Gene therapy, tissue engineering will transform oral and maxillofacial surgery by 2020, says Harold Slavkin, DDS, former director of the National Institute of Dental and Craniofacial Research and keynote lecturer at the 86th American Association of Oral and Maxillofacial Surgeons (AAOMS) annual meeting.
The completion of the Human Genome Project in 2003 and developments in stem cell biology and tissue engineering have created an "avalanche" of possibilities for the application of basic science discoveries and new technologies to the field of oral and maxillofacial surgery. Dr. Slavkin, now dean of the University of Southern California School of Dentistry in Los Angeles, notes that dentistry and medicine have entered a new frontier in which recent advances in the ability to "mimic" biology are finding their way to the chairside and the bedside and transforming the way in which OMSs diagnose and treat disorders and diseases of the face and mouth and expanding their role as healthcare professionals.
"We are evolving from using mechanical solutions to biological solutions for diseases and disorders," he says. "The cornerstone of that evolution is a new way of thinking in science called biomimetics, which means 'to mimic biology.' If we know the biological rules for making bone, muscle, teeth and salivary glands -- and with the completion of the human genome, we do -- then we can mimic them in terms of body replacement and tissue regeneration. We can create new noses, ears and jaws. Along the way, of course, is the possibility to replace periodontal ligaments and tooth enamel," he says. By the end of the "biomimetic era" in about 20 years, stem cells, tissue engineering and gene therapy will have moved into mainstream medicine and dentistry and no longer be 'frontier-related,'" he says.
OMSs are ideally qualified to lead the application of new scientific discoveries within the clinical arena, Dr. Slavkin contends, because "the specialty is the best 'handshake' between the medical and oral/craniofacial components of the human being. OMSs work in hospital surgical settings, handle long- and short-term anesthesia, and function in a medical environment. They have the background and the capacity to do even more and to do it well."
Dental schools and oral and maxillofacial residency programs have some catching up to do, however, he asserts. "We are training people to extract a tooth or reposition a fractured mandible. Those things are very important, but they don't transfer to new thinking about growth factors, tissue regeneration and stem cells. As medical and dental schools revise their curricula, residencies need to follow. Otherwise, we will have a 'disconnect' between what is possible and what is.
"We are changing as a profession, science and technology are the drivers, and we have vast opportunities to enhance, improve and reinvent," he says.
The American Association of Oral and Maxillofacial Surgeons (AAOMS), the professional organization representing more than 7,000 oral and maxillofacial surgeons in the United States, supports its members' ability to practice their specialty through education, research, and advocacy. AAOMS members comply with rigorous continuing education requirements and submit to periodic office examinations, ensuring the public that all office procedures and personnel meet stringent national standards.