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Al Ahmari NM, Alshehri AH, Gadah TS, Alqahtani JA, Almushafi MA, Al Moaleem MM, Al Hatlan EN, Alqhatani AS, Alabydi SM. Comparison of color changes, fracture strengths, and failure modes of conventional endocrowns and endocrowns with different design modifications. Technol Health Care 2024; 32:2395-2408. [PMID: 38427513 DOI: 10.3233/thc-231175] [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] [Indexed: 03/03/2024]
Abstract
BACKGROUND Endocrowns (ECs) are alternatives for rebuilding severely damaged teeth and show superior efficacy in molars over premolars. OBJECTIVE The objective of this in vitro study is to evaluate the effects of different preparation designs with short pulp chambers on the mean color change (ΔE), fracture resistance, and failure types of mandibular molar ECs. METHOD A total of 40 extracted mandibular molars were treated endodontically and divided into four groups. Samples in groups 1, 2, 3, and 4 had occlusal preparation depths of 5 mm, 3 mm, 3 mm with ferrule, and 3 mm with boxes, respectively. The samples were immersed in coffee and their ΔE values were measured by using the Commission Internationale de l'Eclairage color system. They were also subjected to a fracture test. Next, all specimens were examined visually under a stereomicroscope to evaluate their failure modes and identify their fracture origins. Data were entered and analyzed by using Statistical Package for Social Sciences. RESULTS Among all groups, group 4 (3 mm + boxes) presented the highest ΔE (4.15) after immersion in coffee. Moreover, ANOVA revealed that the ΔE of group 4 (occlusal preparation depth of 3 mm with boxes) was significantly different (p< 0.05) from that of group 2 (3 mm + ferrule, 3.07). The EC with a 3 mm chamfer and ferrule showed the highest maximum load of 2847.68 ± 693.27 N, whereas that with a 5 mm chamfer finish line had a marginally reduced load at fracture of 2831.52 ± 881.83 N. The EC with a 3 mm chamber and boxes had a slightly increased maximum load of 2700.75 ± 436.40 N, whereas that with the 3 mm chamber had the lowest maximum load at fracture of 2385.97 ± 465.61 N. One-way ANOVA showed that different EC preparation designs had no effect on maximum fracture load (F [3,16] = 0.550, p= 0.6). CONCLUSION The recorded ΔE values of ECs in all groups were equal or marginally higher than the acceptable values. The EC with a 3 mm chamfer and ferrule displayed the highest mean maximum load. The EC with a 5 mm chamfer finish line had a marginally lower maximum load at fracture than other ECs. Failures, such as ceramic fracture, split fracture, and ceramic and tooth splitting above the cemento-enamel junction (CEJ) or vertically were predominant in samples with occlusal preparation depths of 3 mm with ferrule and 5 mm.
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Affiliation(s)
| | - Abdulkarim H Alshehri
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Thrya S Gadah
- College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Jaber A Alqahtani
- Aseer Specialized Dental Center, Ministry of Health, Abha, Saudi Arabia
| | | | - Mohammed M Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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El-Ashkar A, Nabil O, Taymour M, El-Tannir A. Evaluation of zirconia crowns restoring endodontically treated posterior teeth with 2 finish line designs and 2 occlusal reduction schemes: A randomized clinical trial. J Prosthet Dent 2022:S0022-3913(22)00634-5. [PMID: 36396490 DOI: 10.1016/j.prosdent.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/17/2022]
Abstract
STATEMENT OF PROBLEM Preparation design has been linked to restoration survival, and the finish line geometry, such as a deep chamfer or shoulder, has been linked to marginal integrity. However, limited data are available for restoration success with the feather-edge finish line when used with monolithic zirconia crowns with different occlusal reduction schemes. PURPOSE The purpose of this randomized clinical trial was to evaluate the clinical performance of 2 finish line designs (feather-edge and rounded shoulder) in relation to 2 occlusal designs (flat and planar) in endodontically treated teeth restored with monolithic zirconia crowns. MATERIAL AND METHODS Sixty-six complete-coverage monolithic zirconia crowns were provided for posterior endodontically treated teeth. The participants were divided into 3 groups based on the preparation design: the control group (PS) had a planar occlusal scheme with a rounded shoulder finish line; the first intervention group (FF) had a flat occlusal scheme with a feather-edge finish line; and the second intervention group (FS) had a flat occlusal scheme with a rounded shoulder finish line. The crowns were designed with the exocad software program and milled with a 5-axis machine. After cementation, clinical performance in terms of marginal adaptation, marginal discoloration, fracture, and secondary caries was evaluated by using the modified United States Public Health Service (USPHS) criteria. The gingival index score system was used to evaluate the gingival response. The scores were recorded immediately after cementation and at 3 subsequent follow-up visits every 3 months for 1 year. The chi-square test was used in all comparisons of outcomes and follow-up durations (α=.05). RESULTS In terms of marginal adaptations, the control group (PS) demonstrated the best marginal adaptation scores during follow-up visits, followed by intervention 2 (FS), and lastly, intervention 1 (FF), which was scored mostly with Bravo. At the third follow-up visit, the intervention 1 (FF) group reported the most gingival responses of all groups. No significant difference among the groups was found in terms of marginal discoloration, fracture, or secondary caries at any of the follow-up visits. Each group received a perfect Alfa score of 100% on all 3 follow-up assessments. CONCLUSIONS In this 1-year randomized clinical trial, all evaluated preparation schemes and corresponding crowns were clinically successful. The clinical performance of monolithic zirconia crowns of the novel preparation design (FF) was successful in terms of marginal adaption, fracture, secondary caries, and marginal discoloration.
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Affiliation(s)
- Alaa El-Ashkar
- Lecturer, Fixed Prosthodontics Department, Faculty of Dentistry, Galala University, Suez, Egypt.
| | - Omnia Nabil
- Lecturer, Fixed Prosthodontics Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Maha Taymour
- Professor, Fixed Prosthodontics Department, Faculty of Dentistry, Cairo University, Cairo, Egypt; Professor, Fixed Prosthodontics Department, School of Dentistry, New Giza University, Giza, Egypt
| | - Adel El-Tannir
- Professor, Fixed Prosthodontics Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Mezied M, Alhazmi A, Alhamad G, Alshammari N, Almukairin R, Aljabr N, Barakat A, Koppolu P. Endocrowns versus post-core retained crowns as a restoration of root canal treated molars - A review article. J Pharm Bioallied Sci 2022; 14:S39-S42. [PMID: 36110800 PMCID: PMC9469346 DOI: 10.4103/jpbs.jpbs_159_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/20/2022] [Accepted: 03/10/2022] [Indexed: 11/18/2022] Open
Abstract
Normally root canal-treated teeth are covered with crowns to prevent fracture, which becomes challenging in cases where the tooth is extensively damaged. In such instances, various restorative methods such as post-core and endocrowns have been in use. The former methodology in recent times is being discouraged owing to impending tooth weakening. Due to this reason, an uncommon type of reconstruction, endocrowns are preferred. We carried out a comparative review of restorations for endodontically treated molars.
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Gupta R, Thakur S, Pandey NK, Roopa B, Fares KT. Endocrown - A Paradigm Shift in Rehabilitation: A Report of Two Cases. Contemp Clin Dent 2021; 12:195-198. [PMID: 34220164 PMCID: PMC8237820 DOI: 10.4103/ccd.ccd_557_20] [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: 07/13/2020] [Revised: 08/01/2020] [Accepted: 09/26/2020] [Indexed: 11/12/2022] Open
Abstract
Along with the advent of dentistry, the ideal restoration of an endodontically treated tooth has been a widely discussed and controversial topic. Coronal rehabilitation of an endodontically treated tooth is quite a challenge for clinicians as considerations should be taken for its minimally invasive preparation and the retention and stability of the restoration. With the development of adhesive systems, the need for intraradicular anchorage and thus the post-core system is greatly reduced. Endocrown is a restorative option for an endodontically treated tooth, and it serves as a suitable alternative to the conventional post-core restoration and full-coverage restoration. This novel approach promotes the stability and retention of the indirect restoration without the need of a cast metal core or reconstruction with intracanal post, thereby reducing the treatment time. Thus, endocrown has become a promising alternative in the esthetic and functional rehabilitation of an endodontically treated tooth.
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Affiliation(s)
- Rahul Gupta
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Sophia Thakur
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Nitish Kumar Pandey
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - B Roopa
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - K T Fares
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Venturini AB, Wandscher VF, Marchionatti AME, Evangelisti E, Ramos GF, Melo RM, May LG, Baldissara P, Valandro LF. Effect of resin cement space on the fatigue behavior of bonded CAD/CAM leucite ceramic crowns. J Mech Behav Biomed Mater 2020; 110:103893. [PMID: 32957199 DOI: 10.1016/j.jmbbm.2020.103893] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/23/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
Abstract
This study evaluated the influence of occlusal resin cement space on the fatigue performance of bonded-leucite crowns to a dentin-analogue material. Leucite anatomical crowns were adhesively cemented to dentin-like preparations having distinct occlusal cement space (50, 100 and 300 μm) (n = 18), and subjected to step-stress fatigue testing (150 N - 350 N; step-size: 25 N; 20,000 cycles/step; 20 Hz). Fatigue data (load and number of cycles for failure) were analyzed using Kaplan-Meier and Mantel-Cox (log-rank) tests (p <0.05). Fractographic analysis and occlusal internal space measurements were also performed. There was no significant difference for the distinct occlusal cement layer (50 μm: 289 N, 136,111 cycles; 100 μm: 285 N, 132,778 cycles; 300 μm: 246 N, 101,667 cycles). Occlusal internal space analysis showed a mean thickness of 120.4 (50 μm), 174.9 (100 μm) and 337.2 (300 μm). All failures were radial cracks originating at the ceramic-cement interface. Distinct occlusal cement spaces had no effect on the fatigue behavior of anatomical leucite crowns.
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Affiliation(s)
- Andressa Borin Venturini
- Division of Prosthodontics, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Vinícius Felipe Wandscher
- Division of Prosthodontics, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | | | - Edoardo Evangelisti
- Department of Biomedical Sciences and Neuromotor, Division of Prosthodontics, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Gabriela Freitas Ramos
- Division of Prosthodontics, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, Brazil.
| | - Renata Marques Melo
- Division of Prosthodontics, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, Brazil.
| | - Liliana Gressler May
- Division of Prosthodontics, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Paolo Baldissara
- Department of Biomedical Sciences and Neuromotor, Division of Prosthodontics, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Luiz Felipe Valandro
- Division of Prosthodontics, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
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Huang X, Zou L, Yao R, Wu S, Li Y. Effect of preparation design on the fracture behavior of ceramic occlusal veneers in maxillary premolars. J Dent 2020; 97:103346. [PMID: 32325176 DOI: 10.1016/j.jdent.2020.103346] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/27/2020] [Accepted: 04/15/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The fracture strengths of four types of occlusal veneers and a traditional full crown ceramic restoration and the influence of preparation design on the stress of restorations were examined. METHODS Forty intact maxillary premolars randomly divided into five groups were prepared based on the demands of type O (occlusal surface coverage), OF (occlusal and lingual surface coverage), POF (occlusal, lingual, and mesial surface coverage), and POFP (occlusal, lingual, mesial, and distal surface coverage) veneers and full crown, and then restored by glass ceramic. Specimens were subjected to fracture resistance tests after cyclic loading. The fracture strengths and modes were analyzed statistically. The level of significance was set at α = 0.05. One maxillary premolar was prepared for type O, OF, POF, POFP veneer and full crown, and then scanned to establish finite element models. The mean fracture load was applied vertically to calculate the maximum principal stress on the ceramic. RESULTS Type O veneer showed higher fracture strength than type POF and POFP veneers (P < 0.05). Both type O and OF veneers exhibited higher fracture strength than full crown (P < 0.05). No significant difference in failure mode was observed. The maximum principal stress for type O, OF, POF, POFP veneers, and full crown increased progressively and concentrated at the bonding surface directly beneath the loading area. CONCLUSIONS Four types of occlusal veneer showed fracture strengths that considerably exceeded normal biting forces. They represent conservative alternatives to full crowns and present a viable treatment for severely worn teeth. CLINICAL SIGNIFICANCE The occlusal veneers with different preparation designs, including type O, OF, POF and POFP veneers, show higher fracture resistances than traditional full coverage crowns that considerably exceed the normal biting forces. Therefore, these represent conservative alternatives to crown restorations and present a viable treatment for restoring severely worn teeth.
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Affiliation(s)
- Xiaoqiong Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China.
| | - Leiyan Zou
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China.
| | - Run Yao
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Shuyi Wu
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China.
| | - Yan Li
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, People's Republic of China.
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Huang XQ, Hong NR, Zou LY, Wu SY, Li Y. Estimation of stress distribution and risk of failure for maxillary premolar restored by occlusal veneer with different CAD/CAM materials and preparation designs. Clin Oral Investig 2020; 24:3157-3167. [PMID: 32034548 DOI: 10.1007/s00784-019-03190-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 12/26/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To compare stress distribution and failure probability in maxillary premolars restored by simple occlusal veneer (SOV) and buccal-occlusal veneer (BOV) with 3 different CAD/CAM materials. MATERIALS AND METHODS A maxillary premolar was digitized by a micro-CT scanner. Three-dimensional dynamic scan data were transformed, and finite element models of 2 different models (SOV and BOV restored teeth) were designed. Three different CAD/CAM materials, including lithium disilicate glass ceramic (LD) IPS e.max CAD, polymer-infiltrated ceramic-network (PICN) Vita Enamic, and resin nano-ceramic (RNC) Lava Ultimate, were designated to both veneers. Maximum principle stresses were determined by applying a 300-N axial load to the occlusal surface. Weibull analyses were performed to calculate the failure probability of the models. RESULTS LD-restored teeth showed the highest stress in the veneer, lowest stress in substrate teeth, and lowest failure probability for the overall system; RNC-restored teeth showed the lowest stress in the veneer, highest stress in substrate teeth, and highest failure probability. No significant differences were found in the cement layer among the different models. No significant differences of stress and failure probability existed between SOV and BOV preparations. CONCLUSIONS CAD/CAM composite resin occlusal veneers bear lower maximum stress than ceramic veneers. Teeth restored by composite veneers are more prone to failure than those restored by ceramic veneers. Additional reduction of the buccal surface did not increase the stress on the occlusal veneer under axial load. CLINICAL RELEVANCE Both occlusal veneers could be used under physiological masticatory force. CAD/CAM glass ceramic was safer than composite resins.
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Affiliation(s)
- Xiao-Qiong Huang
- Department of Prosthodontics, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, No. 56 Lingyuan West Road, Guangzhou, 510055, China
| | - Nan-Rui Hong
- Department of Prosthodontics, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, No. 56 Lingyuan West Road, Guangzhou, 510055, China
- Department of Stomatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lei-Yan Zou
- Department of Prosthodontics, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, No. 56 Lingyuan West Road, Guangzhou, 510055, China
| | - Shu-Yi Wu
- Department of Prosthodontics, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, No. 56 Lingyuan West Road, Guangzhou, 510055, China.
| | - Yan Li
- Department of Prosthodontics, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, No. 56 Lingyuan West Road, Guangzhou, 510055, China.
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Endocrown restorations: A systematic review and meta-analysis. J Dent 2016; 52:8-14. [DOI: 10.1016/j.jdent.2016.07.005] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 07/07/2016] [Accepted: 07/11/2016] [Indexed: 11/21/2022] Open
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Habib SR, Asiri W, Hefne MJ. Effect of anatomic, semi-anatomic and non-anatomic occlusal surface tooth preparations on the adaptation of zirconia copings. J Adv Prosthodont 2014; 6:444-50. [PMID: 25551003 PMCID: PMC4279041 DOI: 10.4047/jap.2014.6.6.444] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 09/04/2014] [Accepted: 10/07/2014] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To compare the accuracy of marginal and internal adaptation of zirconia (Zr) copings fabricated on anatomic (A), semi-anatomic (SA) and non-anatomic (NA) occlusal surface preparations. MATERIALS AND METHODS 45 extracted bicuspid teeth were prepared for receiving zirconia crowns, with different occlusal preparation designs A=15, SA=15 & NA=15. The Zr copings were fabricated by using CAD4DENT, CAD/CAM. The copings were adjusted, cemented and were cross sectioned centrally from buccal cusp tip to lingual cusp tip into mesial and distal halves. The copings were examined under electron microscope at ×200 magnification and the measurements were recorded at 9 predetermined areas in micrometers. RESULTS Overall mean gap values for the three groups was found to be 155.93±33.98 µm with Anatomical Occlusal preparation design having the least gap value of 139.23±30.85 µm showing the best adaptation among the groups. Post Hoc Tukey's test showed a statistically significant difference (P=.007) between the means of gap for A & NA preparation designs. Measurements recorded at 9 predetermined points showed variations for the three groups. CONCLUSION Anatomical occlusal preparation designs resulted in better marginal and internal adaptation of Zr copings. There is a considerable variation between the measured marginal and internal gap values for the Zr copings fabricated by the (CAD4DENT-CAD/CAM). This variation may be associated with the lack of standardization of the preparation of teeth, computerized designing of the coping for each tooth, cement used, uniform pressure application during the cementation of the copings, sectioning of the copings and the microscopic measurements.
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Affiliation(s)
- Syed Rashid Habib
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Waleed Asiri
- College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
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