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Table of Contents
REVIEW ARTICLE
Year : 2021  |  Volume : 7  |  Issue : 2  |  Page : 6-10

Nanotechnology in periodontics: A review


Department of Periodontics and Oral Implantology, Santosh Dental College, Santosh Deemed to be University, Ghaziabad, Uttar Pradesh, India

Date of Web Publication6-Dec-2021

Correspondence Address:
Deepali Singhal
Department of Periodontics and Oral Implantology, Santosh Dental College, Santosh Deemed to be University, Ghaziabad, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2455-1732.331785

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  Abstract 


Nanotechnology or nanoscience is the research and development of an applied science at the atomic, molecular, or macromolecular levels (i.e., molecular engineering and manufacturing). Periodontitis is one of the most common diseases involving tooth and it's supporting structures. Management of which is important for improving the quality of life of the patient that has it's impact on the overall health of an individual. With upsurge of various treatment methodologies for the treatment of periodontitis, nanotechnology has evolved as a promising mode of treatment. Applications of nanotechnology in medical and dental fields have only approached the horizon with opportunities and possibilities for the future that can only be limited by our imagination. This paper provides an early glimpse of nanotechnology applications in dentistry and also illustrates the potential of different nanomaterials and their impact on clinical practice.

Keywords: Guided bone regeneration, local drug delivery, nanotechnology, periodontitis


How to cite this article:
Singhal D, Aggarwal P, Bali S, Pal K. Nanotechnology in periodontics: A review. Santosh Univ J Health Sci 2021;7:6-10

How to cite this URL:
Singhal D, Aggarwal P, Bali S, Pal K. Nanotechnology in periodontics: A review. Santosh Univ J Health Sci [serial online] 2021 [cited 2022 Aug 11];7:6-10. Available from: http://www.sujhs.org/text.asp?2021/7/2/6/331785




  Introduction Top


In today's world where we have an aging population, there has been numerous research for different ways to apply the principles of cell transplantation, material science, and bioengineering to develop biological alternatives that will reinstate and sustain normal function in diseased and injured tissues.[1] It is an important issue to develop more refined means for providing site-specific medication at therapeutic level, so for the application of such methods in dentistry, specially periodontics many studies have been done on various drug delivery systems.[2]

At present, the main prominent areas are guided tissue regeneration and tissue engineering that pursues to develop techniques and materials to abet in the emergence of new tissues and to restore the defaced one. Thus, science is continuously evolving and developing to help mankind by creating a new era, i.e., era of nanotechnology.[3]

Nanotechnology, or nanoscience, refers to the research and development of applied science at the atomic, molecular, or macromolecular levels. The prefix “nano” is defined as a unit of measurement, in which the characteristic dimension is one-billionth of a unit.[1] Definition provided by the NATIONAL NENOTCHNOLOGY INITIATIVE, nanotechnology exploits specific phenomena and direct manipulation of materials on a nanoscale.[2]


  History Top


As early as 1867, James Clerk Maxwell proposed a revolutionary concept of nanotechnology.[4] The first observations and size measurements of nanoparticles were made during the first decade of the 20th Century by Richard Zsigmondy in 1914.5 Richard Freyman, the Nobel prize winning physicist in his historic lecture, “there is plenty room in the bottom” at the American Physical Society in 1959 investigated the insinuation of matter manipulation and concluded saying,” this is the development which I think cannot be avoided.” The term nanotechnology was first used by Nario Taniguchi in 1974. Prof Kerie Eric Drexler, who published “Engines of creation: The coming Era of Nanotechnology” in 1986 stated that, in near future, this kind of technology will be used to assemble atoms and molecule to build nanocircuits and nanomachines.[5] Robert Freitas Jr. was the first scientist who described the medical applications of nanotechnology and nanorobots. In the article published in the journal of the American dental association, he defined nanomedicine as “the science and technology of diagnosing, treating, and preventing disease and traumatic injury; of relieving pain; and of preserving and improving human health through machine systems and nanorobots.”[6] In the year 2000, he gave the term nanodentistry and defined it as the science and technology that will make possible the maintenance of near oral perfect health through the use of nanomaterial and biotechnology including tissue engineering and nanorobotics.[7]


  Nanomaterials Top


Siegel classified nanomaterials into zero dimensional (core shell, hollow nanosphere, and nanocomposite), one dimensional (carbon nanotube, composite nanowire, and coaxial nanowire), two dimensional (graphene, nanoplates, and nanobelts), and three-dimensional (mesoporous electrode, microporous electrode, and 3-d electrode).[3]

Different types of nanoparticles are nanopores, nanotubes, quantum dots, nanoshells, dendrimers, liposomes, nanorods, fullerences (Bucky-balls), nanospheres, nanowires, nanobelts, nanorings, and Nanocap.[8]

Nanoparticles can be synthesized using different approaches as follows:

Top-down

In this, the larger devices are used to direct the assembly to produce smaller devices. Synthesized by grinding and milling. For example, nanocomposites, nanoencapsulation, nanoneedles, nano-based bone replacement cement, nanoimpression material, and nanocoatings on implant.[2],[3]

Bottom-up

These seek to begin with a nanometric structure (molecule) and creating a mechanism larger than the original structure. Synthesized by direct molecular synthesis and bonding, for example, local anesthesia, tooth regeneration, hypersensitivity cure, nanodiagnostics, and oral tissue biomimetics.[3]

Functional

It emphasizes on the production of nanoparticle with specific use rather than method of production.[4]


  Properties of Nanomaterial Top


They showcase vastly superior performance properties than traditional materials which include amplified toughness, stiffness, and better transparency, increased scratch, abrasion, solvent and heat resistance, and decreased gas permeability. Nanoparticles also exhibit special properties, which differ from those of either individual molecules or bulk species including chemical, optical, magnetic, and electro-optical properties. When compared to larger particles, nanoparticles possess a greater surface area per unit mass.[3] The most significant feature of nanostructured particle is self–assembly; it is an autonomous organization of components into patterns or structures without human intervention.[4]


  Nanostructures for Dental Applications Top


Nanoparticles

Nanoparticles (defined as molecular units having diameters of between 0.1 and 100 nm) of numerous compositions depict the extensive use of nanoscale units in dentistry. Resin-based composite restorations (RBC) are the presently use form of nanoparticle. Mostly, the research is focused on making of newer types of silane bonding agents for maximum use with nanoparticles in RBC. Better compatibility is shown by organosilanes, 15 such as allyltrimethoxysilane with nanoparticle fillers such as TiO2. RBC with nanoparticles and associated modifications has demonstrated a considerable record of clinical utility and widespread use.[7]

Nanorods

In a restorative context, nanorods are of specific interest. Self-assembly properties of enamel prism-like hydroxyapatite (HA) nanorods were synthesized by Chen et al. Nanorods could practically contribute to the artificial approximation of the naturally occurring structure since they are similar to the enamel rods that form up the basic crystalline structure of dental enamel.[9]

Nanospheres

To imitate the nanoprocesses that are so far inherent in natural tooth development, nanospheres are searched as restorative systems in association with calcium phosphate deposition and amelogenin nanochain assembly.[10]

Nanotubes

For dental application, various types of nanotubes have been investigated. The acceleration of the kinetics of HA formation in vitro has been shown by titanium oxide nanotubes. In J. Gupta nanotechnology in biomedical sciences 2011, Blackwell Publishing Asia Pvt. Ltd. studied mainly in a context of bone-growth applications for dental implant coatings. Recently, the improvement of the flexural strength of RBC has been shown by the modified single-walled carbon nanotubes (SWCNT). In conjunction with specialized organosilane bonding agents, silicon dioxide has been applied to SWCNT for better results.[2]

Nanofibers

Nanofibers and their uses for biomedical applications have been reviewed. When compared to polymer microfibers, the polymer nanofibers, with diameters in the nanometer range, have a larger surface area per unit mass and allow an easier addition of surface functionalities.[11] The studies have been done on polymer nanofiber materials as drug-delivery systems, scaffolds for tissue engineering, and filters. Recently, nanofibers have been used to produce ceramics containing fluor-HA and HA. Nanofibrillar silicate crystals have also been recently studied in the reinforcement of dental composites, mainly a combination of the widely used 2,2¢-bis-(4-[methacryloxypropoxy]-phenyl)-propane, with thinning agent, i.e. triethylene glycol dimethacrylate. Nanofibers have been demonstrated to improve the physical properties of these composites when added in precise proportions and with uniform distribution of the crystals.[12]


  Dendrimers and Dendritic Copolymers Top


In relation to dental composite applications, dendrimers and dendritic copolymers have been studied, all be it less extensively than other nanostructures. It has been reported that combinations of specific polymers are used to optimize the efficacy of restorative applications.[1]


  Nanocomposites Top


Operating on a stage this minute enables tooth structure restoration at a level that offers progressively closer approximation of its individual anatomic structures. The continuously shrinking size of the nanoparticles in RBC restorative systems continues in an advancement that might be envisaged as ''imitating'' actual tooth structure. To produce nanocomposites, the nanoagglomerated distinct nanoparticles are uniformly distributed in resins or coatings.[13] The mean particle size of approximately 80 nm and a 1:4 ratio of alumina to silica are included in nanofillers aluminosilicate powder. The nanofiller with a refractive index of 1.503 has esthetic and strength advantages over conventional microfilled and hybrid RBC systems, primarily in terms of smoothness, polishability, and precision of shade characterization, plus flexural strength and microhardness, similar to those of the better-performing posterior RBC. Although the long-term benefits of these nanocomposites remain to be determined through clinical studies, the laboratory findings suggest a promising future.[1]


  Applications in Periodontics Top


Kong et al. put forward the application of nanotechnology in the periodontal management. The concept given by their researches formulated many concepts regarding tissue engineering in periodontal regeneration.[11]


  Treatment of Dentinal Hypersensitivity Top


The main cause of dentinal hypersensitivity is changed in the pressure transmitted to the pulp hydrodynamically. When compared to the nonsensitive teeth, it is found in the studies that the dentinal tubules of a hypertensive tooth have twice the diameter and eight times the surface density. Using native materials, nanorobots precisely and particularly block the dentinal tubule, thus providing swift and enduring solace to the patient.[11]


  Nanorobotic Dentifrices (Dentifrobots) Top


Nanorobotic dentifrices, either by mouthwash or toothpaste, cover all subgingival and metabolize trapped organic matter into harmless and odorless vapors. These nanorobots in the dentifrices which scans, recognize, and wreck pathogenic bacteria that are present in the plaque and oral cavity are called dentifobots.[12] Dentifrobots with the size of 1–10 μ are invisibly small, and they crawl at the speed of 1–10 μ/s so provide advantages of being economical and timid as they are purely mechanical devices that would safely deactivate themselves if swallowed.[11]

Periodontal drug delivery

The science of periodontics has witnessed considerable development with the advent of nanopharmaceuticals, nanosensors, nanoswitches, and nanodelivery systems. Triclosan-loaded nanoparticles developed by Pinon Segundo et al. have emerged as a new delivery system for the treatment of periodontal disease.[8] Moving forward in this direction, a preliminary in vivo study has been performed in dogs, which concluded that triclosan nanoparticles were able to reduce the inflammation of the experimental sites.[7] Drugs can be incorporated into nanospheres composed of a biodegradable polymer.[6] This enables timely release of the drug as the nanospheres degrade and specific site drug delivery. For exemplification, restininin which tetracycline is incorporated into microspheres for drug delivery by local means to a periodontal pocket.[12]


  Dental Implants Top


Besides surface contact area and surface topography, bone bonding, and stability play a major role in implant success and osseointegration. Bone growth and implant success can be accelerated by the use of nanotechnology.[7] Osteoblast formations on a more complex implant surface is formed by the addition of nanoscale deposits of HA and calcium phosphate particles. Material engineering, and hence implant dentistry, has advanced extensively on the basis of researches conducted on the effects and subsequent optimization of microtopography and surface chemistry.[8] These new implants constructed on the basis of this technology are more acceptable as they enhance the integration of nanocoatings resembling biological materials to the periodontal tissues. In addition, implant surfaces coated with titanium oxide nanotubes and laced with silver nanoparticles serve the purpose of fighting infection, thus increasing the shelf life of the implants.[9]


  Bone Regeneration Top


Bone transplants are commonly performed (2.2 million bone grafts performed annually worldwide). These transplants need scaffolds that are porous three-dimensional structures which provide cell support and guide bone formation. Despite numerous investigations to develop such porous materials, it is still challenging to fully harness bone's capability to regenerate itself. Bone regeneration requires three essential elements: Osteoconductive matrix (scaffold), osteoconductive signals, osteogenic cells that can respond to these signals, and an adequate blood supply. The first step, fabrication of strong and porous scaffolds, holds prime importance in the whole process. Nanotechnology delivers new useful tools to engineer the scaffold's internal surfaces and to create devices used in drug delivery with carefully controlled spatial release patterns. Different techniques have been suggested to successfully seed scaffolds along with cells. They can be roughly divided into two main groups, i. e., either attaching the cells to the internal scaffold surface or distributing them in the scaffold porosity with the help of a gel-like vehicle. Injectable gels comprising cells could also be used directly in nonload bearing presentations. It has been detected that the presence of calcium within the matrix favors the osteogenic differentiation of the appropriate progenitor cell.[11]


  Bone Replacement Materials Top


Bone is said to be a natural nanostructure which is composed of organic compounds mainly of collagen. Nanotechnology targets to imitate this natural structure for the development of nanobone, which can be used in dental applications. Nanocrystal appears as a loose microstructure with nanopores which are situated between these crystals. Bone display properties that are consistently far more superior to their individual constituent phases. The macroscale orientation of the bones is either compact/cortical (dense material found at the surface of bones) or spongy/cancellous (foam-like material). Compact bone is composed of osteons which surrounds and shields the blood vessels. Osteons have a lamellar pattern, with each individual lamella having fibers arranged in geometrical patterns. Several collagen fibrils collectively form the fibers. These mineralized collagen fibrils are the basic building blocks of bone, composed of collagen protein called tropocollagen. The surfaces of the pores are modified by adding silicon molecules, which then helps in the adsorption of the protein. These HA nanoparticles can be used for treating bone defects in periodontal diseases. Various HA nanoparticles used to treat bone defects are Ostim® (Osartis Gmbh, Germany) HA, Vitosso (Orthovita, Inc., USA), Ha + Tcpnanosstm (Angstrom Medica, USA) HA.[11]


  Laser Plasma Application for Periodontium Top


The use of nano-sized titania particle emulsion on human skin followed by laser irradiation leads to the disintegration of the particles along with other results such as shock waves.[3]


  Microabrasion of Hard Tissues Top


Stimulus to produce collagen. Clinical applications of this laser-plasma application in periodontia are periodontal therapy, melanin removal, and soft-tissue incision (without anesthesia).[3]


  Problems Faced by Nanodentistry Top


Although we have numerous ideas and dreams for nanodentistry, in reality, most of them are not possible to date because of various challenges such as engineering challenges, biological challenges, and social challenges. It is really challenging to position and assemble the nanomolecular scale part precisely. Biological compatible molecules which are environmental friendly, economic, and ethically acceptable still are a distant site in the field of nanodentistry.[4]


  Conclusion Top


With all the technologies present, nanotechnology, at present, is still in its early stage. The application of nanotechnology has been in medicine as well as dentistry, but most of the research is at the basic science level, so the clinical application of the technology is still far away though the current pace of the development is impressive.[1] The impact of nanotechnology on dentistry is providing promising insight into commercial application of the nanomaterials such as local drug delivery systems, tissue engineering, and regeneration of bone using nanotubes, nanocomposites, dendrimers, nanorobots, etc.[3] Basic engineering problems that are faced such as biocompatibility, precise positioning, assembly of molecules, economical mass production, and coordination of the activities of the microrobots are being studied; however, a need exists to collaborate more dentist and dental scientists to resolve these problems.[1],[2] Thus, it can be concluded that nanotechnology has greatly influenced the management, prevention, and diagnosis of dental diseases.[12] Hence, it is envisioned that this trend will be more improved in future and in upcoming times will be commercially researched.[14]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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  In this article
Abstract
Introduction
History
Nanomaterials
Properties of Na...
Nanostructures f...
Dendrimers and D...
Nanocomposites
Applications in ...
Treatment of Den...
Nanorobotic Dent...
Dental Implants
Bone Regeneration
Bone Replacement...
Laser Plasma App...
Microabrasion of...
Problems Faced b...
Conclusion
References

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