Journal of Conservative Dentistry
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REVIEW ARTICLE
Biologic width and its importance in periodontal and restorative dentistry
Babitha Nugala, BB Santosh Kumar, S Sahitya, P Mohana Krishna
January-March 2012, 15(1):12-17
DOI:10.4103/0972-0707.92599  PMID:22368328
An adequate understanding of the relationship between periodontal tissues and restorative dentistry is paramount to ensure adequate form, function, esthetics and comfort of the dentition. While most clinicians are aware of this important relationship, uncertainty remains regarding specific concepts such as biologic width, its maintenance and applications of crown lengthening in cases of biologic width violation. Relevant publications regarding biologic width, its violation and management were identified up to August 2011 using manual and electronic database search in Medline, Embase, Directory of Open Access Journals and Google Scholar. This review discusses the concept of biologic width around tooth and its relationship to periodontal health and restorative dentistry.
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REVIEW BY J CONSERV DENT EDITORS
Root canal irrigants
Deivanayagam Kandaswamy, Nagendrababu Venkateshbabu
October-December 2010, 13(4):256-264
DOI:10.4103/0972-0707.73378  PMID:21217955
Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are discussed. We performed a Medline search for English-language papers published untill July 2010. The keywords used were 'root canal irrigants' and 'endodontic irrigants.' The reference lists of each article were manually checked for additional articles of relevance.
  17,331 2,434 3
EDITORIAL
The revised guidelines of the Medical Council of India for the academic promotions: Need for a rethink
Rakesh Aggarwal, Nithya Gogtay, Rajeev Kumar, Peush Sahni, for the Indian Association of Medical Journal Editors
January-February 2016, 19(1):1-4
DOI:10.4103/0972-0707.173180  PMID:26957784
  18,200 899 -
RESTORATIVE DENTISTRY
Principles of smile design
Mohan Bhuvaneswaran
October-December 2010, 13(4):225-232
DOI:10.4103/0972-0707.73387  PMID:21217950
An organized and systematic approach is required to evaluate, diagnose and resolve esthetic problems predictably. It is of prime importance that the final result is not dependent only on the looks alone. Our ultimate goal as clinicians is to achieve pleasing composition in the smile by creating an arrangement of various esthetic elements. This article reviews the various principles that govern the art of smile designing. The literature search was done using PubMed search and Medline. This article will provide a basic knowledge to the reader to bring out a functional stable smile.
  16,096 1,940 2
LEGENDS
The Father of Modern Dentistry - Dr. Greene Vardiman Black(1836-1915)
Reuben Joseph
April-June 2005, 8(2):5-6
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RESTORATIVE DENTISTRY
Dentin hypersensitivity: Recent trends in management
Sanjay Miglani, Vivek Aggarwal, Bhoomika Ahuja
October-December 2010, 13(4):218-224
DOI:10.4103/0972-0707.73385  PMID:21217949
Dentinal hypersensitivity (DH) is a common clinical condition usually associated with exposed dentinal surfaces. It can affect patients of any age group and most commonly affects the canines and premolars of both the arches. This article concisely reviews the patho-physiology, mechanism and clinical management of the DH. Treatment of DH should start with an accurate diagnosis. Differential diagnosis should be made and all other probable causes should be excluded. An often neglected phase of clinical management of DH is the identification and treatment of the causative factors of DH. By removing the etiological factors, the condition can be even prevented from occurring or recurring. There are various treatment modalities available which can be used at home or may be professionally applied. The "at home" desensitizing agents include toothpastes, mouthwashes or chewing gums and they act by either occluding the dentinal tubules or blocking the neural transmission. This article also discusses the recent treatment options like bioglass, Portland cement, lasers and casein phosphopeptide.
  14,932 1,850 7
DENTAL MATERIALS
Dental ceramics: An update
Arvind Shenoy, Nina Shenoy
October-December 2010, 13(4):195-203
DOI:10.4103/0972-0707.73379  PMID:21217946
In the last few decades, there have been tremendous advances in the mechanical properties and methods of fabrication of ceramic materials. While porcelain-based materials are still a major component of the market, there have been moves to replace metal ceramics systems with all ceramic systems. Advances in bonding techniques have increased the range and scope for use of ceramics in dentistry. In this brief review, we will discuss advances in ceramic materials and fabrication techniques. Examples of the microstructure property relationships for these ceramic materials will also be addressed.
  14,385 1,415 6
ORIGINAL ARTICLES
Evaluation of microleakage in posterior nanocomposite restorations with adhesive liners
B Simi, BS Suprabha
April-June 2011, 14(2):178-181
DOI:10.4103/0972-0707.82631  PMID:21814362
Aims and Objectives : To compare the microleakage in class II nanocomposite restorations without liner, with resin-modified glass ionomer liner and flowable composite liner. Materials and Methods : Thirty-six sound premolars extracted for orthodontic reasons were selected and randomly assigned into three groups of 12 teeth each (Group I, II and III). Class II cavities of specified dimensions were prepared with margins located in the enamel. Cavities in group I were lined with resin modified glass ionomer (GC Fuji II LC-Improved), group II were lined with flowable composite (Filtex Z350 Flowable Restorative) and no liner was placed for cavities in group III. All the teeth were restored with nanocomposite (Z 350 Universal Restorative). The teeth were immersed in 0.5% methylene blue dye, sectioned mesiodistally and observed under stereomicroscope. Results : Group III showed maximum leakage compared to group I and II which was statistically significant. Microleakage was lesser in group lined with resin-modified glass ionomer as compared to flowable composite group but not statistically significant. Conclusions : Placement of liner beneath nanocomposite restoration results in significant reduction in microleakage. Both resin-modified and flowable composite liners under nanocomposite restorations result in comparable reduction of microleakage.
  14,301 447 1
REVIEW ARTICLES
C-shaped root canal configuration: A review of literature
Marina Fernandes, Ida de Ataide, Rahul Wagle
July-August 2014, 17(4):312-319
DOI:10.4103/0972-0707.136437  PMID:25125841
The aim is to review and discuss the etiology, incidence, anatomic features, classification, diagnosis and management of the C-shaped canal configuration. C-shaped canal configuration is a variation that has a racial predilection and is commonly seen in mandibular second molars. The intricacies present in this variation of canal morphology can pose a challenge to the clinician during negotiation, debridement and obturation. Manual and electronic searches of literature were performed from 1979 to 2012, in Pub Med by crossing the keywords: C-shaped canals, mandibular second molar, mandibular first premolar, root canal morphology. Knowledge of the C-shaped canal configuration is essential to achieve success in endodontic therapy. Radiographic and clinical diagnoses can aid in identification and negotiation of the fan-shaped areas and intricacies of the C-shaped anatomy. Effective management of this anomalous canal configuration can be achieved with rotary and hand instrumentation assisted with sonics and ultrasonics. Modifications in the obturation techniques will ensure a 3-dimensional fill of the canal system and chamber retained restorations like amalgam or composites, serve as satisfactory post endodontic restorations.
  13,561 963 -
ORIGINAL ARTICLES
Root canal morphology of maxillary second premolars in an Indian population
Udayakumar Jayasimha Raj, Sumitha Mylswamy
July-September 2010, 13(3):148-151
DOI:10.4103/0972-0707.71648  PMID:21116391
Introduction : The purpose of this study was to investigate root canal morphology of maxillary second premolars in an Indian population. Materials and Methods : Two hundred maxillary second premolars were collected, stained, decalcified, and cleared. Cleared teeth were examined in a steromicroscope under 7.5× magnification and the following observations were made: (1) length of the teeth, (2) number of root canals, (3) root canal configuration by Vertucci's classification, (4)number of isthmi between the canals, (5) frequency of apical deltas. Results : Of the two hundred maxillary second premolars, 64.1% had one root canal at the apex and 35.4 % had two root canals at the apex. The average length of the teeth was 21.5 mm. Concerning the canal morphology, 33.6% of the teeth exhibited Vertucci type II configuration followed by type IV pattern (31.1%); 29.2% of the teeth possessed type I pattern. An additional canal configuration type XIX was found in one tooth. Isthmi and apical deltas was found in 19% and 14% of the cases, respectively. Conclusion : The root canal morphology of Maxillary second premolars can be complex and requires careful evaluation prior to endodontic therapy.
  14,055 426 1
DENTAL MATERIALS
Indirect resin composites
Suresh Nandini
October-December 2010, 13(4):184-194
DOI:10.4103/0972-0707.73377  PMID:21217945
Aesthetic dentistry continues to evolve through innovations in bonding agents, restorative materials, and conservative preparation techniques. The use of direct composite restoration in posterior teeth is limited to relatively small cavities due to polymerization stresses. Indirect composites offer an esthetic alternative to ceramics for posterior teeth. This review article focuses on the material aspect of the newer generation of composites. This review was based on a PubMed database search which we limited to peer-reviewed articles in English that were published between 1990 and 2010 in dental journals. The key words used were 'indirect resin composites,' composite inlays,' and 'fiber-reinforced composites.'
  11,257 1,258 3
REVIEW ARTICLE
Role of Platelet rich fibrin in wound healing: A critical review
Balaram Naik, P Karunakar, M Jayadev, V Rahul Marshal
July-August 2013, 16(4):284-293
DOI:10.4103/0972-0707.114344  PMID:23956527
Aim: The aim is to review and discuss the strategies available for use of platelet rich fibrin as healing aid in dentistry. Background: Platelet rich fibrin (PRF) is a fibrin matrix in which platelet cytokines, growth factors, and cells are trapped and may be released after a certain time and that can serve as a resorbable membrane. Choukroun and his associates were amongst the pioneers for using PRF protocol in oral and maxillofacial surgery to improve bone healing in implant dentistry. Autologous PRF is considered to be a healing biomaterial, and presently, studies have shown its application in various disciplines of dentistry. Materials and Methods: By using specific keywords, electronic search of scientific papers was carried out on the entire PubMed database with custom range of 5 years. The electronic search yielded 302 papers; based on inclusion and exclusion criteria which were specifically predetermined, 72 papers were identified as suitable to the inclusion criteria and the remaining 230 papers were excluded. After adding three more selected papers through hand search, full text of all the articles retrieved and review was done. By pooling the extracted data from selected papers, the reviewed data was synthesized. Conclusion: Recently by showing good promising results with use of the PRF, it has proved to have a good prospect for its use as healing aid in various aspects of the dentistry.
  10,255 1,003 2
RESTORATIVE DENTISTRY
Dental caries: A complete changeover, PART III: Changeover in the treatment decisions and treatments
Usha Carounanidy, R Sathyanarayanan
October-December 2010, 13(4):209-217
DOI:10.4103/0972-0707.73383  PMID:21217948
Comprehensive management of dental caries should involve the management of disease as well as the lesion. Current decision making process in cariology is influenced by numerous factors such as the size/ depth/ activity of the carious lesion and age/ the caries risk status of the patient. Treatment decisions should involve planning the non-operative/ preventive treatment for non-cavitated or early cavitated lesions and also formulating operative treatment for cavitated lesions. Apart from these two responsibilities, a clinician should also be knowledgeable enough to decide when not to interfere in the caries dynamics and how frequently to recall the patient for follow-ups. The non-operative treatment prescriptions vary in dose, intensity and mode of delivery according to the caries risk status. Minimal invasion and maximal conservation of tooth structure has become the essence of current operative treatments. This part of the series elaborates on the paradigm shift in the management of dental caries.
  9,048 918 1
INVITED REVIEW
Advances in endodontics: Potential applications in clinical practice
Anil Kishen, Ove A Peters, Matthias Zehnder, Anibal R Diogenes, Madhu K Nair
May-June 2016, 19(3):199-206
DOI:10.4103/0972-0707.181925  PMID:27217630
Contemporary endodontics has seen an unprecedented advance in technology and materials. This article aimed to review some of the challenges and advances in the following sections: (1) endodontic imaging, (2) root canal preparation, (3) root canal disinfection, (4) root canal filling, and (4) regenerative endodontic procedures (REPs). Jointly, these advances are aimed at improving the state of the art and science of root canal treatment.
  8,651 1,191 -
DENTAL MATERIALS
Dental amalgam: An update
Ramesh Bharti, Kulvinder Kaur Wadhwani, Aseem Prakash Tikku, Anil Chandra
October-December 2010, 13(4):204-208
DOI:10.4103/0972-0707.73380  PMID:21217947
Dental amalgam has served as an excellent and versatile restorative material for many years, despite periods of controversy. The authors review its history, summarize the evidence with regard to its performance and offer predictions for the future of this material. The PubMed database was used initially; the reference list for dental amalgam featured 8641 articles and 13 publications dealing with recent advances in dental amalgam. A forward search was undertaken on selected articles and using some author names. For the present, amalgam should remain the material of choice for economic direct restoration of posterior teeth. When esthetic concerns are paramount, tooth-colored materials, placed meticulously, can provide an acceptable alternative. All alternative restorative materials and procedures, however, have certain limitations.
  8,377 1,139 2
INVITED REVIEW
Dental caries - A complete changeover (Part I)
Carounanidy Usha, R Sathyanarayanan
April-June 2009, 12(2):46-54
DOI:10.4103/0972-0707.55617  PMID:20617066
In spite of a knowledge explosion in cariology science, dental caries still remains a misunderstood phenomenon by the clinicians. In order to effectively use the wide range of preventive and management strategies, it is imperative to look beyond those black and white spots that manifest on the tooth surfaces.This paper focuses on the revised versions of the etiopathogenesis and definition of dental caries disease in the present century.
  7,745 1,590 1
Dental caries: A complete changeover (Part II)- Changeover in the diagnosis and prognosis
Usha Carounanidy, R Sathyanarayanan
July-September 2009, 12(3):87-100
DOI:10.4103/0972-0707.57631  PMID:20543914
Realization that dental caries is a reversible, dynamic biochemical event at a micron level has changed the way the profession recognizes the caries disease and the caries lesion. The diagnosis of dental caries poses challenges due to the complex interaction of multiple endogenous causal factors. The most appropriate diagnostic aid for this purpose is the risk model of caries risk assessment. The analyses of the biological determinants provide clues to the dominant causal factor. The detection of a carious lesion has undergone a rigorous revision and revolution in order to identify the earliest mineral change so that it can be controlled without resorting to invasive management options. Apart from detection, it became mandatory to assess the extent of the lesion (noncavitated/cavitated), assess the activity status of the lesion (active/arrested), monitor the lesion progress (progression/regression over a period of time), and finally to predict the prognosis of the lesion as well as the disease. The prognosis of the disease can be best assessed by analyzing the predictor factors in caries risk assessment. The ultimate objective of such a meticulous and methodical approach aids in devising a tailor-made treatment plan, using preventing measures precisely and restorative measures minimally. This ensures the best oral health outcome of the patient.
  7,867 1,433 1
A new dimension to conservative dentistry: Air abrasion
Vivek S Hegde, Roheet A Khatavkar
January-March 2010, 13(1):4-8
DOI:10.4103/0972-0707.62632  PMID:20582212
Air abrasion dentistry has evolved over a period of time from a new concept of an alternative means of cavity preparation to an essential means of providing a truly conservative preparation for preservation of a maximal sound tooth structure. The development of bonded restorations in combination with air abrasion dentistry provides a truly minimal intervention dentistry. This article reviews the development of air abrasion, its clinical uses, and the essential accessories required for its use.
  7,628 1,233 2
INVITED REVIEWS
Management of supernumerary teeth
Abhishek Parolia, M Kundabala, Marisha Dahal, Mandakini Mohan, Manuel S Thomas
July-September 2011, 14(3):221-224
DOI:10.4103/0972-0707.85791  PMID:22025821
Supernumerary paramolars are the rare anomalies of the maxillofacial complex. These are more common in the maxilla than in the mandible. This article reviews the etiology, frequency, classification, complications, diagnosis and management of supernumerary teeth (bilateral maxillary paramolars)
  8,525 333 6
REVIEW ARTICLES
Variable permanent mandibular first molar: Review of literature
Srinidhi V Ballullaya, Sayesh Vemuri, Pabbati Ravi Kumar
March-April 2013, 16(2):99-110
DOI:10.4103/0972-0707.108176  PMID:23716959
Introduction: The success of root canal therapy depends on the locations of all the canals, thourough debridement and proper sealing. At times the clinicians are challenged with variations in morphology of root canal. This review article attempts to list out all the variations of permanent mandibular first molar published so for in the literature. Materials and Methods: An exhaustive search was undertaken using PUBMED database to identify published literature from 1900 to 2010 relating to the root canal morphology of permanent first molar by using key words. The selected artcles were obtained and reviewed. Results: Total ninty seven articles were selected out of which 50 were original article and forty seven were case reports. The incidence of third canal in mesial root was 0.95% to 15%. The incidence of three rooted mandibular first molar was 3% to 33%. Only ninety cases reported with c-shape canal configuration. Incidence of Taurodintism without congenital disorder was very rare. Conclusion: The root canal treatment requires proper knowlegde of variations in root canal morphology in order to recognise, disinfect and seal all portal of exit. This can be accomplished with proper diagnosis using newer modes, modification in access preparation, use of operating microscope, enhanced methods of disinfecting and sealing of all canals.
  8,260 569 -
The self-adjusting file (SAF) system: An evidence-based update
Zvi Metzger
September-October 2014, 17(5):401-419
DOI:10.4103/0972-0707.139820  PMID:25298639
Current rotary file systems are effective tools. Nevertheless, they have two main shortcomings:
  1. They are unable to effectively clean and shape oval canals and depend too much on the irrigant to do the cleaning, which is an unrealistic illusion
  2. They may jeopardize the long-term survival of the tooth via unnecessary, excessive removal of sound dentin and creation of micro-cracks in the remaining root dentin.
The new Self-adjusting File (SAF) technology uses a hollow, compressible NiTi file, with no central metal core, through which a continuous flow of irrigant is provided throughout the procedure. The SAF technology allows for effective cleaning of all root canals including oval canals, thus allowing for the effective disinfection and obturation of all canal morphologies. This technology uses a new concept of cleaning and shaping in which a uniform layer of dentin is removed from around the entire perimeter of the root canal, thus avoiding unnecessary excessive removal of sound dentin. Furthermore, the mode of action used by this file system does not apply the machining of all root canals to a circular bore, as do all other rotary file systems, and does not cause micro-cracks in the remaining root dentin. The new SAF technology allows for a new concept in cleaning and shaping root canals: Minimally Invasive 3D Endodontics.
  7,903 872 -
ENDODONTICS
Nonsurgical management of periapical lesions
Marina Fernandes, Ida de Ataide
October-December 2010, 13(4):240-245
DOI:10.4103/0972-0707.73384  PMID:21217952
Periapical lesions develop as sequelae to pulp disease. They often occur without any episode of acute pain and are discovered on routine radiographic examination. The incidence of cysts within periapical lesions varies between 6 and 55%. The occurrence of periapical granulomas ranges between 9.3 and 87.1%, and of abscesses between 28.7 and 70.07%. It is accepted that all inflammatory periapical lesions should be initially treated with conservative nonsurgical procedures. Studies have reported a success rate of up to 85% after endodontic treatment of teeth with periapical lesions. A review of literature was performed by using electronic and hand searching methods for the nonsurgical management of periapical lesions. Various methods can be used in the nonsurgical management of periapical lesions: the conservative root canal treatment, decompression technique, active nonsurgical decompression technique, aspiration-irrigation technique, method using calcium hydroxide, Lesion Sterilization and Repair Therapy, and the Apexum procedure. Monitoring the healing of periapical lesions is essential through periodic follow-up examinations.
  7,619 1,097 -
ORIGINAL ARTICLES
Remineralization potential of fluoride and amorphous calcium phosphate-casein phospho peptide on enamel lesions: An in vitro comparative evaluation
S Lata, NO Varghese, Jolly Mary Varughese
January-March 2010, 13(1):42-46
DOI:10.4103/0972-0707.62634  PMID:20582219
Aim: This in vitro study was conducted on enamel blocks of human premolars with the aim of evaluating the remineralization potential of fluoride and ACP-CPP and the combination of ACP-CPP and fluoride on early enamel lesions. Materials and Methods: Fifteen intact carious free human premolars were selected. The coronal part of each tooth was sectioned into four parts to make 4 enamel blocks. The baseline SMH (surface microhardness) was measured for all the enamel specimens using Vickers microhardness (VHN) testing machine. Artificial enamel carious lesions were created by inserting the specimens in demineralization solution for 3 consecutive days. The SMH of the demineralised specimens was evaluated. Then the four enamel sections of each tooth were subjected to various surface treatments , i.e. Group 1- Fluoride varnish, Group 2- ACP-CPP cream, Group 3- Fluoride + ACP-CPP & Group 4- Control (No surface treatment). A caries progression test (pH cycling) was carried out, which consisted of alternative demineralization (3hours) and remineralization with artificial saliva (21 hours) for five consecutive days. After pH cycling again SMH of each specimen was assessed to evaluate the remineralization potential of each surface treatment agent. Then, to asses the remineralization potential of various surface treatments at the subsurface level, each enamel specimen was longitudinally sectioned through the centre to expose the subsurface enamel area. Cross-sectional microhardness (CSMH) was evaluated to assess any subsurface remineralization Results: Statistical analysis using one-way ANOVA followed by multiple comparisons test was applied to detect significant differences at P ≤ 0.05 levels between various surface treatments at different phases. Conclusions: With in the limits, the present study concludes that; ACP-CPP cream is effective, but to a lesser extent than fluoride in remineralizing early enamel caries at surface level. Combination of fluoride and ACP-CPP does not provide any additive remineralization potential compared to fluoride alone. Fluoride, ACP-CPP and their combination are not effective in remineralizing the early enamel caries at the subsurface level.
  7,511 1,031 12
INVITED REVIEW
Optimizing tooth form with direct posterior composite restorations
Ramya Raghu, Raghu Srinivasan
October-December 2011, 14(4):330-336
DOI:10.4103/0972-0707.87192  PMID:22144797
Advances in material sciences and technology have provided today's clinicians the strategies to transform the mechanistic approach of operative dentistry into a biologic philosophy. In the last three decades, composite resins have gone from being just an esthetically pleasing way of restoring Class III and Class IV cavities to become the universal material for both anterior and posterior situations as they closely mimic the natural esthetics while restoring the form of the human dentition. In order to enhance their success, clinicians have to rethink their protocol instead of applying the same restorative concepts and principles practiced with metallic restorations. Paralleling the evolution of posterior composite resin materials, cavity designs, restorative techniques and armamentarium have also developed rapidly to successfully employ composite resins in Class II situations. Most of the earlier problems with posterior composites such as poor wear resistance, polymerization shrinkage, postoperative sensitivity, predictable bonding to dentin, etc., have been overcome to a major extent. However, the clinically relevant aspect of achieving tight contacts in Class II situations has challenged clinicians the most. This paper reviews the evolution of techniques and recent developments in achieving predictable contacts with posterior composites. A Medline search was performed for articles on ''direct posterior composite contacts.'' The keywords used were ''contacts and contours of posterior composites.'' The reference list of each article was manually checked for additional articles of relevance.
  7,854 548 1
CASE REPORTS
Permanent molar pulpotomy with a new endodontic cement: A case series
Saeed Asgary, Sara Ehsani
January-March 2009, 12(1):31-36
DOI:10.4103/0972-0707.53340  PMID:20379438
The aim of this case series was to determine the clinical and radiographic success rate of pulpotomy, with new endodontic cement (NEC), in human mature permanent molar teeth. Twelve molars with established irreversible pulpitis were selected from patients 14 - 62 years old. The selection criteria included carious pulp exposure with a positive history of lingering pain. After isolation, caries removal, and pulp exposure, pulpotomy with NEC was performed and a permanent restoration was immediately placed. At the first recall (+1 day) no patients reported postoperative pain. One wisdom tooth had been extracted after two months because of failure in coronal restoration. Eleven patients were available for the second recall, with a mean time of 15.8 months. Clinical and radiographic examination revealed that all teeth were functional and free of signs and symptoms. Histological examination of the extracted teeth revealed complete dentin bridge formation and a normal pulp. Although the results favored the use of NEC, more studies with larger samples and a longer recall period were suggested, to justify the use of this novel material for treatment of irreversible pulpitis in human permanent molar teeth.
  7,474 873 14
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