Aim: The aim of this study was to compare the effectiveness of 17% ethylenediaminetetraacetic acid (EDTA) with that of 10% citric acid and newer irrigant QMix in the removal of smear layer from root canal wall dentin. Materials and Methods: Twenty single-rooted teeth were accessed and instrumented with crown down technique up to protaper F3. Between each instrument used, the canals were irrigated with 1 ml of 5% sodium hypochlorite (NaOCl). After instrumentation, the teeth were irrigated with distilled water and then divided into four groups according to the different surface treatment with different irrigants. The irrigants used were 1% NaOCl, 17% EDTA, 10% citric acid, and newer irrigant QMix. The samples were prepared and observed by means of scanning electron microscopy. Three photomicrographs (Χ2000) were recorded for each sample regarding the apical, middle, and cervical thirds. A score system described by Takeda et al. was used to evaluate the images.

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Background: The most common dental disease facing the human race is dental caries. For caries, management of early lesions, prevention of initiation, and interruption of progression are desirable. Remineralization is an effective way of preventive management of caries. Aim: To evaluate remineralization efficacy of two different remineralizing agents. Materials and Methods: Forty enamel samples were taken, and they were divided into four groups (n = 10). Demineralization was carried out with Groups A, B, and C. Remineralization was carried out with Groups A and B for 7 continuous days using casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) and calcium sucrose phosphate (CaSP). Group D was kept as positive control with intact enamel without any surface treatment, whereas Group C was kept as negative control with surface demineralization of enamel. Microhardness testing was done using Vickers microhardness tester after 7-day remineralization cycle. Statistical Analysis: One-way analysis of variance and post hoc Tukey tests were performed. Results: Microhardness of CaSP and CPP-ACPF was comparable. Conclusion: Both remineralizing agents showed surface remineralization.

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Advancements in dental technology enable patients to receive modern solutions of conventional dental problems. Prosthodontists can incorporate digital technology into their practices to improve their workflow efficiency and ease of collaboration with laboratories. In this article, digital technologies that are available for prosthetic dentistry such as digital radiography, electronic prescriptions, computerized case presentations, virtual articulator and facebow, computer-aided design/computer-aided manufacturing restorations, digital impressions, and shade selection are described along with emphasis on advantages and limitations of digital technology.

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Background: Supragingival plaque control is elementary to the prevention and management of periodontal diseases. Conversely, significant proportions of all individuals fail to practice a high standard of plaque removal. The adjunctive use of chemicals would therefore appear a way of overcoming deficiencies in mechanical tooth cleaning habits. This prospective, randomized positively controlled clinical trial was aimed to evaluate the short-term clinical effects of a licorice oral rinse in the reduction of plaque and gingival inflammation in individuals with gingivitis. Materials and Methods: A total of 104 individuals, 12–15 years of age diagnosed with chronic generalized gingivitis, were selected and randomly divided into two groups: Group 1: chlorhexidine mouthwash and Group 2: licorice mouthwash. Clinical evaluation was undertaken using the gingival index, the plaque index, and bleeding on probing at baseline, 1^st, 2^nd, and 4^th week. Results: Both chlorhexidine and licorice mouthwash showed a significant reduction in plaque and gingival index scores from baseline to 1^st, 2^nd, and at 4^th week. However, the improvement in plaque and gingival index scores were better in chlorhexidine group than herbal mouthwash. Both mouthwashes were found to be equally effective in reducing bleeding on probing. Conclusion: Unlike chlorhexidine mouthwash, licorice mouthwash was not associated with any discoloration of teeth or unpleasant taste and was effective in reducing plaque accumulation and gingival inflammation. However, chlorhexidine still remains a gold standard in reducing plaque, gingivitis, and bleeding on probing.

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Background: The variations in the morphology of the soft palate in normal patients help to establish the variations in morphology in various diseases. The classification system and statistical findings help to research velopharyngeal closure in cleft palate individuals and etiological study of obstructive sleep apnea syndrome and other conditions. The aim of our study was to investigate the variations in the velar morphology and to analyze the variations of length and density of the soft palate. Materials and Methods: In this study, a sample of 100 normal digital lateral cephalograms was analyzed for the variations in morphology of the soft palate and evaluated for analysis of length and density of the soft palate. Results: The morphology of the soft palate showed seven different morphological types. There was a significant difference in length of the soft palate between preadult and adult age groups. Males showed significantly longer and denser soft palate than the females. Conclusion: There was a significant difference in length of the soft palate between preadult and adult age groups. Males showed signifi cantly longer and denser soft palate than the females

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Cytokines and selective inflammatory mediators play crucial roles in the maintenance of tissue homeostasis. Growth factors such as fibroblast growth factor, platelet-derived growth factor, insulin-like growth factor, and transforming growth factor-β are thought to play important roles in modulating the proliferation and migration of structural cells in the periodontium. These biomolecules have a range of overlapping functions to help engage and control immune and inflammatory responses.

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Introduction: Malignant neoplasm is a major cause of death in developed countries, and its incidence continues to grow, placing a heavy burden on the community. Diabetes mellitus is a serious and leading health problem. Recent studies demonstrated that glucose intolerance was associated with a higher risk of oral cancer death, beginning in the prediabetic range of glucose intolerance. However, few population-based studies, especially in Asian populations, have addressed these issues or have estimated glucose intolerance status. Aim: We undertook this study with the aim of finding out an association between impaired glucose tolerance (IGT) and oral cancer along with finding out prevalence of other risk factors for oral cancer. Materials and Methods: Forty-five cases and 45 controls were selected for the study. Oral glucose tolerance was performed on subjects who satisfied inclusion criteria and were willing to sign informed consent form. Results: Fifty-three percent of the cases had abnormal glucose tolerance when compared to 31% of the controls. Conclusion: To conclude, hyperglycemia (which includes impaired fasting glucose, IGT and diabetes) increases the risk of oral cancer two-fold, however IGT alone as defined by American Diabetes Association does not appear to play a role.

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Background: Biopsy is an important tool which aids in the diagnosis of lesions ranging from simple non-neoplastic growths to malignancies. The choice of technique depends on factors such as anatomic site and morphology of the lesion. Oral biopsies can be performed using different techniques, in which scalpel biopsy is the conventional method. Punch biopsies are also quite popular because they are safe and can be rapidly performed. However, the above techniques cannot provide hemostasis which is required on highly vascular tissues. As a result, lasers have been gaining popularity. Nevertheless, laser-tissue interactions may produce some artifactual changes, especially at the margins, such as thermal damage and coagulation which may impair the histopathological diagnosis. Aim: The aim of this study was to compare artifacts produced in scalpel, punch, and laser biopsies and to determine the most effective tool of the three in terms of oral biopsies. Materials and Methods: Thirty hematoxylin and eosin stained sections, ten each of conventional scalpel, punch, and laser biopsies, were retrieved from the archives and analyzed for artifacts under a light microscope. Results: There was no statistically significant difference between the three techniques in terms of orientation, crush, and hemorrhage. Both horizontal and vertical splits were seen in scalpel biopsies (70%) while none were present in the other two techniques. Loss of epithelium was maximum with laser biopsies, and thermal damage was also exclusively seen in this technique. Conclusion: Punch biopsy revealed the least number of artifacts. Laser, compared to scalpel and punch, produces artifacts which may render the margins of the lesions uninterpretable.

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Background: Studying the prevalence of dental caries in a population located in a specific geographic area and the effect of the psychological factors on the people is considered essential to build a database to assess and compare future results of preventive programs and to assess health and social needs of the communities. Aim of this Research: This study aims to study oral health situation using (decayed, missing, and filled teeth [DMFT], plaque index [PI], and gingivitis index [GI]) indices, and the prevalence of posttraumatic stress disorder (PTSD) among 12-year-old children in Damascus, and the effect of PTSD on oral health. Materials and Methods: The sample included 811 children divided into five geographic areas in Damascus. Special questionnaires were used to measure PTSD level, and the oral health status was measured by clinical examination. Results: Data analysis showed that dental caries prevalence was 86%, DMFT value was 3.36. In detail, the D value was 2.86, M value was 0.48, and F value was 0.02. As for PI value, it was 0.79 and GI value was 0.85. The prevalence of PTSD was 91.5%. The study showed a statistically significant relationship between both DMFT and GI values, and PTSD value; however, there was no statistically significant relationship between PI value and PTSD value. Conclusion: The prevalence of poor oral health among 12-year-old children in Damascus schools was high as was the prevalence of PTSD, where we found in our study a statistically significant relationship between oral health index and PTSD.

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There is a presence of interarticular space between the bony components of the temporomandibular joint (TMJ), i.e., between articular eminence and glenoid fossa of the temporal bone at the base of the skull and the condylar process of the mandible. The intervening articular disc, together with its attachments, divide the joint into two separate compartments, i.e., upper (superior) and lower (inferior) compartments located above and below the disc, respectively, which are referred as joint spaces. The clinical significance of joint space is of great value; the presence of normal joint space is needed for free movement of condyle along with articular disc. The widening or obliteration of joint space may indicate the involvement of TMJ or its pathology. The joint space configuration is greatly influenced by the glenoid fossa, condyle, and condylar positions within the fossa in TMJ on the right and left sides. The present review work is undertaken primarily including 37 studies from PubMed and Medline databases to reveal the information relating to the joint space, its measurement in normal subjects and TMJ disorder (TMD) patients, its correlation to other factors, and its role in TMDs. The review work would be of help to gain insight to predict the TMDs with respect to joint space morphometrics.

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Cutaneous sinus tracts of dental origin have been well-documented in the medical literature. However, these lesions continue to be a diagnostic dilemma. A review of several reported cases reveals that patients have had multiple surgical excisions, radiotherapy, multiple biopsies, and multiple antibiotic regimens, all of which have failed, with a recurrence of the cutaneous sinus tract, as the primary etiology was dental that was never correctly diagnosed or addressed. This case report demonstrates the healing of an extraoral draining sinus by means of conventional nonsurgical root canal treatment.

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Dental implant surgery has developed to a widely used procedure for dental rehabilitation and is a secure and predictable procedure. But, some local and systemic risk factors can result in higher failure rates and affect implant survival. Peri-implant disease, namely peri-implantitis, have been extensively studied in present era as a major cause of implant failure. There are various treatment modalities to treat peri-implantitis, which give satisfactory results and improve survival rate of implant. Though it is difficult to determine what approach will improve implant survival, present case report is an attempt to treat peri-implantitis with implantoplasty and diode laser followed by regenerative periodontal therapy.

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Endo-perio lesions are common clinical finding in the day-to-day dentistry. The treatment approach with respect to periodontal regeneration still remains point at issue. Endodontic treatment not always leads to complete healing of periapical and periodontal tissue. In literature, surgical periodontal intervention along with the use of bone grafts, guided tissue regeneration has been attempted for regeneration. Recently, use of platelet concentrates such as platelet-rich fibrin (PRF) releasing growth factors is extensively used in dentistry for periodontal regeneration. This case report aims at evaluating the efficacy of PRF as regenerative biomaterial in the treatment of Endo-perio lesion.

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Squamous odontogenic tumor-like proliferation (SOT-LP) is a nonneoplastic lesion with a histological pattern similar to that of the SOT. This entity is characterized by SOT proliferations isolated in the cyst wall of an odontogenic cyst. This pattern is rarely seen in radicular cysts. The nature of these proliferations is not clear, and there is a varied opinion on the origin. Although it has a benign behavior, it should be differentiated from other aggressive lesions such as intraosseous carcinoma, ameloblastoma, odontogenic keratocyst, and SOT. Knowledge about this unusual lesion can help in the accurate diagnosis and treatment of the patients. Here, we are discussing a rare case of an SOT-LP emerging in a radicular cyst of the maxilla.

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Background: Palmistry in scientific terms is called as "dermatoglyphics" ("derma" means skin and "glyphic" means carvings). Dermatoglyphics as an independent field of study, even though it has a body of theory, methods, and applications; in many respects, it has been used as an adjunct to other disciplines, serving as a vehicle to resolve broader biomedical problems. Many studies have shown that hereditary factors play contributory role in the development of caries risk and malocclusion. This study was done to check whether dermatoglyphics plays a role in malocclusion and dental caries. Aim: To assess whether dermatoglyphics could help predict genetic susceptibility of children to dental caries and malocclusion. Materials and Methods: A total of 300 children aged 6-12 years were screened for dermatoglyphics, dental caries using decayed, missing, and filled teeth and discrete Fourier transform index and malocclusion using Angle's classification. Statistical Analysis Used: To show significant difference between the expected frequencies and the observed frequencies in one or more categories, a Chi-square test was applied. The observed difference was statistically significant and P = 0.03 (<0.05). Results: There was an increased frequency of loop in right hand digit 3 and 5 (middle and little finger) in caries positive participants. Eighty-one percent of loop pattern was observed in digit 5 (little finger) of right hand in Class II malocclusion. Conclusion: Specific fingerprint patterns may be used as a potential noninvasive anatomical tool for mass screening of dental caries and malocclusion and for guiding future research.

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Aim: The aim of the study is to investigate the influence of temperature rise on a single rooted tooth during biomechanical tooth preparation, obturation and root canal preparation for radicular post. Materials and Methods: Forty-five extracted human mandibular premolars with a single canal, extracted for orthodontic reasons, were stored in saline. Access cavity was prepared with endo access bur and pulp extirpations were done. The teeth were randomly divided into five groups of 9 teeth each. In group 1 and group 2 cleaning and shaping of the root canal was done using protaper file system and Hyflex system respectively. In group 3 and 4 obturation was done using Step-One obturation system and Calamus Dual respectively. In group 5 post space preparation was done using peeso reamers. Each sample tooth was embedded in alginate contained in Eppendorf tube. Tooth was placed in water bath with the two thermocouples attached at the apical and middle third which was in turn attached to thermometer. The rise in temperature was noted at the desired level and statistical analysis was done. Results and Conclusion: The mean temperature rise at the middle third for group 1, 2, 3, 4, 5 was 0.4°C, 0.15°C, 1.80°C,10.33°C, 9.46°C respectively. The mean temperature rise at the apical third for group 1, 2, 3, 4, 5 was 0.08°C, 0.08°C, 1.20°C, 6.91°C, 6.4°C respectively. ANOVA showed significant difference in mean temperatures of different methods. post hoc test comparison using Duncan's test revealed maximum rise in temperature during obturation using Calamus dual (Group 4).

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Aims: The dental clinical setting is a significant learning environment for dental undergraduates which may induce anxiety, which adversely affects the clinical performance. Hence, the aim of this study was to determine the clinical anxiety-provoking situations among dental students in Chennai. Subjects and Methods: A questionnaire-based cross-sectional survey was conducted among 375 clinical dental students in Chennai. The questionnaire used in the study consisted of 37 clinical anxiety-provoking situations. The situations were assessed using a 4-point Likert scale. The questionnaire was distributed and the students completed the questionnaire under the supervision of research assistance, who collected the completed questionnaires immediately for evaluation. Statistical Analysis Used: Data were analyzed by computerized SPSS (version 21). Results: Of the 375 respondents, 21% were male and 78.8% were female. About 98.7% of the population reported anxiety with the majority of study population experiencing moderate anxiety. Examination failure (88%), meeting clinical requirement (82.5%), fracturing a tooth while extraction (94%), extracting a wrong tooth (92%), and getting infected by the patients (92.7%) were considered as more common clinical anxiety-provoking situations. Conclusion: The challenges and stress at different stages of dental education may elicit and increase the level of anxiety which can be prevented by creating a friendly learning environment for better learning with less anxiety and fear

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Context: Comparison between antemortem and postmortem dental records and radiographs produces results with a high degree of reliability and relative simplicity. Kvaal et al. introduced an age estimation method by indirectly measuring secondary dentin deposition on radiographs. Cameriere et al., later, put forth a method based on radiographic estimation of pulp/tooth area ratio (AR) in canines. The purpose of the present study was to assess the reliability of various teeth in Kvaal's and Cameriere's methods of age estimation in a specific populace in Central India. Materials and Methods: One hundred and ten patients aged between 15 and 75 years were selected, and the variables P = complete pulp length/root length (from enamel-cementum junction [ECJ] to root apex), r = complete pulp length/complete tooth length, a = complete pulp length/root width at ECJ level, b = pulp/root width at midpoint level between ECJ level and mid-root level, and c = pulp/root width at mid-root level and pulp/tooth AR were recorded as devised in Kvaal's and Cameriere's methods of age estimation, respectively. Statistical Analysis: Statistical analysis was performed with SPSS (version 10.5) package. Mean comparison of morphological variables was carried out using Student's t-test. Intra- and inter-observer reproducibility of measurements was studied using the concordance correlation coefficient. Results: Comparing between Kvaal's and Cameriere's methods, results of the latter method were found to be more accurate in predicting age. Conclusion: Kvaal's method showed varying results for different teeth, but Cameriere's method was more consistent, accurate and showed less variability.

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Objectives: The objective of this study was to assess knowledge, attitude, and practices (KAPs) related to orthodontic treatment among college students in rural and urban areas of Mysore, India. Materials and Methods: This was a cross-sectional questionnaire study conducted among college students in rural and urban areas of Mysore, India, over 2 months from August to September 2015. The sample size was estimated using nMaster software. One government and one private college each in rural and urban areas of Mysore were selected based on administrative convenience. All eligible participants from these colleges were recruited. A sixteen-item questionnaire was developed and validated. This predesigned and validated, self-administered, structured questionnaire was used for data collection. The statistical analysis was done using SPSS. Results: Four hundred and forty-one college students participated in the present study. 89.3% of the participants were aware about malalignment of teeth. The awareness was significantly higher among females and those in urban areas. 39.2% of the study participants expressed willingness to undergo orthodontic treatment even if treatment duration extends up to 1–2 years with no significant difference in relation to gender and area of residence. 14.1% of the study participants have undergone treatment for malalignment of teeth with no significant difference between males and females. However, a significantly higher percentage of participants from urban areas have undergone treatment. Conclusion: The KAP related to orthodontic treatment was significantly higher among females and those in urban areas. This highlights the need to augment orthodontic awareness programs in rural areas.

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Aim: The aim of this study is to assess pregnant women knowledge and attitudes toward stem cells in dentistry in Bengaluru city. Settings and Design: A cross-sectional study was conducted among 300 pregnant women in Bengaluru city for 3 months. Materials and Methods: Sampling technique used in this study was convenience sampling. A structured questionnaire consisting of sociodemographic details, 20 questions about knowledge and 7 questions about the attitude toward stem cells and its banking were included in the questionnaire. Data were collected by interviewing the participants. Statistical Analysis Used: Data obtained were analyzed using descriptive statistics Chi-square test, t-test, and regression analysis using SPSS version 19. Results: Among 300 pregnant women, 68 (22.7%) attended private maternity hospitals and 232 (77.3%) attended public maternity hospitals. Pregnant women attending both public and private maternity hospitals 230 (76.7%) had no knowledge and 70 (23.3%) had knowledge about stem cells. Conclusion: The majority of the participants had inadequate knowledge about stem cells and its banking and wanted to be informed. The majority of the pregnant women wanted to have their stem cells stored and preferred public cord blood banking. The data obtained in this study can also provide a basis for future studies.

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Orthodontic treatment aims at providing an acceptable functional and esthetic occlusion. Tooth movements are strongly related to interactions of teeth with their supportive periodontal tissues. In recent years, due to the increased number of adult patients seeking orthodontic treatment, orthodontists frequently face patients with periodontal problems. Esthetic considerations, such as uneven gingival margins or functional problems resulting from inflammatory periodontal diseases, should be considered in the orthodontic treatment planning. The purpose of this article is to provide a dental practitioner with basic understanding of the interrelationship between periodontics and orthodontics and also to highlight the orthodontics and periodontics interface in clinical practice for optimized treatment outcomes.

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This case report elaborates the management of white spot lesion (WSL) using air microabrasion as minimally invasive treatment modality. Air microabrasion can remove the outermost layer of enamel to manage superficial discolorations and incipient carious lesions. A WSL on the maxillary left incisor was treated conservatively with air microabrasion technique. This technique might be an alternative to chemical microabrasion, macroabrasion, and invasive restorative treatments for the management of WSLs.

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Glandular odontogenic cyst (GOC) is a rare developmental cystic lesion of the jaws accounting for 0.012%–0.3% of all the odontogenic cysts. It occurs most commonly in middle-aged men, especially in the anterior mandible. It clinically presents as a slow-growing intraosseous lesion. Small cysts may be asymptomatic while larger ones may cause expansion with pain or paresthesia. Radiographically, it frequently presents as a multilocular radiolucency. Microscopic features are characterized by nonkeratinized stratified squamous epithelium of variable thickness with many microcystic or pseudoglandular spaces and plaque-like extensions. Although its microscopic features are characteristic, few situations may arise where this entity may be confused with dentigerous, botryoid odontogenic, radicular cyst, and central mucoepidermoid carcinoma. The importance of GOC relates to its high rate of recurrence making its diagnosis important. The purpose of this study is to present the clinicopathological features of five cases of GOC which have been reported in our institution.

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Background: Ultra conservative caries removal now has become an integral part of Minimal Invasive Dentistry. The main objective of deep caries removal is to conserve the tooth structure as well to maintain the integrity of pulpal health. Aim: To evaluate clinically the efficiency of caries removal using Carie-Care compared to the SmartPrep burs for complete caries excavation. Materials and Methods: Split mouth study was done in 64 children where caries excavation was done using Carie-Care on one side and Smart burs on the other side. The parameters assessed were complete caries excavation, pain reaction, need for local anesthesia and mean time required. Results: The differences between complete caries excavation, pain reaction and need for local anesthesia using both the techniques were statistically insignificant. Whereas the time taken for caries removal using Carie-Care was significantly less than Smart burs (P = 0.001). Conclusion: Both the techniques can be used effectively for caries excavation in primary teeth.

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In the recent years, numbers of suspected bite mark cases examined by forensic odontologist are increasing. Human bite mark analysis is most demanding and complicated part of forensic dentistry, involving identification of assailant by comparing record of their dentition with record of bite mark left on a victim. Like fingerprints and DNA, bite marks are unique to individual such as distance and angles between teeth, missing, and teeth fillings. This type of impression evidence can be left in the skin of a victim and also in food, chewing gums, pens, pencil, etc., In some crimes, bite mark evidence is the only evidence on which conviction has been achieved, particularly alleged rape and child abuse cases. The current protocol for collection, management, preservation analysis, and interpretation of evidences should be employed if information is to be obtained for the court. The aim of this article is to give brief overview of bite mark analysis, its clinical applications, and limitations.

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