Special Issue "Lasers in Dentistry: Hard and Soft Tissues"

A special issue of Dentistry Journal (ISSN 2304-6767).

Deadline for manuscript submissions: closed (31 August 2020).

Special Issue Editors

Prof. Dr. Edward Lynch
E-Mail Website
Guest Editor
Principal Director of Biomedical and Clinical Research, School of Dental Medicine, University of Nevada Las Vegas, USA
Interests: restorative dentistry; periodontology; prosthodontics; oral surgery; clinical trials; laser-assisted endodontics; PBM-Therapy; photobiomodulation; laser-soft tissue; antimicrobial photodynamic therapy; aPDT; laser-assisted dental bleaching
Dr. Steven Parker
E-Mail Website
Guest Editor
Leicester School of Pharmacy, De Montfort University, Leicester, United Kingdom
Interests: PBM-Therapy; photobiomodulation; laser-soft tissue management; antimicrobial photodynamic therapy; aPDT; laser-tissue interaction
Dr. Eugenia Anagnostaki
E-Mail Website
Guest Editor
Leicester School of Pharmacy, De Montfort University, Leicester, United Kingdom
Interests: PBM-Therapy; photobiomodulation; antimicrobial photodynamic therapy; aPDT; laser-assisted endodontics; laser-assisted dental bleaching
Dr. Valina Mylona
E-Mail Website
Guest Editor
Leicester School of Pharmacy, De Montfort University, Leicester, United Kingdom
Interests: PBM-Therapy; photobiomodulation; antimicrobial photodynamic therapy; aPDT

Special Issue Information

Dear Colleagues,

The adjunctive use of laser photonic energy to assist and augment the outcome of treatment in dentistry has expanded dramatically over the past 25 years.

Based on early research and through a dedicated peer-reviewed evidence approach, it has been possible to identify and propose the integration of new techniques using laser photonic energy into general and specialist dental practice.

Lasers generally have many intrinsic, interesting, and useful properties. For instance, lasers have the potential to produce different results depending on the dose. Laser–tissue interaction can produce a range of useful applications in the field of dentistry, from the biochemical and biophysical promotion of healing and the selective suppression of the inflammatory cytokine cascade to the surgical ablation of diseased tissues and photothermal destruction of pathogens.

In this Special Issue, a number of esteemed researchers have contributed narrative reviews of the integration of lasers in a wide range of treatment modalities. Each subject is considered to be a reflection of the authors’ personal experiences along with reference to contemporary research by individual researchers and university research groups throughout the world.

Prof. Edward Lynch
Dr. Steven Parker
Dr. Eugenia Anagnostaki
Dr. Valina Mylona
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Dentistry Journal is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • laser
  • dentistry
  • hard tissue
  • soft tissue
  • PBM-Therapy
  • photobiomodulation
  • wound healing
  • laser–tissue interaction
  • aPDT
  • photodynamic therapy
  • photosensitizers
  • endodontic therapy
  • depigmentation
  • dental bleaching
  • restorative dentistry
  • periodontal disease
  • peri-implantitis
  • periimplantitis
  • mucositis
  • oral mucositis
  • cancer care
  • bone management
  • laser alveolar interaction
  • orthodontics
  • tooth movement
  • pediatric dentistry

Published Papers (11 papers)

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Research

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Open AccessArticle
A Spectrophotometric Study on Light Attenuation Properties of Dental Bleaching Gels: Potential Relevance to Irradiation Parameters
Dent. J. 2020, 8(4), 137; https://doi.org/10.3390/dj8040137 - 16 Dec 2020
Cited by 1 | Viewed by 672
Abstract
Background: During in-office bleaching, appropriate light sources are applied in order to enhance the activity of the bleaching gels applied onto teeth. For this method to be effective, a high absorption of light within the gel is necessary. Variation in the light attenuation [...] Read more.
Background: During in-office bleaching, appropriate light sources are applied in order to enhance the activity of the bleaching gels applied onto teeth. For this method to be effective, a high absorption of light within the gel is necessary. Variation in the light attenuation capability of the gel, the duration of application and light activation can contribute towards safety hazards associated with this procedure. Methods: In this study, seven different gels and hydrogen peroxide have been evaluated for their optical properties by means of spectrophotometry (440–1000 nm). The transmitted light spectrum was used to estimate the intensity loss for each gel. The mean intensity decreases observed were statistically analysed using an analysis of variance (ANOVA). Results: The five more-pigmented gels tested indicated a very similar intensity loss of around 80%, whereas the remaining two gels showed significantly less attenuation (predominantly, p < 10−6). Conclusions: Throughout the spectrum of wavelengths examined, and according to the underlying studies evaluated, five of the gels assessed demonstrated an attenuation high enough to possibly avoid overheating of the underlying enamel dentine and pulp. An evaluation of appropriate irradiation parameters is proposed. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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Open AccessArticle
Photoinhibition of Streptococcus mutans Biofilm-Induced Lesions in Human Dentin by Violet-Blue Light
Dent. J. 2019, 7(4), 113; https://doi.org/10.3390/dj7040113 - 11 Dec 2019
Cited by 2 | Viewed by 905
Abstract
This in vitro study determined the effectiveness of violet-blue light on Streptococcus mutans (UA159) biofilm induced dentinal lesions. Biofilm was formed on human dentin specimens in a 96-well microtiter plate and incubated for 13 h in the presence of tryptic soy broth (TSB) [...] Read more.
This in vitro study determined the effectiveness of violet-blue light on Streptococcus mutans (UA159) biofilm induced dentinal lesions. Biofilm was formed on human dentin specimens in a 96-well microtiter plate and incubated for 13 h in the presence of tryptic soy broth (TSB) or TSB supplemented with 1% sucrose (TSBS). Violet-blue light (405 nm) from quantitative light-induced fluorescence (QLFTM) was used to irradiate the biofilm. Supernatant liquid was removed, and the biofilm was irradiated continuously with QLF for 5 min twice daily with an interval of 6 h for 5 d, except with one treatment on the final day. Colony forming units (CFU) of the treated biofilm, changes in fluorescence (∆F; QLF-Digital BiluminatorTM), lesion depth (L), and integrated mineral loss (∆Z; both transverse microradiography) were quantified at the end of the fifth day. Statistical analysis used analysis of variance (ANOVA), testing at a 5% significance level. In the violet-blue light irradiated groups, there was a significant reduction (p < 0.05) of bacterial viability (CFU) of S. mutans with TSB and TSBS. Violet-blue light irradiation resulted in the reduction of ∆F and L of the dentinal surface with TSBS. These results indicate that violet-blue light has the capacity to reduce S. mutans cell numbers. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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Open AccessReview
Laser Analgesia Associated with Restorative Dental Care: A Systematic Review of the Rationale, Techniques, and Energy Dose Considerations
Dent. J. 2020, 8(4), 128; https://doi.org/10.3390/dj8040128 - 12 Nov 2020
Viewed by 811
Abstract
It is a common experience amongst laser dentists and patients that mid-IR wavelength application in cavity preparation may be achieved without causing any associated pain. The erbium family of lasers (Er,Cr:YSGG 2780 nm and Er:YAG 2940 nm) are frequently used without employing injectable [...] Read more.
It is a common experience amongst laser dentists and patients that mid-IR wavelength application in cavity preparation may be achieved without causing any associated pain. The erbium family of lasers (Er,Cr:YSGG 2780 nm and Er:YAG 2940 nm) are frequently used without employing injectable local anesthesia as an adjunct: the phenomenon arising from the application of these devices is known as laser analgesia. This review seeks to apply a systematic approach to the examination of appropriate published studies but also to highlight the need for much more structured clinical investigations that consolidate photonic dose and methodology. A search of published data using PRISMA criteria was carried out to examine clinical trials into laser analgesia in conjunction with restorative dentistry, applying inclusion and exclusion criteria. From this, 10 published articles were selected for analysis. Suitability assessment was carried out, using a modified Cochrane risk of bias methodology. In 8/10 of the included studies, laser-induced analgesia is claimed to be better and effective, while in 2/10 of the studies, no difference was exhibited compared to the control group. Statistical analysis of three split mouth studies concluded that only one of these investigations reviewed demonstrated a significant analgesic effect for laser treatment while the other two did not support this observation. From this data, it is inconclusive to assess the predictability of laser analgesia in cavity preparation. A possible rationale and laser operating parametry has been discussed. Successful implementation of this treatment modality remains technique sensitive and subject to further investigation. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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Open AccessReview
Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis
Dent. J. 2020, 8(4), 114; https://doi.org/10.3390/dj8040114 - 06 Oct 2020
Cited by 1 | Viewed by 1048
Abstract
Objective: This systematic review and meta-analysis of published randomized controlled trials examines a possible relationship between optical spot size at surface tissue, irradiance, radiant exposure, total energy delivered, operator technique and reported clinical outcomes. Background: Clinical photobiomodulation (PBM) therapy has achieved [...] Read more.
Objective: This systematic review and meta-analysis of published randomized controlled trials examines a possible relationship between optical spot size at surface tissue, irradiance, radiant exposure, total energy delivered, operator technique and reported clinical outcomes. Background: Clinical photobiomodulation (PBM) therapy has achieved a high level of evidence-based acceptance in the mitigation of oral mucositis associated with cancer radiotherapy and chemotherapy, and supportive clinical research in relation to orthodontic tooth movement, oral medical conditions, including burning mouth syndrome, xerostomia and lichen planus. Inconsistent outcomes have been reported not withstanding a substantial body of primary supportive research from clinical, in vitro and animal studies. Materials and Methods: PubMed, Cochrane Database of Reviews and Google Scholar search engines were applied to identify human clinical trials of PBM therapy in clinical dentistry. A total of 766 articles between February 2009 and June 2020 were identified and following a full text evaluation, 38 papers with sufficient data to permit analyses are included in this investigation. Results: Following a detailed assessment of potential factors that may have an influence in clinical outcome, a clear trend is apparent associating optical spot size to a positive or negative effect. Furthermore, there is a clear difference in the reported results in relation to total energy applied, delivery techniques and optical parameters, which merits further investigation. Factorial statistical analyses identified an association between smaller optical surface applications and an overall lower level of reported clinical success in treating superficial and deeper targets, and correspondingly sub-surface larger target tissues were found to be more responsive to therapy by use of a larger optical surface spot size. Moreover, use of multiple small diameter probe applications was found to provide inconsistent results. Conclusions: Many factors can confound clinical success including variations in anatomy, site location, clinical condition and subject individuality. To achieve higher levels of predictable outcome, a mature appreciation of these factors, plus an expanded understanding of laser parametry, tissue volume and target depth to deliver an adequate dose within current recommended guidelines, is essential. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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Open AccessReview
Laser-Assisted aPDT Protocols in Randomized Controlled Clinical Trials in Dentistry: A Systematic Review
Dent. J. 2020, 8(3), 107; https://doi.org/10.3390/dj8030107 - 22 Sep 2020
Viewed by 891
Abstract
Background: Antimicrobial photodynamic therapy (aPDT) has been proposed as an effective alternative method for the adjunctive treatment of all classes of oral infections. The multifactorial nature of its mechanism of action correlates with various influencing factors, involving parameters concerning both the photosensitizer and [...] Read more.
Background: Antimicrobial photodynamic therapy (aPDT) has been proposed as an effective alternative method for the adjunctive treatment of all classes of oral infections. The multifactorial nature of its mechanism of action correlates with various influencing factors, involving parameters concerning both the photosensitizer and the light delivery system. This study aims to critically evaluate the recorded parameters of aPDT applications that use lasers as the light source in randomized clinical trials in dentistry. Methods: PubMed and Cochrane search engines were used to identify human clinical trials of aPDT therapy in dentistry. After applying specific keywords, additional filters, inclusion and exclusion criteria, the initial number of 7744 articles was reduced to 38. Results: Almost one-half of the articles presented incomplete parameters, whilst the others had different protocols, even with the same photosensitizer and for the same field of application. Conclusions: No safe recommendation for aPDT protocols can be extrapolated for clinical use. Further research investigations should be performed with clear protocols, so that standardization for their potential dental applications can be achieved. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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Open AccessReview
Do Lasers Have an Adjunctive Role in Initial Non-Surgical Periodontal Therapy? A Systematic Review
Dent. J. 2020, 8(3), 93; https://doi.org/10.3390/dj8030093 - 16 Aug 2020
Cited by 2 | Viewed by 1122
Abstract
(1) Background: dental lasers have numerous applications for periodontal therapy which include surgical procedures of soft tissue and osseous structures, and non-surgical treatments such as pathogen reduction, removal of surface accretions, and photobiomodulation. The aim of this review was to evaluate the scientific [...] Read more.
(1) Background: dental lasers have numerous applications for periodontal therapy which include surgical procedures of soft tissue and osseous structures, and non-surgical treatments such as pathogen reduction, removal of surface accretions, and photobiomodulation. The aim of this review was to evaluate the scientific literature to ascertain whether lasers have a beneficial role when used adjunctively in initial non-surgical periodontal therapy. (2) Methods: A PubMed search was performed specifically for randomized clinical trials where a dental laser was used adjunctively for initial periodontal therapy on human patients published from January 2010–April 2020. The first search identified 1294 eligible studies. After additional criteria and filters were applied, 20 manuscripts were included in this review. (3) Results: The chosen manuscripts reported on investigations into initial therapy for patients diagnosed with chronic periodontitis. After periodontal charting, conventional instrumentation such as hand and ultrasonic scaling was performed on all patients in the studies, and then a test group or groups of patients were treated adjunctively with a laser. That adjunctive laser group’s periodontal findings showed various degrees of improved health compared to the group treated with only conventional methods. (4) Conclusion: This systematic review found that 70% of the included studies reported significantly better outcomes in certain clinical parameters, but no improvement in others. The remaining 30% of the manuscripts reported no significant difference in any of the measurements. With consideration to correct parametry, lasers have an adjunctive role in initial non-surgical periodontal therapy. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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Open AccessReview
Laser-Assisted Depigmentation—An Introspection of the Science, Techniques, and Perceptions
Dent. J. 2020, 8(3), 88; https://doi.org/10.3390/dj8030088 - 06 Aug 2020
Cited by 1 | Viewed by 975
Abstract
Background: Gingival hyperpigmentation is a major concern for a significant number of patients, as a relevant aesthetic or cosmetic need. Oral melanin pigmentation is considered to be multifactorial and could be related to physiological or even pathological reasons and can be the consequence [...] Read more.
Background: Gingival hyperpigmentation is a major concern for a significant number of patients, as a relevant aesthetic or cosmetic need. Oral melanin pigmentation is considered to be multifactorial and could be related to physiological or even pathological reasons and can be the consequence of a variety of local or systemic factors. This pigmentation varies individually across races or age groups and is without any gender predilection. Evidence gleaned from literature is presented from case–control studies and from the authors’ own research work in prospective, split-mouth, double-blinded, clinical trials comparing treatment modalities in effecting depigmentation. Methods: A systematic review of published articles, using suitable assay criteria, was carried out to formulate a consensus on laser-assisted modalities. A total of 295 published sources were subject to critical analysis and resulted in six papers that were subject to data scrutiny. Additionally, evidence is presented on clinical protocols and treatment outcomes. Results: Analysis of randomized clinical studies identified the use of two laser wavelength groups—near infrared diode and erbium group of mid-infrared lasers. Several areas of analysis were examined, and inconsistent degrees of significance were obtained to establish which laser group was optimal and if they were any better than scalpel depigmentation. Conclusion: A definitive conclusion is wanting as studies with scientific and standardized protocols of evaluation are yet to provide a take on comparative assessments between different techniques of depigmentation. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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Open AccessReview
Photobiomodulation and Oral Mucositis: A Systematic Review
Dent. J. 2020, 8(3), 87; https://doi.org/10.3390/dj8030087 - 05 Aug 2020
Cited by 1 | Viewed by 1065
Abstract
Oral mucositis (OM) is a debilitating complication of chemotherapy, and head and neck radiotherapy. In an effort to offer the best possible advice within the limitations of published research, a systematic review with an extended discussion and commentary on dosimetry and dose delivery [...] Read more.
Oral mucositis (OM) is a debilitating complication of chemotherapy, and head and neck radiotherapy. In an effort to offer the best possible advice within the limitations of published research, a systematic review with an extended discussion and commentary on dosimetry and dose delivery is presented. Using keywords as listed, Pubmed, Google Scholar and Cochrane databases were searched during a period extending from 1995 to 2019. A total of 782 abstracts were identified. A total of 50 papers were analysed, and of these, 29 satisfied criteria required for systematic review in accordance with an optimized PRISMA statement. Clinical outcome as reported was subject to analysis with respect to time of intervention, incidence and severity of oral mucositis, and pain amelioration, and a comprehensive combined univariate and multivariate statistical analysis of the methods employed was performed. Recommendations are made with respect to the timing of the intervention. Moreover, there is an extended discussion available on the treatment care rationale of photobiomodulation (PBM), and its adjunctive association with OM. In conclusion, early prophylactic application offers clear advantages in clinical management. The many studies and associated variables and covariables assessed here revealed a choice of delivery techniques, associated wavelengths and many further indices to consider with regard to the accomplishment of optical parameters. It is therefore our recommendation that clinicians use PBM as a therapy with a full and proper understanding and training in order to optimise the clinical effects achievable. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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Open AccessReview
Adjunctive Use of Lasers in Peri-Implant Mucositis and Peri-Implantitis Treatment: A Systematic Review
Dent. J. 2020, 8(3), 68; https://doi.org/10.3390/dj8030068 - 03 Jul 2020
Cited by 2 | Viewed by 840
Abstract
Background: The aim of this systematic review is to compare the effectiveness of lasers in the treatment of implant mucositis and peri-implantitis compared to conventional treatment (non-surgical or surgical: resective or regenerative). Methods: Sources of PubMed, Cochrane and Google Scholar search engines were [...] Read more.
Background: The aim of this systematic review is to compare the effectiveness of lasers in the treatment of implant mucositis and peri-implantitis compared to conventional treatment (non-surgical or surgical: resective or regenerative). Methods: Sources of PubMed, Cochrane and Google Scholar search engines were used on articles published from 1997 to 2020 in English, with selected keyword criteria applied. Nine randomized controlled trials (RCTs) were selected. Results: All included studies were considered of “high quality” according to the quality assessment scale. The comparative assessment of the RCTs was done twice for each RCT based on the type of treatment and according to wavelength. There is strong scientific evidence that, regarding non-surgical treatment, adjunct laser application can provide better results only in the short term (three months). Regarding the surgical approach, the method of decontamination plays a subordinate role. All wavelengths/applications presented similar results. Conclusion: Within the limitations of this study, the adjunctive use of lasers in the treatment of peri-implant inflammation is effective for up to three months; there is no strong evidence regarding the long term benefit compared to conventional treatment. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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Open AccessReview
Systematic Review on the Role of Lasers in Endodontic Therapy: Valuable Adjunct Treatment?
Dent. J. 2020, 8(3), 63; https://doi.org/10.3390/dj8030063 - 01 Jul 2020
Viewed by 947
Abstract
(1) Background: Adjunctive instruments, such as lasers have been investigated to address the risk of failure of endodontic therapy due to the complexity of the root canal system. Lasers have been used therapeutically, in direct irradiation of the root canals or adjunct to [...] Read more.
(1) Background: Adjunctive instruments, such as lasers have been investigated to address the risk of failure of endodontic therapy due to the complexity of the root canal system. Lasers have been used therapeutically, in direct irradiation of the root canals or adjunct to irrigants placed into the canals, in combination with a photosensitizer (antimicrobial photodynamic therapy) and in pain management (photobiomodulation). The purpose of this systematic review was to evaluate the evidence in clinical use within these three areas of therapy. (2) Methods: PubMed, Cochrane and Scopus search engines were used to identify human clinical trials regarding the use of lasers in endodontic therapy. (3) Results: After applying the keywords and additional filters, inclusion and exclusion criteria, the initial number of 1486 articles was reduced to 17. It was revealed that almost all studies (14/17) presented a statistically significant improved outcome in laser-assisted endodontic therapy, with the remaining three not showing any adverse effects. (4) Conclusions: The use of laser photonic energy of appropriate delivered parameters can be proposed as useful adjunctive when considering optimal treatment modalities in orthograde endodontics. Additionally, a tendency of research towards pain modulation in this field is developing. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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Open AccessReview
Current Concepts of Laser–Oral Tissue Interaction
Dent. J. 2020, 8(3), 61; https://doi.org/10.3390/dj8030061 - 28 Jun 2020
Cited by 2 | Viewed by 824
Abstract
Fundamental to the adjunctive use of laser photonic energy for delivering therapy and tissue management, is the ability of the incident energy to be absorbed by target tissues. The aim of this review is to examine the differential performance of the separate components [...] Read more.
Fundamental to the adjunctive use of laser photonic energy for delivering therapy and tissue management, is the ability of the incident energy to be absorbed by target tissues. The aim of this review is to examine the differential performance of the separate components of oral hard and soft tissues when exposed to laser photonic irradiance of variable wavelengths and power values. Through an examination of peer-reviewed published data and materials, the interaction of laser photonic energy and target tissues are explored in detail. Varying laser wavelength emissions relative to anatomical structures explores the ability to optimise laser–tissue interactions, and also identifies possible risk scenarios as they apply to adjacent non-target structures. The concepts and practical aspects of laser photonic energy interactions with target oral tissues are clearly demonstrated. Emphasis was placed on optimising the minimum level of laser power delivery in order to achieve a desired tissue effect, whilst minimising the risk or outcome of collateral tissue damage. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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