VCU oral health researchers lead project to create personalized tissue grafts in the lab

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In a project that could transform reconstructive oral care, researchers at Virginia Commonwealth University are partnering with Cedars-Sinai Guerin Children's and the University of California, San Francisco to advance the use of stem cells for bioengineering oral tissue grafts. The research effort recently received a five-year, $5.7 million grant from the National Institutes of Health.

Oral tissue graft surgery is used to repair tissue loss caused by oral cancer treatments, gum recession and other injuries. For treatment, dentists typically transplant healthy tissue from the roof of the patient's mouth to cover exposed areas and protect the teeth. While these procedures are usually successful, some grafts fail due to poor healing, infection or limited blood supply. For cancer patients, reconstruction options are limited and rarely personalized to the specific tissue that was lost.

To provide another treatment option for patients, the research team is leveraging advances in stem cell research and bioengineering tools to grow living grafts in the lab that would function as natural oral tissue. By creating grafts designed to match individual patient needs, the research effort is laying the groundwork for a personalized, potentially more effective dental procedure, while also eliminating the need to remove healthy tissue from a patient's mouth.

"Through this study, we have the opportunity to enhance oral healing by producing grafts that are the right type of tissue in the right shape for each patient," said Kevin Matthew Byrd, D.D.S., Ph.D., assistant professor at the VCU School of Dentistry's Philips Institute for Oral Health Research and one of the project leaders. "This research has the potential to transform reconstructive care for head and mouth injuries."

Pluripotent stem cells are unspecialized cells with the unique ability to develop into any type of cell in the body. These cells normally only exist during early embryonic development, but through scientific advancements, researchers can take adult cells and reprogram them into a stem cell state, allowing them to develop into different types of tissue.

"Imagine going back in time and choosing a different profession. Scientists have figured out how to do that with cells, pulling them back in their timeline and giving them the chance to be something different," Byrd said. "With pluripotent stem cells, we aim to create grafts for the specific tissue that needs to be restored, whether that's the gums, the soft palate, the lining of the cheeks or the tongue."

The initial stages of the study, led by Byrd's research team, will map the cellular infrastructure of different oral tissues in unprecedented detail. This includes identifying the various cell types within these systems, where they are located, how they function and how they interact with each other. The researchers will be collaborating with Jinze Liu, Ph.D., a professor in the VCU School of Public Health's Department of Biostatistics, who has developed biomedical AI tools that help analyze large amounts of biological data more quickly and accurately.

Once these cellular blueprints are developed, the research teams at Cedars-Sinai and UCSF will use pluripotent stem cells to design complex oral tissue grafts supported by blood vessel networks that help keep the tissue healthy and functional.

"The goal is to create a process that's effective, reliable and scalable and will ultimately improve the quality of dental care for our patients and establish new health standards for clinics," Byrd said.