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. Last Updated: 07/27/2016

Scientists Team Up to Rebuild Children's Faces

MTRoginsky demonstrating a PolyHap implant and a biomodel built by Popov's team.
When the car carrying 9-year-old Ksenia was involved in a road accident last February, her mom escaped with a concussion.

Ksenia, however, was not so lucky -- after a month in a coma, she was left with brain damage and a massive, 4-centimeter-deep dent in her forehead above her right eye, which is so wide she cannot cover it with her outstretched palm.

But now, after months of recuperation in a Moscow children's hospital, she is gradually getting better and is starting to use a wheelchair. And thanks to a revolutionary new technique being pioneered in Moscow by a team of Russian and British scientists, Ksenia will have a plastic-and-mineral implant inserted into her forehead that doctors say will rebuild her face and bond with bone tissue without causing adverse reactions.

The honeycomb-like material, called PolyHap, is a result of synthesis of a polymer commonly used in dentistry and hydroxyapatite, the main mineral component of bone tissue.

The PolyHap implants have been developed jointly by a team of Russian and British scientists led by Vladimir Popov of the Institute of Laser and Information Technology in Troitsk, near Moscow, and Steve Howdle of the University of Nottingham's School of Chemistry. Their work has been made possible thanks to funding from The Wellcome Trust, Britain's biggest biomedical research charity. It was established as an independent trust in 1936 in the will of Sir Henry Wellcome, whose pharmaceutical company, The Wellcome Foundation Limited, later merged with Glaxo.

In about a week's time, a team of Russian surgeons will operate on Ksenia, using an implant developed with a three-dimensional plastic cast of her skull made by Popov's team. The model is built using a high-tech process called laser stereolithography and allows surgeons to plan operations better.

"The precision with which implants are made is fundamental in the facial area," Popov said. "The parts should be a perfect fit."

Popov's team also found a way to clean the PolyHap implant of toxins using supercritical carbon dioxide, The Wellcome Trust said.

Popov first met Howdle, then a Royal Society university research fellow, on a two-month visit to Britain in 1991. Since then, their acquaintance has grown into a long-standing partnership and joint research into issues varying from laser chemistry to new biomaterials. In 1995, the trust gave them their first research grant.

In Moscow, Popov teamed up with Vitaly Roginsky, Russia's leading expert in cranio-maxillofacial, or head and facial, surgery for children. Roginsky, who is known for his out-of-the-box thinking, was the first surgeon to use PolyHap.

"It's far better than titanium," Roginsky explained in his office at St. Vladimir Hospital in northeast Moscow. "It's cheap, porous and not sensitive to cold."

The use of the new implant also makes operations safer, as it cuts surgery times by one-third, he added.

Clinical trials started in 2001. Since then, more than 100 patients have benefited from the implants, including a baby with a jaw tumor and a 12-year-old girl who had to eat through a straw because she had been unable to open her mouth.

Although PolyHap has so far been used for operations to correct jaw or skull deformities, the implants can also be adapted for use on other parts of the body, Popov said.

Today the implants are being made by hand, but as the program grows the scientists hope they can be produced in greater numbers commercially.

"The technique being developed through this collaboration has some interesting innovations, and once perfected or even further developed it should prove a great help to surgeons involved in this complex area of surgery," The Wellcome Trust quoted John Lowry, secretary-general of the European Association for Cranio-Maxillofacial Surgery, as saying in a statement put out by the charity. Supported by the trust's fourth grant of about $250,000, Popov and Howdle started work on a more advanced, biodegradable version of the implant that would dissolve as bone tissue heals and grows back.

"If we can push the development on to this stage, it will mean children will only have to undergo one operation rather than several," Howdle said. "The benefits from that are obvious."

Last year, together with other scientists, Popov contributed an article to Advanced Materials, an online scholarly journal, outlining the use of biodegradable scaffolds for tissue engineering.

"Cells that form a certain tissue in a human body cannot just hang loose in the air," Popov said. "In order to function they have to be attached to something." The biodegradable substances his team has been working on would serve as a scaffold for a cell, he said.

Popov said that advances in tissue engineering could eventually lead to the growing of human organs from a donor's cells. A potential advantage of tissue engineering for scientists is that it would avoid the ethically gray areas associated with cloning.

Worldwide, hundreds of scientists are currently developing biodegradable polymers, with pharmaceutical giants such as Johnson & Johnson, Smith & Nephew and GlaxoSmithKline investing billions of dollars into research.

Popov's team, however, is on a much more modest budget. Ninety percent of the funding comes from The Wellcome Trust, he said, adding that the only Russian grant the scientists have received so far -- $12,000 over 18 months -- has come from the Moscow city government's committee for science and technology.

More information about the implants program is available from The Wellcome Trust (www.wellcome.ac.uk).