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Cultured pearls are the response of the shell to a tissue implant. A tiny piece of mantle tissue (called a graft) from a donor shell is transplanted into a recipient shell, causing a pearl sac to form into which the tissue precipitates calcium carbonate. There are a number of methods for producing cultured pearls: using freshwater or seawater shells, transplanting the graft into the mantle or into the gonad, and adding a spherical bead as a nucleus. Most saltwater cultured pearls are grown with beads. Trade names of cultured pearls are Akoya

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