The GDPUK.com Blog

All that's new in the world of dentistry
MAR
11

Nobel Biocare – making implant orders easy

 

We live in a digital age. With e-commerce now one of the fastest growing markets in Europe, many companies are now turning to online stores as way to offer customers even better service, with greater flexibility and the option to place orders at any time, day or night.

 

Among the companies leading the way in this field is Nobel Biocare, with its new online store found at: store.nobelbiocare.co.uk. The design and layout of the new store has been based on an extended period of research and development to provide customers with the very best experience possible.

 

Glenn Rhodes is Head of Marketing at Nobel Biocare. With over 20 years’ experience in marketing, Glenn has worked across the dental and healthcare sectors and has overseen the introduction of the new online store to the UK market.

 

“When we set out to create a new online store we wanted to make sure we got it just right,” says Glenn. “Our customers are always our number one priority, so a long time was spent researching the market and assessing what does and doesn’t work in order to provide the best online shopping experience. The result is a finished product that looks incredibly crisp and clean. The menu system in particular has been designed to be simple and intuitive so customers can find the products they’re looking for in as little time as possible.”

 

According to Glenn, the launch of the new online store comes as part of Nobel Biocare’s ongoing commitment to providing the very best service and support. Designed to make online ordering easier and more convenient, providing a valuable extra option for customers who may be pressed for time, or who would like to place orders outside of normal working hours.

 

“We’ve made our entire product range of over 1,700 product available, with everything from implants to tooling and abutments all easily accessible,” continues Glenn. “Each product page contains a detailed description of the product alongside technical specifications and a zoom feature such as you will find in many other high quality stores you will find online.

 

“To make the ordering process easier, the system also relates products together so that if you’re searching for an implant, you will also find drills, tools, healing abutments and numerous other associated products included below the main listing. You can also design your own personalised product catalogue, so that all of the items you commonly order can be found swiftly at the click of a button. This means you can spend less time ordering, and more time doing the things that really matter in practice.”

 

Another notable innovation found in the online store is the inclusion of an organic scrolling “home page”. This page provides a stream of regularly updated information to assist customers, and also acts as a portal to additional services and content, such as online training opportunities with iTunes U, social media links, and video testimonials from satisfied customers. Users will also appreciate easy access to information about returns policy, how to contact the company, and further customer support.

 

Though the new online store has only been in operation for a short time in the UK, according to Glenn, the feedback his team has received so far has been extremely positive.

 

“The response we’ve had so far has been fantastic,” concludes Glenn. “Our customers really appreciate the chance to be able to place orders at a time and location convenient to them. While of course we are always available during our regular office hours the online store has given our customers that extra option to place orders whenever and wherever they want. Our customers also value the fact that they can review their order history and create their own personalised catalogue to make ordering regular items an absolute breeze.”

 

To register for the Nobel Biocare online store, simply visit store.nobelbiocare.co.uk and click to “sign in or register” at the top of the page. This will require only a few simple details including your name, email address and customer number. If you are new to Nobel Biocare, you can also request to be contacted by a sales representative who will be more than happy to assist you in setting up your account and getting started.

 

For more information contact Nobel Biocare on 0208 756 3300 or visit www.nobelbiocare.com

 

To register for the Nobel Biocare Online Store go to:

store.nobelbiocare.co.uk

 

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FEB
13

Paul Tipton – “There was only one implant for me”!

 

“I have been involved with implants and restoring them since 1986 when I went to Malmo on my first implantology course,” says Professor Paul Tipton. “During this time I have seen many changes in techniques, systems and expectations.

“Nowadays patients require not only a long lasting functional stable implant, but also an aesthetic one that can be delivered immediately – hence the rise of immediate loading cases and provisionalisation.”

As a Specialist in Prosthodontics, Paul Tipton has restored thousands of dental implants in a career spanning almost 30 years. But while he may have used almost all of the major implant systems available today, which system would he use in his own mouth?

Unfortunately for Paul, this was the very question he found himself asking, after a fractured crown left him weighing up his options.

“Imagine my anxiety when just over a week ago whilst eating a chicken sandwich I encountered a foreign body in my mouth,” continues Paul. “It was my upper left lateral incisor crown, fractured off at gum level!

“Upon looking in the mirror I saw no ferrule and my mind was settled: no RCT, crown lengthening with bone removal and post crown; it was to be root removal, immediate implant, definitive abutment and reline the original crown over the top, followed by occlusal adjustment.

“I had this done the very next day by two colleagues well versed in implantology and my implant system of choice. I now await my final restoration in 6 months’ time.”

But what system did he choose?

“There was only one implant for me,” says Paul. “After 28 years in implantology I chose Nobel Biocare for its longevity, ease of use, success rate, and innovation.”

 

For more information contact Nobel Biocare on 0208 756 3300 or visit www.nobelbiocare.com

 

To register for the Nobel Biocare Online Store go to:

store.nobelbiocare.co.uk

 


 

 

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JAN
16
0

Why Invent a New Dental Implant? Part 2

By Dr. James C. Grant

 

This is the 2nd part of an article I wrote outlining my journey of the past 6 years on the Proximerge Dental Implant and why I felt compelled to research and develop a new replacement for the existing dental implants.

This is the link to the 1st part:-  https://www.gdpuk.com/resources/implantology/entry/420-why-invent-a-new-dental-implant.

I believe that the Patient is at the center of the Dentist practice, then supported by the finest Surgeon, Dental Lab Tech and Hygienist or Dental Nurse.

 

The Proximerge implant system integrates an eccentrically shaped platform and anchor implant in the jaw. It is the only technology that can anatomically match the profile of the teeth as they emerge from the boneProximerge is currently focused on molars (where the problem is the most significant) but the future designs are in development to provide solutions for all teeth and other applications such as implant-retained dentures. 

 

All current designs use a single round implant screwed into the jawbone to act as an artificial root for replacing lost teeth.  However, the footprint of teeth as they emerge form the jawbone is seldom round so this results in an anatomically poor match.  The problem is especially pronounced in the multi-rooted molar region as this approach leaves unacceptably large gaps, which trap food and cause patient discomfort, bacteria build-up, and long-term health risk to bone, gum tissue and adjacent teeth.  Accumulating bacteria around implants can lead to toxins crossing the membrane barrier and entering the circulatory system.  Research has shown these oral bacteria to be associated with many systemic conditions such as heart disease, stroke, osteoporosis and pregnancy complications.  In addition, existing implant designs provide a smaller, weaker foundation, which can lead to crown failure from shearing, fracturing of implant materials and bone loss due to excessive forces.  Custom abutments and wider diameter implant designs have been developed to help address these issues but still fall short because the source of the problem is the naturally eccentric shape of teeth as they emerge from the bone.

Proximerge is the only technology that can match noncircular shapes in the bone to provide a better biomechanical foundation and anatomically correct interproximal spaces.

Surgical and Restorative Example

 

This system allows the dentist to provide to the patient a final restoration produced by the dental lab tech that biomimic’s the anatomy and morphology of the tooth being replaced.  This natural shape is what the patient should expect from the oral health provider that allows the dental nurse-hygienist to instruct the patient on oral hygiene and maintenance.  Without excessive gaps accumulating food and bacteria, the patient and hygienist will be able to keep the area healthy and expect a successful implant restoration.

To discuss the Proximerge system, please email me This email address is being protected from spambots. You need JavaScript enabled to view it. 

Look forward to hearing your thoughts on the implant system.

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JAN
10
0

Why Invent a New Dental Implant?

Why Invent a New Dental Implant?

By Dr. James C. Grant

Founder/Inventor Proximerge Dental Implant

 

As a dentist, we all have our list of why we chose this profession; I suspect that somewhere on your list is, “Helping people.”  We take people out of pain; we change patient’s lives by creating a smile that gives them a new confidence.  We give patients a healthy mouth that perhaps they never had before, and hope to assist them in maintaining oral health for the rest of their lives.  Even some patient’s gain the ability to chew their food better and gain benefits from nutrition they weren’t aware was missing.  For me, the satisfaction of all these and knowing that I did my best to improve the life of my patient is my first goal.

Six years ago I became compelled to do something to change the way dental implants are restored, being motivated by a recurring complaint from my patients.  They made me aware of a common problem, to which I could not offer a solution, because there was not one available.  I began an evidence-based journey using my own resources, spending countless hours contacting various adjunct manufacturers of dental implants, major implant companies, notable researchers and experts.  It resulted in prototyping my own solution, manufacturing it, and finding suitable clinical patients for my own clinical trial.  After 3 years, I secured my first patent and with the help of Angel Investors started the Proximerge Dental Molar Implant System. We are currently placing and restoring the implant system by outstanding Implantologists and surgeons in the UK.  Why did I bother to incur this time consuming, not to mention expensive project in the first place? It is a complex answer, where I shall start with my philosophy on this journey.

Dentistry is in the most exciting period that I have ever known in the 35 years I have been involved, a sort of renaissance.  The availability of Digital Imaging and Communications in Medicine is a standard of care that makes transmitting, storing, and printing dental information commonplace.  From X ray images to digital impressions with accuracy as impressive as 10 microns are now everyday tools.   The use of Computer Aided Design and Computer Aided Manufacturing (CAD/CAM) and Virtual Design is standard software in dental laboratories and at the chair.  Custom same day design and milling in the dental office that offers a crown in about an hour is remarkable technology.  Additive Manufacturing or 3D printing has applications in the dental lab and stereolithography has impressive accuracy with future applications for expansion.  The routine use of laser’s for hard and soft tissue in dentistry makes the procedure less invasive and impressive results.  The lists go on with new drugs, materials, techniques, quicker, faster and safer methods are being introduced on a regular time frame.

I had a dental instructor who use to say, “You can’t diagnose what you don’t know.”  It was true when I was in school, but in today’s world of social media and computer information the availability of data and access to Internet research makes any undiagnosed question a click away.  On-line forums with other professionals who can write an opinion and give advice from their experience and carry on conversations are an invaluable tool for every complex case or patient problem.  This adjunct to a clinical situation and diagnosis will only make for a more accurate treatment option.  We as dentists must expand and increase our range of standard of care beyond the teeth and gums.  It is required of us to become doctors of the entire body specializing in the oral cavity.  A simple saliva test can now identify a patient’s DNA, Genome Map, specific bacteria and the diseases associated with them.  This information allows us to identify and prevent specific systemic diseases where the oral connection can be actively recognized. 

It has been suggested (Everett Rogers) that about 15% of the population is a combination of Innovator and Early Adopter of new technology.  These people think with their limbic brain often having a “gut feeling.”  They seek out ideas that challenge the dogmatic and pragmatic thinking of the day.  I think most of us have some of this attitude in certain situations where we follow our gut instincts, and maybe can’t define why we are doing something other than it feels right.  Dentistry is a little more cut and dried.  We are taught to examine and apply the tried and true knowledge where our best judgment is used for the situation.  Some of this is taught to us, but the majority is compiled from our curiosity for published research, continued education or evidence based experience. The debate as to which has more value takes on the bias from each perspective, I feel there is value from both and each is just as necessary.  The famous sayings, “You must think outside of the box,” and the definition of, “Insanity, doing the same think over and over, but expecting a different results” are what the 15% Innovators and Early Adopters use as their mantra.  It is important to keep asking, “Why” and pushing the envelope to inspire original thinking.

My hope is that I leave the dental field better than how I found it and my patient’s lives enriched in any small way from my ability to improve a life.  So when my dental implant patients who were experiencing a similar problem and complaint with their molar restorations, I knew that I must look for a solution.  I was compelled to ask the major implant companies about their solution to what my patients viewed as a real irritation.  I knew that for this patient’s it was potentially far more than just a nuisance or being over critical, but a problem that could initiate disease and tooth loss.  These patients were unknowingly uncovering an ignored violation of dental principles we were fundamentally taught in school.  It is understandingly the natural evolution of the procedures we have found to work the best in dental implants and the speed of change to accept implant treatment. It is easy to recognize the many benefits of choosing an implant whenever the situation warrants over traditional treatment choices of the past, even when the easier acceptance of insurance, cost and convenience seems more attractive.  The benefits of replacing one tooth with another root shaped implant makes for the best treatment option given to the patient.  During my career and the use of dental implants, I have seen the success rate increase with the advancement of research and technology.  Better instruments and techniques along with higher manufacturing tolerances, custom component designs, and new ideas pushing the critical thinking outside the norm benefits the patients.  With over 200 dental implant manufactures all looking for the new and better paradigm to attract the dental customer has made for some interesting variations in a fairly pragmatic field.  Yet, in my experience and listening to my patients, I found that there was something omitted and over looked in the development of molar implants that needed to be addressed.

According to the dental labs I have talked to estimate that somewhere between 65-70% of the crowns they fabricate on implant teeth are in the posterior area, mostly molars.  These are the functional grinding teeth and not necessarily the esthetic zone ones, which is not usually what I see when I attend lectures on implants. Rarely are the molars featured in the lectures, it is usually the “sexy” front teeth that get the attention where we start with a visibly compromised mouth and after the implants the patient has a new beautiful smile, new hairdo and less wrinkles.  It makes me proud to be a part of a profession that can change a person’s appearance and confidence to that extent, however we must not forget that the majority of implant crowns are produced for missing molar teeth.  I asked myself, “Why is it that these lectures I attend rarely show photos and x-rays of molars?”  I believe that part of the answer has already been stated above, but in my opinion the real answer is more basic. 

If we look at a clinical photo of a restored implant molar in the mouth, there appears the lab does a remarkable reproduction of the missing tooth.  However, an x-ray shows the real image of the restoration.  Using an implant as large as possible that the available bone allows, still produces a morphology that does not resemble a tooth anywhere else in the dentition.  Even to a non-dental observer the implant crown and replaced implant root are not representative of the natural shape of the missing tooth.  The dis-similarities are obvious with glaring omissions.  Generally, molars have 3 roots, a wide CEJ at bone level, and a rectangular occlusal table.  When they are replaced by implants, which I believe they should be whenever possible, the 3 roots are replaced by 1, and whether the abutment is a manufacturer’s stock or a custom abutment made to follow the emergence profile of the tissue, the resulting crown ends up over contoured and resembles an “apple on a stick.”  An x-ray of this implant system and components, which varies little from company to company, does not biomimic a natural tooth, but because it is the only choice we have as dentists, it has come to be accepted as the norm and “Standard of Care.”  This is what I asked many of the major implant companies worldwide by visiting them personally at their North American Headquarters or writing to the President’s and expecting some sort of a reply.  More often I received a not interested courtesy letter, a referral to some other department, or instructions on how to submit a New Product Idea. I followed up on every replay I received, called whoever I could get to respond, journeyed to meet with Chief Scientists, VP of New Products, Head of Marketing, Research and Development, even a Key Opinion Leader from a major university supported by the one of the largest dental implant company.  The Professor is a well-respected international lecturer who granted me 10 minutes after one of his presentations at the request of my friend the National Sales Manager.  Many of the sales people who are in the field and interact regularly with clinicians practicing dentistry on real patients saw the value of my questioning why there was not an alternative to the molar design, and the advantage of my prototype idea.  The meeting with the Professor lasted about 11 minutes, which was long enough for me to purpose my idea for a solution to the clinical complaints and dilemma we face in treating some of our patients.  Unfortunately, he was not impressed, and in fact called it a “radical” idea and way “outside of the box.”  To which I responded, “ Actually, I am thinking inside of the box.”  Referring to the round peg of a molar implant, being placed inside a square or rectangular space of the missing molar.  He wasn’t amused and probably never knew that his comment was the highest compliment he could have paid me.  I felt I was coming up against the academic dogma and my limbic part of my brain is what was compelling me to continue with this gut feeling that we can find a better solution.  I struggled to discover an alternative treatment for the patients who trusted me to offer the best solution for their missing molar, the dental laboratory technicians who I rely on to fabricate the best crown possible, but finds it frustrating to achieve a biomimic molar using 1 implant when replacing 3 roots, and the dental hygienist who has the professional responsibility to maintain and instruct the patient in the care of the implant, crown, and surrounding tissue to keep it all healthy as the day it was places.  This is why I continued to develop a platform for this circle of support for the patient, including the implant surgeon, restoring dentist, dental lab tech and hygienist.  I was committed then to finding a solution, and am committed to continue to develop and refine any product we develop for the clinical benefit of the people we help….

 

Link to Part 2 - Part 2:  How I developed what I believe is the solution.

 

James C Grant DDS is a clinical dentist in Colorado Springs, Colorado USA.                                                           

Dr. Grant is the founder and inventor of Proximerge Implant System.  He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.

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JAN
02
0

Flapless Implantation with Single-Tooth Champions Implant (R)Evolution

MIMI®- Flapless Implantation with Single-Tooth Champions Implant (R)Evolution® in the Esthetic Zone  

Author: Dr. Stephanie Ott, Dental Care Solutions, Frankfurt/Main

*Please note: The tooth numbers mentioned refer to the FDI Notation System (Dental Chart/Two-Digit World Dental Federation Notation)

As a dentist in private practice, I have placed and restored different implant systems since 2001. For some time, I have incorporated MIMI®-Flapless, the Minimally Invasive Implantation Method, as an additional treatment in my dental office. I am delighted to say that this implantation procedure that is performed without surgical flaps and opened mucosa proves to be less traumatic for patients than the conventional methods of implantation that require reflected flaps and direct visualization of the bone. Most patients feel almost no pain, swelling or post- operative soreness after the surgery. In most cases, patients can resume their activities that day or the next. In this article I would like to describe a case of an implantation of Teeth 11 (#8) and 21 (#9) and the following 8 weeks.

Fig. 1-3: X-rays after the patients’ accident that caused a fracture of the zygomatic bone and the nasal septum: view of the roots of Teeth 11 and 21. Both teeth were lost. The clinical situation 4 months post extraction. 

Implantation

After administering local anesthesia with UDS-forte, we inserted a Champions® conical triangular yellow drill transgingivally until it was in contact with the periosteum to determine the gingival height and thickness (laser markings: every 2 mm). We measured 2 mm-gingival thickness. We drilled transgingivally and slightly palatinally at a slow rotation speed of a maximum of 250 rpm (no water used) (Fig.4 and 5). After measuring the initial gingival thickness and before placing a 10 mm-Champions Implant (R)Evolution®, we prepared the bone with the following 3 conical triangular drills in the D2/D3 bone: first the yellow drill, followed by the black drill and finally the white drill. These drill types allow the spongy bone to be laterally condensed. Between each drill sequence a bone cavity check is performed. (Bone Cavity Check “BCC” is a manual check of the bone cavity to confirm all walls of the prepped bone are intact.”)

Fig. 4-6: Use of the conical triangular yellow drill to prepare the implantation site using the MIMI®-Flapless technique and Bone Cavity Check (BCC) with the flexible thin BCC probe.

 

After the drilling, a 3.0 mm-diameter condenser (Fig.9) was used to extend, expand and condense the spongy bone area to confirm the implant size picked was correct. If primary stability cannot be reached, a larger diameter can be placed. In this case, primary stability of 30/40 Ncm was achieved, which was indicated when the Torque Wrench middle line moved from 20 to 40 Ncm and when the arm of the Torque Wrench bent at 40 Ncm (Fig. 10). We unpacked the blister package and removed the sterile Champions (R)Evolution® implant from the vial. As a rule, you can insert the implant manually with the integrated white plastic Insertion Aid that is attached when the package is opened. There is no need to touch the sterile implant or reset the Insertion Aid. Once the resistance becomes so great that you cannot insert any further, you can remove the Insertion Aid and place the gold hex headed metal driver on the implant head. You have 2 choices to continue the insertions: either use a surgical unit with handpiece at very low RPM (5-10 rpm) or use the Torque Wrench on the gold driver. This treatment is non-traumatic and takes only a few minutes. In this case, the Torque Wrench was used to drive the implants on both 11 (#8) and 21 (#9) to the desired depth. The total time for both placements was less than 1 hour. Finally, X-rays were taken. The patient was very satisfied. She compared this to a friend who had conventional implantation in another office that took two hours to complete.

Fig.7 to 10: After drilling with the yellow, black, and white conical triangular drills in the soft D3/D4 bone, condensers were used with the Torque Wrench. The Torque Wrench was adjusted to 20 Ncm. When the scale sleeve bent around the axis of the Torque Wrench at 40 Ncm and the middle line moved from 20 to 40 Ncm, primary stability at 40 Ncm was reached.

Fig. 11-13: Manual insertion of Champions Implant (R)Evolution® Shuttles by means of the Insertion Aids. The Shuttle (also playing the role of transgingival healing) should not stick out of the tissue more than 1 mm to avoid strong lateral shear forces of occlusion particularly during the first 2-6 weeks post surgery.

Fig. 14-16: The second implant, including the bacteria-proof Shuttle, was placed. The 3.5 mm-high Shuttle is fastened with 10 Ncm from the factory. The implant and Shuttle were placed so only 1 mm of the Shuttle was supragingival. As a rule, if the mucosa is less than 3 mm thick before drilling, subcrestal drilling and positioning of the implant will be preferable to prevent the Shuttle from sticking out more than 1 mm above the gingival height, thus preventing lateral shear forces and movement on the Shuttle head.

Fig. 17-19: After taking X-rays, a WIN! Gingiva-Clix was set on the Shuttle of each Champions Implant (R)Evolution®. Then, a temporary prosthetic restoration (Maryland bridge) was fitted and cemented with Fynal (Dentsply).

 

Impression & Laboratory & Prosthetic Restoration

During the seven weeks post surgery (Transition between Primary Osseointegration Stability and Secondary Osseointegration Stability), the patient felt no pain and experienced no complications. Seven weeks post surgery, the temporary restoration and Gingiva-Clix were removed. A closed transgingival Impregum impression of the implants was made through the Shuttles. The Gingiva-Clix were replaced on the Shuttle and the temporary restoration recemented. The supragingival treatment lasted 15 minutes without the need of anesthesia or X-rays. Our German laboratory, DENTworry in Alzenau, Germany, manufactured two individual zirconium-coated crowns. It is important to provide the laboratory with both Implant Analogs and Shuttles to preserve the exact location of the implant and the soft tissue contour. The lab should use gingival mask material to simulate soft tissues.

After a week, the Shuttles, including the screws, were removed for the first time. The angled titanium Abutments were placed using a resin key and screwed in to a torque of 30 Ncm. The final crowns (zircon) were fitted and cemented.

Fig. 20 to 22: After unscrewing the retaining screw from the Shuttle/Implant, the Shuttle Extractor (R)Evolution was used to remove the Shuttle. With the adapter, the Shuttle Extractor was manually screwed clockwise in through the Shuttle and into  the implant. This lifts the Shuttle off of the implant. Favorable peri-implant soft-tissue results are observed from the Shuttle and Gingiva-Clix. Before the removal of the Shuttle and placement of the Abutments, the inner diameter of the implant has remained sterile during 6-8 week healing. This prevents the problems of peri-implantitis around the healing implant. The titanium Abutments are screwed in and torqued to 30 Ncm, and the screw shafts are covered with cotton pellets and Cavit.  

The implant/Abutment can be connected with the same screw as the one removed from the Shuttle that was connected to the implant. In this case, the crowns were fitted and cemented in only 15 minutes without anesthesia. Highly esthetic results were obtained.

Fig. 23: X-rays. Fig. 24 and 25: After fitting the Abutments and the crowns, excellent esthetic results in the buccal and palatinal areas were obtained.

Conclusion

Apart from the advantages of the non-traumatic, efficient and time-saving treatment, the innovative and high-quality Champions Implant (R)Evolution® and prosthodontic restorations are more affordable for patients than conventional implantation (total price: 135 €, including Gingiva-Clix, angled Abutment, Laboratory Analog, Shuttle, and impression, laboratory and dental accessories). This implant system has now been fully integrated into the treatment services offered in my dental office. I don’t want to be without it!! The innovative Champions Implant (R)Evolution® is a real "Revolution".

In fact, the MIMI®-Flapless method is very promising for patients. Over the past 10 years, international scientific studies at universities have shown that the MIMI®-Flapless method is very beneficial. One of the many advantages of the system is no need of re-entry in the gingival tissue during the impression or when the final restorations are placed. Many patients are enthusiastic about MIMI®-Flapless implantation techniques and the Champions® implants.

Please watch the video of this case here:

https://vimeo.com/75207980

Author:  Dr Stephanie Ott     DENTAL CARE SOLUTIONS

Leipziger Strasse 4    60487 Frankfurt am Main                            

Tel.: 069 - 97 78 33 66     

Internet: www.dr-ott.net       

Mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

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