New research projects address a diverse array of topics

The OMS Foundation recently disbursed Research Support Grants of $75,000 each to four projects that show promise for advancing the specialty through innovation. The Stephen B. Milam Research Award recognizes the highest-ranking proposal of those submitted for review. The four projects are:

Stephen B. Milam Research Award
Magnetic resonance neurography and diffusion tensor imaging of peripheral trigeminal nerve injuries: Surgical correlation and outcomes prediction
PI: Dr. Avneesh Chhabra, University of Texas Southwestern Medical Center
Co-PI: Dr. John R. Zuniga, University of Texas Southwestern Medical Center

Injury to branches of the trigeminal nerve is a well-known risk of dental and oral procedures. Molar tooth extractions alone account for 11 million patient days of “standard discomfort or disability” – pain, swelling, bruising and malaise.

Magnetic resonance neurography (MRN) is an imaging strategy dedicated to the peripheral nerves that provides a non-invasive, 3D map of neuromuscular anatomy, facilitating the detection of neuropathy by showing alterations of nerve caliber, identification of neuroma and abnormal intraneural T2 signal intensity ratio (SIR). In addition, diffusion tensor imaging (DTI) aids in functional evaluation of the intraneural patho-physiology and augments routine MRN for the diagnosis of neuropathy.

This project seeks to improve the diagnosis of peripheral trigeminal nerve (PTN) injury and evaluate whether MRN can serve as a pre-surgical diagnostic and prognostic tool during patient management.

Dr. Chhabra is associate professor of radiology at University of Texas Southwestern Medical Center and chief of its Musculoskeletal Radiology Division. He also serves as chief of musculoskeletal imaging at Parkland Memorial Hospital.

The Oral and Maxillofacial Objective Structured Assessment of Technical Skills (OMOSATS)
PI: Dr. Marco Caminiti, University of Toronto
Co-PI: Dr. Mark Shuren, University of Toronto

To date, the main method of assessment of surgical ability has been written and oral examinations followed by in-training evaluation reports that may or may not deal with technical competency. A technical skills examination that evaluates a surgeon’s ability to properly execute surgical procedures has not been implemented in any academic or licensure setting. The Oral and Maxillofacial Objective Structured Assessment of Technical Skills (OMOSATS) is a procedure-based, multi-station technical skills examination that reflects the range of milestones and Entrustable Professional Activities necessary for OMS surgical practice. Its objective is to enable academic programs to assess the development of skills and how they are taught. It also may help residents establish a self-assessment tool for competency and areas requiring improvement and assist residency programs in assessing candidates for potential entrance into the OMS specialty.

Development of surgically implantable minor salivary gland-based constructs for treatment of xerostomia
PI: Dr. Mary (Cindy) Farach-Carson, University of Texas Health Science Center at Houston
Co-PI: Dr. Simon Young, University of Texas Health Science Center at Houston

Xerostomia, a condition characterized by decreased saliva production and flow, afflicts approximately half a million people worldwide and leads to difficulty in eating, swallowing and speaking along with increased susceptibility to dental caries if the condition persists. Xerostomia is a common consequence of radiation therapy subsequent to treatment of head and neck cancers.

To mitigate the difficulties associated with the loss of salivary cells post-radiation, a team is working to develop a biologically based, surgically implantable salivary gland replacement tissue. Recently developed procedures for culturing intact pieces of resected major salivary glands in 3D hydrogels have shown promising preliminary results. This project aims to identify and optimize methods for long-term culture and expansion of minor salivary gland tissue in 3D hydrogels for future surgical transplantation into oral tissues of patients with xerostomia, thereby developing a novel and effective therapeutic approach for radiation-related xerostomia.

Orthognathic speech pathology
PI: Dr. Laura Anne Jacox, University of North Carolina Adams School of Dentistry
Co-PI: Dr. Timothy Turvey, University of North Carolina Adams School of Dentistry
Co-PI: Dr. George Blakey, University of North Carolina Adams School of Dentistry

Patients with severe jaw disharmonies pursue orthognathic surgery to address issues with esthetics, mastication and speech. Few quantitative data exist to correlate severity of speech distortion with degree of malocclusion. Furthermore, it is unknown whether surgical correction yields lasting improvement in articulation, as long-term follow-up data have rarely been collected. Despite this lack of data, patients undergo invasive jaw surgery in hopes of speech improvement. To address this knowledge gap, the hypothesis will be tested that speech distortions correlate with severity of anterior-posterior and vertical jaw disharmonies and that corrective surgery yields long-term improvement in speech.