Nanotechnology for Dentistry: Prospects and Applications

Advances and perspectives in use of semisolid formulations for photodynamic methods

Although nearly 30 years have passed since the introduction of the first clinically approved photosensitizer for photodynamic therapy, progress in developing new pharmaceutical formulations remains unsatisfactory. This review highlights that despite years of research, many recurring challenges and issues remain unresolved. The paper includes an analysis of selected essential studies involving aminolevulinic acid and its derivatives, as well as other photosensitizers with potential for development as medical products. Among various possible vehicles, special attention is given to gelatin, alginates, poly(ethylene oxide), polyacrylic acid, and chitosan. The focus is particularly on infectious and cancerous diseases. Key aspects of developing new semi-solid drug forms should prioritize the creation of easily manufacturable and biocompatible preparations for clinical use. At the same time, new formulations should preserve the primary function of photosensitizers, which is the generation of reactive oxygen species capable of destroying pathogenic cells or tumors. Additionally, the use of adjuvant properties of carriers, which can enhance the effectiveness of macrocycles, is emphasized, especially in chitosan-based antibacterial formulations. Current research indicates that many promising dyes and macrocyclic compounds with high potential as photosensitizers in photodynamic therapy remain unexplored in formulation and development work. This review outlines potential new and previously explored pathways for advancing photosensitizers as active pharmaceutical ingredients (APIs).

Experimental toothpastes containing β-TCP nanoparticles functionalized with fluoride and tin to prevent Erosive Tooth Wear

OBJECTIVES

The present study aimed to synthesize toothpastes containing Beta- TriCalcium Phosphate (β-TCP) nanoparticles, functionalized with fluoride and tin, and test their ability to reduce erosive tooth wear (ETW).

METHODS

Toothpastes were synthesized with the following active ingredients: 1100 ppm of fluoride (as sodium fluoride, F-), 3500 ppm of tin (as stannous chloride, Sn2+), and 800 ppm of β-TCP (Sizes a - 20 nm; and b - 100 nm). Enamel specimens were randomly assigned into the following groups (n = 10): 1. Commercial toothpaste; 2. Placebo; 3 F-; 4. F- + β-TCPa; 5. F- + β-TCPb; 6. F- + Sn2+; 7. F- + Sn2+ + β-TCPa and 8. F- + Sn2+ + β-TCPb. Specimens were subjected to erosion-abrasion cycling. Surface loss (in µm) was measured by optical profilometry. Toothpastes pH and available F- were also assessed.

RESULTS

Brushing with placebo toothpaste resulted in higher surface loss than brushing with F- (p = 0.005) and F- + β-TCPb (p = 0.007); however, there was no difference between F- and F- + β-TCPb (p = 1.00). Commercial toothpaste showed no difference from Placebo (p = 0.279). The groups F-, F- + β-TCPa, F- + β-TCPb, F- + Sn2+, F- + Sn2+ + β-TCPa and F- + Sn2+ + β-TCPb were not different from the commercial toothpaste (p > 0.05). Overall, the addition of β-TCP reduced the amount of available fluoride in the experimental toothpastes. The pH of toothpastes ranged from 4.97 to 6.49.

CONCLUSIONS

Although toothpaste containing β-TCP nanoparticles protected enamel against dental erosion-abrasion, this effect was not superior to the standard fluoride toothpaste (commercial). In addition, the functionalization of β-TCP nanoparticles with fluoride and tin did not enhance their protective effect.

CLINICAL SIGNIFICANCE

Although β-TCP nanoparticles have some potential to control Erosive Tooth Wear, their incorporation into an experimental toothpaste appears to have a protective effect that is similar to a commercial fluoride toothpaste.

Comparative Analysis of Heavy Metal Content in Impacted Third Molars from Industrial and Non-Industrial Areas and Its Effect on the Isolation, Culture, and Proliferation of Dental Stem Cells (DSCs)

Background: This study investigates the impact of environmental pollution on the quality and viability of dental stem cells (DSCs) from impacted third molars. By comparing DSCs from patients in industrial areas with high air pollution and those from non-industrial regions, the research assesses the adverse effects of heavy metals on stem cell proliferation. Methods: Impacted lower third molars were collected from 28 patients-10 from industrial and 18 from non-industrial areas. Patients were divided into two age groups: 18-27 years and 28-38 years old. Dental pulp was extracted under sterile conditions, and DSCs were isolated and cultured. Heavy metal concentrations in dental tissues were measured using atomic absorption/emission spectrometry. Results: The study found significantly higher concentrations of copper and lead in the dental tissues of patients in industrial areas. Cell viability was lower in samples from these areas, with a statistically significant difference in average doubling time and the number of cells obtained after the first passage. There was no significant impact of gender on heavy metal content, except for higher iron levels in men. Conclusions: Exposure to industrial pollutants negatively affects the viability and proliferation of DSCs, but there are no differences in differentiation in the osteogenic medium regarding cell mineralization. These studies highlight the importance of environmental factors for oral health, suggesting that residents of polluted areas may face greater difficulties in dental and regenerative treatments. Further research is needed to develop strategies to mitigate the effects and improve clinical outcomes for affected populations.

Impact of Silicon Carbide Coating and Nanotube Diameter on the Antibacterial Properties of Nanostructured Titanium Surfaces

This study aimed to comprehensively assess the influence of the nanotube diameter and the presence of a silicon carbide (SiC) coating on microbial proliferation on nanostructured titanium surfaces. An experiment used 72 anodized titanium sheets with varying nanotube diameters of 50 and 100 nm. These sheets were divided into four groups: non-coated 50 nm titanium nanotubes, SiC-coated 50 nm titanium nanotubes, non-coated 100 nm titanium nanotubes, and SiC-coated 100 nm titanium nanotubes, totaling 36 samples per group. P. gingivalis and T. denticola reference strains were used to evaluate microbial proliferation. Samples were assessed over 3 and 7 days using fluorescence microscopy with a live/dead viability kit and scanning electron microscopy (SEM). At the 3-day time point, fluorescence and SEM images revealed a lower density of microorganisms in the 50 nm samples than in the 100 nm samples. However, there was a consistently low density of T. denticola across all the groups. Fluorescence images indicated that most bacteria were viable at this time. By the 7th day, there was a decrease in the microorganism density, except for T. denticola in the non-coated samples. Additionally, more dead bacteria were detected at this later time point. These findings suggest that the titanium nanotube diameter and the presence of the SiC coating influenced bacterial proliferation. The results hinted at a potential antibacterial effect on the 50 nm diameter and the coated surfaces. These insights contribute valuable knowledge to dental implantology, paving the way for developing innovative strategies to enhance the antimicrobial properties of dental implant materials and mitigate peri-implant infections.

Applications of nanotechnology in orthodontics: a comprehensive review of tooth movement, antibacterial properties, friction reduction, and corrosion resistance

Nanotechnology has contributed important innovations to medicine and dentistry, and has also offered various applications to the field of orthodontics. Intraoral appliances must function in a complex environment that includes digestive enzymes, a diverse microbiome, mechanical stress, and fluctuations of pH and temperature. Nanotechnology can improve the performance of orthodontic brackets and archwires by reducing friction, inhibiting bacterial growth and biofilm formation, optimizing tooth remineralization, improving corrosion resistance and biocompatibility of metal substrates, and accelerating or decelerating orthodontic tooth movement through the application of novel nanocoatings, nanoelectromechanical systems, and nanorobots. This comprehensive review systematically explores the orthodontic applications of nanotechnology, particularly its impacts on tooth movement, antibacterial activity, friction reduction, and corrosion resistance. A search across PubMed, the Web of Science Core Collection, and Google Scholar yielded 261 papers, of which 28 met our inclusion criteria. These selected studies highlight the significant benefits of nanotechnology in orthodontic devices. Recent clinical trials demonstrate that advancements brought by nanotechnology may facilitate the future delivery of more effective and comfortable orthodontic care.

Evaluating the potency of laser-activated antimicrobial photodynamic therapy utilizing methylene blue as a treatment approach for chronic periodontitis

Chronic periodontitis is a ubiquitous inflammatory disease in dental healthcare that is challenging to treat due to its impact on bone and tooth loss. Conventional mechanical debridement has been challenging in eliminating complex subgingival biofilms. Hence, adjunctive approaches like low-level laser antimicrobial photodynamic therapy (A-PDT) utilising methylene blue (MB) have been emerging approaches in recent times. This review evaluates the latest research on the use of MB-mediated A-PDT to decrease microbial count and enhance clinical results in chronic periodontitis. Studies have shown the interaction between laser light and MB generates a phototoxic effect thereby, eliminating pathogenic bacteria within periodontal pockets. Moreover, numerous clinical trials have shown that A-PDT using MB can reduce probing depths, improve clinical attachment levels, and decrease bleeding during probing in comparison to traditional treatment approaches. Notably, A-PDT shows superior antibiotic resistance compared to conventional antibiotic treatments. In conclusion, the A-PDT using MB shows promise as an adjunctive treatment for chronic periodontitis. Additional research is required to standardize treatment protocols and assess long-term outcomes of A-PDT with MB in the treatment of periodontitis.

Surface Topography Steer Soft Tissue Response and Antibacterial Function at the Transmucosal Region of Titanium Implant

Metallic dental implants have been extensively used in clinical practice due to their superior mechanical properties, biocompatibility, and aesthetic outcomes. However, their integration with the surrounding soft tissue at the mucosal region remains challenging and can cause implant failure due to the peri-implant immune microenvironment. The soft tissue integration of dental implants can be ameliorated through different surface modifications. This review discussed and summarized the current knowledge of topography-mediated immune response and topography-mediated antibacterial activity in Ti dental implants which enhance soft tissue integration and their clinical performance. For example, nanopillar-like topographies such as spinules, and spikes showed effective antibacterial activity in human salivary biofilm which was due to the lethal stretching of bacterial membrane between the nanopillars. The key findings of this review were (I) cross-talk between surface nanotopography and soft tissue integration in which the surface nanotopography can guide the perpendicular orientation of collagen fibers into connective tissue which leads to the stability of soft tissue, (II) nanotubular array could shift the macrophage phenotype from pro-inflammatory (M1) to anti-inflammatory (M2) and manipulate the balance of osteogenesis/osteoclasia, and (III) surface nanotopography can provide specific sites for the loading of antibacterial agents and metallic nanoparticles of clinical interest functionalizing the implant surface. Silver-containing nanotubular topography significantly decreased the formation of fibrous encapsulation in per-implant soft tissue and showed synergistic antifungal and antibacterial properties. Although the Ti implants with surface nanotopography have shown promising in targeting soft tissue healing in vitro and in vivo through their immunomodulatory and antibacterial properties, however, long-term in vivo studies need to be conducted particularly in osteoporotic, and diabetic patients to ensure their desired performance with immunomodulatory and antibacterial properties. The optimization of product development is another challenging issue for its clinical translation, as the dental implant with surface nanotopography must endure implantation and operation inside the dental microenvironment. Finally, the sustainable release of metallic nanoparticles could be challenging to reduce cytotoxicity while augmenting the therapeutic effects.

Effect of Adding Different Concentrations of Silver Nanoparticles on Flexural Strength and Microhardness of Different Denture Base Materials

AIM

This study aimed to evaluate the effect of adding different concentrations of silver nanoparticles (AgNPs) on the flexural strength and microhardness of various denture base materials.

MATERIALS AND METHODS

For this study, a total of 60 specimens were used and divided into equal groups. The first group consisted of heat-cured acrylic resin (Vertex-Germany), while the second group consisted of thermoplastic resin (Breflex 2nd edition, Germany). The samples were created using a split brass mold with dimensions of 65 × 10 × 2.5 mm, in accordance with the specifications of the American Dental Association (specifically No. 12 for flexural and microhardness). Following this, the samples were divided into three groups (A, B, and C) based on different concentrations of AgNPs (0, 2, and 5%). The flexural and microhardness of the samples were assessed using a universal testing machine and the Vickers hardness test, respectively. The data were gathered, organized, and analyzed using statistical methods.

RESULTS

The flexural strength findings showed a significant difference between the two groups. Also, there was a considerable decrease in the average value of the acrylic group as the concentrations of AgNPs rose, while the flexural strength of the thermoplastic group notably improved. Regarding microhardness, the results showed a significant difference between the two groups. It showed that the mean value of both groups increased with increasing concentrations of AgNPs.

CONCLUSION

Within the limitations of laboratory testing conditions of this study, it was discovered that AgNPs negatively impact the flexural strength of acrylic resins. Furthermore, an increase in the concentration of AgNPs was found to be directly related to the flexural strength of thermoplastic resin and the microhardness of both groups.

CLINICAL SIGNIFICANCE

The concentration of AgNPs has a significant impact on certain mechanical properties of denture base materials, but it is important to consider their potential toxicity. How to cite this article: El-Hussein IG. Effect of Adding Different Concentrations of Silver Nanoparticles on Flexural Strength and Microhardness of Different Denture Base Materials. J Contemp Dent Pract 2024;25(5):417-423.

Analysis of Physical and Mechanical Properties of Universal Composites under Different Types of Polishing before and after Acid Challenge

This study aimed to evaluate in vitro the degree of surface smoothness provided by two different polishing techniques and the effect of acid challenge on the alteration of surface roughness (Ra), microhardness (Knoop), and color (ΔE00) of three nanoparticulate composites, simulating 1 year of exposure to hydrochloric acid (HCl). Eighty specimens for each composite were divided into four groups (n = 240), being control without polishing, control with wear, WPC (wear + polishing with Cosmedent Kit), and WPB (wear + BisCover LV liquid polish). Repeated measures ANOVA was applied for Ra and Knoop Microhardness. For the color (ΔE) three-way ANOVA was applied. In cases of statistically significant the Tukey posttest was applied (α = 0.05). Both types of polishing tested resulted in a surface smoothness below the critical value established by the studies (Ra ≥ 0.2 μm), even after immersion. The microhardness of all composite resins decreased after the challenges. The specimens immersed in HCl showed a lower microhardness (42.2 Kgf/mm2) when compared to the specimens immersed in artificial saliva (44.7 Kgf/mm2). Regarding the color change, the composites presented values compatible with clinical acceptability, with a statistically significant difference only between the control group and the other types of polishing for the Z350 XT resin (ΔE00 = 3.78). It was concluded that both mechanical and chemical polishing produced a satisfactory surface smoothness, even after immersions in artificial saliva and HCl. The microhardness of the composites was affected by the challenges and the composites tested were within clinical acceptability with regard to color change.

Bone implant substitutes from synthetic polymer and reduced graphene oxide: Current perspective

In the present work, bone implant materials (BIM) were produced, in sheet form which comprises epoxy resin (synthetic polymer) (ER), calcium carbonate (CaCO3), and reduced graphene oxide (R-GO), by open mold method, for the possibility uses in bone tissue engineering. The developed BIM was analyzed for its physico-chemical, mechanical, bioactivity test, antimicrobial study, and biocompatibility. The BIM had excellent mechanical properties such as tensile strength (194.44 + 0.21 MPa), flexural strength (278.76 + 0.41 MPa), and water absorption (02.61 + 0.24%). A pore size distribution study using the HR-SEM has proved the 180 and 255 μm average pore was observed in the BIM structure. The Bioactivity test of BIM was examined after being immersed in a simulated body fluids (SBF) solution. The result of BIM formed an excellent deposition of bone tube apatite crystals. High-resolution scanning electron microscopy (HR-SEM) morphology of the bone tube apatite crystals revealed the diameter size in the range from 100 ± 159 to 210 ± 188 nm. BIM has excellent antimicrobial characteristics against E. coli (8.75 + 0.06 mm) and S. aureus (9.82 + 0.08 mm). The biocompatibility of the study MTT (3-(4, 5-dimethyl) thiazol-2-yl-2, 5-dimethyl tetrazolium bromide) assay using the MG-63 (human osteoblast cell line) has proven to be the 78% viable cell presence in BIM. After receiving the necessary approval, the scaffold with the required strength and biocompatibility could be tested as a bone implant material in large animals.