Saudi Arabia’s contribution to systematic reviews in dentistry: A bibliometric analysis

Abstract

Background/objectives

Bibliometric is a quantitative assessment method to identify prevailing trends and patterns of publications in a particular field of study. Systematic Reviews (SRs) give an in-depth study of the literature and the most comprehensive overview of the desired research subject. This study aimed to review the bibliometric properties of SRs published by the dentists of Saudi Arabia.

Materials and methods

Relevant dataset of SRs on dentistry with at least one author affiliated with Saudi Arabia from PubMed database was obtained. Each document of the retrieved data was screened based on the inclusion and exclusion criteria. The citation metric was collected from Google Scholar.

Results

A total of 625 SRs published from the year 2007 to 2023 were included. The average number of citations for each of these SRs is 25.54. Though a low productivity was observed until 2017, the number of SRs published has increased in the previous three years. SRs in Prosthodontics were the most prevalent. The SRs with the first author from Saudi Arabia and internationally collaborated gained a higher citation impact. Most of the SRs were published in the Saudi Dental Journal. Authors from King Saud University contributed to more than a quarter of the SRs. The two nations that collaborated the most SRs were found to be United States and India.

Conclusion

Over the last three years, there has been significant progress in the publishing of SRs from Saudi Arabia. The bibliometric parameters identified in this study support researchers in understanding the current status of SRs publication. There is a need to increase awareness about the importance of high-evidence research in dentistry and enhance the training opportunities as well as research incentives for this kind of scientific production.

1. Introduction

Saudi Arabia holds a prominent status in the field of biomedical research among the Arab World (Meo, 2015, Vennu et al., 2021). The expansion of biomedical facilities and the spectacular advances in healthcare services have led to improvements in biomedical research and development (Khorsheed and Al-Fawzan, 2014). The field of dentistry has not been an exception to these country-wide advancements; it has also grown significantly in recent years in Saudi Arabia. Findings from studies that have mapped the dental literature in Saudi Arabia confirm the promising prospects for dental research in the country (Alrubaig et al., 2023, Alqahtani and Haq, 2023).

Systematic reviews (SRs) are designed to gather all available evidence to resolve a particular research question. They entail a critical evaluation of eligible studies and a reproducible and comprehensive search of the literature (Liberati et al., 2009). Many systematic reviews include meta-analyses (MAs). Meta-analysis is a statistical technique that combines and summarizes the findings of multiple independent investigations (Glass, 1976). The indexing of journals in well-reputed databases like PubMed is an indicator of their high quality and credible scientific content. Many studies have utilized the PubMed database for their investigations on SRs in dentistry (Bassani et al., 2019, Praveen et al., 2022).

Bibliometric studies are conducted to identify patterns and trends in published literature in a specific type of research field. These bibliometric studies utilize quantitative research methodology and statistical measurements to study various aspects of a selected pool of publications (Alfadley et al., 2022). Findings derived from these studies can highlight growing areas of scientific performance through subject dispersion and citation metrics, in addition to giving insights about existing knowledge gaps that may be addressed by future research (Praveen et al., 2022).

Several studies have investigated the publication trends of SRs in a variety of research fields (Fu et al., 2023, Gogos et al., 2020). Nonetheless, there are no published bibliometric analyses of dental SRs that examine the contribution of Saudi Arabia to this specific type of research. As a result, the main objectives of this research were to: (1) List all the SRs in dentistry that are contributed by Saudi Arabia between 2007 and 2023 and indexed in the PubMed database; and (2) Examine the characteristics of the identified SRs including the dental specialty, institution, collaboration, time period, publication source, initial authorship and prolific authors. Results from this study may enable pointing out areas in which SRs are underrepresented and guide further advancements in the realm of dentistry based on evidence.

2. Materials and methods

This study employed a bibliometric method to evaluate SRs produced by Saudi Arabian-affiliated authors in dentistry, published from the 1st of January 2007 until the 31st of December 2023. Data collection from the PubMed database was done on the 10th of January 2024. The search was conducted using following keywords with Boolean Operator “OR”; Dentistry, Dental, Orthodontic, Orthodontics, Prosthodontic, Prosthodontics, Periodontic, Periodontics, Pedodontic, Pedodontics, “Oral surgery”, “Maxillofacial Surgery”, “Restorative Dentistry”, Endodontic, Endodontics, “Oral hygiene”, “Pediatric dentistry” “Paediatric dentistry”, “Oral health”, “Oral Radiology”, “Oral biology”, and “Oral Pathology”. Additionally, the option “AND” was selected, and the affiliations of “Saudi Arabia” OR “Kingdom of Saudi Arabia” were entered. We selected the “Systematic Review” option from the article type filter, excluding all other types of articles.

The analysis included systematic reviews (SRs) and SRs with meta-analyses (MAs) in the field of dentistry, which were published in PubMed-indexed journals between 2007 and 2023. These studies were conducted by authors affiliated with dental facilities in Saudi Arabia. SRs that belong to other medical fields, ahead of prints, duplicates, narrative reviews, and scoping reviews were excluded. Two researchers conducted a separate evaluation of the search strategy results, identified the affiliation of the Saudi Arabian authors, and determined the publications that met the inclusion requirements. The resolution of any discrepancies that arose during the screening of titles was achieved through discussion. Other researchers determined the number of authors, collaboration, specialty of the SR, journal characteristics and citations. The team then analyzed the periodic growth of SRs with citation metrics, productive dental specialties, frequently used journals, the topmost collaborative countries, productive Saudi Arabian institutions, and prolific authors. Data analysis was done employing Excel from Microsoft, Redmond, Washington, USA, version 16 and presented in the form of tables and figures.

3. Results

3.1. Characteristics of the identified literature

The search yielded a total of 1023 records, and after applying the inclusion and exclusion criteria, 625 SRs were selected for data analysis (Fig. 1).

Fig. 1.

Screening process for selection of SRs.

3.2. Productivity and impact − by year

Only two SRs were found between the years 2007 and 2010, and these SRs didn’t meet the inclusion criteria. Low productivity was observed during the first seven years (2011 to 2017) with only 98 published SRs (15.68 %). On the contrary, the last three years (2021 to 2023) showed the highest productivity, where more than 50 per cent of the SRs were published (n = 357; 57.12 %). Collectively, the selected SRs were cited 16,152 times, with an average of 25.84 cites/SR as observed in the Google Scholar database (Fig. 2).

Fig. 2.

Distribution of SRs and Citations by years.

3.3. Productivity and impact − by dental specialty

The analysis of the subject dispersion of SRs revealed that they fall into 11 broad dental specialties and one miscellaneous category (Table 1). Dental specialties were classified as listed by the Saudi Commission for Health Specialties. The miscellaneous category included SRs that covered multiple dental specialties or overlapped more than one specific dental specialty. Prosthodontics emerged to be the most common specialization, followed by periodontics, oral medicine, and orthodontics. More than half (n = 348; 55.68 %) of the SRs are from these four dental disciplines. The fewest SRs were published in Oral and Maxillofacial Radiology. Although only 49 SRs were published in Dental Public Health, these SRs had the greatest citation impact (44.90 citations per SR).

Table 1.

Distribution of SRs by specialty with numbers, citations, and citation impact.

Serial No.	Dental Specialty	Total SRs	Total Citations	Citation Impact
1.	Prosthodontics	103 (16.48 %)	2765	26.84
2.	Periodontics	95 (15.20 %)	2621	27.59
3.	Oral Medicine	81 (12.96 %)	2074	25.60
4.	Orthodontics and Dentofacial Orthopedics	69 (11.04 %)	1967	28.51
5.	Restorative Dentistry	53 (8.48 %)	991	18.70
6.	Dental Public Health	49 (7.84 %)	2200	44.90
7.	Endodontics	47 (7.52 %)	1192	25.36
8.	Oral and Maxillofacial Surgery	44 (7.04 %)	640	14.55
9.	Oral Pathology	33 (5.28 %)	985	29.85
10.	Pediatric Dentistry	28 (4.48 %)	425	15.18
11.	Miscellaneous	14 (2.24 %)	145	10.36
12.	Oral and Maxillofacial Radiology	9 (1.44 %)	147	16.33

3.4. Productivity and impact – by author

3.4.1. Affiliation of the first author

About two-thirds of the SRs (n = 390; 62.40 %) had the affiliation of the first authors from Saudi Arabian institutions, while international authors served as first authors in the remaining one-third of SRs (n = 235; 37.60 %). The SRs with a Saudi Arabian-affiliated first author gained slightly higher citation impact (26.47 cites/SR) as compared to non-Saudi Arabian-affiliated first authors (24.79 cites/SR). However, this was not found to be statistically significant (p = 0.24) using the Mann- Whitney U test (Table 2).

Table 2.

Affiliation of the first author and international collaboration.

	Variables	Total SRs	Total Citations	Citation Impact	Statistical Analysis (Mann- Whitney U test)
					U	Mean Rank	p
First author affiliated to Saudi Arabian institute	Yes	390 (62.40 %)	10,326	26.47	42966.00	305.45	0.24
	No	235 (37.60 %)	5826	24.79		322.88
Collaboration Pattern	All authors from Saudi Arabian institutes	175 (28 %)	3692	21.09	35050.00	288.94	0.04*
	With International Research Collaboration	450 (72 %)	12,460	27.68		320.94

^*p < 0.05- Significant.

3.4.2. International collaboration

Analysis of the collaboration pattern shows that in 28 % of the SRs (n = 175), all the authors were Saudi Arabian-affiliated, among which 65 SRs had a single author. International research collaboration was found in the other 72 % of the SRs (n = 450), with a higher citation impact (27.68 cites/SR) as compared to SRs with all Saudi Arabian-affiliated authors (21.09 cites/SR). The Mann- Whitney U test revealed that this increase in citations when the SRs had international collaboration was significant (p = 0.04) (Table 2).

3.4.3. Number of authors

An overall total of 3292 authors contributed to 625 SRs, with some authors contributing to multiple SRs. The six-author pattern was found to be the most frequent with 102 SRs (16.32 %), followed by five, two, four and seven-author patterns with 84, 69, 67 and 66 SRs, respectively. 65 SRs (10.4 %) were contributed by a single author.

3.4.4. Prolific authors

A total of 1857 Saudi Arabian-affiliated author names have been identified. About three-fourths of the authors (n = 1382; 74.42 %) had contributed to a single SR, while the remaining one-fourth of the authors (n = 475; 25.58 %) had produced more than one SR. Among the authors who published the highest number of systematic reviews (SRs) in the field of dentistry affiliated with Saudi Arabia, Shankargouda Patil had the most publications with 57 SRs. Sadeq Ali Al-Maweri followed with 25 SRs, and Tariq Abduljabbar had 21 SRs.

3.5. Productivity and impact – by collaborative country

In 450 SRs, Saudi Arabian authors collaborated with authors from 62 countries around the world. The top 10 collaborative countries had more than 25 SRs (Table 3), while the remaining 47 countries had collaborations ranging from one to nine SRs. The highest number of research collaborations were done with authors from the United States (n = 141; 22.56 %) followed by India and United Kingdom, with 119 (19.04 %) and 64 (10.24 %) SRs, respectively.

Table 3.

Top-10 collaborative countries with Saudi Arabian authors and Top-10 Saudi Arabian institutions with total SRs (TSR), total citations (TC), and citation impact (CI).

Serial No	Collaborative Country	TSR	TC	CI	Serial No	Institution's Name	TSR	TC	CI
1	United States	141	4747	33.67	1	King Saud University	173	4785	27.66
2	India	119	1996	16.77	2	Jazan University	102	2513	24.64
3	United Kingdom	64	2074	32.41	3	King Abdulaziz University	86	2936	34.14
4	Malaysia	54	1944	36.00	4	Jouf University	47	576	12.26
5	Pakistan	49	1591	32.47	5	Taibah University	44	1373	31.20
6	Italy	44	969	22.02	6	King Khalid University	42	462	11.00
7	Yemen	43	1202	27.95	7	Riyadh Elm University	41	533	13.00
8	Australia	31	810	26.13	8	Imam Abdulrahman bin Faisal University	36	1060	29.44
9	Canada	30	717	23.90	9	Qassim University	34	656	19.29
10	United Arab Emirates	28	300	10.71	10	King Saud bin Abdulaziz University for Health Sciences	27	665	24.63

3.6. Productivity and impact – by institution

Table 3 shows the top-10 most productive Saudi Arabian institutions in dental SRs. Authors from King Saud University produced more than one-fourth of the SRs (n = 173; 27.68 %), followed by those from King Abdulaziz University and Jazan University, with 102 and 86 SRs, respectively.

3.7. Productivity and impact – by journal

The selected SRs were published in 195 different journals, with more than one-fourth of SRs (n = 167; 26.72 %) published in the top 10 most SR-publishing journals (Table 4). The highest number of SRs were published in the Saudi Dental Journal (SDJ) (n = 34). SRs published in the Journal of Prosthetic Dentistry gained the highest citation impact (45.09 cites/SR).

Table 4.

Top 10 most SR-publishing journals.

Serial No.	Journal’s Name	Impact factor	Total SRs	Total Citations	Citation Impact
1.	Saudi Dental Journal	1.8	34	699	20.56
2.	Photodiagnosis and Photodynamic Therapy	3.3	25	934	37.36
3.	Journal of Contemporary Dental Practice	Not indexed	21	267	12.71
4.	BMC Oral Health	2.9	17	362	21.29
5.	Journal of International Society of Preventive & Community Dentistry	1.1	14	242	17.29
6.	European Journal of Dentistry	Not indexed	12	190	15.83
7.	Journal of Prosthetic Dentistry	4.6	11	496	45.09
8.	Journal of Prosthodontics: Implant, Esthetic, and Reconstructive Dentistry	4.0	11	279	25.36
9.	Clinical Oral Investigations	3.4	11	341	31.00
10.	Materials (Basal)	3.4	11	238	21.64

4. Discussion

Researchers use bibliometric analyses to determine the unique influence of a topic in their field of research. These analyses provide a historical perspective on scientific growth and demonstrate trends in research (Tarazona et al., 2017, Zampetti and Scribante, 2020). SRs can help in detecting knowledge gaps, establishing future research objectives, and supporting clinical decision-making (Glasziou et al., 2014).

Saudi Arabia published its first SR in dentistry in 2011, and since then, the quantity of published SRs has steadily escalated from 2011 to 2020. In the years 2021 until 2023, outstanding growth was observed, where publications during this 3-year period comprised more than half (57 %) of the total publications over the 13-year period from 2011 until 2023. In line with this finding, a study focusing on SRs contributed by India found that the first SR was published in 2007, and 59 % of the SRs were published in the past three years from 2020 to 2022 (Praveen et al., 2022).

The citation metric is an important indicator for evaluating individual scientific works (Meng et al., 2020). In the present study, the selected SRs were cited 16,152 times, resulting in an average of 25.84 cites/SR. Analyzing the Saudi Dental Journal papers from 2009 to 2021, Alkadi et al. (2024) found about the same citation impact of 26.17 citations per article.

Systematic reviews provide valuable information; yet the process of creating these comprehensive studies requires significant time and resources (Hayden and BACK Evidence Collaboration, 2022). The increasing complexity of research leads to internationalization since difficult issues need experts from different fields and a significant amount of funding (Larivière et al., 2015). The present study found that about 28 % of the SRs were contributed by the national collaboration of Saudi Arabian-affiliated authors, while collaboration between researchers from different countries produced 72 % of the SRs. The quality of international collaborated SRs had been found to be higher based on citation impact. The scientific impact of publications from international collaborations is generally greater than that of those from domestic collaborations (Velez-Estevez et al., (2022).

The United States, India, and the United Kingdom had the highest number of collaborations in the present study. Haq et al. (2019) analyzed the dental research indexed in Scopus from Saudi Arabia between 1998 and 2017. Their findings indicate that the United States was the most preferred choice for international research cooperation. The United States created advanced research institutes in the past, placing exceptional emphasis on research activities (Alrubaig et al., 2023).

Prosthodontics was the most popular topic among SRs in the current study, followed by periodontics. Oral and maxillofacial radiology was a less popular choice. The high number of SRs in these specialties may be attributed to the fact that SRs pertaining to implantology were not categorized under a separate discipline but rather counted under one of the three areas of specialization: prosthodontics, periodontics, or oral and maxillofacial surgery. Similar results were reported in a study that assessed 1188 SRs on oral health (Saltaji et al., 2013).

Twenty-seven percent (27 %) of the SRs were published in 10 different journals, and the Saudi Dental Journal was at the top with 34 SRs. Another study on dental research in Saudi Arabia revealed that SDJ published the most research papers (n = 171; 9 %) (Khayat and Rajeh, 2022). Researchers affiliated with King Saud University contributed the maximum number of SRs (28 %) to the productive institutions. A study reported that 85 percent of the dental research conducted in Saudi Arabia between 2010 and 2020 was contributed by educational institutions, and about half of the research (n = 893; 47 %) was produced by 23 institutions located in Riyadh (Rajeh and Khayat, 2021).

This study was limited to SRs indexed in the PubMed databases under dentistry or potential specialties of dentistry. Most PubMed indexed dental and medical journals are also indexed in the Scopus and Web of Science databases. Nevertheless, it is possible that some influential and impactful SRs were overlooked. Data on SRs from these databases may be incorporated into future investigations. Citation metrics were calculated using Google Scholar; subsequent investigations may evaluate the citation counts of alternative databases.

5. Conclusion

This bibliometric evaluation provides an in-depth description of Saudi Arabia's SRs in dentistry. Gradual but progressive growth was found in the first ten years, but remarkable progress was recorded in the last three years of study. The study identified the citation metric, most preferred specialty, authorship patterns, most used journals, most productive institutions, and international research collaboration. These bibliometric parameters aid the researchers in comprehending the current state of scientific publications in Saudi Arabia. There is a need to increase awareness about the importance of high-evidence research in dentistry and enhance training opportunities as well as research incentives for this kind of scientific production.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

CRediT authorship contribution statement

Swapna Munaga: Conceptualization, Data curation, Investigation, Methodology, Project administration, Visualization, Writing – original draft, Writing – review & editing. Aram Alshehri: Conceptualization, Data curation, Investigation, Methodology, Validation, Writing – review & editing. Ikram Ul-Haq: Formal analysis, Methodology, Visualization, Writing – original draft, Writing – review & editing. Sara Kalagi: Conceptualization, Investigation, Formal analysis, Validation, Writing – review & editing. Rajkiran Chitumalla: Investigation, Formal analysis, Writing – review & editing. Kiran Iyer: Formal analysis, Writing – review & editing.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.