus group discussions using a semi-structured guide were arranged through an online meeting platform. Qualitative content analysis identified common themes, and relevant quotes gathered. The impact on OHIP-14 was limited for both RCT and Re-RCT groups with no significant differences in the prevalence of oral health impact. Significant differences were found for functional limitation (RCT higher) and psychological discomfort (Re-RCT higher). Common themes from the discussions include the importance of retaining teeth, the significance of effective communication between clinicians and patients and that the respondents were satisfied with the treatment.
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Affiliation(s)
| | - Zi Yee Sua
- International Medical University, Kuala Lumpur, Malaysia
| | - Shekhar Bhatia
- International Medical University, Kuala Lumpur, Malaysia
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Shivani Kohli
- International Medical University, Kuala Lumpur, Malaysia
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Australia
| | - Giampiero Rossi-Fedele
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Esma J Doğramacı
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Venkateshbabu Nagendrababu
- International Medical University, Kuala Lumpur, Malaysia
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Immich F, de Araújo LP, da Gama RR, da Rosa WLDO, Piva E, Rossi-Fedele G. Fifteen years of engine-driven nickel-titanium reciprocating instruments, what do we know so far? An umbrella review. AUST ENDOD J 2024. [PMID: 38923176 DOI: 10.1111/aej.12870] [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: 05/20/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
Numerous systematic reviews (SRs) have produced conflicting findings on engine-driven nickel-titanium reciprocating instruments (reciprocating instruments) since Yared's seminal study 15 years ago. This umbrella review analysed SRs examining the clinical and laboratory evidence regarding reciprocating instruments for root canal treatment. SRs that evaluated qualitatively and/or quantitatively the outcomes postoperative pain, oral health-related quality of life (OHRQoL), shaping ability, debris extrusion, microbial load, endotoxins reduction, cyclic fatigue, file fracture, dentinal cracks and root canal filling removal were included. The AMSTAR 2 tool was used to evaluate SRs quality, while the ROBIS tool to assess risk of bias (RoB). Forty SRs were included. The SRs revealed predominantly 'high' RoB and 'critically low' quality. Most focused on technical outcomes, exhibiting significant methodological and statistical heterogeneity. Findings suggest comparable efficacy between reciprocating and rotary instruments. However, due to the scarcity of high-quality evidence, future well-designed studies and reviews considering core outcome measures are needed.
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Affiliation(s)
- Felipe Immich
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Lucas Peixoto de Araújo
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
- School of Dentistry, Catholic University of Pelotas, Pelotas, Brazil
| | | | | | - Evandro Piva
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
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Prasad N, Bajaj PD, Shenoy R, Dutta A, Thomas MS. Sodium Hypochlorite Concentration and Post-Endodontic Pain - Unveiling the Optimal Balance: A Systematic Review and Meta-analysis. J Endod 2024:S0099-2399(24)00347-9. [PMID: 38880472 DOI: 10.1016/j.joen.2024.06.005] [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: 01/31/2024] [Revised: 05/28/2024] [Accepted: 06/07/2024] [Indexed: 06/18/2024]
Abstract
INTRODUCTION This study systematically reviewed literature regarding the effect of different concentrations of sodium hypochlorite (NaOCl) used during root canal treatment (RCT) on post-endodontic pain (PEP) and rescue analgesia. METHODS Following registration with PROSPERO (CRD42023388916), a search was conducted using PubMed, Scopus, Web of Science, and Embase databases. Randomized controlled trials (RaCTs) of patients receiving RCT which assessed PEP at different time intervals were included. Following data extraction and Cochrane risk of bias assessment 2, meta-analyses were performed to evaluate PEP during the first 48h along with rescue analgesic intake. The certainty of the evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation approach. RESULTS Five RaCTs with 674 patients were included. One study exhibited a low risk of bias, while four raised some concerns. Patients treated with low concentrations of NaOCl (≤3%) were significantly less likely to report PEP at 24h (OR=2.32; [95%CI, 1.63-3.31]; P<0.05) and 48h (OR=2.49; [95% CI,1.73-3.59]; P<0.05) as compared with high concentrations of NaOCl (≥5%). Furthermore, with low concentrations of NaOCl, significantly lesser moderate-severe PEP was reported at 24h (OR=2.32; [95%CI, 1.47-3.62]; P<0.05) and 48h (OR=2.35; [95%CI, 1.32-4.16]; P<0.05) and lesser analgesia was needed (OR=2.43; [95%CI, 1.48-4.00]; P<0.05). CONCLUSIONS While PEP can be influenced by several factors, low certainty evidence suggests that when NaOCl is used as an irrigant during RCT, PEP may be less likely with lower concentrations of NaOCl. Moderate certainty evidence indicates that lesser analgesia may be required with lower concentrations of NaOCl. These results should be cautiously interpreted.
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Affiliation(s)
- Niharika Prasad
- Dr Niharika Prasad, Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576014, India
| | - Parul Dasson Bajaj
- Dr Parul Dasson Bajaj, Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576014, India
| | - Ramya Shenoy
- Dr Ramya Shenoy, Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576014, India
| | - Arindam Dutta
- Dr Arindam Dutta, Department of Restorative Dentistry, School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff, CF14 4XY, UK
| | - Manuel S Thomas
- Dr Manuel S Thomas, Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576014, India.
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Dawson VS, Fransson H, Isberg PE, Wigsten E. Further Interventions after Root Canal Treatment Are Most Common in Molars and Teeth Restored with Direct Restorations: A 10-11-Year Follow-Up of the Adult Swedish Population. J Endod 2024; 50:766-773. [PMID: 38492798 DOI: 10.1016/j.joen.2024.03.005] [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: 11/30/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION The aims were to investigate 1) the frequency of nonsurgical retreatment, root-end surgery, extraction, and further restorative treatment during a follow-up of 10-11 years after root filling and compare the frequencies according to tooth group and type of coronal restoration and 2) the timing of nonsurgical retreatment, root-end surgery, and extraction. METHODS Data were collected from the Swedish Social Insurance Agency's register. A search for treatment codes identified teeth root filled in 2009 and the type of coronal restoration (direct, indirect, and unspecified) registered within 6 months of root filling. The root-filled teeth were followed 10-11 years, and further interventions were recorded. Descriptive statistics and chi-square tests were used for statistical analysis. RESULTS In 2009, root fillings were registered for 215,611 individuals/teeth. Nonsurgical retreatment, root-end surgery, and extraction were undertaken in 3.5%, 1.4%, and 20% teeth, respectively. The frequency of further interventions varied with respect to tooth group and type of coronal restoration, but only slightly for endodontic retreatments. Further interventions, except for root-end surgery, were registered more often for molars and directly restored teeth (P < .001). The majority of endodontic retreatments were undertaken within 4 years, while extractions were evenly distributed over 10-11 years. CONCLUSIONS The frequency numbers of nonsurgical retreatment and root-end surgery were low, despite 1 in 5 root-filled teeth registered as extracted. Further interventions were most common in molars and directly restored teeth. Endodontic retreatments were performed more often during the first 4 years.
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Affiliation(s)
- Victoria S Dawson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - Helena Fransson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Per-Erik Isberg
- Department of Statistics, Lund University School of Economics and Management, Lund University, Lund, Sweden
| | - Emma Wigsten
- Department of Endodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Ballal NV, El-Karim I, Duncan HF. Postoperative pain following irrigation. Int Endod J 2024; 57:502-504. [PMID: 38576232 DOI: 10.1111/iej.14048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Affiliation(s)
- Nidambur Vasudev Ballal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ikhlas El-Karim
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, UK
| | - Henry F Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Dublin, Ireland
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Edwards D, Rasaiah S, Kirkevang LL, Vaeth M, Stone SJ, Obara I, Durham J, Whitworth J. The use of medicaments in the management of symptomatic irreversible pulpitis: A community-based cohort study. Int Endod J 2024; 57:416-430. [PMID: 38214015 DOI: 10.1111/iej.14020] [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: 09/15/2023] [Revised: 12/15/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
AIM To investigate patient outcomes from either pulpotomy or pulpectomy for the management of symptomatic irreversible pulpitis, with and without application of antibiotic/corticosteroid pastes in urgent primary dental care settings in the United Kingdom. METHODOLOGY All patients receiving intervention for symptomatic irreversible pulpitis in three different primary care settings were invited to participate. Pre-operatively, data regarding patients' numerical ratings scale (NRS), pain score (0-10), analgesic use, oral-health impact profile-14 (OHIP-14) and need for time away from work were collected. For 7 days post-operatively, participants recorded their NRS pain score, global rating of change score, medication use and their ability to work. Analysis used a mixed-effects model with post hoc Tukey's multiple comparisons test for continuous data and chi-squared or Fisher's exact test for categorical data. To test the effect of the corticosteroid/antibiotic paste, pulpectomy and pulpotomy groups were combined following Mantel-Haenszel stratified analysis or a weighted average of the difference between pulpotomy and pulpectomy with and without the use of corticosteroid/antibiotic paste. A binary composite score was constructed using pre- and post-operative data, whereby overall treatment success was defined as: (i) patients did not return for treatment due to pain by day seven; (ii) at day three, there was a 33% (or 2-points) reduction in NRS pain score; (iii) there was a change score of +3 in global rating; (iv) the patient was no longer using analgesia and able to return to work. RESULTS Eighty-five participants were recruited, with 83 completing follow up. Overall treatment success was 57%, with 25% of participants returning for more treatment due to inadequate pain relief. Overall treatment success did not differ between the two groups (p = .645), although patients self-reported greater improvement with an antibiotic/corticosteroid dressing for global rating of change (p = .015). CONCLUSIONS This study identified limited evidence of improved outcomes using antibiotic/corticosteroid dressings in the management of symptomatic irreversible pulpitis in the emergency setting. Further clinical research is needed to understand if these medications are beneficial in affording pain relief, above that of simple excision of irreversibly inflamed pulp tissue.
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Affiliation(s)
- David Edwards
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Sabrina Rasaiah
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Michael Vaeth
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Simon J Stone
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ilona Obara
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK
| | - Justin Durham
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - John Whitworth
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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Arifin FA, Matsuda Y, Kanno T. Development and Validation of Oral Health-Related Quality of Life Scale for Patients Undergoing Endodontic Treatment (OHQE) for Irreversible Pulpitis. Healthcare (Basel) 2023; 11:2859. [PMID: 37958003 PMCID: PMC10648889 DOI: 10.3390/healthcare11212859] [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: 09/30/2023] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
An oral health-related quality of life measure specific to patients undergoing endodontic treatment has not been developed. This study aimed to validate the oral health-related quality of life scale for patients undergoing endodontic treatment (OHQE) for irreversible pulpitis, comprised of 42 questions. Sixty-two patients with irreversible pulpitis, comprising 23 (37.1%) males and 39 (62.9%) females, were enrolled between August 2022 and February 2023. Data were collected at three time points: pretreatment, post-treatment, and at the second week post-treatment. Factor analysis revealed physical, psychological, and expectations as subscales of OHQE. Cronbach's alpha coefficients ranged from 0.87 to 0.95 for each subscale. Each subscale of the General Oral Health Assessment Index (GOHAI) was moderately correlated with the OHQE subscales. Good-poor analysis revealed a significant difference between the high-scoring and low-scoring groups for each OHQE subscale. The intraclass correlation coefficients of the OHQE subscales ranged from 0.89 to 0.95. Multivariate linear regression analysis revealed a significant correlation between the pretreatment and post-treatment psychological factors (p < 0.05). Thus, OHQE will help researchers and policymakers understand the impact of oral health on the quality of life of patients with irreversible pulpitis undergoing endodontic treatment. OHQE could contribute to the appropriate planning, treatment decisions, and management of dental treatment.
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Affiliation(s)
- Fadil Abdillah Arifin
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo 693-8501, Japan; (F.A.A.); (Y.M.)
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Muslim Indonesia, Makassar 90132, Indonesia
| | - Yuhei Matsuda
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo 693-8501, Japan; (F.A.A.); (Y.M.)
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo 693-8501, Japan; (F.A.A.); (Y.M.)
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Esteve-Pardo G, Barreiro-Gabeiras P, Esteve-Colomina L. Pulpectomy vs. Pulpotomy as Alternative Emergency Treatments for Symptomatic Irreversible Pulpitis-A Multicenter Comparative Randomised Clinical Trial on Patient Perceptions. Clin Pract 2023; 13:898-913. [PMID: 37623263 PMCID: PMC10453127 DOI: 10.3390/clinpract13040082] [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: 05/17/2023] [Revised: 07/12/2023] [Accepted: 07/23/2023] [Indexed: 08/26/2023] Open
Abstract
AIM There needs to be more general agreement on the most effective treatment for the emergency patient with Symptomatic Irreversible Pulpitis (SIP). This equivalence randomised clinical study compared the clinical efficiency, as an urgent treatment, of pulpotomy (POT) and pulpectomy (PEC) in the permanent teeth with SIP. The primary outcome was pain management, and the secondary outcome was the patient's perception of duration, comfort, and satisfaction. MATERIAL & METHODS 80 patients were blindly and randomly allocated into two equal parallel groups, the control group treated by PEC and the test group by POT. Data were collected through numerical rating scales (NRS) during the intervention and 6, 24, and 72 h post-op. Non-parametric tests were used to analyse the data. The Brunner-Longer models were adopted for longitudinal data and the analysis of variance (ANOVA)-type statistical was used. RESULTS The mean preoperative pain levels for the whole sample scored 5.8 ± 2.8 and significantly decreased to 2.1 ± 2.4 at 6 h, 1.5 ± 2.1 at 24 h, and 1.3 ± 2 at 72 h, without any differences between the groups. No significant differences were found in the patient's perception of treatment discomfort or duration between the groups. Three days after the intervention, patient satisfaction was high, with 9.2 ± 1.7 and 9.1 ± 2 in the PEC and POT groups, respectively. Self-reported pain was the only variable penalising the patient's final satisfaction. CONCLUSIONS The current randomised control trial (RCT) showed that both pulpectomy and pulpotomy effectively eliminate pain and achieve high levels of patient satisfaction. Furthermore, the patient's perceptions of the duration and discomfort of the two treatments were similar. Given that pulpotomy is a faster and more straightforward technique, it may be recommended as a viable and pragmatic option for treating emergency patients with symptomatic irreversible pulpitis.
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Nagendrababu V, Vinothkumar TS, Rossi-Fedele G, Doğramacı EJ, Duncan HF, Abbott PV, Levin L, Lin S, Dummer PMH. Dental patient-reported outcomes following traumatic dental injuries and treatment: A narrative review. Dent Traumatol 2023. [PMID: 36744323 DOI: 10.1111/edt.12827] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 02/07/2023]
Abstract
Dental patient-reported outcomes (dPROs) are self-reported descriptions of a patient's oral health status that are not modified or interpreted by a healthcare professional. Dental patient-reported outcome measures (dPROMs) are objective or subjective measurements used to assess dPROs. In oral healthcare settings, the emphasis on assessing treatment outcomes from the patient's perspective has increased and this is particularly important after traumatic dental injuries (TDIs), as this group of injuries represent the fifth most prevalent disease or condition worldwide. The purpose of this review is to summarize the current use of dPROs and dPROMs in the field of dental traumatology. Oral Health-Related Quality of Life, pain, swelling, aesthetics, function, adverse effects, patient satisfaction, number of clinical visits and trauma-related dental anxiety are the key dPROs following TDIs. Clinicians and researchers should consider the well-being of patients as their top priority and conduct routine evaluations of dPROs using measures that are appropriate, accurate and reflect what is important to the patient. After a TDI, dPROs can assist clinicians and patients to choose the best management option(s) for each individual patient and potentially improve the methodology, design and relevance of clinical studies.
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Affiliation(s)
| | - Thilla Sekar Vinothkumar
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.,Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | | | - Esma J Doğramacı
- Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Henry F Duncan
- Division of Restorative Dentistry, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Paul V Abbott
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Liran Levin
- Faculty of Medicine and Dentistry, University of Alberta, Alberta, Edmonton, Canada
| | - Shaul Lin
- The Israeli National Center for Trauma & Emergency Medicine Research, Gertner Institute, Tel Hashomer, Israel.,Department of Endodontics, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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