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Received: 19 May 2022 Accepted: 1 October 2022

DOI: 10.1111/jopr.13611

ORIGINAL ARTICLE

Dental floss ties for rubber dam isolation: A proposed

classification and a new technique
Osama A. Alkhatib PhD1 Sami Bissasu PhD2 Alaa Daud FDTFEd3

1
Department of Fixed Prosthodontics, Faculty of Abstract
Dentistry, Damascus University, Damascus, Syria
Rubber dam application has become an essential part of restorative dentistry. In late
2
Restorative Department, Dental Institute, Queen 2019, dentistry faced a new challenge with the COVID-19 pandemic and therefore,
Mary University of London, London, UK
the implementation of extra isolation methods became crucial. This article introduces a
3
College of Dental Medicine, QU Health, Qatar classification of dental floss ties used with a rubber dam, including the “simple” ties that
University, Doha, Qatar
are subdivided into traditional ties, single-loop self-ligating ties and double-loop self-
Correspondence
ligating ties, and a new state-of-the-art design. The “compound tie” design incorporates
Osama Adnan Alkhatib, Department of Fixed a combination of one or more subdivisions of the simple ties. This new design may
Prosthodontics, Faculty of Dentistry, Damascus provide better isolation and more consistent gingival tissue retraction. Furthermore,
University, Damascus, Syria.
Email: dean.dent@damascusuniversity.edu.sy,
due to the advanced technique applied, the tie will offer improved stability and prevent
osamah11@hotmail.com the sheet from sliding over the dental floss tie from all surfaces.

[Correction added on 21 December 2022, after KEYWORDS

first online publication: The copyright line was COVID-19, dental floss ties, isolation, rubber dam
changed.].

The SARS-COV-2 (COVID-19) pandemic created a signifi-
cant challenge for healthcare providers, and their delivery of
care. Dental professionals appear to be at high risk of con-
tagion due to exposure to saliva, blood, and aerosol/droplet
production throughout the majority of dental procedures.1–3
In an attempt to limit contagion, the use of a rubber dam (RD)
was recommended as a preventative measure.4,5 When RD
was used, a reduction in bacterial aerosols was reported to
be around 70-98.9%, significantly minimizing the inhalation
of infective aerosols by dental personnel.6,7 It was suggested
that during many dental procedures, using RD could elimi-
nate almost all means of contamination arising from saliva
and blood.8
On the other hand, based on the increase in requests for
esthetic restorations over the last few decades, adhesive den-
tistry has become a routine procedure in any dental practice.
One critical factor that affects the success of direct or indi-
rect resin-bonded restorations is moisture control. Gingival
fluid, blood, or saliva contamination can affect the strength of
resin bonding to the tooth structure which can lead to loss of
restorations, recurrent caries, postoperative sensitivities, and
discoloration.9 The use of RD is currently considered a gold
standard procedure.10
Isolation with RD is increasingly being used in endodontic,
pediatric, and restorative dentistry during standard treatment
procedures due to several advantages. A significant increase
in shear bond strengths and microleakage reduction of
composite resin restorations were obtained following clinical
procedures when RD isolation was used, in comparison with
cotton roll isolation.11,12 Whenever resin cement is used for
the cementation of all-ceramic restorations, RD placement is
recommended to ensure a dry field. Additionally, adequate
retraction around the gingival margins permits good visual
access for excess cement removal.13
The use of RD has other reported benefits. RD placement
protects the patient from possible aspiration or swallow-
ing of instruments, medicaments, irrigating solutions, and
tooth/material debris which in turn will protect dentists
from possible future legal responsibilities.14–16 Based on the
above-mentioned advantages, RD isolation is now considered
standard practice by dental professional organizations.17,18
With the spread of the COVID-19 virus, strict and effec-
tive infection control protocols are crucial. The use of
RD with high-volume aspirator tips can help minimize
aerosol or spatter in dental procedures. It prevents the virus
from spreading further and helps control any pandemic
situation.19
Different designs of clamps/retainers are available for use
on individual teeth or a group of teeth to secure the RD sheet
in place. However, wooden wedges, wedging/stabilizing

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided
the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
© 2022 The Authors. Journal of Prosthodontics published by Wiley Periodicals LLC on behalf of American College of Prosthodontists.

J. Prosthodont. 2023;32:83–89. wileyonlinelibrary.com/journal/jopr 83


84
cords, or dental floss can also be used to keep it in place.20
For limited operative procedures, it is usually acceptable to
isolate fewer teeth, while isolating a greater number of teeth
is indicated for quadrant procedures.
Techniques for applying RD have been described in the
literature, each with its own merits.20–22 Whatever isolating
technique is used, ligation with floss and knotting the floss
around the tooth/teeth is recommended to stabilize the RD in
position.23
A surgeon’s knot has been described to secure the dental
floss ligature/tie.21,24 However, there has been no study in
the literature classifying floss ties for dental uses. The author
(O.A.) proposes a classification of dental floss ties for isola-
tion purposes and presents a new technique for tying dental
floss.
CLASSIFICATION OF DENTAL FLOSS
TIES
Generally, a dental floss tie consists of one or two loops, a
knot, and two free arms. The term overhand knot has been
used for surgical purposes to provide a secure stopper when
intending the suture to be permanent. The author (O.A) pro-
poses a new classification of dental floss ties as described
below:
1. Simple ties: subdivided into:
I. Traditional tie (surgeon’s tie): A knot is created after
placing the dental floss around the neck of the tooth
gingival to the height of the contour. This tie is sim-
ilar to an interrupted surgical suture in shape. A
suitable length (20-30 cm) is cut and doubled up
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ALKHATIB ET AL.
F I G U R E 1 Traditional tie. (a-c): Step-by-step
illustration of the dental floss tie. (a): A piece of dental
floss made into a U shape. (b): A double overhand
knot clockwise created. (c): A single overhand knot
anticlockwise created. (d-i): Clinical application.
(d): A piece of dental floss of suitable length
(20-30 cm) placed around the neck of the tooth. (e): A
double overhand knot created clockwise. (f): Knot
tightened. (g): A single overhand knot created
anticlockwise. (h): A flat metal instrument used to
ensure the floss tie is secured palatally beyond tooth
bulbosity cervically. (i): The knot tightened toward the
neck of the tooth by pulling its free ends apart until it
is tight and secure.
into a U shape, then placed around the neck of the
tooth and a double overhand knot is created clock-
wise. The knot is then tightened securely around the
tooth followed by making a single overhand knot
counterclockwise.24,25 The main advantage of this
tie is the quick and easy application; however, it
may become loose soon after application. Figure 1
demonstrates the step-by-step procedure of making
this traditional tie and its clinical application.
II. Single-loop self-ligating tie: This knot is prepared
outside the patient’s mouth. A piece of dental floss
of suitable length (20-30 cm) is cut and doubled up
into a U shape. A loop is then created by passing the
curved end of the dental floss over the two free ends
as shown in Figure 2. The curved end of the dental
floss is then inserted inside the loop and pulled out
completely to create a loose tie. The loop is placed
around the cervical area of the tooth and then tight-
ened toward the neck of the tooth by pulling its free
ends apart until it is tight and secure.25
III. Double-loop self-ligating tie: This tie is similar to
the single-loop self-ligating tie but with two loops.
A piece of dental floss of suitable length (20-30 cm)
is doubled up into a U shape, and a loop is created
by passing the curved end of the dental floss over
the two free ends. However, unlike the single-loop
self-ligating tie, the curved end is inserted inside the
loop and only partially pulled out. The curved end
of the dental floss is then opened up, brought over
around the entire knot until it encircles the free ends.
Finally, the free ends are pulled to tighten the double
loops downward. Figure 3 illustrates the step-by-step
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A NEW TECHNIQUE AND CLASSIFICATION FOR DENTAL FLOSS TIES 85

F I G U R E 2 Single-loop self-ligating tie. (a-d):

Step-by-step illustration of the dental floss tie. (a): A
piece of dental floss of suitable length (20-30 cm)
doubled up into a U shape. (b): A loop is created by
passing the curved end of the dental floss over the two
free ends. (c): The curved end of the dental floss is
inserted inside the loop and pulled out completely.
(d): The open-ended loop is placed around the neck of
the tooth, then tightened. (e-h): Clinical application.
(e): The loop prepared outside the patient’s mouth. (f):
The loop placed around the cervical area of the tooth.
(g): A flat metal instrument used to ensure the floss tie
is secured palatally beyond tooth bulbosity cervically.
(h): The knot tightened toward the neck of the tooth by
pulling its free ends apart until it is tight and secure.

F I G U R E 3 Double-loop self-ligating tie. (a-f):

Step-by-step illustration of the dental floss tie. (a): A
piece of dental floss (20-30 cm) doubled up into a U
shape. (b): A loop created by passing the curved end
of the dental floss over the two free ends. (c): The
curved end inserted inside the loop and partially pulled
out. (d): The curved end of the dental floss opened up
and brought around the entire knot. (e): The action
continued until it encircles the free two ends. (f): The
free ends held and pulled to tighten the double loops
downward. (g-j): Clinical application. (g): The
double-looped tie prepared outside the patient’s
mouth. (h): The loop placed around the cervical area
of the tooth. (i): A flat plastic instrument used to
ensure the floss tie is secured palatally beyond tooth
bulbosity cervically. (j): The knot tightened toward the
neck of the tooth by pulling its free ends either apart or
together to tighten the knot.

86
procedure for preparing this tie. Generally, the
double-loop self-ligating tie is easier to tighten as it
enables the dentist to pull the free ends either apart or
together to tighten the knot, allowing them to tighten
it with one hand if needed.25 Conversely, the single-
loop self-ligating tie only allows the dentist to tighten
the knot by pulling the two ends apart using both
hands. The double-loop tie is also tighter and more
stable around the neck of the tooth.25
2. Compound tie: This tie, which was proposed and imple-
mented by Dr. Osama A. Alkhatib, consists of a single-
loop or double-loop self-ligating tie attached to one, two,
or multiple overhand knots followed by another over-
hand knot. This tie is designed to isolate prepared teeth
for crowns, bridges, or cavities with deep margins, espe-
cially palatal and lingual cavities. It provides complete
access to prepared teeth and appropriate isolation by the
RD. Figure 4 shows the step-by-step procedure of mak-
ing a compound tie (1) that consists of a single-loop
self-ligating tie attached to an overhand knot, followed
by another overhand knot, while Figure 5 demonstrates
a compound tie (2) consisting of a double-loop self-
ligating tie attached to overhand knot, followed by another
overhand knot.
DISCUSSION
In some cases, it might not be feasible to use clamps,
necessitating the use of floss ligatures to secure the dam
(Figures 6a-f). There are numerous advantages of using den-
tal floss tie techniques compared to clamps. A dental floss
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ALKHATIB ET AL.
F I G U R E 4 Compound tie 1 (consists of
single-loop self-ligating tie attached to overhand
knots). (a-g): Step-by-step illustration of the dental
floss tie. (a): A single-loop self-ligating tie created.
(b): The dental floss inserted in the loop and folded
into a U shape. (c): The overhand knot made around
the loop. (d): The overhand knot tightened around the
loop. (e): Another overhand knot made behind the first
one for more retention. (f): The overhand knot
tightened. (g): Second overhand knot attached to the
loop of self-ligating tie next to the first one if needed.
(h-k): Clinical application. (h): Single-loop
self-ligating tie attached to the overhand knots
prepared outside the patient’s mouth. (i): The loop
placed around the cervical area of the tooth. (j): A flat
metal instrument used to ensure the floss tie is secured
palatally beyond tooth bulbosity cervically. (k): The
knot tightened toward the neck of the tooth by pulling
its free ends apart and then secured around the clamp
on adjacent teeth.
tie provides complete access to the prepared tooth, while
clamps may impede good access21 (Figure 6a,b). In addition,
it can be safely used to isolate teeth with orthodontic brackets,
as clamps may damage the brackets or debond them during
insertion and removal (Figure 6c,d). Also, with the use of the
dental floss tie techniques, indirect restorations can be tried-
in easily which may be more difficult when dental clamps are
in place. Moreover, if the clamp does not fit the tooth cor-
rectly, or is not seated fully, it can dislodge and be aspirated
or swallowed.26
In some clinical scenarios, dental floss ties are more suit-
able around teeth as opposed to clamps, whereby the latter
may require additional fixation using impression compound
or flowable composite.23 Dental floss ties are less traumatic
to the gingival tissue than clamps, particularly active clamps,
which can cause trauma to the gingival tissue and eventually
irreversible gingival recession. The author suggests that the
compound tie can be easily used if a dentist wants to iso-
late teeth from the second to the second premolar without the
need for using anchor clamps and local anesthesia, as pre-
molar teeth may have sufficient undercut to retain the floss
ligature (Figure 6e,f). When molar teeth need to be isolated,
the floss tie is not recommended as the pressure caused by
the RD sheet may force the sheet to slide over the buccal
knot. This is due to the fact that molars are located poste-
riorly with unfavorable undercuts leading to extra tension on
the RD sheet compared to anterior teeth and premolars.
Different knot types have been investigated in the lit-
erature for surgical application in terms of loop and knot
security,25,27,28 but no study yet has classified different floss
ligatures/ties for dental use. The compound tie technique may
have an advantage over single- or double-loop self-ligating
 1532849x, 2023, 1, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jopr.13611 by Cochrane Mexico, Wiley Online Library on [28/02/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
A NEW TECHNIQUE AND CLASSIFICATION FOR DENTAL FLOSS TIES 87

F I G U R E 5 Compound tie 2 (consists of

double-loop self-ligating tie attached to overhand
knots). (a-g): Step-by-step illustration of the dental
floss tie. (a): A single-loop self-ligating tie created.
(b): The dental floss inserted in the loop and folded in
a U shape. (c): The overhand knot made around the
loop. (d): The overhand knot tightened around the
loop. (e): Another overhand knot made behind the first
one for more retention. (f): The overhand knot
tightened. (g): Second overhand knot attached to the
loop of self-ligating tie next to the first one if needed.
(h-k): Clinical application. (h): Double-loop
self-ligating tie attached to overhand knots prepared
outside the patient’s mouth. (i): The loop placed
around the cervical area of the tooth. (j): A flat metal
instrument used to ensure the floss tie is secured
palatally beyond tooth bulbosity cervically. (k): The
knot tightened toward the neck of the tooth by pulling
its free ends apart and then secured around the clamp.

F I G U R E 6 (a,b): Isolation of multiple teeth after

removing old crowns with clamps versus dental floss
ties. (a): Isolation with clamps impedes direct access
to teeth. (b): Compound ties provide complete access
to prepared teeth. (c,d): Dental floss ties can be safely
used to isolate teeth with orthodontic brackets.
(c): Teeth with orthodontic brackets before isolation.
(d): Teeth after isolation using compound ties instead
of clamps. (e,f): Isolation of multiple teeth using
compound ties instead of anchor clamps. (e): Teeth
after removing old crowns. (f): Teeth after isolation
using compound tie instead of anchor clamps for the
premolars, in addition to the central incisors, and
double-loop self-ligating tie for lateral incisors.
(a-f): Clinical applications of the dental floss ties.

tie techniques as it can provide better isolation and more con-
sistent gingival tissue retraction from the palatal and labial
tooth surfaces simultaneously. The knots described in the
compound tie prevent the RD sheet from sliding over the den-
tal floss tie from all surfaces, as there are at least two knots:
one on the palatal surface and one on the labial surface. When
there is only one knot on the labial surface of the tooth using
the traditional technique, for example, the RD sheet may slide
over the dental floss tie from the palatal or lingual surface if
stretched too far. Moreover, a compound dental floss tie has
labial arms and lingual or palatal arms. This will enable the
dentist to pull both arms simultaneously, which in turn will

88
F I G U R E 7 (a-c): (a): Compound dental floss tie; when pulling the
arms of the compound dental floss tie simultaneously, the loop will move
(slide) in the same direction of the pulling, achieving good gingival
retraction from all the surfaces. (b): Simple dental floss tie; when pulling the
arms of the simple dental floss tie, the loop may slide down in the opposite
direction. (c): In the case of using two dental floss ties, the second one will
face the thickness of the knot of the first tie inside the gingival groove, and
the loops of the two dental floss ties will be in different levels which
internally makes them thicker than the compound tie.
pull the entire loop in the same direction of pulling, achiev-
ing good gingival retraction from all the surfaces of the tooth
(Figure 7). On the other hand, simple ties have only labial
arms, therefore, when the dentist pulls the labial arms, it may
achieve good retraction from the labial surface only. In some
cases, the loop might slide in the opposite direction of the
pulling, especially with teeth prepared for indirect crowns,
or remaining roots that require building up with posts, which
may not have enough retention areas around the neck of the
tooth to retain the loop in place.
To achieve adequate RD isolation, two opposing dental
floss knots may be required. This will help stabilize the RD
sheet around the neck of the tooth from all surfaces and pro-
vide good gingival retraction (e.g., to expose the margins of
a prepared crown). In such clinical scenarios, a dentist may
opt to use two simple dental floss ties, the first one having
a knot on the labial surface of the tooth and the second one
with a knot on the palatal surface of the tooth. However, using
a compound dental floss tie has an advantage over using two
simple dental floss ties. When using a compound dental floss
tie, every knot will be at the same level of the loop, allow-
ing the minimal thickness of the dental floss tie, which may
enable retraction of the gingival tissues and exposure of the
margins, with minimal pressure on the gingiva.
SUMMARY
A new classification and technique of dental floss ties are
proposed in order to simplify isolation when using an RD,
provide a good seal, enhance visibility, and offer good access
to prepared teeth, especially for indirect restorations. With
this simple system, the stress of getting limited access or
clamp dislodgement may be considerably reduced. Future
research could further evaluate the clinical effectiveness of
isolation with the proposed floss ties.
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ALKHATIB ET AL.
AC K N OW L E D G M E N T
We acknowledge the support of Dr Faleh Ahmad Tamimi,
Professor of Prosthodontics, College of Dental Medicine, QU
Health, Qatar University, Qatar.
CONFLICTS OF INTEREST
The authors do not have any conflicts of interest in regard to
the current study.
ORCID
Osama A. Alkhatib PhD https://orcid.org/0000-0002-
5037-3046
REFERENCES
1. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission
dynamics in Wuhan, China, of novel coronavirus–infected pneumonia.
N Engl J Med. 2020;382(13):1199–207.
2. Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, et al. High expression
of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa.
Int J Oral Sci. 2020;12(1):1–5.
3. Xu J, Li Y, Gan F, Du Y, Yao Y. Salivary glands: potential reservoirs
for COVID-19 asymptomatic infection. J Dent Res. 2020;99(8):989.
4. Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission
routes of 2019-nCoV and controls in dental practice. Int J Oral Sci.
2020;12(1):1–6.
5. Izzetti R, Nisi M, Gabriele M, Graziani F. COVID-19 transmission in
dental practice: brief review of preventive measures in Italy. J Dent Res.
2020;99(9):1030–8.
6. Samaranayake LP, Reid J, Evans D. The efficacy of rubber dam iso-
lation in reducing atmospheric bacterial contamination. ASDC J Dent
Child. 1989;56(6):442–4.
7. Cochran M, Miller C, Sheldrake M. The efficacy of the rubber dam as a
barrier to the spread of microorganisms during dental treatment. J Am
Dent Assoc. 1989;119(1):141–4.
8. Harrel SK, Molinari J. Aerosols and splatter in dentistry: a brief review
of the literature and infection control implications. J Am Dent Assoc.
2004;135(4):429–37.
9. Munaga S, Chitumalla R, Kubigiri SK, Rawtiya M, Khan S, Sajjan
P. Effect of saliva contamination on the shear bond strength of a
new self-etch adhesive system to dentin. J Conserv Dent. 2014;17(1):
31–4.
10. Wang Y, Li C, Yuan H, Wong MC, Zou J, Shi Z, et al. Rubber dam
isolation for restorative treatment in dental patients. Cochrane Database
Syst Rev. 2016;9(9):CD009858.
11. Barghi N, Knight G, Berry TG. Comparing two methods of mois-
ture control in bonding to enamel: a clinical study. Oper Dent.
1991;16(4):130–5.
12. Knight G, Berry TG, Barghi N, Burns TR. Effects of two methods
of moisture control on marginal microleakage between resin com-
posite and etched enamel: a clinical study. Int J Prosthodont. 6(5):
475–9.
13. Mizrahi B. All-ceramic silica/glass-based crowns - clinical protocols.
Br Dent J. 2011;211(6):257–62.
14. Peters O, Peters FC. Ethical principles and considerations in endodontic
treatment. ENDO-Endodontic Pract Today. 2007;1(2):101–8.
15. Cohen S. Endodontics and litigation: an American perspective. Int Dent
J. 1989;39(1):13–6.
16. Susini G, Pommel L, Camps J. Accidental ingestion and aspiration
of root canal instruments and other dental foreign bodies in a French
population. Int Endod J. 2007;40(8):585–9.
17. Ahmad IA. Rubber dam usage for endodontic treatment: a review. Int
Endod J. 2009;42(11):963–72.
18. Soldani F, Foley J. An assessment of rubber dam usage amongst spe-
cialists in paediatric dentistry practising within the UK. Int J Paediatr
Dent. 2007;17(1):50–6.

A NEW TECHNIQUE AND CLASSIFICATION FOR DENTAL FLOSS TIES
19. Meng L, Hua F, Bian Z. Coronavirus disease 2019 (COVID-19): emerg-
ing and future challenges for dental and oral medicine. J Dent Res.
2020;99(5):481–7.
20. Patel S, Hamer S. A simple guide to using dental dam. Br Dent J.
2021;230(10):644–50.
21. Heyman HO, Swift EJRA. Sturdevant’s art and science of operative
dentistry - South Asian Edition. 2014.
22. Bhavin B, Bun SC, Patel S. Rubber dam in clinical practice. Endo (lond
Engl). 2008;2(2):131–41.
23. Gray G, Daud A. A practical approach to operative dentistry. 1st
Edition. 2021.
24. Avoine X, Lussier B, Brailovski V, Inaekyan K, Beauchamp G. Evalu-
ation of the effect of 4 types of knots on the mechanical properties of 4
types of suture material used in small animal practice. Can J Vet Res.
2016;80(2):162–70.
25. Surgical knots: history, types, techniques & videos - surgery Encyclo-
pedia. [cited 2022 Sep 2]. Available from: https://worldsurgeryforum.
net/Encyclopedia/index.php?title=Surgical_Knots:_History,_Types,
_Techniques_Videos
1532849x, 2023, 1, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jopr.13611 by Cochrane Mexico, Wiley Online Library on [28/02/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
89
26. Al-Wahadni A, Al Hamad KQ, Al-Tarawneh A. Foreign body ingestion
and aspiration in dentistry: a review of the literature and reports of three
cases. Dent Update. 2006;33(9):561–2.
27. Baums MH, Sachs C, Kostuj T, Schmidt-Horlohé K, Schultz W,
Klinger HM. Mechanical testing of different knot types using high-
performance suture material. Knee Surg Sport Traumatol Arthrosc.
2015;23(5):1351–8.
28. Muffly TM, Boyce J, Kieweg SL, Bonham AJ. Tensile strength of a
surgeon’s or a square knot. J Surg Educ. 2012;1(3):233–45.
How to cite this article: Alkhatib OA, Bissasu S,
Daud A. Dental floss ties for rubber dam isolation: A
proposed classification and a new technique.
J Prosthodont. 2023;32:83–89.
https://doi.org/10.1111/jopr.13611