Dr. Edward Rossomando: Rebel with a Cause: Technology & Biology: Where Dentistry Fits In

Technology has dramatically transformed dentistry, evolving from early innovations to state-of-the-art equipment that enhances precision, efficiency, and patient comfort. One of the pioneering figures in this development is W.D. Miller, a notable alumnus of the University of Pennsylvania School of Dental Medicine's first graduating class in 1879, and an innovator greatly admired by Dr. Rossomando. Miller, often referred to as the "father of modern dental microbiology," made groundbreaking contributions to understanding dental caries in the late 19th century. His seminal work on the relationship between oral bacteria and tooth decay set the stage for subsequent advancements in dental technology and preventive care. Miller's research ultimately paved the way for understanding how the biological processes of oral health could be addressed using technological solutions.

Building on Miller's early research, technological advancements in dentistry have progressed from the rudimentary handpieces of the early 20th century to today's highly sophisticated tools like 3D printing and robotic systems. These innovations enable highly accurate tooth restorations, precise diagnostics, and even surgical procedures that are less invasive and more effective. Dr. Rossomando, president of Penn's W.D. Miller Student Research Society during the 1963-64 school year, highlights how the past 50 years have witnessed remarkable changes, including the shift from belt-driven to high-speed handpieces, the rise of digital imaging, and the incorporation of nanotechnology into dental materials. These technological strides are making dental practices faster, neater, and safer, and open up exciting possibilities for the future of dentistry.

The 20th century marked a turning point in our understanding of biology’s critical role in dentistry, largely thanks to figures like William Gies, whose 1926 report on dental education profoundly shaped the future of dental science. Gies’ work argued that dentistry should be viewed as a branch of medicine and called for a more scientific, evidence-based approach to dental education and practice. This report set the foundation for integrating biology into dentistry on a much deeper level, setting the stage for innovations that continue to influence the field today.

By the 1950s, molecular biology took center stage with the groundbreaking discovery of DNA's structure by Watson and Crick, a moment that sparked new possibilities for understanding genetics and its role in dental health. Gies had predicted the importance of these advances, and by the 1960s, the first dental classes began considering how the structure of DNA could influence dental practice. This evolved into a broader exploration during the 1970s and 1980s as students and researchers delved into molecular biology, wondering how these discoveries could shape dental care.

In the 2000s, the completion of the Human Genome Project opened new frontiers for personalized dental care. The understanding of human genetics began to inform treatments tailored to an individual's genetic makeup. More recently, the advent of gene editing technologies, like CRISPR, has given hope to the possibility of correcting genetic predispositions to dental diseases at their source. In-utero orthodontics, or biodontics, is also a rapidly emerging field pioneered by Dr. Rossomando, offering hope that even before birth, interventions can take place to address future dental issues.

By 2024, the field is entering what Dr. Rossomando refers to as the "engineering phase"—a time when the scientific understanding of molecular biology and genetics is solid, and the key challenge is figuring out how to implement and apply this knowledge in dental practice. Researchers and practitioners are now asking, "What can we do with all this knowledge?"