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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 19  |  Issue : 3  |  Page : 110-116

A comparative evaluation of fracture resistance using different techniques for the reattachment of fractured maxillary central incisor – an in vitro study


1 Department of Conservative Dentistry and Endodontics, Sardar Patel Post Graduate Institute of Dental And Medical Sciences, Lucknow, Uttar Pradesh, India
2 Department of Nuclear Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

Date of Submission31-Jan-2022
Date of Decision01-Apr-2022
Date of Acceptance02-Apr-2022
Date of Web Publication14-Sep-2022

Correspondence Address:
Saini Rashmi
BDS, MDS (Conservative Dentistry and Endodontics), MRA 92A, Block 12, SGPGI, Lucknow, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tdj.tdj_4_22

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  Abstract 


Objective
To comparatively evaluate fracture resistance of different techniques for the reattachment of fractured maxillary central incisors.
Materials and Methods
Sixty intact freshly extracted permanent maxillary central incisors were selected and randomly divided into four groups of 15 each one of control (I) and three experimental groups (II, III, IV) according to the technique of reattachment. The incisal third of the experimental groups were sectioned horizontally. Group I: the teeth were kept intact without sectioning. Group II: an internal dentinal groove (1 mm deep and 1 mm wide). Group III: a pinhole (1.5 mm depth and 1.5 mm diameter). Fractured fragments in group II and group III were reattached using composite resin. Group IV: two vertical grooves (1 mm deep, 1 mm wide, and 4 mm length) with fiber-reinforced composite post (Everstick, GC America). After 24 h of restoration, all samples in each group were then subjected to thermocycling at 5±1 and 55±1°C for 500 cycles each cycle. All the samples were mounted on the universal testing machine (instron). The force was then applied at an angle of 45° of each tooth in a labial to palatal direction at a cross-head speed of 1 mm/min until fractured occurred and the obtained values were subjected to statistical analysis.
Results
The results showed that the mean fracture resistance of group I was the highest followed by group III, group IV, and group II the least (group II < group IV < group III < group I). Comparing the mean fracture resistance of four groups, analysis of variance showed significantly different fracture resistance among the groups (F = 22.93, P < 0.001).
Conclusion
No material and technique can restore the strength of intact tooth. However, reattachment techniques can be considered as an alternate method, when the fractured fragment is available with adequate size and appropriately preserved margins.

Keywords: dental trauma, fiber-reinforced composite post, permanent maxillary central incisor, pin-holes, reattachment techniques


How to cite this article:
Rashmi S, Kumar SV. A comparative evaluation of fracture resistance using different techniques for the reattachment of fractured maxillary central incisor – an in vitro study. Tanta Dent J 2022;19:110-6

How to cite this URL:
Rashmi S, Kumar SV. A comparative evaluation of fracture resistance using different techniques for the reattachment of fractured maxillary central incisor – an in vitro study. Tanta Dent J [serial online] 2022 [cited 2023 Jan 31];19:110-6. Available from: http://www.tmj.eg.net/text.asp?2022/19/3/110/356096




  Introduction Top


Traumatic injuries are the most difficult and perplexing problems in dentistry [1]. Dental traumas not only cause damage to the dentition, but also have a physical as well as psychological impact on the individual [2]. Children and teenagers are becoming more likely to sustain dental trauma as a result of contact sports, automobile accidents, outdoor sports, and falls [3]. Maxillary central incisors are frequently involved (95%) because of their protrusion and position taken during the eruptive process [4].

In traumatized teeth, uncomplicated crown fractures are most prevalent (51%), consisting of enamel and enamel-dentin fractures without pulp exposure. Numerous treatment modalities have been proposed for management of fractured crowns, such as resin crowns, stainless steel crowns, porcelain laminate veneers, porcelain fused to metal crowns, all ceramic crowns, and composite build-ups have been used with varying degrees of success [5]. While restorative materials can mimic natural dental structures, appearance, and function, no restorative material is able to replicate the natural structures, appearance, and function of the dental structure [6]. Thus, reattaching fractured tooth fragments is one valid conservative treatment option for anterior teeth in the present demanding situation [7]. Therefore, when a fractured fragment is available, immediate restorative treatment may be the best option [8].

It has been proposed that many techniques can be utilized for the reattachment of simple fragments, such as circumferential bevels, labial chamfers, internal dentinal grooves, v-shaped enamel notch, use of dental pins, circumferential or lingual composite overcontours, vertical groove technique, or bonding without additional preparation [8]. There are many factors that can affect the choice of reattachment technique, but studies have shown that new dental trauma or nonphysiological usage of the restored tooth is the leading cause of reattachment treatment failure [9]. Therefore, in search of increasing the longevity of treatment outcomes, newer materials and techniques were advocated that could improve the durability of the reattached tooth [2]. There is a lack of consensus on techniques for reattachment having better strength. Therefore, the present in-vitro study was formulated to evaluate and compare the fracture resistance of reattached teeth using three different techniques (internal dentinal groove, pin-holes, and vertical groove with fiber-reinforced post technique).


  Materials and methods Top


Study samples consisted of 60 intact human maxillary central incisors freshly removed from the mouth for periodontal reasons. The teeth were cleaned and scaled thoroughly to remove hard and soft tissues remnants. Teeth were than autoclaved at a temperature 240°C at 20 psi for 40 min and stored in 0.9% normal saline till the experimentation.

Teeth were randomly divided into four groups (n = 15/group) according to the technique of reattachment.

Group I (control group): sound teeth.

Group II: internal dentinal groove.

Group III: pin-holes.

Group VI: vertical grooves with fiber-reinforced.

All the teeth in experimental groups (II, III, and IV) were marked at the junction of the incisal and middle third of the crown. Thereafter, a standardized sectioning was performed perpendicular to the long axis of the teeth using a diamond disc at 30 000 rpm to simulate an Ellis and Davey class II fracture (a fracture involving enamel and dentin) [Figure 1]a and [Figure 1]b.
Figure 1: (a) Sectioning of incisal third of the crown using diamond disc. (b) After sectioning of tooth. (c) Tooth was molded within acrylic block.

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All the teeth in the control group (unsectioned or intact) and experimental groups were embedded into the molds (24 mm height × 24 mm width) using acrylic resin up to the cement–enamel junction such that the long axis of the tooth was aligned with the central axis of the block [Figure 1]c.

Reattachment procedure

Group I (control group)

In this group sectioning of tooth was not carried out and samples were left untreated without any further preparation.

Group II (internal dentinal groove)

Prior to performing the reattachment of a fractured fragment, an internal dentinal groove (1 mm deep and 1 mm wide) was prepared within the dentin of the fragment (obtained from previously done sectioning of teeth, as mentioned) 1 mm away from the dentino–enamel junction with a #2 carbide bur using a high-speed hand piece under a water cooling system [Figure 2]a.
Figure 2: (a) Incisal fragment showing internal dentinal groove placement. (b) Incisal fragment showing pin-hole preparation. (c) Placement of vertical grooves after reattachment of tooth fragment.

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Group III (pin-holes)

In this group, prior to performing reattachment of a fractured fragment, a pinhole (1.5 mm in depth and 1.5 mm in diameter) was prepared bilaterally in the dentin of the tooth fragment, 1 mm away from the dentino–enamel junction using a #4 round carbide bur with a high speed hand piece under water cooling system.

The pin-holes were joined with shallow dentin grooves created with a #1 round carbide bur (diameter 0.8 mm) [Figure 2]b. The prepared fragment was measured by a periodontal probe (GDC, India). Thereafter, in samples of group II and group III, two coats of dentin bonding agent (3M ESPE, single bond universal, Germany) were applied on the fractured fragment and tooth remnant with the help of an applicator tip, which were gently air dried with the three way syringe and light cured (Elipar, 3M, USA) for 20 s.

After application of the bonding agent, a thin film of bulk-fill composite resin (Tetric N–Ceram, Ivaclar, Vivadent, Switerland) was applied on the fractured fragment and the tooth fragment by a Teflon-coated composite instrument, after which the fragment was repositioned on the tooth remnant under firm pressure and excess material was removed using the same instrument. After fragment repositioning, each mesial and distal half of the buccal and palatal surfaces were separately cured for 20 s according to the manufacturer's instructions. All samples were finished with Sof-Lex (3M ESPE, Germany).

Group IV (vertical grooves with fiber-reinforced post)

In this group, after the application of the adhesive system, a small layer of composite was applied on the fractured fragment and positioned correctly to the remaining tooth structure. Light curing was done, exactly as in group II and group III.

Two vertical grooves, each 1 mm deep, 1 mm wide, and 4 mm in length, were prepared on the palatal side perpendicular to the fracture line 2 mm away from the midline using a #2 round carbide bur with a high speed hand piece under water cooling system. From the total length (i.e. 4 mm) of each groove, half the groove (i.e. 2 mm) was placed in the reattached fragment and half the remaining tooth structure (i.e. 2 mm) in the remaining tooth structure [Figure 2]c. Thereafter, the adhesive system (3M, ESPE single bond universal, Germany) was applied within the prepared grooves and the fiber reinforced composite post (Everstick, GC America) of 0.9 mm in diameter was taken out of the foil bag, the required 4 mm length was cut from the silicon strip, and two posts were placed within the prepared grooves on the palatal side. Bulk-fill composite resin (Tetric N–Ceram, Ivaclar) was applied to fill the gap between the post and tooth surface, and light cured.

Thermocycling procedure

During the study period, the samples were stored in normal saline at room temperature to prevent dehydration. After 24 h of restoration, all the samples were subjected to thermocycling at 5±1 and 55±1°C for 500 cycles each, with a dwell time of 15 s between the baths in order to stimulate the conditions in the oral cavity.

Debonding procedure

The acrylic blocks containing samples were mounted on the universal testing machine (Instron, USA). The force was then applied at a 45° angle to each tooth in a labial-palatal direction with a stainless steel wedge with a tip size of 4 mm2 and a cross-head speed of 1 mm/min until fractured [Figure 3] and [Figure 4]. Thereafter, values were noted and the data was subjected to statistical analysis using analysis of variance (ANOVA), Tukey's honestly significant difference post-hoc test, Shapiro–Wilk's test, and Levene's test.
Figure 3: Mounting of sample on universal testing machine.

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Figure 4: Fractured fragment and remaining tooth structure of each group after load application in universal testing machine.

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Statistical analysis

Data were summarized as mean ± SD. Groups were compared by one factor ANOVA and the significance of mean difference between (inter) the groups was done by Tukey's honestly significant difference post-hoc test after ascertaining normality by Shapiro–Wilk's test and homogeneity of variance between groups by Levene's test. A two-tailed (α=2). P value less than 0.05 was considered statistically significant.


  Results Top


The outcome measure of the study was fracture resistance assessed in force and measured in Newton (N). The fracture resistance (N) of four groups is summarized in [Table 1] and also depicted in [Graph 1] which showed that the mean fracture resistance of group I were the highest, followed by group III, group IV, and group II the least (group II, group IV, group III, group I).

Table 1: Fracture resistance (n) of four groups

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Comparing the mean fracture resistance of four groups, ANOVA showed significantly different fracture resistance among the groups (F = 22.93, P < 0.001) [Table 2].
Table 2: Comparison of difference in mean fracture resistance between groups by Tukey test

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Tukey test showed significantly different and higher fracture resistance of group I as compared to both group II (304.98 ± 34.03 vs. 205.14 ± 22.50, mean diff = 99.84, q = 10.70, P < 0.001) and group IV (304.98 ± 34.03 vs. 246.05 ± 38.73, mean diff = 58.93, q = 6.31, P < 0.001) but not differ with group III (304.98 ± 34.03 vs. 287.73 ± 45.43, mean diff = 17.24, q = 1.85, P > 0.05) that is found to be statistically the same [Table 2] and [Graph 2].



Similarly, further, comparing the difference in mean fracture resistance of group II with other groups (group III and group IV), Tukey test showed significantly different and higher fracture resistance of both group III (205.14 ± 22.50 vs. 287.73 ± 45.43, mean diff = 82.60, q = 8.85, P < 0.001) and group IV (205.14 ± 22.50 vs. 246.05 ± 38.73, mean diff = 40.91, q = 4.38, P < 0.05) as compared to group II [Table 2] and [Graph 3].



Further, comparing the difference in mean fracture resistance of group III with group IV, Tukey test showed significantly different and higher fracture resistance of group III as compared to group IV (287.73 ± 45.43 vs. 246.05 ± 38.73, mean diff = 41.69, q = 4.47, P < 0.05) [Table 2] and [Graph 4].




  Discussion Top


The major objective of restorative dentistry is to restore teeth in a way that allows conservation of healthy dental tissues, esthetics, function, and durability. Uncomplicated coronal fractures are most common among children and teenagers, resulting from accidental trauma or sports injuries [10]. When the fractured fragment is still available, repositioning and bonding it immediately to the tooth remains is the first restorative immediate treatment option that should be performed [11].

In this present study, only maxillary central incisors were included because there are a greater number of incidences of trauma/fracture to these teeth [4]. In the current study, the teeth were sectioned in a standardized manner with a mounted disc, as the aim was to compare reattachment techniques. In an attempt to obtain an equal amount of area for adhesion, all of the teeth were cut at the junction of the middle and incisal third of the crown. Sushma et al.[12] reported that using a disc results in a smooth surface and allows standardization of the mode of 'fracture,' which is an advantage as the number of defects in the adhesive interface results in a better approximation between the fractured tooth and the cut tooth surface. Thereafter, teeth were embedded in acrylic resin blocks to simulate the support given to healthy teeth by the alveolar bone and to reduce stresses caused by unrealistic bending movements [2],[13].

So the amount of dentin removed in the internal dentin groove group was standardized using a # 2 round carbide bur with a diameter of 1 mm. A standard depth of 1 mm of dentin was removed for the dentinal groove using the same bur for the entire group. Similarly, in pin-holes technique #4, a round carbide bur was used for the preparations, which had a diameter of 2 mm.

In this study, the thermocycling procedure was carried out at 5 and 55° for 500 cycles with a 15 s dwell time between each cycle to simulate short-term ageing of dental material [14],[15]. After the reattachment procedures, the samples were subjected to the universal testing machine for the evaluation of their fracture resistance. The cross-head speed used to fracture the specimens in this study was 1 mm/min, as recommended by the ISO standard (ISO/TS 11405:2003-Dental Materials-Testing of adhesion to tooth structure). The force was applied in a labial to lingual direction because 80% of traumatized incisors fracture in an oblique fashion from labial to lingual aspects with the fracture line proceeding in an apical direction. Here, the compressive load was applied to the incisal third of teeth at 45° using a universal strength testing machine to simulate impact from a fall [12],[14],[16].

In the current study, the control sound group had the highest fracture strength followed by pin-holes, vertical grooves with fiber-reinforced post, and internal dentinal groove, and the difference was significant. The fracture load values obtained for group I (intact teeth) were the highest amongst all the tested groups. The reason for this high fracture resistance may be the higher mechanical strength of sound or intact teeth [17],[18]. The results of this study are in accordance with many studies like Demarco et al. [19] and Sushma et al. [12] who confirmed that no material or technique was able to attain the fracture strength of sound natural teeth.

In this study, group II (internal dentinal groove technique) showed the least fracture resistance among all the tested groups. This could be due to the fracture resistance of the reattached teeth being directly proportional to the surface area of adhesion [18]. Therefore, the lower values of group II might be due to the presence of a lower surface area for adhesion. Similar values were reported by Karre et al. [20] and Beltagy [21].

According to this study, group III (pin-holes technique) showed the highest fracture resistance among the experimental groups. This may be due to the two vertical slots on both (mesial and distal) sides with a horizontal channel were created on fractured fragments in the pinhole design. This channel filled with composite acts as a horizontal resin bar and two vertical resin slots provide additional retention, both opposing to each other, resulting in the distribution of load to a larger area [22]. Thus, the increase in surface area of adhesion in this group enhances the retention and distribution of forces, resulting in increased fracture resistance [20],[23]. Therefore, the greater surface area is present for adhesion in group III, which provides additional retention and better resistance against the applied forces, and here nearly similar higher values of fracture resistance were noted, which was in accordance with the previous study done by Beltagy [21] using the internal dentinal groove, pin-holes techniques for reattachment.

Results of group IV showed higher fracture load values than group II. The reason for this fracture resistance may be that the reinforcing glass fibers present in the everstick post cause stress transfer from the matrix to the fibers, which act as stress absorbers and prevent the crack propagation [24],[25]. The results of fracture load obtained in this group were in accordance with the study conducted by Karre et al. [20] But lower than group III may be due to the additional stress introduced by the preparation of the vertical groove for the placement of fiber-reinforced composite post in the fracture segment line [26],[27].

In the modern era of evidence, re-fixation procedures have proven beneficial in patients with clinical crown fractures due to alveolar damage. Reattaching the fragment can provide a great, durable esthetic appearance. This is a more conservative and simple procedure that also restores dental function. Reattaching the tooth fragment allows the tooth to be restored with minimal damage to the rest of the tooth structure. Therefore, it is preferable to reattach a tooth fragment rather than to restore a broken tooth. This is an extensive and widely used procedure.


  Conclusion Top


Within the limitations of this in vitro study, it can be concluded that tooth preparations and different techniques for reattachment have an influence on the fracture resistance of teeth. However, no reattachment technique or material was able to achieve the strength of an intact tooth.

In addition to restoring tooth function, esthetics and requiring less time in the dental office, reattachment of fractured tooth fragments is an excellent restorative option for both clinicians and patients. Therefore, reattachment techniques can be considered as an alternate method when the fractured fragment is available.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Karre D, Kumar duddu M, Swathi S. Conservative vertical groove technique for tooth rehabilitation: 3-year follow-up. Case Rep Dent 2018; 2018:2012578.  Back to cited text no. 1
    
2.
Singhal R, Pathak A. Comparison of the fracture resistance of reattached incisor tooth fragments using 4 different materials. J Indian Soc Pedod Prev Dent 2012; 30:310–316.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Stellini E, Stomaci D, Stomaci M. Fracture strength of tooth fragment reattachments with postpone bevel and overcontour reconstruction. Dent Traumatol 2008; 24:283–288.  Back to cited text no. 3
    
4.
Khinda VIS, Dang P, Khinda P. A comparison of impact strength of reattached incisor tooth fragments using different restorative materials: an in vitro study. Pak Oral Dent 2016; 1:112–176.  Back to cited text no. 4
    
5.
Badakar CM, Shashibhushan KK, Naik NS. Fracture resistance of microhybrid composite, nano composite and fibre-reinforced composite used for incisal edge restoration. Dent Traumatol 2011; 27:225–229.  Back to cited text no. 5
    
6.
Terry DA. Adhesive reattachment of a tooth fragment: the biological restoration. Pract Proced Aesthet Dent 2003; 15:403–409.  Back to cited text no. 6
    
7.
Brar GS, Jindal R, Mahajan S. In vitro comparative analysis of fracture resistance using different adhesive materials and preparations on reattached tooth fragments. Int J Contemp Dent 2011; 2:112–123.  Back to cited text no. 7
    
8.
Reis A, Loguercio AD, Kraul A, Matson E. Reattachment of fractured teeth: a review of literature regarding techniques and materials. Oper Dent 2004; 29:226–233.  Back to cited text no. 8
    
9.
Andreasen FM, Daugaard-Jensen J, Munskgaard EC. Reinforcement of bonded crown fractured incisors with porcelain veneers. Endod Dent Traumatol 1991; 7:78–83.  Back to cited text no. 9
    
10.
Makkar S, Aggarwal A, Aggarwal K. In vitro comparative analysis of fracture strength recovery of teeth restored with two different techniques: direct build up and reattachment of a segment. J Adv Med Dent Sci 2014; 2:5–9.  Back to cited text no. 10
    
11.
Farik B, Munksgaard EC, Andreasen JO. Drying and rewetting anterior crown fragments prior to bonding. Endod Dent Traumatol 1999; 15:113–116.  Back to cited text no. 11
    
12.
Sushma S, Karunakar P, Solomon RV. Evaluation of tooth fragment reattachment fracture resistance using three different techniques and materials: an in vitro study. Int J Dent Health Sci 2016; 3:315–326.  Back to cited text no. 12
    
13.
Shalan HM. Evaluation of esthetics and marginal adaptation of composite restorations for fractured permanent incisors. Acta Sci Dent Sci 2019; 11:90–96.  Back to cited text no. 13
    
14.
Miyazaki M, Sato M, Onose H. Influence of thermal cycling on dentin bond strength of two-step bonding systems. Am J Dent 1998; 11:118–122.  Back to cited text no. 14
    
15.
Hashimoto M, Ohno H, Kaga M. In vivo degradation of resin-dentin bonds in humans over 1 to 3 years. J Dent Res 2000:79:1385–1391.  Back to cited text no. 15
    
16.
Stokes A, Hood J. Impact fracture characteristics of intact and crowned human central incisors. J Oral Rehabil 1993; 20:89–95.  Back to cited text no. 16
    
17.
Bruschi-Alonso RC, Alonso RC, Correr GM. Reattachment of anterior fractured teeth: effect of materials and techniques on impact strength. Dent Traumatol 2010; 26:315–322.  Back to cited text no. 17
    
18.
Badami AA, Dunne SM, Scheer B. An in vitro investigation into the shear bond strengths of two dentine bonding agents used in the reattachment of incisal edge fragments. Endod Dent Traumatol 1995; 11:129–135.  Back to cited text no. 18
    
19.
Demarco FF, Fay RM, Pinzon LM, Powers JM. Fracture resistance of reattached coronal fragments – influence of different adhesive materials and bevel preparation. Dent Traumatol 2004; 20:157–163.  Back to cited text no. 19
    
20.
Karre D, Muppa R, Duddu MK, Nallachakrava S. Fracture resistance of reattached fragments using three different techniques with emphasis on vertical grooves and fiber-reinforced composite post: a novel technique. J Conserv Dent 2017; 20:474–478.  Back to cited text no. 20
[PUBMED]  [Full text]  
21.
Beltagy MT. Laboratory and clinical evaluation of uncomplicated fragment reattachment using pinholes. Tanta Dent J 2018; 15:117–126.  Back to cited text no. 21
  [Full text]  
22.
Srilatha JS, Chhasatia N, Rani PJ. Reattachment of fractured anterior teeth-determining fracture strength using different techniques: an in vitro study. J Contemp Dent Pract 2012; 13:61–65.  Back to cited text no. 22
    
23.
Pavone AF, Ghassemian M, Mancini M. Autogenous tooth fragment adhesive reattachment for a complicated crown root fracture: two interdisciplinary case reports. Case Rep Dent 2016; 2016:9352129.  Back to cited text no. 23
    
24.
Garoushi S, Vallittu PK, Lippo VJ. Depth of cure and surface microhardness of experimental short fiber-reinforced composite. Acta Odontol Scand 2007; 66:38–42.  Back to cited text no. 24
    
25.
Kurniawati CS, Rachmawati D, Mas'ada D. The fracture resistance of fiber reinforced composite restorative material has higher yield than nanohybrid resin composite. J Phys Conf Ser 2018; 1073:05.  Back to cited text no. 25
    
26.
Ellakwa AE, Shortall AC, Shehata MK, Marquis PM. The influence of fibre placement and position on the efficiency of reinforcement of fibre reinforced composite bridgework. J Oral Rehab 2001; 28:785–791.  Back to cited text no. 26
    
27.
Fennis WMM, Kreulen CM, Wolke JGC. Fracture resistance of reattached incisor fragments with mini fibre-reinforced composite anchors. J Dent 2009; 37:452–467.  Back to cited text no. 27
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1], [Table 2]



 

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