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Dr. Marcela Romero-Reyes NYU College of Dentistry Professor Dr. Marcela Romero-Reyes has been selected by the Migraine Research Foundation and the American Headache Society as the first recipient of the Heftler Migraine Research Award for her innovative proposal to investigate whether a treatment for migraine headaches can also be used to manage orofacial pain disorders, such as trigeminal neuropathies, which are often associated with burning sensations and sudden episodes of stabbing, electric shock-like pain in the lips, tongue, nose, scalp, forehead and jaws. Dr. Romero-Reyes, an Assistant Professor of Oral & Maxillofacial Pathology, Radiology & Medicine and Director of the Orofacial and Head Pain Clinic, will study a molecule that has shown promise as a treatment for acute migraine pain. This molecule blocks CGRP, or calcitonin gene-related peptide, a protein that triggers migraine pain by causing blood vessels in the trigeminovascular system (brainstem) to dilate and release inflammatory substances. Like migraines, orofacial pain disorders are rooted in the trigeminovascular system. In her study, Dr. Romero-Reyes will examine whether blocking CGRP prevents orofacial inflammation and pain in mice. Dr. Romero-Reyes is collaborating on the grant with her former mentor, Dr. Andrew Charles, Director of the Headache Research and Treatment Program at the University of California at Los Angeles, where Dr. Romero-Reyes was a Postdoctoral Fellow in Neurosciences before joining the NYUCD faculty in September 2009.
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The NYU School of Medicine has awarded a one-year Center of Excellence grant to an NYU College of Dentistry professor to study how bladder tumors progress to invasive cancer. Bladder cancer is the fourth most common cancer in men, and the eighth most common in women, with over 50,000 new cases and 14,000 bladder cancer-related deaths reported annually in the United States. Molecules found in tobacco smoke, processed meats, and rubber products have been linked to bladder cancer, and the new study, led by Dr. Joseph Guttenplan, a Professor of Basic Science and Craniofacial Biology at the College of Dentistry, will focus on one such molecule, known as BBN, or N-butyl- N-(4-hydroxybutyl) nitrosamine. Dr. Guttenplan will investigate how BBN damages the DNA of mice to create mutations leading to cancer. He will also examine whether certain enzymes increase BBN’s toxicity to determine why some mice develop mutations and others do not. His findings could aid in the development of genetic tests to identify those individuals at a high risk for bladder cancer and also contribute to the development of new drugs or dietary supplements to prevent the disease. Dr. Guttenplan’s laboratory is one of only a handful of laboratories in the U.S. that can analyze and measure mutations in mouse organs. Dr. Guttenplan also uses mouse mutation analysis for oral cancer research. NYU’s Senior Vice Provost for Research, Dr. Pierre Hohenberg, provided supplemental funding for the study. Dr. Xue-Ru Wu, Co-Director of the Center of Excellence on Urologic Disease at the NYU School of Medicine, is a coinvestigator on the grant.
NYU College of Dentistry Professor Dr. Ananda P. Dasanayake has been awarded a one-year NYU Global Public Health Research Challenge Fund grant to continue his study of how periodontal disease can contribute to gestational diabetes mellitus. Dr. Dasanayake, a Professor of Epidemiology & Health Promotion, Director of the Graduate Programs in Clinical Research, and the Oral Health Concentration Leader for the NYU Global Master’s in Public Health Program, will collaborate with researchers at Khon Kaen Hospital and Khon Kaen University Teaching Hospital in northeast Thailand. Dr. Dasanayake’s hypothesis is that molecules related to periodontal disease block insulin, the hormone that enables cells to absorb glucose, the body’s main source of energy. In gestational diabetes, the body cannot transport glucose to the cells during pregnancy. “Although gestational diabetes usually disappears when pregnancy ends, nine out of ten women who have had gestational diabetes will later develop the most common form of diabetes, known as Type 2, and their babies will be at risk for developing it, too,” said Dr. Dasanayake, adding that Type 2 diabetes has already been linked to inflammation caused by periodontal disease. Asian women are known to be at high risk for gestational diabetes mellitus. Thailand was chosen for the study because Thai women have low rates of smoking and alcohol use, thus enabling Dr. Dasanayake to eliminate these practices as possible risk factors for periodontal disease and gestational diabetes mellitus in his study. Each year, periodontists on the staff of the two Thai hospitals participating in the study treat 2,500 women for periodontal disease in the hospitals’ prenatal clinics. These highly experienced periodontists will help facilitate the study, which will focus on 100 women drawn from this population. The women will be given a periodontal examination and tests to screen for gestational diabetes. Dr. Dasanayake hypothesizes that those women found to have the greatest amount of bleeding and inflammation in their gums as a result of periodontal disease will have the highest levels of glucose in their blood. Such a finding would bolster the results of a previous study completed in spring 2009, in Sri Lanka, where pregnant women with periodontal disease and low smoking and alcohol use rates were shown to be at increased risk for developing gestational diabetes. The results of that study were presented last March at the Fifth International Symposium on Diabetes and Pregnancy in Sorrento, Italy. “If our hypothesis is borne out, it will be further evidence that pregnant women should see a dentist if they become pregnant, and even after becoming pregnant,” said Dr. Dasanayake. “Treating gum disease during pregnancy has been shown to be safe and effective in improving women’s oral health and minimizing potential risks.” Dr. Dasanayake’s coinvestigators on the Global Challenge Fund grant include Dr. Waranuch Pitiphat, Associate Professor and Associate Dean of Research; Dr. Nawarat Wara-Aswapati, Dean and Associate Professor of Periodontology; Dr. Waraporn Suwannarong, Assistant Professor of Periodontology; Dr. Doosadee Hormdee, Associate Professor of Periodontology; and Dr. Anyarat Chokwiriyachit, a graduate student in the Department of Periodontology, all at the Khon Kaen University Faculty of Dentistry. Additional coinvestigators include Dr. Gunniga Sumanonta, a periodontist in the Dental Division of Khon Kaen Hospital; Dr. Witoon Prasertchareonsuk, Associate Professor of Obstetrics and Gynecology at the Khon Kaen University Faculty of Medicine; Ms. Joan Combellick, a student in the NYU Global Master’s in Public Health Program, and Ms. Nok Chhun, a junior research scientist in the NYU College of Dentistry’s Department of Epidemiology & Health Promotion.
Dr. John Ricci is NYUCD's principal investigator on the grant. Two NYUCD professors are partnering with researchers from the University of Medicine and Dentistry of New Jersey and Rutgers University on a $2.8 million grant from the National Institute of Dental and Craniofacial Research, part of the NIH, to assess the effectiveness of anti-inflammatory, three-dimensional bone tissue scaffolds in regenerating missing sections of skull. The study is being led by Dr. Patrick O’Connor, an Assistant Professor of Biochemistry and Molecular Biology at UMDNJ. The NYU College of Dentistry, a subcontractor on the grant, received a $352,000 award. Dr. John Ricci, an Associate Professor of Biomaterials & Biomimetics, and Ms. Elizabeth Clark, an Adjunct Assistant Professor of Biomaterials & Biomimetics, will design and fabricate the calcium-phosphate scaffolds, which will contain a unique anti-inflammatory biomolecule known as a lipoxygenase inhibitor, as well as a novel anti-inflammatory polyaspirin polymer developed by Dr. Kathryn Uhrich, a Professor of Chemistry and Chemical Biology and Dean of Mathematical and Physical Sciences at Rutgers University School of Arts and Sciences, which is also a subcontractor on the grant. The scaffolds will release the anti-inflammatory biomolecule and polymer into the surrounding bone and skin. This is believed to be the first time that anti-inflammatory therapies, which have shown great promise for the stimulation of bone repair, are being used in scaffolds. The scaffolds will be made using a robotic deposition printer, or Robocaster, that can print layered, porous, three-dimensional scaffolds from data obtained from CT scans and MRIs of missing or damaged bone and other sources. Because the structural elements of the scaffolds are similar in size to bone structure (a quarter of a millimeter), the bone is expected to grow more quickly and accurately than bone generated from other random-orientation tissue scaffolds. NYUCD is believed to be the only dental school using the printer for bone regeneration. In addition to skull repair, the scaffolds could have a variety of other craniofacial applications, including bone regeneration for periodontal disease patients, and cleft palate repair. Human trials would be needed before the scaffolds could be put into clinical use. Dr. Ricci and Ms. Clark are designing and fabricating the scaffolds in collaboration with Dr. Van Thompson, Professor and Chair of the Department of Biomaterials & Biomimetics; Dr. Mitchell Pines, Clinical Professor of Biomaterials & Biomimetics; Dr. Racquel Z. LeGeros, Professor and Associate Chair of Biomaterials & Biomimetics and Linkow Professor of Implant Dentistry; and three second-year students from the MS in Biomaterials Science program: Dr. Afraa Murriky, Dr. Ioana Chesnoiu-Matei, and Mr. Lukasz Witek.
Dentistry has a unique window into patient care. Many dental patients develop long-term relationships with their dentist that last decades and occasionally generations. But many patients who regularly see dentists do not see a primary healthcare provider with anything approaching the same regularity. This places the dental practitioner in a privileged position to observe and intervene in potentially lifesaving general health matters. At the New York University College of Dentistry we have adopted a patient care philosophy based on the conviction that it is our obligation to care for the entire patient, not just the mouth. As NYU College of Dentistry Dean Charles N. Bertolami often notes, “a disembodied mouth doesn’t walk into a dental office—a person does; and that person brings along a body as well as a mouth.” Accordingly, our students are taught to evaluate patients for a variety of general health risks, not solely because such health risks may affect dental health outcomes, but because they may affect general health outcomes. Using an integrated health-care risk assessment approach, these oral health professionals in training are learning to identify risk factors for both oral and systemic disease, and to refer their patients for further screening, evaluation, and medical treatment, as needed. For example, all dentists are aware that tobacco use negatively affects periodontal health and increases the risk of oral cancer. But at NYUCD our students do more than just tell patients they should quit. In keeping with our philosophy of caring for the whole patient, and given our knowledge that smoking causes premature death, we launched a formal, mandatory program last spring to train students and faculty to utilize the five As of Tobacco Interventions for Healthcare Clinicians; Ask, Advise, Assess, Assist, and Arrange for follow-up. Moreover, NYUCD is partnering with the Manhattan Tobacco Cessation Center, housed at NYUCD and headed by Dr. Donna Shelley, Director of Interdisciplinary Research and Practice, on a tobacco cessation project involving dental students, who, to date, have dispensed more than 500 units of nicotine replacement to patients seeking to quit smoking. Impressive as this is, our students’ social responsibility does not end there. They also provide information for follow up, which is available both at NYUCD through its onsite NYU College of Nursing Faculty Practice and through the New York State Quit-line. The NYU College of Nursing Faculty Practice, which opened at NYUCD in 2006, is playing an important role in advancing NYUCD’s educational philosophy of linking oral and systemic health needs in order to improve comprehensive health outcomes. Working together, the NYU Colleges of Dentistry and Nursing offer a unique opportunity for all patients to have access to an integrated health-care “home” that addresses both their oral and general healthcare needs. The Nursing Faculty Practice, which is managed by nurse practitioners who are on the faculty of the NYU College of Nursing, offers comprehensive primary health care, including routine physical examinations, counseling, and age appropriate health and cancer screenings, and has the advantage of being conveniently located on the lobby level of the College of Dentistry. NYU dental students have always collected data on their patient’s health, but the collaborative programs that have resulted from the dentistry/nursing alliance at NYU and the convenience of having a Nursing Faculty Practice onsite at NYUCD have given a new relevance to the importance of incorporating risk assessment for serious systemic conditions into the dental exam. For example, a patient with the complaint of excessive thirst, hunger, and frequent urination could have the early signs of diabetes. A patient who sleeps on two pillows and complains to their dentist of waking in the middle of the night may be suffering from congestive heart failure. Another example is a patient who presents to the dental office with modifiable risk factors for heart disease, such as smoking, obesity, and elevated blood pressure. Each of these patients has conditions that might affect dental care outcomes, but more importantly, these conditions may be life threatening. Our students are encouraged to identify a series of health indicators and risk predictors that could save a life. Dental students seek consultation from the patient’s primary healthcare provider and encourage the patient to control their risk and disease. If a patient does not have a primary care provider or has not seen a provider in a year or more, a referral is made to the Nursing Faculty Practice for an appointment with one of the NYU College of Nursing nurse practitioners. The unique collaboration between the NYU Colleges of Dentistry and Nursing, with its focus on screening for physical health problems in a dental office, highlights the opportunities that exist to develop a collaborative model that expands access to care by addressing oral health as part of general health, well being, and life expectancy.
