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Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: The development of technology transfer programs at universities throughout the US was catalyzed by the passage of the Bayh–Dole Act in 1980. This landmark legislation allowed universities to own and manage all inventions developed by their employees with federal funding. An effective technology transfer program requires: productive and innovative researchers; clear, supportive policies; knowledgeable professional staff; and adequate funding for operating expenses and for patenting inventions. When all four components are in place, technology transfer can enhance the university’s ability to interact with industry and can make a significant contribution to economic development at the local, state and national level.
Abstract: This manuscript reviews the sequence of events surrounding the development of a proposed diagnostic test for periodontal disease based on analysis of a host mediator in gingival crevicular fluid (GCF). The mediator is lysosomal β -glucuronidase (β G), a marker of granule release from polymorphonuclear leukocytes. Preliminary studies were conducted to evaluate the most reproducible method of collecting GCF and analyzing the data. This was followed by analysis of the mediator in GCF in a variety of cross-sectional and short-term longitudinal studies, and eventually by a study of the relationship of β G in GCF to disease progression (probing attachment…loss) in a single center longitudinal trial. Development of an academic-industrial collaboration allowed the project to progress, as a rapid, practical assay system was developed, and a multi-center longitudinal trial was conducted. The multicenter trial indicated that patients with elevated β G in GCF were at 6 to 14 times higher risk for experiencing probing attachment loss. The technical, regulatory, business and marketing issues surrounding the introduction of a diagnostic test for periodontal disease were considered. While technical and regulatory issues were not major impediments, business and marketing concerns contributed to a decision to halt development of the test. Specifically, there was concern about acceptance of the test by practitioners and third party reimbursement. Underlying these issues were the multifactorial nature of periodontal disease, and the lack of a direct cause and effect relationship of test results to disease outcome. While analysis of β G in GCF is not currently available as a diagnostic test for periodontal disease, the development process has identified important issues for the introduction of diagnostic tests, including consideration of the relationship of test results to treatment, the need to integrate diagnostic tests into dental practice, and an appreciation of the financial and health care benefits derived by practitioners and patients with use of such tests.
Abstract: OmniGene Diagnostics. Inc. has applied the principles of genetic engineering to develop species-specific DNA probe tests for eight periodontal pathogens (Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetem-comitans, Fusobacterium nucleatum, Eikenella corrodens, Campylobacter rectus, Bacteroides forsythus, and Treponema denticola). The test requires minimal effort on the part of the clinician: subgingival plaque samples are collected from the patient and sent through the mail for analysis by OmniGene Diagnostics’ fully licensed clinical reference laboratory. Results are transmitted to the practitioner by phone, fax, or mail. The use of diagnostic tests for periodontal pathogens is a relatively new concept in dentistry and acceptance of…the OmniGene Diagnostics tests by the dental marketplace has been slower than anticipated. OmniGene Diagnostics’ challenge for the future is to persuade the dental community that monitoring periodontal pathogen levels, as well as other clinical indicators of disease, is essential to providing optimal care to the periodontitis patient.
Abstract: Universities and dental schools are increasingly emphasizing the importance of transferring technology based upon faculty research into marketable products. One area of current interest to dentistry involves the utilization of recombinant DNA and protein purification technologies to produce therapeutics based upon the biologic activity of the proteins. This work builds upon the discovery and characterization of several families of protein capable of inducing potent biological responses both in vitro and in vivo. It is motivated by the need to provide patients with additional alternatives for the prevention, diagnosis, arrest or repair of a number of oral conditions or their sequela…such as periodontitis, caries, and neoplasia. This article addresses some incentives and disincentives extant within academic institutions encountered during the development of a therapeutic agent for the regeneration of the periodontium. Incentives include professional rewards associated with the development of new therapeutics and disincentives include conflicts between traditional measures of academic achievement and the nature of the work associated with the development of such products. Some ideas for the resolution of disincentives are presented.
Abstract: For thirty years now oral implants and methods for implantation have been developed further to assure a lifetime stability of these devices and to optimize function and esthetics. Coming from osteosynthesis the Institut Straumann in cooperation with leading clinicians had a considerable share in this development. Out of this longtime cooperation an institutionalized form was devised, where clinicians, material scientists and engineers were united in the International Team for oral Implantology (ITI). This scientific organization, although legally and financially independent from Institut Straumann, works in close cooperation with the company in an unique form of symbiosis. The ITI takes care…of research and education of clinicians and practitioners and it gives the needed input for the development of new products to the Institut Straumann as its exclusive licensee. The company again pays license fees to the ITI Foundation enabling thus a continuous scientific clinical research. Over many years a whole philosophy and implant system – the ITI Dental Implant System – was developed this way with its sound scientific background.
Keywords: Dental implants, ITI Dental Implant System, technology transfer, cooperation between research and industry
Abstract: This paper describes my attempt to develop a new technology for sampling the contents of the gingival crevice. Following a brief introduction on the potential of the gingival crevice as a prognosticator of periodontal health, the problems associated with attempting to fulfill this potential are discussed. These problems include difficulties in identifying a crevice component or property that was correlated with disease, the shortcomings of the paper strip method used for sampling from the crevice, and finally difficulties in defining periodontal disease and finding clinical parameters useful for correlation with biochemical studies. A new technology for sampling the contents…of the gingival crevice is described. This technology is based on immunomagnetic capture in which antibody coated magnetic microspheres are introduced into the sulcus. Following the capture of antigens, the micro spheres are removed and the amount of antigen quantified by immunochemical assays. This paper describes attempts to develop this technology into a commercial product and includes experiences with raising capital and marketing the discovery. A brief discussion of the role of the scientific community, the practicing dentist and insurance coverage to the technology transfer process is included. Finally, some suggestions for improving the technology transfer process are included.