From Patent to Practice? A Retrospective Cohort Analysis of Translational Attrition in Endodontic Innovation
H. Better, T. Asbi, G. Chaushu, K. Better, J. Moshonov, S. Lin, D. HaimABSTRACT
Aim
To characterize the translational pathway of endodontic technology from patent filing to clinical availability, with four objectives: (i) determine the grant rate and jurisdictional distribution; (ii) characterize temporal dynamics of the grant process; (iii) map distribution across technology categories; and (iv) evaluate maturity and regulatory status in a strategic subset.
Methodology
A retrospective cohort of 201 patent families was identified from European Patent Office Espacenet (Cooperative Patent Classification class A61C5*), priority years 2012–2014. Variables included technology category, jurisdiction, granted status in the USA, Europe, and Japan, time until first grant, and patent status at 31 December 2025. A strategic subset ( n = 20), defined as families with identifiable regulatory or commercial signals, was further analysed using a Technology Maturity Index (TMI, 1–5) and regulatory signals (Food and Drug Administration (FDA) clearance, Conformité Européenne (CE) marking, clinical evidence). Kaplan–Meier analysis modelled time to first grant, and translational attrition was mapped across the translation process.
Results
Of 201 endodontic patent families, 112 (55.7%) were granted in at least one major market. Median time until the first patent was granted was 1652 days (Interquartile Range (IQR) 1290–2043). Instrumentation dominated (80.1%), and energy‐based devices showed a numerically higher grant rate (66.7%), although this difference was not statistically significant. Twenty families (10.0%) carried identifiable regulatory or commercial signals; 16 (80.0%) reached near‐commercial maturity (TMI ≥ 4) and 15 achieved TMI = 5, representing 7.5% of the original cohort.
Conclusions
Endodontic technology translation is prolonged and highly selective, showing progressive narrowing from filing to commercial realization, with only 7.5% (15/201) of the families reaching confirmed full market availability. These findings provide a descriptive framework for interpreting emerging technologies and highlight the need to consider both time and attrition when evaluating innovation in endodontics.