Periodontitis, also known as gum disease, is one of the most common oral diseases, affecting 4 in 10 adults aged 30 and 60% of adults aged 65 or older The over 65 age group was one of the most prevalent among severe periodontitis patients in the United States, according to a 2018 JADA study. This severe form of gum infection damages gum tissue and causes bone loss around teeth.
Scientists at the ADA Forsyth Institute and Brigham and Women’s Hospital are working on a groundbreaking bioengineering advancement to address this bone loss in the treatment of the disease. The project involves 3D printing bone graft materials to create customized bone grafts that regenerate bone more effectively than present treatments by including medicines in the bone graft that control inflammation.
The project is one application of a 25-year-long scientific exploration of immune response and inflammation led in part by Dr. Thomas Van Dyke, Vice President of Clinical and Translational Research at ADA Forsyth.
“The ultimate goal is to treat or control periodontal disease,” Dr. Van Dyke said. “We can save teeth and restore lost tissue with customized bone grafts that regenerate tissue quickly and effectively.”
Current bone graft treatments for periodontitis are only partially effective at best, and patients need six or more months to heal from the procedure. However, exploiting the body’s own mechanisms for controlling inflammation can prevent inflammation from damaging newly installed bone grafts or dental implants.
We can save teeth and restore lost tissue with customized bone grafts that regenerate tissue quickly and effectively.
Dr. Thomas Van Dyke
Dr. Charles Serhan and his team Brigham and Women’s Hospital discovered specialized pro-resolving lipid mediators (SPMs), the molecules that are naturally produced to resolve inflammation. SPMs serve as the body’s ‘off’ signal for inflammation.
This discovery proved that the body’s response to injury includes an active, not passive, end to inflammation.
“This is a seminal discovery, because it opens up control of inflammation,” Dr. Van Dyke said. Drs. Serhan and Van Dyke have been working together for over 20 years to harness this discovery for the treatment of oral and other diseases.
In this new project, Dr. Van Dyke and his team at ADA Forsyth are working with Dr. HaeLin Jang and her team at Brigham and Women’s Hospital’s to devise enhanced bone graft materials. The team plans to incorporate SPMs into the bone graft materials to resolve inflammation and boost bone regeneration simultaneously.
SPMs occur naturally in humans, but their production diminishes with age. Chronic inflammatory diseases such as periodontitis are often associated with failure of natural resolution pathways.
Exploration into this new bioengineering approach has produced encouraging results in animals. Van Dyke thinks his project can speed up the healing process – in which the SPM printed bone graft is replaced by new bone more rapidly and completely.
“We do a lot of bone grafting related to periodontitis,” Dr. Van Dyke said. “It doesn’t work very well, and there is significant room for improvement. With this new approach, we think we can take it and make bone grafts work all the time.”
