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Gadgets and gizmos pave way for grants

Periodontics research team

The periodontics research team,
from left to right: Dr. Stephen Harrel,
clinical professor; Angela Noles,
surgical assistant; Dr. Francisco
Rivera-Hidalgo, professor;
and Dr. Celeste Abraham,
associate professor.

Photo by Steven Doll

The periodontics research team is halfway into an SBIR-funded study, and so far, the results are even better than expected

It was during a recent meeting with the four-person periodontics department research team that an interesting trend was revealed. The group gathered in Dr. Francisco Rivera-Hidalgo’s office to share the current results of their two-year, $800,000 National Institutes of Health Small Business Innovation Research grant.

Nearly a year and 15 bone regenerative surgeries into the study, the team has gotten very positive feedback. Their work involves testing the benefits of using a new technology developed by Dr. Stephen Harrel ’72, clinical professor in periodontics, during minimally invasive surgery. They’re hoping results for the next 15 patients mirror the trend.

"What I’m hearing is that most of them say they have little to no pain,” says Harrel, who secured the funding for the grant, titled “Evaluation of a Unified Surgical Instrument System for Minimally Invasive Periodontal Surgery."

“Everyone that has come in has healed outstandingly,” says Rivera, professor of periodontics and principal investigator for the study. He formulated this opinion based on patient measurements and comments six months after surgery.

“Some of them say they didn’t even feel like they had surgery,” Rivera adds.

“Part of the research focuses on developing technology that doesn’t exist yet.”
— Dr. Stephen Harrel

Dr. Celeste Abraham, associate professor of periodontics and study coordinator for the project, gathers the six-month and day-of-surgery measurements and follows up with patients during their visits, scheduled at specific intervals throughout the healing process.

“The majority of them will say they have zero pain the day after and the week after surgery,” Abraham says.

The patients even go so far as to express their desire to get their entire mouths fixed with this technology, adds Angela Noles, surgical assistant in periodontics, who works with the patients during their visits and photographs their progress.

Developing technology

This is a far cry from typical bone regenerative surgery, which creates incisions of up to four centimeters, as opposed to just four millimeters, which is what the team is now capable of doing. So just what is this revolutionary technology that has patients clamoring for more?

“A video scope is at the heart of it. That’s really what this whole thing is about,” Harrel says of his latest innovation, the patented Gas Shield, which resulted in the grant funding.

Harrel took a 2 1/2 millimeter Olympus camera — smaller than a match head and typically used for kidney surgery — and applied an envelope of air around it, allowing periodontists to view the root of the tooth during minimally invasive surgery.

“In dentistry if you place it in the mouth without the Gas Shield it will be obscured by blood and debris in five seconds,” Harrel says of the video scope matter-of-factly. “The Gas Shield creates an envelope of air that keeps the camera clear.”

Periodontics research team
Noles, left, and Harrel, right, reveal a clean view of a bone defect with
Harrel's patented device, the Gas Shield, which creates an
envelope of air around the video scope.

Photo courtesy Dr. Francisco Rivera-Hidalgo

Harrel’s been using minimally invasive surgical techniques for 15 years, but with the video scope and Gas Shield technology, he now is able to create incisions that are 10 times smaller than what is created during traditional bone regenerative surgery, decreasing patient pain and healing time. While this is a major plus, he says that some periodontists have steered away from the technique simply because of a lack of available technology.

“Part of the research focuses on developing technology that doesn’t exist yet,” says Harrel. “What we’re aiming for is developing a surgical instrument system the average dentist or average periodontist can use on a daily basis.”

As Harrel shares a video taken during surgery, Rivera marvels at the progress, stating that in the past, they were essentially working blind because they had to go by touch.

“This is the first time we can go and see. We are just mesmerized,” Rivera says.

Long history of innovation

While the clinical portion of the research study is being conducted in the college’s graduate periodontics clinic, Harrel is no novice to the scientific process. In fact, he’s been developing and patenting gadgets and gizmos for decades now, including a granulation device that allows periodontists to surgically remove tissue, and an instrument which reduces the amount of aerosol released by ultrasonic cleaning tools.

What’s perhaps just as unique is that Harrel typically conducts his research at his Dallas-based private practice, which he opened in 1976. His findings have been published multiple times in the Journal of Periodontology and the Journal of the American Dental Association, which may have helped secure the most recent NIH-SBIR grant funded in May 2010.

“The other articles I’ve written have had at least something to do with some of the technology I have developed,” says Harrel. “I didn’t do it with the intent to get the grants, but when you fill out the grant application, it helps.”

Rivera views Harrel’s efforts as fulfillment of the dental profession — sharing findings so others will know what works.

“It’s part of the profession,” says Rivera. “It keeps the profession alive and moving and changing.”