The nano era in dentistry

An Evaluation of Experimental Calcium Ion-Leachable Nanocomposite Glass Ionomer Cements

Glass ionomer cements (GICs) are among the main restorative dental materials used broadly in daily clinical practice. The incorporation of clay nanoparticles as reinforcing agents is one potential approach to improving GIC properties. This study aims to investigate whether the incorporation of calcium-modified clay (Ca-clay) nanoparticles in conventional GICs alters their structural characteristics, along with their physicochemical and mechanical properties. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) analyses were performed to assess the surface characterization of GIC nanocomposites, whereas a setting reaction was carried out via an attenuated total reflection Fourier transform infrared spectrometer (ATR-FTIR). A universal testing machine was used for compression tests, while calcium ion release was quantified using inductively coupled plasma optical emission spectrometry (ICP-OES). GIC composite groups reinforced with Ca-clay were found to release a fine amount of calcium ions (5.06-9.91 ppm), with the setting reaction being unaffected for low Ca-clay loadings. The median compressive strength of 3 wt% in the Ca-clay group (68.97 MPa) was nearly doubled compared to that of the control group (33.65 MPa). The incorporation of Ca-clay nanoparticles in GICs offers a promising alternative among dental restorative materials regarding their chemical and mechanical properties.

Perspectives on the Application of Nanomaterials in Medical and Dental Practices

A new field of study called nanotechnology concentrates on manipulating matter at atomic and molecular levels. Modern medicine may benefit tremendously from developments in the field of nanotechnology, and as a result, nanomedicine has emerged as a key location of education in the specific area of nanotechnology. This article aims to describe nanotechnology's possible applications in therapeutics. Nanotechnology and nanomedicine have allowed for the development of new dental materials that are stronger, more resistant to microbial seeding, etc. Other examples include high-strength denture bases, antimicrobial dental glue, aesthetic restorative materials comprised of small particles, and interface adorning for dental posts. Nanotechnology has been perfectly utilized in the medical industry for tissue engineering, biosensors, nanoscale diagnostic tools, and medication delivery using nanoparticles.

Medical and Dental Applications of Titania Nanoparticles: An Overview

Currently, titanium oxide (TiO₂) nanoparticles are successfully employed in human food, drugs, cosmetics, advanced medicine, and dentistry because of their non-cytotoxic, non-allergic, and bio-compatible nature when used in direct close contact with the human body. These NPs are the most versatile oxides as a result of their acceptable chemical stability, lower cost, strong oxidation properties, high refractive index, and enhanced aesthetics. These NPs are fabricated by conventional (physical and chemical) methods and the latest biological methods (biological, green, and biological derivatives), with their advantages and disadvantages in this epoch. The significance of TiO₂ NPs as a medical material includes drug delivery release, cancer therapy, orthopedic implants, biosensors, instruments, and devices, whereas their significance as a dental biomaterial involves dentifrices, oral antibacterial disinfectants, whitening agents, and adhesives. In addition, TiO₂ NPs play an important role in orthodontics (wires and brackets), endodontics (sealers and obturating materials), maxillofacial surgeries (implants and bone plates), prosthodontics (veneers, crowns, bridges, and acrylic resin dentures), and restorative dentistry (GIC and composites).

Healing Assessment of Osseous Defects after Surgical Removal of Periapical Lesions in the Presence of Hydroxyapatite, Nanohydroxyapatite, and a Combination of Nanohydroxyapatite and Platelet-rich Fibrin: A Clinical Study

Abstract: Aim: to evaluate the bone healing in failed endodontically treated teeth after surgical removal of periapical lesions and placement of hydroxyapatite (HA), nanohydroxyapatite (nHA) and a combination of nanohydroxyapatite with platelet rich fibrin (PRF) periapically. Subjects and methods: the study was conducted on twenty-four patients having periapical radiolucency in single rooted teeth. The selected teeth were divided into three groups: Group A, Group B, and Group C; of 8 teeth each. All the teeth were retreated in two visits. In the first visit the old filling was removed using Protaper retreatment files (Dentsply Sirona®) then irrigation with sodium hypochlorite 2.5% was done. All canals were dried and filled with Di-antibiotic paste (metronidazole and ciprofloxacin). In the second visit the canals were obturated with Pro Taper gutta-percha points and root canal sealer (Adseal resin sealer) followed by surgical intervention in the same day. A periapical curettage along with apicoectomy were established. In all the groups, root end cavity was prepared and filled with MTA (ProRoot MTA; DENTSPLY Tulsa Dental Specialties). In Group A, hydroxyapatite powder was packed in the curetted periapical defect. In Group B, nanohydroxyapatite powder was packed in the curetted periapical defect. In Group C, nanohydroxyapatite with PRF were mixed and packed in the curetted periapical defect. In all groups, patients recall visits were scheduled at 1, 3, and 6 months’ time intervals for clinical and radiological evaluation. Results: after one month; there was a statistically significant difference between the median percentage changes in lesions size in the three groups. Pair-wise comparisons between groups revealed that there was no statistically significant difference between group B (nHA) and group C (PRF and nHA) groups. Both showed statistically significantly higher median percentage reduction in lesions size than group A (HA group). After three as well as six months; there was no statistically significant difference between the median percentage decreases in lesions size in the three groups. Conclusion: It was concluded that nHA combination with PRF produced faster periapical healing (bone regeneration) in the first three months than nHA alone. However, HA produce periapical healing (bone regeneration) after six months.

Comparing Antibiotic Pastes with Electrospun Nanofibers as Modern Drug Delivery Systems for Regenerative Endodontics

Nanomaterials have various features that make these types of materials able to be applied in different biomedical applications like, diagnosis, treatment, and drug delivery. Using such materials in endodontic filed both to face the challenges that occur during treatment processes and to make these materials have an antibacterial effect without showing any harm on the host cells. The approach of nanofibers loaded with various antibacterial drugs offers a potential treatment method to enhance the elimination procedure of intracanal biofilms. Clinically, many models of bacterial biofilms have been prepared under in vitro conditions for different aims. The process of drug delivery from polymeric nanofibers is based on the principle that the releasing ratio of drug molecules increases due to the increase in the surface area of the hosted structure. In our review, we discuss diverse approaches of loading/releasing drugs on/from nanofibers and we summarized many studies about electrospun nanofibers loaded various drugs applied in the endodontic field. Moreover, we argued both the advantages and the limitations of these modern endodontic treatment materials comparing them with the traditional ones.

Effect of Nanostructures on the Properties of Glass Ionomer Dental Restoratives/Cements: A Comprehensive Narrative Review

Overall perspective of nanotechnology and reinforcement of dental biomaterials by nanoparticles has been reported in the literature. However, the literature regarding the reinforcement of dental biomaterials after incorporating various nanostructures is sparse. The present review addresses current developments of glass ionomer cements (GICs) after incorporating various metallic, polymeric, inorganic and carbon-based nanostructures. In addition, types, applications, and implications of various nanostructures incorporated in GICs are discussed. Most of the attempts by researchers are based on the laboratory-based studies; hence, it warrants long-term clinical trials to aid the development of suitable materials for the load bearing posterior dentition. Nevertheless, a few meaningful conclusions are drawn from this substantial piece of work; they are as follows: (1) most of the nanostructures are likely to enhance the mechanical strength of GICs; (2) certain nanostructures improve the antibacterial activity of GICs against the cariogenic bacteria; (3) clinical translation of these promising outcomes are completely missing, and (4) the nanostructured modified GICs could perform better than their conventional counterparts in the load bearing posterior dentition.

Development and Characterization of Fe3O4@Carbon Nanoparticles and Their Biological Screening Related to Oral Administration

The current study presents the effect of naked Fe3O4@Carbon nanoparticles obtained by the combustion method on primary human gingival fibroblasts (HGFs) and primary gingival keratinocytes (PGKs)-relevant cell lines of buccal oral mucosa. In this regard, the objectives of this study were as follows: (i) development via combustion method and characterization of nanosized magnetite particles with carbon on their surface, (ii) biocompatibility assessment of the obtained magnetic nanoparticles on HGF and PGK cell lines and (iii) evaluation of possible irritative reaction of Fe3O4@Carbon nanoparticles on the highly vascularized chorioallantoic membrane of a chick embryo. Physicochemical properties of Fe3O4@Carbon nanoparticles were characterized in terms of phase composition, chemical structure, and polymorphic and molecular interactions of the chemical bonds within the nanomaterial, magnetic measurements, ultrastructure, morphology, and elemental composition. The X-ray diffraction analysis revealed the formation of magnetite as phase pure without any other secondary phases, and Raman spectroscopy exhibit that the pre-formed magnetic nanoparticles were covered with carbon film, resulting from the synthesis method employed. Scanning electron microscopy shown that nanoparticles obtained were uniformly distributed, with a nearly spherical shape with sizes at the nanometric level; iron, oxygen, and carbon were the only elements detected. While biological screening of Fe3O4@Carbon nanoparticles revealed no significant cytotoxic potential on the HGF and PGK cell lines, a slight sign of irritation was observed on a limited area on the chorioallantoic membrane of the chick embryo.

Application of Nanotechnology in Orthodontic Materials: A State-of-the-Art Review

Nanotechnology refers to the science that manipulates matter at molecular and atomic levels, and studies matter at the nanoscale level to detect and exploit the useful properties that derive from these dimensions; materials with components less than 100 nm in at least one dimension are called nanomaterials. Nanotechnology is applied in many fields, such as medicine (nanomedicine) and dentistry (nano-dentistry). The purpose of these innovations and research in this field is to improve human life and health. This article aims to summarize and describe what the most recent and known innovations of nanotechnology in dentistry are, focusing on and paying particular attention to the branch that is orthodontics, and on the application of new nanomaterials in the realization, for example, of orthodontic elastomeric ligatures, orthodontic power chains, and orthodontic miniscrews. We also address a very important topic in orthodontics, which is how to reduce the friction force.

Advances of nanomaterial applications in oral and maxillofacial tissue regeneration and disease treatment

Using bioactive nanomaterials in clinical treatment has been widely aroused. Nanomaterials provide substantial improvements in the prevention and treatment of oral and maxillofacial diseases. This review aims to discuss new progresses in nanomaterials applied to oral and maxillofacial tissue regeneration and disease treatment, focusing on the use of nanomaterials in improving the quality of oral and maxillofacial healthcare, and discuss the perspectives of research in this arena. Details are provided on the tissue regeneration, wound healing, angiogenesis, remineralization, antitumor, and antibacterial regulation properties of nanomaterials including polymers, micelles, dendrimers, liposomes, nanocapsules, nanoparticles and nanostructured scaffolds, etc. Clinical applications of nanomaterials as nanocomposites, dental implants, mouthwashes, biomimetic dental materials, and factors that may interact with nanomaterials behaviors and bioactivities in oral cavity are addressed as well. In the last section, the clinical safety concerns of their usage as dental materials are updated, and the key knowledge gaps for future research with some recommendation are discussed. This article is categorized under: Implantable Materials and Surgical Technologies > Nanomaterials and Implants Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement.

Novel dental composite with capability to suppress cariogenic species and promote non-cariogenic species in oral biofilms

Recurrent caries often occurs and is a primary reason for the failure of dental composite restorations. The objectives of this study were to: (1) develop a bioactive composite containing dimethylaminohexadecyl methacrylate (DMAHDM), (2) investigate its antibacterial effects and suppression on biofilm growth, and (3) investigate its ability to modulate biofilm species composition for the first time. DMAHDM was incorporated into a composite at mass% of 0%, 0.75%, 1.5%, 2.25% and 3%. A commercial composite Heliomolar served as a comparative control. A biofilm model consisting of Streptococcus mutans (S. mutans), Streptococcus sanguinis (S. sanguinis) and Streptococcus gordonii (S. gordonii) was tested by growing biofilms for 48 h and 72 h on composites. Colony-forming units (CFUs), metabolic activity and live/dead staining were evaluated. Lactic acid and polysaccharide productions were measured to assess biofilm cariogenicity. TaqMan real-time polymerase chain reaction was used to determine the proportion of each species in the biofilm. DMAHDM-containing composite had a strong anti-biofilm function, reducing biofilm CFU by 2-3 orders of magnitude, compared to control composite. Biofilm metabolic activity, lactic acid and polysaccharides were decreased substantially, compared to control (p < 0.05). At 72 h, the cariogenic S. mutans proportion in the biofilm on the composite with 3% DMAHDM was 19.9%. In contrast, an overwhelming S. mutans proportion of 92.2% and 91.2% existed in biofilms on commercial control and 0% DMAHDM, respectively. In conclusion, incorporating DMAHDM into dental composite: (1) yielded potent anti-biofilm properties; (2) modulated the biofilm species composition toward a non-cariogenic tendency. The new DMAHDM composite is promising for applications in a wide range of tooth cavity restorations to modulate oral biofilm species and combat caries.

A review of nanostructured surfaces and materials for dental implants: surface coating, patterning and functionalization for improved performance

The emerging field of nanostructured implants has enormous scope in the areas of medical science and dental implants. Surface nanofeatures provide significant potential solutions to medical problems by the introduction of better biomaterials, improved implant design, and surface engineering techniques such as coating, patterning, functionalization and molecular grafting at the nanoscale. This review is of an interdisciplinary nature, addressing the history and development of dental implants and the emerging area of nanotechnology in dental implants. After a brief introduction to nanotechnology in dental implants and the main classes of dental implants, an overview of different types of nanomaterials (i.e. metals, metal oxides, ceramics, polymers and hydrides) used in dental implant together with their unique properties, the influence of elemental compositions, and surface morphologies and possible applications are presented from a chemical point of view. In the core of this review, the dental implant materials, physical and chemical fabrication techniques and the role of nanotechnology in achieving ideal dental implants have been discussed. Finally, the critical parameters in dental implant design and available data on the current dental implant surfaces that use nanotopography in clinical dentistry have been discussed.

Use of magnetic nanoparticles as a drug delivery system to improve chlorhexidine antimicrobial activity

Nanotechnology offers new tools for developing therapies to prevent and treat oral infections, particularly biofilm-dependent disorders, such as dental plaques and endodontic and periodontal diseases. Chlorhexidine (CHX) is a well-characterized antiseptic agent used in dentistry with broad spectrum activity. However, its application is limited due to inactivation in body fluid and cytotoxicity toward human cells, particularly at high concentrations. To overcome these limitations, we synthesized nanosystems composed of aminosilane-coated magnetic nanoparticles functionalized with chlorhexidine (MNP@CHX). In the presence of human saliva, MNPs@CHX displayed significantly greater bactericidal and fungicidal activity against planktonic and biofilm-forming microorganisms than free CHX. In addition, CHX attached to MNPs has an increased ability to restrict the growth of mixed-species biofilms compared to free CHX. The observed depolarization of mitochondria in fungal cells treated with MNP@CHX suggests that induction of oxidative stress and oxidation of fungal structures may be a part of the mechanism responsible for pathogen killing. Nanoparticles functionalized by CHX did not affect host cell proliferation or their ability to release the proinflammatory cytokine, IL-8. The use of MNPs as a carrier of CHX has great potential for the development of antiseptic nanosystems.

Research and Discovery Science and the Future of Dental Education and Practice

Dental graduates of 2040 will face new and complex challenges. If they are to meet these challenges, dental schools must develop a research and discovery mission that will equip graduates with the new knowledge required to function in a modern health care environment. The dental practitioner of 2040 will place greater emphasis on risk assessment, disease prevention, and health maintenance; and the emerging discipline of precision medicine and systems biology will revolutionize disease diagnosis and reveal new targeted therapies. The dental graduate of 2040 will be expected to function effectively in a collaborative, learning health care system and to understand the impact of health care policy on local, national, and global communities. Emerging scientific fields such as big data analytics, stem cell biology, tissue engineering, and advanced biomimetics will impact dental practice. Despite all the warning signs indicating how the changing scientific and heath care landscape will dramatically alter dental education and dental practice, dental schools have yet to reconsider their research and educational priorities and clinical practice objectives. Until dental schools and the practicing community come to grips with these challenges, this persistent attitude of complacency will likely be at the dental profession's peril. This article was written as part of the project "Advancing Dental Education in the 21^st Century."

Environmental dynamics of metal oxide nanoparticles in heterogeneous systems: A review

Metal oxide nanoparticles (MNPs) have been used for many purposes including water treatment, health, cosmetics, electronics, food packaging, and even food products. As their applications continue to expand, concerns have been mounting about the environmental fate and potential health risks of the nanoparticles in the environment. Based on the latest information, this review provides an overview of the factors that affect the fate, transformation and toxicity of MNPs. Emphasis is placed on the effects of various aquatic contaminants under various environmental conditions on the transformation of metal oxides and their transport kinetics - both in homogeneous and heterogeneous systems - and the effects of contaminants on the toxicity of MNPs. The presence of existing contaminants decreases bioavailability through hetero-aggregation, sorption, and/or complexation upon an interaction with MNPs. Contaminants also influence the fate and transport of MNPs and exhibit their synergistic toxic effects that contribute to the extent of the toxicity. This review will help regulators, engineers, and scientists in this field to understand the latest development on MNPs, their interactions with aquatic contaminants as well as the environmental dynamics of their fate and transformation. The knowledge gap and future research needs are also identified, and the challenges in assessing the environmental fate and transport of nanoparticles in heterogeneous systems are discussed.

Effect of using nano and micro airborne abrasive particles on bond strength of implant abutment to prosthesis

Connecting prostheses to the implant abutments has become a concern and achieving a satisfactory retention has been focused in cement-retention prostheses recently. Sandblasting is a method to make a roughened surface for providing more retention. The aim of this study was to compare effects of nano and micro airborne abrasive particles (ABAP) in roughening surface of implant abutments and further retention of cemented copings. Thirty Xive abutments and analogues (4.5 D GH1) were mounted vertically in self-cured acrylic blocks. Full metal Ni-Cr copings with a loop on the top were fabricated with appropriate marginal adaptation for each abutment. All samples were divided into 3 groups: first group (MPS) was sandblasted with 50 µm Al2O3 micro ABAP, second group (NSP) was sandblasted with 80 nm Al2O3 nano ABAP, and the third group (C) was assumed as control. The samples were cemented with provisional cement (Temp Bond) and tensile bond strength of cemented copings was evaluated by a universal testing machine after thermic cycling. The t test for independent samples was used for statistical analysis by SPSS software (version 15) at the significant level of 0.05. Final result showed significant difference among all groups (p<0.001) and MPS manifested the highest mean retention (207.88 ± 45.61 N) with significant difference among other groups (p<0.001). The control group showed the lowest bond strength as predicted (48.95 ± 10.44 N). Using nano or micro ABAP is an efficient way for increasing bond strengths significantly, but it seems that micro ABAP was more effective.

Advances in Dental Materials through Nanotechnology: Facts, Perspectives and Toxicological Aspects

Nanotechnology is currently driving the dental materials industry to substantial growth, thus reflecting on improvements in materials available for oral prevention and treatment. The present review discusses new developments in nanotechnology applied to dentistry, focusing on the use of nanomaterials for improving the quality of oral care, the perspectives of research in this arena, and discussions on safety concerns regarding the use of dental nanomaterials. Details are provided on the cutting-edge properties (morphological, antibacterial, mechanical, fluorescence, antitumoral, and remineralization and regeneration potential) of polymeric, metallic and inorganic nano-based materials, as well as their use as nanocluster fillers, in nanocomposites, mouthwashes, medicines, and biomimetic dental materials. Nanotoxicological aspects, clinical applications, and perspectives for these nanomaterials are also discussed.

Nanotechnology in dentistry: prevention, diagnosis, and therapy

Nanotechnology has rapidly expanded into all areas of science; it offers significant alternative ways to solve scientific and medical questions and problems. In dentistry, nanotechnology has been exploited in the development of restorative materials with some significant success. This review discusses nanointerfaces that could compromise the longevity of dental restorations, and how nanotechnolgy has been employed to modify them for providing long-term successful restorations. It also focuses on some challenging areas in dentistry, eg, oral biofilm and cancers, and how nanotechnology overcomes these challenges. The recent advances in nanodentistry and innovations in oral health-related diagnostic, preventive, and therapeutic methods required to maintain and obtain perfect oral health, have been discussed. The recent advances in nanotechnology could hold promise in bringing a paradigm shift in dental field. Although there are numerous complex therapies being developed to treat many diseases, their clinical use requires careful consideration of the expense of synthesis and implementation.

Cytotoxic and genotoxic characterization of aluminum and silicon oxide nanoparticles in macrophages

OBJECTIVE

Although aluminum oxide and silicon oxide nanoparticles are currently available as dental materials, there is a lack of basic information concerning their biocompatibility. This study evaluates the biological responses of cultured macrophages (RAW264) to aluminum oxide (Al2O3NPs) and silicon oxide nanoparticles (SiO2NPs) by analyzing cytotoxicity and genotoxicity.

METHODS

The nanoparticles are amorphous and spherical, with diameters of 13 nm for the Al2O3NPs and 12 nm for the SiO2NPs. The cultured RAW264 are exposed to the nanoparticles (NPs) and examined for cytotoxicity using the WST-8 cell viability and Hoechst/PI apoptosis assay, for genotoxicity by micronucleus analysis, for changes in nuclear shape (deformed nuclei) and for comet assay using confocal microscopy, and micromorphological analysis is done using scanning and transmission electron microscopes.

RESULTS

Nuclei and DNA damage because of exposure to both types of NPs is observed by inmunostaining genotoxicity testing. The cytotoxicity and genotoxicity are well correlated in this study. Numerous NPs are observed as large aggregates in vesicles, but less or nonexistent NP internalization is seen in the nucleus or cytoplasm. These morphological results suggest that a primary cause of cell disruption is the chemical changes of the NPs in the low pH of vesicles (i.e., ionization of Al2O3 or SiO2) for both types of oxide NPs.

SIGNIFICANCE

Although further research on the elution of NP concentrations on cell or tissue activity under simulated clinical conditions is required, NP concentrations over 200 μg/mL are large enough to induce cytotoxic and genotoxic effects to cells.

Revolutionizing restorative dentistry: an overview

The field of science and research is ever changing and the scientific discipline of prosthodontics is no exception. The practice of prosthodontics and the supporting technology involved has evolved tremendously from the traditional to the contemporary. As a result of continual developments in technology, new methods of production and new treatment concepts may be expected. Clinicians must have certain basic knowledge if they are to benefit from these new procedures. This article reviews the contemporary trends in the field of prosthodontics and provides an insight into what one might expect in the near future.

Nanorobotic Applications in Medicine: Current Proposals and Designs

Advances in technology have increased our ability to manipulate the world around us on an ever-decreasing scale. Nanotechnologies are rapidly emerging within the realm of medicine, and this subfield has been termed nanomedicine. Use of nanoparticle technology has become familiar and increasingly commonplace, especially with pharmaceutical technology. An exciting and promising area of nanotechnological development is the building of nanorobots, which are devices with components manufactured on the nanoscale. This area of study is replete with potential applications, many of which are currently being researched and developed. The goal of this paper is to give an introduction to the emerging field of nanorobotics within medicine, and provide a review of the emerging applications of nanorobotics to fields ranging from neurosurgery to dentistry.