Joshua Segal, DDS, MD | Feinstein Institute for Medical Research

Reconstruction of a Segmental Mandibular Defect Using the Induced Membrane Technique

Bio:
Following graduation from Northwestern University with a bachelor's degree in biology, Dr. Segal performed two years of developmental neuroscience research at the Children’s Memorial Institute for Education and Research.  He then earned a DDS degree from Stony Brook University School of Dental Medicine.  He completed his Oral and Maxillofacial Surgery residency at Long Island Jewish Medical Center during which time he earned an MD degree from Stony Brook University School of Medicine.  Following residency, Dr. Segal has dedicated himself to resident education in the field of Oral and Maxillofacial Surgery, serving as associate residency director at Brookdale Hospital Medical Center and now at Long Island Jewish Medical Center - Northwell Health.

Abstract:
Segmental defects of the mandible can result from a myriad of traumatic and pathologic conditions.  Various treatment modalities have been advocated for the reconstruction of these defects in order to restore both function and aesthetics.  Reconstructive options include vascularized bone grafts, nonvascularized bone grafts, distraction osteogenesis and utilization of exogenous osteogenic factors. The induced membranes technique is a biphasic technique for the treatment of infected post-traumatic long-bone defects.  The first stage involves placement of a poly-methylmethacrylate cement spacer into the defect. Following a specified time period, a second surgery is performed where the spacer is removed and replaced with autogenous cancellous graft. The foreign body reaction caused by the presence of the cement spacer induces a granulation tissue-type membrane that both maintains the physical space for subsequent graft material, and has significant osteogenic potential.  We propose to evaluate the osteogenic potential of this technique when applied to the rat mandibular model.  This research aims to determine the feasibility of this technique for reconstruction of human mandibular segmental defects.

Hsiao Hsin Sung Hsieh, DDS | University of Michigan

Effects of sclerostin antibody on the peri-implant bone in an osteogenesis imperfecta mouse model

Bio:
Dr. Hsieh is a junior faculty member in the Oral and Maxillofacial Surgery Department at the University of Michigan. She completed dentistry, OMFS residency and a master’s degree in genetics at the University of Chile. Clinically, she works with vulnerable and underserved populations with poor oral health, most of whom are suffering a certain degree of low bone mass disorder caused by genetic, metabolic or chemical derangement.  The success of their oral rehabilitation depends on the quantity and quality of the alveolar bone. Dr. Hsieh’s research project is focused on the mechanism of bone regeneration induced by a novel anabolic drug, the sclerostin antibody, in an osteogenesis imperfecta mouse model.

Abstract:
Osteogenesis imperfecta (OI) is a heterogeneous group of bone disorders resulting in generalized osteoporosis of the skeleton. Clinical studies have shown a higher risk of partial or total edentulism in OI patients. The edentulism, in the general population, are treated preferentially with dental implants. Implants have been proven to be a safe procedure with low failure rate, although success depends largely on the quality and quantity of the available bone in the remaining alveolar ridge. Surgeons tend to disregard implants among OI patients based on the assumption that poor bone quality inherent to OI may have detrimental effects on mandible bone healing.  Recent experiments have shown that sclerostin, a small osteocyte-derived glycoprotein expressed by the SOST gene, plays a crucial role in the inhibition of bone formation by inhibiting Wnt/β-catenin signaling. Subjects with mutations in the SOST gene have increased bone mineral density and low fracture risk. Consequently, anabolic sclerostin antibodies (SclAb) have been developed that increase bone formation and bone strength. Recent studies have shown that systemic delivery of SclAb leads to acceleration of the peri-implant bone formation rate and increases pull-out strength of implants on normally loaded and unloaded long bones. If similar findings were to be observed in the mandible of the OI model, they might lead to a new strategy to improve the peri-implant osseointegration in OI and other low bone mass disorders. We aim to determine the effect of systemic delivery of SclAb on the peri-implant bone formation and implant fixation strength across in an OI mouse model.

Ryan Tomlinson, PhD | Thomas Jefferson University

The Role of NSAIDs in Osseointegration of Dental Implants

Bio:
The Principal Investigator is Dr. Ryan E. Tomlinson, PhD, Assistant Professor of Orthopaedic Surgery at Thomas Jefferson University. His research in bone repair has yielded substantial acclaim in the field, including the Harold M. Frost Young Investigator Award, the Endocrine Fellows Foundation Award, the ASBMR Young Investigator Award, and the IBMS Alice L. Jee Young Investigator Award. The Co-Principal Investigators are Dr. Robert Diecidue, DMD, MD, MBA, MSPH, Professor and Chair; and Dr. Daniel Taub, DDS, MD, Associate Professor and Vice-Chair of the Department of Oral and Maxillofacial Surgery at Thomas Jefferson University, both accomplished physician-scientists in the field of oral surgery.

Abstract:
This study on the role of NSAIDs in dental implant osseointegration is divided into two specific aims, for new implants (Aim 1) and failed implants (Aim 2). In Aim 1, subjects receiving maxillary dental implants will be randomized to take either naproxen or placebo following surgery, with longitudinal, quantitative data on osseointegration collected by Osstell radiofrequency analysis. In Aim 2, failed implants will be retrieved from subjects who provide NSAID usage information. These specimens will be analyzed using microCT, undecalcfied histology, and protein analysis. Together, our results will quantitatively determine the risks of NSAIDs on dental implant osseointegration.

Yunqing Kang, PhD | Florida Atlantic University

Multiple channels in bioceramic scaffolds promote rapid vascularization and robust bone formation

Bio:
Dr. Yunqing Kang received his PhD degree in Biomedical Engineering from Sichuan University, and did post-doctoral research in bone tissue regeneration from the Department of Osteopaedic Surgery, Stanford University. Currently, he is an Assistant Professor at Florida  Atlantic University since 2014. Dr. Kang's research interest is  craniofacial bone tissue regeneration.

Abstract:
Our goal in this project is to develop new functional bone scaffolds for the preservation of post-extraction sockets and alveolar bone augmentation. In this proposal we will use our developed template-casting method to create multiple hollow channels in porous β-TCP scaffolds. We will examine the effect of the channeled macroporous scaffolds on angiogenesis and osteogenesis in vitro, and we will also study the functionality of the multiple channels in the macroporous scaffolds to promote bone formation in a rat mandibular bone defects. The interconnection of hollow channels and macropores in the scaffold minimizes the diffusion distance of nutrient and blood supply, thus significantly promoting rapid vascularization and robust bone formation. This “off-the-shelf” scaffold will be convenient for dentists to directly use it with appropriate shaping treatments. This scaffold will have the potential not only for preservation of the post-extraction socket but also for bone regeneration of craniofacial bone defects in the future.

Publications:

1. Kang Y. Chang J. Channels in a porous scaffold: a new player for vascularization. Future Medicine. Regenerative Medicine, Vol. 13, No. 6. Online, 24 Sep 2018. Full Text

Ismael Khouly, DDS, MS, PhD | New York University

Effect Of Alveolar Ridge Preservation After Tooth Extraction in the Posterior Maxilla: A Randomized Trial

Bio:
Dr. Khouly is currently Associate Director of Periodontology & Implant Dentistry at Bluestone Center for Clinical Research, and Clinical Assistant Professor in the Department of Oral & Maxillofacial Surgery at New York University (NYU).He obtained his DDS between Spain, UK and Norway. He also obtained a master degree in tissue engineering. At the NYU, he completed a 3-year advanced program in implant dentistry. This was followed by his PhD in biomedicine, specialized in sinus bone augmentation. Dr Khouly has also published in major journals, and lectured nationally and internationally. He is also a Diplomate of the American Board of Oral Implantologist, and Diplomate and Fellow of the International Congress of Oral Implantologists. 

Abstract:
The aim of this prospective, randomized, blinded, controlled trial is to evaluate through a split-mouth design the postextraction dimensional changes in the posterior maxilla occurred in the same subject following alveolar ridge preservation using porcine-derived xenograft combined with a collagen membrane or extraction alone. Subjects who will require double extraction of contralateral second maxillary premolar and first/second maxillary molar will be recruited at Bluestone Center for Clinical Research at New York University College of Dentistry. Study-subjects who meet the inclusion and exclusion criteria will be randomly assigned to receive both alveolar ridge preservation and extraction alone.