Craniofacial Lab

Understanding the structure and function of bone and finding new ways to improve treatment for children and adults with craniofacial anomalies has been the focus of the Craniofacial Research Laboratory, led by Dr. Steven R. Buchman, for the past quarter-century. Our highly collaborative, translational work spans lab bench to patient bedside. Our discoveries in the areas of tissue engineering, regenerative medicine and pharmacotherapeutics will help surgeons worldwide better treat pediatric and adult patients with craniofacial bone deformities and radiation-related bone injuries.

Work in our lab, informed by our clinical practice, recently led to a Michigan Surgical Innovation Prize for our development of a novel therapeutic device to dramatically improve bone healing after difficult fractures. With consistent funding through competitive National Institutes of Health R01 and other grants, we are excited to continue making discoveries that offer new hope to patients. With support from an NIH T32 training grant, we're also training the next generation of surgical scientists to do the same.

How bone interacts with our inner and outer environments and how forces interact with and impact its structure and function can tell us a great deal about how to stimulate it to regenerate — even under the most challenging conditions, including in tissue that has been irradiated. The precise ways in which mechanotransduction affects bone growth had long been unclear. Early on, our lab investigated the mechanisms underlying pediatric craniofacial anomalies, such as craniosynostosis and cranial suture morphogenesis. That work led us to look at the molecular mechanisms at play in a common surgical treatment to stimulate bone regeneration, known as distraction osteogenesis (DO).

This deeper understanding prompted us to ask further questions. Could DO also be used for reconstruction of bone that has been irradiated, such as in our patients who have undergone treatment for cancer? How can we optimize DO to improve efficacy and outcomes in the face of these often-devastating effects? Although we've known that radiation is destructive to bone tissue, our lab further clarified the effects, including decreased vasculature and a marked decline in bone cells. Success addressing radiation damage to bone and even proactively preventing such damage next led us to ask how what we've learned about bone regeneration can lead to breakthroughs in fracture repair in otherwise healthy bone. It also prompted us to ask whether our insights might apply to the regeneration and healing of soft tissues. Questions around how to apply what we know about bone growth and repair in the craniofacial skeleton to other specialties, too, including orthopedics, gerontology, oral surgery and many others now drive our work.

Our research builds upon and continues to elucidate the role of force in pediatric and adult craniofacial anomalies, including in bone that has been irradiated, and the impact of radiation on bone healing. As a result, we are exploring ways to proactively protect bone and, more recently soft tissue, from the destructive effects of radiation and to more effectively stimulate its regeneration following radiation therapy. In addition to clarifying the fundamental science, strategies include the use of pharmacotherapeutics and stem-cell-based methods.

Over the course of more than 25 years, our work has advanced the understanding of bone structure and function, repair and regeneration. We have elucidated the mechanisms that cause the development of craniosynostosis in infants in order to better diagnose and treat it in our pediatric patients. Our work has helped clarify the mechanisms by which radiation damages bone and led to development of metrics to characterize bone healing following radiotherapy. We have been developing new strategies to mitigate the damage to bone in patients who have undergone radiation therapy for head and neck cancer and in soft tissue in breast cancer patients treated with radiation. The murine model we created is the most widely accepted model for studying distraction osteogenesis (DO), a commonly used reconstructive technique, to understand bone healing and tissue regeneration.