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It's the season of awards in the film and music industry and, while dental practices also compete for prizes based on criteria which certainly do involve the long-term survival of restorations, it will not surprise readers to hear that there are no such awards for dental research publications. However, it is interesting to note that the Journal of Dental Research has published its own top ten, namely, the most-read articles of 2014 (assessed by number of downloads). While some articles may not appear to be of immediate relevance (at least at the present time) to everyday dental practice, such as a paper on bone morphogenetic proteins and selective serotin re-uptake inhibitors, some of the highly rated articles make relevant reading to contemporary dental practice. I have chosen my top three.
Of everyday relevance and well worth a read is the review by Setzer and Kim comparing long-term survival of implants and endodontically treated teeth,1 a topic which is increasing in relevance alongside the seemingly unstoppable increase in courses on implant placement. The authors demonstrate poorer success rates of implants placed by inexperienced operators than by implant ‘specialists’, surly an indictment of the implant one-day course, but conclude that implants and restoration of endodontically treated teeth demonstrated significant outcome rates if the treatments are appropriately chosen and rendered. They add a great line – ‘that there is no lifetime guarantee for either a natural tooth or an implant’. Accordingly, they concluded that, as a missing tooth is irreversibly gone, a tooth should only be removed after suitable deliberation.
Also of relevance to the post-Minamata era is the meta-analysis by Opdam and colleagues,2 which examined the longevity of posterior composites. From 1,581 papers initially screened, the authors identified 11 longitudinal studies for which the original datasets were available for analysis, although these were from only three research groups, with the attendant potential for bias. The 10-year annual failure rate was calculated at 4.6% for high caries risk patients and 1.6% for low risk patients, perhaps not a surprise, nor was it surprising to learn that restorations with higher numbers of surfaces had a higher risk of failure. It is a shame that there was no comparative data for amalgam restorations.
Another paper3 advised us that tooth loss showed a significant decline at global, regional and country levels between 1990 and 2010, with the proportion of edentate persons falling from 4.4% to 2.4% and the highest risk of tooth loss being in the seventh decade. No real surprises here perhaps, but what seemed interesting to me was the reduction in a previous difference between the sexes in terms of tooth loss to be not statistically significantly different in 2010. Reasons for this? – perhaps improvements in female education, an increasing focus on women's health, or even improved nutrition.
Of course, there are other notable research publications such as the Journal of Dentistry and Dental Materials, the editors of which are based in the UK, but these have not, to my knowledge, published a Top10. It would be interesting if all such research journals could get their data together and produce an overall list of the papers which were the most popular downloads. Perhaps we should do the same at Dental Update?
Finally, this issue of Dental Update presents the first article in a groundbreaking series on something that practising dentists either treat on an everyday basis or spend time trying to manage or prevent. Pain! To the best of my knowledge, there has not been, in the history of dental publishing, such a complete exposition of the subject. The authors deserve an award for their massive work. I am certain that their in-depth examination of the subject will give us all a better understanding of this complex subject.