“Mending Mouths: Rebuilding Jawbones With
Stem Cells”
Robert Marx, DDS
Robert E. Marx, DDS, Professor of Surgery and Chief, Oral and Maxillofacial Surgery at the
University of Miami Miller School of Medicine, talks about stem cells for the jawbone.
Now you’re able to create bone instead of using the patient’s own bone to create a jaw
bone, is that what’s happening?
Dr. Marx: Yes. It’s called In-situ tissue engineering. We’re able to regenerate large portions of
missing bone; at least the jaw bone and not taking any bone from the patients themselves using
three things: stem cells aspirated from their bone marrow, recombinant human bone
morphogenetic protein (BMP), and cadaver crushed bone, which is sterile from the University of
Miami Tissue Bank.
So, you put all of this in with a metal plate in the jaw and it turns into hardened bone in six
months?
Dr. Marx: In six months the bone is absolutely normal. Any of the cadaver bone has been
dissolved and replaced by the patient’s own bone, stimulated by the BMP, and actually produced
by the bone marrow. The metal plate that’s internal stays there as a form of rigid fixation and
holds the bone still during the healing process.
How much time does this shave off of a patient’s stay in the hospital from the old method
to the new method?
Dr. Marx: It shaves off at least three days, maybe four. In the standard use of open hip grafting,
patients are in the hospital for about four days. Another alternative is to take a leg bone called the
fibula. Those patients are in the hospital ten days and usually three days in the intensive care
unit. With In-situ tissue engineering, the patients are out the next day.
Tell me about Ramsey, what happened to his jawbone?
Dr. Marx: Ramsey suffered complications from a wisdom tooth removal. He developed a pretty
serious infection. It progressed to weaken his jaw; then his jaw finally broke and resulted in a
significant amount of dead bone that we had to remove.
And how did he respond to the therapy?
Dr. Marx: He responded perfectly. He was a good patient and his otherwise general body health
helped him through difficult times. Because we had to remove about four or five inches of his
jawbone and replace it, we did it in two separate surgeries. The first one was to eradicate the
infection. The second one was to rebuild the bone with this In-situ tissue engineering. Then he
had a routine dental implant placement placed. He had not only his bone placed back, but also
his teeth placed back through dental implants.
What is this used for, tumors and broken jaws?
Dr. Marx: It can be used in trauma. We’ve done this for gunshot wounds, benign tumors, and for
individuals who have had malignant tumors removed as long as they did not have active cancer.
This combination works in almost all patients. Right now we’re trying to make it work in the most
difficult group and that is the radiated patients, but we are still in research format.
When you take the bone marrow, is it taken at the same time that you replace it into the
jaw?
Dr. Marx: Yes. That’s the large advantage of it. It’s the patient’s own bone marrow and it’s
essentially at the same time. There is no delay. There’s also no risk of infection by transferring it
into a culture plate to an outside institution. It’s very practical and has proven now to be very
successful.
Did anybody fund this study?
Dr. Marx: No one funded this study. We do have a research chair that funded this study, but this
is not beholden to any company at all. It is internally funded through the University of Miami.
Are you directly or indirectly compensated by the manufacturer for your involvement in
this procedure?
Dr. Marx: No, not this particular procedure. I have been a paid consultant to these companies for
the FDA required research, but this is not that part. These are our own independent non-funded
studies.
Will your hospital or organization benefit financially by this procedure?
Dr. Marx: I think they will only because they have less cost. It’s a shorter operation, less hospital
time for a very good reason, and less complications. So, there is less redo. In the long run it
saves a lot of their expenses.
What concerns do other doctors have as to why they are not using this procedure?
Dr. Marx: This is a relatively new technique that came from all of our research. We have been
developing books. Because it is new, not everyone has been trained in this. So, we are training
fellows and residents each year.
This information is intended for additional research purposes only. It is not to be
used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any
medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no
responsibility for the depth or accuracy of physician statements. Procedures or
medicines apply to different people and medical factors; always consult your
physician on medical matters.
If you would like more information, please contact:
Robert E. Marx, DDS
Professor of Surgery and Chief
Oral and Maxillofacial Surgery
University of Miami Miller School of Medicine
(305) 256-5270
rmarx@med.miami.edu
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