Table of Contents  
REVIEW ARTICLE
Year : 2013  |  Volume : 5  |  Issue : 1  |  Page : 9-14

Nanotechnology in dentistry: Current achievements and prospects


1 Department of Public Health Dentistry, Gian Sagar Dental College and Hospital, Rajpura, Punjab, India
2 Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
3 Department of Periodontics, Laxmi Bai Dental College, Patiala, Punjab, India
4 Department of Oral Medicine and Radiology, Punjab University Dental College, Chandigarh, India
5 Department of Periodontics, Sarabha Dental College, Ludhiana, Punjab, India
6 Department of General Dentistry, Apollo Dental Centre, Chandigarh, India

Date of Web Publication20-Jun-2013

Correspondence Address:
Ramandeep Singh Gambhir
Department of Public Health Dentistry, Gian Sagar Dental College, Rajpura, Punjab - 140 601
India
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Source of Support: None, Conflict of Interest: None


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  Abstract 

Nanotechnology offers advances particularly in each and every field of human activity such as electronics, industry, telecommunications, environmental science, etc., The field of nanotechnology has got remarkable potential that can bring considerable improvements to the human health, enhanced use of natural resources, and reduced environmental pollution. Since 1990s, nanotechnology has been exploited for potential medical and dental applications. Nanotechnology holds promise for advanced diagnostics, targeted drug delivery, and biosensors. Dentistry is undergoing yet another change to benefit mankind, this time by transforming itself to the nanodentistry. A variety of nanostructures such as nanorobots, nanospheres, nanofibers, nanorods, etc., have been studied for various applications in dentistry and medicine. Preventive dentistry has also utilized nanodentistry to develop the nanomaterials for inclusion in a variety of oral health-care products. However, due to insufficient evidence on potential hazards on human health and environment, nanotechnology has become a controversial issue. It is documented that nanomaterials can enter the human body through several routes and can pose a threat to human health by interacting with the DNA. The present article focuses on the current status and the future implications of nanotechnology in dentistry.

Keywords: Nanodentistry, nanostructures, nanotechnology, preventive dentistry


How to cite this article:
Gambhir RS, Sogi G M, Nirola A, Brar R, Sekhon T, Kakar H. Nanotechnology in dentistry: Current achievements and prospects. J Orofac Sci 2013;5:9-14

How to cite this URL:
Gambhir RS, Sogi G M, Nirola A, Brar R, Sekhon T, Kakar H. Nanotechnology in dentistry: Current achievements and prospects. J Orofac Sci [serial online] 2013 [cited 2017 Mar 25];5:9-14. Available from: http://www.jofs.in/text.asp?2013/5/1/9/113682


  Introduction Top


'Nano' is derived from the Greek word, which means 'dwarf'. Nanotechnology can be defined as the science and engineering involved in the design, synthesis, characterization, and application of materials and devices whose smallest functional organization in at least one dimension is on the nanometer scale (one-billionth of a meter). Therefore, nanomaterial or a nanodevice can be considered as a particle with a maximum size of 1 × 10−7 m. [1],[2] The term 'nanotechnology' was first used in 1974 when Norio Taniguchi, a researcher at the University of Tokyo used it to refer to the ability to engineer materials precisely at the nanometer level. [3] Nanotechnology and the science of nanomaterials have a potential to provide benefits in numerous areas such as synthesis of new materials with advanced properties, production technology, information technology and electronics, ecology and energy conservation, nano-biosystems, medical appliances, transportation, economy, etc. [4]

Nanotechnology is widely used in medicine in areas such as drug development, and imaging. Furthermore, the targeted delivery of drugs to diseased cells, such as cancer cells, this is an effective, and safer way of treating a disease. The potential applications of nanotechnology are very vast; however, one of the greatest values of nanotechnology will be in the development of new and effective medical treatments. [5],[6] The advances of nanotechnology in dentistry have been relatively slow in comparison to the application of nanotechnology in areas like medicine. In the last 10 years, numerous theoretical predictions have been made based on the potential applications for nanotechnology in dentistry, with varying levels of optimism. [7],[8] Nanodentistry has a potential to improve oral health by providing the sophisticated preventive, diagnostic, and therapeutic measures using the nanomaterials, biotechnology, and nanorobots. [9] Current research in dentistry includes the use of Nanoparticles, which are being used in resin-based composite (RBC) restorations and in preventive dentistry specifically in control and management of bacterial biofilms. The present article will throw a spotlight on the various applications of nanotechnology in dentistry and their potentially far reaching future prospects.


  Various Nanostructures used in Dentistry Top


Commonly explored nanostructures, which can show promising results in dentistry are as follows:

Nanoparticles

Nanoparticles (diameters of between 0.1 nm and 100 nm) of the various compositions represent the most widespread use of nanoscale units in dentistry. Two year clinical results have shown that these are currently being used in RBC restorations. [10],[11] Together with the evolution of nanoparticles for dental composites, sharper focus is being applied to reformulations of interfacial silanes. Nanohybrid RBCs are currently the most ubiquitous example of such technology.

Nanorods

These serve as a useful tool in restorative context. Some authors have synthesized enamel-prism-like hydroxyapatite (HA) nanorods that have exhibited self-assembly properties. [7],[12] Nanorods could possible contribute to a practical artificial approximation of a naturally-occurring structure like enamel as they are similar to the enamel rods that make up the basic crystalline structure of dental enamel.

Nanospheres

Nanospheres can be used in a similar fashion like the nanorods in formulating in restorative technology. Specifically, nanosphere assembly in conjunction with the calcium phosphate deposition and amelogenin nanochain assembly is discussed elsewhere in a restorative context. [7],[13]

Nanotubes

Different types of nanotubes have been investigated for dental applications in a number of interesting directions. Titanium oxide nanotubes have been shown in vitro to accelerate the kinetics of HA formation, so as to serve as coatings, which can accelerate bone growth on the surface of the implants. More recently, modified single-walled carbon nanotubes have been shown to improve the flexural strength of RBCs. [7],[14]

Nanofibers

Nanofibers have been expored for their potential use in dentistry to generate ceramics containing HA and fluor-HA. Nanofibrillar silicate crystals have also been recently studied in the capacity of reinforcement of dental composites. [15] These nanofibers demonstrated an improvement the physical properties of the composites when added in correct proportions and with uniform distribution. [7]

Dendrimers and dendritic copolymers

Dendrimers are macromolecular compounds that are made up of a series of branches around an inner core. [16] Dendrimers and dendritic copolymers have been studied, although less extensively than other nanostructures, in relation to dental composite applications. Combinations of specific polymers to optimize efficacy of restorative applications have been reported. [7],[17]

Nanopores

Titanium implants are widely used in dental and orthopedic surgery because of favorable mechanical and biocompatible properties. In order to promote the osseointergration of implants, various surface treatments have been proposed. It has been recently shown that Titanium surfaces with nanopores 30 nm may promote early osteoblastic differentiation and consequently, rapid osseointegration of titanium implants. [18]

Nanoshells

They can prove to be beneficial in the treatment of patients suffering from oral cancer. These are miniscule beads coated with gold. By manipulating the thickness of the layers making up the nanoshells, scientists can design these beads to absorb near-infrared light, creating an intense heat that is lethal to cancer cells. [19]

Other nanostructures, which have potential applications in other health-care fields and can also prove to be a useful tool in dentistry are follows. [20]

  1. Liposomes
  2. Quantum Dots
  3. Fullerenes
  4. Nanowires
  5. Nanobelts
  6. Nanorings
  7. Nanocapsules

  Various Applications of Nanotechnology in Dentistry Top


Nanotechnology offers a broad range of innovations and improvements in prevention, diagnostics and treatment of oral diseases. There are basically two perspectives of approaching nanodentistry. [21]

  • Building up of particles by combining atomic elements, which is called as 'Bottom-up approach.'
  • Using equipment to create mechanical nanoscale known as 'Top-Down approach.'
There are numerous applications of nanotechnology in dentistry, which are as follows:

  1. Nanorobots-Dental nanorobots can go a long way in maintenance of comprehensive oral health of the people. When the first micro-size dental nanorobots can be constructed, dental nanorobots might use specific motility mechanisms to crawl or swim through human tissue with the navigational precision, acquire energy, sense, and manipulate their surroundings, achieve safe cytopenetration and use any of the multitude techniques to monitor, interrupt, or alter nerve impulse traffic in individual nerve cells in real time.
  2. These nanorobot functions may be controlled by an onboard nanocomputer that executes pre-programed instructions in response to local sensor stimuli. [8],[22]
  3. Nanocomposites - Non-agglomerated discrete nanoparticles that are homogeneously distributed in resins or coatings to produce nanocomposites have been successfully manufactured by Nanoproducts Corporation. The nanofiller used include an aluminosilicate powder having a mean particle size of 80 ran and a 1:4 M ratio of alumina to silica and a refractive index of 1.508. The main advantages of this nanofiller are its Superior hardness, Superior flexural strength, modulus of elasticity and translucency, 50% reduction in filling shrinkage, and Excellent handling properties. [23]
  4. Nanosolutions - Nanosolutions produce unique and dispersible nanoparticles, which can be used in bonding agents. This ensures homogeneity and ensures that the adhesive is perfectly mixed every time. [23]
  5. Impression Materials - Nanofillers are integrated in vinyl polysiloxanes, producing a unique addition of siloxane impression materials. Impression materials are available, which use nanotechnology for e.g., Nano Tech Elite HD+ (High Intensity Resistance to Deformation). The material has better flow, improved hydrophilic properties, and enhanced detail precision. [21]
  6. Nanoencapsulation - South-West Research Institute has developed targeted release systems that encompass nanocapsules including novel vaccines, antibiotics, and drug delivery with reduced side-effects. [20] According to a study, Triclosan-loaded Nanoparticles, 500 nm in size, used in an attempt to obtain a novel drug delivery system adequate for the treatment of periodontal disease. These particles significantly reduced inflammation at the experimental sites. [24] An example of this technology is arestin in which minocycline is incorporated into microspheres for drug delivery by local means to a periodontal pocket. [25]
  7. Nano in Oral Anesthesia Induction - Nanorobots will play a powerful role in the induction of local anesthesia in the era of nanodentistry. A colloidal suspension containing millions of active analgesic micron-size dental robots will be instilled on the patient's gingiva. After contacting the surface of crown or mucosa, the ambulating nanorobots reach the pulp via the gingival sulcus, lamina propria, and dentinal tubules. [8]
  8. Once installed in the pulp, the analgesic dental robots may be commanded by the dentist to shut down all sensitivity in any particular tooth that requires treatment. After oral procedures are completed, the dentist orders the nanorobots to restore all sensation, to relinquish control of nerve traffic and to egress from the tooth by similar pathways used for ingress. [26],[27] Nanorobotic analgesics offer greater patient comfort, reduced anxiety, no-needle, greater selectivity, and control ability of the analgesic effect, fast and completely reversible action and avoidance of most of the side-effects and complications.
  9. Treating Dentinal Hypersensitivity-Natural hypersensitive teeth have eight times higher surface density of dentinal tubules and diameter with twice as large as non-sensitive teeth. Reconstructive dental robots, using the native biological materials, could selectively and precisely occlude specific tubules within minutes, offering a quick, and permanent cure. [8],[28]
  10. Nano-Orthodontics-Orthodontic nanorobots could directly manipulate the periodontal tissues including gingival, periodontal ligament, cementum and alveolar bone allowing rapid and painless tooth alignment, rotating and vertical tooth repositioning within minutes to hours. This is in contrast to contemporary orthodontic techniques which require several weeks or even months to complete. [8]
  11. Nano replacement of tooth-The day is not far enough when we will be able to generate a whole new tooth by utilizing the principles of genetic engineering, tissue engineering and tissue regeneration, and manipulating cellular and mineral components at nanoscale. Some authors were able to simulate the natural biomineralization process to create enamel by using the nanorods like calcium HA crystals, which were oriented roughly parallel to each other. [12]
  12. Tooth durability and appearance-Durability and appearance of the tooth may be improved by replacing upper enamel layers with covalently bonded artificial materials such as sapphire or diamond, which have 20-100 times the hardness and failure strength of natural enamel or contemporary ceramic veneers and good biocompatibility. Pure sapphire and diamond are brittle and prone to fracture, can be made more fracture resistant as part of a nanostructured composite material that possibly includes embedded carbon nanotubes. [29] Nanotechnology has improved the properties of various kinds of fibers. Poly nanofibers and carbon fibers with nanometer dimensions possess larger surface area per unit mass, which permit an easier addition of surface functionalities and also increase in osteoblast adhesion necessary for successful orthopedic/dental implant applications respectively. [30],[31] Nanofibers are also integrated in vinyl siloxanes, producing a unique addition Siloxane impression material. Better flow improved hydrophilic properties, hence fewer voids at the margin and better model pouring, enhanced detail precision are some of the advantages of this impression material. [31],[32]
  13. Nanorobotic dentifrice - subocclusal dwelling nanorobotic dentifrice delivered by mouthwash or toothpaste can be developed that could patrol all supragingival and subgingival surfaces at least once a day, metabolizing trapped organic matter into harmless and odorless vapors and performing continuous calculus debridement. [33]
  14. Diagnosis and Treatment of Oral Cancer-Nano electromechanical system coverts biochemical to an electrical signal and cantilever array sensor is an ultrasensitive mass detection technology that can be used for the detection of 10-12 bacteria, viruses and DNA. These are extremely useful in the diagnosis of oral cancer and diabetes mellitus for the detection of bacteria, fungi, and viruses. Nanomaterials for brachytherapy like "BrachySilTM" (Silvida, Australia) deliver 32 P are in the clinical trial. Drug delivery system that can cross the blood brain barrier will be more effective in the treatment of Parkinson Disease, Alzeimer disease and other tumors of the brain. Hydrophobic porphyrins are potentially interesting molecules for the photodynamic therapy of solid cancers or ocular vascularization diseases. [21]

  Nanotechnology in Preventive Dentistry Top


The purpose of modern dentistry is the early prevention of tooth decay (caused by bacterial biofilms on the tooth surface) rather than invasive restorative therapy. Recent studies indicate that nanotechnology might provide novel strategies in preventive dentistry, specifically in control and management of bacterial biofilms or demineralization of sub-micrometer-sized tooth decay. [34] Various types of biomimetic approaches have been used to develop nanomaterials for inclusion in a variety of oral health-care products for biofilm control and remineralization of sub-micrometer-sized enamel lesions. These bio-inspired strategies for biofilm management are based on size-specific effects of the apatite nanoparticles, and are thought to be more effective than traditional approaches that use micrometer-sized hydroxyl apatite in toothpastes. [35] These include liquids and pastes that contain nano-apatites for biofilm management at the tooth surface, and products that contain nanomaterials for the remineralization of early sub-micrometer-sized enamel lesions. Easy-to-clean, wear-resistant and biocompatible nanocomposite surface coatings for biofilm management are close to being used in dental practice. However, biomimetic restoration and filling of small clinically visible cavities with the nanomaterials is not conceivable at the moment, and requires extensive further research with respect to clinical applicability.


  Recent Advances in Implant Dentistry Top


Dental implant therapy has been one of the most significant advances in dentistry in the past three decades. The success and longevity of dental implants are strongly governed by surface characteristics. Three factors have become key areas for improved implant device topography. Nanoscale surfaces structuring, which would optimize cell colonization; surface chemistry, which attempts to control and optimize the chemical surface properties of an implant material; and wettability, due to the observation that cell adhesion and subsequent activity are generally better on hydrophilic surfaces. Structuring chemistry modification would require nanoscale processes while engineered nanomaterial would play a role in increasing wettability. [36]


  Barriers to Nanotechnology Top


Numerous challenges faced by the nanotechnology are enlisted in [Table 1]. These challenges are posing as hurdles, which need to be removed for successful implementation of nanotechnology in the different parts of the globe.
Table 1: Barriers to nanotechnology

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  Nanotechnology: A Threat to Human Health Top


Since nanotechnology is a very recent discovery and is only just being put in to use, there are issues that need to be addressed. As long-term effects of nanotechnology are unknown, therefore, potential hazards caused by the nanotechnology might not show for many years. Various factors govern the amount of free Nanoparticles in nature such as their physico-chemical properties, quantity, and time of exposure. Nanomaterials released in the environment can be further modified by: Temperature, pH, different biological conditions, and presence of other pollutants. In this interaction, nanomaterials can alter atmosphere, soil and water and prove to be harmful to human health and the environment. [4],[37]

It has been reported that nanomaterials can enter the human body through several ports. Accidental or involuntary contact during production or use is most likely to occur via the lungs and skin, from which a rapid translocation is possible to other vital organs through the bloodstream. Carbon black Nanoparticles have been implicated in interfering with cell signaling. [2],[38] It could also have unwanted effects on the DNA of cells, which could potentially cause genetic defects if this were to happen it would take a lot of time and research to put right. There is a need for developing systemic solutions, monitoring, and recording of the potential hazard as well as finding timely responses in order to achieve safety for human health and the environment.


  Conclusion Top


Nanotechnology is such a new and exciting area of science, so there are many ways in which it can progress. It is an emerging field with a significant potential to yield new generation of technologically advanced clinical tools and devices for oral health-care. Nano-enabled technologies thus provides an alternative and superior approach to assess the onset or progression of diseases, to identify targets for treatment interventions as well as the ability to design more biocompatible, microbe resistant dental materials, and implants. Major advances are also expected in the field of preventive dentistry and imitating processes that occur in nature (biomimetic). For all these things to happen, nanodentistry needs to overcome the various barriers or challenges for its application and yield more effective therapies and preventive properties. As every coin has two sides, same implies for nanotechnology, as well. Nanotechnology also carries a significant potential for misuse and abuse on a scale and scope never seen before. Nanotechnology might cause adverse effects to human health and environment that are poorly understood. How the world reacts to the application of nanotechnology is yet to be seen. A successful future of nanotechnology will only be achieved through open sharing of ideas, research findings, testing, and forthright discussions.

 
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