A 60-year-old who gardens all summer, golfs into October and hits the slopes in winter might be expected to sport the chiselled jawline of a man half his age.
But the jowl of Peter Russel is even younger than that. In fact, the silver-haired retired banking executive grew it himself just two years ago.
Like a salamander that can sprout itself a new tail, Mr. Russel has regrown seven centimetres of bone along the bottom right of his jaw, tissue he lost to a benign tumour in 2003.
“I've counted my blessings and moved on,” the dapper Mr. Russel said this week as he raised a glass of red wine to his revolutionary treatment.
He is one of eight patients in Canada who has quietly undergone a method of bone regeneration that could literally change the face of reconstructive surgery.
Using a protein that can seduce adult stem cells into becoming bone tissue, Cameron Clokie, head of oral and maxillofacial surgery at the University of Toronto, has pioneered a technique to reset the jaw's skeletal clock — coaxing bones to grow as they do in a newborn baby.
“This is pretty much back to the embryonic state of bone generation,” Dr. Clokie said. “With this patient we've actually regrown a jawbone that is identical [to the one] he lost.”
The procedures, performed at Toronto General Hospital and Mount Sinai Hospital, are a significant milestone for researchers long chasing the dream of tissue regeneration. Current methods of rebuilding body parts usually rely on the painful process of stealing bone, fat and muscle from one site to fill gaps in another.
Twenty-year-old Janine McFarlane knows this too well. As with Mr. Russel, a benign tumour swelled from the right side of Ms. McFarlane's jaw two years ago. Left untreated, the rare and aggressive jaw-tissue growth, known as ameloblastoma, can balloon to distort the face and fill the airways until it chokes a patient to death.
But unlike Mr. Russel, Ms. McFarlane, who was not a candidate for the new method because her larger tumour also involved the joint, underwent traditional surgery. In her case, surgeons replaced the jaw tissue she lost with 12 centimetres of bone carved out of her shin: “I couldn't walk for two months,” said Ms. McFarlane, an aspiring singer.
Dr. Clokie, who presented both cases at a U of T conference this week on regenerative medicine, said Ms. McFarlane's case involved a 19-hour operation and two weeks in hospital, one of them in the intensive care unit. In January, she faces a second operation in which surgeons plan to use bone from her hip to further build up her mandible so that dentists can implant false teeth.
In contrast, Mr. Russel underwent a four-hour operation that left him with little more than a faint scar, and he spent just two nights in the hospital: “Two weeks later, I was skiing in Colorado,” he said. The only lingering effect Mr. Russel described is numbness in his lower lip and chin due because a sensory nerve had to be cut to remove the tumour. “It's been amazing.”
To reconstruct Mr. Russel's jaw, Dr. Clokie added a particular growth protein to a putty-like gel that actually liquefies in the freezer and solidifies in warmer temperatures. He then modelled it into the shape of Mr. Russel's missing jaw piece. “You can imagine what it's like trying to model a [jaw] shape from bone . . . it's like wood,” Dr. Clokie said. “This is like Play-Doh.”
The gel model was then placed to fill the missing section in Mr. Russel's jaw, which was supported by the implanting of a titanium rod. Five days later, as blood vessels started growing over the gel structure, the gel itself began to dissolve. At the same time, the jawbone began to regrow to close the gap.
