Research Methods for Implementing Infection Quality Control for Dental Implants (IQ-ReMDI).

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Dental implants are set to become increasingly popular as the population ages.Implant failures are relatively uncommon but can be challenging to replace. Thosethat mandate immediate surgical removal are typically caused by peri-implantitis,an inflammatory disease caused by microbial infection. A replacement implant hasrelatively lower success rates and often requires additional soft and/or hard tissuegrafts, new abutments and longer healing times. Microbial infection of the tissuesaround the implant is a major challenge which may jeopardise the success ofosseointegrated implants. Therefore, an understanding of the predictive potentialof infection-resistant implants is essential to reduce such complications. There islimitation in the current methods of investigating anti-microbial biomaterials, in thatfew bacterial species models have been used so far, which are arguably notreflective of the rich microbial populations observed in the oral environment.Methodological development based on complex microbial biofilms in variousdysbiotic states could be more suited to predict progression to peri-implantitis.The group at University of Leeds (UoL) Dental School has previously successfullydeveloped a robust periodontitis biofilm model which will be adapted to replicatemicrobiological conditions associated with peri-implantitis. This unique andcomplex system will be used as a tool to conduct rigorous tests on dental implants'anti-microbial properties.Through this secondment scheme, we propose an innovation partnership betweenthe UoL and the Nottingham-based dental implant manufacturer AttenboroughDental Laboratory (ATT). Building on our previous successful research in bothmicrobiome and biomaterials development at UoL, the project will offer theopportunity to form a highly efficient multi-disciplinary team with the aim to designand implement a new biological system of health and quality control of implantmaterials at ATT. ATT and UoL's knowledge of biomechanics modelling of porous implantscombined with 3D-printing of additive material coatings will provide the project withnovel infection-resistant, customisable implants. The cytotoxicity, bactericidalactivities, vascularisation and osseointegration properties will be carried out usingco-culturing with human osteoblasts and endothelial cells in the presence orabsence of peri-implantitis-associated microbes. Our biological system approachwill cumulate in being tested for implementation into ATT's in-line manufacturingprocess as an efficient method for ensuring the reduction of the risk of implantfailure.The work is expected to have high translational impact and value for both UoL andATT through knowledge transfer and will provide training and enhanced careerprospects for the secondee.