{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T03:55:43Z","timestamp":1779335743802,"version":"3.51.4"},"reference-count":52,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The use of biomaterials in dentistry is extremely common. From a commercial perspective, different types of osteoconductive and osteoinductive biomaterials are available to clinicians. In the field of osteoconductive materials, clinicians have biomaterials made of heterologous bones at their disposal, including biomaterials of bovine, porcine, and equine origins, and biomaterials of natural origin, such as corals and hydroxyapatites. In recent years, it has become possible to synthesize nano-Ha and produce scaffolds using digital information. Although a large variety of biomaterials has been produced, there is no scientific evidence that proves their absolute indispensability in terms of the preservation of postextraction sites or in the execution of guided bone regeneration. While there is no scientific evidence showing that one material is better than another, there is evidence suggesting that several products have better in situ permanence. This article describes a preliminary study to evaluate the histological results, ISQ values, and prevalence of nano-HA. Materials and Methods: In this study, we planned to use a new biomaterial based on nanohydroxyapatite for implantation at one postextraction site; the nano-HA in this study was NuvaBONE (Overmed, Buccinasco, Milano, Italy). This is a synthetic bone graft substitute that is based on nanostructured biomimetic hydroxyapatite for application in oral\u2013maxillofacial surgery, orthopedics, traumatology, spine surgery, and neurosurgery. In our pilot case, a patient with a hopeless tooth underwent extraction, and the large defect remaining after the removal of the tooth was filled with nano-HA to restore the volume. Twelve months later, the patient was booked for implant surgery to replace the missing tooth. At the time of the surgery, a biopsy of the regenerated tissue was taken using a trephine of 4 mm in the inner side and 8 mm deep. Results: The histological results of the biopsy showed abundant bone formation, high values of ISQ increasing from the insertion to the prosthetic phase, and a good reorganization of hydroxyapatite granules during resorption. The implant is in good function, and the replaced tooth shows good esthetics. Conclusions: The good results of this pilot case indicate starting the next Multicentric study to have more and clearer information about this nanohydroxyapatite (NH) compared with control sites.<\/jats:p>","DOI":"10.3390\/medicina59111978","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T08:08:58Z","timestamp":1699517338000},"page":"1978","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Use of Nano-Hydroxyapatite (NH) for Socket Preservation: Communication of an Upcoming Multicenter Study with the Presentation of a Pilot Case Report"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9283-2861","authenticated-orcid":false,"given":"Roberto","family":"Rossi","sequence":"first","affiliation":[{"name":"Independent Researcher, 16149 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabetta","family":"Carli","sequence":"additional","affiliation":[{"name":"Unit of Pediatric Dentistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4371-900X","authenticated-orcid":false,"given":"Fabrizio","family":"Bambini","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, 60126 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3566-0434","authenticated-orcid":false,"given":"Stefano","family":"Mummolo","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, Universit\u00e0 degli Studi dell\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0018-8096","authenticated-orcid":false,"given":"Caterina","family":"Licini","sequence":"additional","affiliation":[{"name":"Department of Clinic and Molecular Science, Polytechnic University of Marche, 60126 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0441-3596","authenticated-orcid":false,"given":"Lucia","family":"Mem\u00e8","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, 60126 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Zhao, R., Yang, R., Cooper, P.R., Khurshid, Z., Shavandi, A., and Ratnayake, J. (2021). Bone Grafts and Substitutes in Dentistry: A Review of Current Trends and Developments. Molecules, 26.","DOI":"10.3390\/molecules26103007"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1089\/ten.teb.2019.0047","article-title":"Reconsidering Osteoconduction in the Era of Additive Manufacturing","volume":"25","author":"Weber","year":"2019","journal-title":"Tissue Eng. Part B Rev."},{"key":"ref_3","first-page":"60","article-title":"Substituts osseux","volume":"33","author":"Jordana","year":"2017","journal-title":"Med. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/j.coms.2007.06.002","article-title":"A Review of Bone Substitutes","volume":"19","author":"Kao","year":"2007","journal-title":"Oral Maxillofac. Surg. Clin. N. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.oooo.2016.04.010","article-title":"Biologic and clinical aspects of integration of different bone substitutes in oral surgery: A literature review","volume":"122","author":"Zizzari","year":"2016","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/j.ijom.2017.03.008","article-title":"Lateral ridge augmentation with Bio-Oss alone or Bio-Oss mixed with particulate autogenous bone graft: A systematic review","volume":"46","author":"Aludden","year":"2017","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/j.bjoms.2022.03.009","article-title":"Comparison of the osteogenic effectiveness of an autogenous demineralised dentin matrix and Bio-Oss\u00ae in bone augmentation: A systematic review and meta-analysis","volume":"60","author":"Li","year":"2022","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"151722","DOI":"10.1016\/j.aanat.2021.151722","article-title":"Histological evaluation of extraction sites grafted with Bio-Oss Collagen: Randomized controlled trial","volume":"237","author":"Keil","year":"2021","journal-title":"Ann. Anat.\u2014Anat. Anz."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"336","DOI":"10.4103\/0972-124X.134572","article-title":"A comparative evaluation of bovine-derived xenograft (Bio-Oss Collagen) and type I collagen membrane (Bio-Gide) with bovine-derived xenograft (Bio-Oss Collagen) and fibrin fibronectin sealing system (TISSEEL) in the treatment of intrabony defects: A clinico-radiographic study","volume":"18","author":"Palachur","year":"2014","journal-title":"J. Indian Soc. Periodontol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1097\/SCS.0000000000000679","article-title":"Equine and porcine bone substitutes in maxillary sinus augmentation: A histological and immunohistochemical analysis of VEGF expression","volume":"25","author":"Zizzari","year":"2014","journal-title":"J. Craniofac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1111\/j.1708-8208.2010.00314.x","article-title":"A collagenated porcine bone substitute for augmentation at Neoss implant sites: A prospective 1-year multicenter case series study with histology","volume":"14","author":"Pagliani","year":"2012","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.tibtech.2016.10.003","article-title":"Natural and Synthetic Coral Biomineralization for Human Bone Revitalization","volume":"35","author":"Green","year":"2017","journal-title":"Trends Biotechnol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1002\/jbm.b.33651","article-title":"Substituted hydroxyapatites for bone regeneration: A review of current trends","volume":"105","author":"Ratnayake","year":"2016","journal-title":"J. Biomed. Mater. Res. Part B Appl. Biomater."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1016\/j.carbpol.2016.11.003","article-title":"Development and characterization of a bioglass\/chitosan composite as an injectable bone substitute","volume":"157","author":"Khoshakhlagh","year":"2017","journal-title":"Carbohydr. Polym."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3197","DOI":"10.1002\/jbm.a.36156","article-title":"Bioglass\u00ae 45S5-based composites for bone tissue engineering and functional applications","volume":"105","author":"Rizwan","year":"2017","journal-title":"J. Biomed. Mater. Res. Part A"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e430","DOI":"10.1097\/SCS.0b013e31825e4abf","article-title":"Osteoconductive Properties of \u03b2-Tricalcium Phosphate Matrix, Polylactic and Polyglycolic Acid Gel, and Calcium Phosphate Cement in Bone Defects","volume":"23","author":"Luvizuto","year":"2012","journal-title":"J. Craniofacial Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1089\/ten.teb.2012.0443","article-title":"Physicochemical properties and applications of poly(lactic-co-glycolic acid) for use in bone regeneration","volume":"19","author":"Lanao","year":"2013","journal-title":"Tissue Eng. Part B Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.actbio.2020.06.022","article-title":"\u03b2-tricalcium phosphate for bone substitution: Synthesis and properties","volume":"113","author":"Bohner","year":"2020","journal-title":"Acta Biomater."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4749","DOI":"10.1016\/j.biomaterials.2003.12.005","article-title":"Structure and properties of nano-hydroxyapatite\/polymer composite scaffolds for bone tissue engineering","volume":"25","author":"Wei","year":"2004","journal-title":"Biomaterials"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.msec.2006.05.018","article-title":"Nanocrystalline calcium phosphate ceramics in biomedical engineering","volume":"27","author":"Kalita","year":"2007","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.jpcs.2006.12.011","article-title":"Computer simulation of stoichiometric hydroxyapatite: Structure and substitutions","volume":"68","author":"Mostafa","year":"2007","journal-title":"J. Phys. Chem. Solids"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1016\/j.msec.2008.09.052","article-title":"Physical characterization of hydroxyapatite porous scaffolds for tissue engineering","volume":"29","author":"Teixeira","year":"2009","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1023\/A:1025048724330","article-title":"Effects of sintering temperature on structure of hydroxyapatite studied with Rietveld method","volume":"14","author":"Guo","year":"2003","journal-title":"J. Mater. Sci. Mater. Med."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Kavasi, R.-M., Coelho, C.C., Platania, V., Quadros, P.A., and Chatzinikolaidou, M. (2021). In vitro biocompatibility assessment of nano-hydroxyapatite. Nanomaterials, 11.","DOI":"10.3390\/nano11051152"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.5005\/jp-journals-10024-3243","article-title":"Vertical Bone Augmentation with GBR Pocket Technique: Surgical Procedure and Preliminary Results","volume":"22","author":"Maddalone","year":"2021","journal-title":"J. Contemp. Dent. Pr."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Alkindi, M., Ramalingam, S., Alghamdi, O., Alomran, O.M., Binsalah, M.A., and Badwelan, M. (2021). Guided bone regeneration with osteoconductive grafts and PDGF: A tissue engineering option for segmental bone defect reconstruction. J. Appl. Biomater. Funct. Mater., 19.","DOI":"10.1177\/2280800020987405"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Quirino, L.C., Carvalho, P.H.d.A., Neto, R.T.A., Comachio, C.A., Monteiro, N.G., Ervolino-Silva, A.C., Okamoto, R., and Pereira-Filho, V.A. (2023). Polydioxanone Membrane Compared with Collagen Membrane for Bone Regeneration. Polymers, 15.","DOI":"10.3390\/polym15040868"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"306","DOI":"10.5051\/jpis.2300640032","article-title":"Evaluation of the clinical and radiographic effectiveness of treating peri-implant bone defects with a new biphasic calcium phosphate bone graft: A prospective, multicenter randomized controlled trial","volume":"53","author":"Lee","year":"2023","journal-title":"J. Periodontal Implant. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Zych, \u0141., Osyczka, A.M., \u0141acz, A., R\u00f3\u017cycka, A., Niemiec, W., Rapacz-Kmita, A., Dzierzkowska, E., and Stodolak-Zych, E. (2021). How Surface Properties of Silica Nanoparticles Influence Structural, Microstructural and Biological Properties of Polymer Nanocomposites. Materials, 14.","DOI":"10.3390\/ma14040843"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"685","DOI":"10.11607\/prd.4522","article-title":"Guided Bone Regeneration with Nonresorbable Membranes in the Rehabilitation of Partially Edentulous Atrophic Arches: A Retrospective Study on 122 Implants with a 3- to 7-Year Follow-up","volume":"40","author":"Pistilli","year":"2020","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"112298","DOI":"10.1016\/j.msec.2021.112298","article-title":"Development of Si doped nano hydroxyapatite reinforced bilayer chitosan nanocomposite barrier membranes for guided bone regeneration","volume":"128","author":"Tamburaci","year":"2021","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1177\/039463201402700315","article-title":"Novel hydroxyapatite biomaterial covalently linked to raloxifene","volume":"27","author":"Santarelli","year":"2014","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1177\/1721727X1301100322","article-title":"MG63 and MC3T3-E1 osteoblastic cell lines response to raloxifene","volume":"11","author":"Santarelli","year":"2013","journal-title":"Eur. J. Inflamm."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Santos, A.M.d.S., Pereira, R.d.S., Montemezzi, P., Mello-Machado, R.C., Okamoto, R., Sacco, R., Lisboa-Filho, P.N., Messora, M.R., Mour\u00e3o, C.F., and Hochuli-Vieira, E. (2023). The Interplay of Raloxifene and Sonochemical Bio-Oss in Early Maxillary Sinus Bone Regeneration: A Histological and Immunohistochemical Analysis in Rabbits. Medicina, 59.","DOI":"10.3390\/medicina59091521"},{"key":"ref_35","first-page":"523","article-title":"Osteopontin, osteocalcin and OB-cadherin expression in synthetic nanohydroxyapatite vs. bovine hydroxyapatite cultured osteoblastic-like cells","volume":"28","author":"Santarelli","year":"2014","journal-title":"J. Biol. Regul. Homeost. Agents"},{"key":"ref_36","first-page":"249","article-title":"Histologic and histomorphometric analysis of maxillary sinus augmentation with different biomaterials. A pilot split-mouth human study","volume":"11","author":"Mummolo","year":"2018","journal-title":"ORAL Implantol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"737","DOI":"10.11607\/prd.4178","article-title":"Periosteal Inhibition Technique for Alveolar Ridge Preservation as It Applies to Implant Therapy","volume":"39","author":"Nguyen","year":"2019","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Grassi, A., Mem\u00e8, L., Strappa, E.M., Martini, E., and Bambini, F. (2022). Modified Periosteal Inhibition (MPI) Technique for Extraction Sockets: A Case Series Report. Appl. Sci., 12.","DOI":"10.3390\/app122312292"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Mem\u00e8, L., Bambini, F., Gallusi, G., Strappa, E.M., and Mummolo, S. (2023). The Effect and the Potential Use of Magnetic\u2013Dam Barrier in Guided Bone Regeneration: A Laboratory Study. Appl. Sci., 13.","DOI":"10.3390\/app13031625"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Thurzo, A., G\u00e1lfiov\u00e1, P., Nov\u00e1kov\u00e1, Z.V., Pol\u00e1k, \u0160., Varga, I., Strunga, M., Urban, R., Surovkov\u00e1, J., Le\u0161ko, L., and Hajd\u00fachov\u00e1, Z. (2022). Fabrication and In Vitro Characterization of Novel Hydroxyapatite Scaffolds 3D Printed Using Polyvinyl Alcohol as a Thermoplastic Binder. Int. J. Mol. Sci., 23.","DOI":"10.20944\/preprints202211.0141.v1"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.actbio.2018.11.039","article-title":"Three-dimensional (3D) printed scaffold and material selection for bone repair","volume":"84","author":"Zhang","year":"2018","journal-title":"Acta Biomater."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Wang, T., and Guo, Y. (2023). The Host Response to Autogenous, Allogeneic, and Xenogeneic Treated Dentin Matrix\/Demineralized Dentin Matrix-Oriented Tissue Regeneration. Tissue Eng. Part B Rev.","DOI":"10.1089\/ten.teb.2023.0065"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Mem\u00e8, L., Strappa, E.M., Monterubbianesi, R., Bambini, F., and Mummolo, S. (2022). SEM and FT-MIR Analysis of Human Demineralized Dentin Matrix: An In Vitro Study. Appl. Sci., 12.","DOI":"10.3390\/app12031480"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Sultan, N., and Jayash, S.N. (2023). Evaluation of osteogenic potential of demineralized dentin matrix hydrogel for bone formation. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-02928-w"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1080\/17434440.2023.2190512","article-title":"Comparison of clinical efficacy of three different dentin matrix biomaterials obtained from different devices","volume":"20","author":"Puzzolo","year":"2023","journal-title":"Expert Rev. Med. Devices"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"114","DOI":"10.4067\/S0717-95022017000100019","article-title":"Histological characterization of Sacco\u2019s concentrated growth factors membrane|Caracterizaci\u00f3n Histol\u00f3gica de la Membrana de los Factores de Crecimiento Concentrados Sacco","volume":"35","author":"Bernardi","year":"2017","journal-title":"Int. J. Morphol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"169","DOI":"10.4103\/jips.jips_301_21","article-title":"Effect of advanced platelet-rich fibrin and concentrated growth factor on tissues around implants in maxillary anterior region","volume":"22","author":"Jain","year":"2022","journal-title":"J. Indian Prosthodont. Soc."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"S68","DOI":"10.4103\/jpbs.jpbs_552_21","article-title":"Randomized controlled study on effect of concentrated growth factors on crestal bone levels and peri-implant bone density in dental implants","volume":"14","author":"Karthik","year":"2022","journal-title":"J. Pharm. Bioallied Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2705","DOI":"10.1002\/jbm.b.35122","article-title":"Effect of leukocyte-platelet-rich fibrin in bone healing around dental implants placed in conventional and wide osteotomy sites: A pre-clinical study","volume":"110","author":"Jalkh","year":"2022","journal-title":"J. Biomed. Mater. Res. Part B Appl. Biomater."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Gheno, E., Alves, G.G., Ghiretti, R., Mello-Machado, R.C., Signore, A., Louren\u00e7o, E.S., Leite, P.E.C., Mour\u00e3o, C.F.d.A.B., Sohn, D.-S., and Calasans-Maia, M.D. (2022). \u201cSticky Bone\u201d Preparation Device: A Pilot Study on the Release of Cytokines and Growth Factors. Materials, 15.","DOI":"10.3390\/ma15041474"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1080\/09537104.2020.1775188","article-title":"In vivo evaluation of the biocompatibility and biodegradation of a new denatured plasma membrane combined with liquid PRF (Alb-PRF)","volume":"32","author":"Gheno","year":"2020","journal-title":"Platelets"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/09537104.2017.1293812","article-title":"The impact of the centrifuge characteristics and centrifugation protocols on the cells, growth factors, and fibrin architecture of a leukocyte- and platelet-rich fibrin (L-PRF) clot and membrane","volume":"29","author":"Pinto","year":"2018","journal-title":"Platelets"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/11\/1978\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:20:27Z","timestamp":1760131227000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/11\/1978"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,9]]},"references-count":52,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["medicina59111978"],"URL":"https:\/\/doi.org\/10.3390\/medicina59111978","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,9]]}}}