The temporomandibular joint (TMJ) is arguably one of the most complex synovial joints in humans. Like other synovial joints, the TMJ allows movements and transmits mechanical stresses. Unlike most other synovial joints, however, the TMJ in humans and higher primates are bilaterally linked and consists of fibrocartilage, instead of hyaline cartilage. Temporomandibular joint disorders (TMJD) represents an array of diverse pathological and psychosocial disorders that affect any or all structures within the joint, including the disc, condyle, articular eminence and synovium, as well as other related structures including orofacial musculature,sensory neurons, subchondral bone and surrounding soft tissues.
Columbia University is uniquely positioned to develop scientists and/or clinicians into independent investigators in multiple areas that collectively encompass TMJDP. First, mentors for this training program collectively hold no less than 28 independent and existing NIH funded research grants (R01s) that are either directly in the TMJDP field or directly related areas including biomechanics, stem cell biology, tissue engineering, cellular/molecular imaging, pain physiology, bone/cartilage biology and molecular genetics. These existing NIH R01 awards provide ample opportunities, both in depth and breadth, to prepare trainees with different academic and clinical background. Second, the TMJ and Orofacial Pain Clinic at Columbia University Medical Center treats patients from New York, New Jersey, Connecticut and other surrounding states, and offer a platform for translational and clinical research initiatives. Clinicians and scientists have ongoing collaborations in the areas of TMJ-related research. In this proposal, we will cross-train mentees with basic science and clinical backgrounds. For example, a basic scientist, in addition to his/her core research projects, will participate in a translational research project and observe clinical procedures that are relevant to his/her bench top research. Similarly, a clinician (typically a postgraduate resident) will be trained to think critically and engage in bench top experiments. Third, New York City attracts myriad candidates with ethnically and professionally diverse background and provides ample opportunities for career transition. Fourth, the College of Dental Medicine (CDM) has partnered with and leveraged a wealth of existing resources at Columbia and New York City, including New York Academy Sciences’ Science Alliance, Irving Institute of Clinical and Translational Research (CTSA), CUMC Office of Post-Doctoral Affairs, and Columbia Stem Cell Initiative (CSCI) to consolidate multiple training opportunities for professional growth and career transition of trainees in TMJDP. Fifth, interdisciplinary research is a particular strength at Columbia. Despite the fact that many departments and programs at Columbia are highly ranked nationwide, the common mindset is that research gains power and rigor in increasingly interdisciplinary areas and through collaboration among seemingly irrelevant fields. Finally, a remarkably dense concentration of research intensive universities in New York and surrounding states of New Jersey, Connecticut and Philadelphia, in addition to abundant biotechnology and pharmaceutical companies with Research and Development programs, further offer abundant career transition opportunities.
This proposal carries on the tradition of vision and leadership in dental research and education at Columbia University, as exemplarily demonstrated by Dr. William Gies, a biochemistry professor at Columbia in the first half of the 20th century. Dr. Gies was the founding editor of the Journal of Dental Research in 1919, and a co- founder of the American Association for Dental Research (AADR), and American Dental Education Association (ADEA) in 1920-1923. The Gies Report, a 650-page report on the status of dental education and research, is broadly acknowledged as the guiding document for academic dentistry. Today, the College of Dental Medicine is positioned to follow Dr. Gies’ footsteps. Through strategic recruitment in the past 5 years or so, a number of NIH funded scientists have joined College of Dental Medicine and are fulfilling critical roles in the proposed training program. The existing strength within the College of Dental Medicine, in addition to a wealth of scientific expertise and resources at Columbia that are immobilized specifically for this career development program, cumulate to an intellectually rich and challenging platform that is ready to be exploited by a group of highly selected trainees to receive rigorous training in TMJDP.
The TMD/Orofacial Pain Clinic at Columbia University Medical Center has a long-standing and rich history. Founded in 1949 by Dr. Laszlo Schwartz, the TMJD/Orofacial Pain Clinic was among the first programs of its kind. Dr. Schwartz was among the pioneers in the TMJD/Orofacial Pain field, and was instrumental in transforming the thinking of the community of TMJDP treatment from merely dental occlusion to broad medical approaches. Dr. Schwartz utilized abundant resources at Columbia University Medical Center to treat TMJDP patients and recognized TMJDP as a medical problem involving the musculoskeletal and dental systems. By the mid-1980s, a vibrant research program was funded by NIH/NIDCR and led by Dr. Howard Israel and Dr. Anthony Ratcliffe1-4 on TMJ biomarkers and extracellular matrix molecules. With the recruitment of Dr. Regina Landesberg whose NIH/NIDCR R01 was in the areas of genetic mouse models of TMJ degeneration, additional progress was made in the 1990s to examine the involvement of single and multiple genes in subchondral bone arthritis.
Scholars to be supported by the institutional career development program must be at the career level for which the planned program is intended. Scholars are expected to devote a minimum of 9 person-months (75% of full-time professional effort) during the appointment on the K12 award.
Scholars to be supported by the institutional career development program must be at the postdoctoral or junior faculty level, or established investigators redirecting their research focus to TMJD or orofacial pain, and must be committed to developing a research career in these areas. They should have a background in orofacial pain research or in a complementary research area that could be applied to orofacial pain research. Other areas of expertise include, but are not limited to, genetics, tissue engineering, biobehavioral research, epidemiology, neuroplasticity, or neurodegeneration. Scholar candidates must demonstrate a strong interest in becoming independent principal investigators, managing their own multidisciplinary research team and obtaining appropriate independent funding for such endeavors.
The School of Dental Medicine will provide support for each scholar position up to $65,000 salary and associated fringe benefits per year, based on a full-time professional 12 person-month effort, commensurate with the applicant institution’s salary structure for persons of equivalent qualifications, experience, and rank. Additionally, CDM will provide funds for travel, supplies and publication fees associated with the research.