Annals of Maxillofacial Surgery最新文献

{"title":"A Biomechanical Assessment of three Types of Plating Systems in a Combined Mandibular Parasymphysis and Angle Fracture - An <i>In vitro</i> Study.","authors":"Apoorva Basavaraj Kumbar, P Hema Mythily, Girish B Giraddi, K Sridevi","doi":"10.4103/ams.ams_211_25","DOIUrl":"10.4103/ams.ams_211_25","url":null,"abstract":"<p><strong>Introduction: </strong>Mandibular fractures are the most encountered fractures by oral and maxillofacial surgeons, and for their fixation, different systems have been studied and used in clinical practice. Miniplates in lines of osteosynthesis described by Champy have stood the challenge of time for maxillofacial fractures. Many designs have been proposed since then. Three-dimensional (3D) plates, designed to have a geometric shape, claimed to add strength and stability to fracture fragments. Locking plates were designed to have screws that lock in the plate and thus provide added stability to fixation.</p><p><strong>Materials and methods: </strong>The aim of this study was to compare the efficacy of three internal fixation systems for osteosynthesis of combined angle and parasymphysis mandibular fractures. Fifteen sheep mandibles were used. Osteotomy simulating parasymphysis and contralateral angle fracture were done and fixed with three plating systems, 5 in each group. Group A with straight non-locking miniplates, Group B with 3D miniplates and Group C with locking miniplates. Universal Testing Machine was used to apply force ranging from 0 to 900 Newton (N) on the occlusal surface. The forces which caused significant displacement between fracture segments were recorded. The <i>post hoc</i> test showed significance between forces in the groups, i.e., <i>P</i> < 0.05.</p><p><strong>Results: </strong>Plates which least resisted displacement between fractured segments were straight non-locking miniplates with a mean end-point force of 109.20N, as compared to 3D plates, 327N and locking plates, 345.2.</p><p><strong>Discussion: </strong>Biomechanically, locking miniplates are more efficient than 3D miniplates which in turn are more efficient than non-locking miniplates in an <i>in vitro</i> scenario.</p>","PeriodicalId":7972,"journal":{"name":"Annals of Maxillofacial Surgery","volume":"16 1","pages":"66-70"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Effectiveness of Pharmacological and Non-pharmacological Management of Temporomandibular Joint Pain - A Systematic Review.","authors":"Hiren Patel, Haren Pandya, Nimisha Desai, Nitu Shah, Mukarram Devla, K S Athira","doi":"10.4103/ams.ams_122_25","DOIUrl":"10.4103/ams.ams_122_25","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular disorders (TMDs) are a heterogeneous group of conditions affecting the temporomandibular joint (TMJ) and masticatory musculature, commonly presenting with pain and functional limitation. Although both pharmacological and non-pharmacological treatment modalities are widely used, their relative effectiveness remains unclear.</p><p><strong>Objectives: </strong>To systematically compare the clinical effectiveness of pharmacological and non-pharmacological interventions in the management of TMJ-related pain and dysfunction.</p><p><strong>Data sources: </strong>This systematic review was conducted in accordance with PRISMA-2020 guidelines and registered with PROSPERO (CRD42025641487). Electronic searches of PubMed, Scopus, Web of Science and Cochrane Library were performed for randomised controlled trials (RCTs) published between 2014 and 2024. Adult patients diagnosed with TMDs were included. Primary outcomes were pain reduction and improvement in mandibular function. Risk of bias (RoB) was assessed using the Cochrane RoB-2 tool.</p><p><strong>Study eligibility criteria: </strong>Eighteen RCTs comprising 871 participants were included. Pharmacological interventions (NSAIDs, corticosteroids, muscle relaxants, hyaluronic acid and platelet-based injectables) demonstrated effective short-term pain relief, with benefits often diminishing beyond 4-6 weeks.</p><p><strong>Interventions: </strong>Non-pharmacological interventions (physiotherapy, occlusal splints, exercise therapy, low-level laser therapy and behavioural therapy) showed more consistent and sustained improvements in pain, mandibular mobility, and patient-reported outcomes.</p><p><strong>Study appraisal: </strong>Combined conservative approaches yielded superior and longer-lasting results.</p><p><strong>Conclusions: </strong>Non-pharmacological modalities appear to provide superior long-term outcomes in TMD management and should be considered first-line therapy. Pharmacological agents remain useful as adjuncts, particularly for acute symptom control.</p>","PeriodicalId":7972,"journal":{"name":"Annals of Maxillofacial Surgery","volume":"16 1","pages":"79-84"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Outcomes of Tooth-implant Supported Prostheses - A Systematic Review and Meta-analysis.","authors":"Abhishek Kumar Gupta, Gomati Dhandai, G Anitha, M Nagaraj, Bhawana Tiwari, Rohit Kumar Singh, Saroj Kumari","doi":"10.4103/ams.ams_160_25","DOIUrl":"10.4103/ams.ams_160_25","url":null,"abstract":"<p><strong>Background: </strong>Tooth-implant supported prostheses (TISP) combine natural teeth and implants to restore function when full implant support is impractical. Their biomechanical performance remains debated due to differences in tooth and implant mobility.</p><p><strong>Objectives: </strong>To evaluate long-term survival, success and complication rates of TISP and assess how connector design, framework material and patient condition affect outcomes.</p><p><strong>Data sources: </strong>PubMed, Scopus, Embase and Web of Science were searched through July 2024, with additional manual reference screening.</p><p><strong>Study eligibility: </strong>Clinical studies with ≥12-month follow-up (short term) reporting survival, success or biological/mechanical complications of fixed TISP were included.</p><p><strong>Participants and interventions: </strong>Twelve studies (732 patients; 840 prostheses) involving rigid or non-rigid connectors (NRCs) and metal-ceramic or zirconia frameworks were analysed.</p><p><strong>Study appraisal: </strong>Two reviewers independently extracted data and assessed bias using Cochrane Risk of Bias 2 and the Newcastle-Ottawa Scale. Pooled proportions were calculated via random-effects meta-analysis.</p><p><strong>Results: </strong>The pooled survival rate was 91.7% (95% confidence interval 0.89-0.93) with low heterogeneity. NRCs showed fewer mechanical complications and slightly higher survival (+2.8%). Zirconia frameworks provided aesthetic benefits with survival comparable to metal-ceramic designs. Mechanical (screw loosening, chipping) and biological (marginal bone loss, tooth intrusion) complications were frequent, indicating survival alone does not ensure success.</p><p><strong>Limitations: </strong>Few primary studies and variable follow-up restrict generalisability.</p><p><strong>Conclusions: </strong>TISP is a conservative, reliable long-term option when multiple implants or grafting are unfeasible. NRCs and monolithic zirconia frameworks enhance biomechanical performance, but larger controlled trials are needed.</p>","PeriodicalId":7972,"journal":{"name":"Annals of Maxillofacial Surgery","volume":"16 1","pages":"92-100"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feracrylum Pressure Pack Versus Conventional Pressure Pack in Achieving Post-extraction Haemostasis in 4-12-year-old Children - A Comparative Study.","authors":"Shreyas Neelkanthan, Ashwin M Jawdekar","doi":"10.4103/ams.ams_133_25","DOIUrl":"10.4103/ams.ams_133_25","url":null,"abstract":"<p><strong>Introduction: </strong>Achieving effective haemostasis following dental extractions in children is vital to prevent post-operative complications. Although conventional pressure packs (CPPs) are routinely used, feracrylum, a topical haemostatic agent with antimicrobial and hygroscopic properties, may offer superior clinical outcomes.</p><p><strong>Materials and methods: </strong>A total of 187 healthy children aged 4-12 years requiring routine dental extractions were included, with 92 participants allocated to the feracrylum pressure pack (FPP) group and 95 to the CPP group. Post-operative bleeding was assessed using the Rai and Ratan haemostasis scale at predefined time intervals. Statistical analysis was performed using the Chi-square test, Student <i>t</i>-test and logistic regression.</p><p><strong>Results: </strong>At T₁, 82% of the FPP group achieved a haemostasis score of 0, while 85% of the CPP group recorded a score of 1. Logistic regression revealed lower odds (0.17) for achieving score 0 and higher odds (5.92) for score 1 in the CPP group. The mean bleeding score at T₁ was 0.21 in the FPP group and 0.49 in the CPP group.</p><p><strong>Discussion: </strong>FPP was significantly more effective than CPP in achieving post-extraction haemostasis in children and may be considered a reliable option in paediatric dental practice.</p>","PeriodicalId":7972,"journal":{"name":"Annals of Maxillofacial Surgery","volume":"16 1","pages":"2-7"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical Integrity Following Hemimandibulectomy With Free Fibular Flap Reconstruction Under External Impact Loading - An <i>In Vitro</i> Study.","authors":"Sravani Malapati, Divya Puvvada, Shivajiraju Uddarraju, Kishore Moturi, Anil Budumuru, Sravani Pampana","doi":"10.4103/ams.ams_246_25","DOIUrl":"10.4103/ams.ams_246_25","url":null,"abstract":"<p><strong>Introduction: </strong>Hemimandibulectomy for aggressive mandibular pathology results in significant functional and structural loss, necessitating reconstruction. The fibular free flap, although the gold standard, introduces biomechanical disparities that may alter the mandible's response to traumatic forces. While previous studies have focused on masticatory stress, the impact of high-energy trauma remains underexplored. This study aimed to evaluate and compare the biomechanical response of normal and fibula-reconstructed mandibles to external impact forces using finite element analysis (FEA), focusing on stress distribution and fracture-prone regions.</p><p><strong>Materials and methods: </strong>Computed tomography-derived three-dimensional models of a normal mandible and a fibula-reconstructed mandible post-hemimandibulectomy were developed. Standardised impact loads of 2000 N were applied at the symphysis and mandibular body. Material properties were assumed to be linearly elastic and isotropic, and von Mises stress (VMS) analysis was performed to evaluate load response patterns.</p><p><strong>Results: </strong>The normal mandible demonstrated symmetrical stress distribution, with peak values at the bilateral condyles and predictable contralateral transfer under lateral loading. In contrast, the reconstructed mandible exhibited elevated and asymmetrical stress, particularly at the condylar necks, graft-host interfaces and fixation zones, indicating increased susceptibility to mechanical failure, especially under lateral loading.</p><p><strong>Discussion: </strong>Fibula-reconstructed hemimandibles show distinct biomechanical vulnerabilities under high-impact loading, particularly at the graft-host interface and condyles. These findings highlight the need for reinforcement strategies, optimised fixation planning and patient counselling regarding trauma risk. Strategic reinforcement at the graft-host junction and consideration of condylar load redistribution may help reduce fracture risk under traumatic conditions.</p>","PeriodicalId":7972,"journal":{"name":"Annals of Maxillofacial Surgery","volume":"16 1","pages":"60-65"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tunnelling Versus Non-tunnelling Techniques in Posterior-based Buccinator Myomucosal Flap Reconstruction - A Prospective Study.","authors":"Hamdan Saadi Abbas, Ahmed Omar Mahmoud Abdallah, Diaa El-Dein Saber Ahmed","doi":"10.4103/ams.ams_250_25","DOIUrl":"10.4103/ams.ams_250_25","url":null,"abstract":"<p><strong>Introduction: </strong>The posterior-based buccinator myomucosal flap is a reliable option for reconstructing posterior oral defects, though pedicle transfer methods vary. This prospective study compared functional outcomes, complications and burden of care between tunnelling and non-tunnelling techniques.</p><p><strong>Materials and methods: </strong>Patients were randomised into Group A (tunnelling, <i>n</i> = 20; single-stage) and Group B (non-tunnelling, <i>n</i> = 20; two-stage). Primary outcomes were flap survival and need for secondary surgery. Secondary outcomes included trismus, oral opening and mobility. Data were analysed using independent <i>t</i>-tests and Fisher's exact test.</p><p><strong>Results: </strong>Flap survival was comparable (95% vs. 100%, <i>P</i> = 1.000). However, the non-tunnelling group required a second surgery and had significantly longer hospital stays (4.0 vs. 2.0 days; <i>P</i> = 0.002). At 6 months, the tunnelling group achieved substantially greater maximum oral opening (39 mm vs. 33 mm, <i>P</i> = 0.008), despite higher rates of venous congestion (25% vs. 5%) and trismus (15% vs. 5%).</p><p><strong>Discussion: </strong>The tunnelling technique is superior for operative efficiency, offering a single-stage reconstruction that avoids the morbidity and cost of a second operation. While simpler initially, the non-tunnelling technique necessitates a second stage and results in greater long-term limitation of mouth opening.</p>","PeriodicalId":7972,"journal":{"name":"Annals of Maxillofacial Surgery","volume":"16 1","pages":"15-19"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cone-beam Computed Tomography-based Investigation of Hard Palate Morphometry in Iraqi Arab and Kurdish Populations - A Retrospective Study.","authors":"Omar Basheer Taha, Noor Sabah Irhayyim, Omar Abdul Jabbar Abdul Qader, Mohamad Arif Awang Nawi, Matheel Al-Rawas, Johari Yap Abdullah","doi":"10.4103/ams.ams_220_25","DOIUrl":"10.4103/ams.ams_220_25","url":null,"abstract":"<p><strong>Introduction: </strong>The hard palate (HP) has clinical and anthropological significance; nevertheless, there is a paucity of cone-beam computed tomography (CBCT)-derived data for Iraqi populations. The aim of this study was to assess HP linear measurements and indices in Iraqi Arabs and Kurds while exploring gender and ethnic differences as well as the gender predictive potential.</p><p><strong>Materials and methods: </strong>Four hundred CBCT scans (200 Arabs, 200 Kurds; equal distribution of males and females) were analysed for palatal length (PL), palatal breadth (PB), palatal height (PH), palatine index (PI) and palate height index (PHI). Independent <i>t</i>-tests, Chi-square testing for differences and binary logistic regression for gender prediction were selected.</p><p><strong>Results: </strong>Males from both ethnic groups had greater PL, PB and PH compared to females. Only PB exhibited a statistically significant difference across ethnic groups (<i>P</i> = 0.000). Leptostaphyline PI and orthostaphyline PHI were the most prevalent forms. The accuracy of gender prediction was 81% for Arabs and 70% for Kurds, with PB being the most effective predictor, reporting exact <i>P</i> values when applicable.</p><p><strong>Discussion: </strong>Males had larger palatal dimensions in both populations. Both groups had leptostaphyline PI and orthostaphyline PHI preponderance. Palatal measures are clinically relevant for treatment planning and supportive in forensic and anthropological examinations; however, their use in sex estimate should be considered complementary rather than definitive.</p>","PeriodicalId":7972,"journal":{"name":"Annals of Maxillofacial Surgery","volume":"16 1","pages":"39-45"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Printing the Future of the Face - Hydrogel Micro-fabrication and Craniofacial Reconstruction.","authors":"S M Balaji","doi":"10.4103/ams.ams_113_26","DOIUrl":"10.4103/ams.ams_113_26","url":null,"abstract":"","PeriodicalId":7972,"journal":{"name":"Annals of Maxillofacial Surgery","volume":"16 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buccal Lobular Capillary Haemangioma in Children - A Case Report.","authors":"Amit Khatri, Rishi Tyagi, Geetanjali Arora, Deepak Khandelwal, Divya, Chithaluru Pranathi","doi":"10.4103/ams.ams_172_25","DOIUrl":"10.4103/ams.ams_172_25","url":null,"abstract":"<p><strong>Rationale: </strong>Lobular capillary haemangioma (LCH), also known as a pyogenic granuloma, is a benign vascular tumour that can appear in the oral cavity but its occurrence in the buccal mucosa is relatively rare.</p><p><strong>Patient concerns: </strong>A 7-year-old girl presented with a painless, gradually enlarging lesion on the right buccal mucosa, associated with bleeding and swelling.</p><p><strong>Diagnosis: </strong>Clinical evaluation and histopathology confirmed the diagnosis of LCH.</p><p><strong>Treatment and outcomes: </strong>The lesion was surgically excised under local anaesthesia. Healing was uneventful, with no recurrence over a 6-month follow-up.</p><p><strong>Take-away lessons: </strong>Early recognition and appropriate management are essential to prevent complications such as bleeding, interference with function, or aesthetic concerns.</p>","PeriodicalId":7972,"journal":{"name":"Annals of Maxillofacial Surgery","volume":"16 1","pages":"133-135"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Factors for Marked Granuloma-like Neoplasm at the Wound Site after Partial Glossectomy - A Retrospective Study.","authors":"Kousuke Matsumoto, Izumi Mitani, Takumi Hasegawa, Akira Kimoto, Manabu Shigeoka, Masaya Akashi","doi":"10.4103/ams.ams_79_25","DOIUrl":"10.4103/ams.ams_79_25","url":null,"abstract":"<p><strong>Introduction: </strong>Marked granuloma-like neoplasm (GLN) formation after partial glossectomy interferes with wound healing and complicates postoperative management. Although polyglycolic acid (PGA) sheets are frequently used in oral surgery, few studies have comprehensively evaluated GLN incidence with and without PGA application, particularly in tongue lesions.</p><p><strong>Materials and methods: </strong>This retrospective study analysed 110 patients (112 surgical sites) with tongue cancer or precancerous lesions who underwent partial glossectomy. GLN was defined as an abnormally protruding mass identified during postoperative healing. Clinical factors including patient background, surgical methods and postoperative findings were evaluated. Univariate and multivariate logistic regression analyses were performed to identify risk factors.</p><p><strong>Results: </strong>GLN was observed in 17 of 112 surgical sites (15.2%). Univariate analysis identified medical history affecting wound healing, malocclusion or abnormal dental arrangement and postoperative partial detachment of PGA sheets as significant risk factors. In contrast, intraoperative PGA sheet application alone was not significant (<i>P</i> = 0.0501). All three factors remained independent risk factors in the multivariate model.</p><p><strong>Discussion: </strong>To reduce GLN risk, careful occlusal evaluation, preoperative management of medical conditions influencing wound healing and monitoring of PGA sheet detachment are advised. Early excision of granulation tissue may support wound healing and help distinguish GLN from tumour recurrence.</p>","PeriodicalId":7972,"journal":{"name":"Annals of Maxillofacial Surgery","volume":"16 1","pages":"54-59"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}