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Congratulations to all of the Faculty of Dentistry researchers that were successful in the 2017 CIHR Fall competition. This year was a remarkable year with seven grants totaling over $3 million being awarded to the researchers from the Faculty. The recent success reflects the quality of听research currently being done in the Faculty's research divisions.听

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Announced on January 24, 2018, the CIHR awarded 512 research grants from coast to coast, for a total investment of approximately $372 million dollars to 501 principal investigators. The Canadian Institutes of Health Research (CIHR) supports excellence across all four pillars of health research: biomedical; clinical; health systems services; and population health.

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Researchers from both the Division of Biomedical Sciences and the Division of Oral Health and Society took part and were successful in the competition. A total of nine researchers from the Faculty received grants.

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Principal Investigators: Christophe听Bedos, J Rousseau, Shahrokh Esfandiari, Richard听Hovey
Co-investigators:听Dr. M. Brondani, Dr. A. Dawson, Dr. E. Emami, Madame K. Farrell, Ms. M. Levesque, Dr. M. Macdonald, Dr. N. Morin, L Gauthier, L Morissette, I Ducharme, C Savage
Community partners: RAPLIQ and KEROUL

Lay abstract:

Winning pathways toward accessibility: the case of dental services for people using wheelchairs

Les personnes en fauteuil roulant ont d'immenses difficult茅s pour trouver des cliniques dentaires physiquement accessibles; une fois dans la clinique (quand cela est possible), elles sont re莽ues par des professionnels peu comp茅tents pour r茅pondre 脿 leurs besoins sp茅cifiques. Les cons茅quences de ces situations d'exclusion sont dramatiques: leur sant茅 dentaire se d茅grade, ce qui affecte une sant茅 g茅n茅rale d茅j脿 fragile.

Cette situation n'est pas surprenante: les professionnels dentaires sont peu form茅s pour soigner les personnes en fauteuil roulant. Les 茅coles professionnelles sont conscientes qu'il faut mieux former leurs 茅tudiants, mais elles savent mal r茅pondre 脿 ces questions: Qu'est-ce qu'une clinique accessible? Quelles comp茅tences enseigner aux futurs professionnels?

La litt茅rature r茅pond tr猫s mal 脿 ces questions. Voil脿 pourquoi nos buts sont de: 1) d茅finir un mod猫le de clinique dentaire accessible (incluant les espaces physiques et les comp茅tences des professionnels dentaires)听; 2) d茅velopper et implanter des modules 茅ducatifs dans ce domaine dans les 茅coles professionnelles dentaires canadiennes.

Nous adopterons une approche appel茅e investigation appr茅ciative: cette m茅thode vise 脿 identifier ce qui 芦听marche le mieux听禄 dans les pratiques existantes, puis 脿 s'en inspirer pour d茅velopper et implanter de nouvelles fa莽ons de faire. Ainsi 茅tudierons-nous en profondeur 8 cliniques dentaires championnes, c'est-脿-dire des cliniques ayant d茅velopp茅 un int茅r锚t et des savoir-faire sp茅cifiques aux personnes en fauteuil roulant.

L'茅tude de ces cliniques nous permettra de d茅finir un mod猫le de clinique accessible, puis de d茅velopper des modules de formation professionnelle de 1^er cycle et continue. A la fin de la recherche, toutes les 茅coles dentaires Canadiennes enseigneront notre mod猫le de clinique accessible, et tous les professionnels dentaires d茅j脿 茅tablis (incluant hygi茅nistes et assistantes/secr茅taires dentaires) auront acc猫s 脿 notre programme de formation continue.

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Principal Investigators: Drs. Philippe Campeau and Dieter Reinhardt
Co-Investigators: Drs. Florina Moldovan and Stefan Parent
Amount: $680,850
Duration: 5 years

Lay abstract:

Role of fibronectin mutations in spondylometaphyseal dysplasia and idiopathic scoliosis

We identified rare mutations in the important matrix protein fibronectin in individuals with a rare bone disease affecting the spine and growth plates (spondylometaphyseal dysplasia) and in individuals with the common condition which is isolated scoliosis. Since the role of fibronectin in forming the skeleton is poorly studied, we propose various methods to better understand it. We propose to study the effect of the mutations on cartilage and bone biology in cell lines and in transgenic mice, and we also propose to study a larger cohort of individuals with isolated scoliosis to determine how frequent this protein is responsible for isolated scoliosis. A better understanding of the mechanism of disease might lead to optimized therapy for the affected individuals.

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Principal Investigators: Mary Ellen Macdonald, Herenia P听听Lawrence, Belinda F Nicolau
Co-Investigators:听 Franco听Carnevale, Khady Ka, Mark Keboa, Mary E听Mcnally, Sonica听Singhal, Nazik M听Suleiman
Collaborators: Paul Allison,听Miguel听 Arevalo, Hamsa Assi, Paul Clarke,听Irwin Fried, Bernhard听Ganss,听Vice Dean,听Chamroeun听 Lay, Theresa听Marentette, Natalie Morin, Paul Posluns, Paul Sweet, James Taylor
Amount: $580635

Duration: 3 years

Lay abstract:

The oral health and dental care pathways of humanitarian migrants: Advancing a mixed methods program of research

There are over 21 million refugees and 3 million asylum seekers in the world today. Canada actively seeks these humanitarian migrants for resettlement. Over 80,000 refugees were resettled between 2015 and 2017, with an additional 58,000 awaiting their asylum requests. Studies indicate that the general health of humanitarian migrants is fragile, especially for those having lived through war, famine, poverty and spent years in refugee camps. Oral health is one area where health research has not yet developed for this population. According to the World Health Organization, there is an urgent need to develop research in this neglected area. Tooth decay (cavities), periodontal disease (bone loss around the teeth), tooth loss, oral cancers, HIV/AIDS-related oral disease and dental trauma are major public health problems. Further, research is increasingly demonstrating important connections among oral health, general health and quality of life (e.g., pain, disability, stigma, loss of taste and smell, inability to eat, smile or communicate). Many general diseases (e.g., diabetes, cardiovascular diseases, cancer) have oral manifestations which then in turn increase the risk of oral disease. Importantly, oral health follows a gradient of socioeconomic status (SES): those with the lowest SES demonstrate the worst oral health, least service use, and poorest treatment adherence. This study is designed to better understand the oral health of newly-arrived humanitarian migrants in Canada and their pathways to finding dental care. This is the first project in Canada to take a systematic approach to the oral health of this population. This study is necessary to provide baseline data from which to develop targeted interventions through a longitudinal program of research on the oral health of humanitarian migrants in Canada.听

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Principal Investigator: Marc O. Martel
Co-investigators: Mark Ware, Manon Choini猫re, Sonia Lupien
Collaborators: Marie-Jos茅e Rivard, Yoram Shir
Amount: $ 302, 174
Duration: 3 years

Lay abstract

Psychological and biological determinants of opioid craving among chronic pain patients prescribed opioid therapy

The use of opioids for patients with chronic pain has increased exponentially within the past decade. This has been accompanied by dramatic increases in rates of prescription opioid misuse, opioid addiction, and opioid-related overdose deaths in these patients. Recent research indicates that opioid craving (i.e., the subjective desire to consume opioids) is one of the strongest factors that contribute to the misuse of opioids. To date, however, little is known on the factors that are responsible for opioid craving in patients with chronic pain. Studies have shown that patients do not crave opioids simply because they experience high levels of pain. Although psychological factors such as negative affect might contribute to opioid craving, there is reason to believe that biological factors such as central nervous system (CNS) abnormalities and hypothalamicpituitary-adrenal (HPA) axis dysfunctions might also contribute to opioid craving in patients with pain. The overarching goal of the proposed research is to better understand the psychological and biological determinants of opioid craving among patients with chronic pain. In this research, we will recruit 100 adult patients with chronic pain who are prescribed opioids as part of their care at the Pain Management Unit (PMU) of the Montreal General Hospital. Patients will first undergo procedures assessing CNS abnormalities in a laboratory setting. Patients will then be asked to complete electronic questionnaires and to provide saliva samples over a 10-day period, at home, to assess psychological factors, opioid craving, and HPA axis (i.e., cortisol) activity. Analyses will examine the influence of psychological and biological factors on opioid craving. Findings from our research will help better understand why patients with pain may crave opioids. Our findings could also lead to new treatment interventions to reduce prescription opioid craving and, in turn, rates of opioid misuse among patients with pain.

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Principal investigator: Ana Miriam Velly
Co-investigators: E. Franco, M. Gornitsky, L. Gudmundsson, I. Karp, D. Morales., D. Moulin, R. Steele
Amount: $141,526
Duration: 2 years

Lay abstract:

The risk of cancer among opioid users

The preference for opioid analgesics has increased substantially in recent years. Opioid drugs are among the most commonly prescribed medications for the management of acute and chronic pain, which affects over 20% of the Canadian population. Opioid drugs, however, have many adverse effects. Recently, our study revealed that opioids are associated with the risk of pneumonia. Studies demonstrated that opioids suppress immune function and modulate angiogenesis. Moreover, our recent study based on a nationwide cohort using data from Iceland suggests that opioid use increases cancer risk. These results, however, may have been subject to confounding bias, because data on several important factors were unavailable. Thus, the opioids-cancer hypothesis remains to be properly tested in epidemiological studies. The objective of the current study is to determine whether opioid analgesics increase the risk of cancer. The source population will consist of patients 18 years or older registered with the Clinical Practice Research Datalink (CPRD), between 1 January 2000 and 31 December 2016.听 We will identify specific cases of cancer occurring during follow-up, by searching all episodes of cancer in the CPRD. Up to 10 cancer-free controls will be matched to the cases. Exposed patients will be those who received an opioid prescription between the cohort entry and 5 years preceding the index date. This study will provide the medical community with further evidence on the relationship between opioids and cancer.

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Principal investigator: Ana Miriam Velly
Co-investigators: K. Armstrong, J. Katz, M. Morelli, R. Plat, I Shrier
Amount: $118, 575
Duration: 1 year

Lay abstract:

Optimizing pain management: a pilot randomized trial in patients undergoing听arthroscopic shoulder surgery

Pain after surgery is a major health concern. The goal of this pilot study is to evaluate the feasibility for a larger randomized controlled trial (RCT) addressing pain management after surgery. Other objectives are to: 1) identify solutions to challenges that may arise in conducting the study, and 2)听obtain preliminary data to determine how many patients will be needed for the larger RCT. We opted to study patients undergoing shoulder surgery since it is a common surgery associated with fairly severe postoperative pain that is inadequately controlled with current opioid-based regimens. Patients will be randomized to receive: 1)听a combination of pain medications before surgery, 2)听a听nerve block, or 3) a combination of pain medications before surgery plus the nerve block. This pilot study is a cost-effective and practical first step to assess the feasibility and benefits of a larger definitive RCT that will address important clinical issues related to pain management after surgery.

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PI: Ji Zhang
Co-PI: Sylvie Fournier听
Collaborators: Rami Massie; Silvia Vidal; Ana听Miriam Velly
Amount:听$852,975
Duration: 5 years

Lay Abstract:

Tackling CD8+ T cells and macrophages in autoimmune peripheral neuropathy

Autoimmune diseases result from a dysfunction of the immune system in which immune cells start to attack the body鈥檚 own organs, tissues and cells. Guillain Barr茅 Syndrome (GBS) is an autoimmune disease in which the immune system attacks the peripheral nerves. Two thirds of cases are preceded by virus or bacterial infection. Patients suffer from numbness, weakness and pain in the legs which spread to the arms and upper body. The symptoms can increase in intensity until the affected person is almost totally paralyzed. It is the most common acute paralysis and represents one of the serious emergencies in neurology. GBS also causes severe persistent disability in a significant number of patients. Although pathological changes have been well established with massive immune cell infiltration into the nerves, which results in destruction of the myelin sheath (a structure that protects nerve cells) and the nerve fibers themselves, many fundamental questions remain to be answered: Why so many people have virus or bacterial infections, but only a small population develop GBS? Where is the site of the abnormality that initiates the disease process? What are the key molecules or cells that determine the fate of the disease? Why some patients recover spontaneously, while others not? We observed that B7.2 transgenic mice and cytomegalovirus infected WT mice develop abnormal symptoms, which mimic clinical and pathological features of GBS in humans. In the current proposal, we will use these two settings to dissect the molecular and cellular mechanisms leading to the initiation, progression and recovery of the disease. We will focus on the roles of two types of major immune cells, T lymphocytes and macrophages, to understand how these cells normally present in the blood can move into peripheral nerves and damage the nervous tissue. Direct evidence from GBS patients will be correlated with preclinical animal studies to dissect the contribution of these immune cells in disease pathogenesis. Our investigation will contribute to the development of more efficacious and clinical applicable therapeutic strategies for the millions of GBS patients around the world.

for a full list of winners.

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