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Oral Medicine

The major research focus for the Department of Oral Medicine is clinical issues at the interface of dentistry and medicine, to include: mucositis and other oral sequelae related to cancer therapies; discovery of biomarkers (including microbiome changes) in the oral complication of cancer therapies; bacteremia of oral bacterial pathogens and the risk of infective endocarditis; Oral and Maxillofacial Surgery; and pathophysiology and treatment options for Sjögren’s syndrome.

Contact Information

Michael T. Brennan, DDS, MHS
Department of Oral Medicine
Carolinas Medical Center
1000 Blythe Blvd.
Charlotte, NC 28203
704-355-4197 (phone)
704-355-5301 (fax)

Faculty Research Interests

Michael T. Brennan, DDS, MHS
Richard H. Haug, DDS
Peter Lockhart, DDS
Farah Mougeot, PhD

 

Peter B. Lockhart, DDSPeter B. Lockhart, DDS
Professor and Chairman Emeritus

Research Interests: Dental Management Issues of Medically Complex Patients and Bacteremia from Invasive Surgical Procedures and Risks for Systemic Infections (e.g., endocarditis)

Dr. Lockhart was involved in clinical research for the 10 years while on the faculty at Brigham and Women's Hospital. Since joining the faculty at CMC, he has guided and participated in the research program for the department. He has had funding for bacteremia research for the past 20 years, most recently as the PI on an NIDCR R01 grant concerning surrogate measures of risk for IE. He has over 125 peer-reviewed medical and dental journal articles and textbook chapters, and he is the Editor of the Textbook, Oral Medicine and Medically Complex Patient.

Recent Publications

Wingard JR, Walsh TJ, Redding SW, Wade JC, Cohen JI, Donnelly JP, Lockhart PB, Klastyersky J, Raber-Durlacher, JE. Oral mucositis in high-dose chemotherapy. JNCI. (In press)

Lockhart PB, Blizzard J, Maslow AL, Brennan MT, Sasser H, Carew J. Drug cost implications for antibiotic prophylaxis for dental procedures. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013; 115(3):345-353. PMID: 23265984

Likar-Manookin K, Stewart C, Al-Hashimi I, Curtis W, Berg K, Cherian K, Lockhart PB, Brennan MT. Prevalence of oral lesions of autoimmune etiology in patients with primary Sjogren's syndrome. Oral Dis. 2013; 19(6):598-603. PMID: 23279206

Mougeot JL, Mougeot FK, Peterson DE, Padilla RJ, Brennan MT, Lockhart PB. Use of archived biopsy specimens to study gene expression in oral mucosa from chemotherapy-treated cancer patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013; 115(5):630-637. PMID: 23541936

Napeñas JJ, Oost FC, Degroot A, Loven B, Hong CH, Brennan MT, Lockhart PB, van Diermen DE. Review of postoperative bleeding risk in dental patients on antiplatelet therapy. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013; 115(4):491-499. PMID: 23332510

Hong CH, Scobey MW, Napenas JJ, Brennan MT, Lockhart PB. Dental postoperative bleeding complications in patients with suspected and documented liver disease. Oral Dis. 2012; 18(7):661-666. PMID: 22458329

Hong C, Brennan MT, Kaplan J, Lockhart PB. Infection from an exfoliating primary tooth in a child with severe neutropenia: a case report. Pediatr Dent. 2012; 34(1):51-53. PMID: 22353458

Hearnden V, Sankar V, Hull K, Vidovic Juras D, Greenberg M, Kerr A, Lockhart PB, Patton LL, Porter S, Thornhill M. New developments and opportunities in mucosal drug delivery for local and systemic disease. Adv Drug Deliv Rev. 2012; 64(1):16-28. PMID: 21371513

Lockhart PB, Hong, CH, van Diermen DE. The influence of systemic diseases on the diagnosis of oral diseases: a problem-based approach. Dent Clin North Am. 2011; 55(1):15-28. PMID: 21094716

Lockhart PB, Bolger AF, Papapanou PN, Osinbowale O, Trevisan M, Levinson ME, Taubert KA, Newburger JW, Gornik HL, Gewitz MH, Wilson WR, Smith Jr SC, Baddour LM; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, Council on Epidemiology and Prevention, Council on Peripheral Vascular Disease, and Council on Clinical Cardiology. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation. 2012; 125(20):2520-2544. PMID: 22514251

Lockhart PB. Antibiotic Prophylaxis for Dental Procedures: Are We Drilling in the Wrong Direction? Circulation. 2012; 126:11-12. PMID: 22689928

Sankar V, Hearnden V, Hull K, Juras DV, Greenberg M, Kerr AR, Lockhart PB, Patton LL, Porter S, Thornhill M. Local drug delivery for oral mucosal diseases: challenges and opportunities. Oral Dis. 2011; 17(Suppl 1):73-84. PMID: 21382140

Baddour LM, Epstein AE, Erickson CC, Knight BP, Levison ME, Lockhart PB, Masoudi FA, Okum EJ, Wilson WR, Beerman LB, Bolger AF, Estes III, NA, Gewitz M, Newburger JW, Schron EB, Taubert KA; A summary of the update on cardiovascular implantable electronic device infections and their management: a scientific statement from the American Heart Association. J Am Dent Assoc. 2011; 142(2):159-165. PMID: 21282681

Thornhill MH, Dayer MJ, Forde JM, Corey GR, Chu VH, Couper DJ, Lockhart PB. Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of infective endocarditis: before and after study. Br Med J. 2011; 342:d2392. PMID: 21540258

Hong C, Napenas JJ, Brennan M, Furney S, Lockhart P. Risk of postoperative bleeding after dental procedures in patients on warfarin: A retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 114:464-468. PMID: 22986241

Rouleau TS, Shychuk AJ, Kayastha J, Lockhart PB, Nussbaum ML, Brennan MT.A retrospective, cohort study of the prevalence and risk factors of oral burning in patients with dry mouth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 111(6):720-725. PMID: 21497523

Mougeot JL, Bahrani-Mougeot FK, Lockhart PB, Brennan MT. Microarray analyses of oral punch biopsies from AML patients treated with chemotherapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 112:446-452. PMID: 21862359

Napeñas JJ, Hong CH, Kempter E, Brennan MT, Furney SL, Lockhart PB.  Selective serotonin reuptake inhibitors and oral bleeding complications after invasive dental treatment.  Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 112:463-467. PMID: 21821439

Books and Chapters

Lockhart PB (Ed): Oral Medicine and Medically Complex Patients. 6th Edition. Wiley-Blackwell. 2013.

Greenberg MS, Hodgson T, Jontell M, Kerr AR, Lockhart PB, Peterson DE, Wray D, Editors. Proceedings of the Fifth World Workshop in Oral Medicine. Oral Diseases 17 (Suppl. 1):1-6, 2011.

Current, Recent and Pending Grant Support

Grant Title: A before and after study of the effect of ceasing to give antibiotic prophylaxis for dental procedures to prevent infective endocarditis
Funding Agency: NIDCR (R03 DE023092-01)
Role: Co-Investigator
Years: 2013-2015

Grant Title: Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients
Funding Agency: NIDCR (U01 DE022939-01)
Role: Co-Investigator
Years: 2012-2017

Grant Title: Osteonecrosis of the Jaw (ONJ) Case Registry
Funding Agency: Amgen Pharmaceuticals
Role: Principal Investigator
Years: 2012-

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Mike Brennan DDS, MHS

 

Mike Brennan DDS, MHS
Professor and Chairman

Research Interests: Pathophysiology and Management of Sjögren’s Syndrome and Other Salivary Gland Diseases, Oral Mucositis and Other Oral Complications from Cancer Therapies, Dental Management Issues of Medically Complex Patients and Mucosal Oral Lesions

Dr. Brennan received a Certificate in Oral Medicine at the National Institutes of Health (NIH) in Bethesda, MD., and a Masters of Health Science in Clinical Research from Duke University. Upon completion of his master's, Dr. Brennan joined the department of oral medicine at Carolinas Medical Center in June 2000. He is currently the department’s chairman, oral medicine residency director, and director of the Sjögren’s Syndrome and Salivary Disorders Center. To date, he has written more than 100 peer-reviewed articles and book chapters.  In the field of oral complications related to cancer therapy, there are numerous ongoing studies to include assessment of acute and chronic oral sequelae of cancer treatment, new preventive strategies for mucositis and evaluation of biomarkers in cancer patients.  Dr. Brennan is the co-principal investigator of a five year U01 NIH grant (OraRad), which is a prospective multicenter study of oral complications in head and neck cancer patients.

In the field of Sjögren’s syndrome (SS), multiple ongoing studies include genetic biomarkers for SS, management guideline, oral sequelae of SS and role of medications in dry mouth and salivary gland dysfunction.

Recent Publications

Lessard CJ, Li H, Adrianto I, Ice JA, Rasmussen A, Grundahl KM, Kelly JA, Dozmorov MG, Miceli-Richard C, Bowman S, Lester S, Eriksson P, Eloranta ML, Brun JG, Gøransson LG, Harboe E, Guthridge JM, Kaufman KM, Kvarnström M, Jazebi H, Cunninghame Graham DS, Grandits ME, Nazmul-Hossain AN, Patel K, Adler AJ, Maier-Moore JS, Farris AD, Brennan MT, Lessard JA, Chodosh J, Gopalakrishnan R, Hefner KS, Houston GD, Huang AJ, Hughes PJ, Lewis DM, Radfar L, Rohrer MD, Stone DU, Wren JD, Vyse TJ, Gaffney PM, James JA, Omdal R, Wahren-Herlenius M, Illei GG, Witte T, Jonsson R, Rischmueller M, Rönnblom L, Nordmark G, Ng WF; for UK Primary Sjögren's Syndrome Registry, Mariette X, Anaya JM, Rhodus NL, Segal BM, Scofield RH, Montgomery CG, Harley JB, Sivils KL. Variants at multiple loci implicated in both innate and adaptive immune responses are associated with Sjögren's syndrome. Nat Genet. 2013;45(11):1284-92. PMID: 24097067 or PMCID: PMC3867192

Limaye SA, Haddad RI, Cilli F, Sonis ST, Colevas AD, Brennan MT, Hu KS, Murphy BA. Phase 1b, multicenter, single blinded, placebo-controlled, sequential dose escalation study to assess the safety and tolerability of topically applied AG013 in subjects with locally advanced head and neck cancer receiving induction chemotherapy. Cancer. 2013;119(24):4268-76. PMID: 24114811

Saunders DP, Epstein JB, Elad S, Allemano J, Bossi P, van de Wetering MD, Rao NG, Potting C, Cheng KK, Freidank A, Brennan MT, Bowen J, Dennis K, Lalla RV; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients. Support Care Cancer. 2013; 21(11):3191-207. PMID: 23832272

Elting LS, Chang YC, Parelkar P, Boers-Doets CB, Michelet M, Hita G, Rouleau T, Cooksley C, Halm J, Vithala M, Bossi P, Escalante C, Brennan MT; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Risk of oral and gastrointestinal mucosal injury among patients receiving selected targeted agents: a meta-analysis. Support Care Cancer. 2013; 21(11):3243-54. PMID: 23636648

Lockhart PB, Blizzard J, Maslow AL, Brennan MT, Sasser H, Carew J. Drug cost implications for antibiotic prophylaxis for dental procedures. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115(3):345-53. PMID: 23265984

Likar-Manookin K, Stewart C, Al-Hashimi I, Curtis W, Berg K, Cherian K, Lockhart PB, Brennan MT. Prevalence of oral lesions of autoimmune etiology in patients with primary Sjogren's syndrome. Oral Dis. 2013;19(6):598-603. PMID: 23279206

Daikeler T, Mauramo M, Rovó A, Stern M, Halter J, Buser A, Tyndall A, Häusermann P, Gratwohl A, Tichelli A, Brennan MT, Waltimo T. Sicca symptoms and their impact on quality of life among very long-term survivors after hematopoietic SCT. Bone Marrow Transplant. 2013; 48(7):988-93. PMID: 23292241

Mougeot JL, Mougeot FK, Peterson DE, Padilla RJ, Brennan MT, Lockhart PB. Use of archived biopsy specimens to study gene expression in oral mucosa from chemotherapy-treated cancer patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115(5):630-7. PMID: 23541936

Sollecito TP, Rogers H, Prescott-Clements L, Felix DH, Kerr AR, Wray D, Shirlaw P, Brennan MT, Greenberg MS, Stoopler ET. Oral medicine: defining an emerging specialty in the United States. J Dent Educ. 2013;77(4):392-4. PMID: 23576584

Kumar A, Brennan MT. Differential diagnosis of orofacial pain and temporomandibular disorder. Dent Clin North Am. 2013; 57(3):419-28. PMID: 23809301

Issa B, Padilla R, Brennan MT. Diagnosis and management of mucosal lesions with the potential for malignant transformation. J Calif Dent Assoc. 2013; 41(5):343-8. PMID: 23795519

Fortuna G, Brennan MT. Systemic lupus erythematosus: epidemiology, pathophysiology, manifestations, and management. Dent Clin North Am. 2013;57(4):631-55. PMID: 24034070

Napeñas JJ, Oost FC, Degroot A, Loven B, Hong CH, Brennan MT, Lockhart PB, van Diermen DE. Review of postoperative bleeding risk in dental patients on antiplatelet therapy. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115(4):491-9. PMID: 23332510

Hong CH, Scobey MW, Napenas JJ, Brennan MT, Lockhart PB. Dental postoperative bleeding complications in patients with suspected and documented liver disease. Oral Dis. 2012;18(7):661-6. PMID: 22458329

Raber-Durlacher JE, Brennan MT, Verdonck-de Leeuw IM, Gibson RJ, Eilers JG, Waltimo T. Bots CP, Michelet M, Sollecito TP, Rouleau TS, Sewnaik A, Bensadoun RJ, Fliedner MC, Silverman S, Spijkervet FKL. Dysphagia Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO). Swallowing dysfunction in cancer patients. Support Care Cancer. 2012;20(3):433-43. PMID: 22205548

Rouleau TS, Manookin KM, Brennan MT. Restricted mouth opening. J Am Dent Assoc. 2012; 143(7):767-70. PMID: 22751979

Hong C, Brennan MT, Kaplan J, Lockhart PB. Infection from an exfoliating primary tooth in a child with severe neutropenia: a case report. Pediatr Dent. 2012; 34(1):51-3. PMID: 22353458

Current, Recent and Pending Grant Support

Grant Title: Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients Funding Agency: NIH/NIDCR (U01 DE022939-01)
Role: Principal Investigator
Years: 2012-2017

Grant Title: Oral Complications in Stem Cell Transplant Patients: ORASTEM, Swedish Government: Western Region of Public Dental
Funding Agency: Swedish Government Grant
Role: Co-PI
Years: 2011-2014

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Richard H. Haug, DDS
Professor and Section Head

Research Interests: Biomechanics of the Craniomaxillofacial Skeleton and it’s reconstruction with Titanium Plates and Screws. Epidemiology of Craniomaxillofacial Trauma victims.

Dr. Haug began his academic career at the Metrohealth Medical Center of the Case Western Reserve University, where his interest in Craniomaxillofacial Trauma and the medically complex maxillofacial surgery patient was instilled. His interest in Craniomaxillofacial biomechanics and reconstruction of the Craniomaxillofacial skeleton with Titanium plates and screws, coupled with his interest in clinical Oral and Maxillofacial Surgery has resulted in more than 150 peer reviewed publications and textbook chapters and a half dozen books, monographs and atlases.

Recent Publications

Haug RH. Microorganisms of the nose and paranasal sinuses. Oral Maxillofac Surg Clin North Am. 2012; 24(2):191-6.  PMID: 22341509

Blakey GH, Gelesko S, Marciani RD, Haug RH, Offenbacher S, Phillips C, White RP Jr. Third molars and periodontal pathology in american adolescents and young adults: a prevalence study. J Oral Maxillofac Surg. 2010;68(2):325-9. PMID: 20116703

Gelesko S, Blakey GH, Partrick M, Hill DL Jr, White RP Jr, Offenbacher S, Phillips C, Haug RH. Comparison of periodontal inflammatory disease in young adults with and without pericoronitis involving mandibular third molars. J Oral Maxillofac Surg. 2009; 67:134-9. PMID: 19070759

Arosarena OA, Fritsch TA, Hsueh Y, Aynehchi B, Haug RH. Maxillofacial injuries and violence against women. Arch Facial Plast Surg. 2009; 11:48-52. PMID: 19070759

Haug RH, Abdul-Majid J, Blakey GH, White RP. Evidenced-based decision-making: the third molar. Dent Clin North Am. 2009;53:77. PMID: 19215746

Blakey GH, Parker DW, Hull DJ, White RP Jr, Offenbacher S, Phillips C, Haug RH. The Impact of Removal of Asymptomatic Third Molars on Periodontal Pathology. J Oral Maxilofac Surg. 2009;67:245-50. PMID: 19138595

Madsen M, Haug RH, Christensen BS, Aldridge E. Management of Atrophic Mandible Fractures. Oral Maxillofac Surg Clin North Am. 2009;21:175-83. PMID: 19348982

Blakey GH, Golden BA, White RP Jr, Offenbacher S, Phillips C, Haug RH. Changes over time in the periodontal status of young adults with no third molar periodontal pathology at enrollment. J Oral Maxillofac Surg. 2009;67:2425-30.  PMID: 19837312

Books and Chapters

Haug RH. Design and Function of Implants and Instruments (Chapter 1.4.3). In Ehrenfeld M, Manson PN, Prein J (Eds): Principles of internal Fixation of the Craniomaxillofacial Skeleton: Trauma and Orthognathic Surgery. New York, NY, Georg Thieme Verlag, 2012, Pgs. 53-80. 

Serafin B, Koshgerian, PG, Haug RH. Soft Tissue Injuries. In Anderson L, Kahnberg K-E, Pogrel MA (Eds.): Oral and Maxillofacial Surgery. Oxford, United Kingdom, Wiley-Blackwell Publishing, 2010, pgs. 911-941.

Current, Recent and Pending Grant Support

Grant Title: A Biomechanical Comparison of Two Edentulous Mandible Fracture Repair Techniques
Funding Agency: Synthes Maxillofacial
Role: Principal Investigator
Year: 2004

Grant Title: A Biomechanical Comparison of Mandibular Symphysis Fracture Repair Techniques
Funding Agency: Synthes Maxillofacial
Role: Co-Investigator
Year: 2006

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Oral Medicine Research Laboratory

At the Oral Medicine Research Laboratory, using molecular-based strategies the lab uses samples obtained through clinical trials to study the bacteria involved in disease in their human niche. Our most recent work has included the determination of the microbial profile of oral cavity and the human genes involved in mucositis following chemotherapy in cancer patients. Currently, our lab studies the effects of oral microbiome and host factors and their impact in various cancers and cardiovascular diseases. The combined state-of-the-art of microbial metagenomics with the host tissue proteomics, and gene expression arrays will be employed to determine microbial profile in health versus disease and to discover biosignatures of the disease.

Additionally, the lab provides identification of difficult-to-culture bacterial pathogens from human biological samples using 16S rRNA gene sequences.

Oral Medicine Research Laboratory functions in close collaboration with internal and external collaborators. The lab operates under BSL-2 condition and is equipped with essential equipment, including bacterial culture specific incubators, refrigerated ultracentrifuge, low-speed centrifuge, microfuge, conventional and real-time quantitative PCR machines, spectrophotometer, light microscopy and high-speed computers.

Farah K. B. Mougeot, PhDFarah K. B. Mougeot, PhD
Senior Scientist and Associate Professor
Director, Microbiome Research - Oral Medicine Research Laboratory

Research Interests: Molecular mechanisms of Pathogenesis of Bacterial Infections, Determination of Microbial Biomarkers in Health and Disease

For over 25 years, Dr. Mougeot’s research has revolved around understanding of the mechanisms of pathogenesis of bacteria in infectious diseases. The results of some of her previous studies have laid the groundwork for ongoing vaccine development against common uropathogens, including Proteus mirabilis and uropathogenic E. coli, the design of anti-pathogenicity molecules against the enteric bacterial pathogens such as Shigella flexneri, the identification of diverse and novel bacterial pathogens involved in systemic infections such as pneumonia caused by the bacterial colonizers of the oral cavity, and characterization of the bacteremia following dental procedures.
Dr. Mougeot has also been involved in epidemiological studies of healthcare-associated infections caused by Clostridium difficile and carbapenemase producing Enterobacteriaceae in collaboration with Departments of Infection Control and Gastroenterology at CMC.

Laboratory Members

Farah K. B. Mougeot, PhD, Senior Scientist, Laboratory Director (Phone: 704-355-8132)
Darla Morton, MS, Research Coordinator
Craig Stevens, BS, Research Tech II

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