Year : 2019 | Volume
: 30 | Issue : 6 | Page : 817--818
Translational research in dentistry: The need of the hour
Professor, Endodontics Program; Graduate Coordinator, Graduate Education; Principal Investigator, Dental Research Institute, Faculty of Dentistry, University of Toronto, Toronto, Canada
Prof. Anil Kishen
Professor, Endodontics Program; Graduate Coordinator, Graduate Education; Principal Investigator, Dental Research Institute, Faculty of Dentistry, University of Toronto, Toronto
|How to cite this article:|
Kishen A. Translational research in dentistry: The need of the hour.Indian J Dent Res 2019;30:817-818
|How to cite this URL:|
Kishen A. Translational research in dentistry: The need of the hour. Indian J Dent Res [serial online] 2019 [cited 2020 Apr 5 ];30:817-818
Available from: http://www.ijdr.in/text.asp?2019/30/6/817/275888
“Creativity is not the finding of a thing, but the making something out of it after it is found”.
James Russell Lowell (1819–1891)
In recent decades, the clinical practice of dentistry has witnessed several technological advances. These advances mostly leveraged on in-vitro testing, and at least in certain cases, controlled clinical valuations prior to commercialization. These technological advances are largely intended to enhance clinical efficiency and perhaps treatment predictability. There are only few research advances aimed to generate a major paradigm shift in the scientific or therapeutic perspectives of dental sciences. Along these lines, translational research is known to play a key role in scientific inventions that would impact clinical dentistry and set the foundation for a major paradigm shift. A clinical translation research with major paradigm shift is generally centered on the discovery of a fundamental knowledge gained through systematic basic science research. Translational research has several important roles in a research enterprise. Primarily, it closes the knowledge gaps between the basic science (lab-based inventions) and clinical research (clinical knowledge) with goals for clinical application. Translation research also helps develop strategies to promote the adoption of best practices in clinical settings, community, and policy development.
A translational research is described as a continuum of research in which basic science discoveries are utilized clinically to prevent or treat human disease. It involves a frequent repeated process wherein scientific discoveries are integrated into clinical requirements and applications. Interestingly, when such basic science discoveries are applied to a clinical environment, it can lead to more knowledge gain in clinical science, which further contributes to additional basic science discoveries. Translational research is planned in three phases. In phase 1, the basic science research findings are evaluated on clinical-related tissues models, cell lines, etc., (clinical sciences). In phase 2, assessments are carried out in clinical/clinical practice environment. In phase 3, it is used to translate clinical practice knowledge for more widespread health care improvement. These phases in translational research are rarely straightforward. It requires continued research in both clinical and laboratory settings. Competent investigators, sufficient resources, and collaborative academic culture are foundations for an ideal translational research environment.
A significant barrier to translational research includes cultural differences between basic scientists and clinicians, lack of resources in terms of workforce and infrastructure, and the complex regulatory environment. Cultural differences between the two groups of investigators stem from the lack of communication, differences in education and training, and different goals and reward mechanisms. Resource problems include lack of trained interdisciplinary staff to support investigations throughout the translational research cycle, protected time for research, particularly for clinicians, as well as access to shared resources.,
How do we establish translational research environment in an institution? Different recommendations to encourage translational research enterprises include: (1) Facilitate training and skills needed to conduct translational research effectively. (2) Mentor research career development program in translational science for junior faculty members. (3) Build translational research team that constitutes clinicians, clinician scientists, basic scientists, and business managers who need to be conversant in data integration and interpretation. (4) Create focused research grants and platforms for regular research seminars. (5) Develop collaborative groups with investigators having diverse research background and different levels of experiences. (6) Promote community engagement in the institutional research enterprise. (7) Develop research focus groups based on the community needs and strength of the institution. (8) Establish summer research experiences for undergraduate students that offer introduction to translational research. (9) Create databases that links potential collaborators. (10) Professional societies should publicize the availability of resources and funding opportunities. (11) Administrators should fund translational research projects that engage multidisciplinary investigators. (12) Evaluate the outcomes of translational research programs to recognize and replicate the programs that are working. (13) Establish networking opportunities for basic and clinical science investigators and trainees with similar research interests. (14) The system should provide incentives via promotion, tenure, etc., to encourage as well as support basic scientists and clinician scientists interested in pursuing translational research.
How difficult is it to implement health care technologies developed from translational research? One of the formidable challenges in the implementation of technologies presenting a major paradigm shift or tangible clinical impact is the process of educating the clinicians and the support staff about the usage and compliance. With the rapidly aging populations in both developed and developing countries, it is now more critical than ever to develop concerted interactions to discover oral/dental healthcare monitoring/diagnostic and therapeutic technologies to impact our society globally.,
In summary, it is noteworthy to recognize that planned translational research is decisive for impactful clinical advances in dentistry. Basic researchers, clinician scientists and clinicians should work as an integrated team to achieve their goals. The constant challenges of teaching, researching, publishing and competing for limited sources of funding, coupled with pursuing career ambitions may seem as a daunting task. However, it can be an intensely satisfying and exhilarating endeavor, especially when the fruits of the laboratory studies are translated to improved healthcare strategy or generate a paradigm shift in clinical practice with subsequent benefits to our patients and societies globally.
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