Dental Hygiene Commons^™

Effect Of Brushing Time With A Whitening Dentifrice On Surface Roughness Of Anterior Composite Resins, Ahmet Hazar, Sinem Akgül, Sibel Koçak, Mustafa Murat Koçak

Journal of Dentistry Indonesia

Objectives: This study aimed to compare the surface roughness of three anterior composite resins with different filler size, rate, and shape after brushing for 5000, 10000, and 20000 cycles with a whitening dentifrice. Methods: 44 disk-shaped specimens of each material (5mm diameter, 2mm depth) G-aenial Anterior, Harmonize, Asteria were prepared and divided into four groups according to the brushing cycles (Initial, 5000, 10000, and 20000 cycles). Initial surface roughness values (Ra-values) were assessed using a profilometer and measurements were repeated after each brushing cycle. 4 specimens from each composite resin were observed by scanning electron microscopy before and after brushing. …

Evaluation Of The Effect Of Two Polishing Techniques And Thermocycling Process On Surface Roughness, Hardness, And Color Stability Of Composites, Muhammet Fidan, Zeynep Dereli

Journal of Dentistry Indonesia

Objectives: The aim of this study was to evaluate the effect of two polishing techniques and 10.000 thermocycles on the color stability, surface roughness, and hardness of two nanohybrid (Tetric N-Ceram, Escom100) and one bulkfill (Filtek) resin composites. Methods: A total of 60 specimens were prepared using three resin composites and 20 discs from each composite. Specimens for each composite were randomly divided into two different polishing groups (Optrapol rubber and Sof-Lex discs) (n=10). Surface roughness (Ra, μm), microhardness (VHN), and color change (ΔE00) values were measured pre- and post-thermocycling. Two-way analysis of variance (ANOVA) was used to evaluate …

A Comparison Of Four Different Methods Of Prediction Of Mesiodistal Widths Of Unerupted Permanent Canines And Premolars, Waqar Jeelani, Washma Asad, Maheen Ahmed

Journal of Dentistry Indonesia

The success of orthodontic treatment depends upon the accurate assessment of mesiodistal widths of unerupted canines and premolars in mixed dentition stage. There are several methods available for mixed dentition analysis with dubious reliability in our population. Objective: To statistically develop new prediction equations for Pakistani subjects to predict the widths of unerupted upper canines and premolars (U345) and lower canine and premolars (L345) using mesiodistal widths of lower incisors (I1I2) and lower incisors and first molars (I1I2M1) and compare their performance with previously established methods of Moyers and Tanaka-Johnston. Methods: Study was conducted using the data from the dental …

Endodontic Management Of Mandibular First Molar With Four Roots - A Rare Case Report With Clinical Management Guidelines, Shaikh Shahbaz, Huma Iftekhar, Sharique Alam, Zehra Shavez

Journal of Dentistry Indonesia

Mandibular molar is usually two rooted with one mesial and one distal root. Additional roots are rare which requires accurate diagnosis and a methodical and scrupulous endodontic treatment. Objective: This paper aims to report the endodontic management of an unusual case of a mandibular permanent first molar with four roots (two mesial & two distal) and provide a clinical guideline to detect and manage these variant cases. Case report: A 15-year-old boy reported with a deep carious lesion in the lower left first molar (#36). The apical root contour of #36 on an intraoral periapical radiograph taken in different angulations …

Salivary Iga Depression In Drug-Influenced Gingival Enlargement Among Hypertensive Patients, Muhammad Annurdin Sabarudin, Haslina Taib, Wan Majdiah Wan Mohamad, Siti Lailatul Akmar Zainuddin, Wan Syamimee Wan Ghazali, Ahmad Azhar Misran

Journal of Dentistry Indonesia

Drug-influenced gingival enlargement (DIGE) among hypertensive patients is commonly associated with antihypertensive drugs such as calcium channel blockers (CCBs). Immune response alteration is one of the proposed mechanisms for DIGE. Immunoglobulin A (IgA) in saliva which involves in defense mechanism was shown to be affected in patients with DIGE. Objective: This study aimed to determine the association of salivary IgA level with DIGE. Methods: This cross-sectional study comprised 47 hypertensive patients who had consumed antihypertensive drugs for at least 3 months. Twenty-one (44.7%) males and 26 (55.3%) females had participated in this study. Data was analyzed using SPSS version 26.0. …

Knowledge And Awareness Regarding Uses Of Extracted Natural Tooth In Clinical Practice, Momina Anis Motiwala, Shizrah Jamal, Karshma Devi, Rabia Ghafoor

Section of Dental-Oral Maxillofacial Surgery

Restoration of aesthetics is one the major patients’ concern in dentistry which may be disrupted due to tooth-loss secondary to trauma, or as part of orthodontic treatment or periodontal problem. A number of treatment options are available for the replacement of teeth, but they may be expensive, and time-consuming, involving artificial teeth. For immediate tooth replacement, patient’s own intentionally extracted or unintentionally avulsed tooth maybe used. The current narrative review was planned to discuss various techniques for the use of natural tooth pontic, which preserves the original contours, size and colour of the replaced tooth. Before using these teeth in …

Radiographic Evaluation Of The Margins Of Clinically Acceptable Metal-Ceramic Crowns, Sheikh Bilal Badar, Kamil Zafar, Rabia Ghafoor, Farhan Raza Khan

Section of Dental-Oral Maxillofacial Surgery

Objective: To radiographically evaluate the proximal marginal fit of the clinically acceptable metal-ceramic crowns.
Methods: The prospective study was conducted at the dental clinics of Aga Khan University, Karachi, from July to December 2018, and comprised metal-ceramic crowns that were evaluated prior to the cementation. Clinical examinations were conducted by seating the crown on the tooth preparation and visual assessment was done using sharp explorer along the margins. Clinically acceptable crowns were then evaluated on the bite-wing radiograph. Any horizontal or vertical inaccuracy of >0.5mm at the proximal margins was recorded as 'discrepancy'. Data was analysed using SPSS 22.
Results: …

Navigating Through Our History In Research: An Altmetric Analysis For Publications By The Full-Time Operative Dentistry Faculty At The Aga Khan University Hospital In The Past Decade, Nighat Naveed, Fahad Umer

Section of Dental-Oral Maxillofacial Surgery

Objective: To analyse the social dissemination of publications by fulltime faculty at a tertiary care facility.
Methods: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised publication records of the fulltime Operative Dentistry faculty members between July 2011 till July 2021. The search was done on Google Scholar, Altmetric Explorer and PubMed electronic databases. After final screening, all the publications in PubMed-indexed journals, including in vitro studies, randomised controlled trials, original research articles, case reports and letters to the editor, for which the Altmetric Attention Score was available were included.
Results: Of the 225 publications …

Management Of Severe Dento-Alveolar Traumatic Injuries In A 9-Year Old Boy: A Case Report, Elnaz Mousavi, Masoomeh Khoshdel, Hamidreza Sharifiyan

Journal of Dentistry Indonesia

Dentoalveolar traumas can lead to various injuries that may result in tooth loss. A suitable treatment plan and appropriate interventions should be performed to maintain the dental function and aesthetics, especially for the anterior teeth. Objective: To report the interventions performed on dentoalveolar trauma on a 9-years old male patient who presented with gingival immersion of the right maxillary central incisor and missing a tooth due to a falling accident. Case Report: The patient had multiple traumatic injuries. The medical and dental history was taken, and the clinical and radiologic examinations were performed. The patient underwent surgical intervention and splinting …

Antibacterial And Antibiofilm Efficacy Of Pineapple Hump (Ananas Comosus) On Porphyromonas Gingivalis In Vitro, Abdul Gani Soulissa, Billy Lombardo, Armelia Sari Widyarman

Journal of Dentistry Indonesia

Background: Periodontal disease is one of the most prevalent oral health problems in Indonesia that affects supporting tissues of the teeth. Porphyromonas gingivalis plays an important role in the pathogenesis of periodontal disease. Alternative therapy with natural plant extracts, including pineapple (Ananas comosus) hump extract may inhibit the growth of bacteria that cause periodontal disease. Objective: To determine the effect of pineapple hump extract on bacterial growth and adhesion of Porphyromonas gingivalis biofilms. Method: The bacterial inhibition test was performed by the agar well diffusion method, and biofilm density measurements were made using the biofilm assay method. Results: Pineapple hump …

The Effect Of Parabiotic Reuterin On The Expression Of Genes Involved In Candida Albicans Biofilm Formation: An Ex Vivo Study, Anastasya Muna Riad, Armelia Sari Widyarman

Journal of Dentistry Indonesia

Candida albicans has a number of properties, including resistance to various antimicrobial agents, which allow it to survive in the root canals. Lactobacillus reuteri plays a role in maintaining oral health through interactions with the oral microbiome. L. reuteri has potential as a preventive and therapeutic agent against inflammatory diseases. Objective: The aim of this study was to investigate the effect of irrigation with a reuterin-containing solution on BCR1, ACE2, EFG1, and TEC1 gene expression in C. albicans root canal biofilms. Methods: L. reuteri was cultured in MRS broth and incubated anaerobically for 24 hours at 37°C. C. albicans was …

Effects Of Different Finishing Procedures On Surface Roughness Of Hybrid Cad/Cam Materials, Ender Akan, Ozlem Colgecen, Ibrahim Talha Meşe, Bora Bağiş

Journal of Dentistry Indonesia

Hybrid ceramics combine the beneficial properties of resin with the advantage of glass ceramics. However, there are limited study about on roughness properties of hybrid materials. Objective: To investigate of the effects of surface finishing methods on roughness of dental restorations made from hybrid CAD/CAM blocks. Methods: A total of 60 samples were produced (n=20) for three main material groups, two different hybrid ceramic (LAVA Ultimate and VITA Enamic) and a conventional glass ceramic (IPS e.max CAD). Each material group was divided into two subgroups (n=10). Ten samples were polished and 10 were glazed according to related manufacturer instructions. Surface …

Interrelationship Between Orthodontics And Implantology In Anterior Aesthetic Rehabilitation: A Case Report, Adailton De Morais Cavalcante, Renata Cordeiro Teixeira Medeiros, Danilo Lopes Ferreira Lima, Saulo Ellery Santos

Journal of Dentistry Indonesia

The rehabilitation of complex cases in the anterior region of the maxilla may require knowledge of several dental specialties. when dental involvement also causes bone and gingival involvement, management usually requires adjustment of gingival zenitis and bone graft to compensate for bone loss.

Objective: to discuss a case of previous orthodontic treatment for implant-prosthetic rehabilitation in the anterior region.

Case report: This case report describes a 40-year-old patient who came with the intention of extracting the tooth and installing a bridge. The implant-prosthetic treatment was performed after previous orthodontic treatment to adapt the gingiva and space.

Conclusion: The interrelationship of …

Evaluation Of The Relationship Between Sella Turcica Bridging And Dental Anomalies, Ahmet Karaman, Saadet Cinarsoy Cigerim Assistant Professor, Nourtzan Kechagia Research Assistant

Journal of Dentistry Indonesia

Objectives: This study aims to evaluate the relationship between the morphological variations of Sella Turcica (ST) and dental anomalies.

Methods: This study included 765 individuals between the ages of 13 and 35. ST morphology was examined in 3 groups as no calcification, partially calcified and completely calcified according to the interclinoid ligament (ICL) on lateral cephalometric films, and it was examined and evaluated in terms of its relationship to impacted canines (unilateral and bilateral), impacted teeth (except 3rd molars), root dilaceration, tooth deficiency (upper incisor lateral - lower and upper second premolar), supernumerary tooth and taurodontism.

Results: The rates of …

Evaluation Of The Bone Thickness Of Mandibular Molars Using Cone Beam Computed Tomography, Deniz Yanık, Ahmet Mert Nalbantoglu

Journal of Dentistry Indonesia

Objective: To investigate buccal and lingual bone thicknesses and fenestration rate of mandibular first and second molars using cone-beam computed tomography (CBCT).

Methods: A total of CBCT images of 41 patients were selected and overall 120 mandibular molars were investigated. The buccal and lingual alveolar bone widths were measured at apex of the roots. The prevalence of fenestration in mandibular molars was recorded. Statistical analyses were performed.

Results: The buccal bone widths of mesial root of second molars were significantly lower than the lingual (p<0.05). The lingual bone widths of mesial and distal root of second molars were lower than the buccal (p<0.05). The lowest thickness of buccal and lingual bone was observed in mesial root of first molar and distal root of second molar. The prevalence of fenestration in mandibular first and second molars was 5% and 10%.

Conclusion: The buccal bone widths were lower at the first molar than the second molar. …

Effect Of Natural And Industrial Juices On Surface Microhardness Of Microhybrid And Nanohybrid Composites, Razieh Meshki, Hanieh Hoseini

Journal of Dentistry Indonesia

Numerous studies have been conducted on the effect of various beverages on the mechanical properties of tooth-colored materials, however, little is known about the effects of these materials on composites, particularly newer types such as nanocomposites.

Objectives: This study aimed to evaluate the surface microhardness of two types of composites, micro-hybrid (point 4) and nanohybrid (premise), after exposure to natural and industrial juices.

Methods: In this experimental study, 90 disc-shaped specimens with a thickness of 2 mm and a diameter of 10 mm were taken from two composites, micro-hybrid Point4 (Kerr) and nanohybrid premise (kerr) (two groups of 45). Then, …

Periodontal Parameters And Anti-Cardiolipin Antibodies Following Periodontal Therapy In Chronic Periodontitis, Wan Majdiah Wan Mohamad, Noor Rashidah Saad, Siti Lailatul Akmar Zainuddin, Haslina Taib

Journal of Dentistry Indonesia

Anti-cardiolipin (anti-CL) antibodies are autoantibodies which are directed against cell membrane phospholipids. A significant number of periodontitis patients showed positive for anti-CL antibody. Objective: This study aimed to determine the periodontal parameters and anti-CL antibodies levels before and after non-surgical periodontal therapy in chronic periodontitis. Methods: This cross-sectional study had been carried out at Periodontal Clinic, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Thirty five chronic periodontitis (CP) and 39 non-periodontitis (NP) patients underwent clinical periodontal examination at baseline. Plaque index (PI), gingival index (GI), periodontal pocket depth (PPD), and clinical attachment loss (CAL) were measured. Scaling …

Assessment Of Gingival Status And Gingival Overgrowth Among Immunosuppressed Patients In Universiti Sains Malaysia Hospital, Wan Majdiah Wan Mohamad, Syamimi Izzati Mat Zaid, Haslina Taib

Journal of Dentistry Indonesia

Drug-induced gingival overgrowth (DIGO) is defined as an abnormal growth of the gingiva due to adverse effect of some drugs such as immunosuppressant, calcium channel blocker, and anticonvulsant. Immunosuppressive drugs play an important role in controlling organ transplant rejection and were widely used to treat different diseases. Objective: Immunosuppressive drugs are used for prevention of transplant rejection and management of autoimmune disease. Drug-induced gingival overgrowth (GO) is abnormal growth of gingiva due to adverse effect of these drugs. This study aimed to assess the gingival status, the prevalence of gingival overgrowth and its associated factors among immunosuppressed patients. Methods …

Multiple Oral Ulcerations In A Seizure Patient With Undiagnosed Brain Arteriovenous Malformation, Ambar Kusuma Astuti, Febrina Rahmayanti

Journal of Dentistry Indonesia

Multiple ulcerations are rarely caused by a traumatic event, but seizures can induce repeated injury to the oral mucosa. A patient with a seizure history possesses a challenge in their dental management. Objective: In order to describe a case of multiple oral ulceration in a post-seizure patient with undiagnosed arteriovenous malformation (AVM) in the left parietal lobe and provide short guidelines for dentists in managing patient with a seizure history. Case report: A 23-years old female had multiple oral ulceration in the right and left buccal mucosa and her tongue. She reported having a seizure attack six days before. …

Trimming And Ph Effects On Nickel Ion Release From Stainless Steel Crowns Of Primary Teeth, Milad Arab-Nozari, Mohammad Shokrzadeh, Nastaran Zamehran, Jamshid Yazdani Charati, Azam Nahvi

Journal of Dentistry Indonesia

Objective: Stainless steel crowns (SSCs) are preformed metal crowns used to restore severely decayed primary teeth. The aim of this study is to evaluate the effects of pH changes and SSC margin trimming on nickel release in artificial saliva solution. Methods: A total of 90 SSCs were divided into three groups and placed in 35 ml of artificial saliva of pH 6.8, 5, and 3.5. Another group consisting 30 SSCs with trimmed margins was placed in saliva of pH 6.8. All SSCs were incubated at 37°C. The concentration of released nickel was assessed on days 1, 7, 14, 21, and …

Evaluation Of Maxillary Impacted Teeth And Their Relationship With Adjacent Teeth And Anatomic Structures With Cone Beam Computed Tomography, Emre Köse, Emin Murat Canger

Journal of Dentistry Indonesia

Objective: This study aimed to examine the cone beam computed tomography (CBCT) images of impacted maxillary canines and mesiodentes. Methods: This retrospective radiographic study was performed on 177 patients with 200 impacted maxillary canines and 12 mesiodentes. Using CBCT images, the unilateral/bilateral occurrence, presence of root dilaceration, mesio-distal and buccopalatal location, impaction condition, contact region of adjacent teeth, presence and degree of root resorption of adjacent teeth, dental follicle width, closest distance to the nasal cavity, nasopalatinal canal, and maxillary sinus were assessed. For mesiodentes, the types, follicle width, direction, and relationship with anatomical structures were evaluated. Results: No statistical …

Comparative Evaluation Of Apical Extrusion Debris And Irrigant During Calcium Hydroxide Removal And Endodontic Instrumentation Using Three Types Of Instrumentation Systems, Selen İnce Yusufoğlu, Esma Saricam

Journal of Dentistry Indonesia

Many root canal preparation techniques and instruments produce apically extruded materials to a certain extent depending on the preparation system adopted. The extrusion of debris from the apical foramen during chemomechanical preparation may cause postoperative pain and failure of endodontic treatment. Objective: This study evaluates the differences in the apical extrusion of debris and calcium hydroxide (CH) during endodontic instrumentation by using Reciproc Blue (RB), WaveOne Gold (WOG), and F6 Skytaper (F6). Methods: Six experimental study groups (n = 13) were established. The root canal procedures for all groups were prepared with different methods: Group I: One Shape (OS) instrumentation, …

Reliability Of Panoramic Radiography For Vertical Facial Pattern Assessment, Waqar Jeelani, Maheen Ahmed, Shakeel Ahmed

Journal of Dentistry Indonesia

The orthopantomogram (OPG) is a common dental screening radiograph that has multiple implications. However, lateral cephalogram is the investigation of choice for the assessment of vertical facial pattern. Objective: The aim of the current study was to investigate the validity of an OPG parameter i.e. panoramic gonial angle (PGoA) for the assessment of the vertical facial pattern. Methods: A cross-sectional study was conducted on the pretreatment OPG and lateral cephalograms of 200 orthodontic patients aged 15-40 years. The PGoA was measured on both sides and an average was used for statistical analysis. The Pearson’s correlations of PGoA were measured with …

Effect Of Salivary Ph On Water Absorption And Solubility Of Enhanced Resin- Modified Glass Ionomer, Yosi Kusuma Eriwati, Muhammad Dhiaulfikri, Ellyza Herda

Journal of Dentistry Indonesia

The influence of immersion period and liquid pH on water absorption capacity and solubility of the resin-modified glass ionomer cement (RMGIC) raises the question of whether the critical pH of hydroxyapatite and fluoroapatite influences the water absorption capacity and solubility of enhanced resin-modified glass ionomer (ERMGI). Objective: This study was designed to investigate the effects of immersion periods and various pH levels of artificial saliva on the water absorption and solubility of RMGIC and ERMGI. Methods: Fifty-four disc-shaped specimens (15 mm x 1 mm) of enhanced RMGI (ACTIVATM BioACTIVE-RESTORATIVE, Pulpdent, Watertown, MA, USA) and 54 disc-shaped specimens (15 mm x …

Nanomaterials And Nanorobotics In Dentistry: A Review, Yelda Kasimoglu, Derya Tabakcilar, Zeynep A. Guclu, Seiko Yamamoto-Nemoto, Elif B. Tuna, Bugra Ozen, Tamer Tuzuner, Gökhan Ince

Journal of Dentistry Indonesia

Nanotechnology is a branch of science focusing on the manipulation of materials measured on the nanoscale (size = 1–100 nm). Recent advances in the field of nanodentistry have resulted in the development of alternative treatment plans for common dental problems, bringing about a paradigm shift in dentistry. Nanorobots, also known as “nanites” or “nanomachines,” are theoretical microscopic devices that may be used for the diagnosis and treatment of oral health problems. This paper aims to discuss the latest innovations in the field of nanodentistry.

Effect Of Short- And Long-Term Use Of Home And In-Office Bleaching With Carbamide Peroxide And Hydrogen Peroxide On Enamel Microhardness, Nazila Ameli, Niloofar Kianvash Rad, Farzane Nikpour, Raheb Ghorbani, Shadi Mohebi

Journal of Dentistry Indonesia

Bleaching is a well-known esthetic dental treatment performed to lighten the tooth shade. Among different cosmetic dental procedures, including direct and indirect tooth-colored restorations, bleaching is likely the most conservative approach. Bleaching has been accepted well by patients and proven as a safe and effective approach. Objective: Tooth bleaching can be conducted at home or in offices. This study was performed to compare the enamel microhardness before bleaching and one and eight weeks after the application of different bleaching agents. Methods: Forty human premolars were randomly divided into four groups, and their buccal surface underwent a Vickers microhardness test …

Oral Rehabilitation Of A Patient With Congenital Erythropoietic Porphyria: A Rare Case Report, Raif Alan, Hakkı Çelebi, Fahriye Kilinc, Recep Dursun

Journal of Dentistry Indonesia

Congenital erythropoietic porphyria (CEP) is an extremely rare disorder involved in chronic porphyrias. One of the recommended evaluations to determine disease severity and needs of a person with CEP is dental assessment. Objective: To present a case of CEP and its oral rehabilitation. Case Report: A 32-year-old female patient was admitted to the clinic with hyperkeratinization, skin fragility, fissures, and wounds in her perioral region and hands. Intraoral gingival bleeding, mucogingival stress, and missing teeth were recorded. After medical consultation, phase I and II periodontal therapies were performed. The patient expressed satisfaction of the results of the procedures in terms …

Treatment Of A Class I Malocclusion With Severe Crowding Using Passive Self-Ligating Brackets, Agita Pramustika, Retno Widayati

Journal of Dentistry Indonesia

Presently, dental crowding is the most common problem among orthodontic patients. The prevalence of crowding in the dental arch is significantly increased in modern dentitions, and it is the most common reason why patients pursue orthodontic treatment. Objective: To report an advanced bracket systems, namely self-ligating brackets, to increase the efficacy of orthodontic treatment especially in patients with severe crowding. Case Report: A 22-year-old female patient presented with severe crowding of the maxillary and mandibular arches. In the upper arch, both second premolars were palatally positioned; in the lower arch, the lower right canine was lingually positioned and the lower …

Direct Composite Resin Restoration Of Anterior Maxillary Teeth And Esthetic Smile Design: A Case Report, Christina Widya Nugrohowati, Wignyo Hadriyanto, Tunjung Nugraheni

Journal of Dentistry Indonesia

Dental esthetic complex involves more than one caries with malformed shape and malposition. Dental trauma most commonly affects maxillary anterior teeth, and subsequently affects the esthetics, functions, and psychological well-being of the individual. Composite resins have become an integral part of contemporary restorative and minimally invasive dentistry. Objective: To summarize the successful use of direct composite resin restoration in the management of a 29-year old male patient. Case Report: A 29-year old male patient presenting with multiple secondary caries and crown fractures in the anterior maxillary teeth, resulting in an unaesthetic smile. Comprehensive esthetic dental treatment was carried out. The …

Effectiveness Of Lentinus Edodes Mushroom Extract On Eradication Of Enterococcus Faecalis Biofilm, Putri Lestari Anggiarini, Meiny F Amin, Juanita A Gunawan, Armelia Sari Widyarman

Journal of Dentistry Indonesia

Sodium hypochlorite is a commonly used irrigation solution in endodontic procedures, but it irritates tissues and has toxic effects. Lentinus edodes is a mushroom that has antibacterial properties. Enterococcus faecalis is an anaerobic bacterium that can cause root canal treatment failure. Objective: This study aimed to determine the effect of L. edodes extract on the eradication of E. faecalis biofilms. Methods: Phytochemical tests of L. edodes were performed to analyze alkaloids, steroids, triterpenoids, phenolics, tannins, flavonoids, and glycosides from this extract qualitatively. E. faecalis ATCC 29212 was cultured in brain heart infusion broth for 24 h at 37°C …