A Bibliometric Analysis and Visualisation of Research Trends in Allergy of Chromium Implants

The metal hypersensitivity of implants is a vital factor affecting the safety of implants. The bibliometric analysis had been conducted to understand the active authors, organizations, journals, and countries involved in the research domain of “allergy of Chromium implants”. All published articles related to “allergy of Chromium implants” from “Scopus”, were analyzed using the VOS viewer to develop analysis tables and visualization maps. This article had set the objective to consolidate the scientific literature regarding “allergy of Chromium implants” and also to find out the trends related to the same. The most active journal related to this research domain was Contact Dermatitis. The most active countries were the United States of America and Germany. The leading organization was Ludwig Maximilian University of Munich, Germany. The most active authors who had made valuable contributions related to the allergy of implants was Thomas P.


Introduction
Allergy of metals is a serious issue associated with metal implants. The allergy may be of varying degree to different patients (Akil et al., 2018). Metal hypersensitivity at an extreme stage may even lead to failure of implant or replacement of implant with a comparatively safe metal. Different types of metals and materials are used to create implants and the most popularly used metals and alloys for bio-implants are stainless steel, cobaltchromium alloy, and Titanium (Priyanka et al., 2014). Various types of implants had been used in modern medicine and include sensory implants, neurological implants, cardiovascular implants, orthopedic implants, contraceptive implants, and cosmetic implants.
Despite having various advantages associated with implants, the safety of implants is an important parameter associated with acceptance. The allergy or hypersensitivity of implants and treatments to reduce implants is an important matter to be addressed. Material engineering and surface engineering play a vital role in the selection and usage of safe metals and alloys as implants. The hypersensitivity of the implant can be worse due to wear and corrosion of the metal; and through allergy of the metal implant. Serious health issues due to corrosion and wear of metal-metal implants based on Cobalt and Chromium (Campbell and Estey, 2013) (Cobb and Schmalzreid, 2006)Cytotoxic effects of chromium-based dental implants had been identified (Arvidson et al., 1987). Implants derived Cobalt-Chromium and molybdenum (CoCrMo alloy) nanoparticle disrupts DNA replication dynamics in neuronal cells (Bijukumar et al., 2021) Hip-implant based on chromium had been reported the issue of toxicity (Ng, Ebneter and Gilhotra, 2013); similarly, toxicity and allergy due to implants based on cobalt-chromium alloys ; (Posada, Tate, and Grant, 2015). Allergy, toxicity, and health issues associated with chromium implants may be serious not only to users but the health professionals, regularly handling chromium implants (Armstead et al., 2017).
This bibliometric analysis will be a useful platform for future researchers by realizing the top researchers, organizations, and countries involved in research regarding the hypersensitivity of chromium based-implants. This article is arranged into four sections. The first section is the introduction, followed by the discussion of the methodology by which the research was conducted. The third section deals with results and discussion. The fourth section deals with the conclusion. The following research objectives and research questions were framed for conducting bibliometric analysis systematically. c) Which are the main journals related to the allergy of chromium implants?

Research Methodology
Scopus files had been used for this article. For the article selection, the Boolean used was TITLE-ABS-KEY (Allergy Chromium Implants) on 03/03/2021. All the tables in this paper were created by using Microsoft Excel and VOS Viewer. Grammarly was used for spelling and grammar checks. Mendeley was used for article review and citation. This paper had been inspired by bibliometric analysis in its presentation style, analysis, and methodology from the works (Farhat et

Results and discussion 3.1 Results
This first round of search produced an outcome of 178 documents, in five languages, out of which 136 documents were in English. The classification of document categories is shown in Figure 1. For improving the quality of the analysis, we had selected only the peer-reviewed articles and all other documents had not been considered. Thus after using filters "Article" and "English" the second round search produced an outcome of 91 English articles (both open access and others) and had been used to conduct bibliometric analysis and visualization using VOS Viewer. The English research articles in this domain since 1976 had been shown in Figure 2.  figure 3. For a better presentation of the analysis, the parameters used were the minimum number of documents of an author as two and the minimum number of citations of authors as one. This combination plotted the map of 24 authors, in ten clusters. The overlay visualization map of co-authorship analysis plotted in Figure 3, points out the major researchers with their strong co-authorship linkages and clusters involved.  In Co-occurrence analysis, we had used all keyword analyses, by keeping the minimum number of occurrences of a keyword as 15. This combination plotted the map of 32 thresholds, in three clusters. The overlay visualization of co-occurrence analysis of keywords has been shown in Figure 4.  Co-authorship analysis of the countries engaged in the research on "allergy of chromium implants" had been shown in Figure 5. The overlay visualization map of co-authorship analysis plotted in Figure 5, points out the main countries with their strong co-authorship linkages and clusters involved.  The most active country in this research domain was the United States of America and Germany, with the highest number of publications, links, and citations.
Link analysis and citation analysis were used to identify the most active journal in this research domain. We have taken the parameters of the minimum number of documents of a journal as one and the minimum number of citations of a journal as one for the link analysis and citation analysis. Highlights of the most active and relevant journals related to "allergy of chromium implants" are shown in table 4. Table 4 shows the journal activity of this research domain through parameters of publication volume, citations, and co-authorship linkages. From the above discussion regarding the bibliometric patterns in the research regarding "allergy of Chromium implants", this research had observed a gradual increase in research interest regarding "allergy of Chromium implants" from the starting of the millennium and the momentum is going on positively. This points out the relevance and potential of this research domain (Refer to Figure 2). The most active author in this research domain was Thomas P. with the highest publication, citations, and co-authorship links (Refer to table 1). The overlay analysis of top countries researching "allergy of Chromium implants" indicates that the United States of America and Germany were the leading countries relating to the highest number of publications, citations, and coauthorship links (Refer to figure 5). The top journal of this research domain was identified as the Contact Dermatitis with the highest publication, citations, and co-authorship links. From these wide sources of information, researchers can focus on top journals where they can identify the most relevant and highly cited articles regarding the allergy of Chromium implants.

Conclusion
Allergy of implants was an interesting research domain and the most active journals related to this research domain was Contact Dermatitis. The most active countries were the United States of America and Germany. The leading organization was Ludwig Maximilian University of Munich, Germany. The most active authors who had made valuable contributions related to the allergy of implants was Thomas P. with the highest publication, citations, and co-authorship links respectively. This research domain offers a new avenue for researchers and future research can be on innovations in the allergy of Chromium implants.