Nanotechnology: A New Dimension in Prosthodontics

Abstract

Dentistry is growing up very fast day by day. It’s an golden era of dentistry where new technologies are emerging like CAD-CAM, 3D Bioprinting, Nanotechnology, Nanorobotics and much more. Dentistry is originating as more digital in this era and development in every field of dentistry is taking place so as in the field of Prosthodontics which is not far apart from this. In this review article significance of nanotechnology in the field of Prosthodontics is discussed.

INTRODUCTION

Dentistry is presently undergoing a great evolution, taking humanity to a new era which is the era of nanotechnology. Nanotechnology era is fast approaching which was not heard two decades ago. All disciplines of human life will be impacted by advancement of nanotechnology in near future. It deals with the physical, chemical and biological properties of structures and their components at nanoscale dimension. Nanomaterials are classified as zero dimensional, one dimensional, two dimensional and three dimensional nanostructures. Various nanostructures include like nanoparticles, nanopores, nanotubes, nanorods, nanospheres, nanofibers, nanoshells, dendrimers and dendritic copolymer.

Nanotechnology is based on the concept by controlling atoms and molecules on a one-by one basis. Basically nanotechnology can be termed as engineering of functional system at the molecular scale. If technology considered as an engine then science will be its fuel. Nanotechnology is quite diverse leading to development of new materials, the technology can be judiciously applied to the field of medicine and dentistry.

It is thus considered as the science of small which deals in inventing materials, devices and much more. Nanotechnology plays a vital role in profound development in nanomedicine and similar to nanomedicine, the development of nanodentistry will allow nearly perfect dentistry by use of nanomaterials and biotechnologies, include tissue engineering and nanorobots. Nanotechnology has application in many fields like in medicine- diagnosis, drug delivery and tissue engineering.

Emerging technologies and information regarding new nanoscale have the potential to transform dental practice by advancing all aspects of diagnostics, therapeutics and cosmetic dentistry. One of the key changes is the applying new research tools which have changed dental research into nano size scale. Now using nano scale dentistry changed the outlook of dentistry by seeing it at molecular level.

Thus, nano-enabled technologies provides an alternative and superior approach which can assess the onset or initiation of disease, or to identify the targets to assess the treatment as well as the ability to design biocompatible, any microbe resistant dental materials and implant which overall improves the oral health care of the patient.

Nanotechnology in the field of Prosthodontics have taken place in the following like :

• Impression materials
• Ceramic
• Implant material
• Coatings for implants
• Nanocomposite denture teeth
• Nano sterilizing solution

IMPRESSION MATERIAL

Impression materials are now these days available with the use of nanotechnology. Polyvinylsiloxane is the material which is being used, in this material nanofillers improves the physical properties of impression material like-better flow, improved hydrophilic properties so having fewer voids and enhanced precise detailing1. In a study various fillers were being added including nanosized fumed silica and they were blended with three silicone polymer and the result was best as modulation of physical properties of polyvinylsiloxane material was possible by combining nanofillers during formulation. Trade Name : Nanotech elite H-D.(Fig. – 1)

NANO CERAMIC

In market composite resin blocks are available but not so popular like ceramic as dental personal believes that composites are not as strong is like ceramic restoration. As composite restoration can easily undergo general surface wear and not very good or ideal for posteriors and also believes that ceramic finishing last longer than the composite. So, an alternative monolithic esthetic material has been recently introduced in block form of CAD/CAM fabrication using both chairside and laboratory systems and the new material is based on the integration of nanotechnology and ceramics2.

Advantages of this material over ceramic was easier clinical finishing & polishing, no need of use of porcelain oven, good strength, good surface gloss. E.g. Lava Ultimate contains a blend of nano particles agglomerated in clusters and individual bonded nano particles embedded in a highly cross-linked polymer matrix. This nanoceramic material is not as brittle as ceramic material and does not require considerable time & effort to polish. It has a modulus of elasticity very close to dentine so absorb more stress and less fracture can be used for implant restoration as well replacing resin veneer.

IMPLANT MATERIAL

Dental implants is the most recent upcoming treatment in the field of dentistry. Lot of researches are taking place to improve the implant making as a high end treatment modality. Nanotechnology also played a role in improving the implant material . In dental implant two things which are of major concern is : osseointegration and infection. Titanium dioxide nanotubes is the most upcoming variation added in dental implant which minimizes the infection as well as increase the osseointegration. Titanium dioxide nanotubes etched into metallic titanium and thus surface holds promise for improving the longevity of dental implant. Nanotubes can also be used as drug delivery system. Loading of TiO2 nanotubes with anti inflammatory drug sodium naproxen and released gradually after implant surgery3. Further to fight infection these Ti02 nanotubes can be laced with silver nanoparticles. One advantage of Ti02 nanotubes that they are esthetically well accepted and also can be used for new type made from zirconia. (Fig. – 2)

Various surface modifications like chemical & physical processes. A great variety of techniques are used to create nanofeatures on dental implant surface which can be divided into chemical and physical processes.

1. Chemical Modification.

Anodic Oxidation: It creates nanostructure with diameter of less than 100nm on titanium implant. Voltage and direct current (galvanic current) are used to thicken the oxide layer among the implant surface4.

Combination of Acid & Oxidants: Combination of strong acids is effective in creating a thin grid of nanopits on a titanium surface (diameter 20-100nm)5. The titanium sample etched with a solution of strong acids e.g. H2SO4 and H202 at constant temperature and for specific duration. After etching it dropped in distilled water, washed further with ethanol in an ultrasonic bath for 20 min & dried6.

2. Physical Modification.

Plasma Spray: It is to create an engineered surface nanostructure, which usually standing below 100nm. It is to increase osteoblast density on implant surface7.

Blasting: Creation of porous layer on implant surface achieved through the collision with microscopic particles, alumina is one of the most used for blasting8. A further improvement in this technology was achieved through the integration of bioceramic grit-blasting and acid etching, to produce submicrometric topographies on titanium implants5. (Fig. – 3)

Nano Composite Denture Teeth:

Recent advancement in artificial teeth is that they are now made up of nanocomposite9,10. In these teeth, inorganic fillers in nano dimensions are diffused homogenously without any accumulation in matrix. They are more durable and have a higher resistance for abrasion11. Moreover, the colour is better in composite resin artificial teeth.(Fig. – 4)

NANO STERLIZING SOLUTION

Gens Nano photocatalyst has strong effect on killing almost all kinds of bacteria and virus as including SARS, HSN1 etc. It got silver antibacterial property. Due to photocatalyst it can complete and decompose the bacteria and virus12.

One more Gandy Enterprises Inc. Florida have introduced a new disinfectant based on superscience of nano-emulsion technology. It uses nano-sized emulsifier droplets of oil (similar in size of HIV virus) that bombard the pathogens e.g. Eco Tru Disinfectant. Advantages of this are: Broad Spectrum, Hypoallergic, Does not stain fabric, environment friendly and compatible with impression material.(Fig. – 5)

CONCLUSION

With emerging technologies and upcoming of new nanotechnology in the field of dentistry there is improvement in all aspects of diagnostics, therapeutics and cosmetic dentistry. Nanotechnology will make healthcare more effective and affordable. In the next coming years, molecular technology will be destined to become core technology underlying all of the 21st century of medicine and dentistry.

The evolution of nanotechnology will help us with more precision materials, drugs and equipments which will enhance patient compliance. Whatever the changes occurring in dentistry but still role of the dentist will continue to evolve along the lines of currently visible trends. The best technical abilities, professional judgement and strong interpersonal skills will always remain as the hallmark of the contemporary dentist.

REFERENCES