Research and Innovation

Our holistic approach to world-class research and innovation is central to our ability to offer a seamless continuum from the laboratory to the clinic and to our aim of providing an exceptional experience for our postgraduates. We have outstanding strengths in the basic oral sciences, clinical specialities, dental public health and health services research, as well as a sustained track record of clinical translation.

We offer access to an interdisciplinary team of clinical and basic science researchers with international reputations in their respective fields, all underpinned and supported by state-of-the-art facilities.

We work in close partnership with the Leeds Teaching Hospitals NHS Trust. Its dental hospital, the Leeds Dental Institute, enables our students to deliver patient treatment as an integrated part of their undergraduate and postgraduate training. This allows our researchers close working relationships and day-to-day interaction with the Institute’s clinicians and wider network.

We have the capacity and expertise to respond rapidly and effectively to the needs of our partners and stakeholders, and pride ourselves on understanding their drivers, goals and delivering to their needs.

Working together with our partners and students, we have never been better placed to address clinical innovation challenges and deliver our vision through underpinning excellence in clinical research in synergy with outstanding basic science.

Advancing the genetics of enamel developmental abnormalities (AGEnDA)

Background

The advancing the genetics of enamel developmental abnormalities (AGEnDA) project brings together researchers and clinicians from the University of Leeds and the National Health Service (NHS) to collaboratively work with others around the world. 

This partnership aims to improve insight into the basis of developmental enamel abnormalities to advance understanding of biomineralisation and inform translation to advance clinical care.

Impact and benefits

This approach has delivered novel insights into gene function critical to biomineralisation and in selected families, associated retinal degeneration, immunological function, muscle formation or renal impairment. These discoveries translate immediately with global relevance to the care of those affected.

We have published our findings with collaborators from over 20 countries. The group helped establish and promote NHS AI genetic panel testing in the United Kingdom.  This creates the platform needed for NHS service reorganisation that will be achieved by development of clear patient pathways, better informed management choices and improved public-patient engagement and understanding.

The approach aligns strongly with the strengths of the School in Biological Physics & Biomineralisation, Dental Materials, Digital Dentistry and Paediatric Dentistry.

The aerosol-generating procedures study 

Background

Our collaborative research harnessed the multidisciplinary expertise of microbiology, engineering, and clinical dentistry to provide practical, evidence-based solutions to a major problem faced by dentistry during the Covid-19 pandemic. We aimed to develop an innovative viral surrogate model to advance the understanding of mitigating risks associated with viral aerosolization during common dental procedures.

Impact and benefits

This collaborative research from the University of Leeds brings a step-change in understanding the risks of spreading the SARS-CoV-2 virus in aerosols generated from dental drills. Two peer-reviewed publications achieving attention scores in the top 0.25% of all publications, led to private discussions with the Chief Dental Officer, where our work was deemed “a substantial step forward” for the field.

Ultimately, the research informed an updated rapid review of aerosol-generating procedures commissioned by the NIHR and Infection Prevention and Control, NHS, as well as the Dental Schools Council and the Association of Dental Hospitals' guiding principles on the use of electric handpieces.

The School of Dentistry is now using electric drills without air coolant, as indicated as safe mitigation by our research, providing students with more clinical practice time and patients with reduced wait times. Practices and dental schools across the country can now utilise these tools to confidently move forward with procedures, allaying any patient and clinician concerns at the same time.

The research field is changing, with more groups looking to implement our novel viral marker methodology as opposed to inanimate particle measurements, providing a far more reflective picture of viral aerosol production, whilst remaining entirely safe from any handling of dangerous viruses. This has “become a gold standard for research into dental infection control” and strengthens the quality of research worldwide, helping towards efforts to future-proof dentistry in the face of future pandemics.

Effect of self-assembling peptide (SAP) technology

Background

Multi-disciplinary research at Leeds has led to a step change for the treatment of early tooth decay, using a minimally invasive regenerative therapy and eliminating the need for surgical excavation.

In 2010, Credentis ag, was founded to commercialise the University of Leeds’ intellectual property in the field of self-assembling peptides (SAPs) for use in dentistry. Successful ‘first in man’ trials were carried out in the School’s Dental Translational and Clinical Research Unit, and a CE mark was awarded in 2012, approving the clinical use of the first commercial product ‘Curodont Repair’™ in the treatment of early caries.

Impact and benefits

The School of Dentistry has demonstrated the ability of P₁₁-4 to promote bone regeneration and repair in a critical defect model in vivo. Work to determine the effect of the application of P₁₁-4 on periodontal repair has shown unequivocally that P₁₁-4 promotes periodontal healing and repair. 

A grant was awarded by the University of Leeds’ Medical Technologies Innovation and Knowledge Centre (funded by EPSRC and BBSRC) to the School of Dentistry, to provide proof of concept data demonstrating that SAPs can be used as drug delivery vehicles for the control of periodontal pathogens.

An international collaboration between Leeds and the University of Campinas Brazil has also demonstrated the viability of P₁₁-4 as a treatment for demineralised dentine and potential application for increasing bond strength in etch and rinse adhesive systems.

The research programme illustrates how a multi-disciplinary team of clinicians, chemists and life scientists were able to draw upon the physicochemical principles of peptide assembly behaviour and mineral nucleation ability to design biomimetic materials to recapitulate skeletal tissue development and so effect regeneration and repair across a range of oral healthcare challenges.

Credentis AG was acquired by Swiss dental company vVardis and is now a research and development arm of that parent company. Curalox technology is becoming established as a global brand, bringing benefits to patients and clinicians across the world.

Innovation in digital dentistry

Background

Digital workflows in dentistry are likely to have a profound effect on the profession in terms of the way dentists diagnose disease, restore function & appearance and communicate with patients and other dental professionals.

Currently, digital dentistry solutions provide limited information to the dentist about a patient’s teeth and mouth. Existing digital technology is often prohibitively expensive, cumbersome to use and difficult to adapt into a dentist’s conventional workflow. The lack of quality of some scan data produced by current commercial scanners prevents key steps in traditional dentistry from being replaced by digital alternatives.

Impact and benefits

Overcoming the problems of poor resolution and cumbersome digital workflows will make digital solutions more streamlined and accessible. High-quality data will allow the dentist to make informed clinical decisions; predict and prevent future complications; and reduce chair time.

This in turn will benefit the patient, as they will have fewer unforeseen complications and a greater confidence in their dentist.

Children's oral health: A whole systems approach

Background

Dental decay is the most prevalent childhood disease. It is also preventable. A multidisciplinary team led by Dr Peter Day has developed a package of interventions to support families with young children to adopt good oral health habits. 

Impact and benefits

This package of early interventions provides:

1. Enhanced training for early-years and dental professionals;
2. Bespoke digital and paper-based resources for professionals and parents;
3. A structured and consistent oral health message to families with young children that appreciates the daily challenges they face;
4. Toolkits to support supervised toothbrushing programmes in different settings.

Skeletal tissue repair and regeneration

Background

The Schools of Dentistry and Design at the University of Leeds have a long-standing academic collaboration between materials scientists and textile engineers, with a common interest in the repair and regeneration of both hard and soft tissues. We aim to apply the knowledge gained by working together in the development of therapies to benefit patients.

Impact and benefits

Importantly, we have a focus on translating this underpinning knowledge into products for clinical use.

Funding has been obtained along the whole translational pipeline to carry out discovery research to develop the technology platform, to take novel materials through to pre-clinical testing to regulatory approval / first-in-patient trial. Partners at material supply, manufacture and end-users have been engaged.  

Equally importantly, this collaboration has facilitated the training of many PhD students and Postdoctoral Research Assistants in a multidisciplinary way of working.

The Rheumatoid Arthritis – Periodontitis  project 

Background

The long-standing collaborative project between the Leeds NIHR Musculoskeletal Biomedical Research Unit, the Division of Oral Biology’s Microbiology & Cell Biology research group, and the Division of Restorative Dentistry aims to examine the mechanistic link between periodontitis and rheumatoid arthritis (RA). 

This collaboration has placed us in a highly distinguished, competitive, and world-leading position among the scientific community on microbiome profiling in studies investigating oral-systemic links, particularly in RA. 

Impact and Benefits

Our findings have important implications for the prevention and treatment of RA. By targeting the oral microbiome, we may be able to reduce the risk of developing RA or prevent the disease from progressing. This research is expected to follow an upward trajectory in terms of translational impact and value, in line with our School and University’s research strategy. 

Dental materials research 

Background

Following the introduction of the Minimata convention and the calls for a phase-down in the use of mercury-containing products, composite materials were suggested as the most suitable alternative to amalgam.

However, the average life span of composite restorations remains just under 10 years, after which clinical intervention may be required with recurrent caries and restoration fracture remaining as the primary reasons for failure.

Research at Leeds aimed to improve the properties of current resin composites by the development of novel resin composite materials addressing the main reasons for failures of current dental composites.  

Impact and benefits

Dental resin composite materials containing anisotropic FA bundles and rods were successfully developed which were shown to have improved strength, as well as the potential to resist and reverse caries formation through the short and long-term release of fluoride under acidic conditions. This shows a promising step towards a potential 'smart' fluoride-releasing dental composite.  

Improving outcomes for chronic orofacial pain including temporomandibular disorders – The TMD study 

Background

We have shown that self-management interventions using a biopsychosocial approach are effective in reducing long-term pain intensity and depression in patients with chronic pain that affects the mouth, jaws and face. 

Current treatments like mouth guards, pharmacotherapy and / or surgical tooth removal are not supported by Cochrane systematic reviews. These biomedical approaches are directed towards finding and treating an organic pathology for symptoms.   

This imposes a huge burden on patients and already stretched healthcare resources. Patients frequently attend multiple specialities in medical and dental settings, where they undergo numerous ineffective and invasive tests and treatments that increase costs to healthcare services. 

Impact and benefits 

Biopsychosocial interventions, if applied early, have the potential to educate and empower patients and provide techniques to break vicious cycles that exacerbate symptoms. This prevents chronicity and its associated impact on quality of life. Our current research is therefore evaluating:

1. The extent to which early management with our intervention can improve outcomes for patients with TMD. 
2. The potential to re-configure current clinical pathways for optimal referral, triage and management of TMD so that patients who are amenable to self-management are easily managed in primary care with more complex cases being appropriately referred to secondary care services. This will prevent costly, invasive and ineffective treatment of patients with TMD who can readily be managed in primary care using our self-management intervention.  

Caring optimally: Promoting effective mouth minutes in care homes
(The COMMIT study)

Background

Nearly half a million older people live in nursing and residential care homes in the UK. This population is living longer and people are retaining their own teeth.  This also means that these people will be living with co-morbidities, cognitive impairments and potentially complex oral health needs.

Many studies have looked at how to maintain mouth care for people living in care homes, but so far this research has not translated into practice.

Impact and benefits

The study has already published one article outlining the needs and challenges of oral health maintenance in older people living in care homes.  An overview of reviews identifying interventions and strategies has been registered and undertaken, as well as a scoping review on the barriers and enablers when supporting the oral health of older people in care homes.

The research has created a partnership between the dental school, NICHE-Leeds, care homes and our academic partner SoH to make a real contribution to the oral health of care home residents. So far, bespoke oral health training and an oral health top tips guide have been developed and disseminated at the request of care home staff, and local dental services have been connected to care homes.

These steps are hoped to enhance the oral health care residents receive and have a real impact on the residents themselves. Two further papers are planned.

Understanding the oral health needs of those experiencing homelessness

Background

The impacts of homelessness on health are stark. Life expectancy is 30 years lower compared to the general population, and people experiencing homelessness have the largest unmet oral health needs.

Impact and benefits

The research supported two Master’s level projects, published ( Identifying the barriers and facilitators for homeless people to achieve good oral health, Csikar, J. et al., 2019) with one student gaining experience of co-authorship. This research was the starting point for three final-year projects within the Masters in Clinical Dentistry programme. Two linked projects were published and one was presented at a national conference.

The research was also used to inform guidance from the National Institute for Health and Care Excellence (NICE); ‘Integrated health and social care for people experiencing homelessness.’ The paper was appraised and deemed ‘valuable and highly relevant’ by NICE and has gone on to inform service specification development in a new dental service for homeless people in Leeds.

A pilot service was commissioned by NHS England and NHS Improvement in Leeds and this model of delivery is being rolled out to other localities within the region.