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Orofacial Biomechanics and the Consequences of Alveolar Cleft Morphology: Clinical Translation for Comprehensive Craniofacial Care

Award Number: R03DE036042
ORGANIZATION: NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/15/2026
PERIOD OF PERFORMANCE END DATE: 09/14/2028

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Orofacial Biomechanics and the Consequences of Alveolar Cleft Morphology: Clinical Translation for Comprehensive Craniofacial Care - Project Summary/Abstract Orofacial clefts are the most common congenital craniofacial anomaly and can range from a bifid uvula to a complete fissure of the bony palate, alveolus and lip. Alveolar arch collapse may occur with both hard and soft tissue deficiencies, causing issues with feeding and speech that require multiple coordinated surgical procedures throughout childhood and adolescence. In addition to functional challenges, patients often experience esthetic and psychosocial challenges while their families incur eight times the financial burden of care as a child without a cleft. Alveolar bone defects are typically repaired before permanent canine eruption, by grafting bone from the patient’s iliac crest into the cleft site. Although this is the current “gold standard treatment,” complications are not uncommon. Patients risk pain, discomfort and infection at both donor and graft sites. At the graft site, bone maintenance and osteogenesis are frequently problematic. At one-year post- op, as much as 54% of grafted bone may be lost, leading to complete graft failure in some cases. The etiology of graft failure is multifactorial, involving interactions between mechanical variables and cellular processes, but the precise role of these factors is unknown. In particular, mechanical variables remain poorly understood. We propose to use in silico experiments to test patient-specific mechanical variables (cleft size and shape).The objectives of this proposal are designed to fill a critical gap in our knowledge of cleft biomechanics, a first steps towards the development of more successful, integrative treatment plans. To do so, we must (1) understand how mechanical variables such as alveolar cleft size and shape affect orofacial function, (2) identify risk factors for graft failure, and (3) simulate the mechanical consequences of existing and new repair techniques. We will accomplish these objectives through two specific aims. We will define variation in alveolar cleft size and shape (SA 1), investigate external orofacial forces related to the non-masticatory behaviors (SA 2.1) and predict the biomechanics of alveolar cleft repair (SA 2.2). Our approach brings together geometric morphometrics (GM), finite elements analysis (FEA), and surface electromyography (sEMG)-based in vivo studies. Our novel modeling protocol incorporates previously validated cranial (non- cleft) finite element models (FEMs) together with (cleft) patient imaging to build rigorous, validated, anatomically complete composite models. We will apply experimentally-derived muscle forces to establish a “functional performance envelope,” and demonstrate degrees of deviation from “typical” to pathological (cleft) orofacial function. Our results will provide a more complete understanding of biomechanical factors related to everyday oral function putatively influencing the success of alveolar graft repairs. This will aid in future collaborative studies to explore novel treatment approaches, such 3D printed cell culture bioscaffolds in place of autologous bone graft, to reduce the number of operative interventions and improve patient quality of life, our long-term goal.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $361,817 )
2026	2026	TOURO UNIVERSITY	1310 CLUB DR	VALLEJO	CA	94592	SOLANO	USA	Oral Diseases and Disorders Research	000	1	9/17/2026	NEW	$361,817
														Subtotal = $361,817

Grand Total All Awards = $361,817

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Orofacial Biomechanics and the Consequences of Alveolar Cleft Morphology: Clinical Translation for Comprehensive Craniofacial Care

Award Number: R03DE036042

ORGANIZATION: NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/15/2026

PERIOD OF PERFORMANCE END DATE: 09/14/2028

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