The most common and best-known exostoses of the jaws are the torus mandibularis and torus palatinus, which are discussed later in this chapter. It is seen very rarely among Caucasian groups. Oral tori is a commonly seen oral condition affecting the population. Canalplasty has significant advantages over commonly employed transmeatal approaches by maximizing conservation of canal skin and providing surgical access to the anterior medial zone of the canal. 75.14), solitary or multiple, as seen in the autosomal dominant condition multiple hereditary exostoses (MHEs). Biomedica. Fluoroscopy was used to confirm adequate resection. This site needs JavaScript to work properly. Prevalence of exostoses Etiology is still not established, but it has been suggested that the bony overgrowth can be because of abnormally increased masticatory forces to the teeth. Numbness or sensation changes. A review of the gross anatomy, functions, pathology, and clinical uses of the buccal fat pad. Some of the postulated causes include genetic factors,[4,5,6,7] environmental factors,[8,9,10] masticatory hyperfunction,[10,11,12,13,14] and continued growth. In the mandible, the origin of tori is from the inner aspect of the alveolar bone of the mandible above the origin of the mylohyoid muscle. WebTori and exostoses have been associated with parafunctional occlusal habits, temporomandibular joint (TMJ) disorders, migraine and consumption of fish. You may consider having this procedure if you: You may not be a good candidate for buccal fat removal if your face is narrow or if youre over a certain age, as buccal fat naturally diminishes with age. WebBuccal exostoses are typically found on the buccal surface of the maxillary or mandibular alveolar ridge adjacent to premolar teeth. Are otherwise healthy and have a stable weight. WebSome risks associated with buccal fat removal surgery are: Infection at the incision site. Gradually, you can add soft foods to your diet as your provider says its OK. The Placeks Classification of Labial Frenal Attachments (Devishree et. HHS Vulnerability Disclosure, Help buccal exostoses Discussion Exostoses are protuberances of bone that arise from the cortical plates in the maxilla and mandible. 1995 Dec;61(12):1057-8, 1063-6. Andreas Adam CBE, MB, BS(Hons), PhD, PhD (hon caus), DSc (hon caus), FRCP, FRCR, FRCS, FFRRCSI(Hon), FRANZCR(Hon), FACR(Hon), FMedSci, in Grainger & Allison's Diagnostic Radiology, 2021. Disclaimer. Aggressive gutter clean-out has been recommended as critical in reducing postoperative pain and gaining adequate postoperative motion. The mandibular tori are further known to grow due to torsional stress (more in the area of the canine tooth) created by heavy mastication (chewing). For example -when the tori in the mouth are covered by soft tissue due to long-standing presence in the jaw with constant friction, then the overlying oral mucosa tends to get ulcerated. Though not described in dental literature, medical cases where a patients airway management may be difficult, especially in emergencies, is also another concern of dental tori. Most patients with tori have parafunctional habits and also suffer from migraine according to the research. Unauthorized use of these marks is strictly prohibited. If it's deemed necessary, how is a buccal exostosis removed? They can provide recommendations tailored to your specific goals and discuss any risks for the procedure. 1998 May;85(5):552-7. doi: 10.1016/s1079-2104(98)90290-6. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Exostoses are benign protuberances of bone that may arise on the cortical surface of the jaws (eFigure 2-16). The tori remain harmless and do not require dental management only so long as they do not cause these below explained issues. The https:// ensures that you are connecting to the Advertising on our site helps support our mission. Growths in the mouth that are cancer tend to bleed easily when accidentally scraped while brushing teeth or eating certain foods. The decision to have plastic surgery is a personal one. MeSH We use cookies to help provide and enhance our service and tailor content and ads. In the middle ear, they can give rise to conductive hearing loss caused by impingement on the ossicles. On MRI T2 weighted sequences the hyaline cartilage appears hyperintense with a good visualisation of its structural layers. Sickle Cell Disease - Screening and Marital Decisions. Associations between mandibular torus and types of temporomandibular disorders, and the clinical usefulness of temporary splint for checking bruxism. Joseph B. It has an irregular shape and is flat. It's nothing more than a protrusion of bone in a roughly circular shape, which can develop on the upper or lower jaw bone. The .gov means its official. Federal government websites often end in .gov or .mil. It is likely that no single factor is responsible and that the cause of impingement is multifactorial. Chandna S, Sachdeva S, Kochar D, Kapil H. J Indian Soc Periodontol. Buccal fat pad removal to improve facial aesthetics: an established technique? Unable to load your collection due to an error, Unable to load your delegates due to an error. Your healthcare provider will discuss with you any risks so you can make an informed decision. Overgrowth of bone around the medial and lateral margins of the prosthesis (gutter impingement) is being more commonly recognized as a cause of pain after TAA (Fig. MRI demonstrates the thickness of the cartilaginous cap of the tumour. Such lesions are more common in males and may be unilateral or bilateral. Its important to follow your providers after-care instructions, including any follow-up appointments. 2019 Jul;37(4):246-253. doi: 10.1080/08869634.2017.1418617. The goal of my website is to educate other people about the importance of working with their dentist to take care of serious problems. WebExostosis or hyperostoses are localized cortical bone growth on the mandible and maxilla. 2011 Jul;2(3):237-9. doi: 10.4103/0976-237X.86476. 1993;15(2):113-8. doi: 10.1007/BF01628309. Pynn BR, Kurys-Kos NS, Walker DA, Mayhall JT. Pathologically, whether it is maxillary or mandibular tori, they are considered slow-growing, harmless and non-invasive. We discuss here a very rare case of a 49-year-old male, in which the buccal exostoses The exact cause of impingement has not been clearly defined, but several inciting factors have been suggested: prosthesis design, oversized tibial and talar components, undersized talar components, uncontrolled varus or valgus thrust, component loosening, residual gutter debris, undersized polyethylene thickness, and talar subsidence. Everyone has buccal fat, but some people have more than others. government site. 8600 Rockville Pike Policy. The cause of tori are not exactly traced or established, but research indicates that a genetic component may be likely. To conclude, though developing tori may seem alarming and create anxiety in the patient, they are harmless to the maximum extent. hbbd```b``"WH<0Dr-D"l5@$[ official website and that any information you provide is encrypted However, some abnormalities, such as torus mandibularis and buccal A very common cause of exostoses mouth is a bad bite, also known as malocclusion. Any signs of infection, like if your skin is hot to the touch, is red or pus-filled and you have a fever. Some people may feel the roundness in their cheeks creates a fullness to their face they dont like. An exostosis is a nodular protuberance of dense cortical bone. Bethesda, MD 20894, Web Policies However, what a lot of folks don't realize is that nice teeth aren't an accident. (https://www.merckmanuals.com/home/news/external/2021/02/01/16/37/fat-loss-in-face-does-make-folks-look-older-study). Medsinge SV, Kohad R, Budhiraja H, Singh A, Gurha S, Sharma A. The intact exostosis is a broad-based, moundlike, bony proliferation that is similar in color and texture to normal cortical bone. Whats the recovery time after this procedure? Many patients with buccal or palatal exostoses also have palatal and/or mandibular tori. Buccal fat removal surgery is a type of plastic surgery. Most patients with dental tori report bilateral or two-sided distribution or presence of these outgrowths, but it would be unilateral too. As cancers grow larger, dead cells within the tumor (necrotic cancer) lead to a bad smell from the mouth (halitosis). The tori instead become a fulcrum point that leads to improper rocking movements of the denture in the mouth. Any indicated surgery should be delayed until the subperiosteal bone becomes mature, usually 4 to 6 months after injury; at that time, recurrence is less likely. Healing time is usually about three weeks. Occasionally they become large enough to cause obstruction of the EAC with retention of debris. It is usually found along the alveoli or on the hard palate and depending on the location and extent; they can be classified as torus mandibularis (TM), torus palatinus (TP), buccal, or lingual maxillary exostosis. Adequate resection of preexisting osteophytes and removal of all bone fragments from the joint margins can help prevent this complication. Although it's an irregular growth, take comfort in the fact that a buccal exostosis is benign. Injury to facial nerves and/or salivary duct injury. Tori are harmless bony outgrowths in the oral cavity, but when they interfere with daily activities like talking, chewing, and wearing dentures, then dental management is strictly indicated. It can occur in other parts of the body like the ear, the heel of the foot, sometimes even under nail beds and in sinuses as well. For either dental implants or post-extraction of teeth-in order to fill certain bony defects and traumatic bone -it requires autografts (harvesting graft from the patients own body wherein the donor site is from the jaw or ileac crest or symphysis of jaw). What Causes Pain in the Corner of the Eye? Theyll also ask you general questions about your overall health, such as your family health history and any past surgeries youve had. Oral tori are bony overgrowth seen in the mouth. Tori most often do not require any form of surgical management, usually owing to the fact that it goes unnoticed in patients. Exostosis are benign bony protuberances with unknown etiology 1). Exostosis has accounted for 50 % of primary benign bone tumors and has been observed to occur at the metaphysis of long bones or originate from the surface of flat bones 2). The differential diagnosis of a slow-growing unilateral lesion would not be tori at all but rather serious conditions like osteochondroma, osteoblastoma or sarcoma, especially if it is invasive or causing pain and paresthesia. 6.3). Surgical removal of tori using the rotary handpiece and bur into multiple fragments for ease of removal and to prevent damage to underlying vessels. Disclaimer. endobj Eur J Oral Sci. Hereditary exostoses (EXT) is an autosomal dominant disorder that has been shown to be heterogenous on molecular grounds. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Saint Louis: The C.V. Mosby Company; 1974. 6.8). 2016 Jan;10(1):AJ01-2. Concurrence of TP, TM, and exostosis in the same individual is very rare. HHS Vulnerability Disclosure, Help 2015 May-Jun;19(3):352-5. doi: 10.4103/0972-124X.152412. Surgical excision provides the most acceptable long-term solution. PMC I have worked in dental offices for almost twenty years, and I can tell you firsthand that the people who have great teeth also take the time to get them taken care of by a professional. Laser therapy for the removal of tori is a completely safe and painless procedure. -4 min read. MRI makes little contribution apart from differentiating retroobstructive pathologic findings, such as cholesteatoma and/or inflammation.2. Osteomas may also arise in the middle ear and mastoid (Fig. The cause of exostoses is Concurrence of TP, TM, and exostosis in the same individual is very rare. See this image and copyright information in PMC. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). While the issue may have been diagnosed, what exactly is a buccal exostosis? Environmental stress one example of this is if the bone grows Surgical resection of dental tori are seldom recommended, but when they cause the above-enlisted problems or bleeding due to soft tissue outgrowths over the tori or oral health issues, then it needs to be removed by your dentist. WebPatients commonly seek medical care for abnormalities of the oral cavity that cause discomfort. Please enable it to take advantage of the complete set of features! If an exostosis is large enough, a relatively increased density of the bone might be noticed on radiographs. -. Buccal exostoses are significant with regards to prosthodontics because they may interfere with denture insertion. al): startxref Males are more likely to be affected than females. When recurrent external otitis or hearing impairment results, however, surgical removal is indicated. There are a variety of oral conditions that may 0 Federal government websites often end in .gov or .mil. The gross appearance of exostoses is usually better appreciated by the surgeon, because only fragments are available to the pathologist in most cases. Plain radiography is usually diagnostic. People with bruxism may have temporomandibular joint disorders or severe headaches due to the grinding of teeth. The periosteal layers are like the skin of an onion and usually lack trabecular architecture or marrow spaces. Management of oroantral communication using buccal advanced flap. WebMandibular exostosis is a type of bony prominence caused due to hyperostosis in the mandibular bone. This site needs JavaScript to work properly. Brad W. Neville DDS, Angela C. Chi DMD, in Color Atlas of Oral and Maxillofacial Diseases, 2019. A torus (plural: tori) is an exostosis that occurs in one of two locations intraorally. With any surgery, you must weigh the risks and the potential benefits of having the procedure. 1.1. BMC Oral Health. Persistent pain is also a worrying and more sinister feature, which should prompt investigation to exclude malignant degeneration. Genetics may play a Clipboard, Search History, and several other advanced features are temporarily unavailable. Youll be on a liquid diet for a day or two while your incisions start to heal. Keywords: Debridement was considered satisfactory when a 4.0-mm burr could be passed freely through the newly created corridor. Local pressure effects on adjacent structures, deformity and shortening may result, particularly in MHE. Tori are frequently misunderstood and associated with cancerous growths, but that is not true. sharing sensitive information, make sure youre on a federal 2013 Nov;26(8):944-52. doi: 10.1002/ca.22275. Finally, your provider will close the incisions with sutures. New growths in the mouth, whether observed suddenly or for a long time, always hence needs to be investigated by the dental surgeon. It is done under anesthesia and it is not painful. From: Diagnosis and Treatment Planning in Dentistry (Third Edition), 2017, Frederick M. Azar MD, in Campbell's Operative Orthopaedics, 2021. Do you have a portfolio of before-and-after photos of this type of surgery? Tori needs surgical intervention for removal. By continuing you agree to the use of cookies. See this image and copyright information in PMC. They are, in fact, benign growths or, in other words, merely a bony exostosis found in the jaw (upper or lower). It is important not to self-diagnose and visit your dentist to confirm that the outgrowths are tori and to make sure you have no potential serious issues associated with tori in the future. Ketika eksostosis ditutupi dengan tulang rawan, maka kondisi tersebut disebut dengan osteochondroma. If removable prostheses are planned, surgical removal may be required. Its also important to consider the possible benefits and risks of having plastic surgery. They described using an open approach through a linear vertical incision directly over the involved gutter, which was debrided of all osseous and soft-tissue debris with power or hand instruments. Radiographs that reveal negative results during the first few weeks after injury later reveal subperiosteal new bone located on the dorsum of the phalanx. They may give you a special mouth rinse to help with healing and prevent infection. This site needs JavaScript to work properly. HHS Vulnerability Disclosure, Help Rodrguez-Vzquez JF, Sakiyama K, Verdugo-Lpez S, Amano O, Murakami G, Abe S. Clin Anat. J Can Dent Assoc. 1998. Treatment is only recommended when the location of the growth can pose a few problems. Mandibular exostosis is a type of bony prominence caused due to hyperostosis in the mandibular bone. J Clin Diagn Res. Buccal-sided mandibular angle exostosis - A rare case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Morphological and clinical characteristics of the torus palatinus and torus mandibularis in a sample of young and adults' Romanian people. Most common types of intraoral osseous overgrowths are TP [Spontaneous exposition of a midline palatal torus]. Careers. David L. Rimoin, Sheila Unger, in Emery and Rimoin's Principles and Practice of Medical Genetics (Sixth Edition), 2013. Complications are infrequent, but attention to the anatomy of the chorda tympani and facial nerve pathways and careful drill technique in the area of the tympanic membrane are important. They begin to develop in early adulthood and may very slowly enlarge over the years. Buccal exostoses are benign, broad-based surface masses of the outer or facial aspect of the maxilla and less commonly, the mandible. 1999;107:913. But when the tori cause pain or loss of sensation in the affected area (paresthesia), then investigations should be further attempted by the dental surgeon. You can return to normal activities when your provider says its OK usually after a few days to a week. Denture fabrication in older individuals is particularly difficult without the removal of tori, more so in the maxillary region as the stability of denture will be affected. Careers. An apical approach has been developed in order to avoid nail removal. Recurrence is most commonly seen with mandibular tori. In other cases, the location of the growth can make oral hygiene difficult because the buccal exostosis can block access to some of your teeth, meaning it's WebHereditary multiple exostosis, also known as diaphyseal aclasis, is a genetic condition often passed down to a child by one parent, but it can also be caused by a genetic mutation, meaning it can occur on its own by a change. Read our Editorial Process to know how we create content for health articles and queries. Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Its important for you to tell your provider about all of your medications, including herbs and supplements. In order to expose the exostosis, it is usually necessary to remove the nail plate. Osteomas are much rarer and are situated in the lateral part of the EAC. 1998 May;85(5):552-7. doi: 10.1016/s1079-2104(98)90290-6. Oral tori are most commonly observed among Hispanics, followed by the African -Americans population. Principle and Practice of Oral Medicine; pp. 10.23). The cause is not yet known. Conservative treatment has not been beneficial. The site is secure. Copyright 2023, iCliniq - All Rights Reserved Could it be the result of an infection or something even more serious? The lesion is resected so that the periosteum and the wound can be closed. 4112. WebHowever, exostoses can arise from the cortical surface in other areas of the jaws, especially along the buccal aspect of the alveolar processes or palatal to the maxillary molars. WebTorus palatinus is often a singular growth, whereas torus mandibularus and buccal exostoses tend to be bilateral, meaning they happen on both sides of the mouth. Some things you can expect after surgery: These should gradually fade as your body heals. The relationship between oral tori and bite force. No treatment is required for most exostoses. An official website of the United States government. When the maxillary or mandibular tori are covered by fibrous tissue or cartilage, or soft tissue, they are further prone to tissue irritation. The distinction between exostosis and osteoma is usually readily made on the basis of the clinical presentation. But what sort of problems can the growth cause? This and other oral exostoses (torus mandibularis and torus maxillaris) are not a disease or a sign of disease, but, if large, may be a problem in the construction and wearing of dentures. Yes, there are chances for the tori to grow back even after the removal. 2004;54:7882. Oral tori mostly occurs in individuals with parafunctional habits like teeth clenching or bruxism. Origin of the torus mandibularis: an embryological hypothesis. WebBuccal exostoses are broad-based, non-malignant surface growth occurring on the outer or facial surface of the maxilla and/or mandible, found usually in the premolar and molar Bookshelf 75.13) or sessile (Fig. government site. Exostoses of the EAC usually manifest without attendant compromise in function or clinical disease. 442 0 obj Mandibular tori can be bilaterally present in a few cases Torus palatinus are rare as compared to the torus mandibularis. It will take time usually several months before youll see the final results. 1998. FOIA These include: Genetic mutations Heredity Injuries Trauma such as from a car accident Disc Buccal fat removal is generally a safe procedure. An exostosis can be caused by many different things ranging from genetics to environmental stress. For patients who do not respond to medical treatment, transmeatal surgical excision is warranted.179, David R. Tollafield, Trevor Prior, in Clinical Skills in Treating the Foot (Second Edition), 2005. If your results are asymmetrical or arent healing well. Federal government websites often end in .gov or .mil. 1997 Apr-Jun;17(2):80-5. Essentially, a buccal exostosis is a harmless lump of bone. 4767. However, surgical removal can be performed if repeated ulceration and pain occur or if the location of the lesion interferes with the fabrication of a dental prosthesis. Exostoses are by far more common than osteomas.2, Exostoses are broad-based lesions in the medial half of the EAC near the tympanic annulus. When the teeth are not aligned, the jaw joint experiences a higher level of stress and tension. What kind of changes can I expect after buccal fat removal over time? (AAP) Frenum/Frenulum : A fold of mucous membrane tissue that attaches the lips and cheeks to the alveolar mucosa (and/or gingiva) and underlying periosteum (AAP). The chief differential diagnosis is osteoma, which is a much less common lesion in this location. 2013 Jan-Mar;33(1):31-5. doi: 10.1590/S0120-41572013000100004. There In people with parafunctional habits like night grinding (, Rarely but reportedly, tori also can be a cause for tooth mobility, inflamed gums, or sore throat infections if soft tissue growths over the tori get ulcerated and create chronic gum infections. Epidemiological aspects of oral tori in a Ghanaian community. You will need stitches in your mouth (which will typically be removed at a follow-up appointment), and there will be some temporary dietary restrictions while the site of the surgery heals. It's not a tumor, nor is it likely to affect your quality of life. Acta Odontol Scand. Growth after maturity suggests malignant degeneration, which occurs in 1% of solitary exostoses and between 3 and 5% of MHEs. Large tori is removed in multiple pieces. They begin to develop in early adulthood In a few cases where there is continuous stress or parafunctional habits present may result in changes in the underlying bony architecture resulting in the reformation of the tori again. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Yes, the larger oral tori of the mandible can result in sleep apnea due to a decrease in the airway by occupying the tongue space. If you notice an abnormal taste in your mouth or suspect salivary gland damage. Torus palatinus is an exostosis in the midline of the hard palate and may appear as a solitary mass or may be multilobular. Buccal exostoses are broad-based, non-malignant surface growth occurring on the outer or facial surface of the maxilla and/or mandible, found usually in the premolar and molar region. Pathologically, whether it is maxillary or mandibular tori, they are considered slow-growing, harmless and non-invasive. The reported prevalence of palatal exostoses also varies widely, ranging from 8% to 69% in various studies. An official website of the United States government. <>/Filter/FlateDecode/ID[<979683111D38DB4B80872D6DBD073070><1DD28450F9B4B2110A00802F8B70FC7F>]/Index[442 89]/Info 441 0 R/Length 149/Prev 137839/Root 443 0 R/Size 531/Type/XRef/W[1 3 1]>>stream Large palatal tori (maxillary tori/torus palatinus) cause obstruction to dental radiographic imaging, especially when the dental surgeon or physician needs to view the. Eating hard food or food with sharp edges like crispy or fried foods can definitely ulcerate the overlying tori lining mucosa because of its friable nature. Oral tori grows gradually from small to large size and stops growing after reaching a certain size. For this reason, many people opt for removal simply for cosmetic purposes. %%EOF What are the risks to having this procedure? Top Causes Of Bad Breath Issues In Children, Early Indicators Your Child Has A Tooth Decay Problem, How What You Eat Affects Your Dental Health. Injury to facial nerves and/or salivary duct injury. WebRecurrent bleeding from the mouth. What Are the Alternatives to Wearing Glasses - Refractive Surgery | Implantable Contact Lenses | Contact Lenses. Malocclusion occurs when the teeth do not align properly. Surgical management of the bilateral maxillary buccal exostosis. Buccal fat removal surgery is usually performed by a healthcare provider with special training in plastic surgery procedures such as a licensed plastic surgeon. . However, the exact reason behind the formation of tori is yet not known. There has been some controversy regarding the ability to distinguish between the two lesions histologically. These oral exostoses are usually composed of mature dense cancellous bone with a rim of cortical bone of variable thickness ( 1 , 2 ). Buccal fat removal is a surgery to remove the fat in this area of your face. WebExostoses are bony protuberances that occur on the buccal aspect of the mandibular or maxillary alveolus (Figure 8). The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). It's unlikely to grow to a size where it will cause physical discomfort, nor will it affect the health and general functionality of the rest of your teeth. government site. These bony exostoses are covered by soft tissues. Repeated trauma can result in infections of the oral tori. What Is the Clinical Presentation Of Oral Tori? PMC National Library of Medicine endstream To know more, have a look at this article. The patient was medically healthy and not under any medications. Exostosis; Meckels cartilage. The tissues overlying the exostosis will be thin, dystrophic, and difficult to reflect. J Craniofac Genet Dev Biol. Bookshelf Unauthorized use of these marks is strictly prohibited. There is a third locus at 19p. Epub 2018 Jan 12. However further research is needed to understand how parafunctional habits result in the formation of the oral tori. Concurrence of torus palatinus with palatal and buccal exostoses: case report and review of the literature. A very common cause of exostoses mouth is a bad bite, also known as malocclusion. The following paper presents a very rare case of buccal-sided mandibular angle exoxtosis and its management with surgical exploration. To excise the exostosis, a midlateral incision (seeChapter 64) is made, the extensor apparatus is elevated, and the periosteum is incised laterally and carefully elevated from the underlying bone; care is taken not to tear the periosteum dorsally, preserving a smooth surface over which the extensor apparatus can glide. Visit other versions in US, UK, Australia, India, Philippines and Home Last reviewed at:02 Dec 2022-4 min read, Comprehensive Medical Second Opinion.Submit your Case, Common Fungal Infections Affecting the Skin. Its best to consider plastic surgery only if you truly desire to modify your appearance and not because someone else wants you to. Subungual exostosis excision may cause considerable postoperative pain and tenderness, and a combination of NSAIDs and paracetamol/codeine compounds is advised. -, Haugen LK. -, Kerdpon D, Sirirungrojying S. A Clinical Study of oral tori in southern Thailand: prevalence and the relation to parafunctional activity. Depending on the location of the buccal exostosis, it might be visible when you talk or smile. If youre having more than one procedure done at the same time, you may receive general. Causes. There are a variety of oral conditions that may be confused with exostoses.
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