Aus der Klinik für Parodontologie und Brückenprothetik
Direktor: Prof. Dr. Dr. h.c. Niklaus P. Lang

The International
Team for Implantology(ITI) Research
Foundation
A retrospective analysis of research grants
allocated in the years 1988 - 2006
Inaugural-Dissertation zur Erlangung der Doktorwürde
der Zahnmedizin der Medizinischen Fakultät
der Universität Bern

VORGELEGT VON ANDRÉ BUSSLINGER
VON BADEN, AG

A B ST RA CT

The International Team for Implantology (ITI) Foundation has a Research

119’128. Of the 232 ﬁnanced projects, 94 produced at least one veriﬁ-

Committee that distributes ﬁnancial support amongst researches inable publication in a peer-reviewed journal, totalling 206 publications.

dental implantology and related ﬁelds. Since 1988, approximately CHF

These publications appeared in journals with impact factors ranging

27 million has been granted making the ITI one of the leading private

from 0 to 7.666 (average = 1.562) and were cited between 0 to 450 times

institutions in research funding in dentistry.

(average = 25.9).

Aim

Conclusion

The aim of this search and analysis was to study the nature, quality and

The ITI Foundation is a leading research granting agency in dentistry at

allocation dynamics of all research grant applications submitted to thelarge and especially in implant dentistry. In the last two decades, the ITIITI Foundation since 1988 and through 2006.

Foundation has substantially set the trends and contributed paradigm
shifts in implant dentistry.

Results
499 grant applications were submitted to the ITI Foundation. Of these,
46.5 % of the applications were ﬁnanced. Annually, 3 to 62 applications
were received per year with a success rate of 29.4 % to 100 % for funding.
Applications were received from 31 countries, the most originating fromthe USA, with a success rate of 54.5 %. Eighteen applicants submitted 4
or more applications. The applicants were citizens of 37 countries. Most
applicants were either medical doctors or dentists, both with PhDs (n =226). Twenty-nine percent of the applicants were ITI Fellows and were
58.9 % of the time successful in their applications. One hundred andforty-one different universities and institutions with 75 different departments submitted applications. The ITI have 4 different grant programs,
where the Single Grant Application (SGA) was selected by the applicants
44.5 % of the time with a success rate of 43.2 %. Most of the proposed
studies were clinical studies (36.9 %). The majority of the projects dealt
with dental implant surface research, bone augmentation, predictability of implants and implant prosthodontics. A total of CHF 27.6 million
was allocated to the successful applicants ranging from CHF 8’000 to
CHF 1.5 million per project with an average amount per project of CHF

page // 2

page // 3

// INTRODUCTION

noitcudortnI

Introduction
Through the efforts of two researches, P.-I. Brånemark at the University
of Gothenburg, Sweden and A. Schroeder at the University of Berne, Switzerland implant dentistry was to become a predictable treatment option
in the rehabilitation of edentulous and partially edentulous patients
through the procedure of “osseointegration” or “functional ankylosis”(Berglundh et al. 2002, Brånemark et al. 1969, Brånemark et al. 1977,
Schroeder et al. 1976).
In subsequent years this treatment concept was scrutinized by a numberof clinical and laboratory studies. In an effort to promote further researchand development in the ﬁeld Prof. Dr. André Schroeder and Dr.h.c. Fritz
Straumann, amongst others, founded the International Team for Implantology, in short the ITI. For many years the ITI was predominantly aforum for exchange of thoughts and clinical experience in implant dentistry. The development of a novel implant system (today the Straumann
Dental Implant System®) in 1984-1986 was the result of industry withvery loose consulting arrangements with some members of the ITI. The
network grew fast and more academics became interested in promoting
the ﬁeld of implant dentistry. As a consequence, basic questions aroseand had to be answered through hypothesis testing and well-designed

page // 5

// INTRODUCTION

research. Also, the need for staging clinical studies on the longevity of theAimimplant system and it’s complication rate made it necessary to prioritize

The aim of this search and analysis was to study the nature, quality andthe funds available for research and development outside the Instituteallocation dynamics of all research grant applications submitted to theStraumann AG, Waldenburg BL, Switzerland.

ITI Foundation since 1988 through 2006.

Hence, as a non-proﬁt academic organisation of clinicians and academics
active in research, development and education of implant dentistry the ITIFoundation for the Promotion of Implantology was established in 1988.
Ever since, the Team of the Research Committee of the ITI allocated theavailable funds to researchers after a peer-review process and the degreeof relevance of the proposals, the scientiﬁc content and methodology
and the reputation of the research groups applying for grants. The ITI wasfounded by Dr.h.c. Fritz Straumann and Prof. Dr. André Schröder. Initialfunding was provided by the Institute Straumann AG, Waldenburg BL,
Switzerland. Subsequently, the ﬁnancing of the ITI Foundation is guaranteed by a compensation from Straumann AG, Basel BS, Switzerland.
However, the allocated ﬁnances of the ITI are administered and further
allocated in independence of the industrial partner.
Generally, 51 % of the compensation are distributed by the Research Committee to the various grant applicants, while the remainder is used for
educational projects and to run the ITI Center in Basel BS, Switzerland.
Since 1988, approximately 230 research projects have been ﬁnancially supported by ITI Research Committee to the sum of about CHF 27 million.
Hence, by its own estimates, ITI is the largest non-governmental organisation to assign research grants in implant dentistry and its related ﬁelds.
Owing to the peer-review process the grant applications are allocatedsolely on the basis of scientiﬁc merit. Therefore, all researchers aroundthe world, both ITI Fellows as well as non-ITI researchers are free to submit applications.

page // 6

page // 7

// MATERIALS & METHODS& slairetaM
sdohteM

Materials &Methods
THE GRANTING MECHANISM
The application for a research grant from the ITI Foundation for the Promotion of Implantology is made by the senior author /researcher on apre-printed application form. The completed forms must be submitted
to the ITI Research Committee before the 27th of February or the 31stof August of each year for review by the Research Committee of the ITIFoundation. The Research Committee is composed of eleven members
who all review each application and express their judgement individuallyand in advance of convening with the peers. The application is either
rejected, returned for revision or the grant is approved, all at the discretion of the entire Research Committee. The Committee convenes twicea year.
There are four different grant programs available. These are:1 | Small Grant Application (SGA):

These grants are primarily intended for those research proposals
submitted by young investigators who have been working withinestablished groups, but who wish to expand their scope and level ofpage // 9

// MATERIALS & METHODS

responsibility. This grant is also intended for newer investigators who

documenting the projects served must be provided. Applications

want to establish a track record in implant dentistry. This may be byhave to be submitted in a letter format that provides evidence for the

pursuing their own research interests or by building up their own

existing expertise and the rationale as to why an SLS grant applica-

research group. The grants should not exceed the sum of CHF 50’000.

tion should be undertaken instead of a different funding category.

Annual reports, either intermediate or ﬁnal, must be provided. The
goal of the project is directed towards publication in an international

These grant programs have been used since 1993. For clarity and forpeer-reviewed journal.

the present analysis the grant applications submitted before 1993 wereretrospectively classiﬁed.

2 | Research Proposal for Clinical or Laboratory Research (RCL):

These grants will be awarded to researchers or research groups who

With the application the main applicant signed a statement obliging thehave established a reputation of credibility and thoroughness in theapplicants to three things:

ﬁeld as demonstrated by a continuous publication record in peer-

1 | to submit a ﬁnal report to the ITI Foundation at the end of thereviewed journals. The grant amount may exceed CHF 100’000, but

study;

should not be higher than CHF 200’000. Funding from other sources

2 | to include a footnote in all abstracts or publications stating that “this(universities, foundations or third parties) must be disclosed. Results

project was supported by a grant from the ITI Foundation for thefrom such granted project proposals are to be published in inter-

Promotion of Oral Implantology, Switzerland”;

nationally recognised peer-reviewed journals. Annual reports, either
intermediate or ﬁnal, have to be provided.

3 | that all funded equipment be registered at the ITI Foundation andthat this equipment becomes the property of the institute where thestudy took place and be clearly marked with a special sticker supplied

3 | Research Program Projects (RPP):

by the ITI Foundation.

These grant proposals may contain several single research projects(RCL’s) or several single aspects within a major line of research, andWith these statements it was possible to track the publications to theare usually granted for several (3 - 5) years. RPP’s are only awarded

funding source (ITI).

to well-established research teams of international repute. A single

The decision by the ITI Research Committee is communicated after theannual sum of CHF 200’000 should not be exceeded. Annual reports

meeting in June, respectively in December. As a matter of policy, the Re-

and a ﬁnal report must be provided.

search Committee does not provide any reasons for not awarding a grant
to any one particular project. The Committee deems some applications

4 | Single Laboratory Support (SLS):interesting but the present form does not fulﬁl the criteria of the Com-

These grants are allocated to established laboratories with expertisemittee. Such projects are returned to applicants with suggested modiﬁca-

in a ﬁeld of interest for the ITI Foundation. The support should nottions. The revised projects are then resubmitted and newly appraised.

exceed the salary of one laboratory technician. Annual short reports

Revised projects are not automatically supported by the Foundation.

page // 10

page // 11

// MATERIALS & METHODSTHE SEARCH STRATEGYSTRUCTURE OF THE ANALYSISThe analysis was based on the information available from each applica-

The information relevant for this analysis was divided into sections.

tion’s form, progress reports and the ﬁnal reports stored at the ITI Center

The ﬁrst section, Grant Application, mentioned the grant applicationin Basle, Switzerland. Furthermore, publications were retrieved electroni-

number, the title of the project, the application year and the principal

cally from PUBMED. Also the tables of content of Clinical Oral Implants

and secondary country of origin of the application. The principle country

Research and International Journal of Oral and Maxillofacial Im-

was always given as that country where the senior applicant was based atplants were hand searched for the years 1990 - 2006 for possible papers

the time of the application. The secondary country was given as the coun-with the titles revealed by the application forms of the grant proposals.

try where all the co-applicants were based, when it did not correspond to
the principle country of the senior applicant.

An attempt was made to objectively analyse the data with respect torejection or approval, as well as the country of origin of the applications,

As the last piece of information in the Grant Application section, the re-the universities or research groups involved, the senior and co-applicants,

search group was noted. Here the research group of the senior applicant

the grant program applied for and the study design of the project.

was given. The groups were ﬁrst arranged together in the same countries

With the studies supported by the Research Committee a search for aand then the same regions or cities and then subdivided into all the

publication in peer-reviewed journals was performed. The impact factor

different universities or institutions. The applicants from the same de-and the number of citations of the published study were determined.

partments in the same universities or institutions were grouped together.
In this way a list was compiled, where each group received a code. This

Most of the data was stored in a FileMaker Pro 7 (FileMaker, Inc., Santa

code lists the country e.g. CH for Switzerland, the abbreviation for the

Clara, California, USA) database designed for the electronic storage of theuniversity, e.g. UBE for the University of Berne and the number indicatedrelevant information for the ITI Foundation. This database was augment-a Department. The number given was arbitrarily. When one listed grouped by the inclusion of further information that had not been entered incollaborated with another group, this was noted.

the original database.
The second section dealt with the Senior Applicant. Here, the name,For the information that was not in the original database, all the applica-

nationality, academic title, highest qualiﬁcation and age of the principle

tions were individually analysed in numerical order and the information

applicant were noted. Moreover, the ITI Fellowship or Membership was

fed into and stored on a laptop computer (iBook, Apple Computer, Inc.,

noted. The address and position of the senior applicant was recorded.

USA). The completed database was used for the statistical evaluation of
the entered data.

In the third section, the, Co-Applicant with the name, nationality, academic title, highest qualiﬁcation as well as ITI Fellowship or Membershipwas entered. Any other co-applicants were listed in the fourth section.

page // 12

page // 13

// MATERIALS & METHODS

1 | Implant surface and implant tissue interface research
2 | Osseointegration, wound healing, metabolism and systemic inﬂuence
3 | Surgery
a | Primary Surgery: Implant insertionb | Secondary Surgery: Re-entryc | Surgery: GBR/Augmentationd | Periodontal Regeneration (EMD)
4 | Prosthetics, including occlusion and aesthetics
5 | Pathology
a | Pathology: Diagnosisb | Pathology: Mucostitis
c | Pathology: Periimplantitis
6 | Treatment of
a | Treatment of Complications: Mucostitis
Complications
b | Treatment of Complications: Periimplantitis
c | Treatment of Complications: Prosthetics
7 | Risk factors for dental implants
8 | Implant therapy treatment planning
9 | Predictability of implant restorations
10 | Implant orthodontics

Table 1 | Classiﬁcation of studies

and clinical trials it was stated how many subjects and /or implants were
to be used. Therefore, under the heading “n”, two numbers were listed if
applicable. The ﬁrst number represents the number of subjects and thesecond number was the amount of implants to be placed in the proposed
project. At the end of this section the prospective duration of the study
was noted.
Study Topics, being the eighth section, contains the classiﬁcation of thestudies submitted — TABLE 1 .
The ninth section is titled Grant Status. Here, it was mentioned if the
grant was ﬁnanced or rejected or sent back for revision. Some grants sent
back for revision were resubmitted as a new grant. In this section it was

Grant Program was the title of the ﬁfth section where the grant cat-mentioned if the project was terminated. The project was regarded as

egory and type of project was classiﬁed. The grant categories are thestill running when the prospective end date was not yet reached, as offour programs mentioned above, namely: Small Grant Application (SGA);

the end of 2006. At the end of this section, the dates of the prospective

Research Proposal for Clinical or Laboratory Research (RCL); Researchstart and prospective end of the study were noted. These dates were used

Program Projects (RPP) or Single Laboratory Support (SLS). The project

to calculate the prospective duration of the project and determine if thetype was either classiﬁed as new, continued or revised.

project was terminated or was still running.

In the sixth section, Grant Sum, the amount was expressed in Swiss

In the following section, Reports, the status of the reports were presented.

Francs (CHF).

The date of each report ﬁled was given. The status of the intermediate
and ﬁnal reports was classiﬁed numerically as follows:

The Study Design was analysed in the seventh section. Here, the project

0: no report was necessary

was classiﬁed either as an in vitro, animal or clinical study. Clinical stud-

1: the report was due andies were subclassiﬁed into one of ﬁve subclasses, namely a Randomised

2: a report was ﬁled.

Controlled Clinical Trial (RCT), a Non-Randomised Clinical Trial (Non-Publications that acknowledged the ﬁnancial support of the ITI Founda-

RCT), a Prospective Cohort Study (PCS), a Retrospective Cohort Study

tion or publications that obviously were ﬁnanced by the Foundation were

(RCS) or a Case Series and/or Case Report (CS). Also the size of the study

listed in the databank. The fact that no acknowledgement was made was(n) was evaluated. In the in vitro studies it was difﬁcult to discern thealso noted.

size of the material from the project proposal. In most animal studies

page // 14

page // 15

// MATERIALS & METHODS

Besides publications it may be possible that ﬁnanced study results were

for the present analysis, as well as how many approved projects were

presented at an IADR or another international or national academic

still running at of the end of 2006 and how many had been fully or parti-

meeting, meaning that an abstract of the work existed. This was listed

ally ﬁnanced.

in the section Abstract Available. The year of the abstract publication
was noted.

Another area of interest to was the ﬁnancial aspect of the supported
grants. For each grant, the average size of the approved grant sum, theFinally, the section Publication listed papers that were published pre-agreed amount, the total amount, the average size of the additional sum

senting the results of the ﬁnanced studies. The publication was listed as

granted and the total paid in the end was evaluated.

follows: senior author, all co-authors, the title of the paper, the journal inwhich it was published as well as the year, the impact factor of the journalin the year of publication and the number of times the publication had
been cited up until the end of 2006.
Occasionally, more than one publication was published from a single
grant. If this was the case, it is duly mentioned. The subsequent publications were listed in the same way as the ﬁrst publication. When morethan ﬁve publications were available, the further publications were listed together.
With the raw data entered as described the following analyses were undertaken. From all grant applications the number of approved studies
was of interest. The fate of the projects sent for revision was researched.
All grant applications were also grouped according to year of submission
and analysed. The data was divided by principle country. Further, the data
was divided into the different research groups and analysed as to how
many applications stemmed from each group and how many of thesewere rejected or supported. Lists of all universities and private institutions grouped by countries, as well as all departments, grouped by ﬁelds,
were compiled.
The grant programs were to be evaluated by the type of projects, thestudy designs, the study topics according to ITI classiﬁcation and thatpage // 16

As to the reports: the applicants had to sign an agreement where they promised to send
regular progress reports and at the end a ﬁnal report. It interested us if these reports were dulyﬁled. Even if there was no reports ﬁled we wanted to know if publications of the results of the
supported studies were printed, and where, or if an Abstract is available. In which journals did
the publications appear? What was the impact factor of each journal at the time of publicationof the article? How many times was the publication cited? The publications that were notsent to the Foundation were searched for online from the Pubmed resource from the National
Library of Medicine in the USA. The search conﬁned itself to the applicant or co-applicantsfrom each supported study. The abstracts that were not enclosed in the reports sent to theFoundation were searched for manually from the meetings of the International Association of
Dental Research (IADR) in the Journal of Dental Research, the Academy of Osseointegration(AO) in the International Journal of Oral and Maxillofacial Implantology and the European
Association of Osseointegration (EAO) in the Journal of Clinical Oral Implant Research. The
impact factors for each journal for each year was searched for in the Journal Citation Reports,
Thomson Scientiﬁc, Philadelphia, PA, USA. This information was online from 1997 onwards.
Before 1997 the impact factors for the journals are not online and had to be searched for
manually at the Medical Library of the University of Berne, USB. If a journal was not listed in
the Journal Citation Reports then the journal was give an impact factor of zero. The numberof citations an article had was searched for online, also using the Journal Citation Reports,
Thomson Scientiﬁc, Philadelphia, PA, USA.

page // 17

// RESULTS

stluseR

Results
NUMBER OF GRANT APPLICATIONS AND FUNDING BY
THE ITI FOUNDATION
Up to the closing date, 499 grant applications were submitted from 1988
until August 2006. Of these, 232 applications were funded by the ITIFoundation (Fig. 1). This, in turn, means that 46.5 % of all applications
submitted were funded. Twenty-two projects (4.4 %) were returned forrevision. Of these 22 applications, 13 were supported at a later date but
all resubmitted as new projects. One application was sent back for revision twice and ﬁnally funded (# 158, # 164) — SEE FIGURE 1 .
Only 3 grant applications were approved in 1988. In 2003 and 2006, mostgrant applications (n = 62) were received up to present and 26 and 29
were funded respectively. The detailed description of grants submitted
for the entire period is presented in Table 2 and in Fig. 2 — SEE TABLE 1 |FIGURE 2 . During this observation period of 18 years, the rejection rate

ranged from 0 % to 70.6 % for any given year.

page // 19

// RESULTS

Applications were returned for revision in the years 1999 through 2006

n300

and ranged from 3.33 % to 19.1 % of all applications received in eachparticular year — SEE TABLE 1 | FIGURE 2 .

250
49,1%
46,5%

200

GEOGRAPHICAL DISTRIBUTION OF GRANT APPLICATIONS

150

In total, 31 nations submitted applications.
Most grant applications (n = 99) originated from the USA. Out of these,
54 grants (54.5 %) were funded — SEE TABLE 3 .

100

Switzerland submitted the second most applications (n = 98) of which50

070 (71.4 %) were funded, 27 rejected, and one was returned for revision.
4,4%

ﬁnancedprojects

rejectedprojects

Switzerland was the most successful country in terms of grant allocation.

grant
statusprojects sent
for revision

Germany submitted the third most applications (n = 91) and yielded a
success rate of 36.2 %.

Figure 1 | Grant application success rate

245

Table 2 | Grant applications during the observation period (1988-2006)

page // 20

25
20
15
10
5

2006

2005

2004

2003

0
2002

100.0

30

2001

499

22

Financed n
Rejected n
Revision n

35

2000

0.6
1.8
2.2
2.4
3.6
1.0
4.0
3.8
3.4
4.2
3.8
4.2
6.0
3.8
10.0
12.4
8.0
12.2
12.4

1999

3
9
11
12
18
5
20
19
17
21
19
21
30
19
50
62
40
61
62

1998

0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
19.1
3.3
15.8
6.0
6.5
5.0
6.6
1.6

n

1997

232

0
0
0
0
0
0
0
0
0
0
0
4
1
3
3
4
2
4
1

40

1996

Total

0.0
11.1
45.5
50.0
66.7
20.0
35.0
63.2
70.6
66.7
63.2
38.1
26.7
21.1
50.0
51.6
47.5
57.4
51.6

Total
%

1995

0
1
5
6
12
1
7
12
12
14
12
8
8
4
25
32
19
35
32

n

1994

100.0
88.9
54.6
50.0
33.3
80.0
65.0
36.8
29.4
33.3
36.8
42.9
70.0
63.2
44.0
41.9
47.5
36.1
46.8

Revision
%

1993

3
8
6
6
6
4
13
7
5
7
7
9
21
12
22
26
19
22
29

n

1992

1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006

Rejected
%

1991

n

1990

Financed
%

1989

n

1988

Year

year

Figure 2 | Grant application success rates per year

page // 21

// RESULTS

Along with the above-mentioned countries, Denmark, Italy, Japan, theEight further nations (Colombia, Egypt, Greece, India, Jordan, Portugal,

Netherlands and the United Kingdom all submitted more than ten

Romania, Serbia-Montenegro) sent only one application; all except the

grant applications. Australia, Austria, Belgium, Brazil, Canada, Finland,

application from Romania were rejected.

France, Israel, Lebanon, New Zealand, P. R. of China, Singapore, Spain,
Sweden and Turkey all submitted between two to ten grant applications

Besides the principle country of origin other countries may have been

since 1988.

involved in the projects. Almost one third (27.7 %) of all applications had
a second country involved. Mostly only one other country collaborated in

Principle
Countries

Financed

RejectedTotal

a single project. Eighteen projects had more than one secondary coun-

98
99
91
29
26
27
13
13
9
10
10
6
4
9
6
9
6
9
4
3
2
5
3
1
1
1
1

%
19.2
19.8
18.2
5.8
5.8
5.4
2.6
2.6
1.8
2.0
2.0
1.2
1.0
1.8
1.2
1.8
1.2
1.8
1.0
0.6
0.4
1.0
0.6
0.2
0.2
0.2
0.2

try collaborating in a particular project. Of all the projects originating

1
1
1
1

0.2
0.2
0.2
0.2

499

100.0

Revision

n=31

n

%

n

%

n

%

n

Switzerland
USA
Germany
Italy
UK
Denmark
Netherlands
Japan
TurkeyFranceFinland
Belgium
Spain
BrazilSwedenAustria
CanadaNew ZealandAustralia
Singapore
LebanonP. R. China
IsraelPortugal
Romania
Egypt
JordanSerbiaMontenegro
Colombia
India
Greece

70
54
33
10
12
16
3
3
2
2
3
3
0
2
3
5
3
4
2
0
0
1
0
0
1
0
0

71.4
54.5
36.2
34.5
46.2
59.3
23.1
23.1
22.2
20.0
30.0
50.0
0.0
32.2
50.0
55.6
50.0
44.4
50.0
0.0
0.0
20.0
0.0
0.0
100.0
0.0
0.0

27
43
55
17
12
8
9
7
7
8
7
1
4
7
2
4
3
5
2
3
2
3
2
1
0
1
1

27.6
43.4
60.4
58.6
46.2
29.6
69.2
53.8
77.8
80.0
70.0
16.7
100.0
77.8
33.3
44.4
50.0
55.6
50.0
100.0
100.0
60.0
66.7
100.0
0.0
100.0
100.0

1
2
3
2
2
3
1
3
0
0
0
2
0
0
1
0
0
0
0
0
0
1
1
0
0
0
0

1.0
2.0
3.3
6.9
7.7
11.1
7.7
23.1
0.0
0.0
0.0
33.7
0.0
0.0
16.7
0.0
0.0
0.0
0.0
0.0
0.0
20.0
33.3
0.0
0.0
0.0
0.0

0
0
0
0

0.0
0.0
0.0
0.0

1
1
1
1

100.0
100.0
100.0
100.0

0
0
0
0

0.0
0.0
0.0
0.0

Total

232

245

22

Table 3 | Geographic distributions of grant applications (1988-2006)

outside of Switzerland (n = 401), forty-six (11.5 %) collaborated with an
institution within Switzerland. This, in turn, means that Switzerland was
the country most often collaborating.
ACCEPTANCE AND REJECTION RATES FOR VARIOUS
RESEARCH TEAMS
The analysis of the success or failure rates of the various research teams
revealed large differences. In total, 223 research teams submitted applications. Only one application was submitted by 127 (57 %) of these teams.
Out of all research teams, 125 teams (56 %) never received any funding
leaving 98 teams with occasional or consistent approvals of their proposed
projects. Of those research teams having submitted multiple applications,
7 teams were always successful. These included:_

Federal Institute of Technology | Laboratory of Ultrarapid Spectroscopy (LSU), Lausanne, Switzerland (n = 3);_

Medical University of Vienna | Central Research Laboratory, Vienna,
Austria (n = 2);_

Technical University of Dresden | Department of Orthodontics, Dresden, Germany (n = 2);

page // 22

page // 23

// RESULTS

_
_
_
_

University of Berne | Department of Periodontology & Fixed Prostho-hodontics, Berne Switzerland (n = 10); University College of London,

dontics, Berne, Switzerland (n = 10);Department of Periodotology, London, UK (n = 9); University of Erlan-

University of Gothenburg, Department of Periodontology, Gothen-gen-Nuremberg, Department of Oral and Maxillofacial Surgery, Erlangen,burg, Sweden (n = 3);

Germany (n = 8); University of Freiburg, Department of Oral and Maxil-

University of Lausanne, Department of Experimental Physics, Lau-lofacial Surgery, Freiburg, Germany (n = 8) and the University of Geneva,

sanne, Switzerland (n = 2);

Department of Fixed Prosthodontics, Geneva, Switzerland (n = 9). The

University of North Carolina, Department of Periodontics, Chapel

success rates for these institutions were 62.5 %, 100 %, 77.8 %, 37.5 %,Hill, NC USA (n = 2).

50 % and 88.9 %, respectively.

Of those research teams having submitted a single application, 34 teams
were supported for this single project.

ACCEPTANCE AND REJECTION RATES FOR VARIOUS

This, in turn, means that 41 research teams out of 98 (42 %) with funding

RESEARCHERS

were 100 % successful.
Four or more applications for a grant were submitted to the ITI FoundaThe most applications were received from the research team at the Uni-tion by 18 applicants — SEE FIGURE 4 . From the University of Erlangen-versity of Berne, Department for Oral Surgery, Berne, Switzerland with16

Nuremberg, Department of Prosthodontics, Erlangen, Germany (S. M.

applications or 3.2 % of all applications submitted. Thirteen (81.3 %) of

Heckmann) sent the most applications to the Foundation. From 11 pro-these were supported by the ITI Foundation.

jects, ﬁve were supported. From the University of Copenhagen, Depart-The second most applications were received from the University of Co-

ment of Oral and Maxillofacial Surgery, Copenhagen, Denmark (S. Schou)penhagen, Department of Oral and Maxillofacial Surgery (n = 14) with a

8 applications were received, and 4 were supported. From the University

success rate of 64.3 %.

of Berne, Department of Oral Surgery and Stomatology, Berne, Switzer-

The third largest amount of grant applications were received out of Ger-

land (D. Buser) 7 applications were received and all were supported. From

many and Switzerland (n = 12) from the University of Erlangen-Nurem-

the University of Berne, Department of Periodontology and Fixed Prost-

berg Department of Prosthodontics, Erlangen with a success rate of 50

hodontics as well the ITI Research Institute for Dental and Skeletal Biol-% and from the University of Berne, ITI Research Institute for Dental andogy, Berne, Switzerland 6 applications from both institutes were received.

Skeletal Biology, Berne with a success rate of 66.7 %, respectively.

Four of the 18 applicants submitted 5 applications and 9 applicants sent

The fourth most applications were received from the University of Texas

4 applications to the ITI Foundation. Their success rates are indicated in

Health Sciences Centre at San Antonio, Department of Periodontics, TX,

Table 4 — SEE TABLE 4 .

USA (n = 11) with 90.9 % success rate.
Between 10 and 8 applications were received from the Harvard Schoolof Dental Medicine, Department of Restorative Dentistry, USA (n = 8);
the University of Berne, Department of Periodontology and Fixed Prost-

page // 24

page // 25

// RESULTS

NameFinancednRejectedn

Revision
n

Total
n

Bernard, Jean-Pierre
Boyan, Barbara D.
Buser, Daniel
Cochran, David L.
Descouts, Pierre A.R.
Heckmann, Siegfried M.
Hunziker, Ernst Bruno
Jensen, Simon
Karring, Thorkild
Kelly, John R.
Lang, Niklaus P.
Liu, Yuelian
Matarasso, Sergio
Schou, Soren
Simpson, James P.
Textor, Marcus
Vogel, Giorgio
Weber, Hans-Peter

3
4
7
4
4
5
5
2
3
2
6
2
2
4
1
3
1
3

2
1
0
0
1
6
1
1
1
2
0
2
2
4
2
1
2
2

0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
1
0

5
5
7
4
5
11
6
4
4
4
6
4
4
8
4
4
4
5

Total

58

28

3

89

Principle
Countries
n=31

Financed

Rejected

Revision

n

n

n

n

40
36
49
17
11
15
12
7
4
6
4
7
2
4
4
3
2
4
5
2
1
1
1
0
0
0
1
1
1
0
0
0
0
0
0
0
0
12

61
36
13
17
14
8
12
9
11
5
10
4
9
2
3
4
6
3
1
3
3
1
1
1
2
2
0
0
0
1
1
1
1
1
1
1
1
17

3
1
0
2
1
2
0
3
1
3
0
1
0
2
1
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0

104
73
62
36
26
25
24
19
16
14
14
12
11
8
8
8
8
7
6
5
4
2
2
2
2
2
1
1
1
1
1
1
1
1
1
1
1
19

plicants were also the most successful in receiving grants (50.4 %) for

Germany
USA
Switzerland
Italy
UK
Denmark
FranceJapan
Netherlands
GreeceFinland
CanadaTurkeyBelgium
SwedenP.R. China
BrazilNew ZealandAustria
Australia
Spain
Columbia
IrelandIsraelEgypt
LebanonIndonesia
MexikoPakistan
Croatia
IcelandIndia
JordanPortugal
SerbiaSingapore
Zimbabwe
Dual Citizens

their proposed projects. The latter group was less successful (42.4 %)Table 5 | Researchers’ nationalities and granting success (ranked)

Table 4 | Applicants with 4 or more submissions including granting success. The
nationalities of the various researchers were analysed in Table 5. There are 37 different nationalities listed. Most applicants were Germans (n = 104). Seventy-three US
citizens submitted applications, and 62 applicants were Swiss. Nineteen applicants
were dual citizens. These dual citizens are also included in the single national list.

QUALIFICATIONS OF THE APPLICANTSIn Table 6 the highest qualiﬁcations the researchers is analyzed — SEE
TABLE 6 . A slim majority of the applicants (n = 226) have degrees inmedicine or dentistry as well as a PhD, and 210 out of a total of 499
researchers have either a medical or a dental qualiﬁcation. The ﬁrst ap-

Total

than the ﬁrst group in receiving grants. Only one applicant had a Masterof Science (MS) degree without a medical or dental degree as her highest

The average age of the applicants was 44 years old. The youngest appli-

education. Four applicants had other qualiﬁcations than one of the 3

cant from the University of Sao Paulo was 23 years of age at the time of

mentioned: one was an engineer and the remaining 3 are dental labora-

submission of his project. The oldest researcher was from the University

tory technicians.

of Berne and was 74 years old at the time of submission.

page // 26

page // 27

// RESULTS

ITI MEMBERSHIP OF THE APPLICANTS— SEE TABLE 10 . Some of these individuals are also among the persons

that submitted four or more applications as principle investigators.
Among the applicants that submitted grant applications about a third are
ITI Fellows (n = 146) — SEE TABLE 7 . More than double the applicants

In 16 projects, Buser and Lang were co-applicants, and the ITI Foundation

were not members of ITI (n = 353). The non-members had more researchsupported 10 and 12 of these, respectively. Belser, Cochran, Hjørting-projects ﬁnanced than the Fellows. However, the ITI Fellows were more

Hansen and Weber were co-applicants in 7, 11, 12 and 7 submitted pro-successful and received in 58.9 % of their submitted applications an ap-

jects, respectively. Of the 448 co-applicants 144 (32.1 %) were ITI Fellows

proval for funding from the ITI Foundation compared to 41.4% of all

and 296 (66.1 %) were non-members. Of these former submitted pro-

grant applications being funded for the non-members.

jects, 89 (61.8 %) were supported. Among non-member projects, only 118(39.9 %) were supported by the ITI Foundation and 169 were rejected

INSTITUTIONS APPLYING FOR FUNDING(57.1 %). Three percent of the applications were sent for revision.

One hundred and thirty-nine universities from 30 countries submitted
grant applications to the ITI Foundation in the period of 1988-2006— SEE TABLE 8 . Among the universities, 79 different departments wererepresented — SEE TABLE 9 .
Forty-two departments in schools of dental medicine constituted thelargest contingent of all applicants. Medical school departments bothclinical and basic research also submitted applications from 23 different
departments. Eleven institutions in basic sciences or technical scienceswere represented. Only two private institutions were named. Furthermore, 7 private practices submitted 8 applications. Four of these were
supported (Data not shown).

Qualiﬁcation

FinancednRejectedn

Revision
n

Total
n

MD/DDS & PhD
PhD
MD/DDS
MS
BSc
Other

114
28
89
0
0
1

96
29
116
1
0
3

16
1
5
0
0
0

226
58
210
1
0
4

Total

232

245

22

499

Table 6 | Highest qualiﬁcations of the researchers

COAPPLICANTS
ITI

Only 51 grant applications (10.2 %) were submitted by single authors.
The remainder had between 1 and 11 co-authors. The average age of the
Co-applicants from the remaining 448 (89.8 %) applications was 48 years.
Thirteen individuals were co-applicants in four or more applications

page // 28

Membership

Fellow
Non-member
Total

Financed
n
%*
86
146
232

58.9
41.4

Rejected
n
%*
50
195
245

34.2
55.2

Revision
n
%*
10
12
22

6.9
3.4

n

Total
%**

146
353
499

29.3
70.7
100.0

* percentage of total | ** Percentage of all grant applications (n = 499)

Table 7 | Grant success rates for ITI Fellows and Non-members

page // 29

// RESULTS

Switzerland
University of Basel
University of Berne
Cantonal Hospital
ETH Lausanne
ETH Zurich
University of Geneva
Institute Straumann AG
University of Lausanne
University of Zurich
USA
University of Boston
University of California,
Los Angeles (UCLA)
Columbia University
University of Connecticut Health Centre
Cleveland Clinic Foundation
University of Florida
Georgia Institute of Technology
Harvard
Hospital Centre at Orange
University of Indiana
University of Iowa
Loma Linda University
University of Miami
New York University
University of North Carolina at Chapel
Hill
Ohio State University
Oregon Health & Science University
University of Pennsylvania
University of Rochester
University of Southern California
University of Tennessee
Texas A&M University System HSC
University of Texas at Houston
University of Texas at San Antonio
University of Texas South-western
Medical Centre
Virginia Commonwealth University(VCU)
University of Washington
Germany
University of Bonn
University of Düsseldorf
University of Erlangen-Nuremberg
University of Frankfurt
University of Freiburg
University of Giessen
University of Göttingen
Hannover Medical School
University of Heidelberg
Humboldt University Berlin
Katharinen Hospital
University of Kiel
Knappschafts Hospital Bochum
Langendreer
University of Mainz
University of Marburg
University of Munich
University of Münster
University of Regensburg
RWTH Aachen

Technical University of Dresden
University of Tübingen
University of Ulm
University of Wiesbaden
University of Witten/Herdecke
Italy
Ariminum Research & Dental Education
Centre (ARDEC)
University of ChietiChildren’s Hospital Vittore Buzzi, Milan
G. Eastman Hospital, Rome
Hospital Castelfranco
University of Milan
University of Naples
National Health Institute
University of Padova
Polytechnic University of the Marshes
Second University of Naples
Vergata University
UK
University of Aberdeen
Barts & The London, Queen Mary’s
School of Medicine and Dentistry
University of Bristol
Edinburgh Postgraduate Dental
Institute
University College London
University of Glasgow
Image Diagnostic Technology Ltd.
University of Manchester
University of Newcastle
University of Wales
Denmark
University of Aalborg
University of Aarhus
University of Copenhagen
Netherlands
ACTA Free University
de Weezenlanden Hospital
University Medical Centre Groningen
University of Nijmegen
St. Elisabeth Hospital
Japan
Centre of Implant Dentistry Japan
University of Kagoshima
Kumamoto Implant Centre
University of Kyoto
University of Tsurumi
TurkeyUniversity of Ankara
Gazi University
University of Hacettepe
University of Istanbul
University of Marmara
FranceLouis Pasteur University
University of Nantes
University of Paris 7
REP, Toulouse
Finland
University of Helsinki
University of Kuopio
University of Oulu

University of Turku
Belgium
University of Brussels
Catholic University Leuven
University Hospital P8, Gent
University of Liège
Spain
University of Cantabria
University Complutense
University of Santiago de Compostela
BrazilFederal University of Rio de Janeiro
Federal University of Santa Catarina
University of São Paulo
SwedenUniversity of Gothenburg
Austria
General Hospital of Vienna
Medical University Of Innsbruck
Medical University of Vienna
CanadaUniversity of British Columbia
McGill University
New Zealand
University of Otago
Australia
University of Adelaide
University of Queensland
University of Western Australia
Singapore
Singapore General Hospital
National Dental Centre, Singapore
LebanonAmerican University
Lebanese University
China
Quindu Stomatological College
University of Zhejiang
IsraelGeriatric Dental Clinic, Jerusalem
University of Tel-Aviv
Portugal
University of Lisbon
Egypt
University of Mansoura
JordanJordan University of Science &Technology
Serbia-Montenegro
Military Medical Academy, Belgrade
Columbia
Instituto de Ciencias de la Salud CES
India
Royal Dental College, Kerala
GreeceUniversity of Athens
Private PracticePrivate Practicen = 139

Table 8 | Geographic distribution of applicant universities and institutions

page // 30

Dental Schools
Adult Dental Care
Centre for Rural and Remote Oral
HealthCentral Research Laboratory
Colgate Australian Clinical Dental
Research Centre
Dept. of Craniofacial Sciences &Therapeutics
Dept. of Dental Diagnostic Science
Dept. of Dental Hygiene
Dept. of Dental Materials
Dental Research InstituteDept. of Fixed Prosthodontics andPeriodontology
Geriatric Dental Clinic, Jerusalem
Dept. Of Implant Dentistry
Institute for Oral Transplantation and
Implantation
New Jersey Institute of Implant
Dentistry
Dept. of Odontostomatology
Dept. Of Operative Dentistry andPeriodontology
Dept. of Oral Biochemistry
Dept. of Oral Biological & Medical
Sciences
Dept. of Oral Biology
Dept. of Oral Cell Biology
Dept. of Oral & Dental Science
Dept. of Oral Diagnosis
Dept. of Oral Function
Oral Implant Centre
Oral Implant Clinic
Dept. of Oral & Maxillofacial Surgery
Dept. of Oral Medicine & Pathology
Dept. of Oral Rehabilitation
Dept. of Oral Sciences
Dept. of Oral Surgery
Dept. of Orthodontics
Dept. of Paedodontics
Dept. of Periodontology
Dept. of Prosthodontics
REP, Toulouse
Dept. of removable Prosthodontics
Dept. of Research & Graduate Studies
Dept. of Restorative Dentistry
SCTD, Strasbourg
Soejima Dental Clinic
Unit of Oral & Max. Implantology
The Weintraub Centre for Reconstructive Biotechnology
Medical Schools
Dept. of Anatomy
Dept. of Bio-Medical Physics &Bio-Engineering
Dept. of Biomaterials
Dept. Biomedical Engineering
Dept. of Biomedical Engineering andImaging
Dept. of Clinical Research
Division of Biomedical Swine Research
Dept. of Endocrine Pharmacology

Group of Mechanics of Biological
Materials
Institute for Surgical Research
Dept. of Internal Medicine
ITI Research Institute for Dental andSkeletal Biology
Lab. for Research of Calciﬁed Tissues
and Biomaterials
M.E. Müller Institute for Biomechanics
Matrix Biology & Tissue Repair
Research Unit
Dept. of Microbiology
Dept. of Morphology, Stomatology &Physiology
Dept. of Neonatology
Dept. of Orthopaedics
Osteoarticular Research Group/Instituteof Pathology
Dept. of Pathology
Dept. of Plastic Surgery
Research Centre of Materials with
Biological Interest
Science Departments
Automatic Control Laboratory
Bio Interface Group, Laboratory for
Surface Science and Technology
Dept. of Biochemistry
Dept. of Chemistry
GAP-Biomedical
Dept. of Experimental Physics
Institute of Theoretical Physics
Laboratoire de Spectroscopie
Ultrarapide (LSU), Institut de Science etIngenerie Chimiques (ISIC)
Dept. of Mathematics, Statistics andComputation
Dept. of Physics
Dept. of Theoretical Physics
Private Institutions
Image Diagnostic Technology Ltd.
Institute Straumann AG
Private Practicen = 79

Table 9 | List of applicant departments and institutions

page // 31

// RESULTS

NameFinancednRejectedn

Revision
n

Total
n

Belser, Urs C.
Buser, Daniel A.
Berglundh, Tord O.
Cochran, David L.
Donos, Nikolaos
Hjørting-Hansen, Erik
Hunziker, Ernst B.
Karring, Thorkild
Lang, Niklaus P.
Natali, Arturo
Schenk, Robert K.
Schlegel, Karl A.
Weber, Hans-Peter

6
10
4
10
4
7
2
1
12
1
4
1
5

1
5
0
1
0
5
3
2
3
2
2
3
2

0
1
1
0
1
0
0
1
1
1
0
0
0

7
16
5
11
5
12
5
4
16
4
6
4
7

Total

61

28

6

95

Financed
n
%*

SGA
RCL
RPP
SLS

96
107
22
7

Total

232

43.2
49.3
44.0
70.0

Rejected
%*
n
122
94
26
3

55.0
43.3
52.0
30.0

Revision
%*
n

n

Total
%**

1.8
7.4
4.0
0.0

222
217
50
10

44.5
43.5
10.0
2.0

499

100.0

4
16
2
0
22

245

All the applications that were submitted to the ITI Foundation were categorized into four different grant programmes, namely SGA, RCL, RPP
and SLS. All the projects submitted before 1990 were retrospectively
categorized for analysis. Most grant applications were of the SGA type —SEE TABLE 11 .

From 222 projects of the SGA category, 96 (43.2 %) were supported, 122(55%) were rejected and 4 (1.8 %) were sent for revision.
In the RCL category 217 projects were submitted. Of these, 107 (49.3 %)were supported, 94 (43.3 %) were rejected and 16 (7.4 %) returned

Table 10 | Co-applicants with 4 or more submissions
Name

RESEARCH PROJECTS AND GRANT PROGRAMS* percentage of total | ** Percentage of all grant applications (n = 499)

for revision.
In the RPP category, 50 projects were submitted and 22 (44 %) of thesewere supported, while 26 (52 %) were rejected and 2 (4 %) returned for revision. The last category (single laboratory support SLS) category yielded
10 projects with 7 (70 %) being supported and 3 (30%) rejected.
The majority (n = 456) of the submitted projects were new research projects, 24 were continued and 19 were revised projects — SEE TABLE 12 .

Table 11 | Categorization of submitted grants according to the nature of the
proposalmembers

Less than half (44.3 %) of the new projects were ﬁnanced by the ITIFoundation (n = 202), 234 (51.3 %) were rejected and 20 (4.4 %) were sent

Name

n

Total
%**

456
24
19

91.4
4.8
3.8

ported, six (25 %) were rejected and one (4.2 %) was returned for revision.

499

100.0

and ﬁve (26.3 %) were rejected, while one (5.3 %) project was returned* percentage of total | ** Percentage of all grant applications (n = 499)

for a second revision. Therefore, the continued projects had a fractionallyFinancedn%*

NewContinued
Revised

202
17
13

Total

232

44.3
70.8
68.4

Rejected
%*
n
234
6
5

51.3
25.0
26.3

245

Table 12 | New, continued and revised research proposals

Revision
%*
n
20
1
1
22

4.4
4.2
5.3

back for revision. Seventeen (70.8 %) of the continued projects were supAmong the revised projects 13 (68.4 %) were subsequently supported

the better success rate than the revised projects, which both performed
better than the new projects.
There were three basic study designs, such as in vitro, animal studies
or clinical trials. One quarter of all proposed projects (26.7 %) were in

page // 32

page // 33

// RESULTS

Revision
%*
n

n***

Total
%**

Study
classiﬁcation

ﬁnanced. The smallest subcategory was the case reports (n = 13), where

1 | Implant surface and implanttissue interface research
2 | Osseointegration, woundhealing, metabolism andsystemic inﬂuence
3 | Surgery
a | Primary: Implant
insertionb | Secondary:Re-entryc | GBR/
Augmentationd | Perio. regen.
(EMD)
4 | Prosthetics including
occlusion and aesthetics
5 | Pathology
a | Diagnosisb | Mucostitis
c | Peri-implantitis
6 | Treatment of Complications
a | Mucostitis
b | Peri-implantitis
c | Prosthetics
7 | Risk factors for dental
implants
8 | Implant therapy treatment
planning
9 | Predictability of implant
restorations
10 | Implant orthodontics

the ITI Foundation also supported almost half these studies. On aver-

Total

Study design

Financed%*nRejected%*n

In vitro
AnimalClinical****

64
88

48.1
48.9

68
81

51.1
45.0

1
11

0.8
6.1

133
180

26.7
36.1

RCT
Non-RCT
PCS
RCSCS
Subtotal clinical

27
3
35
8
7
80

45.0
14.3
47.3
53.3
43.8
43.5

28
16
37
7
6
95

46.7
76.2
50.0
46.7
46.2
51.6

5
2
2
0
0
9

8.3
9.5
2.7

60
21
74
15
13
184

12.0
4.2
14.8
3.0
2.6
36.9

Total

232

244

21

4.9

497

* Percentage of total | *** Project No. 025 is not included | ** Percentage of all grantapplications (n = 499) | **** Project No. 016 could not be categorised further

Table 13 | Study design categories and success rates for funding

vitro studies (n = 133), of which 64 (48.1 %) were supported, 68 (51.1%) were turned down and one (0.8 %) was returned for revision — SEE
TABLE 13 . Of the 180 animal studies, 88 (48.9 %) were supported, 81(45 %) rejected and eleven (6.1 %) had to be revised. The largest groupof studies comprised of 184 proposed clinical trials. This is 36.9 % of all
grant applications received by the ITI Foundation. The clinical projects
were subdivided into subcategories, where the largest group was the prospective cohort study (n = 74), where almost half of them (47.3 %) wereage, the prospective duration of all the studies was 24 months ranging
from 2 months to 121 months. Among the supported studies the averageprospective duration of the studies was 24.5 months with a range of 3

Financedn%*Rejectedn****%*

Revision
n
%*

n****

Total
%**

50

57.5

35

40.2

2

2.3

87

17.4

29

45.3

33

51.6

2

3.1

64

12.8

2

20.0

7

70.0

1

10.0

10

2.0

0

0.0

34

43.1

40

50.6

5

6.3

79

15.8

8

38.1

12

57.1

1

4.8

21

4.2

36

42.3

47

55.3

2

2.4

85

17.0

4
3
4

50.0
75.0
36.4

4
0

50.0
0.0
54.5

0
1
1

0.0
25.0
0.9

8
4
11

1.6
0.8
2.2

2
6

50.0
50.0

6
2
5

50.0
41.7

0
1

0.0
8.3

4
12
0

0.8
2.4
0.0

12

63.2

7

36.8

0

0.0

19

3.8

2

16.7

10

83.3

0

0.0

12

2.4

31
9

44.9
69.2

33
3

47.8
23.1

5
1

7.2
7.7

69
13

13.8
2.6

498

100.0

232

244

22

* Percentage of total | ** Percentage of all grant applications (n = 499)**** Project No.016 not classiﬁed

Table 14 | Study design categories and success rates for funding

months to 10 years. At the end of 2006, there were 51 projects (10.2 %of all grant applications) still running.

page // 34

page // 35

// RESULTSSTUDY TOPIC CHARACTERIZATION AND FUNDING

size of the grant was agreed upon, but that needed further ﬁnancing as
the project was executed. A number of these grants were subsequently

A study topic categorization for all the submitted projects was created forgiven more money. Among the fully ﬁnanced projects, 7.9% (n = 15) were

the purpose of this analysis. Ten research topics, three of which (surgery,further ﬁnanced. Among the partially ﬁnanced projects, 7.3 % (n = 3)

pathology and treatment of complications) are subdivided into three toneeded more funds.

four subheadings are presented in Table 1 — SEE TABLE 1 . In Table 14,
however, the results of the grant allocations according to the research

Since 1988 and until December 2006, the total sum of grants allocatedtopic classiﬁcation are shown — SEE TABLE 14 . Under the classiﬁcationby the ITI Foundation was CHF 26’547’393. When the 18 projects thatof “Implant surface and implant tissue interface research“ the most grant

received subsequent ﬁnancing are taken into account, the Foundation,

applications were found (87 projects) that made up 17.4 % of the entire

to date, has distributed CHF 27’637’797 — SEE TABLE 15 . The smallest

submitted applications. In this class, 57.5 % (n = 50) of the projects were

grant allocated was CHF 2’693 (S. M. Heckmann, University of Erlangen-supported by the Foundation. The second most grants were found underNuremberg). The largest grant awarded (W. Wager, University of Mainz)

the classiﬁcation „Prosthetics including occlusion and aesthetics“ (n =amounted to CHF 1’513’740. Interestingly, this was a project that was85) with a success rate of 42.3 % (n = 36). The third most grants were

only partially ﬁnanced. Among the total amounts paid for the fully

found under the subclassiﬁcation „GBR/Augmentation“ with a successﬁnanced projects the average was CHF 110’108. The average per projectrate of 43.1 % (n = 34). The highest success rate of 75 % for ﬁnancial

for the partially ﬁnanced projects was CHF 161’15.

support was for the class “Mucostitis“ from the “Pathology” category.
“Implant orthodontics was the second most successful class with 69.2

REPORTING AND PUBLISHING%. The subclasses “Secondary: Re-entry“ from the “Surgery” class and“Prosthetics” from the “Treatment of complications” class both received

All the authors of the grant applications signed a statement agreeing to

no grant applications. The least successful classes with a success rate ofsend to the ITI Foundation an annual interim report during and/or a ﬁnal

only 16.7 % (n = 2) and 20 % (n = 2) were from the class “Implant therapy

report at the end of the proposed project. Of the 232 supported projects,

treatment planning“ and the subclass “Primary: Implant insertion” fromonly 30.6 % (n = 71) projects had ﬁled interim reports and 23.7 % (n =the class “Surgery”, respectively.

55) of the projects had ﬁnal reports ﬁled as of the 31st December 2006. It
has to be kept in mind, however, that a large number (n = 51) the projects

Applications for grants that were supported by the ITI Foundation either

were still running. Nevertheless, 177 ﬁnal reports were due.

received the full amount that was asked for by the applicants or were
only partially ﬁnanced. As stated above, 46.5 % (n = 232) of the 499

Forty-six (out of 232) supported studies produced at least one abstract

submitted applications were ﬁnanced by the Committee; 82.3 % (n =that was published in a Journal resulting in 19.8 % of all supported pro-191) of these grants were fully ﬁnanced. The remainder of 17.7 % (njects complying with the Foundations conditions for funding.

= 41) were partially ﬁnanced. There were accepted projects where thepage // 36

page // 37

// RESULTS

AgreedamountAmount*Fully ﬁnanced projects:
Average
Range:
Min.
Max.
Total
Partially ﬁnanced projects:
AveragRange:
Min.
Max.
Total
Total of all projects

Totalamount**Total paid

DifferencenImpact factor
Range

104’840.84
2’693.00
1’000’000.00
20’024’600.90

110’107.87
2’693.00
1’000’000.00
21’030’603.90

5’267.03
0.00
0.00
1’006’003.00

21’030’603.90

159’092.49
8’000.00
1’513’740.00
6’522’792.00

161’151.05
8’000.00
1’513’740.00
6’607’193.00

2’058.56
0.00
0.00
84’401.00

6’607’193.00

26’547’392.90

27’637’796.90

27’637’796.90* In CHF** The amount that was additionally paid to 18 projects above the agreed amount

Table 15 | Finances of supported grants

Publications available*
No
Yes
Number of publications per project**1
2 to 5
>5

Year

n

%

139
94

59.9
40.1

43
42
9

46.2
44.1
9.7

1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007

0
0
11
6
7
4
7
3
8
9
10
10
9
25
14
19
24
22
16
2

Entire range* Percentage of all accepted projects (n = 232)** Percentage of projects with publications available (n = 94)

Table 16 | Publications availability and number of publications per project

Total

Number of citations
Sum Average

Min

Max

0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.791
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000

2.232
1.865
3.019
1.897
3.773
1.405
2.242
2.096
4.060
7.666
5.877
3.350
3.248
2.903
3.652
4.698

0.000

7.666

206

5.952
4.408
6.591
4.180
8.286
2.172
16.23514.00021.26319.56319.22040.67323.51232.48655.34944.668

0.541
0.735
0.942
1.045
1.184
0.724
2.029
1.556
2.126
1.956
2.136
1.627
1.680
1.710
2.306
2.030

318.558

1.562

Range

Sum Average

Min

Max

9
2
4
8
11
10
11
6
6
0
1
1
0
0
0
0
0

176
450
86
53
126
37
73
270
108
90
43
30
33
32
21
18
2

0

450

564
1130
259
93
293
74
252
869
368
283
202
415
161
187
54
77
6

51.27
188.33
37.00
23.25
41.86
24.67
32.00
96.56
36.80
28.30
22.44
16.60
11.50
9.84
2.25
3.50
0.38

5287

25.92

Table 17 | Publications per year including impact factors and citations

In Table 17 all publications per year, as well as the impact factor andnumber of citations until the end of 2006 are listed. If the journal was
not listed in the ISI Citation Index in that year, the impact factor of

Many of supported projects produced publications. The publicationthat journal was zero. Book chapters and dissertations or theses were

statistics are summarised in Tables 16 and 17 — SEE TABLE 16/17 . In

not included in the analysis. A total of 206 publications were identi-

Table 16, the availability and amount of publications per project are

ﬁed. These publications were cited 5287 times resulting in an average oflisted. Among the supported studies, 94 projects produced at least one

26 citations per publication.

publication corresponding to a rate of 40.1 %. Forty-six percent (n = 43)

The range of citations for the publications was between no citations upof the studies among these 94 projects produced only one publication.

to 450 citations for a single article. The publications appeared to a large

Forty-four percent (n= 42) of the projects produced between two to ﬁve

extent in journals with impact factors. The cumulative impact factor

publications, and 9.7 % (n = 9) of the projects produced more than ﬁve

for all the journals in which the studies appeared was 318.558, giving apublications (range 6 to 12).

mean of 1.562 per article. The range for the impact factors varied from0 to 7.666.

page // 38

page // 39

// RESULTS

In the years 1988 and 1989 no publications appeared yet — SEE TABLE
17 . By the year 1990, 11 articles had been published supported by the

ITI Foundation. These early articles were cited collectively 564 times up
until the end of 2006. The average Impact factor for the journals in whichthese articles appeared was 0.541. The following year, only 6 articles
supported by the ITI Foundation were published. The impact factor had
risen to an average of 0.735 per article and these were cited collectively
1130 times, resulting in the largest average citation of 188 times per
study. In that year, one article was cited 450 times. The most publications
supported by the ITI Foundation appeared in 2001 with 25 articles. 2004
produced the highest cumulative and mean impact factor of 55.350 and
2.306, respectively.

page // 40

// DISCUSSION

noissucsiD

Discussion
This analysis has shown that the ITI Foundation for Implantology andrelated ﬁelds, an independent granting agency since 1988, has allocatedover 27 Million Swiss Francs to clinical and laboratory research within thecourse of 19 years. Although the funds were generated through a contractof the ITI Foundation with its industrial partner, Straumann AG, Basel,
Switzerland, it has to be realized that the distribution and allocation offunding is entirely at the discretion of an academic body, the ResearchCommittee of the ITI Foundation.
Hence, priorities are set on the basis of scientiﬁc originality, feasibility and methodology as well as reputation of the group behind a grantapplication. This truly professional and academic system provides 100% independence from the industrial partner. As a consequence, the ITIFoundation acts as the biggest private and independent granting agency
in the ﬁeld of implant dentistry and most likely, the entire discipline ofdental medicine or odontology.
From the total sum allocated throughout the years, the in vitro studies(n = 64) were supported with a sum of approximately CHF 7.9 million
with an average per grant sum of CHF 124’095. Eighty-eight projects
involved animals and were allocated totally CHF 8.5 million resulting

page // 43

// DISCUSSION

in an average of CHF 97’119 per project. Finally, the clinical studies

2006; Taborelli et al. 1997; Tosatti et al. 2002; Zhao et al. 2005). This, in(n = 80) received a total of CHF11.1 million with a mean per project ofturn, means that the roughened surfaces were more osteophylic due to

CHF 139’366. This documents the signiﬁcance of clinical studies and thetheir adhesive properties (Raz et al. 2004; Zenhäusern et al. 1993; Zinger

assumed need for those in the ﬁeld of implant dentistry as judged by

et al. 2005). Also, osteoblasts were shown to prefer roughened titanium

the peer review and the applicants’ perception. Although not substan-surfaces to adhere to than machined surfaces (Boyan et al. 1999, Boyantially behind the category of clinical studies, in vitro and animal studies

et al. 2002; Boyan et al. 2003; Brett et al. 2004; Harle et al. 2004; Lohm-

ranked in a lower priority.

ann et al. 2000; Lohmann 2002; Lossdörfer et al. 2004; Masaki et al. 2005;

This is in contrast to a number of governmental and national granting

Schneider et al. 2004; Schwartz et al. 1999; Schwartz et al. 2001; Sisk etagencies preferring the funding of more basic over clinical research (Swiss

al. 2001; Zhao et al. 2006; Zinger et al. 2005).

National Research Fund, 2005) It can be speculated that funding of good

In the animal studies implants with roughened surfaces required moreclinical studies is facilitated by the efforts of the ITI Foundation, hereby

torque force to be removed than did smooth surface implants, andproviding an essential contribution for implant dentistry. The fact thatroughened surfaces yielded more bone to implant contact histologicallyfunding for clinical research occurred without the inﬂuence of industry(Abrahamsson et al. 2004; Berglundh et al. 2005; Bernard et al. 2003;

points to the necessity of independence from marketing trends leading

Buser et al. 1991; Buser et al.1998; Buser et al. 1999; Li et al. 2002). Thisto objective assessments of products.

supported research has lead to a paradigm shift favouring rough tita-

In this respect it is noteworthy that the Research Committee attributed

nium implant surfaces as apposed to the “original” propagated smooth

CHF 5 million to the highest level of evidence studies, the Randomized

machined implant surfaces.

Controlled Clinical Trials (RCTs), while Non-RCTs were only funded for CHF
0.9 million. On the other hand, the lower level of evidence, the Prospec-

The third most supported research was in the area of surgical augmen-

tive Cohort Studies (PCS), also received a substantial amount of funding

tation of alveolar bone for implant insertion. In this research ﬁeld, thewith CHF 4.6 million. Remarkably, the even lowest levels of evidence, the

ITI Foundation invested CHF 2.9 million. Here, the different studies had

Retrospective Cohort Studies (RCS) and Case Series (CS) received only aanalysed ways to augment the edentulous alveolar ridge vertically andtotal of CHF 0.8 million within the entire period of granting. This clearlyhorizontally using autogenous bone grafts, xenografts and different fac-indicates that the ITI Foundation prefers the funding of well-designed

tors such as bone morphogenic proteins (BMP’s) and/or enamel matrix

clinical studies.

proteins (EMP’s), with or without the use of barrier membranes. Throughthe supported research in this ﬁeld more predictable augmentation

The most supported research topic involved the implant surface and im-

methods have been found, and promising new materials as well as newplant tissue interface. In this category, CHF 7.8 million was invested.

indications of existing materials will help develop more predictable andAt the in vitro level, the research revealed that roughened titanium

easier methods for increasing the alveolar bone volume prior to or during

surfaces interacted better with ﬂuids and proteins than did machineddental implantation (Blom et al. 2001, Botticelli et al. 2004, Botticelli etor turned titanium surfaces (Portuondo-Campa et al. 2006; Rupp et al.

al. 2005, Brunel et al. 1998, Donos et al. 2005, Haas et al. 2002, Jensen etpage // 44

page // 45

// DISCUSSION

al. 2005, Jensen et al. 2006, Lynch et al. 1991, Moradian-Oldak et al. 2006,

provides further evidence that nepotism was avoided and projects must

Schlegel et al. 2006, Schou et al. 2003 a, Schou et al. 2003 b, Schou et al.

predominately show scientiﬁc merit rather than the applicant being afﬁ-

2003 c, Thorwarth et al. 2005, von Arx et al. 2001, von Arx et al. 2002).

liated with the ITI.

Another ﬁeld of research supported by the ITI Research Committee withAll applicants had to sign a statement obliging them to provide interima large sum of money was in the predictability of dental implants. Closeand ﬁnal reports to the ITI Foundation. A total of 232 projects were sup-to CHF 6.0 million have been allocated to various groups of researchers

ported. Twenty-two percent (n = 51) of these studies are still running.

to execute large multi-centre studies or RCTs on the predictability ofHence, approximately 181 ﬁnal reports should have been ﬁled. To the end

dental implants (Buser et al. 1997, Buser et al. 1991, Payne et al. 2003,

of 2006, only 24 % of the reports (n = 55) have been received. This clearly

Timmermann et al. 2004). Consequently, the clinical long-term successdemonstrates that researchers tend not to volunteer required documentsof the Straumann® Implant System has been documented in a number

unless continuously motivated to do so. This fact resulted in a new policyof longitudinal studies (Buser et al. 1990, Buser et al. 1994, Heckmann etby the ITI Foundation to withhold 10 % of the grant sum until receipt ofal. 2004, Schrott et al. 2004, Weber et al. 2000).

a ﬁnal report.

The ﬁeld of implant dentistry is one of the fastest growing disciplines in

The ﬁnal report may be in the form of a publication. More than double

dentistry today. A multi-billion dollar industry has evolved around dental

the amount of projects that submitted a ﬁnal report has at least one

implants over the last 30 years with a still ongoing large annual growth

publication available indicating that ﬁnal reports are usually substituted(Straumann 2006).

by the ﬁrst publication submitted to a scientiﬁc journal.
Among the approximately 200 publications identiﬁed, not all were veriﬁ-

In the diagnosis and treatment of complications associated with im-able by an acknowledgement to the ITI Foundation, although required byplants few research proposals have been submitted. This reﬂects, on one

the signed statement at the time of granting the funds. Therefore, we may

side, the not yet recognised need for diagnosis of complications such as

have missed a number of publications. This makes tracking of ITI Founda-

periimplantitis and the treatment thereof. On the other side, there seems

tion supported projects in the literature difﬁcult and even unpredictable.

to be a willingness to allocate more resources to these ﬁelds of research.
In these categories, a modest CHF 1.2 million had been invested so far.

By manually searching the journals Clinical Oral Implants Research,

With the enormous growth in implant dentistry the increase in late com-

International Journal of Oral and Maxillofacial Implants and theplications may grow. Through the funding of the ITI Foundation some es-

Journal of Dental Research, 46 abstracts were identiﬁed. Unfortunately,

sential animal studies could be performed providing the basis for clinicalthe electronic search did not reveal abstracts. This, in turn, means thatexamination of periimplant tissues (Etter et al. 2002, Lang et al. 1994).

probably a hidden number of abstracts may have been overlooked.

Thirty percent of the applicants and 32% of the co-applicants were ITIFrom 94 projects, 206 publications resulted up to the end of 2006. These

Fellows. The majority of grants however, went to non-members. This fact

94 grants only account for half of the funds distributed (CHF 11.1 mil-

page // 46

page // 47

// DISCUSSION

lion). Calculating the mean cost per publication on the basis of theseresults in an average cost of approximately CHF 54’273. The other halfof the CHF 27 million distributed during the 18-year period is not accounted for in terms of publications. However, it has to be consideredthat approximately 22 % of the projects are still running representing
a grant value of CHF 8.4 million with a mean cost of CHF 164’451 per
project. About CHF 7.5 million of grants have not yet produced peerreviewed publications.
The high percentage of supported studies reﬂects the high standardsof proposed research for relatively modest amounts of money. That thebudget of the ITI Research Committee could be divided among 46.5 %of the applications supports this statement. However, the number of applications being submitted per year has increased over the last 19 years.
Consequently, a smaller fraction of the proposed projects may be fundedin the future increasing the competition, and therefore, the quality of
the research. A method to quantify the quality of the research may bechosen by analyzing the impact factor of the publications. The average
impact factor per publication found has increased ten fold over the19years documenting the greater impact of the research funded as well as
the increased quality of the single studies. Another method to quantify
the quality of research is by searching the number of times a publication
was cited. However, the number of cites decreased per year because thenewer articles haven’t been around long enough to be cited as often as
the older articles. Hence, this evaluation method may not be suitable forlongitudinal comparison.

page // 48

// CONCLUSION

noisulcnoC

Conclusion
It is surprising to realize that, within the course of two decades, the ITIFoundation invested an astounding amount of money for predominantly
clinical research. The supported research has contributed to the acceptance of dental implants as a treatment and to the conﬁdence in predictable implant dentistry. This, in turn, has lead to the establishment ofa global industry with one of the fastest annual growths. It is difﬁcult,however, to quantify the results of the research performed in objective
terms. The investment of the ITI Foundation as a self-governing, peerreviewed, independent research institution has provided essential funding for research projects independently of market-driven forces usually
governing industry.
Consequently, the ITI Foundation represents one of the most important
granting agencies for the promotion of evidence-based implant dentistry.

page // 51

A CKN O WL ED GEMENTS

This analyis was supported by the Clinical Research Foundation (CRF) for
the Promotion of Oral Health, Brienz, Switzerland.
The cooperation of the ITI Center, Basel and its staff is highly appreciated. Special thanks go to Mr. Rolf Hafner, former Executive Director of
the ITI, and Mr. Walter Widmer for their support. Matthias Joesch and his
collaborators are acknowledged for a competent design and editing.

page // 52

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Swiss National Research Fund (2005) 2005 – Forschungsförderung in Zahlen. Annual Report 2005: 28-49.

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Publications supported by the ITI Foundation (presently submitted to a journal)
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Publications supported by the ITI Foundation, but not acknowledged
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Theses supported by the ITI Foundation
Blom, E. (2000) Growth factor loaded calcium phosphates for bone regeneration. PhD Thesis, ACTA, Amsterdam, the Netherlands.
Ding, T.A. (2002) Evaluation of the Morse Taper Implant – Abutment Design with an Internal Modiﬁcation. MS Thesis, Baylor
College of Dentistry, Dallas, USA.
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med. dent. Dissertation, University of Erlangen-Nuremburg, Erlangen, Germany.
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Tosatti, S. (2003) Functionalized titanium surfaces for biomedical applications: Physico-chemical characterization and biologicalin vitro evaluation. PhD Thesis, ETH, Zurich, Switzerland.

Book Chapters supported by the ITI Foundation
Delgado, D., Fuentes, A.A., Jones, R. & Lumsdaine A. (2002) Quantitative determination of the stability of implant-bone interface
using resonance frequency analysis. In: Proceedings of IMECE 2002, 1st edition, IMECE2002: 33490. American Society of
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Contact: André Busslinger | Cabinet Dentaire Central CDC | Bahnhofstrasse 54 | 2502 Biel-Bienne
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