JIMMA UNIVERSITY

JIMMA INSTITUTE OF TECHNOLOGY

FACULTY OF MATERIALS SCIENCE AND ENGINEERING

DEPARTMENT OF MATERIALS SCIENCE AND ENDINEERIND

Assignment of Nanotechnology on Dental implant

Prepared by: Abdulbare Kelil

Submitted to: Dr.Sathiesh Kumar

Submission date: 4/2/2022

APPLICATION OF NANOTECHNOLOGY IN DENTAL IMPLANTS

Background

Nanotechnology or molecular nanotechnology is also known as molecular engineering. It is the

control of matter at the nanoscale at dimensions between 1 to 100 nm. Using nanotechnology, it
is easy to analyze and manipulate atoms, chemical bonds and molecules present between various
compounds. Using various physical and chemical methods, functional materials can be
synthesized in nanoscale. The US national nanotechnology has three requirements for
nanotechnology:-

1. Technology development at an atomic, molecular, or macromolecular levels, in the length

scale of 1-100 nm range.

2. Creating and using devices, structures, and system that will have novel properties and
functions because of their small and –or intermediate size.

3. Ability to control or manipulate on the atomic– molecular scale.

To control the ultimate performance of the material to which the nanoparticles are incorporated
is crucial thus control of the chemical composition of the surface of nanoparticles becomes a
prerequisite to the reliability and reproducibility of the nanoparticles. There can be a molecular
scale interaction between these nanoparticles and the materials comprising the matrix. This could
be due to size of individual nanoparticles often approaches that of the host matrix materials.

Nanotechnology is used in most of the medical field in high degree of planning. They are
incorporated because they manipulate the structure of materials to provide dramatic
improvements in chemical, mechanical, and optical properties. This factor has been utilized in
providing unique characteristics to dental adhesives such as adhesion strength and radiopacity
without adversely affecting other properties. The control of chemical composition of the surface
of nanoparticles is an important factor for the reliability and reproducibility of the nanoparticles.
The control of chemical composition is paramount due to the extremely small size they have and
due to a high surface area to volume ratio. Another factor is the interaction between the size of
individual nanoparticles and host matrix materials. The crucial factor is that while adding the
nanoparticle, the performance of the material into which they are incorporated is enhanced.
Synthesis of Nanoparticles

Nanoparticles can be synthesized using bottom-up and top-down methods. In the top-down
approach lithography is used to remove unwanted regions on the thin films and it is finally
etched to get nanostructures. This procedure is used in advanced electronic industries. Contrary
to the top -down approach the bottom-up approach involves mostly synthesis from molecular or
atomic level. These methods have been used in industries and the success is dependent on the
requirements of the application.

1. Synthesis by Mechanical Attrition

Large coarse –grained particles are ground to form smaller sized particles with the help of
ceramic processing and powder metallurgy. These attrition techniques which is a type of “top
down” manufacturing technique have been used to produce nanoparticles. The procedure
involves consumption of energy and is successful in providing nanostructured components for
dental materials.

2. Synthesis through Sol-Gel Process

This method is considerably less cost effective comparatively to the other techniques of
synthesis. A sol is defined as a fluid suspension of a colloidal solid in a liquid. A gel is a semi-
solid colloidal suspension of a solid dispersed in a liquid. A sol –Gel preparative method which
is in a liquid form is mixed with different precursor which gives a solution.

3. Functionalization of Oxide Nanoparticles

Two types of functionalization of the surface of nanoparticles are followed. In the first method,
the nanoparticle or nanocluster is isolated and grafted to the nanoparticle. The organic group is
used in the second method in the synthesis. There is a reaction between the oxide nanoparticles
and silicon halides. The modification after synthesis is seen by using silane coupling agent.

4. Synthesis of Silsesquioxane Nanoparticles

These type of nanoparticles are like cage structures, ladder and random structures. The
silsesquioxane have the empirical formula RSiO1.5. They have hybrid compositions where the
ratios of oxygen to silicon are different. They are polyhedral and often referred to as POSS
materials.
5. Synthesis of Polymer-Templated Nanoparticles

Assemblies of polymers are used to template the synthesis of nanoparticles. These assemblies
create an environment suitable for the synthesis and are made of polymers. Nanoapetite needle
like crystals are synthesized by polyacrylic acid, surfactants are also used as templates as they
produce micelles. Chitosan and collagen precipitate Nano hydroxyapatite crystals. All these
polymer –Template nanoparticles are used in dental adhesives.

Nanoparticles used in dentistry

Dentistry is one field where nanoparticles like nanocomposites containing oxide nanoparticles
are used to enhance the properties of the material. Nanohybrids and nanofills are the widely used
dental nanocomposites. In nanohybrids, the particles are large and are 4-5 nm in size. In
nanofills, the particles vary from 1 to 100 nm throughout the resin matrix.

Various applications of NPs that are used in the field of dentistry are shown in fig 1

The chemical and physical property based on the metals or the compounds used to prepare the
NPs. We are summarizing the pure NPs as well as the composite NPs used in the field of
dentistry.
Figure 1: Different nanoparticles used in various application of dentistry
1. Carbon based nanomaterial

a. Carbon nanotubes

Carbon nanotubes (CNTs) have unique electrical as well as mechanical properties. Strength and
flexibility of CNTs are because of C=C covalent bond and hexagonal orientation. CNTs also
have thermal and electrical conductivity (semi conductivity). Because of it's excellent
mechanical and electrical properties such as heat stability, heat transmission efficiency, high
strength and lower density, it is used as a candidate for teeth filling and various
applications .CNTs needles are used for bringing active agents to live cells

b. Graphene

Graphene, an allotrope of carbon having sp2 hybridized carbon atoms has one-atom thick
densely packed planar sheets structure arranged in honeycomb crystal lattice. This makes
graphene as the thinnest material forming a uniform crystal lattice without any vacancies or
structural dislocations. This property yielded graphene new physical properties. Conducting
electrons of graphene, mostly behave like electrons or neutrons which move like the speed of
light. Thus graphene is used in photovoltaic, bio-devices, ultra-capacitors for diagnosis and
detection of disease and building of anti-bacterial surfaces. Thus graphene is used to treat various
bacterial biofilm .Oral biofilms are important for dental caries development (Streptococcus
mutants – 10 etiological agents in dental caries formation) and several periodontal diseases.
Implants can replace absent teeth.35 Biofilms are important due to its implant failure nature.
Graphene/zinc oxide nanocomposite (GZNC) has the potential to the biofilm caused by
Streptococcus mutans. Acrylic teeth coated with graphene (Fig. 4) are used due to its cost
effectiveness, fracture resistant and low-density property is suitable for implantation. Anti-
biofilm assays show biofilm reduction in presence of GZNC. PCL/graphene was also used for
porous scaffolds formation.

2. Hydroxyapatite (HAp)

Hydroxyl apatite NPs has been used widely in medicine and dentistry. It's similar composition
with teeth and bone make it a biocompatible substance for the physiological process. This is the
main composition of mineralized tissues of the human body (Ca10 (PO4)6 .2(OH)). It is a
natural calcium phosphate ceramic, predominant in 97% enamel. The hardest tissue of our body
is tooth enamel which has HAp nanocrystals as the building blocks. Teeth are acellular in nature,
thus it cannot be logically repairedlike a bone. Thus regenerating the enamel surface is a
significant challenge.

3. Iron oxide

Iron compound (FeOx) nanoparticle has an important role in biology and medicinal field.
Magnetite and Maghemite, the two common forms of iron oxide nanoparticles are most popular
in biomedical science due to its biocompatibility and non-toxic property to humans. Furthermore,
iron oxide is well decomposable and thus helpful in favor of in vivo applications. Mostly used
NPs in medical science are nanoparticles based on Super- paramagnetic iron oxide. Bacterial
biofilms on dental implants are difficult to eliminate by antibiotics as a result of their protective
layer of exopolymers that insert the microorganisms in a matrix, which is impenetrable for
immune-cells and for many antibiotics. The nanoparticulate substance is presently used to
control microbial infections. Iron-oxide nanoparticles are widely utilized to eradicate biofilms on
dental implants (Figs. 2).

4. Zirconia

The use Zirconia (Zirconium dioxide, ZrO2) has considerable significance in dental science. It
has similar metallic properties and color like tooth. Zirconia is a chemical oxide which is
insoluble in water. Thus, it reduces the bacterial adhesion and has low cytotoxicity. This makes
ZrO2 as a widespread biomaterial for dental implants. Zirconia implants encompass glorious
resistance against corrosion and carry, as well as sensible biocompatibility. Moreover, high
fracture resistance can be acquired by ZrO2 because of energy retention property throughout the
conversion of polygonally shaped molecules into monoclinic ones. Zirconia NPs is a bio inert
material, the encapsulation by animal tissue is weak and also the unleash of remains virtually
unnoticeable. Additionally, Zirconia is Osseo conductive, thereby it facilitates bone formation.
Besides ZrO2 NPs various nanocomposites are also used in various application of dentistry
(Figs. 4 and 5). Nano zirconia-alumina materials combine the physical and chemical properties
of ceramic material. In these NPs, low percentage of tetragonal ZrO2 particles is in an aluminum
oxide matrix. Thus, the toughness and longevity which are the principal interest in the dentistry
are retained. Alumina/zirconia nanocomposites are new implant materials which show better
efficacy as compared to the ceramic materials. Zirconia oxide nanoparticles are found to have
anti-biofilm activity against certain bacteria (such as Enterococcus faecalis) and therefore they
can be effectively used as a polishing agent in dental practices.

5. Silica

Silica-based NPs have a significant role in nanotechnology, due to its size, surface area,
biocompatibility, low toxicity, low density and adsorption capacity. Si NPs are used in various
filed of medical science to diagnose, control diseases and correcting genetic disorders. Thus
Silica NPs used in biomedical research, such as drug delivery, enzyme supporters and
biosensors. In the field of dentistry silica NPs used as dental filler. Variation in dimension and
outline of packing particles affect the possessions of the materials. Thus various dental filler
products developed to improve their mechanical properties. Tooth polishing is a conventional
practice. Silica particles are used in polishing for their biocompatibility and low cost. Some
cariogenic bacteria that lives inside the oral cavity causes damage of the tooth enamel by
producing acids that demineralize the enamel, thereby causing caries. Polishing of teeth surfaces
is often done to protect the enamel surfaces. Studies have shown a considerable lower roughness
of the polished surface when silica nanoparticles were used for polishing. Thus, polishing
prevents dental caries, which acts as a primary defense mechanism against the cariogenic
bacteria. Modified silica nanoparticles are used to treat dental hyper- sensitivity (Figs. 2).
Enamel loss exposes dentinal tubules, thereby increasing the risk of dental hypersensitivity. Over
the years, a number of desensitizing agents are commercially available that aim at occluding
dentinal tubules. But none of them are consistent and reliable. Recently, a number of dental care
products have been developed for the occlusion of exposed dentinal tubules. Unfortunately, the
products can penetrate only up to a small depth into the dentinal tubules which may not combat
the daily adverse conditions. Therefore, it's necessary to develop biomaterials that can penetrate
deeper inside the dentinal tubules without irritating the pulp, rapid in action, and provide lasting
tubule occlusion in dentin. Mesoporous silica possesses well-defined structures, high surface
areas, tunable pore sizes, hydrocarbon sorption efficacy, and high thermal/hydrothermal stability;
as such, mesoporous silica have been widely researched over the past two decades.ch uses silica
particles.

6. Titania (TiO2)

TiO2 nanoparticles are mostly used in medical and in the field of dentistry. Insertion of implants
gives rise to the allergic reaction by inducing antigen/antibody type 1 and type IV complex
reaction. However, adhesion of microbes on Titania implants has a strong effect on teeth healing
process and show the long-term effect on implants. Roughness or chemical decomposition on
implants can form plaque inside the oral cavity. Titanium plates were placed in bacterial
suspension for around 1 h for bacterial colony count, adhesion angle measurements represent no
significant difference on surface modification. Adherent bacteria number reduces significantly
on stable Titania (titanium/zirconia nanoparticles) rather than polished titanium. So physical
modification (silica/ Titania nanoparticle coating) significantly decreases microbial adhesion for
result promotion. Bone reacts to physically modified titanium implants for the formation of
inorganic nanoporous substances and intensively used to form drug-releasing implants (Figs. 2).
Surface modification improves hardness and strength of dental RBCs and affects linkage and
dispersion of TiO2 present inside a resin matrix.
7. Silver

Silver compounds are known to exhibit antibacterial activity. With the advancement of
nanotechnology more silver nanoparticles are synthesized (AgNPs). AgNPs are widely used in
water purification, toothpaste, washing machines, shampoo, kitchen utilities, fabrics, nursing
bottles, and humidifiers. AgNPs have also been studied for use in several areas of dentistry
which includes endodontics, dental restorative material, dental prosthetics, and dental implants.
Incorporation of AgNPs decreases microbial colonization over dental parts and increases oral
health. As the nanoparticles possess small size having the larger surface area, they show the
antimicrobial effect at very low level. Because of its minute size, AgNPs can able to penetrate
easily the bacterial cell membrane resulting in rapid bactericidal activity. Silver can interfere
with DNA and proteins by interacting with - SH groups, and also alters the base pairing,

DNA unwinding, cell wall synthesis and respiratory processes, resulting in bacterial death
Various NPs used in the field of dentistry and its positive and negative impacts. Although Ag
acts as a potent antimicrobial agent, it also has many advantages, such as its biocompatibility,
low toxicity, low bacterial resistance and long-term antibacterial activity. The disadvantages of
using AgNPs is that it changes dental color.

8. Nanofill Composites

The nanofills consist of two types of nanoparticles monodispersed nonaggregated form of silica
and nanometric agglomerated particles with the filler particle size ranging from 1-100 nm.
Prevention of agglomeration is done by adding a coupling agent such as methacrylopropyl
trimethoxysilane (MPTS).The mode of reaction is by the silica ester which is added to one end of
the bonding to the inorganic surface and methacrylate group to the other end, this prevents
agglomeration. Researchers at 3M have introduced nanofillers called nanoclusters which help in
improving the rheological properties. The nanoclusters range from 5 to 75 nm and are usually
from oxides of silica and zirconia. They have an average size of 0.6ps to 10 nm.

9. Nanohybrid Composites

Agglomeration usually causes undesirable rheological properties and in order to overcome this
aspect the manufacturers have improvised by adding prepolymerised organic filler which are
called nanohybrids. The nanohybrids still have certain drawbacks such as loss of initial gloss.
Calcium Phosphate and Calcium Fluoride Nanoparticles-Based Composites

Xu and coworkers have used nanoparticles with calcium fluoride and calcium phosphate as they
release phosphate and calcium ions. The new advances with nanoparticles was the introduction
of nanohydroxyapatite (HAP) which mimic human enamel and studies are in the process of
completion. Nano silica fused whiskers were added to enhance the mechanical properties.

Figure 2: Different approaches of nanoparticles applied in dentistry

Surface Modifications by nanoparticles

Interaction of implant surface with blood is dependent on the surface properties of materials. It
occurs through a complex series of protein adsorption and displacement steps. This is known as
the Vroman effect. A hydrophilic surface is better for blood coagulation than a hydrophobic
surface. So, dental implants manufacturers have developed high hydrophilic and rough implant
surfaces with better Osseointegration than conventional one. Osseointegration is described as a
direct structural and functional bone to implant contact under load. The biological events
occurring at the tissue-implant interface are influenced by the chemistry, topography, and
wettability of dental implant surfaces. The challenge is to develop new implant surfaces which
result in increasing the clinical success rate as well as decreasing the tissue healing time for
immediate loading of implants, particularly in aesthetic situations. Alumina and Zirconia
nanocomposites and nanocomposite ceramics can be used to develop new implant materials.
However, the unique mechanical properties of dental tissues cannot be exhibited by these
materials. A new hybrid of inorganic and organic materials can be developed to closely match
the properties of dental tissues. So the use of synthetic composite materials as permanent
replacements for bone, which generated much excitement 30–40 years ago, remains largely
unmet due to significant challenges related to fabrication, performance, and cost. Current hybrid
organic/inorganic composites have significant problems related mostly to their mechanical
performance and their degradation in vivo. As a result, the use of synthetic composite materials
as permanent replacements for bone is nearly nonexistent.

New coating technologies have also been developed for applying hydroxyapatite and related
calcium phosphates (CaP), the mineral of bone, onto the surface of implants]. However, there are
some controversial and contradictory reports as well, claiming HA coatings as not very
beneficial. Since the discovery of original Bioglass composition by Hench, there is increasing
interest to use it in the fabrication of coatings. But attempts to coat bioactive glass on metallic
surfaces failed due to large thermal expansion stresses and high reactivity between metal and
glass]. It is difficult to fabricate an ideal coating with a single technique or material. A
combination of techniques and materials are required to fabricate layers that properly blend
organic and inorganic phases and achieve a thickness in nanometers.

Methods for creating nano features on CP Titanium implants

1 Ceramic coating

2 Plasma spraying

3 Sputtering

4 Ion deposition

5 Sol-gel (colloidal particle adsorption)

1 Ceramic coating
A thin layer of bioactive ceramics such as hydroxyapatite (HA), tricalcium phosphate (TCP) and
bioactive glasses can be applied on the implant surface. They can bond to the implant surface
and the surrounding tissue and promote deposition of bone. They form a carbonated apatite
(HCA) layer on the surface of implant through dissolution and precipitation. Histological studies
have shown that coated implants yield a more reliable interface with bone than mechanical
osseointegration of Ti.

Advantages of coating implant alloys with CPs:

 Faster healing time

 Enhanced bone formation
 Firmer implant bone attachment
 Reduction of metallic ion release

2. Plasma Spraying
Surface contamination is removed with the help of vacuum and charged metallic ions or plasma
is deposited on the surface. Deposition on the implant surface occurs by kinetic energy. This
process is widely used for deposition of calcium phosphate coatings (HA) onto dental implant
surfaces to modify its bioactivity. Osteoblast density increases on the implant nano scale surface.
There is higher percentage of bone implant contact in hydroxyapatite coated implants. However,
there are disadvantages as well. The long term stability of dental implants could be affected by
the variations in the composition of coatings and non -uniform thickness of the material. Also
lack of adherence of the coating in the long term can lead to health hazards

3. Sputtering

Thin films of bio ceramic is deposited by bombardment of high-energy ions. Improved healing
response and initial fixation were found with sputtered CaP coatings. The main drawback of this
technique is that this process is very slow as well as deposition rate is also very low. The slow
deposition rate can be improved by radio frequency and magnetron sputtering.

4. Ion Implantation

This approach offers possible insertion of biologically effective ions such as calcium ion (Ca2+),
fluoride ion (F-), sodium ion (Na+). It includes atomic rearrangements. This method enables to
inject any element on the near-surface region of any substrate. It uses a beam of high energy (10
KeV) ions to fall on metal surface under vacuum. Due to the collision between incident ions and
substrate ions, incident ions lose energy and come to rest on near-surface region of metal.
Synthesis of high purity layers is possible with controlled depth and concentration of impurities.
The properties of the implant material is not affected because this process takes place at low
substrate level.

5. Sol-Gel Method (colloidal particle adsorption)

It is one of the widely used methods for the deposition of CaP, TiO2, TiO2-CaP composite and
silica based coatings on the surface of implant. This method leads to the formation of a uniform
suspension of submicroscopic oxide particles in liquid (sol) by the procedure of controlled
hydrolysis and condensation. When substrate is immersed in simulated body fluid for 1 to 15
days results in faster growth of apatite crystals in gel containing titania. Deposition of discrete
20-40 nm nanoparticles on a dual acid-etched implant surface leads to early bone healing and
enhanced mechanical interlocking with bone .Sol-gel coating process improves dental implant
surfaces by nanoscale surface modifications.

Dental companies in in the United States

1. Straumann

2. Envista

3. Dentsply sirona

4. BioHorizons

5. Zimmer Biomet

6. Osstem implant (HIOSSEN)

7. ACE Surgical

8. MegaGEN

9. Bicon

10. Henry Schen

Selected Properties of Dental Materials Containing Nano Particles

1. Optical Properties

The most important feature of using nanoparticles is the improved mechanical strength, wear
resistance and extremely low visual opacity due to the small particle size. The nanoparticles are
smaller than the wavelength of visible light. Although the nanofill composite have an average
size which is similar to that of microhybrid fillers or conventional hybrid the nanoclusters are
different from hybrid and micro hybrid filler particles. The nanoclusters consist of spacing
between and the addition of nanomer reduces the spacing and gives a smooth finish in the
nanofilled composite. The surface of hybrid and microhybrid restorations wear away in contrast
to the nanoclusters. Thus the filler particles are usually exposed in case of hybrid and
microhybrid restorations and wear causes formation of voids and pits thus leaving an unpolished
surface.

2. Wear Properties

Wear could be due to masticatory load or neuromuscular habits such as bruxism which leads to
attrition of the restoration. Tests have been conducted and hybrid composite showed wear
resistance which was developed by Academisch Cantrum Tandhulkund Amsterdam. AFM
(Atomic Farce Microscopy ) was used to find the wear resistance and Filtek Superior had better
wear resistance than most of the hybrid and microhybrid composites. Studies by Cha et al have
proven wear resistance of nanofill composite using an oral simulator.

3. Mechanical Properties

Curtis et al studied the flexural strength of nanosized filler particles and nanoclusters. The bi-
axial flexural strength was more with nanofill composite with a pre-load of about 20 and 50 N
cyclic preload. Filtek Supreme is considered as a better material than various other composites as
water immersion test up to 1 year showed better results. Nanoclusters showed better
reinforcement property, improved strength and reliability, irrespective of the environment
conditions than hybrid and microfill. This is due to the silane infiltration in nanoclusters
enhanced the damage tolerating capacity of the material

Conclusion

Nanotechnology is going to be an essential part of the clinical dental practice. Nanomaterials are
used in toothpaste and other rinsing solutions for better oral healthcare services which will
become less stressful for the dental surgeons. New nano strategies cope up to address the dental
problems. Nanomaterial used in the dental filling, polishing of the enamel surface to prevent
caries, also used as implant materials that are more effective than the conventional materials.
Some of the nanoparticles act as antimicrobial agent thus prevent bacterial growth.
Nanodentistry attracts patients towards dentistry, since, it will be cost effective, time-saving and
prevent the patient from mental trauma. Development of modified nanomaterial is surely going
to help to solve the dental problems. Nanotechnology’s effect for treatment of oral disease is
limited, which rapidly progress the investigations ensuring developments that are possible in
near future.

Nanotechnology is still advancing and need much more testing before appreciating its maximum
potential in implant dentistry. Several nano surface modification methods are widely being
developed to enhance surface properties of titanium dental implant that result in rapid
osseointegration and faster bone healing. Many in vitro and animal studies have shown that
nanometer-controlled surfaces have a great effect on healing after implant placement. It affects
the adsorption of proteins, blood clot formation, and cell behaviors occurring upon implantation.
The techniques and methods developed should be applicable to clinical practice. Nanotechnology
opens a new spectrum of possibilities for advancement in implant dentistry.

Reference

(1) Subhashree Priyadarsini, Sumit Mukherjee, Monalisa Mishra*, Nanoparticles used in

dentistry: A review, Journal of Oral Biology and Craniofacial Research, 2017

(2) Dr. Abhinav Gupta, Dr. Gaurav Singh, Dr. Saba Afreen, Application of Nanotechnology In
Dental Implants, Journal of Dental and Medical Sciences (IOSR-JDMS),