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Hot Topics in Clinical Oral Implants Research: Recent Trends in Literature Coverage

Vesela valkova.

1 Medical University of Vienna, Bernhard Gottlieb School of Dentistry, Sensengasse 2a, A-1090 Vienna, Austria; [email protected] (V.V.); moc.oohay@aneeneec (C.U.M.)

Ceeneena Ubaidha Maheen

Bernhard pommer.

2 Academy for Oral Implantology, Lazarettgasse 19/DG, A-1090 Vienna, Austria

Xiaohui Rausch-Fan

3 Medical University of Vienna, Rausch-Fan Laboratory, Sensengasse 2a, A-1090 Vienna, Austria; [email protected]

Rudolf Seemann

4 Medical University of Vienna, Department of Oral and Maxillofacial Surgery, Währinger Gürtel 18-20, A-1090 Vienna, Austria; [email protected]

This systematic review looks at thematic trends in clinical research publications on dental implants. For this purpose, MEDLINE electronic searches as well as additional hand searches of six main journals in the field were conducted. A total of 2875 clinical studies published between 2001 and 2012 met the inclusion criteria and were subjected to statistical analysis. Hot topics in dental implant literature included immediate loading (14.3%), bone substitutes (11.6%), cross-arch full bridges (8.0%), and immediate implant placement (7.5%). A significant increase in scientific interest for immediate loading (+6.3%, p = 0.001), platform switching (+2.9%, p = 0.001), guided implant surgery (+1.9%, p = 0.011), growth factors ( p = 0.014, +1.4%), piezoelectric surgery (+1.3%, p = 0.015), and restorative materials (+0.7%, p = 0.011) was found. A declining scientific interest in onlay grafting (−0.3%, p = 0.042) was recorded. The findings regarding current clinical oral implants research tie in with better-informed consumers and increased patient demands. Our results demonstrate an increasing interest in techniques that avoid complicated procedures such as bone grafting and that reduce treatment duration.

1. Introduction

The present special issue of Dentistry Journal deals with “Advances in Implant Dentistry,” and the following keywords denote hot topics in this field: template-guided implant placement, minimally invasive techniques, short lengths and reduced implant diameters, novel bone grafting techniques, medically compromised patients, peri-implantitis treatment, immediate placement and restoration, transition from a failing dentition, CAD/CAM prosthetics, and optical intraoral impressions. As the first paper in this special issue, the following review aims to provide the background to recent trends and “hot topics” in advanced and minimally invasive oral implant treatment [ 1 ].

The concept of osseointegration of oral implants was introduced by Branemark 40 years ago and set the precedent for new knowledge in oral medicine. Since then, oral implantology has become one of the most investigated topics in dental medicine, with exponential growth in the use of implant products [ 2 ]. Data shows that the number of implants used for oral rehabilitation in the USA increased ten-fold between 1983 and 2002 and also ten-fold from 2000 to 2010 [ 3 ]. While previously the primary aim of research on oral implantology was to find ways to rehabilitate function [ 4 ], many efforts nowadays are focused on the shortening of treatment procedures, simplifying surgical techniques, and esthetic improvement [ 5 ]. It is well known that oral implantology is a prosthetically driven field with a major surgical component [ 6 ]. Therefore, the current state of the art in implant dentistry represents advances in both surgical and prosthodontic techniques [ 5 ].

Keeping pace with research development, the aim of this systematic review was to investigate contemporary issues in oral implantology research and to perform a topical trend analysis of clinical studies published in the time period from 2001 to 2012.

2. Material and Methods

2.1. search strategy.

A MEDLINE electronic literature search was conducted, limited to clinical studies on dental implants published between 2001 and 2012. The search term “dental implant,” sorted by “year of publication” was used in order to capture all relevant articles [ 7 ]. Additional hand searching was performed to examine six main journals in the field: The International Journal of Maxillofacial Implants , Journal of Oral Implantology , Clinical Oral Implant Related Research , Implant Dentistry , European Journal of Oral Implantology , and Clinical Oral Implant Research . Two reviewers independently identified all trials [ 8 ]. The PubMed search initially identified 15,695 publications, and 5048 additional results were identified by hand search. These studies were screened for their relevance based upon a threshold set [ 9 ]:

• inclusion criteria: prospective and retrospective studies, cross-sectional studies, case-control studies, case reports with at least 10 patients
• exclusion criteria: non-English publications, statistical studies, animal studies, finite element analyses, in vitro studies, review articles, and case series with fewer than 10 patients.

A total number of 3695 articles were subjected to abstract review. Where the abstract provided little information, a full text analysis was performed. Authors of potentially relevant publications, which were not available or lacked data, were contacted and asked for cooperation. Ultimately, 2875 clinical studies were identified as meeting the inclusion criteria. Our goal was to investigate how trends change over time as regards the topics examined in modern implant dentistry research. In this respect, we have determined that 31 topics were appropriate: 23 of them concerned surgical issues and 8 dealt with prosthodontic issues ( Table 1 ). First, all relevant publications were screened for the topics listed in Table 1 independently by two reviewers. Thereafter, the results were verified, and all doubtful publications were discussed before the final decision was taken.

Topics sorted by literature coverage. Absolute numbers of publications per year as well as the total percentage of all clinical papers 2001–2012 (* indicates prosthodontic topics).

2.2. Statistical Analysis

As mentioned above, 2875 publications were analyzed. In order to find statistical trends in respect to the relevant topics between 2001 and 2012, Poisson regression analysis was performed, taking the level of significance as p ≤ 0.05, using R-project statistical software version 3.1.0. This statistical test was used to model count data, which in this case was the number of publications. p -values were calculated for every topic, taking into account the relative number publications per topic from the total number of publications.

The surgical and prosthodontic topics of interest were computed as percentages of the total number of publications ( Table 1 ). Among the most covered surgical topics in the literature were immediate loading (14.3%), bone substitutes (11.6%), immediate implant placement (7.5%), simultaneous implant placement with bone augmentation (6.4%), onlay grafting (4.3%), medically compromised patients (4.0%), healing modality (3.7%), transcrestal sinus floor elevation (3.0%), flapless surgery (2.7%), socket grafting (2.6%), and guided surgery (2.4%). Immediate loading (14.3%), cross-arch implant bridges (8.0%), early loading (4.5%), and platform switching (1.7%) were ranked as the most prevalent prosthodontic issues in current oral implant research.

The surgical issues were the more prevalent topics, demonstrating an increasing rate of publications over the time in terms of mean coverage (0.53 ± 0.01) per publication ( Figure 1 ), as compared to prosthodontic issues (0.33 ± 0.05 hits). The mean coverage values were estimated based on yearly ratios: the number of prosthodontic/surgical publications per year in relation to the total number of publications per year. The significant increase in publications on surgical issues over the years was demonstrated by Poisson regression analysis ( p = 0.002).

Literature coverage of surgical (s) versus prosthodontic (p) issues: x-axis indicates year of publication, y-axis indicates the ratio of numbers of publications (surgical/prosthodontic) to the total number of publications per year.

A total of eight topics showed significant trends ( p < 0.05) over the years 2001 to 2012 ( Table 2 ). Immediate loading demonstrated the highest increase with a positive change of +6.3% and p = 0.001 ( Figure 2 a). Platform switching (+2.9%, p = 0.001) was the second topic showing a significant increase; however, only one relevant article was detected between 2001 and 2006 ( Figure 2 b). These topics were followed by guided implant surgery (+1.9%, p = 0.011), growth factors (+1.4%, p = 0.014), piezoelectric surgery (+1.3%, p = 0.015), and restorative materials (+0.7%, p = 0.011). The green line represents the percentage of the total number of publications for every year. The black trend line reveals the relationship between the year of publication (x-variable) and the percentage of the total number of publications (y-variable). Since there were no publications on platform switching between 2002 and 2005, there is a negative trend line intercept starting from 2001 ( Figure 2 b). Decreasing scientific interest and a corresponding downward trend were recorded for the topic onlay grafting (−0.3%, p = 0.042).

Trend curves (percentage out of the total number of publications per year) for ( a ) immediate loading; ( b ) platform switching; ( c ) flapless implant surgery; ( d ) guided implant surgery; ( e ) growth factors; ( f ) piezoelectric surgery; ( g )restorative materials; and ( h ) onlay grafting.

Topics demonstrating a significant increase (positive) or decrease (negative change) of scientific interest in the years 2001–2012.

4. Discussion

Comparisons of published clinical trials per year revealed a trend of increasing interest in conducting clinical trials, starting with 137 relevant articles in the year 2001 and reaching the number of 446 publications in the year 2012. However, even the total number of 3695 articles is smaller than the total number of 4655 clinical studies published between 1989 and 1999 reported by Russo et al. [ 10 ]. Given that the number of publications increased with every year, it was considered more appropriate to perform Poisson regression analysis related to percentage-based values rather than related to absolute values for all topics.

Immediate loading proved to be the most studied topic in the last decade ( Figure 2 a). This avid scientific interest can be explained by several advantages it offers, such as shortened treatment protocols, immediate rehabilitation of the function, and high patient satisfaction. Meta-analyses on single-tooth implant placement have shown encouraging results for the immediate loading protocol as a promising alternative to conventional loading, as it may be equally successful and may not significantly affect marginal bone resorption and implant success rates [ 11 , 12 , 13 ]. Another meta-analysis by Papaspyridakos et al. [ 14 ] reported that there was no significant difference between immediate, early, and conventional loading in edentulous patients with fixed prostheses, and all three protocols showed a high level of success. However, other reviewers disagree with this assessment of the unimpaired success of the immediate loading protocol. A meta-analysis of clinical studies comparing the immediate and conventional loading of single tooth implants discovered that immediate loading has a significantly higher risk of implant failure [ 15 ]. Schimmel and coworkers [ 16 ] concluded that, despite the high implant survival rates, the conventional and early loading protocols are superior to immediate loading as better documented protocols, providing better results in the first year of loading. A survey among implantologists from 16 countries all over the world stated that immediate loading was the treatment protocol most accepted by dentists in Australia and Europe [ 17 ]. Based on these controversial statements in the literature, it can be concluded that there is still a lack of well-designed RCTs concerning loading protocol [ 18 ] and immediate loading may well retain its place as a hot topic of discussion over the coming years.

The platform-switching concept arose in 1980 with the introduction of the wide diameter implants. Due to the lack of commercially available matching components for wide diameter implants, the standard-diameter abutments were used. Later, it was found that “platform-switched” implants demonstrated osseointegration with less initial crestal bone loss and were thus superior to the “platform-matched implants” [ 19 ]. However, the first introduction of this concept appeared in 2005 [ 20 ]. Radiographic observation over a period of 13 years demonstrated that platform switching resulted in little or no crestal bone loss as compared to the conventional implants, whereas marginal bone resorption of 1.5 mm on average was accepted as one of the criteria for success of the dental implant [ 21 ]. Our study shows that the increasing publication rate of clinical studies happened to coincide with the first official introduction of this concept, with a positive linear trend for this topic starting in 2005 ( Figure 2 b). Since guided surgery is performed in combination with the flapless procedure in most cases, [ 22 ] the similarity in literature coverage, illustrated in both scatter plots, does not come as a surprise ( Figure 2 c,d).

In contrast to the last decade of the 20th century, when the main progress in the field of oral implant research was made in alveolar bone resorption management to refine the different graft techniques [ 23 ], our findings show that in the 21st century there has been increasing interest in methods developed to overcome the grafting procedures and even a loss of interest in one of the most used augmentation techniques, i.e. , onlay bone grafting. It seems that dental implant scientific work is inspired more by the patient’s appraisals [ 24 ], seeking to improve minimally invasive surgical techniques [ 25 ], diminish patient morbidity, and shorten the treatment time. However, the role of industrial funding for conducting clinical studies should be taken into consideration. 32.4% of the clinical trials are supported by industry as a source of funding, which is a suitable way for companies not only to comply with safety and efficacy standards, but also to introduce their new products to the market [ 26 ]. This industry sponsorship may lead to biased reporting and pro-industry conclusions [ 27 ]. This does have the potential to reflect on ongoing trends in clinical research. In this connection for instance, the relatively innovative technique of guided implant surgery provides less painful and invasive treatment but at the same time is a more difficult and expensive procedure than conventional implant placement, demonstrating the same survival rate. However, a survey by Hof and coworkers [ 28 ] showed that the main priority for the patients when it comes to implant therapy remains the predictability of treatment success. The achievements brought about by ongoing clinical research, such as improved quality, ease of use of implant systems, as well as shorter treatment duration [ 29 ] may provide grounds for future researchers to face the challenge of preserving the perspectives of clinical implant research, and specifically, to enhance the relationship between private practice and science without involving marketing.

In order to adhere to ethical rules on explicit reporting, including also the disadvantages of any study, the researchers are obligated to report their study’s limitations. Undoubtedly, meta-analysis is the “gold standard” for performing any systematic review aiming at assessing treatment effects. Given that the variable investigated in the present study was the number of publications, the Poisson regression was selected as a statistical tool. The Poisson regression is used to model count data (in the present case this is the number of publications) and is an appropriate statistical method for predicting trends. Therefore, no methods estimating risk of bias, quality design, or heterogeneity of the studies provided by the meta-analysis were applied in this study.

A further limitation is presented by the use of only one database source. The findings in the present work are based on analysis, including studies from MEDLINE, and an additional hand search of six journals. However, the search strategy did not consider other databases such as EMBASE and the Cochrane Central Register of Controlled Trials.

In conclusion, the analysis of scientific literature on dental implants revealed several hot topics in the time period between 2001 and 2012. The most frequently covered surgical issues were bone substitutes (11.6%) and immediate implant placement, (7.5%), while the most prevalent prosthodontic topics involved immediate loading (14.3%) and cross-arch full bridges (8.0%). Given that the topics demonstrating the highest increase in interest were prosthodontic topics, i.e. , immediate loading (+6.3%) and platform switching (+2.9%), the interest in researching prosthodontic topics will most likely continue to increase.

Acknowledgments

No funding was received to support the study.

Author Contributions

Bernhard Pommer conceived and designed the experiments; Vesela Valkova and Ceeneena Ubaidha Maheen performed the experiments; Rudolf Seemann analyzed the data; Xiaohui Rausch-Fan contributed analysis tools; Vesela Valkova wrote the paper.

Conflicts of Interest

The authors declare no conflict of interest.

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The 100 most cited articles in dentistry

Affiliation.

• 1 Grupo de Investigación en Odontología Médico-Quirúrgica (OMEQUI). School of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela A Coruña, Spain.
• PMID: 23771182
• DOI: 10.1007/s00784-013-1017-0

Objectives: To identify the 100 most cited articles published in dental journals.

Materials and methods: A search was performed on the Institute for Scientific Information (ISI) Web of Science for the most cited articles in all the journals included in the Journal Citation Report (2010 edition) in the category of "Dentistry, Oral Surgery, and Medicine". Each one of the 77 journals selected was analyzed using the Cited Reference Search tool of the ISI Web of Science database to identify the most cited articles up to June 2012. The following information was gathered from each article: names and number of authors, journal, year of publication, type of study, methodological design, and area of research.

Results: The number of citations of the 100 selected articles varied from 326 to 2050. All articles were published in 21 of the 77 journals in the category. The journals with the largest number of the cited articles were the Journal of Clinical Periodontology (20 articles), the Journal of Periodontology (18 articles), and the Journal of Dental Research (16 articles). There was a predominance of clinical research (66 %) over basic research (34 %). The most frequently named author was Socransky SS, with 9 of the top 100 articles, followed by Lindhe J with 7. The decades with most articles published of the 100 selected were 1980-1989 (26 articles) and 1990-1999 (25 articles). The most common type of article was the case series (22 %), followed by the narrative review/expert opinion (19 %). The most common area of study was periodontology (43 % of articles).

Conclusions: To our knowledge, this is the first report of the top-cited articles in Dentistry. There is a predominance of clinical studies, particularly case series and narrative reviews/expert opinions, despite their low-evidence level. The focus of the articles has mainly been on periodontology and implantology, and the majority has been published in the highest impact factor dental journals.

Clinical significance: The number of citations that an article receives does not necessarily reflect the quality of the research, but the present study gives some clues to the topics and authors contributing to major advances in Dentistry.

PubMed Disclaimer

• The 100 most cited articles in dentistry--some discussions. Pitak-Arnnop P. Pitak-Arnnop P. Clin Oral Investig. 2014;18(2):683-4. doi: 10.1007/s00784-013-1171-4. Epub 2014 Jan 8. Clin Oral Investig. 2014. PMID: 24398971 No abstract available.

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by Mary Beth Versaci

June 12, 2022

Original Article

Pathways to dentistry: Researchers move dental profession forward

Contributions have lasting impact on oral health care.

Editor's note: This is the third article in a series that celebrates the diversity of career paths in dentistry and the Association's efforts in supporting dentists' career choices in the profession.

From examining the connections between oral and overall health to evaluating the behavior of materials used in dentistry, researchers ask the questions and do the work to inform how dentists care for their patients every day.

"Dentistry is an amazing profession that has offered so many of us the opportunity to improve patients' lives. It is critical that we continue to evolve and expand our understanding of the diseases and conditions that affect our patients and continue to work to optimize the treatments that they receive," said Mia Geisinger, D.D.S., professor and director of the Advanced Education Program in Periodontology at the University of Alabama at Birmingham School of Dentistry. "My goal in research is always to change the way that we treat patients for the better, and while the pace of scientific discovery may be incremental, we continually strive to improve oral and overall health for all."

The American Dental Association recognizes the importance of research — like Dr. Geisinger's on the impact of periodontal disease and treatment on overall health — to the practice of dentistry. One of its core values is to be a science- and evidence-based organization, a goal that is supported by the ADA Science & Research Institute, which conducts research and produces evidence-based resources for dentists.

"Scientific research is so important to the health and advancement of the dental profession. That's why I'm really proud of the work ADASRI does," said Marcelo Araujo, D.D.S., Ph.D., chief science officer of the ADA and CEO of ADASRI. "At ADASRI, our work runs the gamut of scientific research — everything from basic science, like the creation of novel dental materials, to applied science that tests and refines dental materials, to clinical and translational research that communicates that basic and applied science in a way that is easy to implement chairside. As a whole, the work of ADASRI’s researchers, and really the work of all dental researchers, has a profound impact on improving dentistry."

The ADA also has two scientific journals: The Journal of the American Dental Association and JADA Foundational Science.

"The ADA continues to demonstrate its strong commitment to the health sciences through many avenues, including the dissemination of basic, translational and clinical research through its journals and other media offerings," said Jack L. Ferracane, Ph.D., editor-in-chief of JADA Foundational Science. "It all boils down to creating new and better pathways to oral health, and we all find it exciting and gratifying to play our different roles in the process that links discovery to successful clinical care."

A New Day for Dentistry, a campaign launched by ADA President Cesar R. Sabates, D.D.S., celebrates the ADA’s diverse community of dentists by recognizing their personal differences and the varied career paths they have chosen within the profession.

"Researchers are essential members of the dental workforce," Dr. Sabates said. "Clinicians strive to provide the best care they can to their patients, and researchers provide the evidence they need to make informed decisions. Their work also helps to expand dentistry’s knowledge base, driving innovation and advancement in our profession. The contributions of researchers have a lasting impact on all facets of oral health care."

For dentists who choose to pursue research as part of their career, a natural curiosity is key.

"I was exposed to research and science when I was in high school, and ever since, I was always interested in learning the underlying mechanisms of diseases," said Hatice Hasturk, D.D.S., Ph.D., director of the Center for Clinical and Translational Research and senior member of the staff at the Forsyth Institute. "I believe that without knowing what is really involved in tissues or structures we are working with, we cannot provide an effective and long-lasting solution."

Dr. Hasturk, who won the ADA’s 2020-21 Norton M. Ross Award for Excellence in Clinical Research and serves on the ADA Council on Scientific Affairs, teaches at the Boston University Henry M. Goldman School of Dental Medicine and Harvard School of Dental Medicine and practices once a week as a staff dentist/periodontist at the Forsyth Faculty Associates Clinic. Her research focuses on periodontology and immunology.

Dr. Hasturk's studies have shown that changing the body's response to infections and diseases can reduce the oral disease it is experiencing, provide better stability and lead the body to produce more beneficial molecules that can help improve its defense system against other infections and diseases.

"As a dentist/periodontist, my goal is to provide the best prevention and best treatment to my patients," Dr. Hasturk said. "As a researcher, this goal drives me to better understand health and disease, not only to improve oral health, but also overall health."

For Rajesh Lalla, B.D.S., Ph.D., professor of oral medicine and associate dean for research at the University of Connecticut School of Dental Medicine, his favorite part of being a researcher is the ability to create new knowledge.

"It is extremely satisfying to be able to go through the process of having an idea, designing a study to test that hypothesis and determining what the truth really is," said Dr. Lalla, who studies the oral side effects of radiation therapy and chemotherapy used in the treatment of cancer.

His research team is working to publish results from a multicenter clinical study that enrolled more than 500 patients undergoing radiation therapy for head and neck cancer.

"One of the novel findings is that the radiation treatment led to a striking increase in gingival recession," said Dr. Lalla, who is the immediate past president of the Multinational Association of Supportive Care in Cancer — the first dentist to hold the role. "It was known that these patients tend to get cervical caries after radiation therapy, but the reasons were not clear. Our finding indicates that exposure of the cervical areas of teeth due to gingival recession may explain the increased risk for cervical caries."

At the University of Connecticut, Dr. Lalla developed the dental school’s course on evidence-based decision making, which emphasizes the importance of evidence to the practice of dentistry.

"Dentistry is a scientific profession. The care we provide for our patients must be evidence based," said Dr. Lalla, who won the ADA’s 2020 Evidence-Based Dentistry Accomplished Faculty Award. "Research provides that evidence, so research is the very foundation of our profession."

With a background in engineering, Nathaniel Lawson, D.M.D., Ph.D., performs applied dental materials research at the University of Alabama at Birmingham School of Dentistry, where he is an associate professor, director of the biomaterials residency program and director of the division of biomaterials. He and his team devise testing equipment and protocols to evaluate dental materials to best predict their clinical performance, and they are perhaps most well known for performing wear testing. His lab is currently testing the wear of new 3D-printed materials being developed for dentures, crowns and occlusal guards.

"There are many different types of dental research. Many dentists may think of the incredible scientific work conducted by basic and translational scientists who are working to develop new treatments, materials and drugs to treat dental and oral conditions," said Dr. Lawson, who won the ADA's 2016 John W. Stanford New Investigator Award. "However, there is still research needed to evaluate the materials that are already in clinical use in order to determine the best uses of these materials. This information can help the clinician better perform work in their office."

Dr. Lawson began conducting research when he was applying to dental school at the University of Alabama. After a brief stint in clinical practice following graduation, his dental school research adviser asked if he would be interested in returning to his alma mater for an academic position performing research and teaching.

"Within a couple years of working in the position, I realized that I really loved what I was doing," Dr. Lawson said. "I really enjoy thinking of clinical problems, performing a study to try to better understand the best clinical treatment, trying what I learned in practice and then sharing that information through teaching."

Dr. Geisinger, too, was initially unsure of her career path and thought she would go into private practice until she began volunteering as a faculty member at a dental school.

"When I thought about the opportunity to make an exponential impact on our profession through education, research and service, I knew that I had to try to make the biggest impact I could on the oral health of patients and communities," she said. "And it is the research part of that mission that allows me to have the widest reach — impacting the global delivery of dental care through incremental discovery."

Dr. Geisinger, who is a member of the ADASRI Board of Directors and secretary-treasurer of the American Academy of Periodontology, is currently involved in a project examining best practices for delivering oral hygiene care to people with dementia in skilled nursing facilities, as well as the impact of periodontal health on the development and progression of dementia.

The research dentists perform has a lasting impact on not only the profession but public health as well.

"Dentists are an integral part of health care, and as an important health care provider, we need to base what we do on science and biology in order to offer evidence-based, scientifically proven and solid approaches to our patients," Dr. Hasturk said. "They are hungry to learn from us to do better at home and in their lives and to be examples to their children and young generations. We can only be better prepared for the future with proper education, and proper education is a result of research."

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Ge Jin, PhD

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Pushpa Pandiyan, PhD

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Catherine Demko

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Kristin Victoroff

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Oral Medicine research focuses on orofacial pain, oral premalignant disorders, interprofessional education outcomes, and markers for response to treatment of mucosal disorders.

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Mark Hans, DDS, MSD

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*We are currently updating these pages to refresh information. While we work, please visit the Pediatric Dentistry Research and Sponsored Projects page to review our active projects.Orthodontics

Gerald Ferretti, DDS, MS, MPH

Research Interests:

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• Pediatric sedation

Masahiro Heima, DDS, PhD

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Lance Vernon, DMD, MPH

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Nabil Bissada

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Research: How Should Multinational Firms Navigate Local Rules?

• Patrick Regnér
• Ivar Padrón-Hernández

A study of five global companies identified tactics to maintain a competitive edge.

When multinational firms enter new markets, they have to choose how to manage the formal and informal local rules that can vary greatly. Local institutions and rules matter, and there are clear risks for top executives at headquarters who don’t take them seriously. But constantly adapting to local practices could jeopardize a company’s ability to integrate operations across markets. A study of five globally successful Scandinavian companies identified six tactics that firms can use to address local rules while maintaining competitive advantage: Avoid, alter, adapt, imitate, influence, and innovate.

Multinational companies seeking growth opportunities often find them when they enter new countries. Previous research has emphasized the liabilities of foreignness, i.e., the many disadvantages foreign companies face as they do business in new markets. To overcome these liabilities, corporations are often recommended to adapt to local rules. However, as they adapt their strategies and practices to local ones, they risk losing the very basis for their internationalization and advantage over local competitors: the integration of operations across markets.

• Patrick Regnér is professor of strategic management at Stockholm School of Economics and the director of the Center for Strategy and Competitiveness. His current research centers on how diverse types of managerial activities and practices shape strategy development and creation in distinct ways. Another research stream focuses on how multinational corporations can respond strategically to institutions.
• Ivar Padrón-Hernández is an assistant professor at the Institute of Innovation Research at Hitotsubashi University. His research focuses on how firms change societies as they introduce innovative products, services and ideas across national borders.

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Ideas Labs to advance research capacity at the nation's historically Black colleges and universities

The U.S. National Science Foundation has awarded $10.5 million for Ideas Lab projects to assess and address research capacity needs, increase access to research facilities and build human capital at historically Black colleges and universities (HBCUs). The projects, funded through the NSF Advancing Research Capacity at HBCUs through Exploration and Innovation (ARC-HBCU) opportunity, will foster collaboration and build sustainable networks to facilitate interdisciplinary research in science, technology, engineering and mathematics at HBCUs.      "The inaugural NSF ARC-HBCU Ideas Lab is a unique opportunity to connect talent and build research networks across our HBCUs to further advance an integrated and collaborative vision for the most critical research capacity needs of HBCUs," says NSF Director Sethuraman Panchanathan.     Since the early 19th century, HBCUs have played a crucial role in providing higher education opportunities for students who had limited access to other higher education options. Moreover, HBCUs are vital for diversifying the STEM workforce. 8.5% of Black undergraduate students attend HBCUs, yet almost 18% of the Black STEM bachelor's degrees are awarded from HBCUs . A significant number of successful HBCU graduates have made a profound impact in STEM fields. Yet HBCUs are systemically underfunded, historically underrepresented as awardees, and face many infrastructure and administrative resource barriers.      The ARC HBCU Ideas lab was funded by the NSF HBCU-Excellence in Research program in the Research Capacity and Competitiveness section. The focus of the ARC-HBCU program is to promote diversity and inclusion in research, enhance the research capacity of HBCUs and foster collaboration among faculty, students and industry partners. Through the Ideas lab concept, NSF is providing the opportunity for participants to work collaboratively to identify and define the scope of the unique challenges faced by HBCUs in meeting education and research needs. As the projects progress, they will dynamically develop and hone novel ideas about how these challenges may be addressed.      The awardees and summary of each project are listed below:    

Panoramic Institutional Assessments: A Playbook for Advancing Research Capacity  

This project, led by Delaware State, will bring together faculty, research administrators and institutional leaders to develop innovative tools and approaches to enhance research capacity at consortium institutions, with long-term goals to scale up to HBCUs more broadly. The project will provide a framework to guide institutions through a self-directed process to examine their research ecosystem, help institutional leaders identify and address service gaps to strengthen key administrative functions that support research administration, and guide faculty in personalized assessments of their development as individual researchers using an existing framework. The project also includes partnerships with advocacy organizations that will assist in disseminating the research capacity assessments and playbook, ensuring a broad reach and sustainable impact across campuses.   

Collaborating institutions: Tuskegee University, Huston-Tillotson University, Hampton University, Tennessee State University.     Partnership for Advancing Research Capacity in Semiconductors at Historically Black Colleges and Universities  

Central State University is leading this project, which will enhance research capacity in semiconductor technology amongst partnering institutions by establishing robust research networks, enhancing faculty expertise, increasing access to state-of-the-art research facilities, and expanding student opportunities for education, training and hands-on research. This project aligns with the "CHIPS and Science Act of 2022" and has the potential to significantly broaden participation in semiconductor manufacturing and semiconductor research among African Americans, who are underrepresented in this industry even when compared to engineering sectors in general. It offers a rare opportunity for these institutions to engage and partner with industry players while contributing to workforce development in the semiconductor field.   

Collaborating institutions: North Carolina Agricultural and Technical State University, Fayetteville State University, Hampton University.   Sub awardee institutions: Alabama Agricultural and Mechanical University, Coppin State University, and Meharry Medical College.     The HBCU Ujima Collective: Building Research Capacity at HBCUs through a Grow Your Own Research Corps Model

Led by Miles College, this project will assess, align and improve research infrastructure and processes at five HBCUs through the cultivation of highly trained human capital for work in the research enterprise. The project team will use open systems theory to produce a model that builds a corps of research administrators and scientists that can enhance and sustain research capacity across all HBCUs. The project will enhance research capacity at the institutions by speeding up the transition of the research enterprise, establishing the "grow your own model," and disseminating the research and assessment tools to allow model implementation at other institutions.  

Collaborating institutions: Morgan State University, Howard University, Winston-Salem State University, Tennessee State University.  

HBCU Research and Collaboration Exchange    

This project, led by Virginia State University, seeks to create an online HBCU-focused platform to amplify existing research capacity by connecting researchers across HBCUs to other investigators, projects and equipment. The partnering institutions will pilot this project to create a multilayer platform by first developing an expertise and resource directory representative of all researchers at the respective institutions. In addition to raising awareness about and increasing connectivity among existing research expertise within the nation's HBCUs, the long-term impacts of the project will include the creation of a collaboration readiness index for existing and future technologies, as well as the creation of virtual collaboration space.     Collaborating institutions: North Carolina Central University, Winston-Salem State University, Alabama Agricultural and Mechanical University, Fisk University, University of the Virgin Islands.  

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Modern implant dentistry focus of goldhaber lecture.

Daniel Buser

From replacing a single tooth to addressing extensive dental damage, implant dentistry has become a groundbreaking option, giving people the chance to reclaim their smiles and improve their quality of life. Nearly 3 million individuals in the United States have dental implants, a number that is growing by 500,000 annually, according to the American Academy of Implant Dentistry.

Daniel Buser, an internationally renowned dental implant surgeon, will guest lecture about the research and trends of modern implant dentistry during the 2024 Goldhaber Lecture at Harvard School of Dental Medicine (HSDM) on Oct. 7. He has been named this year’s Goldhaber Award recipient.

Buser was a professor of oral surgery at the University of Bern/Switzerland for nearly 20 years. Today, he serves as a lecturer in the Department of Restorative Dentistry and Biomaterials Sciences at HSDM and works part time at a private clinic helping treat implant patients. He continues to lecture at national and international conferences.

Selected for his outstanding national and international contributions to teaching and research in oral health science, Buser is most noted for his contributions in pioneering the Guided Bone Regeneration (GBR). He has remained active with his team at the University of Bern/Switzerland in translational research with countless pre-clinical and clinical studies in implant surfaces, bone augmentation with GBR, bone grafts, and bone substitutes, anatomical studies using CBCT, and long-term documentation of dental implants.

He has served as president of various academic associations including the European Association for Osseointegration, the Swiss Society of Oral Implantology, and the International Team for Implantology. He has authored and co-authored with his team more than 400 publications and book chapters, including the third edition of the book “30 Years of Guided Bone Regeneration (GBR).” His transformative work has earned him several scientific awards.

Buser will share his experience, “Modern Implant Dentistry in the Past 40 Years: Research Milestones, Clinical Progress and Current Trends,” during the annual Paul Goldhaber Lecture on Oct. 7 in the HSDM Research and Education Building (REB) from 4 to 5:30 p.m. A special tea-time reception will occur before the lecture in the REB Lobby.

The lecture is free and open to students, faculty, and staff of HSDM and Harvard University, as well as other interested professionals. Seats are available on a first-come, first-served basis. Please RSVP  to help us plan accordingly.

If you are unable to join in person, register for the Zoom webinar ahead of time.

Established in 1989 in honor of former Harvard School of Dental Medicine Dean Paul Goldhaber, the Goldhaber Award recognizes an individual who is held at the highest international esteem in their field related to oral and systemic health.

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• Published: 26 July 2019

Which dental research topics are relevant to patients?

• Paul Hellyer 1  

British Dental Journal volume  227 ,  page 113 ( 2019 ) Cite this article

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Kakudate N, Yokoyama Y, Sumida F et al. Practice-based research agendas priorities selected by patients: findings from a practice-based research network. Int Dent J 2019; 69: 183−191.

Study shows priorities differ with age and gender.

'Public involvement in research is defined as research that is done with or by the public and not to, about or for them' (Involve www.invo.org.uk ) and many grant funders now require evidence of public and patient involvement in research projects. The research agenda, however, may still be being set by academics and not by patients. Relatively little research is based in general practice.

Using a questionnaire with patients in 11 dental clinics in Japan, Kakudate and colleagues have attempted to find out which research topics would be important and relevant to patients. Involving patients 'may provide opportunities to produce research which is valid, relevant, acceptable, sustainable and innovative.'

Following a pilot study, a 31 item questionnaire, divided into 11 categories was developed (orthodontic treatment, regular dental check ups, prognosis of dental treatment, dental implants, tooth brushing, diet and food, aesthetic dental care, topical fluoride application, social health insurance, bruxism and miscellaneous) and was completed by 482 patients (87.6% response rate).

The most commonly selected research agenda was 'age specific care to maintain oral health' (n = 84), followed closely by topics related to toothpastes and brushing, the durability of restorations and questions relating to diet, caries and periodontal disease. The least popular topic related to the use of interdental cleaning aids. In patients <40, selection of toothpaste was the most popular topic. Only responders <30 listed the timing of wisdom teeth extractions and orthodontic as topics. Only those aged >60 listed the durability of restorations in relation to treatment available under the national health insurance scheme.

Statistically significant age and gender differences were noted. Younger patients rated orthodontic treatment, aesthetic dental care and fluoride applications more frequently than older patients. Older patients rated regular dental check ups, implants, diet and health insurance as more interesting than younger ones. Females rated aesthetics as more important than did males, who rated toothbrushing as more interesting than did females.

Responses may be different from within a different culture. However, these results clearly show that different age groups have differing priorities with regard to research priorities. If research is to be patient centred and relevant, then shaping research questions around actual patients' concerns, needs and values assumes greater importance. These results may 'help research funders identify future priorities that have the greatest impact on patients and the clinicians who treat them.'

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Hellyer, P. Which dental research topics are relevant to patients?. Br Dent J 227 , 113 (2019). https://doi.org/10.1038/s41415-019-0567-1

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Published : 26 July 2019

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DOI : https://doi.org/10.1038/s41415-019-0567-1

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5 facts about student loans

Americans owe about $1.6 trillion in student loans as of June 2024 – 42% more than what they owed a decade earlier. The increase has come as greater shares of young U.S. adults  go to college and as the cost of higher education increases.

Here are five facts about student loans in America based on a Pew Research Center analysis of data from several sources, including the Federal Reserve Board’s 2023 Survey of Household Economics and Decisionmaking .

Pew Research Center conducted this analysis to understand how many Americans have outstanding student loan debt and how this debt is associated with their economic well-being.

In this analysis, adults with student loan debt include those whose student loans are temporarily on hold or in forbearance. The analysis does not include debt incurred through credit cards or other types of loans used for education.

The analysis is mostly based on the Federal Reserve’s 2023 Survey of Household and Economic Decisionmaking (SHED). Conducted annually since 2013, the SHED measures U.S. adults overall financial well-being and difficulties meeting expenses. It also regularly includes a battery of questions on debts incurred for education, education decisions, and an assessment of the value of higher education. The 2023 SHED had 11,400 respondents, weighted to be representative of the U.S. adult civilian noninstitutionalized population.

One-in-four U.S. adults under 40 have student loan debt. This share drops to 14% among those ages 40 to 49 and to just 4% among those 50 and older.

Of course, not all Americans attend or graduate from college, so student loan debt is more common among the subset of people who have done so. Among adults under 40 who have at least a four-year college degree, for example, 36% have outstanding student loan debt.

Age differences reflect, in part, the fact that older adults have had more time to repay their loans. Still, other research has found that young adults are also more likely now than in the past to take out loans to pay for their education. In the 2018-2019 academic year, 28% of undergraduate students took out federal student loans. That’s up from 23% in 2001-2002, according to data from College Board – a nonprofit organization perhaps best known for its standardized admissions tests (like the SAT) that also documents trends in higher education.

The amount of student loan debt that Americans owe varies widely by their education level. Overall, the median borrower with outstanding student debt owed between $20,000 and $24,999 in 2023.

• Among borrowers who attended some college but don’t have a bachelor’s degree, the median owed was between $10,000 and $14,999 in 2023.
• The typical bachelor’s degree holder who borrowed owed between $20,000 and $24,999.
• Among borrowers with a postgraduate degree the median owed was between $40,000 and $49,999.

Looking at the same data another way, a quarter of borrowers without a bachelor’s degree owed at least $25,000 in 2023. About half of borrowers with a bachelor’s degree (49%) and an even higher share of those with a postgraduate education (71%) owed at least that much.

Adults with a postgraduate degree are especially likely to have a large amount of student loan debt. About a quarter of these advanced degree holders who borrowed (26%) owed $100,000 or more in 2023, compared with 9% of all borrowers. Overall, only 1% of all U.S. adults owed at least $100,000.

Young college graduates with student loans are more likely than those without this kind of debt to say they struggle financially. A quarter of college graduates ages 25 to 39 with loans say they are either finding it difficult to get by financially or are just getting by , compared with 9% of those without loans. And while only 29% of young college graduates with outstanding student loans say they are living comfortably, 53% of those without loans say the same.

Young college graduates with student loans still tend to have higher household incomes than their counterparts who haven’t completed college. For many young adults, student loans are a way to make an otherwise unattainable education a reality. Although these students have to borrow money to attend college, the investment might make sense if it leads to higher earnings later in life.

College graduates ages 25 to 39 who have student loan debt have higher household incomes than non-college graduates in the same age group (regardless of student loan status). But their household incomes are lower than those of young college graduates who don’t have student loan debt.

Around half of young college graduates with student loans (48%) have household incomes of at least $100,000. That compares with just 14% of non-college graduates. But among college graduates without student loan debt, 64% have household incomes of $100,000 or more.

Household income includes an individual’s income and the income of any spouse or partner living with them. So these differences may at least partly reflect the fact that college graduates are more likely to be married.

Young college graduates with student loan debt are more likely than those without debt to say their education wasn’t worth the cost . About a third (35%) of those ages 25 to 39 who have at least a bachelor’s degree and outstanding student loan debt say the benefits of their degree weren’t worth the lifetime financial costs. By comparison, 16% of young college graduates without outstanding student loans say the same.

Note: This is an update of a post originally published Aug. 13, 2019.

• Age & Generations
• Higher Education
• Student Loans

Richard Fry is a senior researcher focusing on economics and education at Pew Research Center .

Anthony Cilluffo is a former research analyst who focused on social and demographic trends at Pew Research Center .

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