This theme area seeks to understand molecular and cellular processes underlying tissue injury and health (periodontitis, endodontics & caries and oral cancer) to develop novel and improved approaches to diagnosis, prevention and therapy.
In the periodontal disease area, a major strand of research is focussed on unravelling the complex stress response pathways which occur during periodontal inflammation at the molecular, cellular and clinical levels.
Identifying the mechanisms underpinning disease pathogenesis and the inter-relationships between periodontal inflammation and other chronic inflammatory diseases (such as rheumatoid arthritis) and the ageing immune system are key goals. Translation is a priority through clinical trials to provide novel diagnostics and host-modulating therapies. Indeed we have completed the first ever randomised phase 3 controlled trial of a phytonutrient supplement, designed for periodontitis treatment and developed over the last 6 years in collaboration with Unilever.
We now lead a large European multicentre trial to test the clinical significance of these findings in an “un-treated” population. Characterisation of the saliva and crevicular fluid proteome for the first time in health, gingivitis, mild and severe periodontitis, is being undertaken in a project designed at novel biomarker discovery.
Pulp biology and regenerative endodontics
In the Pulp biology and regenerative endodontics research area, our long-standing programme on dental tissue regeneration is exploring the dentinogenic potentiality of stem/progenitor cells, their recruitment, tissue niches and matrix-mediated cell signalling, to provide a strong mechanistic foundation for clinical translation.
We are active members of Birmingham University Stem Cell Centre and national/international stem cell societies, which keeps us at the leading edge of developments within the field. This focus is complemented by our pioneering work on engineering of a physiological-like vital pulp tissue and is based on our mechanistic studies in pulp regeneration, identification of novel signalling pathways, matrix biology, and inflammation-regeneration interaction, which is central to clinical translation.
Aspects of this work are in collaboration with world-leading. Other novel developing areas for translation include the biomodulatory application of ultrasound and photonics, and the exploitation of dental pulp stem cells for neurological repair.
Developing dental technologies
In the area of developing dental technologies, our research on ultrasound has characterised its use in the cutting and cleaning of dental hard-tissues. Studies bridge both periodontal and endodontic research programmes and also underpin our biological studies into the use of US for stimulating tooth regeneration.
This work has evolved to include novel imaging of nanoflow under ultrasound and has recently attracted significant EPSRC funding. The dental cleaning aspect of ultrasound is further complemented by our research on the abrasive properties of dentifrices which has informed the development of novel toothpaste compositions in collaborative research funded by GSK for more than 25 years. These novel formulations minimise tooth wear whilst optimising cleaning and stain removal.
We are growing our research programme in Oral Cancer, which draws upon interdisciplinary research in cell biology, biomedical imaging and the computational modelling of patho-physiological processes. This programme aims to identify and develop novel evidence-based diagnostic tools, novel biomarkers and therapeutic targets for oral cancer. Recent recruitment of significant cancer epigenetics expertise means this area is anticipated to have significant sustainable growth and also complements our epigenetic studies in pulp biology.