Melbourne Research Unit for Facial Disorders

Our Unit and its Translational Research Mission

  • mrufd-vertical-h200px.gifFounded in 2000, we comprise a group of orofacial clinicians and researchers with a common vision that translational research holds much promise for our field of healthcare. Our primary aim is to improve the health and well-being of children who are afflicted with facial disorders (i.e. oral, dental and craniofacial problems). As elsewhere, Melbourne faced the problem of scientists working in isolation from the "clinical coalface" and from each other. And our clinicians were too busy fixing people to become deeply engaged in research. The founding goal therefore was to foster an integrated approach to research translation, with clinicians and scientists of various disciplines working together. In this way, important problems would be defined by clinicians and then basic scientists would pursue exciting discoveries in these areas. Subsequently, translational researchers, clinicians and public health workers would extend the benefits of this new knowledge to patients and the general population. Improved education was seen to be a critical part of this goal, for specialists and the public alike. Based at the Royal Children's Hospital, the Melbourne Research Unit for Facial Disorders (MRUFD) is hosted by the University of Melbourne's Department of Paediatrics (administrative base) and Department of Pharmacology ( Hubbard lab).

    Our Achievements

    Over the past decade, MRUFD has successfully developed a translational research network with unparalleled scope in the orofacial arena. Building on existing strengths, most attention has

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    Our vision: a productive cycle of research translation

    been directed at problems associated with children's facial bones and teeth. Our bone-focussed team, led by maxillofacial surgeon A/Prof Andrew Heggie, has continued to pioneer revolutionary advances in the treatment of craniofacial disorders. Their strong progress has come both from a variety of clinical trials and through translation of laboratory-based investigations. In 2003, we engaged Prof Mike Hubbard, a dentally-trained biochemist, to develop our research-translation plan further. Harnessing contributions from many others (researchers, academics, practitioners, public health, trade, industry, government), Mike and colleague Jon Mangum have since implemented a variety of initiatives that are proving to have broad value for the orofacial field and beyond. A brief summary follows, and you can learn more about MRUFD's translational vision and accomplishments here.

     

    1. Translational Research Networks

    To build community, the MRUFD has initiated and nurtured two cross-sector network groups, one addressing a clinical problem and the other technological. Besides their individual value, these complementary initiatives hold great potential for productive interaction.

    pmv-w200px.gifProteomics & Metabolomics Victoria - Developed with support from the Victorian Government, the PMV network comprises over 200 members representing academia, trade and industry. This initiative continues to strengthen the sector through key improvements in unity, access, communication, education, strategy and advocacy. Visit the Proteomics & Metabolomics Victoria website to read more.

    D3G-logo-200px.gifThe D3 Group for Developmental Dental Defects - With over 100 members from across Australia and New Zealand, The D3 Group comprises a rapidly-expanding community of researchers, clinicians, public health workers, trade and affected families. The primary focus is on improving understanding and care of people with Molar Hypomineralisation, a "dental birth defect" characterised by soft enamel (readmore).

    2. Research and Clinical Successes

    To build momentum, the MRUFD has successfully seeded and supported a variety of orofacial research projects leading to more than 39 peer-reviewed publications in the scientific and clinical literature (see Grants & Publications). One main theme has been to establish better methods for manipulating the generation and shape of facial bone, thus addressing a major challenge in the treatment of craniofacial disorders. And as a showcase for the power of translational research, MRUFD has marshalled a broad-based effort against Molar Hypomineralisation. Already, this pioneering initiative appears on track to produce public health benefits within the foreseeable future.

    Clinical advances in manipulating the generation and shape of facial bone

    Treatment of facial and cranial (skull) disorders is frequently compromised by the difficulties that surgeons have in reshaping or replacing bone. MRUFD maintains a strong interest in developing better treatment options through its work in three main areas. First, a "bone-stretching" technique (i.e. distraction osteogenesis) has been successfully adapted to rebuild small faces affected by developmental syndromes including cleft lip and palate. And through miniaturisation of devices, the same process is being used to lengthen the jaws of infants whose orofacial development has occurred improperly, such as the girl with facial clefting pictured above. The revolutionary benefits include vastly improved abilities to breathe and eat along with improved appearance. Second, important improvements have been made to the "fixation" methods used for stabilising bone segments after they have been repositioned (i.e. osteotomy). This is a particularly challenging problem in small faces and jaws. Third, addressing problems where insufficient bone is available from elsewhere in the patient (e.g. for repair of skull defects), MRUFD has successfully explored use of bone substitutes in experimental model systems.

    Translational project on Molar Hypomineralisation

     


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    Two dentists and two scientists in the lab

    Early canvassing by MRUFD identified this developmental disorder as a major concern to many dentists and academics. "Molar Hypomin" affects about 15% of otherwise healthy kids, putting them at risk of pain, tooth decay and life-long treatment needs. Following the "bench-to-bedside" maxim, MRUFD has built multi-disciplinary research teams, obtained competitive funding, and published novel research exploiting proteomics technology. Excitingly, some of the findings have provided new clues about the underlying disease mechanism, raising hopes that Molar Hypomin may become preventable someday (read more). Other findings have spurred thoughts about new diagnostic and treatment aids, heading MRUFD into the pre-commercialisation arena (patent pending, start-up company under construction).

     

    3. Education and Training Initiatives

     

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    Public lecture on Darwin
    and metabolomics

    Multi-level education is a core theme across all MRUFD initiatives. Strong educational focus is built into the portal websites of PMV and D3G (a new D3-education portal is under construction), and MRUFD staff are regularly invited to speak to diverse audiences (professional, academic, student). In 2009, MRUFD hosted a public lecture commemorating Charles Darwin (see poster) and attracted over 360 registrants from secondary schools, academia and the general public. MRUFD is increasingly involved in research training, providing "bite-sized" projects and simplified technical options for clinical visitors. To capture premium clinical knowhow, a key advance was inclusion of late-career clinicians as hands-on contributors in  basic research teams.

     

    Our Prospects

    Great potential now exists to bring the discovery power of proteomics and metabolomics technologies to the orofacial field. One exciting prospect is a cross-field effort to develop robust biomarkers for monitoring hard-tissue dynamics on a day-to-day basis. 

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    Compromising healthcare today, many clinical situations exist where bone and tooth alterations can only be assessed on long timescales, typically using X-rays. With this in mind, MRUFD has started investigating the feasibility of using body-fluid diagnostics to expedite treatments at the orthodontist. The same concept can be applied to many other bone and tooth problem areas (e.g. bone stretching & orthopaedics, developmental dental defects, osteoporosis).

     

    Continuing Support

     

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    Allan & Maria Myers, mother & child,
    Hubbard & Heggie

    Initiated and sustained with two major donations from Allan and Maria Myers (read more about our benefactors), the MRUFD receives financial support from a variety of sources including patients' families, practitioners, professional societies and industry. We welcome the opportunity to discuss MRUFD activities directly with other potential benefactors and donors.

     

    Learn more