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   Table of Contents - Current issue
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April-June 2021
Volume 21 | Issue 2
Page Nos. 107-214

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EDITORIAL  

Preceptions in the principles and designing of smile Highly accessed article p. 107
N Gopi Chander
DOI:10.4103/jips.jips_87_21  PMID:33938859
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REVIEWS Top

Effect of complete dentures on oral stereognostic ability in edentulous patients: A systematic review p. 109
Bappaditya Bhattacharjee, Ritu Saneja, Atul Bhatnagar
DOI:10.4103/jips.jips_401_20  PMID:33938860
Aim: Oral stereognosis is an important sensation for a human being to percept any type of materials that are introduced in the oral cavity. It is defined as the ability of an individual to recognize objects using only tactile sensation without using vision, audition, balance, somatic function, taste, or smell. The primary purpose of this review was to evaluate the effect of complete dentures on oral stereognostic ability in edentulous subjects. Settings and Design: Systematic review based on PRISMA guidelines. Materials and Methods: A systematic search of the electronic databases like PubMed and Web of Science was done using keywords – “stereognosis,” “oral stereognosis,” “complete denture,” and “complete edentulism.” In addition to this, a manual search of references mentioned in the articles and gray literature was done. Data extraction and assessment were done by two independent reviewers. Statistical Analysis Used: Qualitative analysis. Results: The literature search yielded a total of 61 articles. Thirteen duplicate articles were removed and 36 articles were rejected after initial screening of titles and abstracts. A total of 12 articles were selected for full text reading and 5 of them were included for qualitative analysis. Conclusion: All the included studies showed complete denture treatment therapy improved stereognostic ability in terms of correct identification of test pieces and time taken to identify the objects. There is also a direct relationship between the adaptability of dentures and stereognostic ability.
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Association of interleukin-1 gene polymorphism and early crestal bone loss around submerged dental implants: A systematic review and meta-analysis p. 116
Kaushal Kishor Agrawal, Mohd Anwar, Charu Gupta, Pooran Chand, Saumyendra Vikram Singh
DOI:10.4103/jips.jips_511_20  PMID:33938861
Aim: Early crestal bone loss (ECBL) has been observed regardless of the absence of possible etiologic factors for bone loss during the healing phase and before the second-stage implant surgery. The purpose of this systematic review and meta-analysis was to correlate the possible association of interleukin-1 (IL-1) gene polymorphisms and ECBL (bone loss before the second-stage surgery) around dental implants. Settings and Design: Systematic review and meta-analysis following PRISMA guidelines. Materials and Methods: Considering the inclusion criteria, an electronic search by using specific keywords of three databases PubMed [(“Dental” OR “oral”) AND (“Implants*”) AND (“gene polymorphism” OR “genotype” AND (“IL-1” OR “interleukins”)], Cochrane library [implant AND (biomarker or cytokine), interleukin-1 or IL-1 AND implants], and EMBASE [(“gene polymorphisms”/de OR “interleukins”/cytokine exp OR “biomarker”:ti,ab,kw) AND (“dental implantation”/de OR “oral implant”)] and manual search from 1995 till March 2020 was made by 2 independently calibrated reviewers. ACROBAT-NRSI, Version 1.0.0 and Review Manager, Version 5.3, computer software were used for the risk of bias assessment and to conduct the meta-analysis respectively. Statistical Analysis Used: Cochran's Q test and I2 statistics. Results: Of 38 articles which were found eligible for full-text screening, two articles fulfilled the inclusion criteria and hence were included in the meta-analysis. The I2 statistic and Q-test values of the included studies revealed acceptable homogeneity for studied three IL-1 gene polymorphisms (IL-1A−889: I2 = 0%, IL-1B − 511: I2 = 0%, IL-1B+3954: I2 = 24%). Forest plot of association between IL-1B−511 gene and ECBL revealed a significant association between 2/2 genotype of IL-1B−511 gene and an increased risk of ECBL (OR = 0.23, 95% CI = 0.09–0.58, Pheterogeneity = 0.68, I2 = 0%, and P = 0.002). Results of the IL-1A−889 and IL-1B+3954 gene revealed no significant associations between any genotype of these genes with risk of ECBL. Conclusions: There is an evidence of the association of IL-1B−511 (2/2) genetic polymorphisms and increased ECBL in the individuals of Asian ethnicity (OR = 0.23, P = 0.002).
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Effect of laser irradiation on bond strength between zirconia and resin cement or veneer ceramic: A systematic review and meta-analysis p. 125
Sandro Basso Bitencourt, Letícia Chaves Ferreira, Leticia Cerri Mazza, Daniela Micheline dos Santos, Aldieris Alves Pesqueira, Leticia Helena Theodoro
DOI:10.4103/jips.jips_590_20  PMID:33938862
Aim: This systematic review with meta-analysis aimed to evaluate the effect of the laser treatment on bond strength between Y-TZP and the resin cement or with the veneering ceramic, and the effect on the alteration of the Y-TZP surface roughness. Settings and Design: Systematic review and meta analysis following PROSPERO guidelines. Materials and Methods: A comprehensive review was performed up to September 2020 on four databases (PubMed/MEDLINE, Embase, Scopus, and Cochrane Library), using the combination of keywords: “laser AND zirconia AND surface treatment AND bond strength”. Statistical Analysis Used: The meta-analysis was based on the Mantel–Haenszel and inverse variance methods. The continuous outcome was evaluated by mean difference and the corresponding 95% confidence intervals. Results: A total of 37 studies were identified for the inclusion of data, with only in vitro studies. The types of laser reported in the studies were: Er:YAG, Nd:YAG, Er,Cr:YSGG, CO2, Femtosecond, and Yb lasers. A random-effect model found statistically significant differences between lasers and control groups of Y-TZP (P < 0.00001; MD: 3.08; 95% CI: 2.58 to 3.58). Only the bond strength with the Er:YAG laser did not present statistical difference (P = 0.51; MD: 0.22; 95% CI: −0.44–0.88). In another analysis, a random-effect model found a statistically significant difference between the laser and control groups on surface roughness (P < 0.00001; MD: 0.96; 95% CI: 0.86 to 1.06). Conclusions: Laser irradiation is capable to improve the Y-TZP surface roughness and the bond strength of zirconia with resin cement and veneering ceramics. However, there is a lack of laser protocol for the zirconia surface, a fact that makes a simple and direct comparison difficult.
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The color stability of maxillofacial silicones: A systematic review and meta analysis p. 138
Priya Gupta, Saee Deshpande, Usha Radke, Suresh Ughade, Rajesh Sethuraman
DOI:10.4103/jips.jips_253_19  PMID:33938863
Aim: This systematic review aims to identify and interpret results of studies that evaluated the changes in the color stability of maxillofacial prosthetic materials due to chemical instability of silicones and pigments and the effect of exposure to environmental conditions and aging factors on the same. Settings and Design: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA). Materials and Methods: Relevant articles written in English only, before November 15, 2019, were identified using an electronic search in the PubMed/Medline conducted to identify pertinent articles. The relevancy of the articles was verified by screening the title, abstract, and full text, if they met the inclusion criteria. A total of 42 articles satisfied the criteria, from which data were extracted for qualitative synthesis. This review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number CRD42019124562). Statistical Analysis Used: Since considerable data heterogenicity was present in all studies except the ones on incorporation of TiO2 for which meta-analysis using random effects model was performed. Results: The database search resulted in 234 studies, of which 202 articles were excluded due to lack of relevance, duplication, and unavailability of data. The remaining 32 fulltext articles were assessed for eligibility, out of which 2 articles were excluded. Twelve articles were yielded by manual search. A total of 42 studies were included in the present systematic review. Due to heterogeneous data, meta-analysis could be only carried out with the effect of TiO2 nano particle on color stability. Conclusions: Although there has been extensive amount of research in this field, an ideal maxillofacial silicone exhibiting good color stability in various human and environmental aging conditions is yet to be identified. Human and environmental aging conditions have an adverse effect on the color stability and addition of TiO2 nano particle seems to improve the same.
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ORIGINAL ARTICLES Top

A 3-year prospective cohort study on mandibular anterior cantilever restorations associated with screw-retained implant-supported prosthesis: An in vivo study p. 150
Vizaikumar Vasudha Nelluri, Kandathilparambil Maria Roseme, Rajani Kumar Gedela
DOI:10.4103/jips.jips_446_20  PMID:33938864
Aim: The aim of this study is to evaluate the survival of single implant supported cantilever prosthesis (ISCP) replacing missing two adjacent natural teeth in the anterior mandible. Settings and Design: In vivo - Prospective cohort study. Materials and Methods: Thirty patients with missing both mandibular central incisors were selected. A single implant was used to replace the missing teeth and restored with cantilever screw-retained prosthesis. Twenty-two patients were followed for 3 years for the implant and prosthetic success. Statistical Analysis Used: Weibull test for survival probability. Results: Survival probability of the ISCP for the first 100 days was found to be 97.55%, for 200 days, it was 71.4%, for 250 days, it was 46%, and for 365 days, it was 3.9%, i.e., 20 prosthesis had screw loosening after prosthetic loading. However, it increased to 95.2% at the end of 3 years. Conclusion: Screw-retained ISCP developed early technical complications. After prosthetic loading, the survival probability of the screw-retained ISCP was very low (3.9%) at one year, which increased to 95.2% after retightening and retorquing of the abutment screw, porcelain repair and conformation of the tongue to the prosthesis. The most common prosthetic failure was screw loosening (81%), followed by porcelain fracture (14.3%), and implant survival of 95% at the end of three years.
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Comparative evaluation of color stability of three commercially available provisional restorative materials: An in vitro study p. 161
Cora Abigail Coutinho, Divya Hegde, Vinita Sanjeevan, Ivy Fernandes Coutinho, Akansha Priya
DOI:10.4103/jips.jips_622_20  PMID:33938865
Aim: Esthetics of the provisional restorations is of prime importance to the patients especially in long term in the esthetic zone. Discolouration of these restorations may result in patient dissatisfaction and an additional expense for their replacement. LuxaCrown provisional material being new in market and claimed to be semi-permanent by the company needs to be evaluated for its colour stability. This in vitro study was aimed to evaluate and compare the colour stability of three provisional restorations using three pigmented solutions. Setting and Design: In vitro - comparative study. Materials and Methods: LuxaCrown, Protemp4, Heat cure PMMA were evaluated. 40 specimens of each material were divided into four groups of ten specimens each. Each group was stored in three staining solutions and artificial saliva. Colour values of each specimen were measured before immersion, after one day, one week, one month, three months and six months with a spectrophotometer. Stastistical Analysis Used: One way ANOVA, Post Hoc Tukey Test, Bonferonni Test. Results: Least colour change was seen in Heat Cure PMMA followed by Protemp4 and highest colour change was seen in LuxaCrown when immersed in artificial saliva, tea and coffee. Whereas in turmeric, Heat Cure PMMA showed the least colour change followed by LuxaCrown and highest colour change was seen in Protemp4 at all time intervals except day one, where LuxaCrown was higher than Protemp4. Conclusion: Heat cure showed the best results as compared to Protemp4 and LuxaCrown in terms of colour stability at all time periods.
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Anti candidal efficacy of commercially available triphala, neem, denture cleanser and natural aloevera leaf on heat polymerized acrylic resin p. 167
Polysmita Ojah, Chetan Luniyal, Chandana Nair, Madhusudan Astekar, Ankita Pal, Megha Chopra
DOI:10.4103/jips.jips_599_20  PMID:33938866
Aim: The aim of the study was to evaluate the anticandidal efficacy of Triphala, aloe vera, Neem, and denture cleanser on heat polymerized acrylic resin. Settings and Designs: In vitro - experimental study. Materials and Methods: In this study, forty denture wearer patients were selected and were divided into four groups consisting of ten patients, namely, Group I, Group II, Group III, and Group IV, in which dentures were cleansed with denture cleanser (tablets), Triphala (churna), aloe vera (leaf), and Neem (tablets), respectively, and stored in copper containers. Swabs were collected from the dentures before and after the use of Denture cleanser, Triphala, aloe vera, and Neem. Thereafter, the swabs were cultured on Sabouraud dextrose agar and the total Candida counts (CFU/4 cm2) were determined. Statistical Analysis Used: One way ANOVA and Tukeys HSD post hoc test were used. Results: The pre- to post-reduction in mean Candida count was found highest in Denture cleanser followed by Neem, Triphala, and aloe vera. Further, both Denture cleaner and Neem showed statistically significant reduction (P < 0.001) in the mean Candida count when compared to Triphala and aloe vera. However, reduction in the mean Candida count of both Denture cleanser and Neem was found statistically similar (P > 0.05). Conclusion: The anticandidal efficacy of denture cleanser was found to be the highest. The cost-effective Neem can be used as anticandidal modality in place of denture cleanser.
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A comparative study on the effect of polishing systems on the color and surface texture of different porcelain systems - feldspathic, pressable, and computer-aided design/computer-aided manufacturing p. 173
Preeti Kalia, K Chandrasekharan Nair, Deepesh Jaiswal, Chetna Tikmani, Dhrubojyoti Banerjee, Ritwika Bera
DOI:10.4103/jips.jips_425_20  PMID:33938867
Aim: To find and compare the qualitative and quantitative change in color and surface texture of feldspathic ceramic, pressable ceramic and ceramic used in computer-aided design/computer-aided manufacturing CAD/CAM after different surface treatments namely glazing, abrading and polishing. To compare the effectiveness of pearl finish polishing paste and Soflex polishing system used in the study. Setting and Design: In-vitro, comparative study. Materials and Methods: Disc-shaped feldsapathic, pressable, CAD/CAM ceramic specimens were fabricated. Surface roughness and color parameters Δ L*, Δa*, and Δ b* were measured before glazing, after glazing, after abrasion with 02 diamond bur and after polishing with two different polishing systems. Surface roughness was measured qualitatively using scanning electron microscopy and quantitatively using an optical profilometer. The value of color parameters was obtained using a colorimeter. Data were statistically analyzed with ANOVA. Statistical Analysis Used: SPSS software 20.0 version (IBM, New York, United states of America). Results: Unglazed feldspathic, pressable and CAD/CAM porcelain specimens showed a mean surface roughness value of 2.73 ± 0.38, 3.54 ± 1.42, and 3 ± 1.74 specimens. After glazing and polishing, the surface roughness values decreased. After abrasion, surface roughness values increased. Polishing did not alter the color along the red green axis and yellow blue axis. Conclusions: Abraded specimens of feldspathic, pressable and CAD/CAM after polishing using pearl finish polishing paste and Soflex disc became smoother than glazed specimens. When pearl finish polishing paste and Soflex discs were compared for their effectiveness the former appeared to be more superior but not to a significant level. Mechanically altering feldspathic, pressable, and porcelain used in CAD/CAM technology does not cause any change in shade.
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Resistance of a novel denture identification system to various assault: An in-vitro study p. 180
Vishwas Narang, Harinder Kuckreja, Naveen Oberoi, Jaswinder Kaur, Navneet Kaur Birdi, Santosh Mahajan
DOI:10.4103/jips.jips_24_21  PMID:33938868
Aim: Denture marking has been advocated and recommended by many forensic organizations. The prosthodontists can play a significant role in the identification of geriatric population by adopting denture marking as a routine procedure. These stickers are easily readable and can be connected to smartphone devices without the need of specific equipment, store information in variety of ways, and cost-effective.The purpose of this study is to evaluate NFC stickers against physical insult; acid, base, and heat. Settings and Design: In-vitro evaluation study. Materials and Methods: Denture bases were fabricated, using chemical and heat-cured acrylic resin. NFC stickers were incorporated using postfabrication inclusion method for chemically cured resin base and prefabrication inclusion method for heat-cured acrylic resin base. These bases were subjected to acid, alkali, and thermal insults. Statistical Analysis Used: Descriptive statistics. Results: Both pre and postfabrication inclusion NFC stickers were capable of withstanding various chemical and thermal assaults. Conclusion: NFC stickers could be used as an adjunct to radio frequency identification (RFID) tags for denture identification. NFC stickers appear to be easy to use and more cost-effective than RFID tags.
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Effect of freshly placed core buildup composites on setting of silicon impression materials p. 186
Mohammad A Al-Rabab'ah, Muhanad M Hatamleh, Sandra Al-Tarawneh, Ahmad El-Ma'aita, Ibrahim Abu Tahun, Issam S Jalham
DOI:10.4103/jips.jips_606_20  PMID:33938869
Aim: The aim is to study the effect of freshly placed composite build-ups on setting of additional silicone impression materials. Settings and Design: In vitro - experimental study. Materials and Methods: Three composite materials; Build-It™ F. R™, Filtek™ Bulk Fill flow and Filtek™ Z350 and three light-bodied additional silicone impression materials; Elite HD+, Aquasil LV Ultra and Express™ were used. Cylindrical-shaped specimens were made of each material (diameter 15 mm and height 10 mm). The silicone specimens were brought into contact with the composite specimens, which were either freshly cured (9 groups, n = 90) or cured and then stored in normal saline for 1 week (9 groups, n = 90). Shore A hardness (SAH) scores of silicone surfaces were recorded following the ASTM D2240-5 standards for shore A Durometer testing. Six measurements were made per each silicone surface and medians were calculated. Kruskal–Wallis and Mann–Whitney tests (SPSS v20) were used to check statistical significant differences between all groups and paired comparisons, respectively (P < 0.05). Statistical Analysis Used: Kruskal-Wallis and Mann-Whitney tests. Results: The SAH scores of additional silicones in direct contact with freshly placed composites were significantly less than SAH scores of additional silicones in direct contact with composites specimens aged for 1 week in 7 out of 9 combinations (P < 0.05). Only when Express™ and Elite HD+ were applied over freshly placed Filtek™ Bulk Fill flow, the SAH scores difference was not statistically significant to SAH scores of matching combinations applied after 1 week of composite storage. Conclusions: Freshly placed composite might affect setting of additional silicone impression materials. Dentists should carefully assess final impression on areas of prepared teeth that have received composite fillings recently.
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The marginal and internal discrepancy of zirconia coping milled by two computer-aided design–computer-aided manufacturing systems p. 192
Somchai Urapepon
DOI:10.4103/jips.jips_30_21  PMID:33938870
Aims: This study aimed to evaluate the marginal and internal discrepancy of the zirconia coping fabricated by two dental computer-aided design–computer-aided manufacturing (CAD-CAM) systems. Settings and Design: In vitro comparative study. Materials and Methods: Twenty zirconia crowns fabricated from inCoris ZI by Cerec InLab CAD-CAM system (Dentsply Sirona Inc, USA) and Ceramill ZI by Ceramill CAD-CAM system (Amann Girrbach, Austria) were measured the discrepancy at six locations using silicone replica technique. Absolute marginal discrepancy (AMD) and marginal gap (MG) represent the marginal discrepancy, and the other four locations at chamfer area, axial wall, cusp tip, and occlusal adaptation represent the internal discrepancy. The gap was measured using an optical light microscope at ×50 magnification. Statistical Analysis Used: The data were analyzed using two-way ANOVA and Game–Howell post hoc test. Results: The statistical analysis showed that the accuracy of zirconia coping depends on CAD-CAM system and the location of measurement. Cerec InLab showed the marginal discrepancy of the coping 119.5 ± 44.8 μm at MG position and 125.3 ± 36.6 μm at AMD position, which was statistically larger than Ceramill system did at 53.0 ± 12.1 μm and 67.2 ± 19.1 μm. On the other hand, the discrepancy in other positions showed no statistical difference between the two CAD-CAM systems. Conclusions: The accuracy of zirconia coping was significant affected by CAD-CAM system and the location of measurement.
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Comparison of cooling methods on denture base adaptation of rapid heat-cured acrylic using a three-dimensional superimposition technique p. 198
Lee Wei May, Jacob John, Lim Ghee Seong, Zubaidah Zanul Abidin, Norliza Ibrahim, Mahmoud Danaee, Noorhayati Raja Mohd
DOI:10.4103/jips.jips_41_21  PMID:33938871
Aim: To investigate the effect of different cooling methods on denture base adaptation of rapid heat-cured acrylic resin using 3D superimposition technique. Setting and Design: In vitro - Comparative study. Materials and Methods: Denture base adaptation of two different rapid heat-cured polymethyl methacrylate acrylic resins using five different cooling methods were compared. Forty maxillary edentulous stone cast were prepared to produce the denture bases with standardized thickness. The specimens were divided into five groups (n = 8) according to type of materials and cooling methods. The master stone cast and all forty denture bases were scanned with 3Shape E1 laboratory scanner. The scanned images of each of the denture bases were superimposed over the scanned image of the master cast using Materialize 3-matic software. Three dimensional differences between the two surfaces were calculated and color surface maps were generated for visual qualitative assessment. Statistical Analysis Used: Generalized Linear Model Test, Bonferroni Post Hoc Analysis. Results: All bench-cooled specimens showed wide green-colored area in the overall palatal surface, while the rapid cooled specimens presented with increased red color areas especially at the palate and post dam area. Generalized Linear Model test followed by Bonferroni post hoc analysis showed significant difference in the root mean square values among the specimen groups. Conclusion: Samples that were bench cooled, demonstrated better overall accuracy compared to the rapid cooling groups. Regardless of need for shorter denture processing time, bench cooling of rapid heat-cured PMMA is essential for acceptable denture base adaptation.
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CASE REPORT Top

Oral rehabilitation of a patient with Kenny–Caffey syndrome using telescopic overdenture p. 204
Abu Nazar, Roshy George, Nicholas Mathew
DOI:10.4103/jips.jips_31_21  PMID:33938872
Kenny–Caffey syndrome (KCS) is a rarely reported autosomal disorder characterized by skeletal, ocular, and oral manifestations. Oral features such as microdontia, hypodontia, malalignment of teeth, bone loss, and difficulty in mastication results in serious esthetic and functional handicap. The prosthetic rehabilitation of such patients is challenging, especially when implant placement is not a good choice due to poor Vitamin D levels. The existing literature is scarce in describing the treatment options. This case report describes the oral rehabilitation of a patient affected with KCS using telescopic overdenture.
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CLINICAL SERIES Top

Mandibular guidance prosthesis: Conventional and innovative approach: A case series p. 208
Ranjoy Hazra, Ayush Srivastava, Dinesh Kumar
DOI:10.4103/jips.jips_12_21  PMID:33938873
Surgical resection of the lower jaw due to the presence of a benign or malignant tumor is the most frequent cause of mandibular deviation. Location and extent of the tumor decide the surgical modality of mandibulectomy to be performed. The clinician must wait for an adequate span of time for completion of the healing and acceptance of the osseous graft before considering a definitive prosthesis. During the inceptive healing period, prosthodontic intervention is of utmost priority for preventing the mandibular deviation. A corrective appliance termed “guide flange prosthesis (GFP)” is indicated to limit this clinical manifestation. The basic intention of rehabilitation is to train the mandibular muscles and to re-establish an acceptable occlusal relationship so that the patient can adequately control the opening and closing movements. This case series describes early prosthodontic management of three patients who had undergone hemimandibulectomy, with different techniques of fabrication of a GFP. The three techniques described consist of two conventional methods of fabrication while the third technique is a new innovative approach.
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