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

Dental implants are set to become increasingly popular as the population ages. Implant failures are relatively uncommon but can be challenging to replace. Those that mandate immediate surgical removal are typically caused by peri-implantitis, an inflammatory disease caused by microbial infection. A replacement implant has

relatively lower success rates and often requires additional soft and/or hard tissue grafts, new abutments and longer healing times. Microbial infection of the tissues around the implant is a major challenge which may jeopardise the success of osseointegrated implants. Therefore, an understanding of the predictive potential

of infection-resistant implants is essential to reduce such complications. There is limitation in the current methods of investigating anti-microbial biomaterials, in that few bacterial species models have been used so far, which are arguably not reflective of the rich microbial populations observed in the oral environment.

Methodological development based on complex microbial biofilms in various dysbiotic states could be more suited to predict progression to peri-implantitis. The group at University of Leeds (UoL) Dental School has previously successfully developed a robust periodontitis biofilm model which will be adapted to replicate

microbiological conditions associated with peri-implantitis. This unique and complex 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 between the UoL and the Nottingham-based dental implant manufacturer Attenborough

Dental Laboratory (ATT). Building on our previous successful research in both microbiome and biomaterials development at UoL, the project will offer the opportunity to form a highly efficient multi-disciplinary team with the aim to design and implement a new biological system of health and quality control of implant

materials at ATT. ATT and UoL's knowledge of biomechanics modelling of porous implants combined with 3D-printing of additive material coatings will provide the project with novel infection-resistant, customisable implants. The cytotoxicity, bactericidal activities, vascularisation and osseointegration properties will be carried out using

co-culturing with human osteoblasts and endothelial cells in the presence or absence of peri-implantitis-associated microbes. Our biological system approach will cumulate in being tested for implementation into ATT's in-line manufacturing process as an efficient method for ensuring the reduction of the risk of implant

failure. The work is expected to have high translational impact and value for both UoL and ATT through knowledge transfer and will provide training and enhanced career prospects for the secondee.