More than 400 broken jaws a year walk and roll through the doors of the University of New Mexico Hospital every year. Most are males, 16 to 40 years old, most are uninsured, and most are facing major surgery with plates and screws to pull the pieces back together. This assembly line of misery bothered Dr. Jon Wagner, a plastic surgeon at the trauma center.
Photo: Jon Wagner
His concern is the brute force it takes to make repairs using current methods. He must make incisions though the face to insert the titanium plates, bending them with heavy tools to fit the curve of the jaw and drilling holes in the bone to insert screws that hold the plate in place.
It is very invasive surgery and has a complication rate of up to 30 percent as the stresses of biting and chewing pull the screws loose, or dislodge the plates or create infections.
Wagner's instincts told him there had to be a better way, but tinkering in the evening in his medical lab wasn’t solving the problem. So he began talking with engineers.
Engineering Implants
Two Mechanical Engineering professors from UNM’s School of Engineering John Wood and Tariq Khraishi looked at the problem and told him it could be analyzed with standard engineering software using finite-element modeling, a computer design software the National Science Foundation has supported for years.
Wagner said that sounded like Greek to him, but he believed them when they told him they could tackle the problem with lots of information about jaws, and a very enthusiastic graduate student.
Khraishi had a master’s degree student looking for an interesting problem and Scott Lovald plunged into the complexities of getting information about the stresses and strains of the human jaw from the software program.
It took three years, but Lovald, who had begun to modify the software along the way began coming up with answers. The plates didn’t have to be as heavy as the ones manufacturers recommended to bridge most fractures.
And they could be reshaped and modified to be lighter and more specialized for different kinds of fractures and patients.
Wagner now had scientific information to back up his instinct; and began using the smaller lighter plates normally used for bone fractures in the upper jaw on the bottom jaw, inserting them from inside the mouth.
That eliminated the facial scars, and the complication rate plunged. It worked so well that he has submitted a paper to the Archives of Facial Plastic Surgery, a scientific journal read by other surgeons.
Working with Industry
Wagner gets most of the hardware he implants in patients from one company in Germany, Stryker-Leibinger.
The company has been keeping an eye on Wager’s work and has been intrigued enough with the initial results to fund a yearly $30,000 fellowship in the UNM School of Engineering’s Mechanical Engineering Department for the next five years.
It’s the largest corporate investment in the department’s history.
Khraishi Expands His Interest
A mechanical engineering professor with even a modest amount of corporate investment can make great progress on problems, and Khraishi now has his first Stryker-Leibinger Biomechanics Fellow, Victor Caraveo, analyzing fractures under differing bite forces.
Another graduate student Julie Kimsal is working on a jaw fracture located in a different part of the jaw.
Khraishi is now intrigued with the idea of helping UNM surgeons solve real-life problems and he is now working with surgeons in the Neurosurgery and Orthopedic Departments to solve other problems of concern to them.
Lovald now has his master’s degree in manufacturing engineering and another degree as a Master of Business Administration.
He and another MBA student, Ryan Smith are trying to build Satyrne Biotechnologies, a start-up company based on Lovald’s software and plate redesigns.
Lovald and Smiths team pitch for the start-up company has landed them awards at several business technology competitions.
They have just received approval from the U.S. Food and Drug Administration to use one of their plates in surgical settings. With that approval, they hope to find a way to manufacture the redesigned plates so that surgeons like Wagner can actually begin using them.
Media Contact: Karen Wentworth (505) 277-5627; email kwent2@unm.edu
Posted by kwentworth at June 13, 2007 01:29 PM