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NANODENTISTRY – A DENTAL BOON

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NANODENTISTRY – A DENTAL BOON

Jaya AR, * Umapathy T, ** Nidhi K Nihal, *** Prasanna Kumar Bhat, †

Miloni S Vora, †† Ramya BJ †††

* Senior Lecturer, Department of Pedodontics & Preventive Dentistry, Rajarajeswari Dental College & Hospital, Bengaluru, Karnataka,
India
** Reader, Department of Pedodontics & Preventive Dentistry, Rajarajeswari Dental College & Hospital, Bengaluru, Karnataka, India
*** MDS, Pediatric Dentist, Kolkatta, West Bengal, India
† Senior Lecturer, Department of Pedodontics & Preventive Dentistry, Rajarajeswari Dental College & Hospital, Bengaluru, Karnataka,
India
†† MDS, Pediatric Dentist, Rajkot, India
††† Senior Lecturer, Department of Pedodontics & Preventive Dentistry, R V Dental College & Hospital, Bengaluru, Karnataka, India
_________________________________________________________________________
ABSTRACT science of manipulating matter measured in the
Nanotechnological advances should be viewed billionths of meters or manometer, roughly the
in the context of other expected developments size of 2 or 3 atoms.[1]
relevant to oral health in the coming decades. HISTORY
Biological approaches such as tissue and There is much controversy regarding the history
genetic engineering will yield new diagnostic of nanotechnology. Although some researchers
and therapeutic approaches much sooner than believe that it is a scientific evolutionary form
will nanotechnology. At the same time that did not develop until the late 1980s, evidence
continual refinement of traditional methods, of nanotechnology dates back to 1959. Others
development of advanced restorative material believe that humans have unwittingly employed
and new medications and pharmacological nanotechnological methods for thousands of
approaches will continue to improve dental years, perhaps even longer. One of the first
care. Trends in oral health and disease also mentions of the distinguishing concepts in
may change the focus on specific diagnostic nanotechnology (but predating the use of that
and treatment modalities. Deeper name) was in 1867. At that time, James Clerk
understanding of the causes and pathogenesis Maxwell proposed, as a thought experiment, a
of other disease processes such as periodontal tiny entity known as Maxwell’s Demon that was
disease, developmental craniofacial defects able to handle individual molecules.[2] The late
Nobel prize winning physicist Richard P.
malignant neoplasm should make prevention a
Feynman speculated the potential of nanosize
viable approach. The role of the dentist will
devices as early as 1959 and in his historic lecture
continue to evolve along the lines of currently
in 1959, he concluded saying, "this is a
visible trends. The best technical abilities,
development which I think cannot be avoided."
professional judgment and strong
Forty years ago, this talk was greeted with
interpersonal skills are the hallmark of the
astonishment and skepticism. However, since
contemporary dentist. Eventhough research
then, there has been a remarkable progress toward
work and clinical trials on nanorobots are in
realizing Feynman’s vision.[3] Nano in Greek
the early stage, researchers are quite
means “dwarf,” and the term “nanotechnology”
optimistic regarding the use these microrobots
was coined by a student at the Tokyo Science
in dentistry.
University in 1974.[4] Growing interest in the
KEYWORDS: Nanomedicine; nanodentistry;
future medical applications of nanotechnology is
nanotechnology; nanorobots leading to the emergence of a new field
called “Nanomedicine” , where it is defined as the
INTRODUCTION science and technology of diagnosing, treating,
Science is undergoing yet another change, in and preventing disease and traumatic injury,
helping mankind enter a new era, the era of relieving pain, and preserving and improving
nanotechnology. "Nano" is derived from the human health, with the help of nanotechnology.[5]
Greek word for 'dwarf. Nanotechnology is the

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Nanodentistry Jaya AR, Umapathy T, Nihal NK, Bhat PK, Vora MS, Ramya BJ

Similarly, development of “nanodentistry” will or tissue samples and to make multiple analyses
make possible the maintenance of near-perfect at the subcellular level. From an in vivo
oral health through the use of nanomaterials,[6,7] perspective, nanodevices might be inserted into
biotechnology[7-11] including tissue engineering, the body to identify the early presence of a
and nanorobotics.[12,13] disease, or to identify and quantify toxic
APPLICATIONS OF NANOROBOTICS TO molecules, tumor cells, and so forth.[17,18]
DENTISTRY Diagnosis of oral cancer
Feynman has described how medical nanorobots Saliva is used as an inexpensive and
might use specific motility mechanisms to crawl noninvasively obtained diagnostic medium that
or swim through human tissues with navigational contains proteomic and genomic markers for
recession; acquired energy, and sense and molecular disease identification. Exosome, a
manipulate their surroundings; achieve safe membrane-bound secretory vesicle, is one such
cytopenetration (for example - pass through marker whose level is elevated in malignancy.
plasma membranes such as the odontoblastic This marker has been studied by using atomic
process without disrupting the cell, while force microscopy, which employs nanoparticles.
maintaining clinical biocompatibility) and use any The nano electromechanical system, oral fluid
of a multitude of techniques to monitor, interrupt nanosensor test, and optical nanobiosensor can
or alter nerve impulse traffic in individual nerve also be used for diagnosing oral cancer.[19,20]
cells.[14] Nanorobots in dentistry have a potential a) Nano Electromechanical Systems (NEMS)
to show its effectiveness in inducing oral Nanotechnology based NEMS biosensors that
analgesia, desensitizing tooth, and manipulating exhibit exquisite sensitivity and specificity for
the tissue to re-align and straighten irregular set detection of abnormal cells at molecular level are
of teeth and improving durability of teeth. being developed. They convert (bio) chemical to
However these devices are in the development electrical signal.[32]
phase and only hypothetical nanorobot has been b) Oral Fluid NanoSensor Test (OFNASET)
produced.[15] The Oral Fluid NanoSensor Test (OFNASET)
Mechanism of action of Nanorobots technology is used for multiplex detection of
The powering of nanorobots is expected to be salivary biomarkers for oral cancer.[33]
done by metabolism of local glucose, oxygen and c) Optical Nanobiosensor
externally supplied acoustic energy. Its functions The nanobiosensor is a unique fiberoptics-based
may be controlled by an on-board nanocomputer tool which allows the minimally invasive analysis
that executes preprogrammed instructions in of intracellular components (Cytochrome C).[19]
response to total local robots via acoustic signals NANOROBOTS IN CLINICAL DENTISTRY
(as are used in ultrasonography) or other means To Induce local anesthesia
similar to an admiral commanding a fleet and By applying a colloidal suspensions containing
Communication with the device can be obtained millions of active, analgesic, micron-sized dental
by acoustic signaling navigational network robots that respond to input supplied by the
installed in the body that would provide high dentist are applied on the crown or mucosa which
positional accuracy to all passing nanorobots and can reach the pulp via the gingival sulcus, lamina
help in keeping track of various devices in the propria, or dentinal tubules.This will result in the
body. When the task of the nanorobots is target tooth instantly becoming completely numb
completed, they can be retrieved by allowing by establishing control over nerve-impulse traffic.
them to effuse themselves via the usual human When treatment is over, a second signal causes all
excretory channels. These can also be removed by sensation to return to normal. providing the
active scavenger systems.[16] patient with anxiety-free and needleless comfort.
APPLICATION OF NANOTECHNOLOGY The advantages includes it is fast, reversible and
IN DIAGNOSIS AND TREATMENT not associated with any side effects or
Nanodiagnostics complications.[17,18]
Nanomedicine could increase the efficiency and Nonsurgical Devices and Nanoneedles
reliability of in vitro diagnostics, through the use A surgical knife has been designed from micro
of selective nanodevices to collect human fluids structured-silicon (non-magnetic and

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Nanodentistry Jaya AR, Umapathy T, Nihal NK, Bhat PK, Vora MS, Ramya BJ

biocompatible) with a diamond-layered tip hybrid composites and composites containing a

(chemically rigid). Nanosized stainless-steel wider distribution of filler particles have come
crystals incorporated into suture needles have into use. Additionally, the even distribution of
been developed with an advantages of giving nanoparticles results in a smoother, creamier
sharper incisions and lower penetration pressure. consistency and improves flow characteristics.
Cell surgery may be possible in the near future Once the material is cured to its hardened state,
with nanotweezers, which are now under these properties contribute to the dentin-like
development.[21] cutability and polishability of the material.[26]
Nanorobotic Dentifrice [dentifrobots] Nanosolutions
Subocclusal dwelling nanorobotic dentifrice Because they produce unique and dispersible
delivered by mouthwash or toothpaste could nanoparticles, nanosolutions can be used as
patrol all supragingival and subgingival surfaces bonding agents. Homogeneity is ensured, because
atleast once a day, metabolising trapped organic the adhesive is mixed perfectly every time.
matter into harmless and odorless vapors and Nanoparticles have also been used as sterilizing
performing continuous calculus debridement. solutions in the form of nanosized emulsified oil
These invisibly small dentifrobots [1-10 micon], droplets that bombard pathogens.[17]
crawling at 1-10 microns/sec, would be Renaturalization Procedures
inexpensive, purely mechanical devices, that Dentition renaturalization procedures may
would safely deactivate themselves if swallowed become a popular addition to the typical dental
and would be programmed with strict occlusal practice providing perfect treatment methods for
avoidance protocol.[22] esthetic dentistry. There would be demand for
Dental Hypersensitivity full coronal renaturalization procedures with the
Dental hypersensitivity is another pathological affected teeth remanufactured to beome
phenomenon that may be amenable to nanodental indistinguishable from the original teeth.[5]
treatment. It may be caused by changes in Tooth repositioning
pressure transmitted hydrodynamically to the Orthodontic nanorobots could directly manipulate
pulp. This is based on the fact that hypersensitive the periodontal tissues including gingivae,
teeth have 8 times higher surface density of periodontal ligament, cementum and alveolar
dentinal tubules and tubules with diameters twice bone allowing rapid and painless tooth
as large than nonsensitive teeth. Dental straightening, rotating and vertical repositioning
nanorobots could selectively and precisely within minutes to hours. A new stainless-steel
occlude selected tubules in minutes, using native wire that uses nanotechnology is being studied
biological materials, offering patients a quick and that combines ultra-high strength with good
permanent cure.[23-25] deformability, corrosion resistance, and surface
Nanocomposites finish in contrast to current molar up righting
Tooth durability and appearance may be techniques, which require weeks or months to
improved by replacing upper enamel layers with complete.[27]
pure sapphire and diamond which can be made Impression materials
more fracture resistant as part of a nanostructured Nanofillers are integrated into vinylpolysiloxanes,
composites material that possibly including producing a unique siloxane impression material
embedded carbon nanotubes.[21] Microfillers in that has a better flow, improved hydrophilic
composites and microcore materials have long properties, and enhanced precision detail.[26]
been in use and nanocomposite particles are Dental implants: structure, chemistry, and
minute enough to be synthesized at the molecular biocompatibility
level and improve the compressive strength of the Bone is a natural nanostructure that is composed
material. Zirconium dioxide used as filler of of organic compounds (mainly collagen) and
submicron size, are necessary to improve reinforced with inorganic ones. Nanotechnology
polishability and esthetics. However, when aims to emulate this natural structure for
particles of this size are used, the material may be orthopedic and dental applications and, more
more prone to brittleness and cracking or particularly, for the development of nanobone.
fracturing after curing. To address this issue, The determining factors for successful

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Nanodentistry Jaya AR, Umapathy T, Nihal NK, Bhat PK, Vora MS, Ramya BJ

osseointegration are surface contact area and and their installation. Complete dentition
surface topography. However, bone bonding and replacement was the basis for research by Chan et
stability also play a role. Bone growth and al., who recreated dental enamel, the hardest
increased predictability can be effectively tissue in the human body, by using highly
expedited with implants by using organized microarchitectural units of nanorods.[21]
nanotechnology. The addition of nanoscale CONCLUSION
deposits of hydroxyapatite and calcium phosphate Nanodentistry still faces many significant
creates a more complex implant surface for challenges in realizing its tremendous potential.
osteoblast formation. Extensive research on the Basic engineering problems from precise
effects and subsequent optimization of positioning and assembly of molecular scale parts
microtopography and surface chemistry has to economical mass production techniques, to
produced ground-breaking strides in material biocompatibility and the simultaneous
engineering. These new implants are more coordination of the activities of large number of
acceptable, because they enhance the integration independent micrometer scale robots. In addition,
of nanocoatings resembling biological materials there are larger social issues of public acceptance,
to the tissues.[30,31] ethics, regulations and human safety that must be
Nanoencapsulation addressed before molecular nanotechnology can
Trials on controlled drug release has been best enter the modern medical armamentarium.
experimented in Nano materials with hollo However, there is equally powerful motivation to
spheres, nanotubes, core-shell structure and surmount these various challenges such as the
nanocomposite.[8,9] Target delivery system has possibility of providing high quality dental care to
been developed successfully by SWRI [South 80% of the world’s population that currently
West Research Institute] that involves receives no significant dental care. Time, specific
nanocapsules including antibiotics ,vaccines and advances, financial and scientific resources and
drug delivery. Targeted release systems that human needs will determine which of the
encompass nanocapsules are under trial for applications to be realized first. However,
inclusion in vaccines and antibiotics.[28,29] researchers have predicted that high-tech and
Treatment of Oral Cancer effective management at the microscopic level,
Nanoshells, which are miniscule beads, are termed nanotechnology, will become an
specific tools in cancer therapeutics. Nanoshells important part of future dental and periodontal
have an outer metallic layer that selectively health.
destroys cancer cells, while leaving normal cells CONFLICT OF INTEREST & SOURCE OF
intact. Brachytherapy is an advanced form of FUNDING
cancer treatment. Still under trial are The author declares that there is no source of
nanoparticle-coated, radioactive sources placed funding and there is no conflict of interest among
close to or within the tumor to destroy it. Other all authors.
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