REVIEW ARTICLE

NANOTECHNOLOGY: A NEW ERA IN DENTISTRY

Shankarram V1, Sivasankari T2, Parthiban Sacket2, Nizar2

ABSTRACT
Nanodentistry will make possible the maintenance of comprehensive oral health by employing nanomaterials,
biotechnology including tissue engineering and ultimately dental nanorobotics (Nanomedicine). When the first
micron size dental nanorobats can be constructed in 10 to 20 years, these devices will allow precisely controlled oral
analgesia dentition replacement therapy using biologically autologous whole replacement of teeth manufactured during
a single office visit and rapid nanometer-scale precision restorative dentistry. New treatment opportunities may include
dentition re-naturalization, permanent hypersensitivity cure. Complete orthodontic realignments during a single office
visit covalently- bonded diamondized enamel, and continuous oral health maintenance using mechanical denitfrobots.

Key words: Nanotechnology, Periodontitis, Nano Robotics, Hyper Sensitivity

Introduction

dvances in all aspects of science and

discovery continue to occur at an exponential
rate, leading to a wealth of new knowledge and
technologies that have the potential to transform
dental practice. Minute particles with diameters
of just million of a millimeter are the building
blocks of new products known as nanoparticles.
They are special because of their unique physical
and chemical properties. It deals with structures
at sub- microscopic level. This new science
within the areas of cell / molecular biology,
genetics, tissue engineering and informatics has
been available for several years.
A Noble laureate physicist Richard P. Feynman
in his historic lecture on 29th December, 1959

speculated the potential of nano-size devices.

The term nanotechnology was coined by Prof.
Kerie E. Drexler, a lecture and researcher of
Nanotechnology.1 Nano is derived from the
Greek work for Dwarf. Nanotechnology is
the science of manipulating matter (at molecular
level), measured in the nanometer, roughly the size
of 2 or 3 atoms. It offers engineers and biologists
new ways of interacting with relevant biological
processes and introduces new horizon to use
microscopic evidence entities to perform tasks
that are new done by hand or with equipment.
The basic idea of this nanotechnology used
in the narrow sense of the world, is to employ
individual atoms and molecules to construct
functional structures. The main purpose of this
report is to provide an early glimpse of nanodental
applications and to illustrate their potentially for
reaching impact on clinical dental practice
The Various nanoparticles are:

Reader, 2Senior Lecturer

Department of Periodontics,
Thaimoogambigai Dental College & Hospital
Corresponding Author:
Dr. Shankarram V
E mail id: mmhvhospital@gmail.com

1. Nanopores
2. Nanotubes
3. Quantum dots
4. Nanoshells

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8.
9.
10.
11.

Fullerenas
Nanospheres
Nanowires
Nanobelts
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REVIEW ARTICLE
5. Denfrimers
6. Liposomes
7. Nanorod

12. Nanorings
13. Nanocapusules.

Nanotechnology is defined as: (Schummer J)2

1. A sphere of the scientific and engineering

activity that is connected with
Organization of the process of creation,
fabrication, implementation, use and
development of the nano-scale systems,
that is, coordination between the various
design tasks and cooperation of the
different specialties who solved these
tasks
Support to assemble and to integrate the
heterogeneous parts of the designed nano
system into organic whole
2. A sphere of knowledge, a complex scientific
and engineering discipline that integrates
Means, methods, operations, and
procedures of designs and research of the
nano scale systems
Methods and principles of the organization
of the scientific and engineering activity
Knowledge and methods of the modern
mathematical, technological, natural and
another sciences that are used for analysis
and design of the nano-scale systems
and for the organization of the scientific
and engineering activity
3. A concrete methodological position that is
connected with the holistic investigation of
the nano-scale systems.

Nanomedicine
Tiny machines, known as nanoassemblers, could
be controlled by computer through dentists to
perform specialized jobs. The nanoassemblers
could be smaller than a cell nucleus so that
they could fit into places where hands are far
from reach. Their components consist of 100
nm manipulator arms, 10-nm sorting rotors for
922

molecule-by-molecule reagent. Purification and

smooth super hard surfaces made atomically
flawless diamond. Nanocomputers would assume
the important task of activation, controlling and
deactivating such nano-mechanical devices. They
would store and execute mission plans, receive
and process external signal and stimuli and
communicate with other nano computers. Such
technology has enormous medical implications,
as in gerontological applications,3 pharmaceutical
research clinical diagnosis, and in dentistry. Other
applications include mechanically reversing
atherosclerosis, enabling near instantaneous
hemostasis, blood sugar control, repairing brain
damage and resolving gross cellular insults.
Diagnosis and treatment will be customized to
match the preferences and genetics of each patient.
Treatment options will become more numerous
and exciting. Developments are expected to
accelerate significantly.
Technology should be able to target specific cells
in a patient suffering from cancer or other life
threatening conditions. Toxic drugs used to fight
these illnesses would become much more specific,
isolated and consequently causing less harm to
the body.4 Quantum dots multi-functionalized
with the amyloid protein a synuclein, act at
nanomolar concentrations as very potent inducers
of the aggregation of micromolar millimolar bulk
concentrations of the protein in vitro and in cells.
Many nano medical advances are moving from
the lab to clinical trials, where they are producing
promising results (Karp JM, Langer R).5 The
combinations with a tetracycline tagged form of
synuclein specific for fluorogenic biaresenicals
constitutes a very sensitive system for studying
pathological amyloid formation in cells (E.g.
Parkinsondisease).
Nanodentistry: Dental naorobots when
constructed, perhaps 10 to 20 years from today,
may be controlled by nanocomputer. Dentists
may issue strategic instructions by transmitting
orders directly to in vivo nanorobots via acoustic
signals. They can destroy bacteria in the mouth

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REVIEW ARTICLE
that cause dental carries or even repair spots on the
teeth where decay has set in, by use of computer to
instruct these tiny workers in their tasks. Recent
applications of nanotechnology in dental care
will permit maintaining near perfect oral health
via nano materials, (Shi H, Tsai WB, Garrison
MD, Ferrari S, Ratner BD)6 biotechnology (West
JL, Halas NJ)7, tissue engineering (Baum BJ,
Mooney DJ)8 and nano robotics.

Nano dentistry approach

1. Local anesthesia
2. Hypersensitivity cure
3. Dentifrobots
4. Dental durability and cosmetics
5. Orthodontic treatment (Sims MR)9
6. Photosensitizers and carriers
7. Diagnosis of oral cancer
8. Treatment of oral cancer
1. Nano particles (Xia Y, Zhang F, Xie H,
Gu N)10: Nano particles are currently being
used in resin based composite restorations.
Organosilanes such as allyltriethoxy silane
have demonstrated good compatibility with
nano particle filler, such as titanium dioxide.

4. Nano fibers (Zhang Y, Lim CT, Ramakrishna

S, Huang ZM.)13: Polymer nano fibers with
diameter in the nano meter range possess a
larger surface area per unit mass and permit
an easier addition of surface functionalitys
compared to polymer micro fibers. Polymer
nano fiber materials have been studied as
drug delivery systems, scaffolds for tissue
engineering and filters. More recently, nano
fibers have been used to generate ceramics
containing hydroxy apatite and Fluor hydroxy
apatite (Kim HW, Kim HE).14
5. Nano characterization in dentistry:
Based on their unique capabilities and
resolution nano scale science probes surface
using forces, displacement resolution, and
concentration on the pico newton. It also uses
atomic force microscopic technique (Sharma
S, Cross SE, Hsueh C, Wali RP, Stieg AZ,
Gimzewski JK)15 in diseases such as dental
caries, tooth hypersensitivity, periodontitis
and oral cancer can be quantified based on
morphological biophysical, and biochemical
nano scale properties of the tooth surface itself
and dental materials and might lead to better
understanding the structure and functionalphysiological relationship of dental surfaces.

2. Nano rods (Chen H, Clarkson BH, Sun K,

Mansfield JF)11: Nano rods are of particular
interest in a restorative context. It has been
synthesized enamel prism like hydroxy
apatite nano rods that exhibit self- assembly
properties. They are similar to enamel rods
that make up the basic crystalline structure
of dental enamel, nano rods could contribute
to a practical artificial approximation of such
naturally occurring structures.

6. Dentifrobots: Nano robots will be used

in the prevention of tooth decay. Properly
planned dentifrobots can identify and
destroy pathogenic bacteria present in the
plaque allowing the harmless species of oral
microflora to increase in a healthy ecosystem.
Dentifrobots are also projected to provide
a check to halitosis (Kleinberg I, Codipilly
M.).16 With use of this kind of daily care
using dentifrobots can result in prevention of
tooth decay and gingival disease.

3. Nano tubes (Oh SH, Finones RR, Daraio C,

Chen LH, Jin S)12: Titanium oxide nano tubes
have been shown in vitro to accelerate the
kinetics of hydroxy apatite formation, mainly
in the context of bone growth application for
dental implant coatings.

7. Dentin hypersensitivity / Hypersensitivity cure

(Addy M, West N)17: Dentin hypersensitivity
is caused by the pressure transmitted
hydrodynamically to the pulp. These teeth
have wide dentinal tubules (Absi EG, Addy
M, Adams D).18 In treatment, nano robots

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will selectively and specifically occlude the
specific tubules giving quick and permanent
cure. (Borlongan CV, Masuda T, Walker TA
et al)19

Figure 1: Occlusion of dentinal

tubule by nano robots

8. Nano anesthesia (Estafan D.J)20: To achieve

nano anesthesia, a colloidal suspension
containing millions of active analgesic
micrometer sized dental nano robots particle
is placed on the patients gingival (Meechan
J.G).21 On coming in contact with the surface
of crown or mucosa, the nano robots reach
dentin by migrating in to the gingival sulcus.
On reaching the dentin, the nano robots
enter dentinal tubules and then into the pulp.
This movement of nano robots is guided
by a combination of chemical gradients,
temperature differentials and position of
navigation, all controlled by onboard nano
computer as directed by the dentist (Freitas
RA Jr).22 It takes about two minutes for nano
robots to reach pulp. On reaching pulp, the
dentist commands the analgesic dental nano
robots to shut down all sensitivity in the
selected tooth that requires treatment. This
causes immediate anesthesia of that tooth.
After completion of the procedure, the dentist
commands the nano robots via the same data
links to restore all sensation (Whitesides
G.M, Love J.C.).23
9. Major tooth repair: A Nano dental technique
involves many tissue engineering procedures
for major tooth repair (Charette MF,
924

Rutherford RB).24 Major tooth repair involves

several stages like using genetic engineering,
tissue engineering and tissue regeneration
and involving the growth of whole new tooth
in vitro (Somerman MJ, Ouyang HJ, Berry
JE, et al)25 and their installation. Mainly
manufacture and installation of a biologically
autologous whole tooth that includes both
mineral and cellular components that leads
to complete dentition replacement therapy
should become feasible within time. (Kuboki
Y, Sasaki M, Saito A, Takita H, Kato H.)26
10. Renaturalization procedures: Dentition
renaturalization procedures may become
a popular addition to the typical dental
practice, providing perfect treatment methods
for esthetic dentistry. This trend may begin
with patients who desire to have their old
dental amalgams excavated and their teeth
remanufactured with native biological
materials (ADA Council on Scientific
Affairs).27 However, demand will grow
for full coronal renaturalization procedures
in which all fillings, crowns and other
20th-century modifications to the visible
dentition are removed, with the affected teeth
remanufactured to become indistinguishable
from the original teeth.
11. Orthodontic nano robots (Shellhart WC,
Oesterle LJ.)28: Orthodontic nano robots can
directly manipulate the periodontal tissue
allowing fast and painless tooth straightening,
rotation and vertical movement within
minutes to hours.
12. Tooth durability and aesthetics: Dental nano
composites of 75 nm silica particles treated
in 3-methacry loxypropyltrimethoxysilane
(MPTS) and dispersed in a resin used for
conventional restorative composites exhibits
mechanical properties equivalent to those of
micro hybrid composites (Dzenis Y).29 The
silane MPTS acts as a good coupling agent.
Yet, there is evidence of several problems,

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when the silane dimerizes or trimerizes
creating methacrylate moieties that no longer
act as coupling agents, making coupling
poor. Finally shrinkage occur leading to
porosity which may be concentrated at
critical interfaces, having a great effect. If
these short comings can be managed, there
is a strong indication that the mechanical
properties of todays composites could be
substantially improved.
Nano composites display a much higher
glossiness (Atabek D, Sillelioglu H, O lmez
A)30 and much higher gloss retention, measured
after 500 tooth brush cycles, than conventional
composites. Nano composites also show a low
visual opacity and high translucency due to the
reduced scattering of light with wavelengths
much longer than the nano particle size. This
allows the clinician to construct a wide range of
shades and opacities and, thus, provide highly
esthetic restoration in all posterior and anterior
applications. With the combination of finishing
and polishing procedures, a nano technology
liquid polish application might provide a glossier
surface for resin composites restorations.

14.

15.

16.

Figure 2: Nano particles used in

composite filling materials

13. Restorative material advances (Muselmann

M)31:
The
Polyhedral
Oligomeric
Silsesquioxane Molecule (POSS) can be used
in dental applications to improve adhesion
at the inter phase between the restorative
material and tooth structure (Costa MT,

17.

Lenza MA, Gosch CS, Costa I, Ribeiro- Dias

F).32 It is also used to reduce tooth sensitivity
through sealing the tubules with POSS nano
sized molecule and also provides structural
reinforcement, toughness, and processability
(Launey ME, Ritchie RO).33
Materials for endodontic regeneration
(Fioretti F, Mendoza-Palomares C, Helms
M)34: Teeth with degenerated and necrosed
pulp are routinely saved by root canal therapy.
Although current treatment modality offer
high level of success for many condition,
an ideal form of therapy might consist of
regenerative approaches in which diseased or
necrotic pulp tissue are removed and replaced
with healthy pulp tissues to revitalize tooth.
Dental bio mimetics: The most interesting
venue for speculation on the nano restoration
of tooth structure is that of nano technology
mimicking process that occur in nature such
as the formation of dental enamel (Wang L,
Guan X, Yin H, Moradian- Oldak J, Nancollas
GH).35 A recent in vitro study elucidated
mechanism of interaction among amelogenin
nano spheres, nano particles, and nano rods
at critical points during the hydroxy apatite
crystal growth process (Sumikawa D.A,
Marshall G.W, Gee L.et al.).36
Nano impression: In the impression material
manufactured by the application of nano
technology, nano fillers will be integrated in
the vinyl polysiloxanes producing a unique
addition Siloxane impression material.
This material will provide better flow and
hydrophilic properties, hence fewer voids at
margin and better model pouring.
Nano solution: Nano solutions will form
unique and dispersible nano particles, which
can be used in the bonding agents. This will
make the solution homogenous and makes
sure that the adhesion is perfectly mixed
every time.

18. Nano encapsulation: South West Research

Institute (SWRI) developed targeted release

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systems which will cover nano capsules
including nano vaccines, antibiotics and drug
delivery with reduced side effects (Couvreur
P., Barratt G., Fattal E., Legrand P. and
Vauthier C).37
19. Application of nanotechnology to the
dental implant surface involves two surface
features (across and away from the mean
surface plane). These nanofeatures can be
arranged in an organized manner (isotropic)
or unorganized manner (anisotropic).
Anisotropic topographies are mainly applied
to a dental implant surface. Isotropic features
such as nanogrooves or nanopits that are
created largely by optical methods are not
readily applied to complex screw shaped
objects. When these concepts are applied
to the endosseous implant surface, implied
is the embellishment of the surface with
nanometer scale 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).38 Several methods
are available for imparting nano features on
cp titanium implants.

structures, nanocomposites, nanoporous materials,

and nanomembranes will play a growing role in
materials development for the dental industry.
Molecular technology is destined to become the
core technology underlying all of 21st century
medicine and dentistry.

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Conclusion
Nanotechnology will change dentistry, healthcare,
and human life, more profoundly than many
developments of the past. Nanodentistry still
faces many significant challenges in realizing
its tremendous potential. There are larger social
issues of public acceptance, ethics, regulation
and human safety that must be addressed before
molecular nanotechnology can enter the modern
medical armamentarium. However there are
equally powerful motivations to surmount
these various challenges, such as possibility of
providing high quality dental care to the 80%
of the worlds population that currently receives
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