(Dr. Hangorsky) Dr. Koo is a professor in the School of Dental Medicine and the co-director of the Center for Innovation and Precision Dentistry at the University of Pennsylvania, which is an inter-school research center bridging engineering, computational science, and dental medicine. He's also the program director of an NIH/NIDCR postdoctoral training program called Advanced Training at the Interface of Engineering and Oral-Craniofacial Sciences, uniting the School of Dental Medicine and Engineering and Applied Sciences. His research focuses on understanding how biofilms cause oral diseases, particularly dental caries, and seeking new therapeutic strategies by fostering interdisciplinary collaborations. He has employed engineering and computational approaches to study of oral biofilms and has applied nanotechnology to develop anti-biofilm nanoparticles targeting dental caries. Using robotics principles, his group developed the first microrobots capable of automated biofilm removal. Dr. Koo has published over 120 papers in dental, biomedical, and multidisciplinary journals. Among others, he's an elected fellow of the American Association for the Advancement of Science, the recipient of the Distinguished Scientist and Innovation in Oral Care Awards from the International Association of Dental Research. Welcome, Dr. Koo. Dr. Koo would you please provide us a general overview for the Center for Innovation and Precision Dentistry? What exactly is the center? What is its mission, vision, and goals? (Dr. Koo) Today, actually more than 3.5 billion people suffer from oral disease and including facial disorders, and unfortunately it affects mostly susceptible populations. The poor, the medically, and physically compromised populations. As a dentist scientist who has been working this area for more than 28 years, I find it very difficult to accept. The CiPD is a brand new center, uniting the Schools of Dental Medicine and the School of Engineering and Applied Sciences to bring both completely out-of-the-box ideas and solutions to address the unmet needs in oral health. The overarching goal is to bring engineering and computation approaches. We can study the disease mechanisms of oral diseases and also craniofacial disorders including oral cancer, so we can understand the whys and hows. The why, the susceptible population is more prone to that condition by bridging not only the faculty, but also the resources and all the students from both schools, so we can stimulate and facilitate collaborations from these goals, so new discoveries and new solutions can emerge. I can summarize the mission of CiPD in three parts. One is to promote the best and the most innovative research as possible that can bring not only new knowledge and new technologies with also a better understanding of the disease, so we can be more innovative, we can be more effective, and it can be more affordable. The second part is to train the next-generation leaders, the new workforce of highly trained dentists and engineers who can work together to advance research and innovation in oral health care. The third part is to create opportunities to bring entrepreneurship, because I think entrepreneurship is an important component to help accelerate translation of this new discoveries, new approaches, and really start to produce new products, and even new ways to treat disease and conditions. This is our driving force which makes us motivated to build the center. I think that also is very much in line with Penn Dental mission of bringing oral health equity both locally and nationally and globally. (Dr. Hangorsky) So Dr. Koo, obviously the innovative part is that there is this collaboration with the School of Engineering. Perhaps you could elaborate, what can the Engineering School contribute to its mission and your objectives? (Dr. Koo) I can maybe list four major areas that do impact dental medicine. I think one is nanotechnology, the other is artificial intelligence, advanced materials, which include fabrication methods, and robotics. I think will bring, and is actually already bringing, a huge impact in biomedicine. As an example, you can just see how lipid nanoparticles are revolutionizing COVID-19 mRNA vaccines, and how AI and machine learning are changing how we see an analyze big data. And robotics, today, is helping surgeons with both big and small surgeries. (Dr. Hangorsky) Dr. Koo, I'm sure you are working now on several projects. Perhaps you could tell us what those projects are and address what potential they have addressing the clinical needs of our population. (Dr. Koo) There are several projects ongoing right now. For example, we are developing microrobots that can remove dental plaque with very high precision using low-cost nanomaterials. There's increasing evidence that children who has iron deficiency anemia is very strongly associated with severe dental caries , with childhood caries. Research in CiPD discovered that an FDA formulation of iron oxide nanoparticles, so this is a nanotechnology, when used topically as a mouth rinse can also very precisely and effectively eliminate dental plaque associated with dental caries and also significantly reduce dental caries. I think this is very interesting. You have one nanotechnology based approach that's already FDA approved to treat iron deficiency anemia, that can be now repurposed to treat tooth decay. We are coming up with a solution to address two major public health problems in children that could be used to resolve them. I think that's just an example of what CiPD is trying to do in terms of addressing the clinical needs of the population. <i>For on-screen text, please refer to "Creating MicroRobots to Remove Dental Biofilm" in the Week 2 On-Screen Text resource.</i> (Dr. Ed Steager) There are exciting opportunities at the intersection of small-scale robotics and oral health care, really, at the engineering dental interface. (Dr. Elizabeth Hunter) One of the most exciting things about this collaboration and this project was really seeing some of the work get translated into an application that had real significant and immediate impact. This allowed some of this fundamental robotics research to be translated into an immediate and practical application. <i>For on-screen information, please refer to "Applying Microfluids and Engineering" in the Week 2 On-Screen Text resource.</i> (Dr. Alaa Babeer) Coming from a dental background, collaborating and interacting with engineers to address the unmet needs in dentistry and in the dental field through applying innovative robotics technologies can change the future of oral health care. (Dr. Koo) We also used lipid nanoparticles for bone regeneration and new fabrication methods to develop portable and affordable diagnostic devices. (Dr. Tagbo Niepa) I was working on the nanoculture and they're just tiny capsules in which we can introduce some microbes in from different communities and to study the human microbiome. (Dr. Daeyeon Lee) By using these micro capsules that we produce using microfluidic technique and understanding how interactions between fungi and bacteria could impact of dental caries development. <i>For on-screen text, please see "Developing more Effective Diagnostics for Oral Pathogens/Biomarkers" in the Week 2 On-Screen Text resource.</i> (Dr. James Pikul) We're developing new materials, and these new materials allow us to more precisely and rapidly pick out very specific targets of interest. These materials look like foams. They're membranes, then they're are magnetic. But what's really unique about them is that they have millions and millions of pores that are very, very tightly packed together that have magnetic properties. As we flow things like saliva through these membranes, we can capture specific analytes of interests, and we let everything else go. <i>For on-screen text, please see "Designing Faster COVID-19 Testing" in the Week 2 On-Screen Text resource.</i> (Dr. Ping Wang) So we all know that today in the pandemic, we have lots of unmet diagnostic needs. One good example is the oral med device that's in collaboration with Dr. Koo and Dr. Corby. What we're trying to do is to develop a oral diagnostic device that's ultrasensitive and also very fast and very convenient by utilizing saliva, readily inaccessible sample from oral cavity. To provide a tool to dentist, for example, to physicians and even to patients at home that can use them to rapidly diagnose COVID-19. What's exciting, I think, about this technology is that it's not only applicable to COVID-19, it also provides a platform that can be readily adaptable to diagnose other oral diseases. (Dr. Koo) We are also using AI to analyze really those big, super large datasets from basic research and clinical studies, which will help us to build better predictive models. (Dr. Cesar de la Fuente) My lab focuses on developing novel technologies to detect, monitor, and treat infectious diseases. We're currently teaching computers how to discover new antibiotics by means of AI. <i>For on-screen text, please see "Using (AI) to Analyze Large Datasets to Build Better Predicted Models" in the Week 2 On-Screen Text resource.</i> We're inventing low-cost rapid diagnostics. We're engineering molecular tools to engineer the microwave. Every single one of these technologies has additional applications in the dental scientists and therefore align very well with the CiPD mission. (Dr. Koo) Finally, we have the plant chloroplast technology here at Penn Dental developed by Henry Daniell, which will help us to produce low-cost therapeutic agents that can be used in dental medicine. <i>For on-screen text, please see "Chloroplast 'Green Biotechnology' for Affordable Therapeutics" in the Week 2 On-Screen Text resource.</i> (Dr. Henry Daniell) You can simply grow these plants, water them, and make capsules and take the drug at the right dose, so this greenhouse is one on the few in the world, which can make this kind of biopharmaceutical in plants. Proteins are made affordable and the drug delivery is topical using the chewing gum and facilitates greater compliance. The treatment for dental caries is $40 billion disease, which a large majority of people suffer, and the current way to treat this is to remove the plaque by scraping down. More recently, this has been done in medicine research from our lab and Dr. Koo's lab. The first step is to create enzymes. Genes from these enzymes are introduced into plant cells, and when they are topically applied, the enzymes degrade the biofilm matrix and reviews the bacterial and fungal colons. (Dr. Hangorsky) So Dr. Koo, obviously, you have been to other places before coming to Penn, do you find that there's anything specific at the University of Pennsylvania which fosters this research and makes such a collaboration possible? (Dr. Koo) I joined University of Pennsylvania, at Penn Dental Medicine in 2013. What I noticed and now I understand very clearly is the power of Penn. This is a highly inclusive, very collaborative, that encourages innovation and impact through interdisciplinary collaborations, and will facilitate the process. I think that combined with world-class scientists, clinicians, and engineers, that are willing to collaborate with you and be creative, in addition to an amazingly rich ecosystem at Penn for health technology resources really make this really not only possible, but also feasible and make us really push even further the limits of what we can do. I think I can give two examples, because of the rich ecosystem of Penn, of health technology resources it allow us to create very meaningful partnerships. One of them is a partnership with Penn Health Tech, which is a center devoted to accelerating medical devices and health care technologies. In collaboration with Penn Health Tech, we will launch the IDEA price. IDEA stands for Innovation in Dental Medicine and Engineering Award. From that IDEA prize, two very exciting projects emerged. One is an engineered baby bottle for children who suffers from cleft palate, and other one is developing a low-cost chewing gum that can break up cavity-causing dental plaque. Another example, as I mentioned earlier, is training the next generation. I think that's very important. Because again, Penn being such a place where it allows collaborations, allows other schools to integrate, to collaborate, has given us an opportunity with the School of Engineering to apply for a training grant from NIH. Our first attempt, we got an NIH/NIDCR, training grant to train postdoctoral dentists and engineers who can together work in issues related to oral health and to develop better ways to study, better ways to treat, and better way to diagnose diseases and craniofacial disorders. We're very excited about this particular training grant because I think we'll be able to create a new workforce of highly trained dentist and engineers who can not only understand each other's language, but be able to collaborate and tackle common problems. I can wait to see what they will develop in terms of research and innovating oral health care. (Dr. Hangorsky) Dr. Koo, thank you so much for joining us, and for this fascinating and stimulating discussion. Thank you. (Dr. Koo) Thank you.
