Dr. Cristina Teixeira enjoys being an orthodontist. She also enjoys her time in the laboratory, interpreting her latest experiments and pursuing more biologically sound answers to the real-world clinical questions that confront her and other orthodontists each day.
But Teixeira discovered about five years ago that her professional life was out of balance. As a new assistant professor in the Department of Orthodontics at New York Universitys College of Dentistry, her teaching responsibilities dominated her days, leaving little time to work in her laboratory.
People told me that my role in the department is to serve as a bridge between clinical orthodontics and basic research, said Teixeira, who in addition to her D.M.D. and specialized training in orthodontics holds a masters degree in oral biology and a Ph.D. in developmental biology. But I discovered that the bridge didnt exist at that point, and I was drowning in the waters below.
Today, Teixeira has reclaimed the balance in her professional life. Shes reduced her hours in the clinic, increased her time in the laboratory, trained scores of NYU dental students in the latest research techniques, and joined forces with another colleague to launch an innovative orthodontics research consortium. Teixeira says she is finally in a position to be the bridge between basic and clinical orthodontic research at NYU.
How did she do it? With the help of an NIDCR Career Development Award, a supportive research dean, good research collaborations, and an unwavering commitment to expand the evidence-base in orthodontics. It wasnt easy, Teixeira notes, but she couldnt be happier now with the outcome.
Going from K to R
When Teixeira arrived in 2002 to the bustle of NYU and Greenwich Village, she imagined most of her daily challenges would involve the complex biology of chondrocytes, or cartilage-forming cells. Although she agreed to supervise students in the orthodontic clinic two days per week, Teixeira had science to teach and a laboratory to run in the Department of Basic Science and Craniofacial Biology.
Soon thereafter, her clinical and teaching responsibilities expanded, leaving no time for research. We have 40 residents, and I was literally seeing hundreds of patients per week. I had almost no time to spend in my laboratory.
As the semesters passed and her teaching and clinic responsibilities remained a constant, Teixeira said her doubts grew that shed ever strike the right professional balance at NYU. In 2005, those doubts reached their nadir when she applied to NIDCR for a K08 Mentored Clinical Scientist Award, which provides protected time to help clinicians develop their research skills and make the transition to independent investigators.
When the reviewers sent their comments on her K08 application, Teixeira both cringed and shook her head in agreement. They stated that Teixeiras research credentials were outstanding, but they worried that NYU had booked her so solidly as an orthodontics instructor that she lacked the time to commit to the grant. They scored Teixeiras application just below the institutes financial means that year to support the grant. She was out of luck.
I brought the reviewers comments to my research dean, Louis Terracio, and the college dean at the time Michael Alfano as if to say, See, the reviewers agree with me, said Teixeira, who had been outspoken about her lack of time in the laboratory. They both agreed to make the changes necessary and eventually a new faculty member was hired in Orthodontics to lighten Teixeiras clinical load. Teixeira then resubmitted her application - with letters of support from Alfano, Terracio and her NYU colleagues _ and this time was successful. In 2006, with the K08 protecting about three fourths of her work time, Teixeira dove into its career development component, learning about mammalian developmental biology, microscopy, and enhancing her writing skills.
She later transitioned into the grants research phase to collect preliminary data on the role of nitric oxide on endochondral ossification, the pathway that produces the majority of the bodys bones.
I had talked with Cristina before she received the K award, and she was very discouraged about the lack of research time and the prospects for her research career, said Kevin Hardwick, D.D.S., M.P.H., chief of NIDCRs Research Training and Career Development Branch. I visited her a year later, after Cristina received the grant, and there was a night-and-day difference. She was so happy to be in the lab again, excited about her research, and her day-to-day job. She had a new light in her eyes because her career was back in the balance that she desired. Her story really shows what a career development award can do for talented clinician scientists who have a passion for research and great ideas, but they lack the protected time to pursue their interests.
Building on her success with the career development award, Teixeira recently was awarded a NIH Small Grant, or R03. She and an NYU colleague are co-principal investigators on the grant, which will allow them to study a novel regulator of skeletal development, the transcription factor Fox01. She also received supplemental support last summer through the American Reinvestment and Recovery Act (ARRA) to hire a dedicated lab technician, which has helped to bring greater throughput and efficiency to the day-to-day work of the Teixeira laboratory.
But the current apple of Teixeiras research eye is a larger undertaking that she and fellow NYU orthodontist Mani Alikhani, D.M.D., M.S., D. Sc., formally launched last year. Their project is called CTOR, short for the Consortium for Translational Orthodontic Research. It brings basic and clinical researchers to the same table to share their ideas on real-world orthodontic issues, pursue collaborative research projects, and, above all, translate their findings into improved, scientifically sound orthodontic care.
Dr. Cristina Teixeira(seated l.) and collaborator Dr. Mani Alikhani (seated r.)
As noted by Alikhani, who holds advanced degrees in biomedical engineering and molecular biology, CTOR currently involves the NYU research community and a handful of international collaborators with previous ties to the university. But they foresee a larger domestic and international consortium in the years ahead.
The CTOR can help to provide orthodontic students with more formalized research training, said Alikhani, noting he and Teixeira now have nearly 30 current students rotating into the laboratory and working part time on studies of bone, cartilage, inflammation, and tooth movement. In addition, Ive talked to some students who say its difficult to keep up with the science after they graduate and go into practice. Our hope is the consortium can serve through the years as an open door for them to advance their scientific training and research interests.
Teixeira said CTOR has completed numerous laboratory and animal studies, and the consortiums research already has generated two patent applications. One is for a unique device that produces small perforations in the gums to enable more efficient tooth movement. The CTOR recently received Institutional Review Board (IRB) approval for a Phase I clinical trial of this device. The other patent application is for a toothbrush-like device that, through non invasive mechanical stimulation, improves the quantity and quality of bone in the jaws.
Teixeira said she continues to supervise students in the NYU orthodontic clinic a day per week, a task she enjoys when balanced appropriately with her laboratory interests. I worked as an oral surgeon for two years, but it didnt give me that interpersonal connection that I like to have with patients, said Teixeira. Thats why I moved into orthodontics. It is almost like being the psychologist of the dental profession, in that you have such a tremendous impact on the patients sense of self and well being. The field has a great need to move forward scientifically, and I think the next few years should be a very interesting time for us at CTOR and for orthodontic research in general.
Thanks to the K08 award and the turnaround in her career, Teixeira likely will be a committed participant for years to come in orthodontics research.