Cleaton-Jones, P.

English

Wits Institutional Repository on DSPACE

Journal of the Dental Association of South Africa, 40, 723-725
The Dental Research Institute at Wits 1954-1985
P. Cleaton-Jones
MRC/University of the Witwatersrand, Dental Research Institute, Johannesburg
Keywords: dental research; research
A. HISTORY OF THE INSTITUTE 
1954-1960
In 1954 the Council for Scientific and Industrial Re­
search (CSIR) entered into an agreement with the Uni­
versity of the Witwatersrand. As a result, the Joint 
CSIR/University Dental Research Unit was formed with 
Professor James Irving appointed as Director. Professor 
Irving was a medical graduate of the University of Cape 
Town with an interest in mineral metabolism and calcifi­
cation. This interest dominated the initial research pro­
gramme of the research unit so that many publications 
during this period dealt with aspects of calcification.
Professor Irving attracted to his staff a chemistry gradu­
ate, Clive Solomons, who in due course obtained his 
PhD in the field of calcification. He subsequently moved 
to the United States where he has maintained his re­
search interest in mineral metabolism and calcification.
A second important staff member was Dr. Jan Dreyer, 
Head of Orthodontics at the time. Dr. Dreyer already 
held a BSc degree and this plus his interest in biochemis­
try made him a natural foil to Professor Irving. Dr. 
Anthony Melcher, later to become head of the Canadian 
MRC Research Group in Periodontology, was another 
researcher who began his research career under Profes­
sor Irving.
In due course Professor Irving was attracted to the 
United States, in his case to Harvard University, to 
continue his research at the Forsyth Dental Infirmary. In 
the approximately 7 years that Professor Irving was at 
the helm some 36 publications appeared in the scientific 
press, and several higher degrees were begun.
1960-1970
In 1960, Dr Jan Dreyer was appointed Professor of 
Experimental Odontology and Director of the Dental 
Research Unit, and the next era commenced. Jan Drey- 
er’s research interests were naturally directed by his 
orthodontic experience. The main direction was thus in 
the field of bone healing after orthodontic treatment, 
surgery and bone infection. In this he gained an inter­
national reputation. A particular contribution was his 
commitment to postgraduate dental education. He was 
one of the founders of the part-time Higher Diploma in 
Dentistry which was the basis on which much post­
graduate dentistry in the RSA was built, and for many 
years he was responsible for the biochemistry compo­
nent of the course.
Jan Dreyer’s ability to attract researchers came to the 
fore when he recruited Drs. Hugo Retief and Peter 
Cleaton-Jones to his staff. Dr. Retief brought to the 
research unit his qualification in chemistry, his experi­
ence in the chemical industry and many years dental 
practice in Vanderbijlpark. Dr. Cleaton-Jones had 
other experience — in his case qualifications in dentistry 
and in medicine. Together the three complemented each 
other.
An activity during this period was fluoride analysis of 
water supplies and teeth. This, plus his chemical know­
ledge resulted in what some have regarded as Jan 
Dreyer’s greatest contribution to dentistry in the RSA, 
his appointment as Member of the Governmental Com­
mission of Enquiry into the Fluoridation of Public Water 
Supplies. The Commission systematically and scientific­
ally examined evidence for and against fluoridation. In 
1967, they unanimously recommended fluoridation and 
urged the RSA government to implement this. Regret­
fully, this has not occurred.
The dissemination of scientific knowledge continued 
and during his directorship approximately 67 papers 
were published. MDS degrees were completed by Alex 
Jacobson, Bernard Joffe, Tony Melcher and Mervyn 
Shear. In addition, two MSc degrees were awarded.
Overseas contact was increased when Dr. J.F.P. Dijk- 
man, an orthodontist from the University of Nijmegen, 
The Netherlands, spent a sabbatical year in the Unit.
The next change that occurred, in 1969, was when the 
newly formed South African Medical Research Council 
(MRC) took over the responsibilities of the CSIR. The 
research unit was renamed the MRC/University of the 
Witwatersrand Dental Research Unit.
1970-1976
In due course Professor Dreyer was appointed Dean of 
the Dental Faculty and once again a new leader was 
required. This time Dr. Hugo Retief was appointed 
Professor of Experimental Odontology. The research 
emphasis in the unit veered towards adhesion. Hugo 
Retief was involved in the development of the direct 
bonding of orthodontic attachments to teeth, a field in 
which his international reputation grew. Coupled with 
this was research into fluoride, with particular reference 
to fluoride analytical techniques; and into the response 
of the dental pulp to various acids and filling materials.
John Austin, a veterinarian, was recruited during this
Journal of the D.A.S.A. — December 1985
723
P. Cleaton-Jones
period. His specialized knowledge and innovative skills 
added much to the research programme.
Postgraduate activity increased in this period. Hugo 
Retief and Peter Cleaton-Jones completed their PhD 
degrees and two M Dent degrees were also awarded. 
Research publications also increased in number, some 
112 being published in local and overseas journals.
In 1975, Professor Retief spent 6 months in the United 
States, during his sabbatical leave, and subsequently 
emigrated to the Institute of Dental Research at the 
University of Alabama at Birmingham, where he is at 
present.
1976 — present
Once Professor Retief had emigrated, Peter Cleaton- 
Jones was appointed to the Chair of Experimental 
Odontology. Initially this was of the Dental Research 
Unit but in 1978 the designation was changed to that of 
an Institute, which indicated its more permanent nature.
As was the case with previous directors, the direction of 
research changed somewhat. Epidemiology came to the 
fore, with emphasis on dental caries and its causation. In 
this research field close links were forged with the 
National Research Institute for Nutritional Diseases of 
the MRC, Epidemiology Section under Dr. B.D. Rich­
ardson, and with Dr. A.R.P. Walker of the MRC Hu­
man Biochemistry Research Unit at the South African 
Institute for Medical Research.
The tooth implantation/replantation research pro­
gramme was also increased and another field that was 
expanded was research into nitrous oxide usage and 
pollution, in collaboration with Professor Don Moyes 
of the Department of Anaesthesia at Baragwanath 
Hospital.
International collaboration increased and the following 
distinguished researchers have been visiting professors 
or lecturers of the institute, several for more than one 
period:
Professor Gerry Winter (London, U.K.) (1981)
Professor Lars Granatn (Malmo, (1982 and
Sweden) 1984)
Professor Ingar Leidal (Oslo, Norway) (1984/1985)
Professor Tony (Edmonton,
Hargreaves Canada) (1985)
Professor Miomir Cvek (Stockholm, (1978-1985,
Sweden) various
periods/ye-
ar)
Professor Leo Sreebny (Stony Brook,
NY, U.S.A.) (1983)
Dr. Graham Roberts (London, U.K.) (1985) 
Professor Hans Peter (Arhus, (1978 and
Philipsen Denmark) 1979)
In addition, Mr. Ruedi Schmid from the University of 
Zurich completed his MSc (Dent) degree in the insti­
tute. Postgraduate activity blossomed with the replace­
ment of the higher diplomas in the faculty with Master’s 
degrees. Since 1976 the following have been completed 
in the Institute: PhD 3; M Dent 14; MSc 1; MSc (Med) 2; 
MSc (Dent) 12.
Dr. Andrew Jodaikin, a “Wits” graduate, joined the 
Institute, completed his MSc (Dent) and then obtained a
scholarship to the Weizmann Institute in Israel to under­
take a PhD, a task with which he is busy at present. 
Another gain was Mrs. Elly Grossman who was trans­
ferred from an MRC unit that was closing. She brought 
with her specialist electron microscope knowledge and is 
presently completing an MSc (Dent).
An advance instituted over the past few years has been 
the introduction of a course in research methodology. 
This is compulsory for students for the MSc (Dent) 
degree by course work and is attended by students for 
other degrees within the faculty, from other faculties 
within the University and from other Universities and 
Technikons.
Research productivity has been aided by a stalwart band 
of honorary research fellows who, over the years, have 
themselves completed higher degrees in the institute. 
These include Dr. Freddie Barbakow (now at the Uni­
versity of Zurich); Dr. Alf Volchansky; Professor Kim 
Mizrahi; Dr. Les Fleisch; Dr. Pam Mclnnes (presently 
at the University of Louisiana Dental School), and Dr. 
Sean Williams. The combined activity of these research­
ers, the postgraduate students, and the many skilled 
technologists who have worked in the institute over the 
years, has resulted in the 32 higher degrees already 
mentioned and 177 full publications in local and over­
seas refereed journals. This productivity has increased 
the international reputation of the Institute and the 
Faculty of Dentistry.
B. PRESENT RESEARCH PROGRAMME
The present research programme is organised under five 
broad headings:
1. Bone and pulpal healing
2. Dental caries
3. Dental materials
4. Nitrous oxide
5. Oral mucosa
1. Bone and pulpal healing
How should the dental pulp be treated after accidental 
trauma has exposed it? Should the pulp be extirpated 
and filled? When teeth are replanted should root fillings 
be inserted immediately? later? or perhaps never? 
Should antibiotics be used routinely? only when in­
fection is present? or perhaps topically? These are 
examples of the types of questions for which answers are 
being sought. Collaboration with Professor Miomir 
Cvek from Stockholm, an expert on the management of 
the traumatised tooth, has provided some of the 
answers, which are being prepared for publication.
Another aspect concerns bone healing after intentional 
trauma such as tooth extraction or orthognathic surgery. 
This type of research is well suited to those with a surgi­
cal background or interest. An asset in research on 
both pulp and bone healing is the availability, within 
the University, of non-human primates for projects, 
approved by the University’s Animal Ethics Committee. 
Close collaboration with Professor John Lownie and his 
staff of the Division of Maxillo-Facial and Oral Surgery, 
ensures a strong link to clinical surgical practice.
2. Dental caries
The main thrust of dental caries research is in the epi-
Tydskrif van dieT.V.S.A. — Desember 1985
724
Dental Research Institute
demiology of the disease, a method which makes use of 
the striking variations within South African populations. 
Groups living side by side but with contrasting and simi­
lar lifestyles may be compared to each other. This 
natural laboratory has attracted collaborators from 
Scandinavia, Switzerland, Canada and the United 
States.
Descriptive epidemiology has been used to indicate 
trends in dental caries and analytical epidemiology is 
being used to investigate the causes of dental caries in 
RSA populations with particular reference to the inter­
action of the causative factors. In all, details of dental 
caries and related data for some 16 000 preschool chil­
dren aged 1-6 years, are stored in a series of computer 
data sets. A direct link with the University’s mainframe 
computer enables rapid manipulation of the data.
Laboratory studies have emerged from epidemiological 
observations and these have studied problems like fluo­
rosis indices, the role of traditional black foodstuffs on 
rat caries; and proton-induced X-ray emission (PIXE) 
analysis of enamel and dentine of extracted teeth, to 
investigate trace elements in dental caries.
Future research will be geared towards investigating the 
role of confounders in the aetiology of dental caries in 
the RSA. This is especially necessary because of the 
varying patterns of caries development — a decrease in 
prevalence among white pre-school children and 
increases among other groups.
3. Dental materials
One of the main thrusts of materials research in the 
laboratory is concerned with the study of microleakage 
following tooth restoration, using fluorescent dye tech­
niques. Thermal cycling is used to speed up stresses 
applied to restored human or monkey teeth.
Gradually the DRI has emerged as an international 
centre for the study of pulpal response to filling 
materials. This is because of the access that the DRI has 
to non-human primates and to the experience gained in 
some 12 years of this type of research. Results obtained 
in 1 000 teeth are stored in a computer data set for future 
reference and comparison. Also, sections from previous 
studies are available for re-examination and assessment. 
This expertise has resulted in several research contracts 
with overseas companies for certification of filling 
materials. It is expected that this will be a major avenue 
of expansion in the near future, because of the unique 
facilities and experience.
Biocompatibility testing of dental materials other than 
filling materials is also in progress and it is hoped that a 
post-doctoral student will soon be active in the synthesis 
of new polymer materials.
4. Nitrous oxide
It has been known for several years now that the inhala­
tion of trace quantities of nitrous oxide by operating 
room and dental surgery personnel is harmful. This 
harm is usually an interference with reproduction mani­
fested by an increased spontaneous abortion rate or 
lowered fertility. The dentist is at particular risk due to
his or her close proximity to the mouth and nose.
In the DRI, research has confirmed that pollution exists 
in typical RSA dental surgeries and present research is 
aimed at reducing the hazard through the evaluation of 
scavenging devices and teratological experiments to 
determine threshold values for safe exposure. Professor 
Don Moyes and staff have brought their wealth of 
medical anaesthetic experience to the team which has 
also involved engineers and chemists. Collaboration 
with international experts is under way with regard to 
the determination of a threshold exposure level.
5. Oral mucosa
The structure and function of oral mucosa has been 
investigated using transmission and electron micros­
copy. Initially normal, unstressed oral mucosa was 
studied and subsequently mucosa against which pressure 
was applied. The latest stress to be applied is suction. 
Quantitative histometric analysis of the changes pro­
duced by pressure has shown that convolutions of the 
cell membrane appear to be for reserve to allow stretch­
ing rather than cellular attachment.
Temperature variation in the oral mucosa is also under 
study, as a possible aid in the early diagnosis of local 
disease including periodontal disease. Some baseline 
studies on variations in apparently clinically healthy 
mucosa have been completed and submitted for publica­
tion.
C. GENERAL PHILOSOPHY
The DRI was established to carry out dental research, to 
provide a training in dental research and to afford facili­
ties for part-time dental research. All of these mandates 
set out in the original design of the Institute, are pres­
ently complied with.
Interdisciplinary co-operation is a key to modern re­
search. Thus, in the DRI, close collaboration has been 
built up with statisticians, engineers, chemists, nuclear 
physicists, nutritionists, medical experts and so on, in 
other University departments and other institutions 
within and without the MRC.
Co-operation with colleagues abroad has gradually been 
built up through personal contact and this co-operation 
is increasing annually. The DRI is essentially a team, 
thus all staff members participate in all activities and 
authorship of articles. This has aided productivity which 
was recognized by the University of the Witwatersrand 
in 1983 when the DRI was presented with a merit award 
for research productivity.
ACKNOWLEDGEMENTS
Grateful thanks are given to all past and present staff 
members who have made the DRI the happy, active 
research institute that it is, and to the Medical Research 
Council and the University of the Witwatersrand for 
their support.
Journal of the D.A.S.A. — December 1985
725


The Dental Research Institute at Wits 1954-1985

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