Current knowledge about stackable guides: a scoping review

Abstract

Purpose
The rise of stereolithographic surgical guides and digital workflow, combined with a better knowledge of materials and loading principle, has enabled the placement of the temporary prosthesis at the time of implant placement. This scoping review aimed to assess the current knowledge available on stackable guides.

Methods
The review focused on fully edentulous or requiring total edentulism patients. The procedure studied was the use of stackable guides for edentulous patients in order to place immediate temporary prostheses. The clinical endpoint was immediate placement of the provisional prosthesis after surgery combined with a prior bone reduction using a stackable guide.

Results
12 case reports or case series articles met inclusion criteria, which did not allow an analysis by a systematic review. The included studies were case reports or case series. Most of the articles showed a base stabilized by 3 or 4 bone-pins, anchored in buccal or lingual part. Regarding the accuracy of bone reduction (ranged from 0.0248 mm to 1.98 mm) and implant placement when compared to planned, only 4 articles reported quantitative data. 11 articles showed an immediate loading with the transitional prosthesis after implant placement.

Conclusions
There are as yet no prospective or comparative studies on the efficiency of this technique. In a reliable way, stackable guides seem to be able to guide the practitioner from the flap elevation to the placement of the temporary screw-retained implant supported prosthesis. Given the lack of studies in this specific field of guided surgery, further studies are needed to confirm the clinical relevance of this technique.

Graphical Abstract

Full text

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Lan et al. International Journal of Implant Dentistry (2024) 10:28
https://doi.org/10.1186/s40729-024-00547-w
delivery of the immediate implant-supported prosthesis.
According to the literature, the rise of stereolithographic
surgical guide, digital planning, and Computer-Aided
Design/Computer-Aided Manufacturing, combined
with improved knowledge of materials and the principle
of immediate loading has led to a major advance: the
delivery of a provisional prosthesis at the time of implant
placement [2].
Despite an increased accuracy in implant placement
compared with a free-hand surgery [3], guided surger-
ies could achieve surgical predictability with an aver-
age overall implant deviation of 4° from planning [2,
4]. Sometimes, this lack of precision did not allow the
Background
Implant-supported screw-retained prosthesis is the gold-
standard for fixed restoration in completely edentulous
patient [1]. Over the past decade, digital workflow has
entered the field of surgical and prosthetic implantol-
ogy. Technological developments (Cone Beam Com-
puted Tomography (CBCT), software, 3D printers, etc.)
have made it possible to anticipate the production and
International Journal of
Implant Dentistry
*Correspondence:
Frédéric Silvestri
frederic.silvestri@univ-amu.fr
Full list of author information is available at the end of the article
Abstract
Purpose The rise of stereolithographic surgical guides and digital workow, combined with a better knowledge
of materials and loading principle, has enabled the placement of the temporary prosthesis at the time of implant
placement. This scoping review aimed to assess the current knowledge available on stackable guides.
Methods The review focused on fully edentulous or requiring total edentulism patients. The procedure studied was
the use of stackable guides for edentulous patients in order to place immediate temporary prostheses. The clinical
endpoint was immediate placement of the provisional prosthesis after surgery combined with a prior bone reduction
using a stackable guide.
Results 12 case reports or case series articles met inclusion criteria, which did not allow an analysis by a systematic
review. The included studies were case reports or case series. Most of the articles showed a base stabilized by 3 or 4
bone-pins, anchored in buccal or lingual part. Regarding the accuracy of bone reduction (ranged from 0.0248mm to
1.98mm) and implant placement when compared to planned, only 4 articles reported quantitative data. 11 articles
showed an immediate loading with the transitional prosthesis after implant placement.
Conclusions There are as yet no prospective or comparative studies on the eciency of this technique. In a reliable
way, stackable guides seem to be able to guide the practitioner from the ap elevation to the placement of the
temporary screw-retained implant supported prosthesis. Given the lack of studies in this specic eld of guided
surgery, further studies are needed to conrm the clinical relevance of this technique.
Keywords Digital, Computer-guided surgery, Dental implants, Dental prosthesis, Prosthodontics
Current knowledge about stackable guides:
a scoping review
RomainLan1, CamilleMarteau2, ChloëMense1 and FrédéricSilvestri1,3*

Page 2 of 10Lan et al. International Journal of Implant Dentistry (2024) 10:28
immediate placement of the provisional prosthesis
when fabricated prior to the placement of implants. In
these situations, this implied a very long session to make
impressions and record the occlusion relationship follow-
ing the surgery [5–7].
Most of the time, in completely edentulous patients,
due to an irregular post-extraction bone anatomy, guided
bone reduction may be essential to establish a suitable
ridge for implant placement and to fit a bone-supported
drill guide [8–11]. In these specific clinical cases, con-
ventional stereolithographic surgical guides, which are
printed solely to guide drilling, cannot be manufactured
to anticipate the new anatomical situation. (Fig.1) Stack-
able guides are a recent evolution of stereolithographic
guides whose main objectives are to achieve both bone
reduction, if necessary, and placement of implants
planned. e previously fabricated temporary screw-
retained prosthesis can then be fitted immediately (for
technical note, see Debortoli et al.) [12]. When using
stackable guides, placing the bone anchored base is the
first stage of a fully guided implant surgery. Different
removable guides are connected with the base during
the surgery to successively perform the bone reduction,
osteotomies, and the placement of implants. (Figures2,
Graphical Abstract

Page 3 of 10Lan et al. International Journal of Implant Dentistry (2024) 10:28
3, 4, 5, 6, 7, 8, 9 and 10) us, the prosthetically-guided
implant planning is followed at every stage. is type of
surgical guide seems to be promising to facilitate manu-
facturing and the placement of a temporary prosthesis at
the time of surgery, which was more difficult with con-
ventional stereolithographic guides. In fact, the base of
these guides is also used to maintain precise position-
ing of the provisional prosthesis while the temporary
Fig. 5 Stackable guide: base + 1rst stage (base positioning) in a clinical
situation
Fig. 4 Stackable guide: base + 2nd stage for fully guided implant
placement
Fig. 3 Stackable guide: base + 1rst stage (base positioning using remain-
ing teeth)
Fig. 2 Stackable guide: base
Fig. 1 Conventional stereolithographic surgical guide (pilot drill guide)

Page 4 of 10Lan et al. International Journal of Implant Dentistry (2024) 10:28
abutments are captured in the provisional prosthesis
using acrylic resin.
e aim of this review is to assess the current knowl-
edge available on stackable guides and actual contri-
butions and limits of this device in both surgical and
prosthetic procedures.
Materials and methods
In this scoping review, the target population is com-
pletely edentulous patients or patients requiring total
edentulism. All types of studies with unlimited publi-
cation period have been collected between March and
May 2023 on Medline database. e procedure studied
was the use of stackable guides for edentulous patients
in order to place immediate temporary prostheses. e
clinical endpoint was immediate placement of the pro-
visional prosthesis after surgery combined with a prior
bone reduction using a stackable guide. Other aspects of
computer assisted surgery like computer guided surgery
without immediate provisional placement and dynamic
navigation were not studied.
Studies of partially edentulous patients whose teeth
were retained or articles on freehand or non-stackable-
guided surgery were not included. Animal or in vitro
studies, studies published in a language other than Eng-
lish, and full texts not accessible via inter-university
credits were excluded. Publications meeting the selec-
tion criteria were included by two independent readers
according to the PRISMA methodology (PRISMA Exten-
sion for Scoping Reviews) [13].
Fig. 10 Implants placed at the end of fully guided surgery
Fig. 9 Fully guided osteotomies
Fig. 8 Stackable guide: base + 2nd stage for fully guided implant
placement
Fig. 7 Anchored base after multiple extractions
Fig. 6 Anchored base before multiple extractions

Page 5 of 10Lan et al. International Journal of Implant Dentistry (2024) 10:28
e search started with the use of MeSH terms to
obtain a search equation including the target population,
the type of targeted intervention and the placement of a
temporary prosthesis: “edentulous jaw AND computer
aided surgery AND dental implant AND temporary pros-
thesis”. With this search equation, the articles obtained
were too irrelevant, mostly focusing on conventional ste-
reolithographic guides. us, free keywords were used in
PubMed database to achieve this review: “stackable tem-
plate OR stackable implant placement guide OR stack-
able surgical template”. is search was supplemented by
a manual search in the PubMed database. General and
clinical information were collected within the limitations
of reported data.
Results
We collected 12 articles that met inclusion criteria [14–
25]. (Table1)
e included studies were case reports (25 patients;
27 arches restored, 173 implants), corresponding to low
level of evidence studies. (Tables2 and 3)
- Stackable guide:
Depending on clinical cases, the guide support tissue
could be different: mucosal-supported guides, bone-
anchored guide, dental-supported guide and mixed-sup-
ported guide (dental and mucosal or dental and bone).
Of the 12 articles selected, regarding material used to
manufacture surgical guides, only two articles reported
metal alloy surgical guides, manufactured by selective
laser melting [18, 25]. In the other articles, 3D printed
acrylic resin was used to manufacture all the stages of
stackable guides, from basis to temporary prosthesis.
(Table3)
Regarding the stabilization of the guide, most of the
articles showed guides with a base stabilized by 3 or 4
bone-pins, anchored in buccal or lingual part [14, 15,
17–22, 24, 25]. Only one article showed an unanchored
mucosa-supported guide [23].
e number of stacked parts varied: 2 articles reported
2-part guides, 7 articles reported 3-part guides and 3 arti-
cles reported 4-part guides. When 4 stacked parts were
present, the first part is tooth-supported to perform an
accurate positioning of a bone-pin anchored base. is
first part was then removed, and the bone resection is
performed using the second part. e third part allowed
full-guided osteotomies and implant placements. e
temporary guided prosthesis was positioned using the
last part. In case of edentulous patients, 3 or 4 stacked
parts could constitute the guide. When there were two
parts, a base was present on which a drilling guide or a
guide for the sinus approach is positioned.
Table 1 Summary of the inclusion and exclusion criteria
Inclusion criteria Exclusion criteria
Completely edentulous jaw or indication of
edentulism
Article in other lan-
guages than English
Fully guided surgery Partially edentulous jaw
Use of a stackable guide Another static surgical
guide used or described
Bone reduction and/or temporary prosthesis Free-hand or half-guid-
ed surgery
No year limit for publication
Table 2 Summary of patients treated in included studies
Authors Patients
treated
Arches Number of implants per
arche
Implants Minimum torque
(N/cm)
Success rate in
% (follow-up)
Barualdi (2019) [14] 11 13 6 (except one case with 8
implants in maxilla)
86 > 35 100
(> 12 months)
Berreta (2017) [15] 1 1 4 4 > 35 100
(12 months)
Costa (2020) [16] 1 1 8 8 NR NR
Creagh (2020) [17] 1 1 8 8 NR NR
Fu (2020) [18] 1 1 6 6 NR NR
Garcia-Sala (2022) [19] 1 1 6 6 NR NR
Granata (2021) [20] 1 1 6 6 NR NR
Lanis (2021) [21] 1 1 5 5 > 50 100
(12 months)
Lu (2021) [22] 4 4 6
(2 mandibles and 1 maxilla)
8 (1 maxilla)
26 NR NR
Papaspyridakos (2021)
[23]
1 1 6 6 NR 100
(6 months)
Salama (2018) [24] 1 1 6 6 NR 100
(24 months)
Yang (2021) [25] 1 1 6 6 NR NR
(NR: not reported)

Page 6 of 10Lan et al. International Journal of Implant Dentistry (2024) 10:28
Table 3 Characteristics of the stackable guides used in selected studies
Authors About the guide
Num-
ber of
parts
Purpose
(each part)
Software Manufactur-
ing process
Support-
ive tissue
Anchoring
devices
Connecting
devices
Imme-
diate
loading
Immedi-
ate post-
operative
radiograph
Barualdi
(2019) [14]
3 - base anchorage
- drilling
- interim
prosthesis
CodiagnostiX,
Dental Wings
3D printing
(acrylic resin)
Teeth Buccal pins (x3) Ball
attachements
Yes Yes
Berreta
(2017) [15]
2 - socle
- drilling
3 Diagnosys,
Ires
3D printing
(acrylic resin)
Plural
(teeth and
bone)
Pins (x4) Screws Yes No
Costa (2020)
[16]
3 - bone reduction
- drilling
- interim
prosthesis
Nemostudio
software,
Nemotec
3D printing
(acrylic resin)
Plural
(teeth and
bone)
Pins Magnets NR No
Creagh
(2020) [17]
3 - base anchorage
- drilling
- interim
prosthesis
Nemostudio
software,
Nemotec
3D printing
(acrylic resin)
Soft tissue Buccal pins (x3)
Palatin pin (x1)
Notches Yes No
Fu (2020)
[18]
3 - base anchorage
- bone reduction
- drilling
Materialise
magics,
Materialise/
Geomagic,
3Dsystem
SLM
(metal alloy)
Teeth Pins (x3) Notches Yes No
Garcia-Sala
(2022) [19]
3− 4 implant
removals
- bone reduction
− 2 implants
Meshmixer,
Autodesk
3D printing
(acrylic resin)
Teeth Buccal pins (x3) Magnet Yes Yes
Granata
(2021) [20]
4 - base anchorage
- drilling
- interim
prosthesis
3 Diagnosys,
Ires
3D printing
(acrylic resin)
Dentaire Buccal pins (x4) Ball
attachements
Yes No
Lanis (2021)
[21]
2 - bone reduction
- drilling
CodiagnostiX,
Dental Wings
3D printing
(acrylic resin)
Soft tissue Pins (x3) Notches Yes Yes
Lu (2021)
[22]
3 - bone reduction
- drilling
- interim
prosthesis
Blue Sky Plan,
Blueskybio
3D printing
(acrylic resin)
Bone Buccal pins (x4) Notches Yes No
Papaspyri-
dakos (2021)
[23]
4 - pins placement
- bone reduction
- drilling
- interim
prosthesis
CodiagnostiX,
Dental Wings
3D printing
(acrylic resin)
Soft tissue Unanchored Pins Yes No
Salama
(2018) [24]
3 - bone reduction
- drilling
- interim
prosthesis
Blue Sky Plan,
Blueskybio/
Implant stu-
dio, 3Mespe/
Exoplan,
Exocad
3D printing
(acrylic resin)
Bone Buccal pins (x3) Screws Yes No
Yang (2021)
[25]
4 - base anchorage
- drilling
- interim
prosthesis
Materialise
magics,
Materialise
SLM
(metal alloy)
Teeth Pins (2 buccal et
1 palatal)
Screws Yes Yes
(SLM: sele ctive laser meltin g; NR: not reporte d)

Page 7 of 10Lan et al. International Journal of Implant Dentistry (2024) 10:28
Different devices were described to connect the differ-
ent parts: 5 articles described screws or pins [14, 23–26],
2 articles described ball attachments [15, 20], 2 arti-
cles described magnetic attachments [16, 19], 4 articles
described notches [17, 18, 21, 22].
Regarding placement or stabilization, no problem was
reported.
- Placement of the provisional prosthesis and stackable
guide accuracy:
11 articles [14, 15, 17–25] reported immediate load-
ing procedures. Regarding the accuracy of bone reduc-
tion and implant placement in relation to planning, only
4 articles reported quantitative data allowed by a super-
imposition of CBCTs before (surgical planning) and after
the placement of implants [11, 19, 22, 23]. e difference
was analyzed using a different calculation software and
the data was expressed in millimeter or degrees depend-
ing on the value indicated. According to the authors,
the accuracy of the actual bone reduction ranged from
0.0248mm to 1.98mm when compared with the reduc-
tion initially planned; one author reports a bone plane
inclination of 6.03° [22]. Regarding implant place-
ment, accuracy ranged from 0.44mm to 1.43mm at the
implant apex, from 0.887mm to 1.90mm at the implant
neck, and from 2.4° to 4.14° in overall implant deviation
depending on the author [11, 16, 19].
Discussion
e use of stackable guides is a developing practice.
Given the lack of studies in this specific field of guided
surgery, the authors concluded that a systematic review
was irrelevant. e results should be noted with caution,
without the possibility of recommendations or conclu-
sions for clinical practice.
is scoping review has enabled to identify several
important points, both positive and negative.
- Placement of the surgical guide:
When there are still teeth on the jaw, the authors
seemed to favour anchoring the base using the remaining
teeth [11, 18, 26], which is also reported in the literature
to improve the accuracy of guide positioning [26–28].
When the teeth are too mobile (e.g. due to periodon-
tal disease), a splint could be made before the CBCT to
prevent any movement that would destabilize the posi-
tioning of the base [25]. An optical impression is recom-
mended to avoid tooth movement, which would result in
a distorted planning [29].
In addition, in cases of simultaneous extraction/
implant placement, the dislocation movement of teeth
during extraction may deform the bony tables which may
complicate the placement of the guide on these modi-
fied supporting tissues. Even without bone deformation,
stabilizing the guide on extraction sockets could be chal-
lenging [20]. e stackable guide provides a secure base
with bone-pins and accurate placement with the dental
support used prior to extractions.
In edentulous patients, attention must be paid to the
compression zone between the supporting tissues and
the surgical guide so as not to destabilize the latter. When
the base of the stackable guide is supported by soft tis-
sues, oedema caused by local anesthesia may lead to
positioning errors. In these clinical situations, it is impor-
tant to infiltrate the anesthetic solution away from the
support area [14].
In cases of limited mouth opening, stacking of the
guide stages may be very complicated or even impossible
and the use of these guides is therefore contraindicated
[24].
Although selected studies were of low level of evidence,
few of them have reported data between planed and final
bone reduction or implant placement [11, 16, 19, 22].
Obviously, these data can only give a trend that needs to
be supported by further studies, but they seem to show
small discrepancies between planning and realization.
- Stacking of the guide stages:
According to Costa et al., magnetic attachments allow
for stable and reproducible stacking of guide bases [16].
e characteristics of attachment devices were not well
developed in the selected studies.
- Possible planning in case of bone reduction of the
ridge:
In completely edentulous patients, the drill guide will
be bone-supported; if bone resection is required, a full
flap is lifted so mucosal support is not possible. e sur-
geon will not be able to achieve an accurate free-hand
bone reduction to fit the drill guide. After ridge resection,
anatomical landmarks are modified, making it difficult to
position the guide later [14].
e interest in guiding bone reduction is major as
it would allow the use of drill guides even in patients
requiring bone resection. Once the intraosseous pins
of the base are placed, the reduction can be performed
up to the limit of the guide, which represents bone mar-
gins planned on software before the surgery. en a drill
guide is “nested” on the base to allow a fully guided sur-
gery from ridge reduction to implant placement. In this
way, the resection is guided, and the new bone level is
true to plan [11, 14, 16, 18, 21–24].
- Placement of the provisional prosthesis:
e immediate loading of the screw-retained tempo-
rary prosthesis avoids repetitive screwing/unscrewing of
the implant superstructures. e provisional prosthesis
is directly placed until complete osseointegration of the
implants. D’Haese et al. have shown that mobilizing the
implants too early during screwing/unscrewing can lead
to deviation of the implant axes from the planning [30].
In addition, the prosthesis is manufactured before sur-
gery, thus avoiding postoperative impressions which are

Page 8 of 10Lan et al. International Journal of Implant Dentistry (2024) 10:28
more complex to manage at the end of surgery. When the
provisional prosthesis is obtained by transforming of the
temporary removable complete denture, the risk of frac-
ture of the prosthesis is high [31]. Moreover, of the vari-
ous milled materials available, polymethyl methacrylate
can be used to manufacture prostheses with improved
mechanical properties [29, 32].
During the digital design of the temporary prosthe-
sis, the implant positions lead to the choice of abutment
height and angulation. is step ensures the necessary
passivity of the prosthesis to avoid any iatrogenic stresses
on the implants during the osseointegration phase [20].
Planning is a time-consuming step, but it saves time
during surgery and limits prosthetic sessions. Indeed,
the temporary restoration can be placed directly after
implant placement. is avoids leaving the patient with-
out a prosthesis for 24–48h as well as an often poorly
tolerated impression and bite registration session at the
end of the surgery [4, 16, 23, 28].
- Decrease in patient comorbidities:
ese static guides eliminate the need for full flap sur-
gery [33]. Indeed, it is no longer necessary to see the
underlying bone structure because the guide has been
designed based on a careful and accurate CBCT analysis.
A flapless surgery can be performed, operating time is
significantly shortened, and postoperative comorbidities
decrease (bleeding, pain, oedema, hematoma) [4, 23].
Patient and surgeon comfort is improved, and the
immediate loading of the implants also avoids a difficult
impression session [20].
- Digital workflow:
Digital workflow is an interesting procedure that
could help in treatment planning and virtual prosthetic
project. Indeed, planning is done virtually on dedicated
software with superimposition of DICOM files and STL
files (initial situation from intraoral scanning and virtual
prosthetic project). en printing surgical templates
made it possible to transfer this prosthetically guided
project from the computer to the patient [34]. Several
authors have reported no differences in the clinical accu-
racy of implant placement between additive and subtrac-
tive manufactured guides [35, 36]. In addition, acrylic
resin is a suitable material for the manufacture of surgical
guides, with the benefits of ease fabrication, reduced cost
and less time wasted by technicians [36, 37].
ere also are many advantages to this digital work-
flow: fewer clinical sessions are required, the provisional
prosthesis fits better, and the placement of implants is
more accurate [16, 38].
Limits.
- Persistent risk of error:
Despite the promising concept of stackable guides,
errors can accumulate throughout treatment steps
(CBCT acquisition, wax up, distortion of the planned
manufacture of the guide, calibration of the 3D printer,
surgical phase, anchoring the guide during surgery, stack-
ing the different parts). e practitioner’s experience is
essential in order to remain focus on the progress of each
step during the surgery and be able to fix any problem or
mistakes [14, 15, 19, 21].
Main limits are in the need to acquire knowledge and
experience in this field; as most of new techniques, it
requires a learning curve for both surgeons and dental
technicians, and the need for a specific software (initial
investment required).
Obviously, limits in the use of conventional stereolitho-
graphic guide are available for stackable guide (mouth
opening, remaining errors in positioning the base…).
e absence of postoperative control radiography in
most studies (6/12) made it impossible to objectively
assess the real effectiveness of the technique presented,
or the correct temporary prosthesis positioning with
regard to biological or prosthetic requirements. e
results should therefore be interpreted with caution.
- Financial cost:
Manufacturing the guide adds a cost to the treatment,
particularly when using magnetic attachments [14, 16].
Clinical relevance:
ere is no study with good levels of evidence to evalu-
ate and measure the benefit of stackable surgery guide.
However, this surgical technique appears promising in
order to improve surgical precision. It differs from the
use of conventional stereolithographic guides which are
already used daily by several practitioners. Deep analysis
and complete planning of each clinical case are time-con-
suming but essential steps to achieve an optimal tempo-
rary the comfort for both surgeon and patient.
In return, the comfort for both surgeon and patient is
clearly increased and the surgery becomes more repro-
ducible. (Table4)
Table 4 Advantages / Disadvantages of stackable guides
Advantages Disadvantages
Accurate base positioning
(remaining teeth)
Same limitations as
conventional stereo-
lithographic guides
(mouth opening,
risk of errors in posi-
tioning the base)
One stage for each surgical step
(base positioning / bone reduction / osteoto-
mies / temporary prosthesis)
Cost
Possible planning in case of bone reduction
Bone reduction guide
Learning curve
/ practionner’s
experience
Accurate and immediate screw-retained tempo-
rary prosthesis without impression procedure
(manufactured before surgery)
No prospective or
comparative studies
to conrm the clini-
cal relevance
Decreased in patient comorbidities

Page 9 of 10Lan et al. International Journal of Implant Dentistry (2024) 10:28
Conclusions
ere are as yet no prospective or comparative studies
on the efficiency of stackable stereolithographic surgical
guides, and the data found in the literature are not stan-
dardized. Only case series are reported, which makes
it impossible to justify a possible impact on clinical
practice.
e management of bone reduction prior to implant
placement or immediate loading of a temporary prosthe-
sis could be facilitated by using a stackable guide, which
appears to be able to guide the practitioner from surgery
to immediate loading of the provisional screw-retained
implant-supported prosthesis.
Further studies are therefore needed to confirm the
improved accuracy of implant placement and pros-
thetic success in immediate loading. Given the growth
of dynamic guided surgeries, in-depth studies are also
needed to assess the benefits of promoting this type of
surgical guide.
Supplementary Information
The online version contains supplementary material available at https://doi.
org/10.1186/s40729-024-00547-w.
Supplementary Material 1
Author contributions
LR: conception, design, interpretation of result, drafting and editing the
manuscript. CMa: literature screening, drafting. CMe: literature screening,
interpretation of result. FS: conception, design, literature screening,
interpretation of result, drafting and editing the manuscript.
Funding
There is no funding related to this article.
Data availability
The datasets used and/or analysed during the current study are available from
the corresponding author on reasonable request.
Declarations
Ethics approval and consent
Not applicable.
Consent for publication
Not applicable.
Competing interests
The authors declare that they have no competing interests.
Author details
1Faculté des Sciences Médicales et Paramédicales, École de Médecine
dentaire, ADES, CNRS, Aix-Marseille University, 27 Boulevard Jean Moulin,
Marseille Cedex 5 13555, France
2Private practice, Marseille, France
3Department of Oral Rehabilitation, Karolinska Institute, Huddinge,
Sweden
Received: 2 February 2024 / Accepted: 21 May 2024
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