Tuesday, 1 July 2014

Engineering - Regenerating Bones Requires Good Doctors and Good Engineers

Imagine having to live without a jaw. Then imagine getting one custom-made, complete with regenerated bone. That’s a lot to imagine, especially if you’re a dog, but that’s exactly the type of patient researchers at UC Davis have been helping.

Some animals are known to regenerate body parts. These include relatively simple life forms such as worms or sea stars to the more complex such as lizards and deer (their antlers, in case you were startled). The ability is rare in mammals and typically not extensive where it exists. But what if you could give the body a little assistance? Lad, a collie from Kentucky, at University of California, Davis School of Veterinary Medicine

A collaborative effort between  UC Davis’ William R. Pritchard Veterinary Medical Teaching Hospital, and biomedical engineers at the campus’ Translating Engineering Advances to Medicine (TEAM) facility has been changing the lives of our four-legged friends. The process starts with impressive science and advanced technologies. It ends with a fully functioning patient.

The process starts with modeling and creating a one-off titanium replacement scaffolding for the dog’s jawbone. This involves 3D scanning and 3D printing. No two dogs are exactly the same, and this method ensures that the replacement is a perfect fit. It also allows for the titanium replacement to be created accurately before surgery ever starts.

The titanium is not intended to be the entire jaw, but rather it acts to hold a special sponge which carries with it bone morphogenic proteins (BMPs). The BMPs essentially induce and govern the regrowth of new bone with the titanium acting as a support. Within eight to ten weeks the patient's remaining jawbone cells can regrow the missing structure.

The procedure has been applied to a number of full and partial regrowths, with every operation being successful.  This technique is certainly helping dogs, but there are implications for human medicine as well. Regenerative techniques are at the forefront of modern medicine and hold the promise of patients being able to provide their own replacement tissues and organs by using their stem cells.

The future of medicine is very much an engineering effort. The technique used to regrow dog jawbones brings together good design, materials selection, tissue engineering and advanced manufacturing technologies. Of course, these are only tools for the doctor, which have to be skillfully applied to be successful. This kind of collaborative effort has good implications for where we are headed in healthcare. For dogs and their owners.

The video below briefly discusses the case of Whiskey, a Munsterlander with oral cancer which received the regenerative surgery.

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