EYEING THE WONDERS OF...

Arora and Gupta. UJMDS 2016, 04 (01): 0-14

Unique Journal of Medical and Dental Sciences 04 (01), January-March 2016 10

Unique Journal of Medical and Dental Sciences Available online: www.ujconline.net

Review Article

ISSN 2347-5579

EYEING THE WONDERS OF NANODENTISTRY

Arora Aman1, Gupta Nitika

2*

1HOD, Department of Prosthodontics, DAV © Dental College, Yamunanagar, India 2PG Student, Department of Prosthodontics, DAV © Dental College, Yamunanagar, India

Received: 22-01-2016; Revised: 20-02-2016; Accepted: 18-03-2016

*Corresponding Author: Dr. Gupta Nitika

PG Student, Department of Prosthodontics, DAV © Dental College, Yamunanagar, India

ABSTRACT

The human characteristics of interest, wonder and creativity are as old as sapiens. For many years population around the world have

been utilizing their curiosity into inquiry and the process of scientific engineering. Science is the fuel for the engine of technology and

hence the fuel for progress. One concept which has and holds further promise in bringing about an ideal shift in the field of diagnostics

and management is nanotechnology. This article intends to provide comprehensive discussion of the present and future of

nanotechnology in dental care applications such as impression materials, nanocomposites, coatings for implant and many more.

Keywords: Nanotechnology, Nanomaterials, Nanorobots and Nanosolution.

INTRODUCTION

Dentistry is facing a major revolution in the wake of

innovations and adaptability. The speed at which advances are

being made in science has captulated nanotechnology from its

theoretical foundations straight into the real world.

Nanotechnology is the manipulation of matter on the

molecular and atomic levels. It is measured in the billionths

of meters or nanometer, roughly the size of two or three

atoms. Genesis of this concept is based on the fact that

microstructures or tiny nanorobots can be manufactured and

utilized in human body for treatment of various diseases by

restoring cellular functioning at molecular level1.

Application of nanotechnology to dentistry has been a novel

area of interest since many years now and has led to the

materialization of a new field called nanodentistry2. Emerging

technologies and information regarding new nanoscale have

the potential to transform dental practice by advancing in all

aspects of diagnostics, therapeutics and cosmetic dentistry.

Preservation and maintenance of oral health utilizing

nanodentistry will be made possible by employing

nanomaterials, biotechnology including tissue engineering and

nanorobotics3. Thus, one of the key changes is the applying

new research tools which have changed dental research into

nano size scale. This nano-enabled technologies provides an

alternative of diagnosing, treating, preventing oral and dental

disease, relieving pain, preserving and improving the oral

health care of the patient.

Applications of nanotechnology in the field of Dentistry are as

under:

• Implantology

• Periodontology

• Nanoceramics

• Nanocomposites

• Impression materials

• Nanoanesthesia

• Nanosterilizing Solution

• Others

IMPLANTOLOGY

The surface of the implant plays a critical role in determining

biocompatibility and biointegration because it is in direct

contact with the tissues. Implant surface composition, surface

energy, surface roughness, surface topography, surface

mechanics are the material related factors which can influence

events at bone-implant interface4. Nanotechnologies are

increasingly used for surface modifications of dental implants

as surfaces properties such as chemistry and roughness play a

determinant role in achieving and maintaining their long-term

stability in bone tissue. Direct bone-to-implant contact is

desired for a biomechanical anchoring of implants to bone

rather than fibrous tissue encapsulation.

Implant surface engineering and nanoscale topography

procedure: The body of the implant is roughened and double-

etched creating the macro-micro surface. Implants are

anodized through an electrochemical process to generate the

natural titanium oxide surface, turning the implant to a

uniform pink color. The Electronic atom deposition process

creates controlled ‘sparking’ to produce a uniform nano

roughened surface, enriched with charged calcium and

phosphorous ions. A surface composition that offers: A

Arora and Gupta. UJMDS 2016, 04 (01): Pag

Unique Journal of Medical and

macro-micro-nano texture similar to that of natural bone and a

moderately roughened pink collar to maximize bone levels

and enhance aesthetic outcomes (Fig.1).

Figure 1: Macro-micro-nano textures

The measurement of the roughness of the implant surface is

challenging and has been explained by a unique parameter

called the WENZEL RATIO5. It is the actual surface divided

by the projected one. This Wenzel ratio was correlated to

biocompatibility measurements. In many cases, the intended

implant site is compromised because of poor bone quality or

insufficient bone quantity. Lack of sufficient alveolar ridge

height is often related to the proximity of the implant site to

other anatomical structures. In these situations separate

preparatory procedures may be required to augment the

available volume of bone before the implant placement, which

may result in longer treatment time, greater risk of

complications and higher costs. Therefore, various

nanomaterials are used to induce bone growth and

regeneration to fill bone defects and adequate bone height and

width prior to implant placement.

Nano implant materials for drug delivery:

Inflammatory responses to implants are a significant problem

in the health care industry. Typically, medications are given to

a patient following surgery to suppress inflammation and to

enable the intended performance of the implanted medical

device. Although generally helpful, in many cases this

approach is insufficient or entirely ineffective .A different

approach is to provide a local dose of anti

agents gradually released from a coating on the surface of

implanted device, encapsulating a hydrophobic antibiotic (for

example, fluoroquinolone, chloramphenicol and/or rifampicin)

and/or a hydrophilic antibiotic (for example, vancomycin and

acyclovir) into antibiotic-containing nanoparticles. The main

advantage of this approach over traditional means of

administering the drug is that the drug can be directly released

at the implant site without having to go through the

bloodstream6. This lowers the amount of drug needed,

reducing the overall toxicity and side effects.

Arora and Gupta. UJMDS 2016, 04 (01): Page 10-14

Unique Journal of Medical and Dental Sciences 04 (01), January-March

nano texture similar to that of natural bone and a

moderately roughened pink collar to maximize bone levels

The measurement of the roughness of the implant surface is

challenging and has been explained by a unique parameter

. It is the actual surface divided

by the projected one. This Wenzel ratio was correlated to

biocompatibility measurements. In many cases, the intended

implant site is compromised because of poor bone quality or

ent alveolar ridge

height is often related to the proximity of the implant site to

other anatomical structures. In these situations separate

preparatory procedures may be required to augment the

available volume of bone before the implant placement, which

may result in longer treatment time, greater risk of

complications and higher costs. Therefore, various

nanomaterials are used to induce bone growth and

regeneration to fill bone defects and adequate bone height and

Inflammatory responses to implants are a significant problem

in the health care industry. Typically, medications are given to

a patient following surgery to suppress inflammation and to

the implanted medical

device. Although generally helpful, in many cases this

approach is insufficient or entirely ineffective .A different

approach is to provide a local dose of anti-inflammation

agents gradually released from a coating on the surface of the

implanted device, encapsulating a hydrophobic antibiotic (for

example, fluoroquinolone, chloramphenicol and/or rifampicin)

and/or a hydrophilic antibiotic (for example, vancomycin and

containing nanoparticles. The main

age of this approach over traditional means of

administering the drug is that the drug can be directly released

at the implant site without having to go through the

. This lowers the amount of drug needed,

PERIODONTOLOGY

Subocclusal dwelling nanorobotic dentifrice delivered by

mouthwash or toothpaste could patrol all supragingival and

subgingival surfaces atleast once a day, metabolizing trapped

organic matter into harmless and odorless vapors and

performing continuous calculus debridement. These invisibly

small dentifrobots crawling at 1

inexpensive, purely mechanical devices that would safely

deactivate themselves if swallowed, and would be

programmed with strict occlusal

configured 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 also woul

continuous barrier to halitosis, since bacterial putrefication is

the central metabolic process involved in oral malodor

NANOCERAMICS

An esthetic material has been recently introduced in block

form of CAD/CAM fabrication using both chair side

laboratory systems, these new materials are based on the

integration of nanotechnology and ceramics. Advantages of

this material over ceramic was easier clinical finishing and

polishing, good surface gloss and good strength. E.g.

NanoCera is a hybrid nanoceramic/resin milling material that

is a highly esthetic and easy-to-use alternative to all

restorations. Ultra is milled into dental restorations using a

dental CAD/CAM system and bonded to tooth structure and/or

implant abutments with adhesive resin cement

indicated for use as a dental restoration including inlays,

onlays, veneers, crowns and bridges. Other examples are

AMBARINO® High Class and Lava Ultimate (Fig.2,3).

NANOCOMPOSITES

The nanocomposites are relatively new composites consisting

of filler particles in nanometric dimensions(between 20 to 75

nm). The main purpose of using fillers with nanometric

dimension in these nanocomposites is the

strength, wear resistance and ability

used to restore teeth have enough

applied forces during chewing and

related part of the teeth. Combination of superior aesthetics,

long term polish retention, and other optimized phy

mechanical properties, the nanocomposite systems would be

useful for all posterior and anterior restorative applications

E.g. Filtek Supreme XTE and Fusion Ceramfill

Figure 2: AMBARINO® High Class

March 2016 11

Subocclusal dwelling nanorobotic dentifrice delivered by

mouthwash or toothpaste could patrol all supragingival and

subgingival surfaces atleast once a day, metabolizing trapped

organic matter into harmless and odorless vapors and

performing continuous calculus debridement. These invisibly

small dentifrobots crawling at 1-10 microns/sec, would be

inexpensive, purely mechanical devices that would safely

deactivate themselves if swallowed, and would be

avoidance protocol. Properly

configured 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 also would provide a

continuous barrier to halitosis, since bacterial putrefication is

the central metabolic process involved in oral malodor7.

has been recently introduced in block

form of CAD/CAM fabrication using both chair side and

laboratory systems, these new materials are based on the

integration of nanotechnology and ceramics. Advantages of

this material over ceramic was easier clinical finishing and

polishing, good surface gloss and good strength. E.g.

nanoceramic/resin milling material that

use alternative to all-ceramic

restorations. Ultra is milled into dental restorations using a

dental CAD/CAM system and bonded to tooth structure and/or

e resin cement8. NanoCera Is

indicated for use as a dental restoration including inlays,

onlays, veneers, crowns and bridges. Other examples are

AMBARINO® High Class and Lava Ultimate (Fig.2,3).

are relatively new composites consisting

of filler particles in nanometric dimensions(between 20 to 75

nm). The main purpose of using fillers with nanometric

dimension in these nanocomposites is the improvement in the

strength, wear resistance and ability to polish. The materials

used to restore teeth have enough strength to resist again

applied forces during chewing and remain strongly on the

related part of the teeth. Combination of superior aesthetics,

long term polish retention, and other optimized physical and

mechanical properties, the nanocomposite systems would be

useful for all posterior and anterior restorative applications9.

upreme XTE and Fusion Ceramfill (Fig.4, 5).

2: AMBARINO® High Class



Figure 3: Nanocera

Figure.4: Filtek Supreme XTE

Figure.5: Fusion ceramfill

IMPRESSION MATERIALS

These days nanofillers are integrated in Polyvinylsiloxanes,

producing a unique addition of siloxane impression materials.

The material has better flow, improved hydrophilic properties

and enhanced detail precision10

. Eg: Nanotech Elite

HD(Zermack)and Image PVS Soft (Dentalline)(Fig.6, 7).

Figure 6: Elite HD



These days nanofillers are integrated in Polyvinylsiloxanes,

impression materials.

The material has better flow, improved hydrophilic properties

. Eg: Nanotech Elite

and Image PVS Soft (Dentalline)(Fig.6, 7).

Figure 7: Image PVS Soft

NANOANESTHESIA

In the era of nanotechnology, the dentist instills colloidal

suspension of nanoparticles encapsulating anesthetic agent

which is instilled through a nanoscopic drug delivery system

on the patient’s gingiva. After contacting the patient’s mucosa,

the nanorobots will migrate into the gingival sulcus, passing

through lamina propria, dentin and finally reaching the pulp

painlessly by a combination of chemical gradients,

temperature differentials and even through positional

navigation, all under the control of

the dentist. Then a nanorobot will have the piezoelectric

element (Fig.8) which has a camera

dentist to view it on the screen11

and established control over nerve impulse traffic,

presses the icon for the desired tooth on the hand held control

stick and the analgesic dental nanorobots shut down all

sensations to that particular tooth which requires treatment

(Fig.10)12

.

Figure 8: Nanorobot with piezoelectric element

Figure 9: Nanorobot with camera

March 2016 12

7: Image PVS Soft

In the era of nanotechnology, the dentist instills colloidal

suspension of nanoparticles encapsulating anesthetic agent

which is instilled through a nanoscopic drug delivery system

on the patient’s gingiva. After contacting the patient’s mucosa,

obots will migrate into the gingival sulcus, passing

through lamina propria, dentin and finally reaching the pulp

painlessly by a combination of chemical gradients,

temperature differentials and even through positional

navigation, all under the control of nanocomputer as guided by

the dentist. Then a nanorobot will have the piezoelectric

element (Fig.8) which has a camera (Fig.9) and helps the 11

. Once installed in the pulp

and established control over nerve impulse traffic, the dentist

presses the icon for the desired tooth on the hand held control

stick and the analgesic dental nanorobots shut down all

sensations to that particular tooth which requires treatment

with piezoelectric element

9: Nanorobot with camera



Figure 10: Nanorobots moving on the tooth

After oral procedures are completed, the nanorobots are

commanded by the dentist (via the acoustic data links) to

restore all sensations to relinquish control of nerve traffic and

to egress from the tooth via the same pathway used for ingress

and finally they are aspirated. Nanorobotic analgesics offer

reduced anxiety and greater patient comfort, fast and

completely reversible action and avoidance of

complications.

NANOSTERILIZING SOLUTION

Gens Nano photocatalyst has strong effect on killing almost all

kinds of bacteria and virus including SARS, HSN1 etc. It has

got silver antibacterial property. Due to photocatalyst it can

complete and decompose the bacteria and virus. Introduction

of one more new disinfectant based on superscience of nano

emulsion technology has been done. It uses nano

emulsifier droplets of oil (similar in size of HIV virus) that

bombard the pathogens e.g. Nano Titanium Dioxide and Nano

silver solution. No shaking of bottle required since the

nanoparticles are stable.It is a broad spectrum solution,

hypoallergic, does not stain fabric, environment friendly and

compatible with impression materials (Fig.11)13

.

OTHERS

Nanotechnology also has its advantages in the field of

medicine like in detection of cancer (Quantum dots) and

cardiac diseases (RFID Chip).

• Quantum Dots

These are nanomaterials that glow very brightly when

illuminated by ultraviolet light and can be coated with a

material that makes the dots attach specifically to the

molecules to be tracked. Quantum dots bind themselves to

proteins unique to cancer cells, literally bringing tum

light14,15

.

• RFID Chip

As we all proceed the case by taking patient’s case history so,

research group developed the smallest possible saliva sensor

device organized to detect special cardiac biomarkers in

saliva. The concept is to build this saliva sensor into a dental

implant that is always in the mouth of a patient with the heart

attack risk. The distinct feature about this saliva sensor is that

it integrated with RADIOFREQUENCY IDENTIFICATION

(RFID) Chip (Fig.12).



10: Nanorobots moving on the tooth

After oral procedures are completed, the nanorobots are

commanded by the dentist (via the acoustic data links) to

sh control of nerve traffic and

to egress from the tooth via the same pathway used for ingress

and finally they are aspirated. Nanorobotic analgesics offer

reduced anxiety and greater patient comfort, fast and

completely reversible action and avoidance of most

Gens Nano photocatalyst has strong effect on killing almost all

kinds of bacteria and virus including SARS, HSN1 etc. It has

got silver antibacterial property. Due to photocatalyst it can

the bacteria and virus. Introduction

of one more new disinfectant based on superscience of nano-

emulsion technology has been done. It uses nano-sized

emulsifier droplets of oil (similar in size of HIV virus) that

oxide and Nano

silver solution. No shaking of bottle required since the

nanoparticles are stable.It is a broad spectrum solution,

hypoallergic, does not stain fabric, environment friendly and

.

Nanotechnology also has its advantages in the field of

medicine like in detection of cancer (Quantum dots) and

that glow very brightly when

illuminated by ultraviolet light and can be coated with a

material that makes the dots attach specifically to the

molecules to be tracked. Quantum dots bind themselves to

proteins unique to cancer cells, literally bringing tumours to

As we all proceed the case by taking patient’s case history so,

research group developed the smallest possible saliva sensor

device organized to detect special cardiac biomarkers in

sensor into a dental

implant that is always in the mouth of a patient with the heart

attack risk. The distinct feature about this saliva sensor is that

ENCY IDENTIFICATION

Figure 11: Nano Silver solution and Nano Titanium Dioxide

Figure 12: RFID tag is inserted into the tooth and

RFID Reader is tied on the wrist

March 2016 13

Silver solution and Nano Titanium Dioxide

12: RFID tag is inserted into the tooth and

RFID Reader is tied on the wrist


Unique Journal of Medical and Dental Sciences 04 (01), January-March 2016 14

Level of cardiac biomarkers in saliva is increased whenever

there will be some problem16

.

• It will emit electromagnetic waves and there will be two

readings: 0 (-ve) and 1(+ve).

• 1(+ve), positive reaction, an alarm signal for the patient

and immediate treatment can be given and 0(-ve) stands

for negative reaction.

Although this innovation can be laborious to be used as there

are some characteristics to be upgraded and will be an

alternative option in the future.

CONCLUSION

The goal for any emerging technology is to contribute to the

flourishing of human race in socially just and environmentally

sustainable ways. The role of ethics in responsible

development of nanotechnology includes elucidating what

constitutes justice, human flourishing and sustainability,

Identifying opportunities for nanotechnology to accomplish

the goals, providing ethical capacity to enable society to adapt

effectively to emerging nanotechnologies and identifying

limits on how the goal should be pursued. The visions

described in this article may sound unlikely, implausible, or

even heretic. Yet, the theoretical and applied research to turn

them into reality is progressing rapidly. Genetic engineering,

nanotechnology and ozone therapy will change dentistry,

healthcare, and human life more profoundly than many

developments of the past. As with all technologies, they carry

a significant potential for misuse and abuse on a scale and

scope never seen before. However, they also have potential to

bring about significant benefits, such as improved health,

better use of natural resources, and reduced environmental

pollution. These truly are the days of ‘Miracle and Wonder’. It

is a bright future that lies ahead in dental field, but we shall all

have to work very long and very hard to make it come to pass.

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Source of support: Nil, Conflict of interest: None Declared

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