Intermediate Restorative Material Research Articles

Evaluation of 4 different bone graft substitutes and autogenous bone grafting in root-end resection osteotomies after retrograde root-filling with Intermediate Restorative Material (IRM): An experimental study in dogs

Purpose: To investigate the periapical tissue response after root end filling with intermediate restorative material (IRM) and filling of the root-end resection bone defects with autogenous bone or a bone graft substitute in comparison to empty controls. Materials and Methods: Vital roots of the second, third and fourth mandibular premolars in six healthy mongrel dogs were apectomized. The root canals were prepared and sealed with IRM following a standardized surgical procedure. The resection bone defects were either filled with autogenous bone (PB) or one of the bone graft substitutes; CERAMENTTM|BONE VOID FILLER, ChronOS?, TigranTM PTG, Easygraft? CLASSIC or left empty. After 120 days the animals were sacrificed and the specimens were analyzed radiologically and histologically. Kruskal-Wallis and Mann-Whitney tests were performed for statistical evaluation. Results: 34 sections were analyzed histologically. The evaluation revealed a variation in the outcome amongst the tested options, regarding reestablishment of the periapical bone healing and inflammatory infiltration in the sections. According to the tested variables, there was no statistical significant difference between the materials when comparing all groups as a whole. When comparing individual materials to each other there was statistical differences among some of the tested materials. Conclusion: The healing outcome after periapical surgery of a five-wall resection defect could not be increased by infill with autogenous bone or bone graft substitutes. The most important factor for the healing outcome in periapical surgery is the quality of the root-end sealing. The healing outcome after some of the tested bone substitutes, might be improved by longer healing time.

Investigation of the physical properties of tricalcium silicate cement-based root-end filling materials

ObjectiveTricalcium silicate-based cements have been displayed as suitable root-end filling materials. The physical properties of prototype radiopacified tricalcium silicate cement, Bioaggregate and Biodentine were investigated. Intermediate restorative material was used as a control. MethodsThe physical properties of a prototype zirconium oxide replaced tricalcium silicate cement and two proprietary cements composed of tricalcium silicate namely Bioaggregate and Biodentine were investigated. Intermediate restorative material (IRM) was used as a control. Radiopacity assessment was undertaken and expressed in thickness of aluminum. In addition the anti-washout resistance was investigated using a novel basket-drop method and the fluid uptake, sorption and solubility were investigated using a gravimetric method. The setting time was assessed using an indentation technique and compressive strength and micro-hardness of the test materials were investigated. All the testing was performed with the test materials immersed in Hank's balanced salt solution. ResultsAll the materials tested had a radiopacity value higher than 3mm thickness of aluminum. IRM exhibited the highest radiopacity. Biodentine demonstrated a high washout, low fluid uptake and sorption values, low setting time and superior mechanical properties. The fluid uptake and setting time was the highest for Bioaggregate. SignificanceThe addition of admixtures to tricalcium silicate-based cements affects the physical properties of the materials.

Comparison of the Microhardness and Morphology of Five Different Retrograde Filling Materials in Aqueous and Dry Conditions

The purpose of the present study was to compare the effect of dry and aqueous conditions on the surface morphology and surface hardness of five materials 24 h after being used as fillings without initial setting time in dry condition. The five materials were ProRoot mineral trioxide aggregate (MTA), super EBA, intermediate restorative materials (IRM), zinc oxide eugenol (ZOE), and amalgam. To evaluate microhardness, the five materials were submitted to the Vickers microhardness (VHN) test. We used a scanning electron microscope (Steroscan 440, Leica Cambridge, England) to observe the microstructural morphology of the five different materials. The VHN of MTA soaked in water showed five times lower than that of MTA soaked in dry condition. On the other hand, super EBA was less influenced by the medium of storage compared with the other materials. Scanning electron microscope (SEM) images showed the similar results with microhardness tests. The surface of MTA soaked in water appeared to be unstable compared with that of dry condition while super EBA showed similarly smooth surface in both conditions (aqueous and dry). In conclusion, the physical property of MTA is reduced after storage in water; however, super EBA is less influenced by aqueous condition.

Periapical Tissue Response After Use of Intermediate Restorative Material, Gutta-Percha, Reinforced Zinc Oxide Cement, and Mineral Trioxide Aggregate as Retrograde Root-End Filling Materials: A Histologic Study in Dogs

To investigate the periapical tissue response of 4 different retrograde root-filling materials, ie, intermediate restorative material, thermoplasticized gutta-percha, reinforced zinc oxide cement (Super-EBA), and mineral trioxide aggregate (MTA), in conjunction with an ultrasonic root-end preparation technique in an animal model. Vital roots of the third and fourth right mandibular premolars in 6 healthy mongrel dogs were apicectomized and sealed with 1 of the materials using a standardized surgical procedure. After 120 days, the animals were sacrificed and the specimens were analyzed radiologically, histologically, and scanning electron microscopically. The Fisher exact test was performed on the 2 outcome values. Twenty-three sections were analyzed histologically. Evaluation showed better re-establishment of the periapical tissues and generally lower inflammatory infiltration in the sections from teeth treated with the intermediate restorative material and the MTA. New root cement on the resected dentin surfaces was seen on all sections regardless of the used material. New hard tissue formation, directly on the surface of the material, was seen only in the MTA sections. There was no statistical difference in outcome among the tested materials. The results from this dog model favor the intermediate restorative material and MTA as retrograde fillings when evaluating the bone defect regeneration. MTA has the most favorable periapical tissue response when comparing the biocompatibility of the materials tested.

In vitro comparative study of sealing ability of Diadent BioAggregate and other root-end filling materials

Aim:This in vitro study evaluated and compared sealing ability of Diadent BioAggregate (DBA) as a new root-end filling material (REFM) versus amalgam, intermediate restorative material (IRM) and white mineral trioxide aggregate (WMTA).Materials and Methods:Crowns of sixty extracted human maxillary incisors were sectioned at the cemento-enamel junction (CEJ). All the roots were instrumented and obturated with gutta-percha and resin sealer. Obturated roots were divided randomly into 2 control groups and 4 experimental groups of 10 samples each. In the negative control group (group I), roots were kept without any further preparation. In the positive and experimental groups roots, were apically resected and root-end cavities were prepared and filled with: (a) gutta-percha (group 2-positive control group); (b) amalgam (group 3); (c) IRM (group 4); (d) WMTA (group 5); (e) DBA (group 6). Apical leakage was assessed using dye penetration technique. Data were submitted to statistical analysis by the one-way analysis of variance (ANOVA) and Tukey's test.Results:Significant difference of sealing ability was found among 4 tested groups. DBA followed by MTA showed the highest sealing ability.Conclusions:DBA with its high sealing ability can be considered a possible alternative to MTA.

The Effects of Humidity and Serum on the Surface Microhardness and Morphology of Five Retrograde Filling Materials

The purpose of this study was to compare the surface morphology and surface hardness of five materials 24 h after filling, in conditions of 100% humidity, and fetal bovine serum. The five materials were ProRoot Mineral Trioxide Aggregate (MTA), Super-EBA, Intermediate Restorative Materials (IRM), Zinc Oxide Eugenol (ZOE), and Amalgam. The microhardness of these materials was evaluated by Vickers microhardness test, and their morphologies were compared by using scanning electron microscopy (SEM). To evaluate the microhardness, the mixed five materials were measured with Vickers microhardness test. Differences between the experimental groups were analyzed by two-way ANOVA and Duncan's multiple comparison tests. All analyses were performed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL). For the microstructural morphological evaluation, the cross cut and root-end cavity prepared surfaces followed by retrograde filling with five different materials were observed under a Scanning Electron Microscope (Steroscan 440; Leica, Cambridge, England) at ×500. To summarize, Super EBA was less influenced by storage medium than the other materials, especially MTA. However, further long-term studies considering other factors, such as biocompatibility (i.e. cellular toxicity) and retention, are needed to be collaborated with these findings in the clinical context.

Preparation and applications of polyamide 6/IRM® tooth root composite filling material

Intermediate restorative material (IRM®) is the most commonly used temporary filling material. This research mixed IRM with Polyamide 6 (Nylon 6) fibers, forming the Nylon/IRM tooth root composite filling materials. Tests such as setting time, degree of solubility, compressing strength, and micro-leakage were carried out to examine the properties of the Nylon 6/IRM® composite material. The result showed that there was no significant difference in the setting time and degree of solubility after adding the Nylon 6 fibers. The loading after the yielding point of the Nylon 6/IRM® was more than 250 N; micro-leakage was found on the 13th day.

Osteoblastic cytokine response to gray and white mineral trioxide aggregate.

The materials used for root-end filling and perforation repair are in direct contact with live tissues e.g. bone and connective tissue; their effects however, are uncertain. The aim of this ex vivostudy was to evaluate the osteoblastic secretory activity adjacent to gray and white mineral trioxide aggregate (MTA) and Intermediate Restorative Material (IRM). The studied materials were prepared and placed in 24-wells plate. Human MG-63 osteoblasts were introduced to materials after their initial set. The supernatant fluid was collected after 1, 3, and 7 days and the level of interleukin-1β was measured by ELISA test. A microscopic exam was also performed to assess proliferation and viability of the cells. Kruskal-Wallis and Tukey tests were used for analysis. T here were significant higher levels of interleukin-1β in the gray and white MTA groups compared to IRM group (P<0.05). The difference in interleukin-1β secretion level between two mineral trioxide aggregate groups was not significant (P>0.05).Morphologic appearance of osteoblasts adjacent to gray and white MTA was similar to normal osteoblasts in all observation periods, however cells adjacent to IRM were round, signifying cytotoxicity of the adjacent material. Human osteoblasts' has a favorable biologic response to white and gray MTA compared to IRM.

Scanning electron microscopic evaluation of the material interface of adjacent layers of dental materials

Objective Many dental materials are used in contact with each other in sandwich techniques. Liners, bases and permanent restorative materials are placed adjacent to each other and allowed to set under the same conditions. The same applies for endodontic materials where irrigating solutions and root canal dressings come in contact with root canal obturating materials and root-end fillers. The aim of this research was to investigate the material interface of mineral trioxide aggregate (MTA) in contact with non-setting calcium hydroxide paste (CH), glass ionomer cement (GIC) and intermediate restorative material (IRM). Methods All materials were mixed according to manufacturer's instructions. Freshly mixed MTA (Dentsply) was placed in a plastic container and another dental material was compacted on it while still unset. These materials included GIC (Fuji IX), non-setting calcium hydroxide (Calasept) and IRM (Dentsply). The materials were allowed to set for 28 days at 37 °C and 100% humidity. The layered materials were sectioned longitudinally embedded in resin and polished to expose the interface between the two materials. Scanning electron microscopy (SEM) was performed of the interface and X-ray energy dispersive analysis (EDX) was conducted at 50 μm intervals to establish elements present at specific distances from the material interface. Results The calcium hydroxide paste did not affect the hydration of MTA. Migration of silicon, aluminum and bismuth from the MTA to the CH occurred. The GIC exhibited a high degree of micro-cracking and some porosity in the interfacial region. Strontium from the GIC was detected at 200 μm within the MTA. The zinc from the IRM cement was detected at 100 μm within the MTA. The zinc affected the hydration of the MTA leading to retardation of setting and increased porosity. Conclusions MTA interacts with other dental materials with resultant elemental migration in adjacent materials. Zinc oxide eugenol based cements should be avoided in the presence of MTA as zinc causes retardation of cement hydration with increased porosity. Glass ionomer cements absorb the water of hydration from the MTA also resulting in increased porosity and incomplete hydration of MTA.

Biocompatibility of Two Novel Root Repair Materials

Introduction The purpose of the present study was to evaluate the biocompatibility of 2 root-end filling materials, Endosequence Root Repair Material Putty (ERRM Putty) and Paste (ERRM Paste) and compare them with gray mineral trioxide aggregate (MTA). Methods ERRM Putty, ERRM Paste, MTA, intermediate restorative material (IRM), and Cavit G were tested. For cytotoxicity assay, human gingival fibroblasts were incubated for 1, 3, and 7 days with extracts of varying concentrations from materials set for 2 days or 7 days. Cell viability was evaluated by methyl-thiazol-tetrazolium (MTT) assay. For cell adhesion assay, materials set for 7 days were examined under scanning electron microscope directly after setting, after incubation in cell culture medium for 7 days, and after incubation in gingival fibroblast suspension at a density of 5 × 10 4 cells/well for 2 and 7 days. The constituents of crystals formed on surface of materials were determined by energy dispersive analysis by x-ray. Results Cell viability was significantly correlated with the type of material, setting time, and incubation time ( P < .001 for all parameters). ERRM Putty and ERRM Paste displayed similar cell viabilities to MTA at all experimental conditions, except that fresh samples of ERRM Paste showed slightly lower cell viabilities than MTA. Cell viabilities with IRM and Cavit G were significantly lower than with the other 3 materials ( P < .001). Similar surface crystallographic features and cell adhesion were observed on ERRM Paste, ERRM Putty, and MTA. Conclusions ERRM Putty and ERRM Paste displayed similar in vitro biocompatibility to MTA.

Effect of cavity varnish and intermediate restorative material on coronal microleakage in endodontically treated tooth

Evaluation of microleakage in endodontically treated teeth that have been coronally sealed with eugenol and noneugenol containing zinc oxide cement, with and without the use of cavity varnish. The crowns of single rooted teeth were removed at the cementoenamel junction (CEJ) and the root canals were prepared and obturated with gutta-percha points and zinc oxide eugenol (ZOE) sealer using lateral condensation technique. The samples were randomly divided into four groups-group 1, coronal seal was obtained with ZOE cement; in group 2, three coats of cavity varnish followed with coronal seal of ZOE cement; in group 3, Litark a (noneugenol cement) was placed in the prepared cavity as in group 1; and in group 4, cavity varnish and Litark were placed instead of ZOE as in group 2. The specimens were immersed in 2% methylene blue dye and examined under traveling microscope for evidence of dye penetration of the material. In this study, Kruskal-Wallis test, Mann-Whitney U, and Wilcoxon W tests were used. Kruskal-Wallis test with P=0.000 indicated that a significant difference exists between the four groups. Mann-Whitney U test and Wilcoxon W test showed a significant difference at 0.05 levels as follows: group 1 with group 3 and 4, group 2 with group 3 and 4, and group 3 with group 4. There was no significant difference at 0.05 levels between group 1 and group 2. Group 4 showed significant less amount of dye penetration as compared with other groups.

Mineral trioxide aggregate solution inhibits osteoclast differentiation through the maintenance of osteoprotegerin expression in osteoblasts

Mineral trioxide aggregate (MTA) is a therapeutic, endodontic repair material that is reported to exhibit calcified tissue-conductive activity. The aim of this study was to investigate whether MTA may prevent osteoclast differentiation in vitro. MTA solution, but not other commonly used retrofilling materials, such as Dycal, Super-EBA, or intermediate restorative material (IRM) solution, dose-dependently inhibited osteoclastogenesis in cocultures of mouse bone marrow cells (BMCs) with primary osteoblast cells (POBs) induced by 1α,25-dihydroxyvitamin D(3) [1α,25(OH)(2) D(3) ]. Exogenous CaCl(2) medium supplementation did not inhibit osteoclastogenesis in cocultures. Furthermore, MTA solution did not affect receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis, suggesting that POBs are targets of MTA. MTA solution suppressed the 1α,25(OH)(2) D(3) -induced reduction of osteoprotegerin (OPG) mRNA and protein production without changing RANKL expression in POBs. Consistent with this result, MTA solution did not inhibit osteoclastogenesis in cocultures of BMCs and POBs from OPG-deficient mice. Therefore, the maintenance of OPG expression in POBs appears to be critical for the inhibitory effect of MTA solution on osteoclast differentiation.

Cytotoxicity of calcium enriched mixture cement compared with mineral trioxide aggregate and intermediate restorative material

Calcium enriched mixture (CEM) cement has been recently invented by the last author. It is composed of calcium oxide, calcium phosphate, calcium silicate and calcium sulphate; however, it has a different chemical composition to mineral trioxide aggregate (MTA). The purpose of this ex vivo study was to investigate the cytotoxicity of CEM cement, and compare it with intermediate restorative material (IRM) and MTA. The materials were tested in fresh and set states on L929 fibroblasts to assess their cytotoxicity. The cell viability responses were evaluated with methyl-tetrazolium bromide assay and Elisa reader at 1, 24 and 168 h (7 days). The tested materials were eluted with L929 culture medium according to international standard organisation 109935 standard. Distilled water and culture medium served as positive and negative controls, respectively. Differences in cytotoxicity were evaluated by one-way anova and t-tests. The cytotoxicity of the materials was statistically different at the three time intervals (P < 0.01). The lowest cytotoxic values recorded were expressed by MTA subgroups followed by CEM cement; IRM subgroups were the most cytotoxic root-end/dental material (P < 0.001). CEM cement and MTA are reasonable alternatives to IRM because of lower cytotoxicity. CEM cement also has good biocompatibility as well as lower estimated cost to MTA and seems to be a promising dental material.

In Vitro Comparison of Dye Penetration through Four Temporary Restorative Materials.

The purpose of this in vitro study was to compare the coronal seal of four temporary filling materials, Coltosol, Zonalin, Zamherir, and Intermediate Restorative Material (IRM) by the India ink dye penetration test. Endodontic access preparations were prepared in 120 extracted intact human premolars. The teeth were randomly divided into six groups including four experimental and two control groups. The access cavities in each group were sealed with Coltosol, Zonalin, Zamherir, and IRM; subsequently thermocycling was applied for 5-55˚C for 150 cycles. The teeth were immersed in 10% India ink for 72 hours to assess leakage. The teeth were then rinsed, dried, and sectioned mesiodistally and evaluated under a stereomicroscope for dye penetration. Data were analyzed using one-way ANOVA and post hoc Tukey tests. Positive control specimens showed complete dye penetration, while negative controls had no penetration. In the experimental groups, the lowest and highest leakage scores were observed in the Zonalin and Coltosol groups, respectively (P<0.05). There were no statistically significant differences in marginal leakage between Zonalin-Zamherir and Coltosol-IRM groups. These results suggest that Zonalin and Zamherir have a superior seal and less micro-leakage into the canals compared to the two other materials.

Evaluation of the physical properties of an endodontic Portland cement incorporating alternative radiopacifiers used as root‐end filling material

To investigate the physical and chemical properties of Portland cement (PC) loaded with alternative radiopacifying materials for use as root-end filling materials in a mineral trioxide aggregate (MTA)-like system. Portland cement loaded with barium sulphate, gold and silver/tin alloy was mixed with water, and the physical and chemical properties of the hydrated cements were evaluated. MTA and intermediate restorative material (IRM) were used as controls. The radiopacity was compared to the equivalent thickness of aluminium, and the setting time of the cements was assessed using an indentation technique. The compressive strength and the stress-strain relationship were determined at 28 days. The stress-strain relationship was determined by monitoring the strain generated when the cement was subjected to compressive load. In addition, the pH was determined in water and simulated body fluid for a period of 28 days. The radiopacity of the cements using alternative radiopacifiers was comparable to MTA (P > 0.05). IRM demonstrated a higher radiopacity than all the materials tested (P < 0.05). All the cements with the exception of IRM exhibited an alkaline pH and had an extended setting time when compared to IRM. MTA had a longer setting time than the PC (P < 0.001), and its setting time was similar to the gold-loaded cement (P = 0.159). The addition of a radiopacifier retarded the setting time (P < 0.001) but did not have any effect on the compressive strength as all loaded cements had comparable strength to PC (P > 0.05). IRM was the weakest cement tested (P < 0.001). The cement loaded with gold radiopacifier had comparable strength to MTA (P = 1). The stress-strain relationship was linear for all the cements with IRM generating more strain on loading. Within the parameters set in this study, bismuth oxide in MTA can be replaced by gold or silver/tin alloy. The physical, mechanical and chemical properties of the cement replaced with alternative radiopacifiers were similar and comparable to ProRoot MTA.

Oral Lichenoid Reaction Associated With Tin Component of Amalgam Restorations: A Case Report

Amalgam or its components may cause type IV hypersensitivity reactions on the oral mucosa. Majority of the reported cases involved a delayed hypersensitivity to mercury. A case of bilateral oral lichenoid reaction is presented, which was present in relation to amalgam restorations. Histopathological features were compatible with lichenoid mucositis. Patch test was positive with pulverized amalgam and tin. The lesion healed up after replacement of restorations with an intermediate restorative material. The clinician should be aware of all possible pathological etiologies of white lesions. If there is any doubt about the nature or management of an unusual oral lesion, referral to appropriate specialists is mandatory.

The effect of several root-end filling materials on MG63 osteoblast-like cells

ABSTRACT Ⅰ. Introduction Nowadays, in endodontic field mineral trioxideaggregate (MTA; Dentsply, Tulsa Dental, Tulsa, OK,USA) has been introduced and widely used in manyindications such as root-end filling, perforationrepair, apexification, and pulp capping. 1,2) Traditionally,various materials, such as amalgam, zinc oxideeugenol (ZOE), Intermediate Restorative Material(IRM; Dentsply Caulk, Milford, DE, USA), andsuper ethoxy benzoic acid (Super EBA) have beenused for root-end filling. Types of root-end fillingmaterials have gone through a lot of changes withtime. Currently, MTA is mainly used for its excellentsealing ability and biocompatibility. 3) In the past, there had been a lot of studies identify-ing cell response to MTA. 4-6) According to these stud-ies, MTA appears to stimulate cytokine production inhuman osteoblasts 4) and allow good adherence of thecells to the material. 5) THE EFFECT OF SEVERAL ROOT-END FILLING MATERIALS ON MG63 OSTEOBLAST-LIKE CELLS Jeong-Ho Lee 1 , Won-Jun Shon

Remineralization of early enamel lesions using casein phosphopeptide amorphous calcium Phosphate: An ex-vivo study

Objective:This study aimed at qualitatively evaluating the remineralization potential of casein phosphopeptide amorphous calcium phosphate on artificial early enamel lesions in an ex-vivo scenario by observing the treated tooth surface using a scanning electron microscope (SEM).Materials and Methods:This randomized study was conducted on 10 subjects undergoing orthodontic treatment with premolar extraction as part of their treatment. Artificial white lesions were created with the application of 37% phosphoric acid for 20 mins. Teeth were then divided into two groups: one experimental and the other control. Customised orthodontic band with a window was luted with intermediate restorative material in the experimental group whereas in the control group, band without a window was luted. The casein phosphopeptide amorphous calcium phosphate (GC TOOTH MOUSSE) paste was then applied on the window region of the experimental group for 3 mins thrice daily after meals for 14 days, whereas no paste was applied in the control group. After 14 days, teeth were extracted and viewed under an SEM.Results:The study groups showed remineralization of the lesions as compared with the control group in most of the samples.Conclusion:Casein phophopeptide could significantly remineralize the artificial enamel lesions in vivo.

Colorimeter and Scanning Electron Microscopy Analysis of Teeth Submitted to Internal Bleaching

Introduction This in vitro study compared the tooth color and the ultrastructure of internal dental tissues before and after internal bleaching. Methods Sodium perborate was placed in the pulp chamber of endodontically treated molars and sealed with intermediate restorative material. The test samples were stored in a physiologic solution, and the bleaching agent was replaced every 7 days. A control group was used. After 1 month, the colors of the test and control samples were measured with a colorimeter, and the internal surfaces were observed under field emission scanning electron microscopy (FESEM). Results Statistically significant differences were found between the test and control sample colors. The FESEM ultrastructure analysis of the internal enamel and dentin surfaces did not show any changes after the internal bleaching. Conclusions The results of the present study show that sodium perborate is effective in bleaching nonvital teeth and does not produce ultrastructural changes in the dental tissues.

In vitro evaluation of bacterial leakage through different perforation repair materials of teeth.

This study was conducted to evaluate micro-leakage through different furcation repair dental materials which are used to repair iatrogenic perforations in teeth. Six commercially available dental materials high copper amalgam, glass ionomer cements (GIC) Fuji II and Fuji IX, intermediate restorative material (IRM), mineral trioxide aggregate (MTA) and fully injectable calcium phosphate cement (Chitra-CPC) were evaluated. Eighty extracted human molar teeth were prepared chemo-mechanically and allocated to six experimental and two control groups, each comprising of 10 teeth. Microleakage was evaluated using the Enterococcus fecalis bacterial penetration test and confirmed with a confirmatory broth. On a daily basis broth was evaluated for visual turbidity for 45 days and leakage was confirmed using Mac Conkey's medium. Statistical analysis using the Chi-Square test has revealed a significant difference among the materials tested, with MTA and Chitra-CPC showing minimal leakage when compared to the other repair materials within this period. MTA and Chitra-CPC showed a similar micro leakage patterns and had a better sealing ability when compared to other materials in this study.