ABSTRACT
Fift y years of Brazilian Dent al Mat erials Group:
VFLHQWL¿FFRQWULEXWLRQVRIGHQWDOPDWHULDOV¿HOG
evaluat ed by syst em at ic review
Wellington Luiz de Oliveira da ROSA1, Tiago Machado da SILVA1, Giana da Silveira LIMA2, Adriana Fernandes da
SILVA2, Evandro PIVA2
1- Universidade Federal de Pelotas (UFPel), Faculdade de Odontologia, Pelotas, RS, Brasil.
2- Universidade Federal de Pelotas (UFPel), Faculdade de Odontologia, Departamento de Odontologia Restauradora, Pelotas, RS, Brasil.
Corresponding address: Evandro Piva - Universidade Federal de Pelotas - Departamento de Odontologia Restauradora - Rua Gonçalves Chaves, 457 - sala 504 - Centro - 96015-560 - Pelotas - RS - Brazil - Phone/fax: +55 53 32226690/135 - e-mail: evpiva@pq.cnpq.br
6XEPLWWHG1RYHPEHU0RGL¿FDWLRQ0DUFK$FFHSWHG0DUFK
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EMHFWLYH $ V\VWHPDWLF UHYLHZ ZDV FRQGXFWHG WR DQDO\]H %UD]LOLDQ VFLHQWL¿F DQG WHFKQRORJLFDOSURGXFWLRQUHODWHGWRWKHGHQWDOPDWHULDOV¿HOGRYHUWKHSDVW\HDUV Mat erial and Met hods: This st udy followed t he Preferred Report ing I t em s for Syst em at ic Reviews and Met a-Analysis ( Prism a) st at em ent . Searches were perform ed unt il Decem ber 2014 in six databases: MedLine ( PubMed) , Scopus, LI LACS, I BECS, BBO, and the Cochrane Library. Additionally, the Brazilian patent database (I NPI - I nstituto Nacional de Propriedade I ndustrial) was screened in order to get an overview of Brazilian technological developm ent LQWKHGHQWDOPDWHULDOV¿HOG7ZRUHYLHZHUVLQGHSHQGHQWO\DQDO\]HGWKHGRFXPHQWV2QO\ studies and patents related to dental m aterials were included in this review. Data regarding WKHPDWHULDOFDWHJRU\GHQWDOVSHFLDOW\QXPEHURIGRFXPHQWVDQGSDWHQWV¿OLDWLRQFRXQWULHV DQGWKHQXPEHURIFLWDWLRQVZHUHWDEXODWHGDQGDQDO\]HGLQ0LFURVRIW2I¿FH([FHO0LFURVRIW Corporation, Redm ond, Washington, United States). Results: A total of 115,806 studies and 53 patents were related to dental m aterials and were included in this review. Brazil had 8% DI¿OLDWLRQLQVWXGLHVUHODWHGWRGHQWDOPDWHULDOVDQGWKHPDMRULW\RIWKHSDSHUVSXEOLVKHG were relat ed t o dent al im plant s ( 1,137 papers) , synt het ic resins ( 681 papers) , dent al cem ent s ( 440 papers) , dent al alloys ( 392 papers) and dent al adhesives ( 361 papers) . The Brazilian t echnological developm ent wit h pat ent ed dent al m at erials was sm aller t han t he VFLHQWL¿FSURGXFWLRQ7KHPRVWSDWHQWHGW\SHRIPDWHULDOZDVGHQWDODOOR\VSDWHQWV followed by dent al im plant s ( 8 pat ent s) and com posit e resins ( 7 pat ent s) . Conclusions: Dent al m at erials science has had a subst ant ial num ber of records, dem onst rat ing an LPSRUWDQWSUHVHQFHLQVFLHQWL¿FDQGWHFKQRORJLFDOGHYHORSPHQWRIGHQWLVWU\,QDGGLWLRQ it is im port ant t o approxim at e t he relat ionship bet ween academ ia and indust ry t o expand t he t echnological developm ent in count ries such as Brazil.Ke yw or ds: Dent al m at erials. Dent ist ry. I nnovat ion. Hist ory. Review.
I N TROD UCTI ON
A wide variet y of m at erials have been used t o replace dent al subst rat es for cent uries such as anim al or hum an t eet h, bones, ivory, shells, and ceram ics4. At t he beginning, dent al m at erials science focused on synthetic restorative m aterials5. Since t hen, a lot of innovat ions have produced new m et hods, devices, t echnologies, and product s in dif f er en t ar eas of den t ist r y, especially f or
t h e t r eat m en t of d en t al p at h olog ies an d t h e replacem ent of t he dent al st ruct ure24. Nowadays,
GHQWDO PDWHULDOV FDQ EH FODVVL¿HG DV SUHYHQWLYH rest orat ive or accessory m at erials4.
w hich ar e used t o r est or e t he funct ion and/ or aest h et ics in m ou t h s w it h dam aged, decay ed or m issing t eet h1,8,10,19,25. Tem porary rest orat ive m at erials are a subcat egory of rest orat ive t hat include product s used for dent al rest orat ions and devices t hat not int ended t o be used for m oderat e or long periods of tim e such as som e dental cem ents ( e.g., convent ional glass ionom er cem ent s or zinc oxide eugenol cem ent ) . Furt herm ore, accessory m at er ials ar e subst ances or pr oduct s used as adj uvant s in dent al pr ocedur es such as dent al im pr ession m at er ials, dent al alloys and acr ylic resins4.
I t is possible t o highlight som e of t he m ost im por t ant hist or ical event s t hat cont r ibut ed t o est ablish con cept s an d t ech n iqu es of cu r r en t dent ist r y. Fir st ly, dent al m at er ials science was m arked by t he work of G.V. Black, who conduct ed WKH¿UVWFRQWUROOHGVWXGLHVZLWKGHQWDODPDOJDPLQ 1900 at Nort hwest ern University5. The idealizat ion of Bowen’s resin6 and glass ionom er cem ent were f ollow ed by den t in adh esiv e sy st em s1 6. Fr om t hat , t he evolut ion of dent ist ry was driven by t he developm ent of new dent al m at erials applied via t reat m ent s in different specialt ies of dent ist ry5.
I n this context, the Academ y of Dental Materials ( ADM) was founded in 1941. I t was int erest ed in t he developm ent and applicat ion of new m at erials to dental care. I n Brazil, the oldest group related to dent al m at erials was t he “ Brazilian Group of Dent al Mat er ials” ( GBMD) , founded in Sept em ber 29, 1965, at t he “ First Meet ing of t he Teachers of t he Disciplines of Dent al Mat erials from Dent al Schools of Brazil”. For t he last 50 years, GBMD aim ed t o provide t eachers and researchers wit h an annual per iod for exchanging ex per iences, discussing effect ive ways t hat allow t he form at ion of new specialized t eachers, and arousing int erest in t he research and st andardizat ion of dent al m at erials in Brazil. One of t he group challenges is t o increase t he relevance of dent al m at erials in t his count ry, which has declined even wit hin t he undergraduat e FRXUVHV$VWKHSUDFWLFHRIGHQWLVWU\LVGH¿QHGE\ current and fut ure developm ent s in t he science of dent al m at erials, t he aim of t his st udy was t o syst em at ically review t he lit erat ure t o analyze t he %UD]LOLDQ VFLHQWL¿F DQG WHFKQRORJLFDO SURGXFWLRQ relat ed t o t he area of dent al m at erials over t he last 50 years.
M A T ER I A L A N D M ET H O D S
Syst e m a t ic lit e r a t u r e se a r ch
The lit erat ure search was perform ed by t wo in d ep en d en t r ev iew er s an d in v olv ed con t en t dat ing from January 1965 t o Decem ber 2014. Six dat abases w er e scr eened: MedLine ( PubMed) , Scopus, LI LACS, I BECS, Bibliot eca Br asileir a de
Odon t ologia ( BBO) , and t he Cochrane Librar y.
Addit ionally, t he Brazilian pat ent dat abase ( I NPI -
I nst it ut o Nacional de Propriedade I ndust rial) was
screened in order to get an overview of the Brazilian t echnological developm ent in dent al m at er ials ¿HOG)XUWKHUPRUHDSDWHQWVHDUFKZDVDOVRPDGH XVLQJWKH,QWHUQDWLRQDO3DWHQW&ODVVL¿FDWLRQ,3& Just as in m ost applicat ions, each pat ent m ay subm it m ore t han one I PC. This t echnology and it s applications are related to different areas of science and t echnology, such as dent ist ry, chem ist ry or pharm acology. The aim of ident ifying t hese codes LVWRFUHDWHDVSHFL¿FWRROIRUVHDUFKDQGUHWULHYDO of docum ent s.
The keywords relat ed t o t he search st rat egy are list ed in Figure 1, which include t erm s relat ed t o dent ist ry and dent al m at erials locat ed in t he MeSH ( PubMed) and adapt ed for ot her dat abases. Filtering tools that were related to dental m aterials, as well as term s for each type of m aterial and dental specialt y, were used t o opt im ize t he search for pot ent ially relevant papers. Endnot e X7 soft ware ( Thom pson Reut ers, New York, New York, Unit ed St at es) w as also u sed t o r em ov e du plicat es. $IWHUWKHLGHQWL¿FDWLRQRISDSHUVLQWKHGDWDEDVHV relat ed t o dent ist ry, t hey were analyzed in order t o include only st udies of dent al m at erials science. This syst em at ic review is described t hrough an adapt at ion of t he PRI SMA st at em ent14.
St u dy se le ct ion
Tw o review aut hors independent ly screened t he t it les and abst ract s of all docum ent s. I nit ially, any st udy relat ed t o dent ist ry was included. To analyze the im pact of dental m aterials on dentistry, t he inclusion crit eria were: laborat ory and clinical st udies focusing on developm ent / evaluat ion of
dent al m at erials from 1965 t o 2014 and pat ent s
relat ed t o dent al m at erials from 1965 t o 2014. The exclusion crit eria were t he following: lit erat ure reviews, case report s, case series; st udies in a language different from Port uguese, English and Spanish; and pat ent s of dent al equipm ent . Those appear ing t o m eet t he inclusion cr it er ia or for ZKLFKWKHUHZHUHLQVXI¿FLHQWGDWDLQWKHWLWOHDQG abst ract t o m ake a clear decision were select ed for analysis of t he full docum ent . Any disagreem ent regarding t he eligibilit y of included st udies was resolved t hrough discussion and consensus or by a t hird reviewer.
D a t a e x t r a ct ion a n d a n a lysis
num ber of paper s/ pat ent s, filiat ion count r ies, num ber of pat ent s w it h t echnology t ransfer t o com pan ies, n u m ber of cit at ion s, an d y ear of publicat ion were analyzed. The m at erial cat egories used were chosen from t he ent ry t erm s found for “ dental m aterials” in the MeSH ( PubMed) database. Addit ionally, t he Brazilian scient ific pr oduct ion was analyzed in order t o obt ain an overview of t he im pact on t he publicat ions relat ed t o dent al m at erials over t he past 50 years.
RESULTS
Se a r ch st r a t e gy
A total of 1,509,406 potentially relevant records ZHUH LGHQWL¿HG IURP DOO GDWDEDVHV )LJXUH Aft er filt er ing and scr eening, 115, 806 st udies relat ed t o dent al m at erials were included in t his review. Regarding pat ent s deposit ed by Brazil, 126 pot ent ially relevant docum ent s were init ially screened. After screening all docum ents, 53 patents relat ed t o dent al m at erials were included in t his review.
Search Terms
#3 Search #1 AND #2
#2 Search (Dentistry) OR (Dental Research) OR (Evidence-Based Dentistry) OR (Oral Medicine) OR (School Dentistry) OR (Specialties, Dental) OR (Operative dentistry) OR (dentística operatória) OR (dentística) OR (Operatoria Dental) OR (Forensic Dentistry) OR (odontologia forense) OR (odontologia legal) OR (Pediatric Dentistry) OR (odontopediatria) OR (Dental Care for Children) OR (Dentistry for Children) OR (Children, Dentistry for) OR (Dentistry, Pediatric) OR (Endodontics) OR (endodontia) OR (Endodoncia) OR (Pathology, Oral) OR (dental, pathology) OR (Stomatology) OR (Medicine, Oral) OR (patologia bucal) OR (Patología Bucal) OR (patologia oral) OR (Periodontics) OR (Periodontia) OR (Periodoncia) OR (dental prosthesis) OR (Dentures) OR (Denture) OR (Prótese Total) OR (Dentadura Completa) OR (Denture, Complete) OR (Prótese Dentária) OR (Prótesis Dental) OR (Prótese Parcial) OR (Surgery, oral) OR (Maxillofacial Surgery) OR (Surgery, Maxillofacial) OR (Procedures, Oral Surgical) OR (Tooth Extraction) OR (Tooth Extractions) OR (Cirurgia Bucal) OR (Cirugía Bucal) OR (Surgery, Oral) OR (Extração Dentária) OR (Extracción Dental) OR (Public Health Dentistry) OR (Saúde Bucal) OR (Salud Bucal) OR (Odontologia em Saúde Pública) OR (Odontología en Salud Pública) OR (Saúde bucal coletiva) OR (Community Dentistry) OR (Odontologia Comunitária) OR (Odontología Comunitaria) OR (Geriatric Dentistry) OR (odontogeriatria) OR (Dental Care for Aged) OR (Dentistry for Aged) OR (Dental implants) OR (Dental Implant) OR (Implantodontia) OR (Implantes dentários) OR (Implantes dentais) OR (Implantes Dentales ) OR (Implantação Dentária) OR (Implantación Dental) OR (Dental Implantatio) OR (Radiography, Dental) OR (Radiologia dental)
255DGLRORJLDGHQWiULD255DGLRJUD¿DGHQWiULD255DGLRJUDItDGHQWDO257RPRJUD¿D&RPSXWDGRUL]DGD
de Feixe Cônico) OR (Tomografía Computarizada de Haz Cónico) OR (Cone-Beam Computed Tomography) OR (Orthodontics) OR (Ortodontia) OR (Ortodoncia)
#1 Search (dental materials) OR (materiais dentários) OR (Materiales Dentales) OR (Dental Alloys) OR (Alloy, Dental) OR (Alloys, Dental) OR (Dental Amalgam) OR (Ligas dentárias) OR (Ligas odontológicas) OR (Dental Casting Investment) OR (Material para fundição odontológica) OR (Dental Cements) OR (Compomers) OR (Dentin-Bonding Agents) OR (Resin Cements) OR (Zinc Oxide-Eugenol Cement) OR (Zinc Oxide Eugenol Cement) OR (glass ionomer cement) OR (cimentos odontológicos) OR (cimentos dentários) OR (Cementos Dentales) OR (Cimentos de Ionômeros de Vidro) OR (Cementos de Ionómero Vitreo) OR (Cimento de Silicato) OR (Cemento de Silicato) OR (Cimento de Óxido de Zinco e Eugenol) OR (Cemento de Óxido de Zinc-Eugenol) OR (Cimento de Fosfato de Zinco) OR (Cemento de Fosfato de Zinc) OR (Cimentos de Resina) OR (Cementos de Resina) OR (Dental implants) OR (Implants, Dental) OR (Dental Implant) OR (Implant, Dental) OR (Implantes dentários) OR (Implantes dentais) OR (Implantes Dentales) OR (Dental Impression Materials) OR (materiais de impressão odontológico) OR (materiais de impressão dentário) OR (Dental Porcelain) OR (Cerâmicas odontológicas) OR (Cerâmica) OR (Cerámica) OR (Porcelana Dentária) OR (Porcelana Dental) OR (Composite resins) OR (Compomers) OR (Resinas compostas) OR (Resinas compuestas) OR (Dentin-Bonding Agents) OR (Dentin Bonding Agents) OR (Sistemas Adesivos) OR (Adesivos dentários) OR (Adesivos odontológicos) OR (Adesivos Dentinários) OR (Recubrimientos Dentinarios) OR (Pit and Fissure Sealants) OR (Pit Fissure Sealants) OR (Selantes de Fossas e Fissuras) OR (Selladores de Fosas y Fisuras) OR (Pulp Capping and Pulpectomy Agents) OR (Pulp Capping Agents) OR (Capeadores pulpares) OR (Root Canal Filling Materials) OR (Root Canal Sealants) OR (materiais restauradores do canal radicular) OR (Materiales de Obturación del Conducto Radicular)
D e scr ipt ive a n d qu a n t it a t ive a n a lysis
Figure 3A shows t hat t he m aj orit y of dent al m at erials st udies were from t he Unit ed St at es of $PHULFD%UD]LOZDVWKHDI¿OLDWLRQFRXQWU\ for 8% of all papers, followed by Japan ( 4% ) , t he Unit ed Kingdom ( 4% ) , and Germ any ( 4% ) . Figure 3B dem onst rat es an annual increase in published SDSHUVUHODWHGWRWKLV¿HOGZLWKDVLPLODULQFUHDVH obser ved in Brazil. Fr om all paper s r elat ed t o GHQWLVWU\ UHSUHVHQW VFLHQWL¿F SURGXFWLRQ RI dent al m at erials ( 1% from Brazil and 19% from t he rest of t he world) .
The Brazilian university with the m ost published papers was Universidade de São Paulo ( USP) , wit h
a t ot al of 1,194 st udies, followed by Universidade Est adual Paulist a ( UNESP) wit h 1,058 papers, and Univ er sidade Est adual de Cam pinas ( UNI CAMP)
wit h 725 st udies ( Figure 4) . The m ost- cit ed papers ZLWK%UD]LOLDQDI¿OLDWLRQVZHUHIURP6DQRHWDO21 ( 1994) , wit h 460 cit at ions, Pashley, et al.16 ( 1997) ( 3 2 2 cit at ion s) , an d Tay, et al.2 3 ( 2 0 0 2 ) ( 3 1 0 cit at ions) ( Figure 5) .
Regarding the m aterial category (Figure 6), m ost papers published in t he last 50 years were relat ed t o dent al im plant s ( 13,708 papers) , dent al alloys ( 6,599 papers) , dent al porcelain ( 5,923 papers) , and synt het ic resins ( 5,688 papers) . Furt herm ore, dent al im plant s ( 1,137 papers) , synt het ic resins ( 681 papers) , dent al cem ent s ( 440 papers) , dent al alloys ( 392 papers) , and dent al adhesives ( 361 papers) were t he m ain dent al m at erials st udied in Brazil. However, t he m ost- pat ent ed t ypes of m at erial were dent al alloys ( 11 pat ent s) , followed by dent al im plant s ( 8 pat ent s) and com posit e resins ( 7 pat ent s) . Considering dent al m at erial
¿HOGWKHQXPEHURISDWHQWVDSSOLFDWLRQVSXEOLVKHG LQ%UD]LOZDVVPDOOHUWKDQWKHQXPEHURIVFLHQWL¿F papers published. Only 17% of pat ent s deposit ed present ed t echnology t ransfer t o com panies wit h furt her developm ent of product s. Besides, dent al prost heses ( 23,634 papers) , im plant ology ( 16,441 papers) , and operat ive dent ist ry ( 11,752) were t he dent al specialt ies t hat m ost oft en appeared in papers about dental m aterials published ( Figure 7) .
D I SCUSSI ON
The m ain focus for dent ist ry will cont inue t o be preserving and im proving oral healt h t hrough p r ev en t i o n o f o r al d i seases, as w el l as t h e rehabilit at ion of lost or dam aged hard and soft t issues4, which can be m ade by using synt het ic m at erials or a t issue engineering approach. Our st udy dem onst rat ed t he presence of t he dent al PDWHULDOV¿HOGLQGLIIHUHQWVSHFLDOWLHV$VVFLHQFH is in con st an t ev olu t ion , n ew t ech n iqu es an d m at erials are t ransform ing m any dent al specialt ies in pot ent ial areas of ent repreneurship in order t o cr eat e new fields of w or k for dent ist s4. I n t his cont ext , it could be dem onst rat ed t hat t he publication of dental m aterials is not only restricted t o specialized hum an resources, but also t o several specialties such as im plantology, dental prosthesis, and operat ive dent ist ry.
of laborat ories wit h resources for physicochem ical m et h ods an d t h e low - cost inv est m en t s w h en com pared wit h biological and m olecular sciences can be related to the rem arkable presence of studies direct ly or indirect ly involving t he invest igat ions of dent al m at erials. Besides, t he great num ber of undergraduat e and post- graduat e st udent s t hat ZRUNDVSDUWRIVFLHQWL¿FSURMHFWVUHODWHGWRGHQWDO m aterials is another possible explanation. I n fact, the Brazilian group was in second place in t he num ber of papers present ed at m eet ings of t he Academ y of Dent al Mat erials ( ADM) in 2014. However, it
is unclear if t here is a relat ionship bet ween t he num ber of published articles and studies presented in congress, m eet ings or conference.
I t was shown t hat in Brazil, dent al im plant s, synthetic resins, dental cem ents, dental alloys, and dent al adhesives were t he dent al m at erials m ost st udied over t he last 50 years. Despit e t he great advances in dent al m at erials during t his period, current challenges, such as longevit y of dent al m at erials, shrinkage st ress, environm ent al issues ( e.g., Minam at a prot ocol) , and t he biological effect of biom at erials ( e.g., bisphenol-A release form s Figure 3- 6FLHQWL¿F SURGXFWLRQ UHJDUGLQJ 'HQWDO 0DWHULDOV ¿HOG D 6WXGLHV RI GHQWDO PDWHULDOV SXEOLVKHG DFFRUGLQJ WR
DI¿OLDWLRQFRXQWULHV7KHPDMRULW\RIGHQWDOPDWHULDOVVWXGLHVZHUHIURPWKH8QLWHG6WDWHVRI$PHULFD
BisGMA- based com posit es) , have been st im ulat ing QHZSURMHFWVDURXQGWKHZRUOG$OWKRXJKVLJQL¿FDQW advances occurred with synthetic m aterials, the best
subst it ut e for an organ or dam aged t issue is t he act ual organ or t issue19,QWKLVFRQWH[WVLJQL¿FDQW effort s have arisen in previous decades regarding
Figure 4- Studies of dental materials published by ten Brazilian Universities (1965-2014)
Authors Title Year Journal Number
of citations
*Brazilian university
Sano, H., Shono, T., Sonoda, H., Takatsu, T., Ciucchi, B., Carvalho, R.M.*, Pashley, D.H.
Relationship between surface area for adhesion and tensile bond strength - Evaluation of a micro-tensile bond test
1994 Dental Materials 460 Universidade de São Paulo (USP)
Pashley, D.H., Carvalho, R.M* Dentine permeability and dentine
adhesion 1997 Journal of Dentistry 322 Universidade de São Paulo (USP) Tay, F.R., Pashley,
D.H., Suh, B.I., Carvalho, R.M.*, Itthagarun, A.
Single-step adhesives are permeable
membranes 2002 Journal of Dentistry 310 Universidade de São Paulo (USP)
Pashley, D.H., Carvalho, R.M.*, Sano, H., Nakajima,
M., Yoshiyama, M., Shono, Y., Fernandes, C.A., Tay, F.
The microtensile bond test: A review 1999 Journal of Adhesive Dentistry
304 Universidade de São Paulo (USP)
Shipper, G., Ørstavik,
D., Teixeira, F.B.*, Trope, M. An evaluation of microbial leakage LQURRWV¿OOHGZLWKDWKHUPRSODVWLF
synthetic polymer-based root canal
¿OOLQJPDWHULDO5HVLORQ
2004 Journal of
Endodontics 295 Universidade Estadual de Campinas (UNICAMP)
Carvalho, R.M.*, Pereira, J.C.*,
Yoshiyama, M., Pashley, D.H.
A review of polymerization contraction:
7KHLQÀXHQFHRIVWUHVVGHYHORSPHQW
versus stress relief
1996 Operative Dentistry
231 Universidade de São Paulo (USP)
Araújo, M.G.*, Sukekava,
F., Wennström, J.L., Lindhe, J. Ridge alterations following implant placement in fresh extraction sockets: An experimental study in the dog
2005 Journal of Clinical Periodontology
225 Universidade Estadual de Maringá
(UEM) Goracci, C., Tavares,
A.U.*, Fabianelli, A., Monticelli,
F., Raffaelli, O., Cardoso, P.C.*, Tay, F., Ferrari, M.
7KHDGKHVLRQEHWZHHQ¿EHUSRVWVDQG
root canal walls: Comparison between microtensile and push-out bond strength measurements
2004 European Journal of Oral
Sciences
221 Universidade de São Paulo (USP)
Hebling, J.*, Pashley,
D.H., Tjäderhane, L., Tay, F.R. Chlorhexidine arrests subclinical degradation of dentin hybrid layers in vivo
2005 Journal of Dental
Research 211 Estadual Paulista Universidade (UNESP) Shono, Y., Ogawa, T., Terashita,
M., Carvalho, R.M.*, Pashley, E.L., Pashley, D.H.
Regional measurement of resin-dentin
bonding as an array 1999 Journal of Dental Research 189 Universidade de São Paulo (USP)
* Brazilian authors in bold
t issue engineering, which will probably represent a pr ogr essive r evolut ion in clinical t r eat m ent s t hat require synt het ic m at erials, considering t hat such t reat m ent s will require bioact ive m at erials, st em cells and growt h fact ors for regenerat ive approaches18.
Since dent al m at er ials have been show n t o b e im p or t an t f or scien t if ic an d t ech n olog ical developm ent in different areas of dent ist ry, t he concern is t he decrease in t he developm ent of new t ailor- m ade biom at erials for dent ist ry. However, WKHHYROXWLRQLQWKH%UD]LOLDQVFLHQWL¿FSURGXFWLRQ seem s t o have followed t he annual evolut ion of t he
ZRUOGVFLHQWL¿FSURGXFWLRQLQUHFHQWGHFDGHV7KH VFLHQWL¿FDQGWHFKQRORJLFDOGHYHORSPHQWLQGHQWLVWU\ increases t he com plexit y of t he area and requires a professional wit h t he com pet ence t o deal wit h a large num ber of fact ors, including t he knowledge t o w or k w it h differ ent cat egor ies of m at er ials t hat are already widely st udied in Brazil ( such as dent al im plant s, synt het ic resins and dent al cem ent s) . Professionals wit h knowledge in dent al m at erials science can m agnify t heir labor m arket opport unit ies, as in research and developm ent inst it ut ions, or even in dent al indust ries, being a sect or wit h a pot ent ial t o be exploit ed by dent ist s.
Figure 6- Number of papers and Brazilian patents related to dental material according to material category (1965-2014).
7KHQXPEHUEHWZHHQEUDFNHWVUHSUHVHQWVSDWHQWVSXEOLVKHGWKURXJKRXWWKHZRUOG%UD]LODVDI¿OLDWLRQFRXQWU\RIWKHSDSHUV
and patents from Brazil, respectively
Furt herm ore, dent al m at erials are a science in t im at ely lin k ed n ot on ly t o ev alu at in g t h e p e r f o r m a n ce o f m a t e r i a l s, b u t a l so t o t h e dev elopm en t of n ew an d bet t er pr odu ct s f or t he dent al m arket , which involves t echnologies protected by patents. The intellectual property rights protect the external exploitation of knowledge used for t he developm ent of product s and innovat ions3.
Accor d in g t o t h e Wor ld I n t ellect u al Pr op er t y Organizat ion ( WI PO) , over 70% of t echnological inform at ion can only be found in t he pat ent s20.
Th e “ st at e of t ech n iq u e” con t ain ed in t h ese docum ent s provides opport unit ies for m onit oring product licensing, draft ing t echnology proj ect s t o REWDLQ¿QDQFLQJRUSDUWQHUVKLSVXQLYHUVLWLHVDQG com panies) and m onitoring com petitors9,20. Patents
FDQ EHQH¿W VRFLHW\ E\ WKH GLIIXVLRQ RI VFLHQWL¿F and t echnological knowledge, and t hey can prot ect invent ors from t he exploit at ion of t he prot ect ed t echnology12.
*UHDWHU RZQHUVKLS RI VFLHQWL¿F LQIRUPDWLRQ LV essential to stim ulate technological innovation20. I n
addit ion, governm ent incent ives for t echnological in n ov at ion ar e f u n d am en t al t o t ech n olog ical developm ent . I n recent years, t he “ I nnovat ion Law” ( nº . 10.973/ 2004) , a result of int egrat ion effort s bet ween universit ies, research inst it ut ions and businesses, stim ulated research, technological product ion and innovat ion; and t he “ Good Law” ( nº . 11.196/ 2005) allow ed t he grant ing of t ax incent ives t o com panies t hat conduct research and technological innovation developm ent15. However, in
%UD]LOWKHUHZHUHPRUHVFLHQWL¿FSURGXFWLRQVWKDQ patent deposits related to dental m aterials over the past 50 years, and m ost dent al m at erials used by t his count ry are foreign priorit ies. According t o The Global I nnovat ion I ndex11, Brazil occupied t he 70t h
posit ion in t he world ranking of innovat ion in 2015, behind count ries in Sout h Am erica such as Chile ( 42nd) and Colom bia ( 67th position) . I n this context,
it is im port ant t o st im ulat e innovat ion via research funding agencies, such as t he Nat ional Council for 6FLHQWL¿FDQG7HFKQRORJLFDO'HYHORSPHQW&13T and t he Coor dinat ion of Higher Educat ion and Graduat e Training ( CAPES) t o prom ot e great er incent ives in ar eas focused on t he generat ion and applicat ion of innovat ive r esear ch r esult s.
I n addit ion, t he pursuit of excellence in product s and pr ocesses can st im ulat e t he developm ent of t echnological innovat ions not only in dent al business, but also in academ ia9.
Co m p a n i es h av e b een m a k i n g ef f o r t s t o rem ain com pet it ive t hrough cont inuous innovat ion pr ocess. Technology push and m ar k et pull or dem and pull represent s t he innovat ion st rat egies. 7KXV FRPSDQLHV FDQ ¿QDQFH DFDGHPLF SURMHFWV be involved in t he int ellect ual prot ect ion or even in t he licensing of new t echnologies developed
at t h e u n iv er sit y lab or at or ies. Fu r t h er m or e, universit ies can st ill receive funds from com panies as royalt ies t o support research and innovat ive act ivit ies9. I n addit ion, ent repreneurship can be st im ulat ed, since univ er sit ies can cr eat e j oint vent ures wit h com panies, encouraging com panies t o hire graduat e st udent s t o carry out research and developm ent proj ects, or to create an environm ent t hat encourages t he creat ion of new com panies in business incubat ors and science parks9,17. Overall, it can be said t hat t here are great opport unit ies for new t echnologies and innovat ive m at er ials t hat could disrupt exist ing business m odels for biom at erials and supplies of t radit ional dent ist ry t hat could provide new t reat m ent alt ernat ives for pat ient s.
Besides, it is im portant t o highlight the current scenario of t he Brazilian product ion being analyzed based on records ret rieved from dat abases using MeSH Term s wit h ot her keywords in t he search VWUDWHJ\¿OWHULQJWRROVDQGODQJXDJHUHVWULFWLRQV Most likely, several st udies could not be included in pooled dat a because of t hese lim it at ions; in addition, som e patents recently deposited were not LQFOXGHG EHFDXVH RI DQ PRQWK FRQ¿GHQWLDOLW\ phase. However, a high num ber of records were scr eened and analy zed in or der t o obt ain t his overview. Finally, t he result s suggest t he need for an approxim ate relationship between the university and the industry to im prove the integration between VFLHQWL¿F DQG WHFKQRORJLFDO GHYHORSPHQW DV ZHOO as t he revaluat ion of professional boundaries and int ersect ions bet ween different areas. Thus, it m ay EHSRVVLEOHWRLQFUHDVHERWKWKHVFLHQWL¿FSURMHFWLRQ of Brazil and it s represent at ion in ownership of healt hcare t echnologies.
CON CLUSI ON S
From t his review, it was possible t o obt ain an RYHUYLHZ RI %UD]LOLDQ SURGXFWLRQ LQ WKH ¿HOG RI dental m aterials. Brazilian production dem onstrated VLJQL¿FDQW SUHVHQFH DQG PXOWLGLVFLSOLQDU\ GHQWDO m at er ials w it h in scien t if ic an d t ech n olog ical scenar ios of dent ist r y over t he last 50 year s. Besid es, it is im p or t an t t o ap p r ox im at e t h e relat ionship bet ween universit y and indust ry in or der t o st im ulat e cont inuous innovat ions and expand t echnological developm ent in count ries such as Brazil.
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