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NOMENCLATURE
The first step in understanding dental anatomy is to learn the nomenclature ,or the system of names use to describe or classify the material included in the subject. The term mandibular refers to the lower jaw or mandible. And the term maxillary is for upper jaw ,maxilla Acc. to dictionary definition the term decidous means not permanent ,transitory but unabridged dictionary means milk tooth, which is define as one of the temporary teeth of a mammal that are replaced by permanent teeth. Also called baby tooth. The term primary indicate first dentition i.e. decidous dentition where as term permanent suggest permanent dentition.
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FORMULAE FOR MAMMALIAN TEETH of all mammalian teeth are expressed by fomulae that The number
is used to differentiate the human dentition from others species. The denomination of each tooth is represented by the initial letter in its name i.e I for incisor,C for canine,P for premolar,M for molar. Each letter is followed by a horizontal line and the number of each type of tooth is placed above the line for maxilla and below the line for the mandible. The dental formula for the PRIMARY DENTITION is I2/2 C1/1 M2/2=10
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1 to 16>Maxillary teeth ,beginning with maxillary right third molar. And for Mandibular teeth numbers 17 to 32 used.
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PALMER NOTATION SYSTEM:Palmer published this system in 1870.In this system the arches are divided into quadrants.For PRIMARY DENTITION it is as follows: E D C B A A B C D E E D C B A A B C D E Thus for single tooth such as maxillary right central incisor the designation is A/ and for mandibular right central incisor the notation is |A. For PERMANENT DENTITION it is as follows: 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 In this the right maxillary first molar is 6
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FDI SYSTEM o Full form is Federation Dentaire Internationale. oAdopted by WHO for both Primary and Permenent dentition. oThis is two digit system. oTooth notation for PRIMARY DENTITION is: 55 54 53 52 51 61 62 63 64 65 85 84 83 82 81 71 72 73 74 75 For eg 53 In this first digit i.e 5 indicates Quadrant and 3 is tooth number so it is maxillary right decidous canine. oTooth notation for PERMANENT DENTITION is: 18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38 For eg 23 is maxillary left permanent canine.
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ROOT
CERVICAL LINE
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CROWN
The pulp chamber is in crown and Pulp canal is in the root. So four tissues of tooth are ENAMEL, CEMENTUM, DENTINE and PULP. The first three are hard tissue and last is soft tissue. The cross section displays a Pulp Chamber and Pulp canal which normally contains a pulp tissue.
11/08/06 Department of pedodontics and preventive dentistry
The root portion of the tooth is firmly fixed in the bony process of jaw. That portion of the jaw serving as support for the tooth is called ALVEOLAR PROCESS. The bone of the tooth socket is called ALVEOLUS. The crown portion is partially covered by the soft tissue called GINGIVA or GUM TISSUE.
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CHRONOLOGY
CHRONOLOGY OF PRIMARY DENTITION
DENTITION TOOTH FEOC Weeks in utero CROWN COM Months ERUPTION Months ROOT COMP
PRIMARY (Upper)
i1 I2 C M1 m2 i1 I2 C M1 m2
10(810(8-12) 11(911(9-13) 19(1619(16-22) 16(1316(13-19) 29(2529(25-33) 8(68(6-10) 13(1013(10-16) 20(1720(17-23) 16(1416(14-18) 27(2327(23-31)
1.5 2.0 3.25 2.5 3.0 1.5 1.5 3.25 2.25 3.0
PRIMARY (lower)
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Permanent (lower)
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i1 I2 C P1 P2 m1 M2 m3
4-5 4-5 6-7 5-6 6-7 2.52.5-3 7-8 Department of pedodontics and 1212-16
preventive dentistry
PRIMARY TEETH
Enamel organs do not develop at the same rate. Some of the primary teeth are undergoing resorption while the roots of others are still forming. Not all teeth lost at the same time. Primary dentition is completely formed at 3y of age
11/08/06 Calcification begins in utero from 13-16 weeks. Department of pedodontics and preventive dentistry
The DENTAL DEVELOPMENT CAN BE CONSIDERED TO HAVE TWO COMPONENTS: formation of crowns and roots. The eruption of the teeth.
A. B.
THE DENTITIONS
C. PERMANENT DENTITION:
Divided into 3 PRIMARY DENTITION: till six years. TRANSTITIONAL DENTITION PERIOD:
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The primary teeth are usually lighter in color than the permanent. The enamel is relatively thin and has a constant depth. The pulp horns are high and pulp chambers are large. Dentine thickness between pulp chambers and the enamel is limited. Primary roots are narrow when compared to crown width.
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MAXILLARY CENTRAL INCISOR Incisal Aspect The incisal edge is centered over the main bulk of the crown and is relatively straight. straight. On the incisal edge, the labial surface is much broader and also smoother than the lingual surface. surface. The lingual surface tapers toward the cingulum. cingulum. MAXILLARY LATERAL INCISOR In general, the maxillary lateral is similar to the central incisor from all aspects, but its dimensions differ. differ. Its crown is smaller in all directions. directions. MAXILLARY CANINE Labial Aspect The crown is more constricted at the cervix in relation to its mesiodistal width, and the mesial and distal surfaces are more convex. convex. Lingual Aspect The lingual aspect shows pronounced enamel ridges that merge with each other. other. This lingual ridge divides the lingual surface into shallow mesiolingual and distolingual fossae. fossae. The root of this tooth tapers lingually. of pedodontics and lingually. Department
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MAXILLARY CANINE Mesial Aspect From the mesial aspect, the outline form is similar. similar. The measurement labiolingually at the cervical third is much greater. greater. Distal Aspect The curvature of the cervical line toward the cusp ridge is less than on the mesial surface. surface. Incisal Aspect From the incisal aspect, the crown is essentially diamond-shaped. diamond-shaped. The tip of the cusp is distal to the center of the crown, and the mesial cusp slope is longer than the distal cusp slope. slope. MANDIBULAR CENTRAL INCISOR Labial Aspect The labial aspect of this crown has a flat face with no developmental grooves. grooves. The mesial and distal sides of the crown are tapered evenly from the contact areas, the measurement being less at the cervix. cervix. The root of the primary central incisor is long and evenly tapered down to the apex, which is pointed. pointed.
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MANDIBULAR CENTRAL INCISOR Lingual Aspect The marginal ridges and the cingulum may be located easily. easily. The lingual surface of the crown at the middle third and the incisal third may have a flattened surface level with the marginal ridges, or it may present a slight concavity, called the lingual fossa. fossa. The root of the primary central incisor is long and evenly tapered down to the apex, which is pointed. pointed. Mesial Aspect The incisal ridge is centered over the center of the root and between the crest of curvature of the crown. crown. The convexity of the cervical contours labially and lingually at the cervical third is pronounced. pronounced. The mesial surface of the root is nearly flat and evenly tapered. tapered. Distal Aspect The outline of this tooth from the distal aspect is the reverse of that found from the mesial aspect. aspect. Incisal Aspect The incisal ridge is straight and bisects the crown labiolingually. labiolingually. The labial surface from this view presents a flat surface slightly convex, whereas the lingual surface presents a flattened surface slightly concave. concave. Department of pedodontics and
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MANDIBULAR LATERAL INCISOR The lateral incisor is somewhat larger in all measurements except labiolingually, where the two teeth are practically identical. identical. The cingulum of the lateral incisor may be a little more generous than that of the central incisor. incisor. The lingual surface of the crown between the marginal ridges may be more concave. concave. MANDIBULAR CANINE The crown is slightly shorter, and the root may be as much as 2 mm shorter than the maxillary canine. canine. The mandibular canine is not as large labiolingually as its maxillary opponent. opponent. MAXILLARY FIRST MOLAR The greatest dimension of the crown of the maxillary first molar is at the mesiodistal contact areas, and from these areas the crown converges toward the cervical region. region. The mesiolingual cusp is the largest and sharpest. sharpest. The distolingual cusp is poorly defined, small, and rounded. rounded. The buccal surface is smooth, with little evidence of developmental grooves. grooves. The three roots are long, slender, and widely spread. spread.
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There are two well-defined buccal cusps, with a developmental wellgroove between them. them.
The bifurcation between the buccal roots is close to the cervical region. region. The roots are longer. longer. The lingual surface has three cusps: a mesiolingual cusp that is cusps: large and well developed, a distolingual cusp, and a third and smaller supplemental cusp (cusp of Carabelli). Carabelli). A well-defined groove separates the mesiolingual cusp from the welldistolingual cusp. cusp. MANDIBULAR FIRST MOLAR The mesial outline of the tooth, when viewed from the buccal aspect, is almost straight from the contact area to the cervical region. region. The mesiolingual cusp is long and sharp at the tip; a developmental tip; groove separates this cusp from the distolingual cusp. cusp. The mesial marginal ridge is well developed. developed. When the tooth is viewed from the mesial aspect, there is an extreme curvature buccally at the cervical third. third. The crown length is greater in the mesiobuccal area than in the mesiolingual. mesiolingual. The longer slender roots spread considerably at the and third. Department of pedodontics apical third.
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MANDIBULAR SECOND MOLAR The mandibular second molar resembles the mandibular first permanent molar. The buccal surface is divided into three cusps that are separated by a mesiobuccal and distobuccal developmental groove. The primary second molar, when viewed from the occlusal surface, appears rectangular with a slight distal convergence of the crown. The mesial marginal ridge is developed to a greater extent than the distal marginal ridge.
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Lingual: Lingual: The lingual aspect presents a distinctive lingual fossa that is bordered by mesial and distal marginal ridges, the incisal edge, and the prominent cingulum at the gingival. gingival.
11/08/06 Department of pedodontics and preventive dentistry
Proximal: Proximal: Mesial and distal aspects present a distinctive triangular outline. outline. This is true for all of the incisors. The incisors. incisal ridge of the crown is aligned on the long axis of the tooth along with the apex of the tooth. tooth.
Incisal: Incisal: The crown is roughly triangular in outline; the incisal edge is outline; nearly a straight line, though slightly crescent shaped. shaped.
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Proximal: In proximal view, the maxillary lateral incisor resembles the central except that the root appears longer-about 1 1/2 times longer than the crown. A line through the long axis of the tooth bisects the crown. Incisal: In incisal view, this tooth can resemble either the central or the canine to varying degrees. The tooth is narrower mesiodistally than the upper central incisor; however, it is nearly as thick Department of pedodontics and labiolingually.
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Mandibular Central Incisor Facial: The mandibular central incisor is the smallest tooth in the dental arch. It is a long, narrow, symmetrical tooth. The incisal edge is straight. Mesial and distal outlines descend apically from the sharp mesial and distal incisal angles. Lingual: The lingual surface has no definite marginal ridges. The surface is concave and the cingulum is Department of pedodontics and minimal in size preventive dentistry 11/08/06
Proximal: Both mesial and distal surfaces present a triangular outline. Incisal: The incisal edge is at right angles to a line passing labiolingually through the tooth reflecting its bilateral symmetry.
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Proximal: Like the central, the crown presents a triangular outline. When viewed critically, the rotation of the incisal edge can be seen. Incisal: The incisal edge 'twisted' from the 90 degree angle with a line passing labiolingually through the tooth.
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Proximal: The mesial and distal aspects present a triangular outline. They resemble the incisors, but are more robust-especially in the cingulum region. Incisal: The asymmetry of this tooth is readily apparent from this aspect. It usually thicker labiolingually than it is mesiodistally. The tip of the cusp is displaced labially and mesial to the central long axis of this Department of pedodontics and tooth. 11/08/06 preventive dentistry
Proximal: The mesial and distal aspects present a triangular outline. The cingulum as noted is less well developed. When the crown and root are viewed from the proximal, this tooth uniquely presents a crescent-like profile similar to a cashew nut. Incisal: The mesiodistal dimension is clearly less than the labiolingual dimension. The mesial and distal 'halves' of the tooth are more identical than the upper canine from this perspective. You will recall that the cusp tip of the maxillary canine is facial to a line through the long axis. In the mandibular canine, the unworn incisal edge is on the line through Department of pedodontics and the 11/08/06 long axis of this tooth. preventive dentistry
Proximal: The mesial aspect of this tooth has a distinctive concavity in the cervical third that extends onto the root. It is called variously the mesial developmental depression, mesial concavity, or the 'canine fossa'--a misleading description since it is on the premolar. The distal aspect of the maxillary first permanent molar also has a developmental depression. The mesial marginal developmental groove is a distinctive feature of this tooth. Occlusal: There are two well-defined cusps buccal and lingual. The larger cusp is the buccal; its cusp tip is located midway mesiodistally. The lingual cusp tip is shifted mesially. The occlusal outline presents a hexagonal appearance. On the mesial marginal ridge is a distinctive feature, the mesial Department of pedodontics and marginal developmentalpreventive dentistry groove. 11/08/06
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In mesial perspective the mesiolingual cusp, mesial marginal ridge, and mesiobuccal cusp comprise the occlusal outline. When present, the Carabelli trait is seen in this view. In its distal aspect, the two distal cusps are clearly seen; however, the distal marginal ridge is somewhat shorter than the mesial one. A small concavity on the distal surface that continues onto the distobuccal root is occasionally described. Occlusal: The tooth outline is somewhat rhomboidal with four distinct cusps. The cusp order according to size is: mesiolingual, mesiobuccal, distobuccal, and distolingual. The tips of the mesiolingual, mesiobuccal, and distobuccal cusps form the trigon, reflecting the evolutionary origins of the maxillary molar. The distolingual cusp is called the talon (heel) and is a more recent acquisition in evolutionary history. A frequent feature of maxillary molars is the 11/08/06 Department of pedodontics and preventive Carabelli trait located on the mesiolingual dentistry cusp.
Proximal:
Proximal: The distinctive height of curvature seen in the cervical third of the buccal surface is called the cervical ridge. The mesial surface may be flat or concave in its cervical third . It is highly convex in its middle and occlusal thirds. The occlusal profile is marked by the mesiobuccal cusp, mesiolingual cusp, and the mesial marginal ridge that connects them. The mesial root is the broadest buccolingually of any of the lower molar roots. The distal surface of the crown is narrower buccolingually than the mesial surface. Three cusps are seen from the distal aspect: the distobuccal cusp, the distal cusp, and the distolingual cusp. Occlusal: This tooth presents a pentagonal 'home plate' occlusal outline that is distinctive for this tooth. There are five cusps. Of them, the mesiobuccal cusp is the largest, the distal cusp is the smallest. The two buccal grooves and the single lingual groove form the "Y5" patern distinctive for this tooth. Department of pedodontics and preventive"Y5" The five cusp and 11/08/06 dentistry pattern is important in dental anthropology.
TOOTH ERUPTION
The word eruption properly refers to the cutting of the tooth through the gum,it is generally understood to mean the axial or occlusal movement of the tooth from its developmental position within in the jaw to its functional position in the occlusal plane.
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However eruption is only part of the total pattern of physiologic tooth movement. Physiologic tooth movement is descried as consisting of the following. 1.PREERUPTIVE TOOTH MOVEMENT When deciduous tooth germs first differentiate ,they are very small and good deal of space is between them.This space is soon used because of the rapid growth of the tooth germs and crowding result,especially in the incisor and canine region. Permanent teeth with deciduous also move before they reach the position from which they will erupt.
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The permanent molars,which have no deciduous predecessors also exhibit movement. For eg.The upper permanent molars,which develop in the tuberosity of the maxilla /,at first have their occlusal surfaces distally and swing around only when the maxilla has grown sufficiently to provide the necessary SPACE.
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3.POST ERUPTIVE TOOTH MOVEMENTmovement that maintains 1)The position of the erupted tooth while the jaw continues to grow . 2)Compensate for occlusal and proximal wear. It involves both the tooth &its socket & ceases when jaw growth is completed .
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events occur that are associated with eruptive tooth movement.They include the formation of roots,the periodontal ligament,and the dentogingival junction. Bone removal is necessary for permanent teeth to erupt.In the case of those teeth with deciduous predecessors there is an additional anatomic feature,the Gubernacular canal and its content,the Gubernacular cord,which may have an influence on tooth movement. After removal of any overlying bone there is loss of the intervening soft connective tissue between the reduced enamel epithelium covering the crown of the tooth and the overlying oral epithelium. 11/08/06 Department of pedodontics
and preventive dentistry
Gubernacular canal and its contents in histologic section. The canal is filled with connective tissue that connects the dental follicle to the oral epithelium. Strands of epithelial cells (arrowheads), remnants of the dental lamina, are often present.
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Erupting molar. Both the reduced dental epithelium, overlying the enamel space in this demineralized section, and the oral epithelium have begun to proliferate into the intervening connective tissue as it breaks down.
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Erupting molar. Fusion of the reduced dental epithelium and the oral epithelium has occurred to form the Department of pedodontics and beginning of an epithelial-lined canal.
preventive dentistry
3.Post eruptive phase- The principal movement is in an axial direction. Movements are also made to compensate for occlusal and proximal wear of the tooth.It is generally assumed that the continous deposition of cement around the apices of the roots of the teeth is sufficient to compensate the occlusal wear. Wear also takes place at the contact points between teeth and to maintain tooth contact mesial or proximal drift takes place. Histologically,this drift is seen as a selective deposition and resorption of bone on the socket walls by osteoblast and osteoclasts 11/08/06 Department of pedodontics and respectively. preventive dentistry
Vascular Pressure It is known that teeth move in synchrony with the arterial pulse, so local volume changes can procedure limited both movement. Periodontal Ligament Traction There is a good deal of evidence that the eruptive force resides in the dental follicle periodontal ligament complex. Tissue culture experiment have shown that ligament fibroblast are able to contract a collagen gel, which in turn brings about movement of a disk of root tissue attached to that gel.
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Pattern of Shedding It is the progressive reserption of the roots of the teeth & their supporting tissue,the periodontal ligament. In general, the pressure generated by the growing & erupting permanent tooth dictates the pattern of deciduous tooth resorption because of the developmental position of the permanent incisor and canine tooth germs and their subsequent physiologic movement in an occlusal and resorption of the roots of the deciduous incisors and canines begins on their lingual surfaces. Later these tooth germs occupy a position directly apical to the deciduous teeth, which permits them to erupt in the position formly occupied by deciduous molars after first begins on their inner surface because the early developing bicuspids are found between them. The areas of early resorption are repaired by the deposition of a cementum like tissue. 11/08/06
Department of pedodontics and preventive dentistry
Roots of a primary molar completely resorbed. Dentin is in contact with the premolar enamel. 11/08/06
Exfoliated deciduous molar. The roots have been lost completely, and the enamel has eroded.
Histology of Shedding The cell responsible for the removal of dental hard tissues are identical to osteoclasts are highly specialised cells responsible for the removal of bone, and are called odontoclast their cytoplasm is vacuolated and the surface of the cell adjacent to the resorbing hard tissue forms a ruffled border. Peripheral to the ruffled border is a clear zone. The clear zone represent the attachment apparatus of the odontoclast. Odontoclast are able to resorb all the dental hard tissues including enamels. When dentine is being resorbed , the presence of the tubules provides a pathway for the easy extension of odontoclast process.
11/08/06 Department of pedodontics and preventive dentistry
Light microscopic appearance of the Fine structure of the odontoclast. This cell is odontoclast. The odontoclast exactly resembles the osteoclast. Its large size, resorbing dentin, and sends extensions multinucleate appearance, and ruffled (arrows) into the dentinal tubules. The ruffled or brush border can be seen, as can the border are visible. multinucleated character of the cell. 11/08/06 Department of pedodontics and preventive dentistry
Odontoclast are most commanly found on surfaces of the roots in relation to the advancing permanent tooth they have also been described root canals and pulp chambers of resorbing teeth lying against the predentin surface. Single rooted teeth are usually shed before root resorption is complete, therefore odontoclast are not found within the pulp chambers of these teeth. In molars the roots are usually completely resorbed and the crown is also partially resorbed, before exfoliation when this happens the odontoclasts layer is replaced by odontoblasts which resorb both primary & secondary dentin. The process of tooth resorption is not continuous since there are periods of rest & repairs.
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The forces of mastication applied to the deciduous tooth are also capable of initiating the resorption. As an individual grows, the muscles of mastication increase in size and exert forces on the deciduous tooth greater than its periodontal ligament can withstand. This leads to the trauma to the ligament and the initiation of resorption.
Electron micrograph of a periodontal ligament fibroblast in an area preceding the root resorption front. Its cytoplasm is filled Photomicrograph showing the abrupt loss of 11/08/06 Department of pedodontics and preventive with collagen (arrowheads) suggesting an interference with the periodontal ligament in a shedding tooth. dentistry synthetic and/or degradative cell physiology. protein
As resorption of the roots initiated by pressure of the underlying tooth occurs, there is progressive loss of surface area for attachment of PDL fibres bundles. This weakening of tooth support occurs because it has to withstand increasingly greater occlusal forces generated by the growing muscles of mastication.
Histology of root resorption. Tooth resorption is occurring at the apex of the root, and as a consequence changes are seen in the periodontal ligament (PDL) as this structure becomes less able to cope with the forces applied to it. The downward and oblique orientation of the ligament fibers is progressively lost (below arrowhead), and local pockets of cementum resorption occur (arrows).
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REFERENCE:WHEELERS Dental Anatomy ,Physiology & Occlusion By:-Major M. Ash,Stanley J. Nelson Dentistry for the child &Adolescent By:-Ralph E. Mcdonald,David R. Avery Dental Anatomy By:-Bhalaji Text Book Of Oral Histology & Embryology By:- Orbans Text Book Of Oral Histology By:- Dr.SATISH CHANDRA. Text Book Of Oral Histology By:- A. R TENKATE.
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