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JOURNAL CLUB
PRESENTED BY
DR.VEENA VENUGOPAL
Nanotechnology in Periodontal
Management
ShivaManjunath,AnjuRana
JOURNALOFADVANCEDORALRESEARCH/JAN-APR2015/VOL6
No.1
History
 Nanotechnology is a technology on “nano” scale .
 Richard. P. Faynman a noble laureate gave the concept of nanotechnology.
 The ter m Nano tec hnology was coined by Prof. Keric E Dre xler who is know n to be the Fa ther of
nanotechnology
 R.A. Frietas Jr., in the year 2000 , coined the term ―Nanodentistry.
 He developed visions using na norobots for orthodo ntics, dentin rege neratio n, na no materials and
robots in dentifrices – dentifrobots
 Nanotechnology when incorporated into biology is referred as
“nanobiotechnology” or “nanomedicine.”
 Similar to Drexler’s concept of developing machines, the aim of
nanobiotechnology is to develop artificial devices (and organs) that could
interact with and analyze the cell’s contents.
Definition
 Nano came from a Greek word which means dwarf.
 “The creation and utilization of materials, devices, and systems through the control of matter on the
nanometer scale (1-100nm), i.e.at the level of atoms, molecules, and supramolecular structures.”
 Nanotechnology when incorporated into biology is referred as “nanobiotechnology” or “nanomedicine.”
PROPERTIES OF NANOMATERIALS
1.Nanomaterials contain constituents <100nm in minimum one dimension.
2.They have significant surface effects, size effects, quantum effects and show better
performance properties than traditional materials.
3.They have special chemical, optical, magnetic, and electro-optical properties.
4.Important property of self-assembly by which they autonomously organize themselves into
patterns or structures without any others intervention.
Main properties in nanotechnology
Increase in Surface Area
Nanoparticles have a greater surface area per unit mass than compared with
larger particles.
Quantum Effect
 According to the laws of quantum mechanics, free carriers in a metal are
semiconductor can only take on specific values of energy as defined by the
crystal structure; that is, the energy is quantized. Nanoparticles have this
peculiar properties of quantum effects.
Self Assembly
 Self- assembly has been classified into static and dynamic processes. In static self- assembly,
formation of ordered structure requires energy but it is stable once it is formed.
 When choosing a material for self -assembly, the materials should have a critical number of
charged groups, below which the assembling procedure does not work at all.
 To form a well- defined stable multilayer, the appropriate opposite charge density is
required for the matched materials. It has cationic and anionic polyelectrolytes.
 The cationic polyelectrolytes include poly( ethyleneimine), poly( allylamine), poly( dially-
ldimethylammonium chloride), poly( allylamine hydrochloride), and diazo- resin and the
anionic polyelectrolytes are poly( styrene sulfonate), poly( vinylsulfate) and poly( acrylic
acid).
Classification
The various nanoparticles are as follows
1.Nanopores
2.Nanotubes
3.Quantum dots
4. Nanoshells
5.Dendrimers
6.Liposomes
7.Fullerenes
8.Nanospheres
9.Nanowires
10.Nanobelts
11.Nanorings
12.Nanocapsules
Various types of nanoparticles being used for biomedical applications. Some of which are
metallic, semiconductor and organic molecule nanomaterials with varieties of shapes, sizes, and
structures
Nanomedicine
 Nanomedicine is defined as the science and technology of diagnosing,
disease, relieving pain and stabilizing, and
treating and preventing
improv ing human
biotechnology, and engineering, and finally complex
health, using nanoscale structured material,
genetic machine
structures, and nanorobots.
Synthesis of Nanomaterials
Synthesis of Nanomaterials
 In the ‘bottom up’ approach materials and components
are built from molecular components which assemble
themselves chemically by principles of molecular
recognition.
 In the ‘top down’ approach, nano objects are constructed
from larger entities without atomic level control
 In green synthesis, the herboceutical products are used to synthesize
nanoparticles, these nanoparticles are ecofriendly moreover the green
synthesised nanoparticles are shown to exhibit enhanced properties.
 Biomimetic approach is the one in which microorganisms including
fungus, bacteria or virus are used to manufacture nanoparticles;
 this method is in its initial stage and further research is needed to show its
effectiveness
Application of nanotechnology in medicine
Nanodiagnostics
 Nanodiagnostic devices are used for early disease identification at the cellular and
molecular levels.
 Nanomedicine can increase the efficacy and reliability of in vitro diagnostics, by
using selective nanodevices in collecting human fluids and tissue samples and by
making multiple analyses at the subcellular level .
 In vivo perspective, nanodevices may be introduced into the body to identify the
early existence of a disease, or to identify and quantify toxic molecules, tumor
cells, and so forth
Nano Electro Mechanical Systems (NEMS)
 Nanotechnology based NEMS biosensors that exhibit exquisite sensitivity
and specificity for detection, down to single molecular level.
 They convert biochemical to electrical signal.
Oral Fluid Nanosensor test (OFNASET)
 OFNASET technology is used for multiplex detection of salivary
biomarkers for oral cancer.
 It has been demonstrated that the combination of two salivary proteomic
biomarkers (thioredoxin and IL-8) and four salivary mRNA biomarkers
(SAT, ODZ, IL-8, and IL-1b) can detect oral cancer with high specificity
and sensitivity
Optical Nanobiosensor
 The nano biosensor is a unique fiber-optics-based tool.
 It allows the minimally invasive analysis of intracellular components such as
cytochrome c.
 These are very important protein to the process which produces cellular
energy and is well-known as the protein involved in apoptosis, or
programmed cell death
Quantum Dots
 QDs are tiny semiconductor nanocrystals that are stable, non -toxic that glow very
brightly when illuminated by ultraviolet light.
 They can be coated with a material that makes the dots attach specifically to the
molecules to be tracked.
 Quantum dots bind themselves to proteins unique to cancer cells, literally bringing
tumours to light.
 QDs can attach an antibody to the target cell upon stimulation by UV light, and
consequently yield a reactive oxygen species that is capable of destroying the target
cells (Bhardwaj et al., 2014).
 Lead-free and cadmium- free QDs are employed in periodontal therapy to enhance
the healing of inflamed periodontal tissues (Harini and Kaarthikeyan, 2014).
Gold nanoparticles
 Gold nanoparticles are among the novel diagnostic tools for healthcare
investigations. They are developed from thin gold layers or tiny gold spheres
and possess good detection sensitivity for various targets (West and Halas,
2003).
 Gold nanoparticles that are coated with silver shells possess strong light -
scattering properties with improved detection capacity (Cao et al., 2002; West
and Halas, 2003).
 These essential diagnostic materials can allow rapid, direct and economically
feasible analysis of samples from whole blood. They have several physical
properties that make them suitable for medical applications.
 The applications of gold nanoparticles stretch from diagnosis to drug delivery
for therapy of diseases (Mieszawska et al., 2013).
Nanotubes
 Nanotubes such as boron nitride or carbon rods are very small and are used as
electrodes with single- stranded DNA probes for detection sensitivity in the
attomole range, and in hybridization of the target DNA or protein.
 These are employed for detecting and locating altered disease -causing genes
 They can also be adapted for analytes other than DNA, e.g., by attaching
enzyme to detect substrate analyte (Azzazy et al., 2006; Fortina et al., 2005).
 Nanotubes offer interesting advantages that are relative to or better than
spherical nanoparticles in some biotechnological and diagnostic applications
(Kong et al ., 2006).
Nanopores
 These are tiny (molecular- scale) structures that have great sensitivity and
detection capability of the conformation and location of a single molecule that is
situated in the pore lumen (Bayley and Jayasinghe, 2004; Wang et al., 2011).
 The nanoholes of nanopores can permit passage of DNA and can also make DNA
sequencing even more efficient.
 The characteristic change in the nanopores conductance enables researchers to be
able to electrically elucidate single- molecule kinetic pathways as well as
quantify the target easily (Wang et al., 2011).
 Significant progress has been made in material science and nanotechnology
towards designing intelligently gated nanoporous devices (Harini and
Kaarthikeyan, 2014).
Nanobelts
Are similar to nanotubes in their application except that they are cost
effective and technique insensitive compared to nanotubes.
In prevention
Dentifrices
 Certain agents in nanoscale can be incorporated in these conventional
dentifrices to aid in repelling the deposition of bacterial biofilms (plaque and
tar) and/or prevent dental caries by remineralization of early carious lesions,
and in desensitization of abraded teeth (Hannig and Hannig, 2010).
 The process of re- deposition of minerals that are lost by tooth enamel is
called enamel remineralization (Cury and Tenuta, 2009).
 Some ceramics like calcium phosphates and nanosized calcium carbonate
particles (also called hydroxyapatite) has been reported to be a suitable
ingredient for dentifrices that can be effectively used in the process of enamel
remineralization.
 Among these ceramics, hydroxyapatite gain more attention being the
prototype in bone as well as tooth apatite crystals, and also one of the
main constituents of natural bone.
 Therefore, its applications as bone implant are being extensively
investigated in a different variety of forms (Vandiver et al., 2005).
Mouthwashes
 Mouthwashes containing silver nanoparticles and triclosan-loaded
nanoparticles have exhibited plaque control actions which are vital for the
prevention of periodontal disease.
 Silver nanoparticles demonstrated strong antibacterial effects in dental
products, because of the antibacterial properties of silver (Allaker, 2010;
Besinis et al.,2014).
 Studies showed that nanoparticles of silver imparted high antibacterial activity
on dental resins, which significantly reduces building-up of biofilm as well as
lactic acid production by the oral bacteria without interfering with the resins’
mechanical and physical properties (Cheng et al., 2015).
Silver Nanoparticle Mouthwashes
 At macroscopic level, silver nanoparticles are known to destabilize the
bacterial cell membrane and increase it‘s permeability leading to leakage
of cell and cell death.
 Studies have assessed that it’s antimicrobial activity is the main
characteristic for it’s selection to be used as an irrigant.
 The main disadvantages of using silver nanoparticles are the potential
browning/ blackening of dentin
Nanocomposite coating materials
 anti -adhesive effect of low surface free energy nanocomposite coating materials
against bacterial biofilm accumulation around the tooth surface, in order to prevent
pathogenic consequences of intra - pocket biofilm build -up and also to hinder
bacterial attachment on the tooth
(Hannig et al., 2007).
 They applied an inorganic nanocomposite coating (with a surface free energy of 18 -
20 mJ/m 2) to enamel and titanium specimens. The specimens were analyzed by
transmission electron microscopy after intraoral exposure.
 The results showed that specimens that were coated with the nanocomposite
significantly reduced biofilm formation and accumulation.
Casein phosphopeptide
 Other preventive nanotechnology-based approach for periodontal disease
is fabrication of products for oral health care that are integrated with
bioinspired apatite nanoparticles alone or together with proteinaceous
substances (like casein phosphopeptides) (Rahiotis et al., 2008).
 Casein phosphopeptide demonstrated an important role in biomimetic
strategies for overall bacterial biofilm management.
Antibacterial Agents
 Nanoparticle derived antimicrobial agents are seen to have superior effect
due to their large surface area.
 Various agents that can exhibit antimicrobial effects includes silica, silver,
copper and zirconia.
 Commercially available nanotechnology-based disinfectant, Eco-True
containing silver salts are employed for disinfecting instruments and
surgical areas
In treatment
Nanoneedles and nanoanaesthesia
 It is a bottom- up approach, Nanotechnology uses millions of active analgesic nanometer s i zed
dental nanorobots in a colloidal suspension for local anesthesia.
 The gingiva of the patient is instilled with a colloidal suspension containing active micron- sized
dental robots that respond according to the dentist.
 Nanorobots then can reach the pulp via the gingival sulcus, lamina propria or dentinal tubules.
 On reaching dentin, nanorobots enter the dental tublar holes that are 1 - 4 μm in diameter and
advances toward the pulp, guided by various chemical gradients that are all under the control of
nanocomputer which is directed by a dentist. Nanorobots can complete its journey into the pulp
chamber in approximately 100 s.
 the analgesic dental nanorobots may be comma nded by the dentist to s hut dow n al l sensitivity in any particular tooth that
requires treatment.
 When on the hand- held co ntroller display, the selected tooth immediately becomes numb.
 After the oral procedures completed, the dentist orders the nanorobots to restore all sensation, to relinquish control of nerve
traffic and to egress, followed by aspiration.
 Nanorobotic analgesics offer greater patient comfort and reduced anxiety, no needles, greater selectivity, and controllability
of the analgesic effect, fast and completely reversible switchable action and avoidance of most side effects and
complications .
Nanoneedles
 nanosized stainless steel needles, which will make cell surgery
possible in the near future.
 Nanoneedles can be used to deliver molecules, -nucleic acids, proteins, or
other chemicals to the nucleus, or may even be used to carry out cell surgery.
 Using the nanoneedle approach, we can get to a very specific location within
the nucleus; this is the key advantage of this method.
Nanotweezers
 The Danish research group (Nanohand) has developed nano tweezers,
which can be used for both imaging and manipulation of nanosized objects
to make cell surgery feasible in the near future.
 These nanotweezer probes consist of two wires tapered consecutively
through a nanopipette and kept electrically isolated.
Use in orthodontics
 Orthodontic robot allows painless tooth uprighting, rotating, and vertical
repositioning, along with rapid tissue repair.
 New stainless-steel wire that uses nanotechnology is being studied these
days that combines ultra-high-strength with good deformability strength,
corrosion resistance, and surface finish.
Nanofillers
 Nanofillers are gaining considerable attention as vital dental nanomaterials for
incorporation into commercial composite materials for different dental
applications.
 The dimensions of nanofiller particles are less than that of visible light.
 Therefore, neither can they be absorbed no do they scatter visible light, and
this feature plays an important role for their aesthetic features and hence, they
can be employed for anterior teeth restorations (Khurshid et al., 2015).
Application in periodontics
 The application of nanotechnology in the periodontal management was
put forward by Kong et al . the concept given by their researches
formulated many concepts regarding tissue engineering in periodontal
regeneration.
Nanorobotic Dentrifices (Dentifrobots)
 It is a bottom -up approach.
 Dentifrobots in the form of mouthwash or toothpaste can clean organic
residues by moving throughout the supragingival and subgingival surfaces,
metabolizing trapped organic matter into harmless and odourless vapors
 It would also identify food particles, tartar and plaque and lift them from the
teeth, aiding in continuous debridement of supra and subgingival calculus.
 These nanorobots are of diameter:0. 5-2microns and can move as fast as 1-10
μ/s and are safely self -deactivated when they are swallowed.
 Properly configured dentifrobots could identify and destroy pathogenic
bacteria residing in the plaque and elsewhere, while allowing 500
species of harmless oral microflora to flourish in a healthy ecosystem.
 Dentifrobots awould provide continuous barriers to halitosis, since
bacterial putrification is the central metabolic process involved in oral
malodour.
 With this kind of daily dental care available from an early age,
conventional tooth decay and gingival diseases will disappear
 The exterior of a nanorobot will likely be constructed of carbon atoms
because of its inert properties and strength.
 Supersmooth surfaces will lessen the likelihood of t riggering the body’s
immune system ,allowing the nanorobots to go about their business
unimpeded.
MECHANISM OF ACTION OF NANOROBOTS
 The powering of nanorobots can be done by metabolizing local glucose and oxy gen
for energy and externally supplied acoustic energy.
 Other sources of energy within the body can also be used to supply the necessary
energy for the device
 Communication is an important fundamental capability of nanorobots. They must
task
other
be able to communicate with each other in order to monitor collective
progress and pass alon g relevant sensory, messagin g, navigational and
operational data.
 Nanorobots function will be controlled by simple onboard computers
capable of performing about 1000 or fewer computations per second.
 Communication with the device can be achieved by broadcast -type
acoustic signaling.
 Navigational network may be installed in the body providing accuracy to
all passing nanorobots that interrogate them, wanting to know their
location.
 This will help to keep track of various devices in the body.
HOW SAFE ARE THESE NANOROBOTS?
 The non pyrogenic nanorobots used in vivo are bulk Teflon, carbon
powder and monocrystal sapphire.
 Pyrogenic nanorobots are alumina,silica,copper,zinc.
 Nanorobots may release inhibitors,antagonists or down regulators for the
pyrogenic pathway in a targeted fashion to selectively absorb the
endogenous pyrogens,chemically modify them and then release them back
into the body in a harmless inactivated form.
ADVANTAGES OF NANOROBOTS
 Build up artificial immunity
 Treat and fight disease and restore lost tissue at the cellular level.
 No harm with their use
 Bloodless surgery
DISADVANTAGES OF NANOROBOTS
 Design Cost is high
 Installation cost is high
 Maintenance is difficult
 Social challenges of ethics, public acceptance, regulation and human safety.
 Precise positioning and assembly of molecular scale parts.
 Biocompatibility.
Treatment of dentinal hypersensitivity
 Changes in pressure transmitted to the pulp hydrodynamically are the main
cause of dentinal hypersensitivity.
 The dentinal tubules of a hypertensive tooth have twice the dia meter and
eight times the surface density of those in non-sensitive teeth .
 Nanorobots selectively and accurately block these dentinal tubules using
native materials, thus offering quick and permanent relief to the patient.
Nanomaterials for periodontal drug delivery
 Nanomaterials are of interest from a fundamental point of view
because the properties of a material (e.g. physical properties,
electronic properties, optical properties) change when the size of the
particles that make up the material becomes nanoscopic.
 Nanotechnological drug delivery approaches are highly promising in
achieving these goals.
 nanoparticles or scaffolds, to allow targeted, sustained and controlled
release to the intended location (Abou Neel et al., 2015).
 Better penetration of the active moiety into junctional epithelium (site of
action) combined with optimal drug release profiles are among the
important benefits of this approach.
Nanofibers
surface area
permit an
per unit mass, when
easier addition of
compared
surface
 Nanofibers havin g a larger
with polymer microfibers,
functionalities.
 Thus, these can be efficiently applied in dru g delivery systems and tissue
engineering scaffolds in dentistry. E.g., Arestin.
 A nanostructured 8.5% doxycycline gel was observed to afford periodontal
surface preservation following experimental periodontal disease in rats.
Nanomaterials For Periodontal Drug Delivery
 Widely used nanomaterials for controlled drug release are core -shell
spheres, hollow spheres, nanotubes and nanocomposite.
 Drugs can be incorporated into nanospheres composed of a biodegradable
polymer, and this allows for timed release of the drug as the nanospheres
degrade facilitating site-specific drug delivery.
 Recently, Pinon- Segundo et al produced and characterized triclosan- loaded
nanoparticles by the emulsification –diffusion process, in an attempt to obtain
a novel delivery system adequate for the treatment of periodontal disease
 Nanoparticles were prepared using poly (D, L-lactide- coglycolide), poly
(D,L-lactide) and cellulose acetate phthalate. poly (vinyl alcohol) was used as
stabilizer.
 These triclosan nanoparticles behave as a homogeneous polymer matrix -type
delivery system, with the drug (triclosan) molecularly dispersed.
 Tetracycline incorporated into microspheres is available as Arestin for drug
delivery by local means into periodontal pocket
Subgingival Irrigation
 Hayakumo et al has described the use of ozone nanobubble water produced
by nanobubble technology in subgingival irrigation.
 The results of their study demonstrated that it can be used as an adjunct to
periodontal therapy because of their enhanced antibacterial activity
Nanoantibiotics
 Delivered through nanocarriers with specialized antibiotic coating on
their surface.
 They manifest broad spectrum of activity and decrease the probability of
secondary infections.
 Gold nanoparticles are described to have increased adhesiveness to
antibiotics.
 Besides nanoscale particles and antibiotics demonstrate positive
interactions.
Guided tissue regeneration
 The concept of guided tissue regeneration (GTR) is being researched to
replace earlier functional graded membranes with novel 3-layered membranes.
 The former system included bilayered GTR membranes with a porous surface
on one side ( for cellular ingrowth), and a smooth surface on the opposite side
(for cellular occlusion).
 A novel system has come up with a 3 - layered GTR membrane composed of an
inner- most layer made of 8% nanocarbonated
hydroxyapatite/collagen/polylactic- co- glycolic acid ( n CHAC/PLGA) porous
membrane, a middle layer of 4% n CHAC/ PLGA, and an outer layer of PLGA
non- porous membrane.
Nanotechnology in dental implants
 Top-Down approach.
 Nanotechnology can be used in the surface modifications of dental
implants since surfaces properties such as roughness and chemistry play a
determinant role in achieving and maintaining their long-term stability in
bone tissue.
 The coating of nano particles over the dental implants, improves the
adhesion and integration of surrounding tissues.
 Biologically active drugs such as antibiotics or growth factors can be
incorporated in the implants. eg: Nanotite™ Nano-Coated Implant.
Nanotopography
 Nanotopography improves biointegration of Titanium Implants when
exposed to an in vivo microenvironment, a titanium surface spontaneously
forms an evasive Titanium oxide layer that is highly bioinert and provides
excellent corrosion resistance.
 This implants have better bio-compatibility, more strength. These nano
particles also help in the expression of genes responsible for
osseointegration
Periimplantitis
 Clot stability can be increased by using nanohydroxyapatite on citric acid
conditioned surface.
 Elangovan et al in their study demonstrated enhanced fibroblast
proliferation with the use of platelet derived growth factor -BB delivered
using calcium phosphate nanoparticle.
Nanoparticles As A Bone Graft Material
 It is a Top-Down approach.
 Nanotechnology can also be used to t reat bone defects with nano -bone graft
materials. Nano bone graft should possess the qualities of bone grafts being
used today.
 Their higher surface area to mass ratio can be used in most advantageous
manner for treating infrabony defects.
Bone grafting
 Bone grafting is faced with limitations such as a limited supply of grafting
materials, variable resorption, high failure rates and persistent pains
(Walmsley et al., 2015).
 These limitations have evoked massive research for solutions to these
limitations.
 3D scaffold matrices and nano-engineered particles that promote the
growth of new bone have been the main areas of focus (Lorden et al.,
2015; Walmsley et al., 2015), and scaffold have been successfully used in
various fields of tissue engineering such as periodontal regeneration and
bone formation (Garg et al., 2012).
 Nanotechnology targets to imitate this natural structure for development
of nanobone, which can be used in dental applications.
 The first step, fabrication of strong and porous scaffolds, holds prime
importance in the whole process.
 Different techniques successfully seed scaffolds along with cells-either
attaching the cells to the internal scaffold surface or distributing them in
the scaffold porosity with the help of a gel-like vehicle.
Nano-hydroxyapatite (n-HAP) bone grafts
 Various alloplastic bone grafts with nanoscale particle sizes are being
developed and tested.
 One of the recent and most promising among them are nano -hydroxyapatite
(n- HAP) bone grafts, which is available in crystalline, chitosan - associated
and titanium- reinforced forms (Kailasanathan et al., 2012).
 When compared with the ‘plain’ chitosan scaffolds, ‘n -HAP’ composite bone
graft scaffolds demonstrated greater biocompatibility, superior mechanical
properties and also appeared to induce better cellular responses (Chesnutt et
al., 2009).
Laser and nanoparticles
 Laser irradiation on nanotitanium particles coated surface are shown to
increase collagen production.
 Using this principle, gingival depigmentation and other periodontal
procedures can be carried out.
 Sadony and Abozaid showed that nanoparticles along with diode laser
has the potential to decontaminate dentin surface.
Laser Plasma Application
 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
like:
 Shock waves
 Microabrasion of hard tissues
 Stimulus to produce collagen.
 Clinical applications of this laser plasma application are melanin
removal and soft tissue incision (without anesthesia).
Nanoencapsulation
 Targeted release systems that incorporate nanocapsules are still under
trial for inclusion into vaccines and antibiotics used by the patients.
NANOMATERIALS FOR PERIODONTAL
TISSUE ENGINEERING
 Currently tissue engineering concepts for periodontal regeneration are
focused on the utilization of synthetic scaffolds for cell delivery purposes.
 It is possible to create polymer scaffolds in the future for cell seeding,
growth factor delivery and tissue engineering via nanodevices implanted to
sites of tissue damage
 Replacement of the whole tooth is achieved through the combined utilization
of approaches like nanotechnology, genetic engineering, and tissue
engineering.
Toxicity of Nanoscale Particles
 Increased surface area although seems to be beneficial they can cause
increased toxicity by enhancing the duration of action, aquaphobic drug
solubility and also their ability to cross blood brain barrier.
 Because of their small size, host immune system reaction to the
nanoparticle cannot be detected.
 Other drawbacks include difficulty in concomitant bulk synthesis,
haemolytic activity towards host cell, cost ineffective, social and ethical
challenges.
Future of Nanoperiodontics
 Method for synthesizing high calibrated nanoparticles in bulk will be
developed in near future.
 Most of the nanoparticles based studies in Periodontics are in -vitro, the
productive outcome of in-vivo studies is to be demonstrated.
 Numerous untreatable diseases may be treated using nanotechnology.
Conclusion
 Nanotechnology is a promising technology that is playing an increasingly
important role in the diagnostics, prognostics, prediction, and management of
various treatments.
 Although the achievement of goal of complete and proper regeneration of the
periodontal tissues which includes the cementum, periodontal ligament and bone
for various periodontal management may not be feasible for many years,
 Recent developments and achievements in nanomaterials and nanotechnology have
provided a promising hand into the commercial applications of nanomaterials in
the diagnosis and management of periodontal diseases.
 It is envisaged that this trend will be further improved in the future as more and
more nanotechnologies are commercially explored
THANK YOU

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nano.pptx

  • 3. History  Nanotechnology is a technology on “nano” scale .  Richard. P. Faynman a noble laureate gave the concept of nanotechnology.  The ter m Nano tec hnology was coined by Prof. Keric E Dre xler who is know n to be the Fa ther of nanotechnology  R.A. Frietas Jr., in the year 2000 , coined the term ―Nanodentistry.  He developed visions using na norobots for orthodo ntics, dentin rege neratio n, na no materials and robots in dentifrices – dentifrobots
  • 4.  Nanotechnology when incorporated into biology is referred as “nanobiotechnology” or “nanomedicine.”  Similar to Drexler’s concept of developing machines, the aim of nanobiotechnology is to develop artificial devices (and organs) that could interact with and analyze the cell’s contents.
  • 5. Definition  Nano came from a Greek word which means dwarf.  “The creation and utilization of materials, devices, and systems through the control of matter on the nanometer scale (1-100nm), i.e.at the level of atoms, molecules, and supramolecular structures.”  Nanotechnology when incorporated into biology is referred as “nanobiotechnology” or “nanomedicine.”
  • 6. PROPERTIES OF NANOMATERIALS 1.Nanomaterials contain constituents <100nm in minimum one dimension. 2.They have significant surface effects, size effects, quantum effects and show better performance properties than traditional materials. 3.They have special chemical, optical, magnetic, and electro-optical properties. 4.Important property of self-assembly by which they autonomously organize themselves into patterns or structures without any others intervention.
  • 7. Main properties in nanotechnology Increase in Surface Area Nanoparticles have a greater surface area per unit mass than compared with larger particles.
  • 8. Quantum Effect  According to the laws of quantum mechanics, free carriers in a metal are semiconductor can only take on specific values of energy as defined by the crystal structure; that is, the energy is quantized. Nanoparticles have this peculiar properties of quantum effects.
  • 9. Self Assembly  Self- assembly has been classified into static and dynamic processes. In static self- assembly, formation of ordered structure requires energy but it is stable once it is formed.  When choosing a material for self -assembly, the materials should have a critical number of charged groups, below which the assembling procedure does not work at all.  To form a well- defined stable multilayer, the appropriate opposite charge density is required for the matched materials. It has cationic and anionic polyelectrolytes.  The cationic polyelectrolytes include poly( ethyleneimine), poly( allylamine), poly( dially- ldimethylammonium chloride), poly( allylamine hydrochloride), and diazo- resin and the anionic polyelectrolytes are poly( styrene sulfonate), poly( vinylsulfate) and poly( acrylic acid).
  • 10.
  • 12. The various nanoparticles are as follows 1.Nanopores 2.Nanotubes 3.Quantum dots 4. Nanoshells 5.Dendrimers 6.Liposomes 7.Fullerenes 8.Nanospheres 9.Nanowires 10.Nanobelts 11.Nanorings 12.Nanocapsules
  • 13. Various types of nanoparticles being used for biomedical applications. Some of which are metallic, semiconductor and organic molecule nanomaterials with varieties of shapes, sizes, and structures
  • 14. Nanomedicine  Nanomedicine is defined as the science and technology of diagnosing, disease, relieving pain and stabilizing, and treating and preventing improv ing human biotechnology, and engineering, and finally complex health, using nanoscale structured material, genetic machine structures, and nanorobots.
  • 16. Synthesis of Nanomaterials  In the ‘bottom up’ approach materials and components are built from molecular components which assemble themselves chemically by principles of molecular recognition.  In the ‘top down’ approach, nano objects are constructed from larger entities without atomic level control
  • 17.  In green synthesis, the herboceutical products are used to synthesize nanoparticles, these nanoparticles are ecofriendly moreover the green synthesised nanoparticles are shown to exhibit enhanced properties.  Biomimetic approach is the one in which microorganisms including fungus, bacteria or virus are used to manufacture nanoparticles;  this method is in its initial stage and further research is needed to show its effectiveness
  • 18.
  • 20. Nanodiagnostics  Nanodiagnostic devices are used for early disease identification at the cellular and molecular levels.  Nanomedicine can increase the efficacy and reliability of in vitro diagnostics, by using selective nanodevices in collecting human fluids and tissue samples and by making multiple analyses at the subcellular level .  In vivo perspective, nanodevices may be introduced into the body to identify the early existence of a disease, or to identify and quantify toxic molecules, tumor cells, and so forth
  • 21. Nano Electro Mechanical Systems (NEMS)  Nanotechnology based NEMS biosensors that exhibit exquisite sensitivity and specificity for detection, down to single molecular level.  They convert biochemical to electrical signal.
  • 22. Oral Fluid Nanosensor test (OFNASET)  OFNASET technology is used for multiplex detection of salivary biomarkers for oral cancer.  It has been demonstrated that the combination of two salivary proteomic biomarkers (thioredoxin and IL-8) and four salivary mRNA biomarkers (SAT, ODZ, IL-8, and IL-1b) can detect oral cancer with high specificity and sensitivity
  • 23. Optical Nanobiosensor  The nano biosensor is a unique fiber-optics-based tool.  It allows the minimally invasive analysis of intracellular components such as cytochrome c.  These are very important protein to the process which produces cellular energy and is well-known as the protein involved in apoptosis, or programmed cell death
  • 24.
  • 25. Quantum Dots  QDs are tiny semiconductor nanocrystals that are stable, non -toxic that glow very brightly when illuminated by ultraviolet light.  They can be coated with a material that makes the dots attach specifically to the molecules to be tracked.  Quantum dots bind themselves to proteins unique to cancer cells, literally bringing tumours to light.  QDs can attach an antibody to the target cell upon stimulation by UV light, and consequently yield a reactive oxygen species that is capable of destroying the target cells (Bhardwaj et al., 2014).  Lead-free and cadmium- free QDs are employed in periodontal therapy to enhance the healing of inflamed periodontal tissues (Harini and Kaarthikeyan, 2014).
  • 26. Gold nanoparticles  Gold nanoparticles are among the novel diagnostic tools for healthcare investigations. They are developed from thin gold layers or tiny gold spheres and possess good detection sensitivity for various targets (West and Halas, 2003).  Gold nanoparticles that are coated with silver shells possess strong light - scattering properties with improved detection capacity (Cao et al., 2002; West and Halas, 2003).  These essential diagnostic materials can allow rapid, direct and economically feasible analysis of samples from whole blood. They have several physical properties that make them suitable for medical applications.  The applications of gold nanoparticles stretch from diagnosis to drug delivery for therapy of diseases (Mieszawska et al., 2013).
  • 27.
  • 28. Nanotubes  Nanotubes such as boron nitride or carbon rods are very small and are used as electrodes with single- stranded DNA probes for detection sensitivity in the attomole range, and in hybridization of the target DNA or protein.  These are employed for detecting and locating altered disease -causing genes  They can also be adapted for analytes other than DNA, e.g., by attaching enzyme to detect substrate analyte (Azzazy et al., 2006; Fortina et al., 2005).  Nanotubes offer interesting advantages that are relative to or better than spherical nanoparticles in some biotechnological and diagnostic applications (Kong et al ., 2006).
  • 29. Nanopores  These are tiny (molecular- scale) structures that have great sensitivity and detection capability of the conformation and location of a single molecule that is situated in the pore lumen (Bayley and Jayasinghe, 2004; Wang et al., 2011).  The nanoholes of nanopores can permit passage of DNA and can also make DNA sequencing even more efficient.  The characteristic change in the nanopores conductance enables researchers to be able to electrically elucidate single- molecule kinetic pathways as well as quantify the target easily (Wang et al., 2011).  Significant progress has been made in material science and nanotechnology towards designing intelligently gated nanoporous devices (Harini and Kaarthikeyan, 2014).
  • 30. Nanobelts Are similar to nanotubes in their application except that they are cost effective and technique insensitive compared to nanotubes.
  • 32. Dentifrices  Certain agents in nanoscale can be incorporated in these conventional dentifrices to aid in repelling the deposition of bacterial biofilms (plaque and tar) and/or prevent dental caries by remineralization of early carious lesions, and in desensitization of abraded teeth (Hannig and Hannig, 2010).  The process of re- deposition of minerals that are lost by tooth enamel is called enamel remineralization (Cury and Tenuta, 2009).  Some ceramics like calcium phosphates and nanosized calcium carbonate particles (also called hydroxyapatite) has been reported to be a suitable ingredient for dentifrices that can be effectively used in the process of enamel remineralization.
  • 33.  Among these ceramics, hydroxyapatite gain more attention being the prototype in bone as well as tooth apatite crystals, and also one of the main constituents of natural bone.  Therefore, its applications as bone implant are being extensively investigated in a different variety of forms (Vandiver et al., 2005).
  • 34. Mouthwashes  Mouthwashes containing silver nanoparticles and triclosan-loaded nanoparticles have exhibited plaque control actions which are vital for the prevention of periodontal disease.  Silver nanoparticles demonstrated strong antibacterial effects in dental products, because of the antibacterial properties of silver (Allaker, 2010; Besinis et al.,2014).  Studies showed that nanoparticles of silver imparted high antibacterial activity on dental resins, which significantly reduces building-up of biofilm as well as lactic acid production by the oral bacteria without interfering with the resins’ mechanical and physical properties (Cheng et al., 2015).
  • 35. Silver Nanoparticle Mouthwashes  At macroscopic level, silver nanoparticles are known to destabilize the bacterial cell membrane and increase it‘s permeability leading to leakage of cell and cell death.  Studies have assessed that it’s antimicrobial activity is the main characteristic for it’s selection to be used as an irrigant.  The main disadvantages of using silver nanoparticles are the potential browning/ blackening of dentin
  • 36. Nanocomposite coating materials  anti -adhesive effect of low surface free energy nanocomposite coating materials against bacterial biofilm accumulation around the tooth surface, in order to prevent pathogenic consequences of intra - pocket biofilm build -up and also to hinder bacterial attachment on the tooth (Hannig et al., 2007).  They applied an inorganic nanocomposite coating (with a surface free energy of 18 - 20 mJ/m 2) to enamel and titanium specimens. The specimens were analyzed by transmission electron microscopy after intraoral exposure.  The results showed that specimens that were coated with the nanocomposite significantly reduced biofilm formation and accumulation.
  • 37. Casein phosphopeptide  Other preventive nanotechnology-based approach for periodontal disease is fabrication of products for oral health care that are integrated with bioinspired apatite nanoparticles alone or together with proteinaceous substances (like casein phosphopeptides) (Rahiotis et al., 2008).  Casein phosphopeptide demonstrated an important role in biomimetic strategies for overall bacterial biofilm management.
  • 38. Antibacterial Agents  Nanoparticle derived antimicrobial agents are seen to have superior effect due to their large surface area.  Various agents that can exhibit antimicrobial effects includes silica, silver, copper and zirconia.  Commercially available nanotechnology-based disinfectant, Eco-True containing silver salts are employed for disinfecting instruments and surgical areas
  • 40. Nanoneedles and nanoanaesthesia  It is a bottom- up approach, Nanotechnology uses millions of active analgesic nanometer s i zed dental nanorobots in a colloidal suspension for local anesthesia.  The gingiva of the patient is instilled with a colloidal suspension containing active micron- sized dental robots that respond according to the dentist.  Nanorobots then can reach the pulp via the gingival sulcus, lamina propria or dentinal tubules.  On reaching dentin, nanorobots enter the dental tublar holes that are 1 - 4 μm in diameter and advances toward the pulp, guided by various chemical gradients that are all under the control of nanocomputer which is directed by a dentist. Nanorobots can complete its journey into the pulp chamber in approximately 100 s.
  • 41.  the analgesic dental nanorobots may be comma nded by the dentist to s hut dow n al l sensitivity in any particular tooth that requires treatment.  When on the hand- held co ntroller display, the selected tooth immediately becomes numb.  After the oral procedures completed, the dentist orders the nanorobots to restore all sensation, to relinquish control of nerve traffic and to egress, followed by aspiration.  Nanorobotic analgesics offer greater patient comfort and reduced anxiety, no needles, greater selectivity, and controllability of the analgesic effect, fast and completely reversible switchable action and avoidance of most side effects and complications .
  • 42. Nanoneedles  nanosized stainless steel needles, which will make cell surgery possible in the near future.  Nanoneedles can be used to deliver molecules, -nucleic acids, proteins, or other chemicals to the nucleus, or may even be used to carry out cell surgery.  Using the nanoneedle approach, we can get to a very specific location within the nucleus; this is the key advantage of this method.
  • 43. Nanotweezers  The Danish research group (Nanohand) has developed nano tweezers, which can be used for both imaging and manipulation of nanosized objects to make cell surgery feasible in the near future.  These nanotweezer probes consist of two wires tapered consecutively through a nanopipette and kept electrically isolated.
  • 44. Use in orthodontics  Orthodontic robot allows painless tooth uprighting, rotating, and vertical repositioning, along with rapid tissue repair.  New stainless-steel wire that uses nanotechnology is being studied these days that combines ultra-high-strength with good deformability strength, corrosion resistance, and surface finish.
  • 45. Nanofillers  Nanofillers are gaining considerable attention as vital dental nanomaterials for incorporation into commercial composite materials for different dental applications.  The dimensions of nanofiller particles are less than that of visible light.  Therefore, neither can they be absorbed no do they scatter visible light, and this feature plays an important role for their aesthetic features and hence, they can be employed for anterior teeth restorations (Khurshid et al., 2015).
  • 46. Application in periodontics  The application of nanotechnology in the periodontal management was put forward by Kong et al . the concept given by their researches formulated many concepts regarding tissue engineering in periodontal regeneration.
  • 47. Nanorobotic Dentrifices (Dentifrobots)  It is a bottom -up approach.  Dentifrobots in the form of mouthwash or toothpaste can clean organic residues by moving throughout the supragingival and subgingival surfaces, metabolizing trapped organic matter into harmless and odourless vapors  It would also identify food particles, tartar and plaque and lift them from the teeth, aiding in continuous debridement of supra and subgingival calculus.  These nanorobots are of diameter:0. 5-2microns and can move as fast as 1-10 μ/s and are safely self -deactivated when they are swallowed.
  • 48.  Properly configured dentifrobots could identify and destroy pathogenic bacteria residing in the plaque and elsewhere, while allowing 500 species of harmless oral microflora to flourish in a healthy ecosystem.  Dentifrobots awould provide continuous barriers to halitosis, since bacterial putrification is the central metabolic process involved in oral malodour.  With this kind of daily dental care available from an early age, conventional tooth decay and gingival diseases will disappear
  • 49.  The exterior of a nanorobot will likely be constructed of carbon atoms because of its inert properties and strength.  Supersmooth surfaces will lessen the likelihood of t riggering the body’s immune system ,allowing the nanorobots to go about their business unimpeded.
  • 50. MECHANISM OF ACTION OF NANOROBOTS  The powering of nanorobots can be done by metabolizing local glucose and oxy gen for energy and externally supplied acoustic energy.  Other sources of energy within the body can also be used to supply the necessary energy for the device  Communication is an important fundamental capability of nanorobots. They must task other be able to communicate with each other in order to monitor collective progress and pass alon g relevant sensory, messagin g, navigational and operational data.
  • 51.  Nanorobots function will be controlled by simple onboard computers capable of performing about 1000 or fewer computations per second.  Communication with the device can be achieved by broadcast -type acoustic signaling.  Navigational network may be installed in the body providing accuracy to all passing nanorobots that interrogate them, wanting to know their location.  This will help to keep track of various devices in the body.
  • 52. HOW SAFE ARE THESE NANOROBOTS?  The non pyrogenic nanorobots used in vivo are bulk Teflon, carbon powder and monocrystal sapphire.  Pyrogenic nanorobots are alumina,silica,copper,zinc.  Nanorobots may release inhibitors,antagonists or down regulators for the pyrogenic pathway in a targeted fashion to selectively absorb the endogenous pyrogens,chemically modify them and then release them back into the body in a harmless inactivated form.
  • 53. ADVANTAGES OF NANOROBOTS  Build up artificial immunity  Treat and fight disease and restore lost tissue at the cellular level.  No harm with their use  Bloodless surgery
  • 54. DISADVANTAGES OF NANOROBOTS  Design Cost is high  Installation cost is high  Maintenance is difficult  Social challenges of ethics, public acceptance, regulation and human safety.  Precise positioning and assembly of molecular scale parts.  Biocompatibility.
  • 55.
  • 56. Treatment of dentinal hypersensitivity  Changes in pressure transmitted to the pulp hydrodynamically are the main cause of dentinal hypersensitivity.  The dentinal tubules of a hypertensive tooth have twice the dia meter and eight times the surface density of those in non-sensitive teeth .  Nanorobots selectively and accurately block these dentinal tubules using native materials, thus offering quick and permanent relief to the patient.
  • 57. Nanomaterials for periodontal drug delivery  Nanomaterials are of interest from a fundamental point of view because the properties of a material (e.g. physical properties, electronic properties, optical properties) change when the size of the particles that make up the material becomes nanoscopic.
  • 58.  Nanotechnological drug delivery approaches are highly promising in achieving these goals.  nanoparticles or scaffolds, to allow targeted, sustained and controlled release to the intended location (Abou Neel et al., 2015).  Better penetration of the active moiety into junctional epithelium (site of action) combined with optimal drug release profiles are among the important benefits of this approach.
  • 59. Nanofibers surface area permit an per unit mass, when easier addition of compared surface  Nanofibers havin g a larger with polymer microfibers, functionalities.  Thus, these can be efficiently applied in dru g delivery systems and tissue engineering scaffolds in dentistry. E.g., Arestin.  A nanostructured 8.5% doxycycline gel was observed to afford periodontal surface preservation following experimental periodontal disease in rats.
  • 60. Nanomaterials For Periodontal Drug Delivery  Widely used nanomaterials for controlled drug release are core -shell spheres, hollow spheres, nanotubes and nanocomposite.  Drugs can be incorporated into nanospheres composed of a biodegradable polymer, and this allows for timed release of the drug as the nanospheres degrade facilitating site-specific drug delivery.
  • 61.  Recently, Pinon- Segundo et al produced and characterized triclosan- loaded nanoparticles by the emulsification –diffusion process, in an attempt to obtain a novel delivery system adequate for the treatment of periodontal disease  Nanoparticles were prepared using poly (D, L-lactide- coglycolide), poly (D,L-lactide) and cellulose acetate phthalate. poly (vinyl alcohol) was used as stabilizer.  These triclosan nanoparticles behave as a homogeneous polymer matrix -type delivery system, with the drug (triclosan) molecularly dispersed.  Tetracycline incorporated into microspheres is available as Arestin for drug delivery by local means into periodontal pocket
  • 62. Subgingival Irrigation  Hayakumo et al has described the use of ozone nanobubble water produced by nanobubble technology in subgingival irrigation.  The results of their study demonstrated that it can be used as an adjunct to periodontal therapy because of their enhanced antibacterial activity
  • 63. Nanoantibiotics  Delivered through nanocarriers with specialized antibiotic coating on their surface.  They manifest broad spectrum of activity and decrease the probability of secondary infections.  Gold nanoparticles are described to have increased adhesiveness to antibiotics.  Besides nanoscale particles and antibiotics demonstrate positive interactions.
  • 64. Guided tissue regeneration  The concept of guided tissue regeneration (GTR) is being researched to replace earlier functional graded membranes with novel 3-layered membranes.  The former system included bilayered GTR membranes with a porous surface on one side ( for cellular ingrowth), and a smooth surface on the opposite side (for cellular occlusion).  A novel system has come up with a 3 - layered GTR membrane composed of an inner- most layer made of 8% nanocarbonated hydroxyapatite/collagen/polylactic- co- glycolic acid ( n CHAC/PLGA) porous membrane, a middle layer of 4% n CHAC/ PLGA, and an outer layer of PLGA non- porous membrane.
  • 65. Nanotechnology in dental implants  Top-Down approach.  Nanotechnology can be used in the surface modifications of dental implants since surfaces properties such as roughness and chemistry play a determinant role in achieving and maintaining their long-term stability in bone tissue.  The coating of nano particles over the dental implants, improves the adhesion and integration of surrounding tissues.  Biologically active drugs such as antibiotics or growth factors can be incorporated in the implants. eg: Nanotite™ Nano-Coated Implant.
  • 66. Nanotopography  Nanotopography improves biointegration of Titanium Implants when exposed to an in vivo microenvironment, a titanium surface spontaneously forms an evasive Titanium oxide layer that is highly bioinert and provides excellent corrosion resistance.  This implants have better bio-compatibility, more strength. These nano particles also help in the expression of genes responsible for osseointegration
  • 67. Periimplantitis  Clot stability can be increased by using nanohydroxyapatite on citric acid conditioned surface.  Elangovan et al in their study demonstrated enhanced fibroblast proliferation with the use of platelet derived growth factor -BB delivered using calcium phosphate nanoparticle.
  • 68. Nanoparticles As A Bone Graft Material  It is a Top-Down approach.  Nanotechnology can also be used to t reat bone defects with nano -bone graft materials. Nano bone graft should possess the qualities of bone grafts being used today.  Their higher surface area to mass ratio can be used in most advantageous manner for treating infrabony defects.
  • 69. Bone grafting  Bone grafting is faced with limitations such as a limited supply of grafting materials, variable resorption, high failure rates and persistent pains (Walmsley et al., 2015).  These limitations have evoked massive research for solutions to these limitations.
  • 70.  3D scaffold matrices and nano-engineered particles that promote the growth of new bone have been the main areas of focus (Lorden et al., 2015; Walmsley et al., 2015), and scaffold have been successfully used in various fields of tissue engineering such as periodontal regeneration and bone formation (Garg et al., 2012).  Nanotechnology targets to imitate this natural structure for development of nanobone, which can be used in dental applications.
  • 71.  The first step, fabrication of strong and porous scaffolds, holds prime importance in the whole process.  Different techniques successfully seed scaffolds along with cells-either attaching the cells to the internal scaffold surface or distributing them in the scaffold porosity with the help of a gel-like vehicle.
  • 72. Nano-hydroxyapatite (n-HAP) bone grafts  Various alloplastic bone grafts with nanoscale particle sizes are being developed and tested.  One of the recent and most promising among them are nano -hydroxyapatite (n- HAP) bone grafts, which is available in crystalline, chitosan - associated and titanium- reinforced forms (Kailasanathan et al., 2012).  When compared with the ‘plain’ chitosan scaffolds, ‘n -HAP’ composite bone graft scaffolds demonstrated greater biocompatibility, superior mechanical properties and also appeared to induce better cellular responses (Chesnutt et al., 2009).
  • 73. Laser and nanoparticles  Laser irradiation on nanotitanium particles coated surface are shown to increase collagen production.  Using this principle, gingival depigmentation and other periodontal procedures can be carried out.  Sadony and Abozaid showed that nanoparticles along with diode laser has the potential to decontaminate dentin surface.
  • 74. Laser Plasma Application  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 like:  Shock waves  Microabrasion of hard tissues  Stimulus to produce collagen.  Clinical applications of this laser plasma application are melanin removal and soft tissue incision (without anesthesia).
  • 75. Nanoencapsulation  Targeted release systems that incorporate nanocapsules are still under trial for inclusion into vaccines and antibiotics used by the patients.
  • 76. NANOMATERIALS FOR PERIODONTAL TISSUE ENGINEERING  Currently tissue engineering concepts for periodontal regeneration are focused on the utilization of synthetic scaffolds for cell delivery purposes.  It is possible to create polymer scaffolds in the future for cell seeding, growth factor delivery and tissue engineering via nanodevices implanted to sites of tissue damage  Replacement of the whole tooth is achieved through the combined utilization of approaches like nanotechnology, genetic engineering, and tissue engineering.
  • 77. Toxicity of Nanoscale Particles  Increased surface area although seems to be beneficial they can cause increased toxicity by enhancing the duration of action, aquaphobic drug solubility and also their ability to cross blood brain barrier.  Because of their small size, host immune system reaction to the nanoparticle cannot be detected.  Other drawbacks include difficulty in concomitant bulk synthesis, haemolytic activity towards host cell, cost ineffective, social and ethical challenges.
  • 78. Future of Nanoperiodontics  Method for synthesizing high calibrated nanoparticles in bulk will be developed in near future.  Most of the nanoparticles based studies in Periodontics are in -vitro, the productive outcome of in-vivo studies is to be demonstrated.  Numerous untreatable diseases may be treated using nanotechnology.
  • 79. Conclusion  Nanotechnology is a promising technology that is playing an increasingly important role in the diagnostics, prognostics, prediction, and management of various treatments.  Although the achievement of goal of complete and proper regeneration of the periodontal tissues which includes the cementum, periodontal ligament and bone for various periodontal management may not be feasible for many years,  Recent developments and achievements in nanomaterials and nanotechnology have provided a promising hand into the commercial applications of nanomaterials in the diagnosis and management of periodontal diseases.  It is envisaged that this trend will be further improved in the future as more and more nanotechnologies are commercially explored