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In the context of the clinical literature reviewed here, the color of oral pigmentation is one factor - but not the only factor - that clinicians use to assess the lesion

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Oxidative stress caused by physical/emotional stress, strenuous exercise, exposure to environmental toxins, and immune stress can all cause an increase in free radicals, which may cause oxidative stress and deplete glutathione

Segmentation and surface reconstruction

At some point the PEGDA:GSH ratio will become low enough that no usable gel will form