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9 Symptoms are typically aggravated by walking or prolonged standing and relieved by bending forward (i.e., shopping cart sign [ Figure 2 ]) or sitting

Two randomized, placebo-controlled clinical trials were conducted at separate clinical centers using consistent protocols for medication, injection method (periodontal tissue injection), inclusion and exclusion criteria, and outcome assessments

This approach is consistent with established methodologies adopted in previous systematic reviews assessing micronutrient interventions