## 4 Discussion  
Most studies on the top cited articles in dentistry show that at least a decade is needed for an article to express all its potential in terms of citation and in case it turns into a citation \begin{table}
\begin{tabular}{c c c c c c} \hline \hline  & \multicolumn{4}{c}{**Comparison for Citations in WOS 2021**} \\ \hline  & Twitter 2019 = 0 & Twitter 2019 \(\geq\) 0 & W & \(p\) \\ N & 2901 & 777 & & & \\ Mean & 8.438 & 13.343 & & & \\ SD & 9.399 & 15.713 & & & \\ Median & 6.00 & 9.00 & & & \\ \hline  & Facebook 2019 = 0 & Facebook 2019 \(\geq\) 0 & W & \(p\) \\ N & 3259 & 419 & & & \\ Mean & 8.776 & 14.995 & & & \\ SD & 9.984 & 17.263 & & & \\ Median & 6.00 & 11.00 & & & \\ \hline  & News Outlets 2019 = 0 & News Outlets 2019 \(\geq\) 0 & W & \(p\) \\ N & 3662 & 16 & & & \\ Mean & 9.467 & 17.875 & & & \\ SD & 11.231 & 15.248 & & & \\ Median & 6.00 & 10.50 & & & \\ \hline  & Policy Sources 2019 = 0 & Policy Sources 2019 \(\geq\) 0 & W & \(p\) \\ N & 3675 & 3 & & & \\ Mean & 9.497 & 18.666 & & & \\ SD & 11.264 & 7.094 & & & \\ Median & 6.00 & 20.00 & & & \\ \hline  & Patents 2019 = 0 & Patents 2019 \(\geq\) 0 & W & \(p\) \\ N & 3672 & 6 & & & \\ Mean & 9.485 & 21.5 & & & \\ SD & 11.243 & 18.13 & & & \\ Median & 6.00 & 20.50 & & & \\ \hline  & Mendeley 2019 = 0 & Mendeley 2019 \(\geq\) 0 & W & \(p\) \\ N & 2417 & 1261 & & & \\ Mean & 7.691 & 12.81 & & & \\ SD & 8.942 & 13.999 & & & \\ Median & 5.00 & 9.00 & & & \\ \hline \hline  & & & & & \\ \end{tabular}
\end{table} 
Table 4: Comparison for citations in WOS 2021 between the groups with Altmetric resources score equal to 0 and greater than or equal to 1 in 2019. (N) number of published items in the group, (Mean) Mean number of WOS citations in the group, (W) Non parametric Mann-Whitney Wilcoxon, significant at \(p<0.05\). \begin{table}
\begin{tabular}{l c c c c c c c c c} \hline \hline  & \multicolumn{4}{c}{**Citations**} \\ \cline{2-10}
**Study Design** & **N** & **AAS** & **AAS/Item** & **WOS** & **SCOPUS** \\ \cline{2-10}
**RCTs** & 32 & 38 & 521 & 581 & 16.3 & 15.29 & 344 & 792 & 359 & 860 \\ \hline Systematic review & 30 & 31 & 340 & 343 & 11.3 & 11.06 & 480 & 1052 & 535 & 1176 \\ \hline Observational (cross-sectional, longitudinal, cohort) & 28 & 43 & 311 & 504 & 11.1 & 11.72 & 211 & 681 & 224 & 761 \\ \hline Systematic review and meta-analysis & 25 & 29 & 282 & 352 & 11.3 & 11.73 & 294 & 836 & 324 & 900 \\ \hline CCTs & 5 & 5 & 61 & 61 & 12.2 & 12.20 & 42 & 147 & 65 & 164 \\ \hline Meta-epidemiological study & 2 & 2 & 23 & 24 & 11.5 & 12.00 & 19 & 46 & 24 & 48 \\ \hline Case series/Case-report & 2 & 4 & 14 & 32 & 7 & 8.00 & 18 & 42 & 18 & 38 \\ \hline In vitro/Basic & 1 & 6 & 122 & 237 & 122 & 39.50 & 1 & 61 & 1 & 78 \\ \hline Editorial & 1 & 2 & 41 & 52 & 41 & 26.00 & 3 & 6 & 2 & 5 \\ \hline Bibliometric & 1 & 3 & 13 & 46 & 13 & 15.33 & 3 & 75 & 2 & 82 \\ \hline Scoping Review & 1 & 1 & 8 & 8 & 8 & 8.00 & 2 & 5 & 1 & 5 \\ \hline _Review_ & & 6 & & 195 & & 32.50 & & 139 & & 158 \\ \hline \hline \end{tabular}
\end{table} 
Table 3: _Cont._classic [17]. Older articles usually display a greater number of citations than the newest ones, despite their actual impact, whereas the impact of more recent papers is normally underrated, maybe due to their recent release, since time has been too short for citations to be accumulated [13]. Compared to the behavior of traditional citations, Altmetric stands out for its immediacy, which allows recently published items to get a significant recognition and prominence in the short term [18]. In previous studies on top-Altmetric papers, most of the published items belonged to the last five years, while none of the publications, in Citation classic studies, was published in such a recent time period [17; 19; 20]. This finding is in line with all previous Altmetric studies that emphasized the widespread and evident presence of recently published literature [21; 22].