Julio Carrion, DMD, PhD, 2009 Educator Scholar, 2013 Foundation Fellow to the ADEA/AAL Institute for Teaching & Learning in the Health Professions, 2014 Teaching Fellow:
1. What is your research focus?
Our main research interests focus on the use of adult stem cells for periodontal and peri-implant regeneration. Currently, with the collaborations of our co-investigators, we are conducting studies in the new state-of-the-art Tissue Engineering and Periodontal Regeneration (TERP) laboratory, to elucidate the contribution of mesenchymal stem cells in GTR and GBR procedures. Stem cells self-renew, give rise to many different types of daughter cells, and exhibit clonogenecity. Mesenchymal stem cells (MSC) are adult stem cells that are derived from mesenchymal tissue and can differentiate into chondrocytes, osteoblasts, and adipocytes, among other cell types. One source of MSC that is readily available can be found within the gingiva, namely gingival mesenchymal stem cells (GMSC). Unlike other adult tissues (i.e. bone marrow), the gingiva is easily accessible and routinely discarded during periodontal surgery. GMSC have been found to be superior to bone marrow MSC, have immunomodulatory and anti-inflammatory properties, and can be found in both healthy and inflamed gingival tissues. Thus, GMSC can be used to enhance regeneration, not only around teeth and dental implants, but to treat chronic systemic diseases, such as ulcerative colitis and diabetes.
2. What has/have been the most significant contribution(s) of your research to our specialty?
Research in periodontology is rapidly expanding in scope and significance leading to the development of new methods for the prevention and treatment of periodontal and peri-implant diseases. One area of research that has experienced rapid growth is in regenerative technologies for the reconstruction of hard and soft tissue lost from periodontitis and peri-implantitis. For many years the standard technique for regenerating the periodontal attachment apparatus has been guided tissue regeneration (GTR). GTR employs the concept of selective cell repopulation by placing a barrier membrane over a periodontal defect to block epithelial downgrowth and gingival fiber adaptation to a root surface while enabling the periodontal ligament stem cells to migrate coronally leading to new bone and cementum with Sharpey's fiber insertion. Unfortunately, the use of the barrier membrane technique and biologic inhibition of the epithelial cell downgrowth do not lead to complete regeneration. At the present time, we are undertaking studies to understand the role of inflammation on GMSC migration. Cell migration is the foundation on which GTR is predicated, that is the selective recruitment of wanted cells (i.e. osteoblasts, cementoblasts, fibroblasts, GMSC) and exclusion of others, such as epithelial cells. By understanding GMSC migration patterns we can potentially redesign existing commercially available barrier membranes used for GTR to become more cell selective, resulting in enhanced regenerative outcomes.
3. What are some future directions of your research program?
One of our main goals is to extend our research efforts beyond periodontal regeneration to potentially be used to repair damaged tissues in the human body. To this end, we are collaborating with world-renowned stem cell biologists, Peter R. Brink, Ph.D. (Professor and Chairman of Stony Brook's Dpt. Physiology and Biophysics), and Yupo Ma, M.D., Ph.D., (Professor and Medical Director of Flow Cytometry, Stony Brook Medicine). We are planning on conducting studies on GMSC interactions with the immune response, cell-to-cell communication, and cell reprogramming. Essentially, cell reprogramming will allow us to use terminally differentiated cells in the gingiva to become undifferentiated cell types that can literally, for instance, turn into cardiomyocytes, which can be used in cardiovascular regenerative medicine. Another, yet, important function of our laboratory is to provide mentorship to the future generation of scientists. Currently, we provide guidance and mentorship to a vast majority of students ranging from high school level through graduate school, including many dental students. The expectation is that our students will developed a sincere appreciation and respect for scientific research and thus get involve in a meaningful way during their professional career development and beyond.
4. What influence did the support from the Foundation have on your career as a researcher?
The AAP Foundation has made my dreams come true. Ever since I was in dental school I knew I wanted to have a career in research, education and academia. Unfortunately, my hopes vanished when I witnessed the financial struggles faced by many trying to pursue a same career path, forcing them to have careers in private practice alone. Certainly, things changed when I came in contact with the AAP Foundation and I discovered the many scholarships and resources they offered to those interested in pursuing a career in academics and research. As my interactions and support with the foundation increased, so increased my desire and passion to pursue what I love, which is to advance our specialty through new scientific research discoveries. Now, I am looking forward to work, collaborate and "give back" to the AAP Foundation to further their mission and thus be able to reach out and support our future generation of young research scientists.