Multiple investigators have documented the importance of patient-oriented research in guiding therapy, implementing translational therapies and in evaluating diagnostic or therapeutic outcomes. Due to a shortage of investigators trained to conduct rigorous patient-oriented research in the field of oral and maxillofacial surgery (OMFS), the specialty literature consists largely of case reports and case series. The broad goals of this award are: 1) to develop a longitudinally funded fellowship program dedicated to training oral and maxillofacial surgeons in the principles and practice of clinical investigation; 2) to continue scientifically rigorous clinical research efforts in the area of reconstructive OMFS surgery; and 3) to initiate clinical research in the prevention and treatment of maxillofacial trauma. To accomplish these broad goals, we propose the following Specific Aims which address both the mentoring and patient oriented research aspects of the award: number 1) To establish the first funded fellowship in clinical investigation designed specifically for the training of oral and maxillofacial surgeons in patient-oriented research. Number 2) To measure the efficacy and safety of reconstructing alveolar bone defects with demineralized bone powder (DBP) or guided tissue regeneration (GTR) techniques in a 3rd molar extraction surgical model. Number 3) To determine the sensitivity and specificity of facial injuries as unambiguous diagnostic indicators of domestic violence and number 4) To identify risk factors for poor outcomes following treatment of mandibular condyle fractures.
Specific aim 1 uses an extramurally funded two-year grant to support a Fellow studying the principles and practice of clinical investigation. Mentoring surgeons to be skilled clinical investigators addresses the acute shortage of well-trained clinical researchers in the specialty.
Specific aim 2 uses an extramural award to conduct a single-blind, randomized clinical trial testing the efficacy of DBP and GTR-therapy for reconstructing alveolar defects following 3rd molar extraction. No current reconstructive techniques are clinically proven to be superior to natural healing of the extraction defect.
Specific aim 3 uses a cross-sectional study to determine the diagnostic value of facial injuries as indicators of domestic violence (DV). As DV is characterized by recurrent violent episodes of increasing severity, the early identification of DV victims may prevent future injury.
Specific aim 4 uses a retrospective study design to identify patients at risk for poor treatment outcomes after mandibular condyle fractures. Condylar fractures are common and treatment is controversial. Identifying patients at risk for poor outcomes from standard treatment begins to address treatment controversies. This award leverages the PI's skills and talents by providing protected time to mentor additional trainees and to conduct high quality patient-oriented research.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24DE000448-04
Application #
6628409
Study Section
Special Emphasis Panel (ZDE1-WG (79))
Program Officer
Hardwick, Kevin S
Project Start
2000-02-01
Project End
2005-01-31
Budget Start
2003-02-01
Budget End
2004-01-31
Support Year
4
Fiscal Year
2003
Total Cost
$123,980
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02199
Susarla, Srinivas M; Dodson, Thomas B (2013) Predicting third molar surgery operative time: a validated model. J Oral Maxillofac Surg 71:5-13
Erakat, Mohammed S; Chuang, Sung-Kiang; Yoo, Roy H et al. (2008) Immediate loading of splinted locking-taper implants: 1-year survival estimates and risk factors for failure. Int J Oral Maxillofac Implants 23:105-10
Susarla, Srinivas M; Chuang, Sung-Kiang; Dodson, Thomas B (2008) Delayed versus immediate loading of implants: survival analysis and risk factors for dental implant failure. J Oral Maxillofac Surg 66:251-5
Markiewicz, Michael R; DeSantis, James L; Margarone 3rd, Joseph E et al. (2008) Morbidity associated with oral mucosa harvest for urological reconstruction: an overview. J Oral Maxillofac Surg 66:739-44
Susarla, Srinivas M; Dodson, Thomas B (2007) Preoperative computed tomography imaging in the management of impacted mandibular third molars. J Oral Maxillofac Surg 65:83-8
Yoo, Roy H; Chuang, Sung-Kiang; Erakat, Mohammed S et al. (2006) Changes in crestal bone levels for immediately loaded implants. Int J Oral Maxillofac Implants 21:253-61
Chuang, S K; Cai, T; Douglass, C W et al. (2005) Frailty approach for the analysis of clustered failure time observations in dental research. J Dent Res 84:54-8
Chuang, S-K; Hatch, J P; Rugh, J et al. (2005) Multi-center randomized clinical trials in oral and maxillofacial surgery: modeling of fixed and random effects. Int J Oral Maxillofac Surg 34:341-4
Susarla, Srinivas M; Lam, Natalie P; Donoff, R Bruce et al. (2005) A comparison of patient satisfaction and objective assessment of neurosensory function after trigeminal nerve repair. J Oral Maxillofac Surg 63:1138-44
Sedaghatfar, Michael; August, Meredith A; Dodson, Thomas B (2005) Panoramic radiographic findings as predictors of inferior alveolar nerve exposure following third molar extraction. J Oral Maxillofac Surg 63:3-7

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