role of nanotechnology in prosthodontics

1. NANOTECHNOLOGY IN
PROSTHODONTICS
Presenter- Dr. Megha Sabharwal
Preceptor- Dr. Karunakar Keshav
1

2. Objectives
1. tofamiliarizeyouwithnanodentistry,
2. recentadvancesinNanodentistryand
3. applicationsof nanodentistryin Prosthodontics.
The growing interest in this field is giving emergence to new field
called Nanomedicine, a science & technology of diagnosing,
treating & preventing diseases, and preserving & improving
human health, using nanoscale structured materials.
2

3. • Because of the growing interest in the future
of dental applications of nano technology, a
new field called nano dentistry isemerging.
• This seminar provides an early glimpse of
nano dentistry applications to explain their
potentially far reaching impacts on clinical
dental practice.
3

4. INTRODUCTION
•It is “the art and science of
manipulating matter at the
nanoscale (1-100 nm)to provide
an understanding of phenomena
and materials at the nanoscale
and to create and use
structures,devices and systems
that have novel properties and
functions because of their small
and/or intermediate size.”
• A nanometer is one billionth of a
meter. 4

5. Definition
 “Nano" is derived from the Greek word for 'dwarf' which
combines with a noun to form words such as nanometer,
nanotechnology, and nanorobot.
 The design, characterization, production, and application of
structures, devices, and systems by controlled manipulation of
size and shape at the nanometer scale (atomic, molecular,
and macromolecular scale) that produces structures, devices,
and systems with at least one novel/superior characteristic or
property.
R. Bawa et al. Protecting new ideas and inventions in nanomedicine with
patentsNanomedicine: Nanomedicine 2005;1(2):150 –158 5

6. HISTORY OF
NANOTECHNOLOGY
•Idea derived from nature-This phenomenon is seen in nature in
the locomotor organs of various organisms and our biological system
as ferritin in red blood cells.
•Discovery of nanotechnology is widely attributed to the American
Physicist and Nobel Laureate, Dr. Richard Phillips Feynman.
•The first use of the word “nanotechnology” attributed to Taniguchi in
1974. Later, in 1986, Eric Drexler introduced and popularized the
term “nanotechnology” in his book “Engines of Creation.”
•It was introduced into dentistry first as nanocomposites in the year
2002 by Filtek Supreme.
6

7. NANODENTISTRY
LOCAL
ANAESTHESIA
TOOTH REPAIR
COSMETICS
NANOMATERIALS
NANO ROBOTS
7

8. APPROACH TO
MANUFACTURING
1. Top-down approach –is reducing
thesize of existingstructuredownto
ananoscale level.
2. Bottom-up approach –is
assemblingthe individualatoms
andmoleculesinto nanomaterial.
3. Functional approach –doesnot
consider themethodof production
of a nanoparticle;ratheritvalues
onthe productionof nanoparticles
witha specific function.
8

9. Nanodentistry as bottom-up
approach
1. Inducinganesthesia
2. Major ToothRepair
3. Hypersensitivity Cure
4. Dental Durability andCosmetics
5. Nanorobotic Dentifrice(dentifrobots)
6. Tooth repositioning
7. Local drugdelivery
8. Nanodiagnostics
9. Therapeutic aid in oraldiseases.
9

10. Nanodentistry as top down
approach
1. Nanocomposites
2. Nano Light-Curing Glass Ionomer
Restorative Materials
3. Nano Impression Materials
4. Nano-Composite DentureTeeth
5. Nanosolutions
6. Nanoencapsulation
7. Plasma Laserapplication
8. Prosthetic Implants
9. Nanoneedles
10. Bone replacementmaterials
10

11. Nanodentistry as bottom-
up approach
1. Local anaesthesia
•A colloidal suspension containing millions of active analgesic
micron-size dental robots instilled on the patient's gingiva. After
contacting the surface of crown or mucosa, the ambulating nano
robots reach the pulp via the gingival sulcus, lamina propria, and
dentinal tubules.
•On reaching the dentin, the nanorobots enter dentinal tubule holes
that are 1 to 2 micrometer in diameter and proceed towards the pulp,
guided by a combination of chemical gradients, temperature
differentials and even positional navigation; all under the control of
the on-board nanocomputeras directed by thedentist.
Freitas,R.A.,2000.Nanodent.J.Am.Dent.Assoc.131(3),1559–1566.
11

12. • With a modest travel speed of 100 micrometers per
second, nanorobots can complete the journey into the
pulp chamber in approximately 100 seconds.
• Once installed in the pulp, the analgesicdental robots
may be commanded by the dentist to shutdown all
sensitivity in anyparticulartooth that requires
treatment.
• After oral procedures are completed, the dentist orders
the nanorobots to restore all sensation, to relinquish
control of nervetraffic, and to egress from the tooth by
similar simultaneously in real time pathways used for
ingress.
12

13. Advantage
s
• Patient has anxiety-free andneedleless comfort.
• Theanesthesia is fastacting and reversible, with no side
effects or complications associated with itsuse
13

14. Nanorobot
• A nanorobot is a specializednanomachine.
• It has dimensions in theorderof nanometers.
• Typically 0.5 to 3 microns large with 1-100 nm
parts made of chemically inert formsof carbon.
• The possibilityof nanorobotswas first proposed
by Richard Feyman in his talk “There’s Plentyof
Room at the Bottom” in1959
• Functions indentistry
• Induces local anaesthesia.
• Avoids discomfort to thepatient.
• Dentrifices (dentofrobots)
• Major ToothRepair
14

15. Major ToothRepair
• May evolve through several stages of technological development, first
using genetic engineering, tissue engineering and tissue
regeneration, and later involving the growth of whole new teeth in vitro
and theirinstallation.
• the nanorobotic manufacture and installation - biologically
autologous whole-replacement tooth that includes both mineral and
cellular components— that is, complete dentition replacement
therapy—feasible ,eliminating economic constraints of a typical
office visit, through the use of an affordable desktop manufacturing
facility, which would fabricate the new tooth, in the dentist’s office.
.
Shellart W.C., Oesterle L.J. uprighting molars without extrusion. JADA 1999;130:381- 15

16. • Chen et al in 2003, took advantage of these latest
developments in the area of nanotechnology to simulate the
natural biomineralization process to create the hardest
tissue in the human body, dental enamel, by using highly
organized microarchitectural units of nanorod-like calcium
HA crystals arranged roughly parallel to each other.
Chen Y, Jung G-Y, Ohlberg DAA, et al. Nanoscalemolecular-switch crossbar circuits.
Nanotechnology.2003;14:462. 16

17. • Also know as Dentitionrenaturalization
• This procedure may become popular and provide perfect treatment methods
forestheticdentistry.
• This trend may begin with patients who desire to have their old dental
amalgams excavated and their teeth remanufactured with native biological
materials, and full coronal renaturalization procedures in which
modifications to the visible dentition are removed, with the affected
teeth remanufactured to become indistinguishable from originalteeth.
Freitas RA Jr. Nanodentistry. Journal of American Dental Association.
2000;131(11):1559-65
REGENERATIVE NANOTECHNOLOGY
17

18. Hypersensitivity
It is characterised by short, sharp pain arising from exposed dentin in
response to stimuli typically thermal, evaporative, tactile, osmotic or
chemical and which cannot be ascribed to any other form of dental
defect or pathology
18

19. • Conventional treatment includes
1. Desensitisation by occluding dentinal tubules
A) Silver nitrate
Fluorides
Fluoride
iontophresis
Potassium nitrate
Varnishes
B) Dentin adhesives
C)placement of restorations- Glass ionomer cements
Composite resins
d)use of lasers-co2 laserNd:yag,er:yag LASER
2. Desensitizing by blocking pulpal sensory nerves
A)potassium nitrate toothpaste
Hypersensitivity cure
19

20. Nanotechnology fortreating hypersenitivity
• The Polyhedral Oligomeric Silsesquioaxane (POSS)
molecule can be used to reduce tooth sensitivity through
sealing the tubules with POSS nano-sized molecules, and
provide structure reinforcement,toughness,and
processability
20

21. Using Nanorobots
• Dentin hypersensitivity may be caused by changes in
pressure transmitted hydro dynamically to the pulp.
This is based on the fact that hypersensitive teeth
have eight times higher surface density of dentinal
tubules and tubules with diameters twice as large as
non sensitive teeth.
• Dental nanorobots could selectively and precisely
occlude selected tubules in minutes, using native
logical materials, offering patients a quick and
permanent cure.
21

22. Dental durability andcosmetics.
• Contemporary ceramic veneers are being replaced with
nanoceramics. These materials are brittle and can be made more
fracture resistant with nanostructured composites, possibly
including embedded, carbon nanotubes.
22

23. Nanotechnology
toothpaste
• The small nano partices of Hydroxyapatite helps to prevent
the tooth from decaying, it also rebuilds teeth by placing a
coating on the tooth to protectit from futuredamage.
• Active ingredients are Patented nano technology aka
Nanoxyd® which is calcium peroxide in nano size, which
penetrates into the most minute of gaps, ensuring an
optimum bleaching result.
• Enzymes (papain and bromelain) gently remove theplaque
• Co-enzyme Q10 protects against inflammation of thegums.
• Vitamin E protects the teeth and vitalises thegums.
23

24. • Fluoride combination protects against tooth
decay.
• It whitens and polishes the teeth and makes it less
sensitive
• It arranges itself in a way that mimics and binds to
the natural enamel structure.
• If Hydroxyapatite is swallowed it does not upset
the stomach and is not as toxic as regular
toothpaste.
24

25. With this kind of daily dental care available from an early age, conventional tooth
decay and gingival disease will disappear.
Nanorobotic dentifrice [dentifrobots]
• Delivered by mouthwash/toothpaste
• Trap organic matterinto odorless vapors
• Invisible dentifrobots , crawling at 1-10 microns/sec
• manufactured non agglomerated nanoparticles
mechanical devices would safely deactivate themselves
if swallowed
• would provide a continuous barrier to halitosis
• Avoiding bacterial putrefaction is the metabolic
process involved in oral malodor
25

26. Evolution in composites
Thechronological developmentof thestateof theartof
dental composite formulations based on filler particle
modifications. 26

27. Nanocomposites
27

28. • Nanotechnology has had its greatest impact on restorative dentistry
by offering refinements to already clinically proven resin based
composite systems.
• Nanohybrid and nanofilled RBCs are generally two types of composite
restorative materials characterized by filler-particle sizes of ≤100 nm
referred to under the term“nanocomposite”.
• Nanomers and nanoclusters are the two types of monodispersed non
agglomerated discrete nanoparticles that are homogeneously distributedin
resinsorcoatings toproduce nanocomposites.
Nanocomposites
An application of nanotechnology in advanced dental materialsSumita b. Mitra, Dong WU,
and Brain N. Holmes JADA October 2003 134(10):1382-1390
28

29. 29

30. Materials used to reinforce composites
• Nanomaterialsavailable as titanium dioxide,
aluminum oxide and silica oxide are used in
small amounts (1%–5%) to improve powder
flow of composites. Eg. Isopast® and
Heliomolar® by Ivoclar Vivadent.
• Nanocream- Nano Aluminium Oxide Fibres
Nano-structural aluminium oxide fibers
provide added strength and improved
performance to metals, plastics, polymers and
composite materials.
30

31. Nanoporous Silica-Filled Composite
 Nanoporous silica filled composite is a fairly new
material still in experimental form, proven to
increase wear resistance in posterior applications.
 Nano sized porous silica fillers allow the monomer to
inter- penetrate it, through a capillary force; the
monomer is drawn in and out of the filler, reinforcing
the composite and increasing the durability of the
bonding between the twophases.
 By impregnating organic monomer into the pores &
adding a light cure system a solid organic/inorganic
nanostructure is formed.
31

32. Silane bonding agents
• Together with the evolution of nanoparticles for dental
composites, sharper focus is being applied to reformulations
of interfacial silanes
• Organosilanes such as allyltriethoxysilane have demonstrated
good compatibilitywith nanoparticle fillers such as TiO2.
• In addition,3-ethacryloxypropyltrimethoxysilane has also
been demonstrated to enhance dispersion of silica
nanoparticles (5–25 nm) within the restorative resinmatrix.
Current practicality of nanotechnology in dentistry. Part 1:Focus on nanocomposite restoratives and
biomimeticsClinical, Cosmetic and Investigational Dentistry 2009:1 47–61 32

33. • Silanization has been reported is one of several theoretical
avenues for increasing fracture toughness of nanocomposites.
• Silanization increased the strength of a novel ion-releasing
calcium phosphate (CaPO4) composite, but decreased the level
of release.
33

34. Figure 6: Sem micrograph of filtek supreme [a=x1,000 b=x2,500 magnification]
spherical nanocluster of 1 to 4um
Trade name - filtek O supremeuniversal restorative pure
nano
34

35. SEM
IMAGE
An application of nanotechnology in advanced dental materials Sumita b. Mitra, Dong WU, and
Brain N. Holmes JADA October 2003 134(10): 1382-1390
a)Composite with
nanometric particles
b)composite with
nanocluster
particles
c)composite with
hybrid fillers
35

36. Advantages
• Mechanical strengthand wear resistance
comparable to hybrid composites.
• Superior flexural strength, modulus of elasticity, and
translucency.
• Superiorpolish and gloss resistancecomparable to
microfill
composites.
• 50% reduction in fillingshrinkage
• Excellent handling properties
36

37. Trade names
• Filtek O Supreme Universal Restorative Pure Nano,
• Premise, Kerr/Sybron, Orange, CA
• Trade name of nanohybrids: Nanohybrid NANOSIT™
nanohybrid composite (Nordiska Dental, Angelholm,
Sweden
• Trade name of nanofills: Filtek™ Supreme Plus
[3MESPE], Estelite® Sigma [Tokuyama America,
Inc Encinitas, CA, USA]
37

38. Other Features Of Composites
• CariespreventionOptimal deliveryof molecules that facilitate
tooth structure remineralization and forestallcaries.
• Fluoride (F)-releasing nanocomposite contains novel CaF2
nanoparticles in a whisker-reinforced resin matrix, and had
sustained F-releasevalues exceeding thoseof conventional and
resin-modified glass ionomers.
• Dicalcium phosphate anhydrous (DCPA) incorporated with
nanosilica-fusedwhiskers found that it increased the strength of
the RBC byas much as threefold while releasing CaPO4.
• Zirconia-amorphous calcium phosphate RBC filler,showed
good release properties in addition toan increase in biaxial
flexural strength
38

39. • Blends Nanotechnology originally developed for Filtek™
Supreme Universal Restorative with fluoraluminosilicate
(FAS) technology.
Advantages:
1. Superb polish.
2. Excellentesthetics.
3. Improved wearresistance
Nano Light-curing glass-ionomer
restorative materials
39

40. Clinical Indications:
Primary teethrestorations.
Transitional restorations.
Small Class I restorations.
Sandwich restorations.
Class III and Vrestorations.
Core build-ups.
40

41. Impression Materials
• Nanofillers are integrated in vinylpolysiloxanes,
producing a unique addition of siloxane
impression materials.
• The material has better flow, improved
hydrophilic properties hence fewer voids at
margin and better model pouring, and enhanced
detailed precision
• Trade name: Nanotech Elite H-D
41

42. Advantages
1. Increased fluidity
2. High tear resistance,
3. Hydrophilicproperties
4. Resistance to distortion
and heat resistance
5. Snapset thatconsequently reduceserrors caused by
micro movements
42

43. Nano-composite dentureteeth
• Conventional denture teeth havetheirown inherent
disadvantage.
• Porcelain is highly wear resistant, but is brittle, lacks
bonding ability to thedenture base, and is noteasy to
polish.
• Acrylic on the other hand is toadjust, but undergo undue
wear. Nanocomposite denture teeth are made of
Polymethylmethacrylate (PMMA) and homogeneously
distributed nanofillers.
43

44. Advantages
• Excellent polishing ability andstain-resistant.
• Superb esthetics, lively surfacestructure.
• Enhanced wear resistance and surfacehardness.
• Trade name: Veracia( Shofu, Kyoto,
Japan) the three layered Veracia SA
teeth consist of MF-H(microfilled
hybrid)composite reinforced with
layeredglass.
44

45. Nanosolution & Nanoadhesives
• The new bonding agents manufactured contain
stable nano particles homogeneously dispersed
throughout thesolution.
• The silica nano filler technology contributes to
higher bond strength performance.
• Since the nano particlesarestable, theydo not
cluster nordo they settle out of dispersion.Nano-
Interaction Zone" (NIZ - <300 nm) with minimal
decalcification and almost noexposure tocollagen
fibres producing an insoluble calcium compound
for a better bond less likely todeteriorate from
enzymes contained in the mouth.
45

46. • 10% 5 nm spherical silica is used as the
filler.
• Trade name: Adper O Single Bond
Plus Adhesive single NanOss™
(Angstrom Medica, USA) HA Bond.
46

47. Nanoadhesive –
Poss
• Polyhedral Oligomeric Silse Squiox (Poss) enables the
design of additives that make plastics that are unusually
lightweight, durable, heat-tolerant and environment
friendly.
• Poss combines organic & inorganic materials in molecules
with an average diameter of 1.5 nanometers. They can be
used as either additives or replacements for traditional
plastics.
Rybachuk AV,Cekman IS. Nanotechnology And Nanoparticles In Dentistry.
Pharmocol Pharm 2009;1:18-21 47

48. • Current applications of Poss include
dental adhesives in which a strength resin
provides a strong interface between the
teeth and the restorative material.
• In addition, tests have shown that Poss
materials are much more resistant to
radiation damage and erosion than
conventional polymers.
48

49. Advantages:
• Broad spectrum
• Hypoallergic
• Non corroding
• Does not stainfabric
• Require no protectiveclothing
• Environment friendly
• Compatible with various impression
materials.
49

50. Coating agents
• These light cured agents contain nanosized fillers
and are used as a final coating over composite
restorations, glass ionomer restorations, jacket
crowns, veneers and provisionals. These coating
agents havehigher wear resistance, preventing
abrasion and discolouration.
• Recently, a nanotechnology liquid polish system was
designed to overcome the limitations of liquid
polishers. The additionof nanofillers provides
excellent results such asa glossy surface fordirector
indirect resin composite restorations
Nanotechnology Liquid Polish. Oper Dent 2010;35:362-69. Back to cited
textno. 14 50

51. NANOTECHNOLOGY IN IMPLANTS
• Implants improved with nanotechnology to
create coatings -
•Promote healing
•Creates more stable
bond
51

52. • These nanofeatures can be arranged in an organized
manner (isotropic) or unorganized manner (anisotropic),
usually it is anisotropic.
• Nano-features that lead to novel physicochemical
behavior (e.g. bone bonding) or biochemical events (e.g.
altered protein adsorption, cell adhesion with changes in
cell behavior).
Mendonça G.et al. Advancing dental implant surface technology – From micron to
nanotopography.Biomaterials 2008;29(28):3822–35
52

53. First approach
• Physical method
• Compaction of
nanoparticles of
TiO2
Second
approach
• Molecular self-
assembly
• Exposed functional
end group could be
an osteoinductive
or cell adhesive
molecule
Third
Approach
• Chemical method
• Expose reactive
groups on the
material surface
and create
nanoscale
topography.
53

54. Fourth Approach
• Sol–gel transformation techniques
• deposition of nanoparticles onto the titanium
surface
• nanometer-scale calcium phosphate accretions to
the implant surface .
Fifth Approach
• optical methods (typically lithography)
• creating nanoscale topography on Titanium is the
use of optical methods (typically lithography)
• to achieve the appropriate nanoscale
modification.
54

55.  Alumina, titania, zirconia and other materials
can also be applied. The deposition of discrete 20–
40 nm nanoparticles on an acid-etched titanium
surface ledto increased mechanical interlocking with
bone and the early healing of bone at the endosseous
implantsurface in a ratmodel.
55

56. Depiction of broad range of nanoscale topography effects due
to nanoscale modification.
56

57. Successful
Osseointegration
Surface
contact
area
Surface
topography
Antibioticsor
growth
factors
Enhance the
integration of
Nano coatings
resembling
biological
materials to
thetissues
57

58. Bone replacement materials
• Bone is a natural nanocomposite made upof organic
compounds (mainly collagen) toughened with inorganic
compounds like hydroxyapatite. This architecture should
be simulated for orthopedic and dental use. Also, with the
reduction in particle size, the surface area increases
manifold. This rule has been utilized by Nano-Bone®.
• Nanophase HA and Nanophase carbon have shown
excellent osteoblastic adhesion and biomechanical
properties.
BONE GRAFT MATERIAL
58

59. Characteristics of nano bone
graft materialsare:
• Osteo inductive
• Non-sintered
• Extremely porous
• Nano-structured
• Bone targeting nanocarriers
59

60. Various HA nanoparticles used in repairingosseous defects-
• Ostim ® HA ( Osartis ,Germany)
• VITOSS ® HA+ TCP.(Orthovita, Inc, USA)
• NanOss HA(Angstorm Medica,USA)
60

61. Nanoneedles
 Nanosized stainless steel crystals incorporated into
commercially available needles have been developed
(Sandvik Bioline 1RK91™, Sandvik).
 Current research is being conducted for the
development of nanotweezers that would make cell
surgery possible in the near future.
Haver HM. Nanotechnology: the future of dentistry. J Nanosci
Nanotechnol. 2005;5(1):15-17
61

62. Safety Issues
 The increased rate of absorption associated with
manufactured nanoparticles is the main concern.
 Nanoparticles have an increased surface area:volume
ratio, which leads to increased absorption of these
particles through the skin, lungs, and digestive tract.
 Nonbiodegradable nanoparticles when accumulated
within the body may be deposited in various organs and
may lead to an unwanted reaction within biological
tissues.
 Nanoparticles caused only DNA damage highly toxic and
was categorized as a health risk.
62

63. 1. Precise positioning and assembly of molecular
scale part.
2. Economical nanorobot mass production
technique
3. Biocompatibility
4. Simultaneous coordination of activities oflarge
numbers of independent micron-scalerobots
5. Social issues of public acceptance,ethics,
regulation
Challenges faced by
nanodentistry
63

64. Problems for research in
nanotechnology
• Painfully slow strategicdecisions
• Sub-optimal funding
• Lack of engagement of privateindustries
• Problem of retention of trainedmanpower
64

65. CONCLUSION
A day may soon come when nanodentistry will succeed in
maintaining near-perfectoral health through the aid of
nanorobotics, nanomaterials and biotechnology.
Richard .P Feynman
65

66. The Next Big Thing Is Very Small…
66

67. Reference
s
• Saravana KR, Vijayalakshmi R. Nanotechnologyin
Dentistry. Indian J Dent Res2006;17(2):62-5.
• Nanotechnology in dentistry: Present and future
Journal of International Oral Health 2014; 6(1):121-
126
• Nanorobots: Future in dentistry The SaudiDental
Journal(2013) 25, 49–52
• International Journal of Biological & Medical
Research Nanotechnology in Dentistry - AReview
Int J Biol Med Res. 2012; 3(2): 1550-1553
• Future impact of nanotechnology on medicineand
dentistry Journal of Indian Society of
Periodontology - Vol 12, Issue 2, May-Aug 2008
67

68. • Current practicality of nanotechnology in
dentistry. Part 1: Focus on nanocomposite
restoratives and biomimetics Clinical,
Cosmetic and Investigational Dentistry 2009:1
47–61
• The changing face of dentistry:
nanotechnology International Journal of
Nanomedicine 2011:6 2799–2804
• ‘Nanodentistry’: Exploring the beauty of
miniatureJ Clin Exp Dent. 2012;4(2):e119-24
• Cover Story Robert A. Freitas Jr., J.D., B.S
JADA, Vol. 131, November 2000
68