{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:40:00Z","timestamp":1790919600202,"version":"4.1.0"},"reference-count":51,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Introduction: Gingival recession, characterized by the apical displacement of the gingival margin, presents challenges to oral health. This study compares the effectiveness of the coronally advanced flap (CAF) and the tunnel technique (TT) for treating gingival recessions. Methods: Bibliographical searches included PubMed, Embase, Web of Science, Cochrane, Scopus, and the grey literature, with keywords \u201croot coverage\u201d \u201ccoronary advanced flap\u201d, and \u201ctunnel\u201d. A systematic coreview was performed that included 26 studies evaluating root coverage, and 14 articles were included for the meta-analysis. Three groups were analyzed: Group 1 compared TT with connective tissue graft (CTG) versus CAF with CTG; Group 2 examined TT with CTG and\/or other biomaterials versus TT with CTG alone; Group 3 compared TT with CAF, regardless of complementary biomaterials. Meta-analysis assessed mean root coverage (MRC), complete root coverage (CRC), and keratinized tissue gain (KTG). Results: In Group 1, TT with CTG demonstrated superior MRC compared with CAF with CTG (\u22128.68 CI95% \u221217.19 to \u22120.17; p = 0.0457). In Group 2, TT with CTG and\/or other biomaterials showed similar MRC (4.17 CI95% \u221217.91 to 26.26; p = 0.7110) and CRC (0.37 CI95% \u22121.14 to 1.89; p = 0.6269) to TT with CTG alone, with variations in keratinized tissue gain. Group 3 indicated higher potential MRC for TT compared with CAF (5.73 CI95% \u22128.90 to 13.55; p = 0.685) but without statistically significant differences. Conclusions: This study suggests that TT with CTG might offer better root coverage than CAF with CTG; however, biomaterial selection requires consideration.<\/jats:p>","DOI":"10.3390\/dj12110341","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T03:46:04Z","timestamp":1729827964000},"page":"341","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Root Coverage Techniques: Coronally Advancement Flap vs. Tunnel Technique: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8713-951X","authenticated-orcid":false,"given":"Luis","family":"Chauca-Baja\u00f1a","sequence":"first","affiliation":[{"name":"College of Dentistry, Universidad de Guayaquil, Guayas 090101, Ecuador"},{"name":"Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5174-8922","authenticated-orcid":false,"given":"Alba","family":"P\u00e9rez-Jard\u00f3n","sequence":"additional","affiliation":[{"name":"Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain"},{"name":"Health Research Institute of Santiago de Compostela (IDIS), ORALRES GROUP, 15706 Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8389-086X","authenticated-orcid":false,"given":"F\u00e1bio Fran\u00e7a Vieira E","family":"Silva","sequence":"additional","affiliation":[{"name":"Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain"},{"name":"Health Research Institute of Santiago de Compostela (IDIS), ORALRES GROUP, 15706 Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0306-8142","authenticated-orcid":false,"given":"Mercedes","family":"Conde-Amboage","sequence":"additional","affiliation":[{"name":"Models of Optimization, Decision, Statistics and Applications Research Group (MODESTYA), Department of Statistics, Mathematical Analysis and Optimization, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5660-3941","authenticated-orcid":false,"given":"Byron","family":"Vel\u00e1squez-Ron","sequence":"additional","affiliation":[{"name":"Dental Prosthesis Department Research, College Dentistry, University of the Americas, UDLA. Av, Colon y 6 de diciembre, Campus Col\u00f3n Quito 170102, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9302-7768","authenticated-orcid":false,"given":"Elena","family":"Pad\u00edn-Iruegas","sequence":"additional","affiliation":[{"name":"Human Anatomy and Embryology Area, Department of Functional Biology and Health Sciences, Faculty of Physiotherapy, University of Vigo, 36001 Pontevedra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2196-9868","authenticated-orcid":false,"given":"Mario","family":"P\u00e9rez-Say\u00e1ns","sequence":"additional","affiliation":[{"name":"Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain"},{"name":"Health Research Institute of Santiago de Compostela (IDIS), ORALRES GROUP, 15706 Santiago de Compostela, Spain"},{"name":"Instituto de los Materiales de Santiago de Compostela (iMATUS), Avenida do Mestre Mateo, 25, 15782 Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/idj.12617","article-title":"Treatment of Gingival Recession: When and How?","volume":"71","author":"Imber","year":"2021","journal-title":"Int. Dent. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1902\/annals.1999.4.1.98","article-title":"Mucogingival deformities","volume":"4","year":"1999","journal-title":"Ann. Periodontol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.36740\/WLek202405131","article-title":"Etiology of gingival recession-a literature review","volume":"77","author":"Niemczyk","year":"2024","journal-title":"Wiad. Lek."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"220","DOI":"10.14219\/jada.archive.2003.0137","article-title":"The etiology and prevalence of gingival recession","volume":"134","author":"Kassab","year":"2003","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1007\/s00784-019-02996-9","article-title":"Prevalence and risk indicators of gingival recessions in an Italian school of dentistry and dental hygiene: A cross-sectional study","volume":"24","author":"Vignoletti","year":"2020","journal-title":"Clin. Oral. Investig."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S178","DOI":"10.1111\/jcpe.12676","article-title":"Gingival recession and root caries in the ageing population: A critical evaluation of treatments","volume":"44","author":"Heasman","year":"2017","journal-title":"J. Clin. Periodontol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"233","DOI":"10.4103\/ijdr.IJDR_207_17","article-title":"Classification systems for gingival recession and suggestion of a new classification system","volume":"29","author":"Guttiganur","year":"2018","journal-title":"Indian J. Dent. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/prd.12059","article-title":"Periodontal plastic surgery","volume":"68","author":"Zucchelli","year":"2015","journal-title":"Periodontology 2000"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1902\/jop.2009.080565","article-title":"Root coverage esthetic score: A system to evaluate the esthetic outcome of the treatment of gingival recession through evaluation of clinical cases","volume":"80","author":"Cairo","year":"2009","journal-title":"J. Periodontol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/j.1600-051X.2008.01267.x","article-title":"Treatment of gingival recession with coronally advanced flap procedures: A systematic review","volume":"35","author":"Cairo","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_11","first-page":"98","article-title":"Soft-tissue plastic surgery","volume":"1","year":"1991","journal-title":"Curr. Opin. Dent."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1111\/jcpe.12780","article-title":"Entire papilla preservation technique in the regenerative treatment of deep intrabony defects: 1-Year results","volume":"44","author":"Aslan","year":"2017","journal-title":"J. Clin. Periodontol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/ID.0000000000000423","article-title":"Early Bone Formation at a Femur Defect Using CGF and PRF Grafts in Adult Dogs: A Comparative Study","volume":"25","author":"Park","year":"2016","journal-title":"Implant Dent."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3339","DOI":"10.1007\/s00784-018-2750-1","article-title":"Split-mouth evaluation of connective tissue graft with or without enamel matrix derivative for the treatment of isolated gingival recession defects in dogs","volume":"23","author":"Shirakata","year":"2019","journal-title":"Clin. Oral Investig."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1111\/jcpe.13452","article-title":"De-epithelialized gingival graft versus subepithelial connective tissue graft in the treatment of multiple adjacent gingival recessions using the tunnel technique: 1-year results of a randomized clinical trial","volume":"48","author":"Bakhishov","year":"2021","journal-title":"J. Clin. Periodontol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1111\/jcpe.12714","article-title":"Connective tissue graft and tunnel or trapezoidal flap for the treatment of single maxillary gingival recessions: A randomized clinical trial","volume":"44","author":"Santamaria","year":"2017","journal-title":"J. Clin. Periodontol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1111\/jcpe.12112","article-title":"Treatment of multiple adjacent Miller class I and II gingival recessions with a Modified Coronally Advanced Tunnel (MCAT) technique and a collagen matrix or palatal connective tissue graft: A randomized, controlled clinical trial","volume":"40","author":"Aroca","year":"2013","journal-title":"J. Clin. Periodontol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1002\/JPER.18-0066","article-title":"Efficacy of tunnel technique in the treatment of localized and multiple gingival recessions: A systematic review and meta-analysis","volume":"89","author":"Tavelli","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"7171","DOI":"10.1007\/s00784-023-05383-7","article-title":"Clinical efficacy of Vestibular Incision Subperiosteal Tunnel Access (VISTA) for treatment of multiple gingival recession defects: A systematic review, meta-analysis and meta-regression","volume":"27","author":"Sabri","year":"2023","journal-title":"Clin. Oral Investig."},{"key":"ref_20","first-page":"14","article-title":"Tunneled coronally advanced flap for the treatment of isolated gingival recessions with deficient papilla","volume":"17","author":"Barootchi","year":"2022","journal-title":"Int. J. Esthet. Dent."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2543","DOI":"10.1007\/s00784-020-03400-7","article-title":"Use of platelet-rich fibrin for the treatment of gingival recessions: A systematic review and meta-analysis","volume":"24","author":"Miron","year":"2020","journal-title":"Clin. Oral Investig."},{"key":"ref_22","first-page":"44","article-title":"Increasing the width of the keratinized mucosa around implants with L-PRF: Report of a case and systematic review","volume":"15","author":"Grieco","year":"2023","journal-title":"Oral Implantol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"b2700","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration","volume":"339","author":"Liberati","year":"2009","journal-title":"BMJ"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1111\/j.1600-051X.2011.01732.x","article-title":"The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: An explorative and reliability study","volume":"38","author":"Cairo","year":"2011","journal-title":"J. Clin. Periodontol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane Collaboration\u2019s tool for assessing risk of bias in randomized trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1111\/jcpe.12477","article-title":"Tunnel technique versus coronally advanced flap with acellular dermal matrix graft in the treatment of multiple gingival recessions","volume":"42","author":"Ozenci","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1111\/jcpe.12254","article-title":"Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: A RCT using 3D digital measuring methods. Part II. Volumetric studies on healing dynamics and gingival dimensions","volume":"41","author":"Rebele","year":"2014","journal-title":"J. Clin. Periodontol."},{"key":"ref_30","first-page":"34","article-title":"Zucchelli\u2019s technique or tunnel technique with subepithelial connective tissue graft for treatment of multiple gingival recessions","volume":"16","author":"Bherwani","year":"2014","journal-title":"J. Int. Acad. Periodontol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1111\/jcpe.12627","article-title":"Root coverage with connective tissue graft associated with coronally advanced flap or tunnel technique: A randomized, double-blind, mono-centre clinical trial","volume":"43","author":"Azaripour","year":"2016","journal-title":"J. Clin. Periodontol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"587","DOI":"10.17219\/acem\/44849","article-title":"A Preliminary Clinical Comparison of the Use of Fascia Lata Allograft and Autogenous Connective Tissue Graft in Multiple Gingival Recession Coverage Based on the Tunnel Technique","volume":"25","author":"Bednarz","year":"2016","journal-title":"Adv. Clin. Exp. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1902\/jop.2016.150676","article-title":"Tunnel Technique with Collagen Matrix Compared With Connective Tissue Graft for Treatment of Periodontal Recession: A Randomized Clinical Trial","volume":"87","author":"Tanasiewicz","year":"2016","journal-title":"J. Periodontol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1111\/jerd.12624","article-title":"The use of collagen porcine dermal matrix and connective tissue graft with modified coronally advanced tunnel technique in the treatment of multiple adjacent type I gingival recessions: A randomized, controlled clinical trial","volume":"32","author":"Rakasevic","year":"2020","journal-title":"J. Esthet. Restor. Dent."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"4475","DOI":"10.1007\/s00784-020-03312-6","article-title":"Tunnel technique with enamel matrix derivative in addition to subepithelial connective tissue graft compared with connective tissue graft alone for the treatment of multiple gingival recessions: A randomized clinical trial","volume":"24","year":"2020","journal-title":"Clin. Oral Investig."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1111\/jcpe.13163","article-title":"Acellular dermal matrix and coronally advanced flap or tunnel technique in the treatment of multiple adjacent gingival recessions. A 12-year follow-up from a randomized clinical trial","volume":"46","author":"Tavelli","year":"2019","journal-title":"J. Clin. Periodontol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"6347","DOI":"10.1007\/s00784-021-03935-3","article-title":"Clinical evaluation of the treatment of multiple gingival recessions with connective tissue graft or concentrated growth factor using tunnel technique: A randomized controlled clinical trial","volume":"25","author":"Korkmaz","year":"2021","journal-title":"Clin. Oral Investig."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1111\/jcpe.13328","article-title":"Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivate for root coverage: 2-year results of an RCT using 3D digital measuring for volumetric comparison of gingival dimensions","volume":"47","author":"Zuhr","year":"2020","journal-title":"J. Clin. Periodontol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1007\/s00784-017-2211-2","article-title":"Effectiveness and predictability of titanium-prepared platelet-rich fibrin for the management of multiple gingival recessions","volume":"22","author":"Uzun","year":"2018","journal-title":"Clin. Oral Investig."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1007\/s00784-019-03008-6","article-title":"Effect of enamel matrix derivative on wound healing following gingival recession coverage using the modified coronally advanced tunnel and subepithelial connective tissue graft: A randomised, controlled, clinical study","volume":"24","author":"Imber","year":"2020","journal-title":"Clin. Oral Investig."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e43","DOI":"10.11607\/prd.4505","article-title":"Treatment of Multiple Mandibular Gingival Recession Defects Using MCAT Technique and SCTG With and Without rhPDGF-BB: A Randomized Controlled Clinical Trial","volume":"40","author":"Parween","year":"2020","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1111\/jcpe.13470","article-title":"Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivate for root coverage: 5-year results of an RCT using 3D digital measurement technology for volumetric comparison of soft tissue changes","volume":"48","author":"Zuhr","year":"2021","journal-title":"J. Clin. Periodontol."},{"key":"ref_43","first-page":"829","article-title":"The modified coronally advanced tunnel combined with an enamel matrix derivative and subepithelial connective tissue graft for the treatment of isolated mandibular Miller Class I and II gingival recessions: A report of 16 cases","volume":"45","author":"Sculean","year":"2014","journal-title":"Quintessence Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"639","DOI":"10.11607\/prd.1998","article-title":"Root Coverage of Multiple Miller Class I and II Recession Defects Using Acellular Dermal Matrix and Tunneling Technique in Maxilla and Mandible: A 1-Year Report","volume":"35","author":"Chaparro","year":"2015","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/jerd.12170","article-title":"Modified Tunnel Technique Combined with Enamel Matrix Derivative: A Minimally Invasive Treatment for Single or Multiple Class I Recession Defects","volume":"27","author":"Charbit","year":"2015","journal-title":"J. Esthet. Restor. Dent."},{"key":"ref_46","first-page":"739","article-title":"Clinical evaluation of a porcine acellular dermal matrix for the treatment of multiple adjacent class I, II, and III gingival recessions using the modified coronally advanced tunnel technique","volume":"47","author":"Cosgarea","year":"2016","journal-title":"Quintessence Int."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"591","DOI":"10.11607\/prd.2748","article-title":"Subepithelial Connective Tissue Graft in Combination with a Tunnel Technique for the Treatment of Miller Class II and III Gingival Recessions in Mandibular Incisors: Clinical and Esthetic Results","volume":"36","author":"Nart","year":"2016","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_48","first-page":"653","article-title":"Treatment of multiple adjacent maxillary Miller Class I, II, and III gingival recessions with the modified coronally advanced tunnel, enamel matrix derivative, and subepithelial connective tissue graft: A report of 12 cases","volume":"47","author":"Sculean","year":"2016","journal-title":"Quintessence Int."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"859","DOI":"10.11607\/prd.2278","article-title":"Coverage of Multiple Mandibular Gingival Recessions Using Tunnel Technique with Connective Tissue Graft: A Prospective Case Series","volume":"36","author":"Thalmair","year":"2016","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/jerd.12337","article-title":"Treatment of multiple maxillary adjacent class I and II gingival recessions with modified coronally advanced tunnel and a new xenogeneic acellular dermal matrix","volume":"30","author":"Borie","year":"2018","journal-title":"J. Esthet. Restor. Dent."},{"key":"ref_51","first-page":"8671484","article-title":"Efficacy of Tunnel Technique (TUN) versus Coronally Advanced Flap (CAF) in the Management of Multiple Gingival Recession Defects: A Meta-Analysis","volume":"2023","author":"Barboza","year":"2023","journal-title":"Int. J. Dent."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/12\/11\/341\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:20:13Z","timestamp":1760113213000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/12\/11\/341"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,25]]},"references-count":51,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["dj12110341"],"URL":"https:\/\/doi.org\/10.3390\/dj12110341","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,25]]}}}