Is there still a scientific literature?

Many years ago, Prof. Pierluigi Sapelli, having to organise a meeting on evidence-based dentistry, “forced” me to give a talk on the subject. This led me to study in a frenzied way in order to better understand what goes behind a scientific publication and to familiarise myself with words that at the time were almost unknown to those who were not “super experts”. Thereafter, I better understood the difference between personal opinions, published here and there, and serious research, multicentre studies, reviews, and meta-analyses.

Those were the days of in-depth research, the days when the same implant remained on the market for years without significant changes and the follow-up lasted for several years.

Then, as now, I used to try to explain to those who attended my conferences how to read the documentation that accompanied new products put on the market. I am now forced to notice that the situation is taking a worrying, and perhaps dramatic, turn. This is certainly true for all sectors and in all countries, but our profession, dentistry, a profession where most are freelancers, is paying the price in an amplified manner for this increasingly emerging phenomenon.

Understanding the dramatic vicious circle is quite simple: research about a product or procedure, well-conducted and with intellectual honesty on the part of researchers, requires a great deal of time and energy and, ultimately, a financial investment. When there is a potential risk of the results being unfavourable to what has been studied, who then wants to spend money on verifying the scientific validity of a protocol or a material that will perhaps be modified owing to market requirements within a short time? Moreover, it is very often enough to comply with CE regulations, which certify that a product has met EU health, safety and environmental requirements, in order to market a new product. This says nothing about its efficacy or real intended use, and, therefore, supposedly therapeutic products can be proposed to us without any kind of scientific support or research behind them. There can sometimes be laughable documentation which refers to general concepts and not to the product in question.

Unfortunately, all this sometimes occurs with the guilty silence of a plethora of scientific societies that all too often talk about the highest systems instead of making themselves, as would be good and desirable, guarantors of the scientific nature of products and protocols. Mala tempora currunt [These are bad times], and it only remains for us to hope that an individual capacity for criticism will be able to guide young colleagues towards conscious choices to prevent experimentation on unsuspecting patients who honour us with their trust—a trust which should never be betrayed.


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