Dentistry & Oral Science (Research Division)

The primary goal of the group is to develop novel strategies to repair, regenerate and image damaged or diseased tissues. The success of this effort requires a multidisciplinary approach, hence, the group combines the disciplines of cellular and molecular biology, material science, imaging and medicine; diverse expertise but a shared mission.

Major interests include basic fundamental science and translation research:

• Development of novel porous, injectable, acellular and cellular scaffolds (polymers, calcium phosphates, carriers for drug delivery and novel dental restorative materials) for maxillofacial and orthopaedic application.
• Stem cell technology (primary cells, development of co-culture models, biologically viable scaffolds).
• Development of novel pre-vascularized biomimetic scaffolds for tissue engineering.
• Optimization and development of high resolution imaging techniques (e.g. confocal, multi-photon fluorescence) to identify cell and cell-,matrix components in tissue engineered constructs and disease diagnosis.
• Development of novel non-invasive opto-diagnostic instrumentation, ranging from carious dentine detection to cancer diagnosis via confocal micro-endoscopy and micro-vascularopathy.
• Restoration of damaged dental tissues using minimal intervention techniques and materials.
• Measurement and development of preventative methods for tooth wear and dental erosion, including in-situ models. Innovation and translation of developed systems from concept to clinic.

The work pursued under this topic includes the following project areas:

• Microbiology of dental caries and endodontic disease – using latest molecular biology techniques to understand complex species diversity, colonisation and the ecological interfaces between the flora and carious dentine/pulp.
• Development of in-vitro, multi-species biofilm models to study caries and endodontic disease and evaluate novel treatments. The use of novel radiographic techniques (Cone Beam Computed Tomography) for the diagnosis of endodontic disease.
• Development of novel diagnostic indicators to aid detection and clinical minimally invasive caries removal using an array of in-vitro and in-vivo microscopy and imaging techniques including confocal fibre-optic micro-endoscopy, electron microscopy, micro-Raman spectroscopy and fluorescence lifetime imaging.
• Investigation of the efficacy and efficiency of novel minimally invasive caries excavation technologies (including pioneering bio-active glass air-abrasion).
• Development of novel adhesive material technologies to "seal and heal" residual caries-affected dentine and endodontically treated teeth (with dental industry collaborations).
• Clinical trials to develop novel caries management strategies for high caries risk individuals (oral oncology and dry mouth patients).

The head is the most complicated structure of the body, housing the brain, sense organs and feeding organs and the commonest birth defects affect organs and tissues of the head. Research investigating the mechanisms that control head development underpins a broader understanding of the genetic basis of craniofacial malformations. A multidisciplinary approach using different experimental models and techniques is employed to investigate cell signaling and transcriptional networks regulating development of craniofacial organs such as teeth, palate, sense organs, salivary glands muscle, skeleton and the brain.

Stem cells are found in most adult organs where they act as reservoirs of cells for continued growth or tissue repair following damage. Stem cells from several different craniofacial organs are being studied to understand their in-vivo function and cell biology and also their potential uses for clinical therapies involving the enhancement of natural repair processes and regenerative approaches to generate replacement tissues and organs for transplantation.

The Dental Institute is an international leader in the development of novel teaching methods. Research work in this area is focused at evaluating such novel techniques as well as investigating ways to improve teaching and assessment. Current project areas include:

• Threshold concepts and construction of curricula;
• Use of technology (haptics) in assessment and feedback for dental students;
• Use of online learning resources;
• Developing novel assessment methods;
• Issues for and advantages of graduate-entrants to dentistry;
• Use of the clinical aptitude test for entry to dentistry;
• Online testing of students;
• Running high stakes examinations in dentistry;
• Haptics as teaching and learning tools in dentistry.

Dental Public Health research is concerned with the health of populations and healthcare delivery to populations. The dental institute facilitates high quality research in support of oral health improvement and the delivery and organisation of high quality evidence-based care. It involves a health systems approach that seeks to understand health and the wider determinants of health, influence pathways to care and the delivery of healthcare, together with the recruitment and retention of the appropriate workforce skill-mix.

Dental Public Health involves a range of research methods from epidemiology to qualitative research involving interviews and focus groups. It includes quantitative methods such as questionnaire surveys, secondary analysis of health related data and operational research modelling. This involves working closely with clinicians, educationalists, social and behavioural scientists and statisticians in multidisciplinary health services research on the following key areas:

• Evaluation of the organisation and delivery of oral health care services;
• Dental workforce recruitment, motivation and skill-mix;
• Promotion of oral health and wellbeing and health outcomes.

• Microbiology of endodontic disease, use of molecular and cultural techniques for the study of the etiology of apical periodontitis.
• Development of in-vitro, multi-species biofilm models to study endodontic disease and evaluate novel treatments to eradicate them.
• Development of novel diagnostic indicators for the real time detection of the bacterial content of the root canal with confocal fibre-optic micro-endoscopy. of the efficacy and efficiency of novel minimally invasive caries excavation technologies (including pioneering bio-active glass air-abrasion).
• Use of novel radiographic techniques (Cone Beam Computed Tomography) for the diagnosis of endodontic disease.
• Development of clinical trials on the outcome of endodontic treatment and on the survival of endodontically treated teeth. Analysis of endodontic instrumentation using micro CT and Synchrotron based micro-CT.
• Development of novel root canal obturation materials.
• Endodontic application of bioactive materials.

Dental caries and periodontal disease are the commonest bacterial disease of man. Microbiology is therefore central to all oral and dental research. Dental Institute microbiology staff perform basic research into fundamental aspects and mechanisms related to the oral microbiota as well as engaging in a wide range of collaborations with clinical colleagues.

Current project areas include:

• Characterisation of the oral microbiome - the Human Oral Microbiome Database
• Culture-independent molecular methods for characterisation of the oral microbiome
• Oral bacterial metagenomics and genomics
• Sub-species diversity - multi-locus sequence typing
• Bacterial-bacterial communication and growth factors in dental plaque
• Cellular Microbiology - bacterial toxins and host targets
• In-vitro and in-vivo evaluation of novel active agents and formulations, up to Phase III
• Multi-species biofilm models of dental plaque formation and endodontic infections
• Biomarkers for dental caries.

Mucosal surfaces represent the major route of entry of infectious microorganisms and are protected by the secretory/mucosal immune system. Research in this area aims at understanding host pathogen interactions at mucosal surfaces, basic immunological responses to exogenous stress and immunopathology of autoimmune mucocutaneous disorders.

The group aims to develop molecular tools for early diagnosis and prediction of responses to radio and chemotherapy. A number of genetic pathways are commonly deregulated in head and neck cancers including the p53 family, the inhibitors of apoptosis proteins (IAPs), as well as kinases including EGFR and PKC-beta. We are investigating these pathways as possible therapeutic targets for the development of small molecule inhibitors, monoclonal antibodies, peptides and microRNAs.

Research interests:

• Tumour specific induction of cell death by the viral proteins Apoptin and E1A and identification of tumour specific kinases 
• Role of p53 family members including p73 and p63 in cancer metastasis and resistance to therapies
• Development of novel gene and protein delivery systems including secretable protein transduction peptides and polymers.
• Combination therapy using novel targeted agents including TRAIL and inhibitors of IAPs (SMAC mimmetics)
• Identification of the mechanisms of response to radio- and chemo-therapeutic agents in human papillomavirus associated oropharyngeal cancer in order to exploit these pathways to improve the management of all head and neck cancers
• Identification of molecular markers including microRNAs predictive of radioresistance in head and neck cancers.

The research work of this topic is founded on an established national leading orofacial pain and trigeminal nerve injury services, with support from liaison psychiatry, psychology, neurosurgery, neurology and pain management. The research ranges from the determination fo the molecular basis for pain through the identification of biomarkers to the development and evaluation of novel therapies.

Current areas of interest include:

• Development of a clinical paradigm for the assessment of patients with trigeminal pain including QST, psychometrics, functionality, pain profiling and genetics
• The identification of trigeminal pain clinical trial biomarkers for post surgical pain related to third molar surgery
• The identification of gene transcripts related to acute post surgical pain
• Investigation of toothache pain pathways Immunohistochemical methods for the evaluation of peripheral pain receptors and transmitters in trigeminal pain
• Development of imaging protocols for chronic trigeminal pain evaluating headaches, burning mouth syndrome and persistent post surgical pain
• Development of cognitive behavioral therapy protocols for patients with persistent trigeminal pain.

The work performed in this topic covers a wide range of research from basic cell biology and immunology to the development and evaluation of novel treatments for periodontal disease.

• Diagnostic and Prognostic Factors in Periodontology
• Salivary and GCF biomarker discovery through proteomic, genetic and other analytical technologies;
• Prognostic factors associated with periodontal treatment outcomes;
• Behavioural and psychosocial factors in periodontal disease.
• Periodontal Disease and Systemic Inflammation
  • Regulation of systemic inflammatory markers in disease and during treatment responses;
  • Disease association studies.
• Biology of Tissue Regeneration
  • Cell biology of bone and periodontal regeneration;
  • Role of growth factors and other biological response molecules in bone regeneration;
  • Tissue engineering and dental stem cells in tissue regeneration.
• Host-Microbial interactions
  • The role of the oral microbiota in periodontal diseases;
  • Innate and acquired immune responses and disease.
• Clinical Trials in Periodontology -
  • The Department has extensive experience, infrastructure and wide patient base in conducting clinical trials including RCTS both in house and with external sponsors.

In this area academic and clinical experts work on a range of projects from basic studies of saliva and salivary gland function to clinical monitoring and treatment of saliva-related disease.

Oral health is critically dependent on behaviour – attendance at the dentist, dietary behaviour, smoking cessation and self-care routines. Social and behavioural sciences provide a critical insight into the determinants of behaviour and how these can be modified. Among other areas, the team are researching in the following areas: