{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:42:44Z","timestamp":1773787364471,"version":"3.50.1"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":62,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008977","name":"Universit\u00e4t Ulm","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008977","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Head Face Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>One component of facial aesthetics is a harmonic facial profile. Orthodontic treatment and\/or orthognathic surgery can affect the facial profile by influencing the underlying hard-tissue structure. The aim of this study was to improve the prediction of treatment outcomes by evaluating 3D perioral frontal and buccal soft-tissue changes after protrusion of incisors in ten young adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The participants had neutral occlusion and physiologic incisor inclination. 3D-printed acrylic veneers with thicknesses of 1\u20134\u00a0mm were bonded to the labial surfaces of the upper and lower incisors. 3D face scans with and without veneers were taken to evaluate perioral soft tissue changes using 44 landmarks. Face scans were superimposed at the forehead. Soft-tissue changes were evaluated using linear mixed-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Interrelations between simulated incisor protrusion and the resulting soft-tissue changes were statistically highly significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.005) and nearly linear. Simulated isolated upper incisor protrusion caused greatest forward positioning of the labrale superius convex [LS-con] landmark\u2014by 0.65\u00a0mm per millimetre of veneer thickness. Lower lip displacement at the labrale inferius convex [LI-con] landmark was greatest when both upper and lower incisors were protruded (0.76\u00a0mm\/mm). The vertical lip displacement rate for simulated upper and lower incisor protrusion was 0.12\u00a0mm\/mm upward positioning of LS-con and 0.66\u00a0mm\/mm downward positioning of LI-con. Mixed-effects models revealed that a 1-mm increase in initial lip thickness at the labrale superius reduces soft-tissue displacement by about 8% of the simulated tooth movement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Anterior positioning of incisors leads to predictable, direction-specific changes in perioral soft tissues. The magnitude and pattern of soft-tissue responses vary with the combination of upper and lower incisor movement and individual lip thickness. These findings may support clinical planning in orthodontic and\/or orthognathic treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13005-025-00561-2","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T05:40:15Z","timestamp":1764222015000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Three-dimensional soft tissue changes after simulated protrusion of upper and lower incisors in young adults: an experimental study"],"prefix":"10.1186","volume":"22","author":[{"given":"Julia C.","family":"Gl\u00f6ggler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"To Mai","family":"Pham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Falko","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Repky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernd G.","family":"Lapatki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"issue":"8","key":"561_CR1","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.14219\/jada.archive.1999.0371","volume":"130","author":"SJ Bowman","year":"1999","unstructured":"Bowman SJ. More than lip service: facial esthetics in orthodontics. J Am Dent Assoc. 1999;130(8):1173\u201381.","journal-title":"J Am Dent Assoc"},{"issue":"3","key":"561_CR2","first-page":"289","volume":"10","author":"D Mirabella","year":"2012","unstructured":"Mirabella D, Quartarone L, Lombardo L, Guarneri A, Guarneri M-P, Siciliani G. Assessment of lower lip changes following incisor displacement in 92 orthodontically-treated adults. Int Orthod. 2012;10(3):289\u2013310.","journal-title":"Int Orthod"},{"issue":"6","key":"561_CR3","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1093\/ejo\/cjv083","volume":"38","author":"G Janson","year":"2016","unstructured":"Janson G, Mendes LM, Junqueira CHZ, Garib DG. Soft-tissue changes in class II malocclusion patients treated with extractions: a systematic review. Eur J Orthod. 2016;38(6):631\u20137.","journal-title":"Eur J Orthod"},{"issue":"2","key":"561_CR4","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1002\/rcs.141","volume":"3","author":"CH Kau","year":"2007","unstructured":"Kau CH, Richmond S, Incrapera A, English J, Xia JJ. Three-dimensional surface acquisition systems for the study of facial morphology and their application to maxillofacial surgery. Int J Med Robot Comput Assist Surg. 2007;3(2):97\u2013110.","journal-title":"Int J Med Robot Comput Assist Surg"},{"issue":"3","key":"561_CR5","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1016\/j.ajodo.2015.04.030","volume":"148","author":"DM Sarver","year":"2015","unstructured":"Sarver DM. Interactions of hard tissues, soft tissues, and growth over time, and their impact on orthodontic diagnosis and treatment planning. Am J Orthod Dentofacial Orthop. 2015;148(3):380\u20136.","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"1","key":"561_CR6","doi-asserted-by":"publisher","first-page":"118","DOI":"10.2319\/022219-134.1","volume":"90","author":"J Au","year":"2020","unstructured":"Au J, Mei L, Bennani F, Kang A, Farella M. Three-dimensional analysis of lip changes in response to simulated maxillary incisor advancement. Angle Orthod. 2020;90(1):118\u201324.","journal-title":"Angle Orthod"},{"issue":"3","key":"561_CR7","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1016\/j.ajodo.2015.08.017","volume":"149","author":"M Kuhn","year":"2016","unstructured":"Kuhn M, Markic G, Doulis I, G\u00f6llner P, Patcas R, H\u00e4nggi MP. Effect of different incisor movements on the soft tissue profile measured in reference to a rough-surfaced palatal implant. Am J Orthod Dentofacial Orthop. 2016;149(3):349\u201357.","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"3","key":"561_CR8","doi-asserted-by":"publisher","first-page":"413","DOI":"10.2319\/050208-247.1","volume":"79","author":"A Hodges","year":"2009","unstructured":"Hodges A, Rossouw PE, Campbell PM, Boley JC, Alexander RA, Buschang PH. Prediction of lip response to four first premolar extractions in white female adolescents and adults. Angle Orthod. 2009;79(3):413\u201321.","journal-title":"Angle Orthod"},{"issue":"5","key":"561_CR9","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1111\/jopr.12135","volume":"23","author":"R Rosati","year":"2014","unstructured":"Rosati R, Menezes M, Da Silva AMBR, Rossetti A, Lanza Attisano GC, Sforza C. Stereophotogrammetric evaluation of tooth-induced labial protrusion. J Prosthodontics: Official J Am Coll Prosthodontists. 2014;23(5):347\u201352.","journal-title":"J Prosthodontics: Official J Am Coll Prosthodontists"},{"issue":"2","key":"561_CR10","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.ajodo.2010.02.022","volume":"138","author":"H-S Baik","year":"2010","unstructured":"Baik H-S, Kim S-Y. Facial soft-tissue changes in skeletal class III orthognathic surgery patients analyzed with 3-dimensional laser scanning. Am J Orthod Dentofacial Orthop. 2010;138(2):167\u201378.","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"12","key":"561_CR11","doi-asserted-by":"publisher","first-page":"1505","DOI":"10.1016\/j.joms.2004.04.022","volume":"62","author":"CH Koh","year":"2004","unstructured":"Koh CH, Chew MT. Predictability of soft tissue profile changes following bimaxillary surgery in skeletal class III Chinese patients. J Oral Maxillofac Surg. 2004;62(12):1505\u20139.","journal-title":"J Oral Maxillofac Surg"},{"issue":"3","key":"561_CR12","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.ajodo.2005.08.045","volume":"132","author":"AE Erdinc","year":"2007","unstructured":"Erdinc AE, Nanda RS, Dandajena TC. Profile changes of patients treated with and without premolar extractions. Am J Orthod Dentofacial Orthop. 2007;132(3):324\u201331.","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"2","key":"561_CR13","first-page":"129","volume":"67","author":"MJ Caplan","year":"1997","unstructured":"Caplan MJ, Shivapuja PK. The effect of premolar extractions on the soft-tissue profile in adult African American females. Angle Orthod. 1997;67(2):129\u201336.","journal-title":"Angle Orthod"},{"issue":"2","key":"561_CR14","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.ajodo.2013.03.018","volume":"144","author":"RC Solem","year":"2013","unstructured":"Solem RC, Marasco R, Guiterrez-Pulido L, Nielsen I, Kim S-H, Nelson G. Three-dimensional soft-tissue and hard-tissue changes in the treatment of bimaxillary protrusion. Am J Orthod Dentofacial Orthop. 2013;144(2):218\u201328.","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"4","key":"561_CR15","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1016\/j.ajodo.2007.03.023","volume":"133","author":"C Lane","year":"2008","unstructured":"Lane C, Harrell W. Completing the 3-dimensional picture. Am J Orthod Dentofacial Orthop. 2008;133(4):612\u201320.","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"5","key":"561_CR16","doi-asserted-by":"publisher","first-page":"833","DOI":"10.2319\/090414.622.1","volume":"85","author":"Y-K Kim","year":"2015","unstructured":"Kim Y-K, Lee N-K, Moon S-W, Jang M-J, Kim H-S, Yun P-Y. Evaluation of soft tissue changes around the lips after bracket debonding using three-dimensional stereophotogrammetry. Angle Orthod. 2015;85(5):833\u201340.","journal-title":"Angle Orthod"},{"issue":"3","key":"561_CR17","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/j.ajodo.2012.01.018","volume":"142","author":"L Eidson","year":"2012","unstructured":"Eidson L, Cevidanes LHS, Paula LK, Hershey HG, Welch G, Rossouw PE. Three-dimensional evaluation of changes in lip position from before to after orthodontic appliance removal. Am J Orthod Dentofacial Orthop. 2012;142(3):410\u20138.","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"2","key":"561_CR18","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1111\/ocr.12006","volume":"16","author":"H Jeon","year":"2013","unstructured":"Jeon H, Lee SJ, Kim TW, Donatelli RE. Three-dimensional analysis of lip and perioral soft tissue changes after debonding of labial brackets. Orthod Craniofac Res. 2013;16(2):65\u201374.","journal-title":"Orthod Craniofac Res"},{"issue":"5","key":"561_CR19","doi-asserted-by":"publisher","first-page":"795","DOI":"10.2319\/112913-877.1","volume":"84","author":"H-W Ahn","year":"2014","unstructured":"Ahn H-W, Chang Y-J, Kim K-A, Joo S-H, Park Y-G, Park K-H. Measurement of three-dimensional perioral soft tissue changes in dentoalveolar protrusion patients after orthodontic treatment using a structured light scanner. Angle Orthod. 2014;84(5):795\u2013802.","journal-title":"Angle Orthod"},{"issue":"11","key":"561_CR20","doi-asserted-by":"publisher","first-page":"1530","DOI":"10.4103\/njcp.njcp_125_19","volume":"22","author":"ND Alqahtani","year":"2019","unstructured":"Alqahtani ND, Alshammari R, Almoammar K, Almosa N, Almahdy A, Albarakati SF. Post-orthodontic cephalometric variations in bimaxillary protrusion cases managed by premolar extraction - a retrospective study. Niger J Clin Pract. 2019;22(11):1530\u20138.","journal-title":"Niger J Clin Pract"},{"issue":"4","key":"561_CR21","doi-asserted-by":"publisher","first-page":"465","DOI":"10.2319\/100317-665.1","volume":"88","author":"ES Baek","year":"2018","unstructured":"Baek ES, Hwang S, Choi YJ, Roh MR, Nguyen T, Kim K-H, et al. Quantitative and perceived visual changes of the nasolabial fold following orthodontic retraction of lip protrusion. Angle Orthod. 2018;88(4):465\u201373.","journal-title":"Angle Orthod"},{"issue":"4","key":"561_CR22","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1093\/oxfordjournals.ejo.a036009","volume":"11","author":"K Lew","year":"1989","unstructured":"Lew K. Profile changes following orthodontic treatment of bimaxillary protrusion in adults with the begg appliance. Eur J Orthod. 1989;11(4):375\u201381.","journal-title":"Eur J Orthod"},{"issue":"1","key":"561_CR23","doi-asserted-by":"publisher","DOI":"10.1186\/s13005-021-00263-5","volume":"17","author":"L-H Shen","year":"2021","unstructured":"Shen L-H, Xie T-Y, Jiang R-P, Jiang Y-R, Chen G, Xu T-M, et al. Measurement of three-dimensional changes in lip vermilion in adult female patients after orthodontic extraction: a retrospective longitudinal study. Head Face Med. 2021;17(1):9.","journal-title":"Head Face Med"},{"issue":"6","key":"561_CR24","doi-asserted-by":"publisher","first-page":"281","DOI":"10.4041\/kjod.2014.44.6.281","volume":"44","author":"H-H Kim","year":"2014","unstructured":"Kim H-H, Lee J-W, Cha K-S, Chung D-H, Lee S-M. Three-dimensional assessment of upper lip positional changes according to simulated maxillary anterior tooth movements by white light scanning. Korean J Orthod. 2014;44(6):281\u201393.","journal-title":"Korean J Orthod"},{"key":"561_CR25","doi-asserted-by":"publisher","DOI":"10.1186\/2196-1042-14-32","author":"R Deli","year":"2013","unstructured":"Deli R, Galantucci LM, Laino A, D\u2019Alessio R, Di Gioia E, Savastano C, et al. Three-dimensional methodology for photogrammetric acquisition of the soft tissues of the face: a new clinical-instrumental protocol. Prog Orthod. 2013. https:\/\/doi.org\/10.1186\/2196-1042-14-32.","journal-title":"Prog Orthod"},{"issue":"6","key":"561_CR26","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1016\/j.ajodo.2005.08.038","volume":"131","author":"H-S Baik","year":"2007","unstructured":"Baik H-S, Jeon J-M, Lee H-J. Facial soft-tissue analysis of Korean adults with normal occlusion using a 3-dimensional laser scanner. Am J Orthod Dentofacial Orthop. 2007;131(6):759\u201366.","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"4","key":"561_CR27","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1093\/ejo\/cjv073","volume":"38","author":"T Murakami","year":"2016","unstructured":"Murakami T, Kataoka T, Tagawa J, Yamashiro T, Kamioka H. Antero-posterior and vertical facial type variations influence the aesthetic preference of the antero-posterior lip positions. Eur J Orthod. 2016;38(4):414\u201321.","journal-title":"Eur J Orthod"},{"key":"561_CR28","doi-asserted-by":"publisher","DOI":"10.1007\/s10006-019-00795-w","author":"SM Mousavi","year":"2019","unstructured":"Mousavi SM, Saeidi Ghorani P, Deilamani A, Rakhshan V. Effects of laterality on esthetic preferences of orthodontists, maxillofacial surgeons, and laypeople regarding the lip position and facial convexity: a psychometric clinical trial. Oral Maxillofac Surg. 2019. https:\/\/doi.org\/10.1007\/s10006-019-00795-w.","journal-title":"Oral Maxillofac Surg"},{"issue":"3","key":"561_CR29","first-page":"326","volume":"75","author":"H Ioi","year":"2005","unstructured":"Ioi H, Nakata S, Nakasima A, Counts A. Effect of facial convexity on antero-posterior lip positions of the most favored Japanese facial profiles. Angle Orthod. 2005;75(3):326\u201332.","journal-title":"Angle Orthod"},{"issue":"6","key":"561_CR30","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1016\/j.asj.2009.08.021","volume":"29","author":"FE Barton","year":"2009","unstructured":"Barton FE. Jr. Aesthetic surgery of the face and neck. Aesthet Surg J. 2009;29(6):449\u201363. quiz 64\u2009\u2013\u20096.","journal-title":"Aesthet Surg J"},{"issue":"2","key":"561_CR31","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1002\/ca.22100","volume":"26","author":"GM Beer","year":"2013","unstructured":"Beer GM, Manestar M, Mihic-Probst D. The causes of the nasolabial crease: a histomorphological study. Clin Anat. 2013;26(2):196\u2013203.","journal-title":"Clin Anat"},{"issue":"3","key":"561_CR32","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1055\/s-0036-1582234","volume":"32","author":"S Cotofana","year":"2016","unstructured":"Cotofana S, Fratila AA, Schenck TL, Redka-Swoboda W, Zilinsky I, Pavicic T. The anatomy of the aging face: a review. Facial Plast Surg. 2016;32(3):253\u201360.","journal-title":"Facial Plast Surg"},{"issue":"4","key":"561_CR33","first-page":"399","volume":"17","author":"S Cotofana","year":"2019","unstructured":"Cotofana S, Lachman N. Anatomy of the facial fat compartments and their relevance in aesthetic surgery. J Dtsch Dermatol Ges. 2019;17(4):399\u2013413.","journal-title":"J Dtsch Dermatol Ges"},{"issue":"4","key":"561_CR34","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1093\/ejo\/cjq095","volume":"33","author":"H Hayashida","year":"2011","unstructured":"Hayashida H, Ioi H, Nakata S, Takahashi I, Counts AL. Effects of retraction of anterior teeth and initial soft tissue variables on lip changes in Japanese adults. Eur J Orthod. 2011;33(4):419\u201326.","journal-title":"Eur J Orthod"},{"issue":"5","key":"561_CR35","doi-asserted-by":"publisher","first-page":"808","DOI":"10.2319\/081706-336","volume":"77","author":"N Tadic","year":"2007","unstructured":"Tadic N, Woods MG. Incisal and soft tissue effects of maxillary premolar extraction in class II treatment. Angle Orthod. 2007;77(5):808\u201316.","journal-title":"Angle Orthod"},{"key":"561_CR36","doi-asserted-by":"publisher","unstructured":"Brock RA, Taylor RW, Buschang PH, Behrents RG. Ethnic differences in upper lip response to incisor retraction. Am J Orthod Dentofacial Orthop. 2005;127(6):683\u201391. https:\/\/doi.org\/10.1016\/j.ajodo.2004.01.026.","DOI":"10.1016\/j.ajodo.2004.01.026"},{"issue":"2","key":"561_CR37","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/0002-9416(82)90492-4","volume":"82","author":"BM Oliver","year":"1982","unstructured":"Oliver BM. The influence of lip thickness and strain on upper lip response to incisor retraction. Am J Orthod. 1982;82(2):141\u20139.","journal-title":"Am J Orthod"},{"issue":"4","key":"561_CR38","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1016\/0002-9416(67)90022-X","volume":"53","author":"CJ Burstone","year":"1967","unstructured":"Burstone CJ. Lip posture and its significance in treatment planning. Am J Orthod. 1967;53(4):262\u201384.","journal-title":"Am J Orthod"},{"issue":"2","key":"561_CR39","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1093\/ejo\/cjab053","volume":"44","author":"D Hodgkinson","year":"2022","unstructured":"Hodgkinson D, Prasad S, Antoun JS, Mei L, Farella M. Biomechanical properties of the lips in a pre-orthodontic sample of adolescents and young adults. Eur J Orthod. 2022;44(2):232\u20139.","journal-title":"Eur J Orthod"},{"issue":"6","key":"561_CR40","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1597\/1545-1569_1997_034_0498_sasost_2.3.co_2","volume":"34","author":"VF Ferrario","year":"1997","unstructured":"Ferrario VF, Sforza C. Size and shape of soft-tissue facial profile: effects of age, gender, and skeletal class. Cleft Palate Craniofac J. 1997;34(6):498\u2013504. https:\/\/doi.org\/10.1597\/1545-1569_1997_034_0498_sasost_2.3.co_2.","journal-title":"Cleft Palate Craniofac J"},{"key":"561_CR41","doi-asserted-by":"publisher","unstructured":"Ferrario VF, Sforza C, Serrao G, Dellavia C, Tartaglia GM. Labial morphology: a 3-dimensional anthropometric study. J Oral Rehabil. 2001;28(5):445\u2009\u2013\u200952. https:\/\/doi.org\/10.1046\/j.1365-2842.2001.00698.x. PMID: 11348556 .","DOI":"10.1046\/j.1365-2842.2001.00698.x"},{"issue":"1","key":"561_CR42","first-page":"64","volume":"39","author":"A Alhumadi","year":"2021","unstructured":"Alhumadi A, Alhayek M, Al-Zain A, Altarazi Y. Gender differences in lower facial soft tissue thickness among different skeletal patterns, based on soft tissue cephalometric analysis. Cranio. 2021;39(1):64\u201371. Epub 2020 Jun 15. PMID: 32570266 .","journal-title":"Cranio"}],"container-title":["Head &amp; Face Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13005-025-00561-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13005-025-00561-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13005-025-00561-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T07:35:35Z","timestamp":1769585735000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13005-025-00561-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,27]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["561"],"URL":"https:\/\/doi.org\/10.1186\/s13005-025-00561-2","relation":{},"ISSN":["1746-160X"],"issn-type":[{"value":"1746-160X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,27]]},"assertion":[{"value":"21 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. The study protocol was approved by the Ethics Committee of Ulm University (no. 249\u2009\u2212\u200912), and written informed consent was obtained from all participants prior to the investigation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All participants provided written consent for publication of anonymized data and images included in this manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"8"}}