J. Max Goodson, DDS, PhD

Creating an environment conducive to the development of new ideas through clinical studies augmented by laboratory analysis is the central theme of clinical research at Forsyth. Results of our work have led to a wide array of discoveries. These include the development of localized drug delivery products for periodontal therapy, investigation of systemic antibiotics in oral therapy, new and improved dental adhesives, improved diagnostic techniques, introduction of light as a therapeutic modality, improvement of local anesthetics and testing of agents that stimulate bone growth. In addition, many of our research efforts are focused on facilitating health care delivery both in the U.S. and abroad. Our emphasis is on facilitating the movement of ideas to reality; our way of saying "translational research."

The Forsyth Clinical Research Collaborative

The Forsyth Clinical Research Collaborative (CRC) is an association of individuals who have in common the desire to conduct and participate in clinical research. Principal research personnel associated with the CRC include:

• Constantino Floros, Research Clinical Assistant
• Michael Palys, Research Periodontist
• Anna Rivkin, Administrative Assistant
• Valarie Smith, Research Clinical Assistant
• Jennifer Soncini, Research Dentist
• Pramod Soparker, Research Dentist
• Mary Tavares Senior, Senior Clinical Investigator

This facility conducts clinical and health care delivery research. Forsyth CRC supports clinical research needs of The Forsyth Institute Departments and in addition embraces many associated groups. These include: The Center for Evidence Based Dentistry (Dr. Richard Niederman), Biostatistics (Dr. Ralph Kent), and The Laboratory of Applied Photomedicine (Dr. Nikos Soukos). Many clinical investigators from other institutions and many practicing clinicians combine their interest in clinical research through appointments to the clinical collaborative. These include:

• Dr. Alexandre DaSilva, Massachusetts General Hospital
• Dr. Garcia-Godoy, Nova Southeastern University
• Dr. Stephen Halem, Private Practice
• Dr. Minoru Horiuchi, Private Practice
• Dr. Ana Karina Mascarenhas, Boston University
• Dr. Wendy Mouradian, University of Washington
• Dr. David Nash, University of Kentucky
• Dr. Aronita Rosenbaltt, University of Pernambuco, Brazil
• Dr. Doyle Williams, DentaQuest
• Dr. Benjamin Alexander White, Delta Dental
• Dr. Tom VanDyke, Boston University

The Forsyth GCRC Satellite

A strong association between the clinical research group at Forsyth and clinical investigators at the Beth Israel Deaconess Medical Center (BIDMC) has been established through a National Center for Research Resources grant that created the Forsyth General Clinical Research Center (GCRC) Satellite. The program director at BIDMC is Steven D. Freedman, MD. This effort supports clinical investigation at Forsyth and an outpatient clinic at BIDMC. Individuals and their positions within the Forsyth GCRC include:

• J. Max Goodson, Associate Program Director
• Philip Stashenko, Assistant Program Director
• Elizabeth Regan, Administrative Manager
• Marie Letteri, Dental Clinic Manager
• Gay Torresyap, Research Hygienist
• Susan Boches, Laboratory Technician
• Ralph Kent, Biostatistician
• Kathy Eklund, Research Subject Advocate
• John Ahern, Clinical Data Analyst

Areas of current research

Local Drug Delivery

Periodontal disease is the result of an underlying bacterial infection. Thus, a significant amount of work in our laboratory aims to understand and improve methods of antibacterial therapy. The use of local drug delivery devices for treatment of periodontal disease has been pioneered in our group. In 1995, Dr. Goodson was awarded the IADR Distinguished Scientist Award in Pharmacology for this research. These devices, which release small amounts of active drugs over time directly to the site of infection, have several advantages over alternative delivery systems. They are particularly well suited to treat isolated periodontal breakdown in the periodontal maintenance phase of therapy.

Systemic Antibiotic Therapy

The use of Systemic antibiotics have the advantage of treating the whole mouth and are particularly valuable in initial periodontal disease therapy. Through our research we have been able to determine that the combination of systemic antibiotics and extensive tooth cleaning can be more effective than expensive and painful surgical techniques.

Phototherapy

In conjunction with Dr. Soukos and The Laboratory of Applied Molecular Photomedicine studies are being conducted that indicate that the growth of black-pigmented bacteria may be controlled by exposure to visible light in the blue light region. These studies began with the observation that light-assisted tooth whitening resulted in healthier gums. It has proceeded through laboratory analysis to indicate that visible light kills black-pigmented bacteria. It is now entering into a phase of discovering and then developing clinical applications of this finding.

Diagnosis

The oral cavity is clearly an important focus for diagnostic development. Our studies suggest that most, if not all, human disease conditions may be detected through appropriate analysis of saliva. By using saliva as a diagnostic, we are doing so much more than early diagnosis of disease. Saliva-based diagnostics are really a potential health surveillance tool, which may allow us to continually monitor the health of an individual. Our goal in this work is to help keep healthy people healthy by providing an early warning system.

We are collaborating with other Forsyth investigators in testing and developing DNA-DNA hybridization approaches for examining changes in microbial populations in the oral cavity. By studying ecological alterations that result from therapy, we are gaining a better understanding of the effects of different antibiotic regimens.

Systemic Disease Associations

The human body is a truly integrated system. The bacteria that trigger periodontal disease have ways of making you bleed. Then they have ways of getting into your blood stream, and making other conditions like heart disease worse. They also trigger the release of hormone-like substances that make diabetes worse. You can actually improve a patient's diabetes by treating his or her gum disease. We have found the DNA of oral bacteria in such disparate locations as the plaques that cause arthrosclerosis and the brains of people with Alzheimer's disease. Understanding the meaning of these observations is crucial to understanding our health and is a current emphasis in our research

Selected Publications

Goodson JM, Gunsolley JC, Grossi SG, Bland PS, Otomo-Corgel J, Doherty F, Comiskey J. 2007. Minocycline HCl Microspheres Reduce Red-Complex Bacteria in Periodontal Disease Therapy. J Periodontol. 78(8):1568-1579.

Moore PA, Doll B, Delie RA, Hersch EV, Korostoff J, Johnson S, Goodson JM, Halem S, Palys M, Leonel JS, Kozlowski VA, Peterson C, Hutcheson M. 2007 Hemostatic and Anesthetic Efficacy of 4% Articaine HC1 With 1:200,000 Ephinephrine and 4% Articaine HC1 With 1:100,000 Ephinephrine When Administered Intraorally for Periodontal Surgery. J. Periodontol. 78(2):247-253.

Haffajee AD, Japlit M, Bogren A, Kent RL Jr, Goodson JM, Socransky SS. 2005. Differences in the subgingival microbiota of Swedish and USA subjects who were periodontally healthy or exhibited minimal periodontal disease. J. Clin. Periodontol. 32(1):33–39.

Mager DL, Haffajee AD, Devlin PM, Norris CM, Posner MR, Goodson JM. 2005. The salivary microbiota as a diagnostic indicator of oral cancer. A descriptive, nonrandomized study of cancer-free and oral squamous cell carcinoma subjects. J. Transl. Med. 3(1):1–8.

Sakellari D, Vouros ID, Aristodemou E, Konstantinidis AB, Socransky S, Goodson JM. 2005. Tetracycline fibers as an adjunct in the treatment of nifedipine-induced gingival enlargement. J. Periodontol. 76(6):1 034–1039.

Soukos NS, Som S, Abernethy AD, Ruggiero K, Dunham J, Lee C, Doukas A, Goodson JM. 2005. Phototargeting oral black-pigmented bacteria. Antimicrob. Agents Chemother. 49 (4):1391–1 396.

Goodson JM, Palys MD, Carpino E, Regan EO, Sweeney M, Socransky S. 2004. Microbiological changes associated with dental prophylaxis. J. Am. Dent. Assoc. 135(11):1559–1564.

Socransky SS, Haffajee AD, Smith C, Martin L, Haffajee JA, Uzel NG, Goodson JM. 2004. Use of checkerboard DNA-DNA hybridization to study complex microbial ecosystems. Oral Microbiol. Immunol. 19(6):352–362.

Goodson JM. 2004. Confusion between definitive and exploratory clinical therapy trials: When to believe and when to question. J. Periodontol. 75(3):493–494.

Royzman D, Recio L, Badovinac RL, Fiorellini J, Goodson JM, Howell H. Karimbux N. 2004. The effect of aspirin intake on bleeding on probing in patients with gingivitis. J. Periodontol. 75(5): 679– 684.

Goodson JM. 2003. Gingival crevice fluid flow. Periodontol. 2000 31 (1):43–54.

Niederman R, Abdelshehid G, Goodson JM. 2003. Periodontal therapy using local delivery of antimicrobial agents. Dent. Clin. N. Am. 46(4):665–677, viii.

Tavares M, Stultz J, Newman M, Smith V, Kent R, Carpino E, Goodson JM. 2003. Light augments tooth whitening with peroxide. J. Am. Dent. Assoc. 134(2):167– 173.

Feres M, Haffajee AD, Allard K, Som S, Goodson JM, Socransky SS. 2002. Antibiotic resistance of subgingival species during and after antibiotic therapy. J. Clin. Periodontol. 29(8):724–735.

Schrodi J, Recio L, Fiorellini J, Howell H, Goodson JM, Karimbux N. 2002. Effect of aspirin on the periodontal parameter bleeding on probing. J. Periodontol. 73(8):871–876.