Multispecies biofilm for investigate non-antibiotic therapies in dentistry (MISFAITH)

Antimicrobial resistance (AMR) – the ability of bacteria to develop resistance to antibiotics, one of the most important medical breakthroughs of the past 100 years – is an increasing global threat. Bacteria are becoming stronger, making antibiotic treatments less effective, and in some cases completely useless. A 2019 study showed that 141,000 deaths in high-income countries were directly linked to AMR. Two factors drive this development: one is the bacteria’s adaptability, which is accelerated by human behaviour and undermines the effect of existing treatments. The other is the lack of new pharmacological solutions. The result is an innovation landscape that is unable to keep pace with the ever-growing threat. This is where we aim to make a difference. In the MISFAITH project, we are developing a new multispecies biofilm model to test technologies that can reduce the need for antibiotics in the treatment of infected implants. We have now established a model that works well and already provides promising results. This model makes it possible to mimic complex bacterial communities in the laboratory and will also help reduce the use of experimental animals. Studies show that the protein layer forming on biomaterials has a major impact on bacterial growth, and that removing this layer is essential to prevent new infections. In the project, we have used six different bacterial species to develop a robust biofilm, which now provides us with a powerful tool to explore new, non-antibiotic therapies in dentistry.

The increasing use of biomaterials and medical devices has led to the emergence of new families of diseases related precisely to the use of these new technologies. Titanium dental implants are made with rough surfaces that facilitate good bone integration, but this approach also promotes bacterial adhesion and biofilm formation, and thus, infections. Preventive measures involve surface modifications of titanium implants, regenerative materials to counteract infection-induced bone loss, and debridement of implant surfaces. It is an intricate balance to find the right combination between the implant material, cleaning methods, and regeneration of bone loss. There is a high rate of colonisation of these surfaces due to the induction of biofilm-growing microorganisms, which are progressively resistant to antimicrobial therapies. The accumulation of microbes and biofilm formation, both in teeth and dental implants, triggers an inflammatory process characterized by the destruction of tooth/implant supporting bone. Unless biofilms are appropriately controlled, they accelerate their physiological heterogeneity and a series of complex interactions follows that results in chronic inflammation and loss of adjacent tissues. The condition thus often develops into a vicious circle with a great toll on the general health of the patients. The only way to break the cycle is through rigid biofilm control. MISFAITH aims to develop a dynamic multispecies biofilm model that can be used to model and test 3 novel methods for tackling the challenges associated with biomaterial-induced infections. Success in MISFAITH will have an enormous impact on the dental biomaterials field since as it would shift current treatment procedures to regenerative outcomes, resulting in better treatments and higher patient satisfaction, and less use of antibiotics. Therefore, if successful, the project outcomes will have an enormous social impact and potential for patient welfare.