NANO TECHNOLOGY IN PROSTHODONTICS

SYNOPSIS

➢ Introduction ➢ IN
➢ Nano dentistry
➢ Nano materiasls
➢ Approaches to nano technology
➢ Application
➢ Nanomaterials applied in
prosthodontics
➢ Nanomaterials applied in other
branches
➢ Challenges faced by nano dentistry
➢ conclusion

INTRODUCTION:

“There is plenty of rooms at the bottom”

- Dr Richard Feynman (1959)

Nano is derived from the Greek word for 'dwarf' whichcombines with a noun to
form wordssuch as nanometer,nanotechnology and nanorobot.Nanotechnology
is the science of manipulating matter on molecular and atomic levels or of
matter measured in the billionths of meters or nanometer, roughly the size of 2
or 3atoms

Nano technology consists mainly of the processing, separating,consolidating,

and deforming of materials by one atom or molecule. Since its origin, the
definition of nanotechnology has generally been extended to include features as
large as 100 nm.A nanometer is 10-9 or one billionth of a meter.
Thebasicidea of nanotechnology, used in the narrow senseof the world, is to
employ individual atoms and molecules toconstruct functional structures.

A nanomanufacturing technology should be

➢ Capable of producing components with nanometer precision

➢ Able to create systems with these components
➢ Able to produce many systems simultaneously
➢ Able to structure in three dimensions
➢ Cost effective
HISTORY:

1857:Michael faraday discovered colloidal ‘ruby gold’,demonstrating that nano

structured gold under certain lighting conditions produced different colored
solutions

1936:Erwin mullerinvented the field emission microscope,allowing near atomic

resolution images of materials

1947: John Bardeen et al discovered the semiconductor transistor and greatly

expanded scientific knowledge of semiconductor interfaces

1951:Erwin muller pioneered the field ion microscope,a means to image the
arrangement of atoms at the surface of a sharp metal tip

1956:Arthur von Hippel at MIT introduced many concepts and coined the term
–molecular engineering as applied to dielectrics,ferroelectrics and piezoelectrics
1974:The term nano technology was defined by noriotaniguchi as consisiting of
the processing of separation, consolidation and deformation of material by one
atom or one molecule

1986:The term nano technology was coined by professor kerie E Drexler,in his
booked named ‘Engines of creation’who promoted the technical scale of
phenomena

1990s:Early nano technology companies began to operate,eg.nano phase

technologies in 1989,Helix energy solutionsgroup in 1990

1999 to early 2000’s:consumer products making use of nano technology

appearing in the market place,including light weight nano technology enabled
automobile bumpers that resist denting and scratching.

NANOMATERIALS:
It can be divided into various categories like Nano powder, Nano fibre, Nano
membrane, Nano blocks etc. Out of which development of nano powder is
longest and its technology is most mature.Nano materials have small size,large
surface area,high surface energy and a large proportion of atoms.
It has four unique effects

➢ Quantum size effect

➢ Quantum tunnelling effect
➢ Surface effect
➢ Small size effect
Nano probes are functionalised to achieve biocompatibility and cell
engineering.The usual aspects of nano probes include
 ➢ Nano tubes
➢ Nano rods
➢ Quantum dots
➢ Polymeric nano particles
➢ Liposomes

General Application of Nano materials and devices

Theranostics Targeted therapy & Tissue engineering

Analytic and
drug delievery system regenerative
imaging tools
sysytems medicine

Improved diagnosis, treatment and

prevention with high efficacy and
cost effective

Safety and compatibility requirements

EQUIPMENTS FOR NANO PARTICLES:

➢ Homogenizer
➢ Ultra Sonicator
➢ Mills
➢ Spray Milling
➢ Supercritical Fluid Technology
➢ Electrospray
➢ Ultracentrifugation
 ➢ Nanofiltration
ADVANTAGES OF NANO PARTICLES:

➢ Surface area to volume ratio

➢ All properties can be controlled
➢ Try to virtually imitate nature by constructing objects from basic
components
➢ High degree of precision & control over final product.
➢ Better penetration to cells.
Because of the growing interest in the future of dental applications of nano
technology, a newfield called Nano dentistry is emerging.

NANO DENTISTRY:

The future holds in store an era of dentistry in which every procedure will be
performed using equipments and devices based on nanotechnology.Researchers
have predicted that high-tech and effective management at the microscopic
level, termed nano technology,will become an important part of future dental
and periodontal health.
APPROACHES TO NANOTECHNOLGY:

Current research is directed towards the production of a wide array ofdifferent

nanoscale structures. The fabrication techniques of these structures can be
divided into two approaches:

1.Top down approach

2.Bottom down approach

(Bachmann, 1998; Freitas, 1999; Pool, 1990; Roukes, 2001;Whitesides& Love,

2001).

Top down approach:

Top down fabrication reduces large pieces of materials all the way down to the
nanoscale.This approach requires a large amount of materials and can lead to
waste,if excess material is discarded.

The 'top-down' techniques that are used to manufacturenanoscale structures are

mostly extensions of methodsalready employed in small-scale assembly at the
micronscale. By further miniaturization, the nanodimension is entered. (Lieber,
2001).

Nano dentistry as top down approach:

➢ Nanocomposites
➢ Nano Light-Curing Glass Ionomer Restorative Materials
➢ Nano Impression Materials
➢ Nano-Composite Denture Teeth
➢ Nanosolutions
➢ Nanoencapsulation
➢ Plasma Laser application
➢ Prosthetic Implants
➢ Nanoneedles
➢ Bone replacement materials
Bottom up approach:
The bottom up approach to nanomanufacturing creates products by building
them up from atomic and molecular scale components,which can be time
consuming. Scientist are exploring the concept of placing certain molecular
scale components together that will spontaneously “self assemble” from the
bottom up into ordered structures.

Nano dentistry as bottom up approach

➢ Nanocomposites
 ➢ Nano Light-Curing Glass Ionomer Restorative
➢ Nano Impression Materials
➢ Nano-Composite Denture Teeth
➢ Nanosolutions
➢ Nanoencapsulation
➢ Plasma Laser application
➢ Prosthetic Implants
➢ Nanoneedles
➢ Bone replacement materials
(Rybachunk AV, Chelkman IS. Nanotechnology and nanoparticles indentistry.
Pharmacol Pharm 2009; 1:18-21).

APPLICATIONS:

Developments in dentistry has made many dental treatment procedures fast,

reliable, safe & less painful. Few examples are given below:

● Tooth sealants & fillers -Improve strength, lustre and resist wear
● Antimicrobial nano particles inrestorative materials -Ag particles in
fillers & tooth pastes
● Repair & rebuild damaged enamel
● Composite filling materials -Incorporate nanoparticles
● Nano particle-based drug delivery system- Drug delivery in oral cancer
● Gene therapy -Delivery of gene to diseased cells may repair the cause of
disease.

NANOMATERIALS APPLIED IN PROSTHODONTICS:

Research of nano technology in dental materials is mainly focused on two ways
➢ Preparation of new inorganic nano particles
 ➢ Modify the surface with inorganic nano fillers.

These materials are widely used in ceramics,metals,resins and composites

providing huge space for the improvement and innovation of dental
material.Studies of nano metal shows that it has better antibacterial property.

1. NANOCERAMICS APPLIED IN PROSTHODONTICS:

Nanoceramic refers to the ceramic material with nanoscale dimensions in the

microstructures phase.Compared with the conventional ceramics,
nanoceramicshave unique properties like good toughness andductility. As far as
the arrangement of atoms in nanoceramicsinterface is quite confusing, the atoms
are very easy tomigrate under the conditions of force deformation.
Secondly,compared to the conventional ceramics, nanoceramic hasthe superior
mechanical properties, such as strength andhardness. The hardness and
strengthof many nanoceramics are four to five times higher than thoseof the
traditional materials. For example, at 100 degree Celsius the microhardnessof
nano-TiO2 ceramics is 13,000 kN/mm2, while that of ordinary TiO2 ceramic is
lower than the 2000Kn/mm2.Most importantly toughness of nanoceramics
ismuch higherthan that of traditional ceramics. Carbon nanotubes (CNTs) have
attracted remarkableattention as reinforcements of materials because of
theirexceptional mechanical and electronic properties.
 Nano-optimized moldable ceramics

2. NANO RESIN BASED MATERIALS

Nanohybridand nanofilled are generally thetwo types of composite restorative

materialscharacterized by filler-particle sizes of ≤100 nm referred to under the
term “nanocomposite”.Nanomers and nanoclusters are the two types
ofmonodispersed nonagglomerated discretenanoparticles that are
homogeneously distributed inresins or coatings to produce nano composites.

Nanomaterials available as titanium dioxide, aluminum oxide and silicaoxideare

used in small amounts (1%–5%) to improvepowder flow of composites.
Eg.Isopast® and Heliomolar® by IvoclarVivadent

Nano-structural aluminiumoxidefibres provide added strength and

improved performance to metals, plastics, polymers and compositematerials.

Nanoporous silica filled composite is a fairly new material still inexperimental

form, proven to increase wear resistance in posteriorapplications.

Together with the evolution of nanoparticles for dentalcomposites, sharper

focus is being applied to reformulations ofinterfacial silanes
• Organosilanes such as allyltriethoxysilanehave demonstratedgood
compatibility with nanoparticle fillers such as TiO2.
• In addition,3ethacryloxypropyltrimethoxysilanehas alsobeen demonstrated to
enhance dispersion of silica nanoparticles(5–25 nm) within the restorative resin
matrix.
Light cure Nanocomposites
The introduction of nano fillers into the resin matrix has lead to the
development of newer light cure nano composites with numerous advantages as:
• Highest mechanical strength.
• Low polymerization shrinkage.
• Reliability.
• Durability.
• Low thermal expansion coefficient.
• Low water sorption.
• Excellent marginal integrity.
• Excellent handling characteristics.

Newer light cure nanocomposites

Advantages:

• Improved mechanical strength and wear resistance comparable

• Superior flexural strength, modulus of elasticity, and translucency
• Superior polish and gloss resistance comparable to microfillcomposites.
• 50% reduction in filling shrinkage
• Excellent handling properties
(Current practicality of nanotechnology in dentistry. Part 1:Focus on
nanocomposite restoratives and biomimeticsClinical, Cosmetic and
Investigational Dentistry 2009:1 47–61)

3. IMPRESSION MATERIALS

Nanofillers are integrated in vinylpolysiloxanes,producing a unique addition of

siloxane impressionmaterials.The material has better flow, improved
hydrophilicproperties hence fewer voids at margin and better model pouring.

Advantages:
1. Increased fluidity
2. High tear resistance,
3. Hydrophilic properties
4. Resistance to distortion andheat resistance
5. Snap set that consequently reduces errors caused by micro movements
(Trade name: Nanotech Elite H-D)

Addition siloxane impression material with incorporated nanofillers

4. NANO COMPOSITE TEETH

Conventional denture teeth have their own inherentdisadvantage.
• Porcelain is highly wear resistant, but is brittle, lacks bondingability to the
denture base, and is not easy to polish.
• Acrylic on the other hand undergoes wear.
Nanocomposite denture teeth are made ofPolymethylmethacrylate (PMMA) and
homogeneouslydistributed nanofillers.

Advantages:

• Excellent polishing ability and stain-resistant

• Superb aesthetics, lively surface structure
• Enhanced wear resistance and surface hardness
[Trade name: Veracia( Shofu, Kyoto, Japan)]
The three layeredVeracia SA teeth consist of MF-H (microfilled hybrid)
composite, reinforced with layered glass.

Nanocomposite denture teeth

5. NANOPARTICLES IN POLYMETHYLMETHACRYLATE RESIN.

Nanoparticles are added to polymethylmethacrylate as antimicrobial agents to

increase the viscoelastic property of resins. Oralpathological condition like
denture stomatitis is mainly caused by adherenceof biofilm onto the denture
base.Incorporation of nanoparticles into thedenture base materials is mainly in
theform of silver and platinum nanoparticles as an effective antimicrobial agent.
Someresearchers showed that the addition of metal nanoparticles such as TiO2,
Fe2O3and silver to PMMA materials couldincrease the surface hydrophobicity
toreduce bimolecular adherence. The AgNPs incorporation within theacrylic
denture base material can improve its viscoelastic properties.Othernanoparticles
such as ZrO2, TiO2, andcarbon nanotubes (CNT) have been usedto improve the
performance of PMMA,and the results showed that desiredmechanical property
enhancement can beachieved in those composites with smallamounts of
nanoparticles

REMOVABLE PROSTHODONTICS:
Incorporation of carbon nanotubes into heat cure monomer has reduced the
polymerization shrinkage and improved the mechanical properties.
Incorporation of metal oxide nanoparticles into conventional polymethyl
methacrylate has improved the flexural strength, antimicrobial property and
reduced porosity.

Carbon Nanotubes

6. NANO ADHESIVES IN PROSTHODONTICS

The new bonding agents manufactured from nanosolutions contain stable nano
particles homogeneously dispersed throughout the solution.
The silica nano filler technology contributes to higher bond strength
performance. Since the nanoparticles are stable, they do not cluster nor do
theysettle out of dispersion. “Nano Interaction Zone"(NIZ - <300 nm)with
minimal decalcification andalmost no exposure to collagen fibres producing
aninsoluble calcium compound for a better bond less likely to deteriorate from
enzymes contained in the mouth.

NANO ADHESIVE POSS:Polyhedral Oligomeric SilseSquiox (Poss) enables

the design of additives that make plastics that are unusually lightweight,durable,
heat-tolerant and environment friendly.
• Poss combines organic & inorganic materials in molecules withan average
diameter of 1.5 nanometers. They can be used aseither additives or
replacements for traditional plastics.
• Current applications of Poss include dental adhesives in which astrength resin
provides a strong interface between the teeth andthe restorative material.
• In addition, tests have shown that Poss materials are much moreresistant to
radiation damage and erosion than conventionalpolymers.
Advantages:

• Broad spectrum
• Hypoallergic
• Non corroding
• Does not stain fabric
• Require no protective clothing
• Environment friendly
• Compatible with various impression materials.
(Rybachuk AV et al, Pharmocol Pharm 2009;1:18-21)

7. COATING AGENTS IN PROSTHODONTICS

These light cured agents contain nanosizedfillers and are used as a final coating
overcomposite restorations, glass ionomer restorations, jacket crowns, veneers
andprovisionals. These coating agents have higherwear resistance, preventing
abrasion anddiscolouration.
• Recently, a nanotechnology liquid polishsystem was designed to overcome the
limitations of liquid polishers. The addition of nanofillers provides excellent
results such as aglossy surface for direct or indirect resin composite restorations.
(Atabek D et al. Oper Dent 2010; 35:362-69.)

8. NANO TECHNOLOGY IN IMPLANTS

The application of nano technology in dental implants can be made by coating
of nano particles over the dental implants.It has been demonstrated that different
cell types respond positively to nanotopography.The surface of the implant
plays a critical role in determining biocompatibility and biointegration because
it is in the direct contact with the tissues.

Implant surface composition,surface energy,surface roughness and surface

topography are the four material factors which can influence events at bone
implant interfaces.Various surface textures have been created and used to
successfully influence cell and tissue responses.The surface textures are of three
types macro, micro and nano.

The nano structured materials can exhibit enhanced mechanical,electrical,

magnetic and optical properties compared with their conventional micro scale or
macro scale counterparts.Nano structured materials contain a large volume
fraction of defects such as grain boundaries,inter phase boundaries and
dislocations and this strongly influences their chemical and physical properties.

Biomimetic implant may be the next development in the field. Coating implants
with nano textured titanium,hydroxyl apatite and pharmacological agents such
as bisphosphonates may induce cell differentiation and proliferation, and
promote greater vascularity in cortical bone thereby improving conditions for
early and long-term bone remodelling.

Surface Modifications:

It t is a powerful way of altering protein interactions with the surface.There is

an increases vitronectin adsorption on nano structured surfaces when compared
to conventional surfaces.This led to increased osteoblast adhesion when
compared to other cell types such as fibroblast on the nano surfaces. Variety of
techniques are used to create nano features on dental implant surfaces.These can
be divided into physical and chemical process.

METHODS CHARACTERISTICS

Self assembly of mono layers Exposed functional end group could be

a molecule with different functions
such as osteoinductive or cell adhesion
molecule

PHYSICAL APPROACHES

1.Compaction of nano particles Conserves the chemistry of the surface

among different topographies

Impact nano features to the surface

2.Ion beam composition
 based on the material used

CHEMICAL METHODS

1.Acid etching Imparts nano surface and remove

contaminants

Produces titanium gel layer

2.Peroxidation
Create new oxide layer
3.Anodization
Produces a sodium titanate gel layer
4.Alkali treatment
allowing hydroxyapatite deposition

Superimposes a nano scale surface

NANO PARTICLE DEPOSITION topographical complexity on the

1.Discrete crystalline deposition surface

Creates a thin film of controlled

chemical characteristics
2.sol-gel(colloidal particle adsorption)

Many different shapes and materials

can be applied over the surface.
3. Lithography

(Advancing dental implant surface technology – From micron to

nanotopographyG.Mendonça et al. / Biomaterials 29 (2008) 3822–3835)

9. BONE REPLACEMENT MATERIALS:

Bone is comprised of natural nano composite made up of nanohydroxyapatite
(HA), which is reinforced by collagen fibrils and this interaction is known to
significantly dictate its strength and toughness. The fibrous collagen matrix
transfer load to apatite crystals and provide resistance to fracture (i.e.high
toughness), whereas the apatite deposit between fibrils can mechanically
stabilize the collagenous fibers. In addition, trace elements in bone are known to
be involvedin its growth and mineralization.This architecture should be
simulated for orthopaedic and dental use. Also, with the reduction in particle
size, the surface area increases manifold. This rule has been utilized by Nano-
Bone

Currently autograft, allograft, synthetic biomaterials and composites are used as

bone substitutes.Autografts ae associated with the need for an additional
surgery (for harvesting the bone) and donor site morbidity whereas in allografts
there is a risk of immune rejection owing to the presence of cells and proteins
that may be left behind during sterilization.
Several synthetic biomaterials are being used in dentistry andsome of the most
commonly used biomaterials include calcium phosphate bioceramics such as
(HA, β-tricalcium phosphate (β-TCP)), and their composites with polymers
such as collagen or gelatin.
Properties of an ideal bone graft substitute
Developing an ideal bone graft still remains a challenge despite extensive
research in materials science.As majority of the graft materials available are
used as a filler within a localized defect, severely resorbed alveolar bone defects
are still unrecoverable or not adequately treated.An ideal bone graft material is
expected to have a balance between the properties that aids in bone regeneration
which include biocompatibility, osseointegration,osteoconductivity,
osteoinductivity, porosity, mechanical stability, biodegradation and
vascularisation.
Porosity is an essential criterion required for new bone regeneration. The
scaffold pore size, porosity volume fraction, and interconnectivity determine
the rate and quality of bone growth and integration. The scaffold pores allow
enhanced protein adsorption, cellular infiltration and vascular ingrowth as well
as the diffusion of nutrients and oxygen for cell survivability.137
Strength and stiffness to tolerate the mechanical load until the biodegradation of
the material is quite essential for the bone substitute. An ideal scaffold should
also be able to degrade in par with new tissue formation.
Nanostructed material for alveolar Bone Augmentation- A) CS-S: Composite scaffold with electrospun PLLA
sheet. B) CS-Y: Composite scaffold with elacrospun yarns [Manju V et al Biomed Mater;13(6), 2018 & Bibi
Halima Shamaz et al Nanotechnology 26 (2015) 405101 (15pp)]

Characteristics of nano bone graft materials are:

• Osteo inductive
• Completely synthetic
• Non-sintered
• Extremely porous
• Nano-structured
• Degradation by osteoclasts
• Excellent processability
• No products in ionic solution
• Bone targeting nanocarriers
Various HA nanoparticles used in repairing osseousdefects include Ostim® HA,
VITOSS ® HA+ TCP,NanOss HA

Conventional calcium sulphate has been used to plug small osseous defectslike
in post extraction sockets and periodontal bone defects and in additionto bone
graft material. A new calcium sulphate based composite has beendeveloped by,
known as Bone Gen –TR which breaks down more slowly andregenerates bone
more effectively.
10.MAXILLOFACIAL PROSTHODONTICS
Various types of materials have been used for the fabrication of maxillofacial
prosthesis. They are Polyvinyl chloride, Polymethyl methacrylate,
Polyurethanes, Chlorinated polyethylene and silicones [Al-Harbi et al 2015].
Out of these materials, silicones are the choice of material for extraoral
prosthesis fabrication due to its favourable properties like acceptable tear and
tensile strength, chemical inertness, high elongation, ease of fabrication [Al-
Harbi et al 2015]. However, there are several drawbacks like discoloration of
the material, deterioration of the physical and mechanical properties, difficulties
related to its repair which results in a short service life time thereby leading to
the failure of the prosthesis [Nguyen et al 2013].These materials undergo drastic
changes in their structure and appearance during their lifetime, mainly due to
aging caused by exposure to solar irradiation, temperature changes, humidity,
etc. The best materials remain aesthetically suitable and functional for an
average of only 1 to 2 years with a decline in patient satisfaction within 3 years
of service. Hence, most silicone prostheses must be replaced frequently due to
these drawbacks [Chamariaet al 2017]. This frequent replacement is not always
affordable for the patient.
Nano-oxides when incorporated into polymers provided materials with
better strength and flexibility [Akash et al 2015]. The nanosized material
particle results in the optimization of characteristics and controls the biological,
mechanical, electrical, magnetic, and optical characteristics as well [Akash et al
2015]. Nano sized rutile TiO₂andZnO have a high ultraviolet (UV) absorbing
and scattering effect that results in UV protection. Nano sized SiO₂, TiO₂, and
ZnO are characterized by their small size, large specific area, active function,
and strong interfacial interaction with organic polymer [7]. Therefore, they can
improve the physical properties and optical properties of the organic polymer,
as well as provide resistance to environmental stress related aging.

Silicone soft liners are most often used to line obturators to reduce the
irritation and utilize the bony and soft tissue undercuts in the patient’s mouth
[Beyth et al 2015]. One of the main drawbacks seen with theses soft liners is
that they do not resist antimicrobial colonization. Microorganisms like Candida
albicans not only adhere to the surface but also penetrate the soft liners [M. I.
Issa et al 2015]. Silver nano particles (AgNPs) are used as antimicrobial agents
in many medical fields. In vitro studies have shown the efficacy of silver NPs as
antimicrobial agents. They reduce or prevent the biofim layer formation [M. I.
Issa et al 2015]. Silver nanoparticles act by inhibiting the replication by
binding to the microbial DNA and they also switch off important
enzymes, leading to microbial death [Hsu et al 2010]. In fact, this metal has a
broad antimicrobial activity spectrum against both Gram-positive and Gram-
negative bacteria. The biosafety of AgNPs have been of concern [Saulou et al
2010]. Studies associated with the toxicity of these AgNPs in the biological and
ecological systems are yet to be reported.

APPLICATIONS IN OTHER ASPECTS OF DENTISTRY:

Nanotechnology and nanomaterials are widely carried outnot only in the field of
prosthodontics, but also in otherareas of dentistry, such as oral medicine, oral
surgery, andpreventive dentistry, and so forth.

NANO TECHNOLOGY IN ORTHODONTICS

Orthodontic nanorobots can directly manipulate the periodontaltissues such as
gingival, periodontal ligament, cementum andalveolar bone, causing rapid,
painless tooth straightening,rotation and vertical repositioning within minutes to
hours, incontrast to traditional orthodontic techniques which requireweeks to
months.

NANO TECHNOLOGY IN ENDODONTICS

Nanoparticles reinforced glass ionomer cement:

Hydroxyapatite and fluorhydroxyapatite nanoparticles withfluoride substitution

levels ranging from 0% to 95% are addedto improve the mechanical properties
and fluoride releasingability of the traditional glass ionomer cement.
Nanoparticles as antimicrobial agents:
Nano particulates display higher antibacterial activity becauseof their
polycationic or polyanionic nature. These disinfectthe canal by removing the
residual microbes in the canal and enhance the antibacterial action of the
intracanal medicaments.
Nanotechnology based root-end sealant:

Nanomaterial enhanced retrofill polymers (NERPs) providesuperior strength

and contour to the tooth structure. Bio-aggregate,white nanoparticle ceramic
cement is new-end filling materialcomposed primarily of calcium silicate,
calcium hydroxide, andhydroxyapatite. NERP materials were found to
significantly reducethe micro-leakage, demonstrating their ability to seal
effectively.

HYPERSENSITIVE CURE

Reconstructive dental nanorobots could selectively andprecisely occlude

selected tubules in minutes, usingnative biological materials, offering patients a
quick, andpermanent cure.

NANO TECHNOLOGY IN ORAL MEDICINE AND RADIOLOGY

Advances in digital dental imaging techniques are expectedin nanotechnology.
The radiation dose obtained using digital radiography with nanophosphor
scintillators is diminished and high-quality images are obtained.

NANO TECHNOLOGY IN PERIODONTICS

Nanomaterials for periodontal drug delivery:

Drugs can be incorporated into nanospheres composed of abiodegradable

polymer thus allowing for timed release of thedrug as the nanospheres degrade.
Recently, triclosan-loadednanoparticles were found to be effective in achieving
reductionof inflammation. Tetracycline incorporated into microspheresavailable
as Arestin for local drug delivery into periodontal pocket

Lab-on-a-chip:

Lab-on-a-chip (LOC) is a device which integrates severallaboratory functions

on a single chip. Assays are performedon chemically sensitized beads populated
into etchedsilicon wafers with embedded fluid handling and opticaldetection
capabilities. This device has been used to assessthe levels of interleukin-1 beta,
C-reactive protein, andmatrix metallo proteinase-8 and other molecules in
wholesaliva, which are potential use of these biomarkers fordiagnosing and
categorizing the severity and extent ofperiodontitis.
Laser plasma application for periodontics:

When nanoscale (20-50 nm) titanium dioxide (TiO2) particlesizes are presented
on the human skin in the form of a gellikeemulsion, these exhibit some
interesting properties suchthat when irradiated with laser pulses, these particles
can beoptically broken down with accompanying effects such asshock wave,
micro-abrasion of hard tissue, and stimulationof collagen production. Its clinical
applications includeperiodontal treatment, depigmentation, incision of soft
tissuewithout anaesthesia, and caries preparation.
Periodontal bone grafts:

With both micro-porosity and nanoporosity, these have greatersurface area as

compared to other synthetic bone graftingmaterials, allowing for ideal bone
regeneration.
Nanotech floss:

It is an ultra-thin, ultra-glide, completely non-shredding flosswith excellent

tensile strength. The unique nanostructure ofdental tape allows for the addition
of flavours and delivery ofmedications
NANO TECHNOLOGY IN ORAL SURGERY
Application in local anesthesia:
To induce oral anesthesia in the era of nanodentistry, a colloidalsuspension
containing millions of active analgesic micron-sizedental nanorobots will be
instilled on the patient’s gingiva, then they reach the dentin by migrating into
the gingivalsulcus and passing painlessly through the lamina propria.On
reaching the dentin, the nanorobots enter dentinal tubules and proceed toward
the pulp, guided by acombination of chemical gradients, temperature
differentials and even positional navigation, all of which are controlled byan
onboard nanocomputer. Assuming a total path length ofabout 10 mm from the
tooth surface to pulp and a very modesttravel speed of 100 /s, a nanorobot
completes the journey intothe pulp chamber in approximately 100s.
Nano needles:

Suture needles incorporating nanosized stainless steel crystals have been

developed. Trade name: Sandvik Bioline, RK 91TMneedles (AB Sandvik,
Sweden).
Advantages:
● Easy flow
● Comfort to the patient
● Easy to inject
● Requires less force
● Higher flow rate

Wound healing:

Biodegradable nanofibers are used to produce haemostasis.Nanocrystalline

silver particles with antimicrobial properties are used on wound dressings.
NANO TECHNOLGY IN PEDODONTICS
Nanorobotic dentifrice (dentifrobots):Effective prevention has reduced caries in
children, and a cariesvaccine may soon be available but a sub occlusal-swelling
nanorobotic dentifrice delivered by mouthwash or toothpastecould control all
supragingival and subgingival surfaces at leastonce a day, metabolizing trapped
organic matter into harmlessand odourlessvapours and performing continuous
calculus debridement. These dentifrobots could identify and destroy pathogenic
bacteria residing in the plaque and elsewhere while allowing the 500 species of
harmless oral microflora to flourish in a healthy ecosystem. Dentifrobots
provide a contiuous barrier to halitosis since bacterial putrefaction is the central
metabolic process involved in oral malador.With this kind of daily dental care
availablefrom an early age, conventional tooth decay and gingivaldisease will
disappear into the annals of medical history

Nano toothpaste:Nano whitening toothpaste is a toothpaste that

containssynthesized hydroxyapatite, a key component of tooth enamel,as
nanosized crystals. It has been proven to freshen breatheas well as whiten teeth.
Nanotechnology toothpaste has beenshown to be harmful because some of the
nanotechnologytoothpastes are made with silver hydroxyapatite.

NANO TECHNOLOGY IN PREVENTIVE DENTISTRY

The purpose of preventive dentistry is the early prevention of tooth decay rather
than invasive restorative therapy. However, the prevention of early caries
lesions isstill challenge for dental research. Recent studies show
thatnanotechnology might provide novel strategies in preventivedentistry.
Biomimetic approaches have been used to developnanomaterials for inclusion
in a variety of oral health-careproducts, such as liquids and pastes that contain
nanoapatites for biofilm management at the tooth surface and productsthat
contain nanomaterials for the remineralization of earlysubmicrometre-sized
enamel lesions. Dental caries is causedby bacterial biofilms on the tooth
surface. Nanocompositesurface coatings can make the tooth surface easy to
clean,prevent the pathogenic consequences, and reducebacterial adherence.
However,currently these oral prevention products with nanoparticlesare also
still in the research stage and intensive study is necessary for clinical application
in the future.

FUTURE CONSIDERATIONS:

➢ Nanotechnology for prevention & early delivery of care to

maintain human health
➢ Nanobots (Nanoscale robots)
➢ Lab-on-a-chip

CHALLENGES FACED BY NANO DENTISTRY:

➢ Positioning and assembly of molecular scale part
➢ Economical nanorobot mass production technique
➢ Biocompatibility
➢ Simultaneous coordination of activities of large
➢ Social issues of public acceptance, ethics,regulation
Problems for research in nanotechnology:

• Painfully slow strategic decisions

• Sub-optimal funding
• Lack of engagement of private industries
• Problem of retention of trained manpower
CONCLUSION
Nanomaterials have been playing a significant role inbasic scientific innovation
and clinical technological changeof Prosthodontics.It shows that many
properties such as modulus of elasticity, surface hardness, polymerization
shrinkage, andfiller loading, of materials used in prosthodontics can
besignificantly improved after their scales were reduced from micron-size into
nanosize by nanotechnology and that theperformances of composites can also
be enhanced by addingappropriate nanomaterials.Nano science is a new
approach and willbring changes in fields of medicine,dentistry, research, and
healthcare.It willhelp dentists with more equipment, drugsand precision-made
materials by whichpatient compliance is enhanced

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