HOW SIGNIFICANT WILL NANOTECHNOLOGY BE IN THE ADVANCEMENT OF DENTISTRY?

Nanotechnology and nanoscience is the study and use of technology that is less than 100 nanometres in all dimensions, which involves manipulating substances at a subatomic level. Due to its extremely small scale, nanotechnology has been recognised to have great levels of potential, resulting in its application across many different science fields such as medicine, physics, material science, and engineering. Another main area in which nanotechnology is anticipated to be implemented in further is, as the title suggests, dentistry. Currently, research is being carried out to develop the applications of nanotechnology and nanoparticles in dentistry, expanding on the present usage of things like nanofillers and nanoceramic composite materials. When it comes to nanotechnology in dentistry, there are considered to be two main approaches: the ‘bottoms-up approach’ (which is concerned with the creation and development of new substances from the nanoscopic scale, organizing to then form larger structures) and the ‘top-down’ approach (which involves taking a bulk material and isolating the key nanoparticle components). Both of these approaches, in my opinion, will help to enable substantial advancements in dentistry and I will be discussing them further, along with further applications, to support my view that nanotechnology will be very significant in the advancement of dentistry.

In an article presented by Shaeesta Khaleelahmed Bhavikatti, MDS, it is stated that the current applications of nanotechnology in dentistry, along with the large rise in interest in the subject matter, will facilitate further research opportunities. As a result of this, it is said that there will be an initiation of “an era of unprecedented advances in dental diagnostics and therapeutics”. This clearly suggests that Dr. Bhavikatti believes there is huge potential surrounding this field and that advancements in the near future are very possible. Throughout the article, the current applications are explained at great depth, including things such as diagnostic dentistry where nanosized quantum dots are discussed as a method of targeting specific bacteria which are thought to be the main cause of many periodontal diseases. The basis of this is profoundly on immunofluorescence, which effectively ‘labels’ the bacteria, providing extremely high resolutions, allowing single cells to be clearly identified, in vitro as well as in vivo. The article also mentions restorative dentistry as a realm that nanoparticles can play a large part in, particularly with nanofillers. This mainly targets composites, increasing their wear resistance since the nanofillers help to reduce polymerisation shrinkage and thermal expansion. This is an example of where the bottoms-up approach is utilised, seeing as how nanomers (5-75nm in diameter) and nanoclusters (2-20nm in diameter) have been manufactured from scratch. Whilst the authors are very clear about the advantages of nanotechnology’s applications throughout dentistry, they also make it clear that there are some disadvantages associated with it. A major aspect to do with this area is nanotoxicology, which is defined as a science that deals with the toxicity of nanomaterials and the effect of them in living organisms. Therefore, techniques that show promise for future use need to be tested stringently in order to make sure that the downsides are kept to a minimum when it is utilised on humans. There is also the recognition in the article that an “area of concern” includes the absorbance of nanoparticles into the skin or through the respiratory system. This points to the idea that these nanoparticles could then travel in the bloodstream and invade vital organs, potentially causing huge problems whilst, due to the very small scale of the particles, doctors will find it very difficult to detect. It is declared that the “the authors have no financial, economic, commercial, and/or professional interest related to topics presented in this article”, meaning that the viewpoints that they have given are purely based on analytical grounds, with no bias. Another article called “Nanotechnology in dentistry: Present and future”, which was published in the Journal of International Oral Health 2014, also shares similar perspectives regarding the world of nanotechnology in dentistry; the authors express that it will cause tremendous improvements in health care in a major way. They have also outlined the fact that The Foresight Institute has offered the Feynman Grand Prize, worth £250,000 to the first individual or group of researchers to develop a nanorobot and a nanocomputer, illustrating that developments in this area are considered very important to the whole medical community. However, it is also pointed out that the initial devices will be quite basic and so the commercial use of them may not be seen until many years later. Throughout the article, there are techniques brought up which are argued to be capable of revolutionising dentistry if they are composed successfully. An example of this is dentition renaturalisation, that would comprise of removing old amalgam restorations and remodelling the tooth with “natural materials”. This process may develop into what would be know as ‘dentition replacement therapy’, essentially utilising tissue and genetic engineering to grow teeth outside of the body (in vitro) and then installing them into the patient’s mouth. Whilst they share the same concerns as the authors in the previous article based around the idea of questionable biocompatibility, they also make it known that there are financial concerns which could mean that nanotechnology in dentistry may not be as significant of an option for treatment due to the high costs associated with it.

The general procedures performed by different types of dentists have not changed much over the last couple decades, seeing how they all manage to get the job done, allowing the patient to leave from the practise feeling content about the end result. Due to this, there isn’t a real push from people to advance the quality and efficiency of dentistry on a large scale. This is because the further improvements that could be brought about by the widespread introduction of fields like nanotechnology are not well-known. After reading through articles and websites which explain the possibilities that can arise, it is clear that nanotechnology will almost definitely be significant in many types of dental fields. One way in which they are likely to benefit various areas within dentistry, is through the implementation of nanosolutions (also known as nano-adhesives). These are made up of nanoparticles which are capable of dispersing, meaning that they have the potential to play a large part in bonding agents, which are notably used in filling materials. This has many advantages associated with it, including the prospects of higher enamel and dentine bond strength, as well as release of fluoride once they have been applied. This further increases the benefits, seeing as how fluoride is vital in preventing tooth decay. Many people also experience problems where the toughness of their enamel has been reduced to a level where their teeth are very susceptible to chipping, accompanying the fact that their teeth would feel much more sensitive due to the lack of enamel resulting in the exposure of the dentin underneath, often bringing the person large amounts of pain and discomfort. A measure that can be put into place for people who are experiencing this is to “change the superficial enamel layer” by adding components such as sapphire or diamond. These would be extremely effective since they are up to one hundred times harder than natural enamel, although the main downside is that they can be very brittle. This is where nanotechnology would come in to increase the durability of these materials. If these materials were incorporated into a nanostructured composite, then they would be much less brittle and so would greatly reduce the discomfort of patients as the sensitivity would be reduced tremendously. On top of this, the layer covering the dentin would now provide much more strength and so would be less susceptible to breaking and chipping, and so there would be less of a need for implants as the chance of the tooth cracking would be significantly lowered. Another revolutionary way in which nanotechnology can be utilised is through pulp regeneration. There is a hormone, called α-MSH, which possesses anti-inflammatory properties and so this hormone can be combined into a nanofilm to help repair damaged teeth. It would be used to replace damaged dental pulp as this would provide a pathway to develop tissues that could potentially save teeth that would otherwise be required to be extracted. Although this sounds promising, there is further research required to be put into these regenerative and therapeutic approaches. Around the same area within the tooth is the nerve, which can quite easily be damaged during extensive dental procedures. This is where nanofibres called amphiphiles would be introduced, considering that they can collect together to reach many micrometres in length. As a result, they can be used to bridge defects found in the spinal cord. Many researchers are hopeful that this can be transferred to the oral region, where it would provide hope in reconstructing a damaged inferior alveolar nerve, for example.

To conclude, I would say that nanotechnology is the field which is most likely to cause the most significant amount of development and advancement in all aspects of dentistry, ranging from preventive to restorative. This is partly because there is so much potential that is being recognised theoretically and it is mainly due to problems like biocompatibility and financial backing that will see the significance of nanotechnology in dentistry hindered. On top of this, researchers and scientists still need to decide how to approach starting to make some of these devices and how they can use the ‘bottoms-up’ and ‘top-down’ approach to assist in this. With the nanotechnology itself, it is evident that the disadvantages will be kept to a minimum if the main problem of unwanted absorbance into major organs can be avoided. However, this is very difficult to manage, seeing as how nanotechnology has been around for almost sixty years and there haven’t been any solutions to date. In my opinion, if a way can be found around this whilst dental nanodevices are being constructed, then the implementation of this technology will certainly provide so many benefits to everyone who is able to obtain it. A major reason is because it provides a way to repair many problems that would otherwise have been permanent for the patient. However, because the idea of nanotechnology hasn’t been widely publicised, people are not fully aware of the benefits and so the push to increase research and development is not as large as it could be, further prolonging the possibility of working devices being made. Yet, when the technology is made, I think that it will first be implemented into private areas rather than the NHS straight away, considering cost is quite a large barrier. People will most likely opt for nanodevices for problems that would otherwise lead to the teeth looking unpleasant or being replaced, and from there, I think that the use of it will increase as it gains more popularity. The NHS could, on the contrary, implement nanotechnology as a means to increase efficiency and performance of existing compounds, such as adhesives. This would greatly improve the results of fillings, for example, and therefore immensely reduce the possibility that the patient has to go back for repair-work. On the whole, I think that once nanotechnology is implemented into dentistry, regardless of how far down the line, it will have the most significant impact on improving dental procedures and will therefore advance dentistry as a field greatly due to the numerous enhancements that it will bring to what dentists are currently working with.

 

References:

  1. Hamouda, I. (2012). Current perspectives of nanoparticles in medical and dental biomaterials. [online] https://www.sciencedirect.com/science. Available at: https://www.sciencedirect.com/science/article/abs/pii/S1674830112600244
  2. Archana Bhardwaj, A. (2014). Nanotechnology in dentistry: Present and future. [online] PubMed Central (PMC). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959150/.
  3. Khurshid, Z., Zafar, M., Qasim, S., Shahab, S., Naseem, M. and AbuReqaiba, A. (2015). Advances in Nanotechnology for Restorative Dentistry. [online] MDPI – Materials. Available at: https://www.mdpi.com/1996-1944/8/2/717/htm.
  4. Khaleelahmed, Shaeesta & Bhardwaj, Smiti & Prabhuji, Munivenkatappa. (2014). Current applications of nanotechnology in dentistry: A review. [online] General dentistry. 62. 72-77.

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Prem Mohanlal