INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.comwww.ind...
ACTIVATORACTIVATOR
www.indiandentalacademy.comwww.indiandentalacademy.com
HISTORYHISTORY
 Kingsley in 1880 introduced the term- jumping the bite forKingsley in 1880 introduced the term- jumping t...
 The activator was originally used by Andresen withThe activator was originally used by Andresen with
vertical extensions...
 Pierre Robin – developed monobloc prior to AndersenPierre Robin – developed monobloc prior to Andersen
appliance.applian...
DRAWBACK OF ACTIVATORDRAWBACK OF ACTIVATOR
THERAPYTHERAPY
1. Dual bite can be a late consequence of activator1. Dual bite ...
EVOLUTION OF APPLIANCEEVOLUTION OF APPLIANCE
 Eschler – developed modification of the labialEschler – developed modificat...
www.indiandentalacademy.comwww.indiandentalacademy.com
 The initial appliance was worn at night and hence its bulkThe initial appliance was worn at night and hence its bulk
was...
www.indiandentalacademy.comwww.indiandentalacademy.com
disadvantages- construction bite cannot be opened too fardisadvantages- construction bite cannot be opened too far
vertica...
2. Appliance consist of two parts joined with wire bows. The2. Appliance consist of two parts joined with wire bows. The
m...
SKELETAL ANDSKELETAL AND
DENTOALVEOLAR EFFECTDENTOALVEOLAR EFFECT
www.indiandentalacademy.comwww.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
FORCE ANALYSISFORCE ANALYSIS
 When activator activates the muscles, various types of forces areWhen activator activates t...
 Two principles are applied in modern activatorTwo principles are applied in modern activator
therapy-therapy-
force appl...
 Types of forces employed in activator therapy-Types of forces employed in activator therapy-
a.a. Natural force- growth ...
CONSTRUCTION BITECONSTRUCTION BITE
Horizontal H activator- low construction biteHorizontal H activator- low construction b...
www.indiandentalacademy.comwww.indiandentalacademy.com
 Vertical V activator- high construction biteVertical V activator- high construction bite
with slightly anterior mandibul...
www.indiandentalacademy.comwww.indiandentalacademy.com
FABRICATION OF ACTIVATORFABRICATION OF ACTIVATOR
www.indiandentalacademy.comwww.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
TRIMMING OF ACTIVATORTRIMMING OF ACTIVATOR
 PRINCIPLES-PRINCIPLES-
The movement andThe movement and eruption of selected ...
 The principles of force application in the trimming processThe principles of force application in the trimming process
a...
c. The magnitude of force can be estimated by determining thec. The magnitude of force can be estimated by determining the...
www.indiandentalacademy.comwww.indiandentalacademy.com
TRIMMING OF ACTIVATORTRIMMING OF ACTIVATOR
FOR VERTICAL CONTROLFOR VERTICAL CONTROL
 IntrusionIntrusion
 Prevention of t...
INTRUSION OF TEETHINTRUSION OF TEETH
 Incisors-Incisors-
Performed by loading the incisor edgesPerformed by loading the i...
 Molars-Molars-
Performed by loading the cusps of teethPerformed by loading the cusps of teeth
Acrylic detail is ground a...
EXTRUSION OF TEETHEXTRUSION OF TEETH
 Incisor-Incisor-
Loading the lingual surfaces above the area ofLoading the lingual ...
www.indiandentalacademy.comwww.indiandentalacademy.com
 Molars-Molars-
Loading the lingual surfaces of teeth above theLoading the lingual surfaces of teeth above the
area of gr...
SELECTIVE TRIMMING OF THESELECTIVE TRIMMING OF THE
ACTIVATORACTIVATOR
 By this only the u & l molars are extrudedBy this ...
TRIMMING OF ACTIVATORTRIMMING OF ACTIVATOR
FOR SAGITTAL CONTROLFOR SAGITTAL CONTROL
 By this protrusion or retrusion of i...
www.indiandentalacademy.comwww.indiandentalacademy.com
Thank you
For more details please visit
www.indiandentalacademy.com
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Activator /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Activator /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com
  2. 2. ACTIVATORACTIVATOR www.indiandentalacademy.comwww.indiandentalacademy.com
  3. 3. HISTORYHISTORY  Kingsley in 1880 introduced the term- jumping the bite forKingsley in 1880 introduced the term- jumping the bite for patients with mandible retrusion. He inserted a vulcanitepatients with mandible retrusion. He inserted a vulcanite palatal plate consisting of an anterior incline that guided thepalatal plate consisting of an anterior incline that guided the mandible in a forward position when the pt closed on it. Thismandible in a forward position when the pt closed on it. This corrected the sagittal relationship without tipping the lowercorrected the sagittal relationship without tipping the lower incisors forward.incisors forward.  Hotz Vorbissplate was a modification of Kingsley plate. HeHotz Vorbissplate was a modification of Kingsley plate. He used it in case of deep bite retrognathism, when the overbiteused it in case of deep bite retrognathism, when the overbite was likely to cause a functional retrusion and the lowerwas likely to cause a functional retrusion and the lower incisors were lingually inclined by the hyperactivity of theincisors were lingually inclined by the hyperactivity of the mentalis muscle and lower lip.mentalis muscle and lower lip. www.indiandentalacademy.comwww.indiandentalacademy.com
  4. 4.  The activator was originally used by Andresen withThe activator was originally used by Andresen with vertical extensions to contact the lingual surfaces ofvertical extensions to contact the lingual surfaces of mandibular teeth. He developed a mobile loose-fittingmandibular teeth. He developed a mobile loose-fitting appliance that transferred functioning muscle stimuliappliance that transferred functioning muscle stimuli to the jaws, teeth and supporting tissues.to the jaws, teeth and supporting tissues.  The progenitor of the appliance was a modifiedThe progenitor of the appliance was a modified Kingsley plate that Andersen used as a retainer overKingsley plate that Andersen used as a retainer over summer vacation for his daughter after he removedsummer vacation for his daughter after he removed fixed appliance used to correct distocclusion. Seeingfixed appliance used to correct distocclusion. Seeing the improvement with this retainer, he called itthe improvement with this retainer, he called it biomechanical working retainer.biomechanical working retainer. www.indiandentalacademy.comwww.indiandentalacademy.com
  5. 5.  Pierre Robin – developed monobloc prior to AndersenPierre Robin – developed monobloc prior to Andersen appliance.appliance.  Andersen became associated with Haupl at the university ofAndersen became associated with Haupl at the university of Oslo. Both termed the appliance as Activator because of itsOslo. Both termed the appliance as Activator because of its ability to stimulate muscle forces.ability to stimulate muscle forces.  Haulp concept of individual optimum. The limitation of theHaulp concept of individual optimum. The limitation of the appliance is that it cannot create a large mandible from a smallappliance is that it cannot create a large mandible from a small one, but can help pt achieve optimal size consistent withone, but can help pt achieve optimal size consistent with morphogenetic pattern.morphogenetic pattern.  The original appliance combined an upper and a lower plate atThe original appliance combined an upper and a lower plate at the occlusal plane. Only one wire element was used- a labialthe occlusal plane. Only one wire element was used- a labial arch for the upper ant. teeth. To achieve expansion, thearch for the upper ant. teeth. To achieve expansion, the appliance was split in the centre and a flexible coffin springappliance was split in the centre and a flexible coffin spring was incorporated.was incorporated. www.indiandentalacademy.comwww.indiandentalacademy.com
  6. 6. DRAWBACK OF ACTIVATORDRAWBACK OF ACTIVATOR THERAPYTHERAPY 1. Dual bite can be a late consequence of activator1. Dual bite can be a late consequence of activator treatment with a false indication.treatment with a false indication. Indicated in retroposition of the condyle in the fossaIndicated in retroposition of the condyle in the fossa as a result of dominant retrusive activity of theas a result of dominant retrusive activity of the posterior temporalis, deep masseter and the hyoidposterior temporalis, deep masseter and the hyoid musculature associated with deep bite.musculature associated with deep bite. 2. Jumping the bite should be performed without2. Jumping the bite should be performed without proclination of the lower incisors. Failure of activatorproclination of the lower incisors. Failure of activator therapy occurred as a result of overjet reduction duetherapy occurred as a result of overjet reduction due to proclination of teeth instead of bodily anteriorto proclination of teeth instead of bodily anterior positioning of the mandible.positioning of the mandible. www.indiandentalacademy.comwww.indiandentalacademy.com
  7. 7. EVOLUTION OF APPLIANCEEVOLUTION OF APPLIANCE  Eschler – developed modification of the labialEschler – developed modification of the labial bow that improved intermaxillarybow that improved intermaxillary effectiveness. One part was active, moving theeffectiveness. One part was active, moving the teeth, the other was passive, holding the softteeth, the other was passive, holding the soft tissue of the lower lip away and thustissue of the lower lip away and thus enhancing the tooth movement desired.enhancing the tooth movement desired. www.indiandentalacademy.comwww.indiandentalacademy.com
  8. 8. www.indiandentalacademy.comwww.indiandentalacademy.com
  9. 9.  The initial appliance was worn at night and hence its bulkThe initial appliance was worn at night and hence its bulk was not critical. Subsequent modifications made to reducewas not critical. Subsequent modifications made to reduce the bulk allowed an increase in wearing time. They werethe bulk allowed an increase in wearing time. They were two types of modifications-two types of modifications- 1.1. Some appliance consist of one rigid acrylic mass for theSome appliance consist of one rigid acrylic mass for the maxillary and mandibular arches but with reducedmaxillary and mandibular arches but with reduced volume/bulk.volume/bulk. a.a. Appliance were reduced in the anterior palatal region- openAppliance were reduced in the anterior palatal region- open activator. Their goal is to restore exteroceptive contactactivator. Their goal is to restore exteroceptive contact between the tongue and palate, which is prevented in thebetween the tongue and palate, which is prevented in the classical activator. Pt prefer it as they are reduced in theclassical activator. Pt prefer it as they are reduced in the linguoincisal area and do not obstruct the oral cavity.linguoincisal area and do not obstruct the oral cavity. www.indiandentalacademy.comwww.indiandentalacademy.com
  10. 10. www.indiandentalacademy.comwww.indiandentalacademy.com
  11. 11. disadvantages- construction bite cannot be opened too fardisadvantages- construction bite cannot be opened too far vertically because it impairs the tongue function. The tonguevertically because it impairs the tongue function. The tongue may thrust into the anterior interincisal gap, creating a posturalmay thrust into the anterior interincisal gap, creating a postural and functional abnormality.and functional abnormality. elastic open activator ( Klammt)- lack of support in the cutawayelastic open activator ( Klammt)- lack of support in the cutaway area of the appliance, especially if guidance of erupting teetharea of the appliance, especially if guidance of erupting teeth or expansion is necessary.or expansion is necessary. b. Appliance with reduced alveolar region and with cross palatalb. Appliance with reduced alveolar region and with cross palatal wires instead of full acrylic plate. They arewires instead of full acrylic plate. They are supported/anchored dentally. Hence due to their tooth bornesupported/anchored dentally. Hence due to their tooth borne anchorage their use is limited and management can beanchorage their use is limited and management can be difficult. The labial bow eliminates abnormal muscle pressuredifficult. The labial bow eliminates abnormal muscle pressure by extending into the buccal vestibule area.by extending into the buccal vestibule area. www.indiandentalacademy.comwww.indiandentalacademy.com
  12. 12. 2. Appliance consist of two parts joined with wire bows. The2. Appliance consist of two parts joined with wire bows. The muscle impulse are reinforced by the wire elementsmuscle impulse are reinforced by the wire elements incorporated in the design. The flexibility of the applianceincorporated in the design. The flexibility of the appliance permits mandibular movements in all directions.permits mandibular movements in all directions. a.a. Schwartz double plateSchwartz double plate b.b. Stockfish- elastic activatorStockfish- elastic activator Difference in the mode of action of rigid one piece activatorDifference in the mode of action of rigid one piece activator (long lasting tonic phase reflex contraction) and flexible two(long lasting tonic phase reflex contraction) and flexible two piece joined by intermaxillary wiring (transient phase reflexpiece joined by intermaxillary wiring (transient phase reflex contraction)contraction) www.indiandentalacademy.comwww.indiandentalacademy.com
  13. 13. SKELETAL ANDSKELETAL AND DENTOALVEOLAR EFFECTDENTOALVEOLAR EFFECT www.indiandentalacademy.comwww.indiandentalacademy.com
  14. 14. www.indiandentalacademy.comwww.indiandentalacademy.com
  15. 15. FORCE ANALYSISFORCE ANALYSIS  When activator activates the muscles, various types of forces areWhen activator activates the muscles, various types of forces are created-created- a.a. Static force-Static force- permanent and vary in magnitude and direction. They doand vary in magnitude and direction. They do not appear simultaneously with the movement of mandible. Eg- forcesnot appear simultaneously with the movement of mandible. Eg- forces of gravity, posture and elasticity of soft tissue and muscle.of gravity, posture and elasticity of soft tissue and muscle. a.a. Dynamic force-Dynamic force- interrupted, appear simultaneously with the movementsinterrupted, appear simultaneously with the movements of the head and body and have a higher magnitude than static force. Eg-of the head and body and have a higher magnitude than static force. Eg- swallowingswallowing a.a. Rhythmic force-Rhythmic force- associated with respiration and circulation. They areassociated with respiration and circulation. They are synchronous with breathing and their amplitude varies with the pulse.synchronous with breathing and their amplitude varies with the pulse. Imp. In stimulating cellular activity. Mandible transmits rhythmicImp. In stimulating cellular activity. Mandible transmits rhythmic vibrations to the maxilla. The applied forces are intermittent andvibrations to the maxilla. The applied forces are intermittent and interrupted. Force application to the teeth are intermittent. Removal ofinterrupted. Force application to the teeth are intermittent. Removal of activator from mouth interrupts these forces.activator from mouth interrupts these forces. www.indiandentalacademy.comwww.indiandentalacademy.com
  16. 16.  Two principles are applied in modern activatorTwo principles are applied in modern activator therapy-therapy- force application- muscleforce application- muscle force elimination- the dentition is shieldedforce elimination- the dentition is shielded away from normal and abnormal functionalaway from normal and abnormal functional and tissue pressure by pads, shields and wireand tissue pressure by pads, shields and wire configuration.configuration. www.indiandentalacademy.comwww.indiandentalacademy.com
  17. 17.  Types of forces employed in activator therapy-Types of forces employed in activator therapy- a.a. Natural force- growth potential, eruption and migration of teeth. These can beNatural force- growth potential, eruption and migration of teeth. These can be guided, promoted or inhibited by the activator.guided, promoted or inhibited by the activator. a.a. Artificially functioning forces- muscle contraction and stretching of soft tissuesArtificially functioning forces- muscle contraction and stretching of soft tissues initiate forces when the mandible is relocated from its postural rest position byinitiate forces when the mandible is relocated from its postural rest position by the appliance. The activator stimulates and transforms the contractions. Whereasthe appliance. The activator stimulates and transforms the contractions. Whereas the forces may be muscular in origin, their activation is artificial.the forces may be muscular in origin, their activation is artificial. sagittal plane- effect on the condylesagittal plane- effect on the condyle vertical plane- teeth and the alveolar process are loaded with or relieved ofvertical plane- teeth and the alveolar process are loaded with or relieved of normal forces. If the construction bite is high it will inhibit the growth of maxillanormal forces. If the construction bite is high it will inhibit the growth of maxilla and influence the inclination of the maxillary base.and influence the inclination of the maxillary base. transverse plane- midline correctiontransverse plane- midline correction c. Various active elements (springs, screws) can be built into the activator toc. Various active elements (springs, screws) can be built into the activator to produce an active biomechanical type of force application.produce an active biomechanical type of force application. www.indiandentalacademy.comwww.indiandentalacademy.com
  18. 18. CONSTRUCTION BITECONSTRUCTION BITE Horizontal H activator- low construction biteHorizontal H activator- low construction bite with marked forward mandibular positioningwith marked forward mandibular positioning a.a. Class II functional retrusionClass II functional retrusion b.b. Class II Div 1 malocclusion with sufficientClass II Div 1 malocclusion with sufficient overjetoverjet c.c. Class II Div 1 malocclusion with posteriorClass II Div 1 malocclusion with posterior positioning of the mandible caused bypositioning of the mandible caused by growth deficiency but with the likelihood ofgrowth deficiency but with the likelihood of a future horizontal growth patterna future horizontal growth pattern www.indiandentalacademy.comwww.indiandentalacademy.com
  19. 19. www.indiandentalacademy.comwww.indiandentalacademy.com
  20. 20.  Vertical V activator- high construction biteVertical V activator- high construction bite with slightly anterior mandibular positioningwith slightly anterior mandibular positioning a. Class II Div 1 malocclusion with verticala. Class II Div 1 malocclusion with vertical growth directiongrowth direction www.indiandentalacademy.comwww.indiandentalacademy.com
  21. 21. www.indiandentalacademy.comwww.indiandentalacademy.com
  22. 22. FABRICATION OF ACTIVATORFABRICATION OF ACTIVATOR www.indiandentalacademy.comwww.indiandentalacademy.com
  23. 23. www.indiandentalacademy.comwww.indiandentalacademy.com
  24. 24. www.indiandentalacademy.comwww.indiandentalacademy.com
  25. 25. www.indiandentalacademy.comwww.indiandentalacademy.com
  26. 26. www.indiandentalacademy.comwww.indiandentalacademy.com
  27. 27. www.indiandentalacademy.comwww.indiandentalacademy.com
  28. 28. TRIMMING OF ACTIVATORTRIMMING OF ACTIVATOR  PRINCIPLES-PRINCIPLES- The movement andThe movement and eruption of selected teeth can be achieved by grinding away areas of acrylic that contact the tooth surface. Carefully planned grinding and trimming of the activator in the tooth contact area improves its effectiveness in the dentoalveolar region by stimulating or restricting selective eruption and movement of anterior and posterior teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  29. 29.  The principles of force application in the trimming processThe principles of force application in the trimming process are determined by the typa, direction and magnitude of forceare determined by the typa, direction and magnitude of force created by the loosely fitting appliancecreated by the loosely fitting appliance a. Intermittent force- isotonic and isometric muscle contractionsa. Intermittent force- isotonic and isometric muscle contractions enabling the appliance to work by utilizing kinetic energy.enabling the appliance to work by utilizing kinetic energy. b. The direction of the desired force is determined by selectiveb. The direction of the desired force is determined by selective grinding of the acrylic surface that contact the u & l teeth.grinding of the acrylic surface that contact the u & l teeth. After proper grinding the desired force acts on predeterminedAfter proper grinding the desired force acts on predetermined areas of the teeth and applies pressure in the direction ofareas of the teeth and applies pressure in the direction of needed tooth movement.needed tooth movement. .. www.indiandentalacademy.comwww.indiandentalacademy.com
  30. 30. c. The magnitude of force can be estimated by determining thec. The magnitude of force can be estimated by determining the amount of acrylic contact with the tooth surface. If the force isamount of acrylic contact with the tooth surface. If the force is delivered to smaller portion of tooth surface, it is greater thandelivered to smaller portion of tooth surface, it is greater than if broader contact occurs between the acrylic and broaderif broader contact occurs between the acrylic and broader tooth surface. Acrylic surface that transmit the desired forcetooth surface. Acrylic surface that transmit the desired force and contact the teeth are called guide planes.and contact the teeth are called guide planes. d. Approximate trimming can be done on the plaster cast but thed. Approximate trimming can be done on the plaster cast but the final trimming is done in the mouth. Any undercut acrylicfinal trimming is done in the mouth. Any undercut acrylic surface that might interfere with planned tooth guidance mustsurface that might interfere with planned tooth guidance must be removed. Need for trimming can be assessed by-be removed. Need for trimming can be assessed by- explorerexplorer observing the shadows created on the acrylic by the undercutobserving the shadows created on the acrylic by the undercut www.indiandentalacademy.comwww.indiandentalacademy.com
  31. 31. www.indiandentalacademy.comwww.indiandentalacademy.com
  32. 32. TRIMMING OF ACTIVATORTRIMMING OF ACTIVATOR FOR VERTICAL CONTROLFOR VERTICAL CONTROL  IntrusionIntrusion  Prevention of teeth from eruptionPrevention of teeth from eruption  Teeth are free to erupt and are stimulated to doTeeth are free to erupt and are stimulated to do so by acrylic planesso by acrylic planes www.indiandentalacademy.comwww.indiandentalacademy.com
  33. 33. INTRUSION OF TEETHINTRUSION OF TEETH  Incisors-Incisors- Performed by loading the incisor edgesPerformed by loading the incisor edges Indicated in deep overbite caseIndicated in deep overbite case www.indiandentalacademy.comwww.indiandentalacademy.com
  34. 34.  Molars-Molars- Performed by loading the cusps of teethPerformed by loading the cusps of teeth Acrylic detail is ground away from the fissuresAcrylic detail is ground away from the fissures and fossas to eliminate any possible inclinedand fossas to eliminate any possible inclined plane stimulation to molar movementplane stimulation to molar movement Indicated in open bite casesIndicated in open bite cases www.indiandentalacademy.comwww.indiandentalacademy.com
  35. 35. EXTRUSION OF TEETHEXTRUSION OF TEETH  Incisor-Incisor- Loading the lingual surfaces above the area ofLoading the lingual surfaces above the area of greatest concavity in the maxilla and belowgreatest concavity in the maxilla and below this area in the mandiblethis area in the mandible Enhanced by placing the labial bow above theEnhanced by placing the labial bow above the area of greatest convexityarea of greatest convexity Indicated for open bite casesIndicated for open bite cases www.indiandentalacademy.comwww.indiandentalacademy.com
  36. 36. www.indiandentalacademy.comwww.indiandentalacademy.com
  37. 37.  Molars-Molars- Loading the lingual surfaces of teeth above theLoading the lingual surfaces of teeth above the area of greatest convexity in the maxilla orarea of greatest convexity in the maxilla or below this area in the mandiblebelow this area in the mandible Indicated in deep bite casesIndicated in deep bite cases www.indiandentalacademy.comwww.indiandentalacademy.com
  38. 38. SELECTIVE TRIMMING OF THESELECTIVE TRIMMING OF THE ACTIVATORACTIVATOR  By this only the u & l molars are extrudedBy this only the u & l molars are extruded  Path of eruption of molars should bePath of eruption of molars should be consideredconsidered  In case of Class II malocclusion- eruption ofIn case of Class II malocclusion- eruption of maxillary molar is inhibited while that of themaxillary molar is inhibited while that of the mandibular molars is stimulatedmandibular molars is stimulated  In case of Class III malocclusion- eruption ofIn case of Class III malocclusion- eruption of mandibular molar is inhibited while that of themandibular molar is inhibited while that of the maxillary molars is stimulatedmaxillary molars is stimulated www.indiandentalacademy.comwww.indiandentalacademy.com
  39. 39. TRIMMING OF ACTIVATORTRIMMING OF ACTIVATOR FOR SAGITTAL CONTROLFOR SAGITTAL CONTROL  By this protrusion or retrusion of incisors andBy this protrusion or retrusion of incisors and change in molar sagittal relationship mesiallychange in molar sagittal relationship mesially or distally can be achieved.or distally can be achieved. www.indiandentalacademy.comwww.indiandentalacademy.com
  40. 40. www.indiandentalacademy.comwww.indiandentalacademy.com Thank you For more details please visit www.indiandentalacademy.com

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