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.
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