INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

www.indiandentalacademy.com
TIP EDGE APPLIANCE

In 1986, change in the edgewise slot is made with
the removal of diagonally opposed corners from the
c...
Such modifications of the slot could not have
been considered by ANGLE, because at that
time there were no mesiodistal upr...
www.indiandentalacademy.com
VARIOUS ADVANTAGES OF TIP EDGE SLOT




Not only does it facilitate space opening or
closing, it also enhances retractio...




Archwire slots, that open or close during
treatment, for maximum ease of archwire
changes and minimal patient discom...


These new archwire slots have in / out
compensations and are preadjusted to
automatically achieve desired degrees of
cr...
Because the arch wire slot permits initial
crown tipping mesially or distally and faces
horizontally, the slot and bracket...
APPLIANCES
TIP EDGE BRACKETS
By removing predetermined, diagonally
opposed corners from the conventional
edgewise archwire...
The slot is designed so that initial second
order changes, mesiodistal crown tipping,
can be accomplished in the presence ...
Forces for subsequent root uprighting, tip
and/or torque are generated by auxiliaries
and not by flexing the arch wires.
T...
Brackets are available in single , twin and
ceramic forms.

www.indiandentalacademy.com
Not only do the archwire slots permit initial crown tipping
but also they are preadjusted to provide the desired final
deg...
MOLAR TUBES
To maximize the advantages inherent in
differential tooth movement, it is
advantageous to utilize relatively l...
www.indiandentalacademy.com
ARCH WIRES


Initial arch wires are formed of high tensile
0.016 inch round stainless steel.
These wires will be able to
...




Arch wires of 0.014 inch or 0.016 inch Ni-Ti
can be used for initial alignment in class I
crowded cases.
Rectangular...
AUXILLARIES
Due to generous size of the vertical slot in
T E bracket many auxiliaries are used
through out treatment.


P...
POWER PINS
Used to accept elastomerics or rotating springs for
rapid, physiologic rotation.

www.indiandentalacademy.com
MESIO-DISTAL UPRIGHTING SPRINGS
OR SIDE WINDERS
They provide localized tip control of individual teeth
without arch wire m...
Sectional wires of Ni-Ti are used for one or two
appointments for initial alignment or the eruption of
the impacted teeth....
www.indiandentalacademy.com
CONCEPT AND FUNCTION
The Tip-Edge concept is to provide an
edgwewise type bracket that is familiar to
all orthodontists an...
This than provides an edgewise bracket
that enhances rather than hinders bite
opening, class II or III correction and the
...
BITE OPENING
Most malocclusions require anterior bite
opening, which involves the intrusion of
incisor teeth. If each toot...
Conventional edgewise slots prevent this
free root movement and when teeth are
tipped mesially or distally can even cause
...
www.indiandentalacademy.com
Because of this one point contact between
the archwire and the bracket slot, it is
possible to open the deepest of anterio...
RETRACTION AND SPACE CLOSURE
WITHOUT LOSS OF VERTICAL CONTROL
All teeth tend to tip distally as they are
retracted.
With c...
Because the
appropriate corners
have been removed
in Tip-edge
archwire slots,
there is no binding
and no deflection.

www....
VARIABLE ANCHORAGE SLOT
Not only are Tip-edge archwire slots designed
to permit crown tipping in one direction but
they al...
The advantages gained by this increase in
archwire slot relative to arch wire include






No binding or archwire defl...




Ease of placing rectangular arch wires when
third order discrepancies exist between the
slots and the wires.
No need...
ANCHORAGE CONSIDERATIONS
Extra oral anchorage is absolutely not
needed with DSAT with tip-edge brackets
as the forces are ...
Binding, which normally occurs between
conventional edgewise slots and archwires
during space closure is nonexistent becau...
Furthermore in the DSAT the archwires
move distally with the anterior teeth during
space closure and premolars are usually...
The only source of sliding friction is within
the molar tubes and is at the absolute
minimum because the molars are held
u...
DIFFERENTIAL STRAIGHT ARCH
TECHNIQUE
The DSAT takes full advantage of TE
brackets. This makes possible the
successful trea...
STAGE 1
This stage is the only stage of DSAT
treatment where arch wires are used to
directly generate tooth moving forces ...
GOALS OF STAGE I






Vertical correction of deep or open anterior
bite.

Horizontal correction of anterior over or
un...
BITE OPENING MECHANICS
Opening the bite is the most important goal
of stage 1
The rapid correction of a deep
anterior over...
OVERJET/UNDERJET CORRECTION
The correction of overjet or underjet is
accomplished simultaneously along with
anterior verti...
ANTERIOR ALIGNMENT
When space is available distal to canines,
anterior alignment is achieved using
elastomeric ties to the...
When moderate to severe crowding is present
at the start of non extraction treatment,
vertical loops are employed in the a...
Rotated teeth are corrected using rotating
springs inserted through the vertical slots
of the brackets.

www.indiandentala...
These auxilaries are available in either
clockwise or counter clockwise versions.
The tooth is viewed from the occlusal to...
STAGE 2
Stage 2 is the shortest of the three stages
of Tip-Edge treatment usually being
completed in 2 to 3 appointments.
...
GOALS OF STAGE II









Close remaining posterior spaces
Correct or maintain dental midline.
Correct posterior c...
STAGE 2 MECHANICS AND
ARCHWIRES
Far less archwire manipulation is required
during stage 2 because the archwires serve
only...
In mild to moderate anchorage situations
the archwires are engaged through the
occlusal, rectangular molar tubes. This
lev...
STAGE 2 BRAKING MECHANICS
During stage 2 positive measures are
sometimes necessary to correct an
abundance of available sp...
Through the application of mechanical
brakes (side winder springs on premolars,
canines and incisors, in conjunction with
...
STAGE 3
GOALS OF STAGE III




Achieve final axial inclination of all teeth.
Maintain all corrections achieved during
st...
All uprighting and torquing is accomplished
by auxillaries. The same stage II archwire
can be used in stage III.
All uprig...
STAGE 3 AUXILIARIES
All individual tooth movements during stage 3 are
accomplished using auxiliaries. To produce
mesiodist...
These springs have several advantages over
conventional uprighting springs

 More efficient since coil located over wire....
The labial surface of each tooth is evaluated
to determine which manner of uprighting is
desired, clockwise or countercloc...
Although side winder uprighting springs
can be inserted into the bracket from
either the gingival or incisal, they are
nor...
TORQUING AUXILIARIES
Torquing of the maxillary incisor roots
palatally can be accomplished using one of
several types of t...
For the successful use of Torque Bars with
the Tip-Edge appliance, special “deep
grove” brackets are used on the maxillary...
During stages 1 and 2, when a one point
contact between archwire and slot is
desired to facilitate bite opening and
retrac...
www.indiandentalacademy.com
If torquing of an individual tooth is desired,
an Individual Root Torquing auxiliary (IRT)
is used.
This auxiliary can del...
ROUND OR RECTANGULAR WIRE IN
STAGE 3 ?
Continuing on round wire simplifies
treatment for the operator. Also when
molar tor...
On the other hand generalized and
individual torquing requirements are the
strongest indications for utilizing
rectangular...
www.indiandentalacademy.com
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Tip edge applaince 2 /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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Tip edge applaince 2 /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. TIP EDGE APPLIANCE In 1986, change in the edgewise slot is made with the removal of diagonally opposed corners from the conventional edgewise slot to permit either mesial or distal crown tipping. www.indiandentalacademy.com
  3. 3. Such modifications of the slot could not have been considered by ANGLE, because at that time there were no mesiodistal uprighting springs. These springs were created by DR BEGG in 1960, to upright teeth in conjunction with ribbon arch type brackets. Without such springs the Tip-Edge bracket itself would not be practical. www.indiandentalacademy.com
  4. 4. www.indiandentalacademy.com
  5. 5. VARIOUS ADVANTAGES OF TIP EDGE SLOT   Not only does it facilitate space opening or closing, it also enhances retraction of the buccal segments of one arch and automatically, through intermaxillary elastics, creates anchorage in the other. Facilitates intrusion of teeth for anterior bite opening. www.indiandentalacademy.com
  6. 6.   Archwire slots, that open or close during treatment, for maximum ease of archwire changes and minimal patient discomfort. The ability to torque and upright teeth from forces generated by auxiliaries, which leaves the stiffer arch wires relatively undisturbed and provides stability and molar control. www.indiandentalacademy.com
  7. 7.  These new archwire slots have in / out compensations and are preadjusted to automatically achieve desired degrees of crown tip and root torque with little or no modifications to the arch wires themselves. www.indiandentalacademy.com
  8. 8. Because the arch wire slot permits initial crown tipping mesially or distally and faces horizontally, the slot and bracket are termed TIP EDGE. The technique, which take full advantage of this slot and differential tooth movement with straight archwire, is termed the DIFFERENTIAL STRAIGHT-ARCH TECHNIQUE (D S A T). www.indiandentalacademy.com
  9. 9. APPLIANCES TIP EDGE BRACKETS By removing predetermined, diagonally opposed corners from the conventional edgewise archwire slot, the Tip-Edge bracket is created. This permits the desired distal crown tipping required for differential tooth movement. Preadjusted in three dimensions the Tip-Edge slot permits the use of straight arch wires in the majority of cases, both extraction and non extraction. www.indiandentalacademy.com
  10. 10. The slot is designed so that initial second order changes, mesiodistal crown tipping, can be accomplished in the presence of a straight round archwire and powered by light intra oral forces---elastics and coil springs. www.indiandentalacademy.com
  11. 11. Forces for subsequent root uprighting, tip and/or torque are generated by auxiliaries and not by flexing the arch wires. This simplifies the treatment through the use of “straight” arch wires while providing increased range of root movement, from physiologic forces with maximum stability and comfort. www.indiandentalacademy.com
  12. 12. Brackets are available in single , twin and ceramic forms. www.indiandentalacademy.com
  13. 13. Not only do the archwire slots permit initial crown tipping but also they are preadjusted to provide the desired final degrees of crown tip and torque. www.indiandentalacademy.com
  14. 14. MOLAR TUBES To maximize the advantages inherent in differential tooth movement, it is advantageous to utilize relatively long and loose fitting molar tubes in the early stages of treatment and shorter , rectangular tubes in the final stage. Therefore tip-edge tubes are of double configuration. The longer round tube is positioned gingivally and the shorter rectangular tubes occulasally. www.indiandentalacademy.com
  15. 15. www.indiandentalacademy.com
  16. 16. ARCH WIRES  Initial arch wires are formed of high tensile 0.016 inch round stainless steel. These wires will be able to overcome anterior vertical force vectors from class II or class III intermaxillary elastics to permit simultaneous bite opening and antero-posterior interarch changes. www.indiandentalacademy.com
  17. 17.   Arch wires of 0.014 inch or 0.016 inch Ni-Ti can be used for initial alignment in class I crowded cases. Rectangular 0.0215 x 0.028 inch stainless steel arch wires should be preferred for final finishing. www.indiandentalacademy.com
  18. 18. AUXILLARIES Due to generous size of the vertical slot in T E bracket many auxiliaries are used through out treatment.  Power pins for elastomerics.  Rotating springs.  Side winder springs.  Ni-ti torque bars.  Single tooth torquing auxiliaries www.indiandentalacademy.com
  19. 19. POWER PINS Used to accept elastomerics or rotating springs for rapid, physiologic rotation. www.indiandentalacademy.com
  20. 20. MESIO-DISTAL UPRIGHTING SPRINGS OR SIDE WINDERS They provide localized tip control of individual teeth without arch wire modifications. When finishing with rectangular arch wires, they can produce the desired final axial inclination for all teeth including torque. www.indiandentalacademy.com
  21. 21. Sectional wires of Ni-Ti are used for one or two appointments for initial alignment or the eruption of the impacted teeth. When using round arch wires, anterior root torque can be achieved by Ni-Ti Torque bars placed in deep grooves of central and lateral incisor brackets. The torquing of a single tooth is rapidly accomplished with an Individual Root Torquing Auxiliary. www.indiandentalacademy.com
  22. 22. www.indiandentalacademy.com
  23. 23. CONCEPT AND FUNCTION The Tip-Edge concept is to provide an edgwewise type bracket that is familiar to all orthodontists and can be used in the simplest manner to treat all malocclusions through differential tooth movement. This is accomplished by maintaining everything that is positively associated with an edgewise bracket, while removing diagonally opposed corners of the slot which prevents mesiodistal crown tipping. www.indiandentalacademy.com
  24. 24. This than provides an edgewise bracket that enhances rather than hinders bite opening, class II or III correction and the closing of posterior spaces. Tip and torque control are delayed until the end of the treatment and than easily achieved utilizing root moving forces that are relatively light, long lasting and generated by auxiliaries and not by flexing the main arch wire. www.indiandentalacademy.com
  25. 25. BITE OPENING Most malocclusions require anterior bite opening, which involves the intrusion of incisor teeth. If each tooth is free to intrude along its own path of least resistance, desired bite opening can be accomplished relatively rapidly and with the lightest of forces--------approx 5 gm per tooth. www.indiandentalacademy.com
  26. 26. Conventional edgewise slots prevent this free root movement and when teeth are tipped mesially or distally can even cause lateral movement of roots to further complicate the intrusion. Tip-edge archwire slots with their one point contact with the archwire prevents the creations of such lateral pressures and permits the roots to intrude in an unhindered fashion. www.indiandentalacademy.com
  27. 27. www.indiandentalacademy.com
  28. 28. Because of this one point contact between the archwire and the bracket slot, it is possible to open the deepest of anterior bites without the need for extra oral forces. The principle of differential forces and mechanics are applied through high tensile stainless steel archwires(0.016 inch), light intermaxillary elastics and to some extent, the forces of mastication. www.indiandentalacademy.com
  29. 29. RETRACTION AND SPACE CLOSURE WITHOUT LOSS OF VERTICAL CONTROL All teeth tend to tip distally as they are retracted. With conventional archwire slot it first causes binding between the slots and the wire and second, the incisal deflection of arch wire itself especially in canine region. The central and lateral incisors are than extruded which deepens the bite or increases gingival display. www.indiandentalacademy.com
  30. 30. Because the appropriate corners have been removed in Tip-edge archwire slots, there is no binding and no deflection. www.indiandentalacademy.com
  31. 31. VARIABLE ANCHORAGE SLOT Not only are Tip-edge archwire slots designed to permit crown tipping in one direction but they also become larger as the teeth tips. www.indiandentalacademy.com
  32. 32. The advantages gained by this increase in archwire slot relative to arch wire include    No binding or archwire deflection during retraction. Ease of stepping up in archwire size. No inadvertent mesial or distal root movements www.indiandentalacademy.com
  33. 33.   Ease of placing rectangular arch wires when third order discrepancies exist between the slots and the wires. No need to use Ni-Ti or memory wires to avoid discomfort and/or accidental debonding. www.indiandentalacademy.com
  34. 34. ANCHORAGE CONSIDERATIONS Extra oral anchorage is absolutely not needed with DSAT with tip-edge brackets as the forces are so light (2 oz) that adequate anchorage can easily be found within the mouth. www.indiandentalacademy.com
  35. 35. Binding, which normally occurs between conventional edgewise slots and archwires during space closure is nonexistent because the corners of the slots which press against the upper and lower surfaces of the archwires during tipping and which causes about 90% of the friction from an edgewise appliance are gone. www.indiandentalacademy.com
  36. 36. Furthermore in the DSAT the archwires move distally with the anterior teeth during space closure and premolars are usually not bracketed. So there is no sliding friction between archwires and brackets or ligatures to produce any additional strain on anchorage. www.indiandentalacademy.com
  37. 37. The only source of sliding friction is within the molar tubes and is at the absolute minimum because the molars are held upright, the tubes are relatively long, large in diameter and of course, there is no ligatures. www.indiandentalacademy.com
  38. 38. DIFFERENTIAL STRAIGHT ARCH TECHNIQUE The DSAT takes full advantage of TE brackets. This makes possible the successful treatment of even the most severe of malocclusions with a minimal number of appointments and archwires. Treatment is divided into three stages. Each stage features a distinct set of treatment goals that must be achieved before moving on to the next. Specific archwires, elastics and auxillaries are used for that particular stage and mixing them will lead to undesirable results. www.indiandentalacademy.com
  39. 39. STAGE 1 This stage is the only stage of DSAT treatment where arch wires are used to directly generate tooth moving forces ( anterior alignment and bite opening ). During the rest of the treatment they serve to preserve the vertical and lateral dimensions , while auxillaries are used to produce all individual movement. www.indiandentalacademy.com
  40. 40. GOALS OF STAGE I    Vertical correction of deep or open anterior bite. Horizontal correction of anterior over or under jet. Align anterior teeth to eliminate crowding or spacing www.indiandentalacademy.com
  41. 41. BITE OPENING MECHANICS Opening the bite is the most important goal of stage 1 The rapid correction of a deep anterior overbite to an edge to edge incisal relationship allows for the full expression of any potential benefits of mandibular growth in the correction of a class II malocclusion. www.indiandentalacademy.com
  42. 42. OVERJET/UNDERJET CORRECTION The correction of overjet or underjet is accomplished simultaneously along with anterior vertical discrepancies. It is accomplished through the use of either class II or III elastics depending on the incisar relationships. www.indiandentalacademy.com
  43. 43. ANTERIOR ALIGNMENT When space is available distal to canines, anterior alignment is achieved using elastomeric ties to the archwire through the vertical slots of the Tip-Edge brackets. The Tip-edge archwire slots allow adjacent teeth to simply tip out of the way as the lingually displaced teeth are brought into position. www.indiandentalacademy.com
  44. 44. When moderate to severe crowding is present at the start of non extraction treatment, vertical loops are employed in the anterior segments of the 0.016 inch archwire. www.indiandentalacademy.com
  45. 45. Rotated teeth are corrected using rotating springs inserted through the vertical slots of the brackets. www.indiandentalacademy.com
  46. 46. These auxilaries are available in either clockwise or counter clockwise versions. The tooth is viewed from the occlusal to determine the desired direction of rotation and the corresponding spring is selected, then engaged. Rotations are overcorrected whenever possible and held in these positions throughout the treatment using either overrotation brackets for incisors or through mesiodistally offset bonding positions on canines and premolars. www.indiandentalacademy.com
  47. 47. STAGE 2 Stage 2 is the shortest of the three stages of Tip-Edge treatment usually being completed in 2 to 3 appointments. The primary goal of stage 2 is the closing of posterior spaces. In this other than horizontal elastics to close spaces, class II or class III elastics are given to maintain desires anterior tooth relation. www.indiandentalacademy.com
  48. 48. GOALS OF STAGE II        Close remaining posterior spaces Correct or maintain dental midline. Correct posterior cross bite. Achieve class I molar relations. Over rotate severely rotated premolars. Level anchor molars. Maintain all corrections achieved during stage I. www.indiandentalacademy.com
  49. 49. STAGE 2 MECHANICS AND ARCHWIRES Far less archwire manipulation is required during stage 2 because the archwires serve only to maintain the vertical and lateral corrections achieved during stage 1. High tensile, round 0.022 inch stainless steel wire should be used for this. www.indiandentalacademy.com
  50. 50. In mild to moderate anchorage situations the archwires are engaged through the occlusal, rectangular molar tubes. This levels the premolar brackets and molar tubes early in treatment, easing the transition to stage 3. In maximum anchorage situations where friction between the tubes is more of a concern, it is preferred to insert the archwires through the larger diameter gingival round tubes. www.indiandentalacademy.com
  51. 51. STAGE 2 BRAKING MECHANICS During stage 2 positive measures are sometimes necessary to correct an abundance of available space which can be caused naturally by congenitally missing or relatively small teeth or by extraction of teeth in borderline extraction cases. Whatever the reason, corrective measures are required to prevent overretraction of the anterior teeth. www.indiandentalacademy.com
  52. 52. Through the application of mechanical brakes (side winder springs on premolars, canines and incisors, in conjunction with 0.022 inch round or 0.0215 x 0.028 inch rectangular wire), anterior teeth are prevented from further unrestricted distal and/or lingual crown tipping. Relatively heavy horizontal forces (6-8 oz) are than applied between these newly created anterior resistance units and the posterior teeth. www.indiandentalacademy.com
  53. 53. STAGE 3 GOALS OF STAGE III   Achieve final axial inclination of all teeth. Maintain all corrections achieved during stages I and II. This is the longest stage of DSAT , usually taking about half the total treatment time. Amount of time varies , but in an extraction case anywhere between 9-12 months. www.indiandentalacademy.com
  54. 54. All uprighting and torquing is accomplished by auxillaries. The same stage II archwire can be used in stage III. All uprighting movements are self limiting as each tooth reaches its final mesiodistal inclination , the uprighting surface of the tip edge arch wire slot contacts the arch wire preventing over uprighting. When using rectangular arch wire the torquing as well as uprighting is self limiting www.indiandentalacademy.com
  55. 55. STAGE 3 AUXILIARIES All individual tooth movements during stage 3 are accomplished using auxiliaries. To produce mesiodistal uprighting , side-winder springs are employed. www.indiandentalacademy.com
  56. 56. These springs have several advantages over conventional uprighting springs  More efficient since coil located over wire.  More esthetic and hygienic as it lies over the bracket. www.indiandentalacademy.com
  57. 57. The labial surface of each tooth is evaluated to determine which manner of uprighting is desired, clockwise or counterclockwise. Once it is determined, the appropriate side-winder uprighting spring is selected and engaged into the vertical slot of the bracket. www.indiandentalacademy.com
  58. 58. Although side winder uprighting springs can be inserted into the bracket from either the gingival or incisal, they are normally engaged from the incisal to prevent coil distortion from occlusal forces. www.indiandentalacademy.com
  59. 59. TORQUING AUXILIARIES Torquing of the maxillary incisor roots palatally can be accomplished using one of several types of torquing auxiliaries. The most commonly employed torquing auxiliaries are nickel titanium Torque Bars. These are curved ribbon arch sections of 0.022 x 0.018 inch Ni Ti formed with 30 degrees of torque. These auxiliaries are invisible when in place because they lie directly behind the main arch wire. www.indiandentalacademy.com
  60. 60. For the successful use of Torque Bars with the Tip-Edge appliance, special “deep grove” brackets are used on the maxillary incisors. These brackets feature conventional preadjusted edgewise archwire slots cast into the bottom of the Tip Edge archwire slots. www.indiandentalacademy.com
  61. 61. During stages 1 and 2, when a one point contact between archwire and slot is desired to facilitate bite opening and retraction, a cap fills the deep groove. At the beginning of stage 3 the cap is removed and the Torque Bar is ligated tightly into the deep groove under the round base archwire. www.indiandentalacademy.com
  62. 62. www.indiandentalacademy.com
  63. 63. If torquing of an individual tooth is desired, an Individual Root Torquing auxiliary (IRT) is used. This auxiliary can deliver palatal or labial root torque depending upon the direction from which it is engaged into the brackets vertical slot. i.e. palatal root torque if engaged incisally and labial root torque ,if inserted gingivally. www.indiandentalacademy.com
  64. 64. ROUND OR RECTANGULAR WIRE IN STAGE 3 ? Continuing on round wire simplifies treatment for the operator. Also when molar torque is not required and torquing of the anteriors is required then a round wire with torque bar can be used along with side winder springs. If a 0.022 SS wire is used in stage III then a molar offset and mild bite opening curves should be incorporated and if class II elastics are being used , the lower arch wire width is increased by 2mm. www.indiandentalacademy.com
  65. 65. On the other hand generalized and individual torquing requirements are the strongest indications for utilizing rectangular arch wires in stage III. That would include torquing molars , canines and incisors. The other advantage of rectangular stage III arch wire along with side winder springs is that the 2nd order power delivered by the springs is translated by the internal geometry of the tip edge bracket into third order moments. The resulting forces are physiologic and stop when the teeth have reached predetermined inclination. www.indiandentalacademy.com
  66. 66. www.indiandentalacademy.com

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