Summer 2016

What Do Dentists Need?

National research initiative aims to get new technologies and treatments to patients more quickly

By Helene Ragovin

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A new NIDCR initiative aims to put the latest advances into the hands of dentists and other health-care providers sooner. Illustration: Harry Campbell

If dentists could ask for new technology and materials to solve some of their most pressing clinical problems, what would they be? And how could these products move as quickly as possible from an idea in the laboratory to use in the dental office?

Those are the questions driving an initiative at the National Institute of Dental and Craniofacial Research (NIDCR) aimed at putting the latest advances in dentistry into the hands of practicing dentists and other health-care providers sooner.

The project, called the Dental, Oral and Craniofacial Tissue Regeneration Consortium, or DOC-TRC, involves multidisciplinary teams from numerous research sites engaged in what is known as translational research. That’s work undertaken with a specific end product in mind that can make the trip, as scientists say, “from bench to bedside”—or, in the case of dentistry, chairside.

Mainstays of modern dentistry, such as titanium implants, amalgam fillings, CAD/CAM prostheses and restorations, tetracycline wraps to treat periodontal disease and mouthwashes to relieve dry mouth and halitosis are all products of translational research. In the case of DOC-TRC, the emphasis, as the name suggests, is on regenerating functional tissue of craniofacial bone, gums, teeth and the temporomandibular joint.

A Jump Start for Research

Tufts School of Dental Medicine received a $125,000 planning grant for the first phase of the project, one of 10 awarded by the NIDCR, an arm of the National Institutes of Health. There will be far fewer grants for the second stage; participating institutions are expected to submit joint proposals and work collaboratively for the duration of the project. The idea is to take advantage of the resources of research, clinical practice, industry and government to spur new work and to speed up work in progress. The goal is “to create a continuous conveyor belt to bring products from bench to bedside,” says Pamela Yelick, G89, director of the division of craniofacial and molecular genetics at the School of Dental Medicine and the lead Tufts researcher for DOC-TRC.

Investigators on the Tufts team include Athena Papas, J66, chair of the dental school’s division of oral medicine; Gerard Kugel, D85, M.S.93, professor and associate dean for research at the dental school; and Andrew Hoffman, director of the regenerative medicine laboratory at Cummings School of Veterinary Medicine.

The goal is “to create a continuous conveyor belt to bring products from bench to bedside.”

Traditionally, it has taken decades for products to move through the research and development stages, Yelick says. The timetable for products promoted through DOC-TRC will vary, depending on how far along they are when NIDCR funding begins. But many could be available to dental offices within 10 years. Discoveries already in clinical trials would obviously have a head start, she says—such as Papas’ work on treatments for Sjögren’s syndrome, an autoimmune disorder characterized by dry mouth and dry eyes. “That work is the closest that we have to reaching the public, and that could be in five years or less, depending on how her clinical trials go.”

Yelick’s own research involves using dental stem cells to regenerate craniofacial bone and teeth, which, she says, would be preferable to synthetic implants (read more at go.tufts.edu/growyourown). “Even if we could fabricate a living root and put a crown on it, it would be a huge improvement over a fixed dental implant,” she says.

Improving Implant Success

Kugel is developing new materials, such as silk coatings, to improve the way dental implants fuse with the jawbone. Such an advance would address a significant concern dentists face: While the success rate for implants is high in healthy patients, in those who smoke, have diabetes or osteoporosis or have had radiation treatment for head or neck cancers, the risk for implant failure is as high as 25 to 30 percent. His Tufts collaborators on the research are David Kaplan, the Stern Family Professor of Engineering and chair of the Department of Biomedical Engineering, and Driss Zoukhri, a professor in the department of comprehensive care at the dental school.

What distinguishes the DOC-TRC project is its focus on clinical needs, says Kugel, who also maintains a practice in addition to conducting research at Tufts. With pressure to spend research dollars wisely, the NIDCR needs to concentrate on science “that is clinically relevant to get these products into our patients’ mouths,” he says. “We need research that addresses everyday issues.”

Contact Helene Ragovin at helene.ragovin@tufts.edu.

 

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