Simon Young, DDS, MD, PhD
Development of a Compromised Maxillofacial Wound Healing Model for Bone Graft Evaluation
March 24, 2018
As an oral and maxillofacial surgeon with experience treating traumatic defects and pathology, Simon Young, DDS, MD, PhD understands the unique challenges associated with the reconstruction of complex maxillofacial wounds. That’s why he and his team at the University of Texas School of Dentistry in Houston are directing a new research effort funded by Osteo Science Foundation. Their focus is on developing a clinically relevant, reproducible model to understand why bone grafting fails in the setting of a compromised wound (i.e. osteoradionecrosis, multiply-operated sites, etc.).
Dr. Young is Assistant Professor at The University of Texas Health Science Center at Houston – School of Dentistry, Department of Oral and Maxillofacial Surgery.
“Our aim is to develop a new animal model to better understand the mechanisms which prevent successful bone grafting in challenging environments and to use those insights to design better therapies in the future,” explained Young, who further noted the study’s broad implications to the field. “A patient who has received radiation as part of their cancer treatment or who has been operated on several times and has significant soft tissue compromise – those circumstances are more difficult because they’re far less predictable. There aren’t any good animal models to guide us.” said Young.
This investigation represents a key opportunity because, as Young noted, “there just isn’t much patient data showing the effectiveness of bone regeneration techniques in a compromised wound setting.” Whether the defect lies in an inadequately vascularized environment, an adversely affected (or missing) progenitor cell population, the complicating presence of bacterial contamination, or a sub-optimal cytokine milieu, the relative contributions of these factors remains to be clearly elucidated.
To replicate the human situation as closely as possible, Young and his co-investigator, Dr. Kurt Kasper, are using a variety of analytic approaches – including advanced imaging modalities and immunohistochemistry – all to measure and predict what will happen in the “patient’s” healing process. Young explained, “Our first step is to establish the rabbit model and, thereafter, to apply it as a way to test bone regeneration techniques. We’re trying to predict likely outcomes – if they’ll heal properly or if there will be healing complications.” As part of the study, Young and his team are seeking to develop new ways to analyze the outcomes, including non-invasive imaging approaches like DCE-MRI imaging.
Such research endeavors are at the forefront of enabling progress in both science and healthcare alike. Young commented on this fact, noting that “without research, our profession wouldn’t move forward. We have to push the envelope and try new ideas. If you’re a surgeon with a good idea but no money to test your ideas, it can be an uphill battle.”
The last few years of funding uncertainties and reductions have continued to threaten and slow the pace of scientific progress. Young cited this as a serious problem for scientists, and especially young scientists and those within oral and maxillofacial surgery. In such an environment where securing research dollars is so much more competitive than ever before, Young passionately praised the unique support of Osteo Science Foundation. “Thank goodness for Peter Geistlich. Osteo Science Foundation supported us and they’re enabling us to get preliminary data. Without their funding, we simply wouldn’t be able to do this research. They understand it and they’re supporting young researchers with research ideas.”
This research study remains in-progress. Young indicated preliminary data should be available in the near future to better understand the effects of the model. Thereafter, focus will turn to assessing the specific effectiveness of bone regeneration techniques in a compromised wound setting.
Dr. Simon Young at the University of Texas, Houston, has conducted extensive research developing a novel model for compromised wound healing that will provide the basis for studying regenerative techniques in complex maxillofacial wounds with compromised healing capabilities.
This work was presented by post-doctorate, Dr. Stacey Piotrowski at the 2018 Annual Meeting of the American Association of Dental Research in Fort Lauderdale, Florida on March 24, 2018.