Hospital Dentistry and Periodontal Medicine

1. Craniomaxillofacial anomalies and the analysis of malocclusions with associated anatomical factors. Principal investigators: Alejandro Rivera / Lluïsa Tobella. This line focuses on fissures (cleft palate and cleft lip) to harness orthodontic solutions and three-dimensional surgical planning. Another area of special research interest is obstructive sleep apnoea-hypopnoea syndrome (OSAHS).
2. Special needs or high-risk patients: Paediatric oral surgery and dentistry. Principal investigators: Lluís Brunet / Mireia Aznar. This line adopts a multidisciplinary approach to oral diseases in children with associated systemic diseases and/or disabilities. Comprehensive treatment guidelines are developed, including psychological aspects related to autism spectrum disorder. We are also conducting studies to examine the effects of some cancer treatments on dental development. We are reviewing the cellular and molecular mechanisms implicated in gingival enlargement.
3. Periodontal Medicine. Principal investigators: Jaume Miranda / Jordi Moncunill. The aim of this research is to study the relationship between periodontal and systemic disease. More specifically, at our maternity/paediatric hospital we have already initiated the study: "Periodontal disease in pregnant women associated with preterm birth. Analysis of maternal subgingival microbiota and placental microbiome." Periodontal Medicine is a line with great potential in the hospital setting as it explores the remote effects of chronic infectious-inflammatory diseases such as periodontitis. This had traditionally been mistakenly considered a disease confined to the gums and oral cavity.

1. To promote periodontal research by establishing synergies with other clinical expert groups with a view to carrying out more ambitious scientific projects.
2. To apply certain orthodontic devices designed especially for patients with obstructive sleep apnoea and for the treatment of severe skeletal class III malocclusions (Alt-RAMEC protocol).

The research carried out by our group focuses on the clinical, microbiological, cellular and molecular aspects of periodontal diseases. Our main goal is to study the systemic and remote effects of chronic, apparently localised, infectious-inflammatory disease, such as periodontitis. Periodontal bacteria (periodontopathogens) in patients with periodontitis can initiate a cascade of immune-inflammatory mediators such as PGE2, IL-6, IL-1 and TNF-α. Certain bacteria such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans can even directly invade cells and tissues.

Several researchers have concurred that one of the most important limitations of studies linking periodontal disease with systemic complications is the immense variability of the clinical criteria used to define periodontitis. However objective reproducible parameters can be established by means of pyrosequencing for the classification of bacterial complexes relating the different stages of periodontal health, gingivitis or periodontitis.

The group is made up of doctors, dentists, experts in paediatric dentistry, orthodontics, oral surgery and periodontics, who offer a holistic approach to the issues raised by both hospital dentistry and periodontal medicine. We also collaborate with microbiologists in our Microbiome Unit. Regarding craniomaxillofacial anomalies, severe malocclusions and special high-risk patients, we collaborate with specialists in paediatrics, maxillofacial surgery, plastic surgery, otorhinolaryngology, oncology and speech therapy.