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Molecular momentum How nanotechnology is harnessing small particles with big results. Technology is all around us—electronic communication, digital imaging, podcasts, wireless computers, etc.—and most often, when thinking “tech,” we think “high-tech.” But what about nanotechnology? And what of nanotechnology’s impact on the dental and dental hygiene professions? Starting small Advances in nanotechnology holds promise in fields ranging from information technologies, optics, electronics, cosmetics, medicine and dentistry. Simply stated, nanotechnology is the science of “building small,”1 the engineering of functional systems at the molecular level. Nanoscale devices range from 100 to 10,000 times smaller than the human cell and can easily pass through human cells. Scientists are able to manipulate the atomic or molecular properties of materials to develop new materials and devices, essentially from the bottom up. Researchers looked on the late Richard Feynman’s—a Nobel Prize-winning physicist—futuristic vision of molecular engineering with great skepticism 40 years ago, but today, the development of nanotechnology has become one of the most highly energized disciplines in science and technology.2 Somewhere in the not too distant future, it may be possible to construct nanomachines with robotic components to allow physicians to perform precision-level interventions on the body at the cellular level. Medical nanorobots could be used to diagnose, treat and prevent disease as well as treat traumatic injuries and relieve pain. Drug delivery systems are already being developed utilizing nano-engineered crystals to deliver anticancer drugs directly to the tumor site.3 Molecules and the mouth The term, “nanodentistry,” first introduced in 2000 by research scientist Robert Freitas, envisions that nanotechnological developments will enable dental consumers to achieve optimal oral health through the utilization of nanomaterials, tissue engineering and dental nanorobotics.2 Although the routine use of dental robots to identify and destroy pathogenic bacteria in the periodontal sulcus may be many years away, the use of nanotechnology in the area of dental materials is now becoming state of the art.4 Manipulating the structure of materials at the nano level—essentially building the material from the bottom up—has the capability of making significant improvements in its chemical, mechanical and optical properties. Let’s look at the areas where nanomaterials are being utilized in dentistry today. Dental Composites. The chemical structure of dental composites has changed dramatically since the first composites were introduced in the 1960s. The first generation of composites contained large particles of quartz, glass and ceramic fillers. They had a rough surface when explored, and proved to be inappropriate for Class I and II restorations due to their low strength and high incidence of shrinkage. Microfilled composites developed in the 1970s had small particle size fillers to produce a lustrous surface, but they lacked strength due to expansion of the resin matrix. Hybrid composites came to the marketplace in the 1980s and featured a combination of large and small fillers thus providing increased strength and a smooth finish. The introduction of nanoparticles to dental composites has transformed the composite manufacturing process from the molecular level up, and created materials that have enhanced esthetic features of high translucency and luster while maintaining strength and wear resistance. Nanocomposites can now be placed in anterior as well as posterior teeth. The development of the nanofilled composite restorative materials provides clinicians and consumers with an esthetic and reliable tooth conserving option for replacing lost tooth structure.4 Bonding Agents. Along with dental composites, bonding agents are said to have revolutionized modern dentistry.4 The ability to bond materials to both enamel and dentin began as a multi-step process requiring etching, rinsing, conditioning, priming and curing. The latest generation of bonding agents are self-etching, one-step materials. The new bonding agents manufactured from nanosolutions contain stable nanoparticles homogeneously dispersed throughout the solution. The silica nanofiller technology contributes to higher bond strength performance while providing a stable, dispersed, filled adhesive that prevents particle settling, eliminating the need to be shaken prior to use. Impression Materials. The development of automixed addition silicone impression materials eliminates many of the shortcomings of alginate and the old technology of reversible hydrocolloid impression materials. Addition silicones are not only accurate and stable, they also are more comfortable for the patient. The integration of nanofillers into silicone or vinyl polysiloxane impression materials improves the flow of the material and enhances the material’s hydrophilic properties. These enhancements provide an even more accurate impression, fewer retakes and ultimately a better restoration for the patient. Dental Implants. Nanotechnology is now the latest technique being used in the fabrication of dental implants. While it has long been recognized that the microstructure of the titanium surface influences biocompatibility and osseointegration, the nanotechnology-based dental implant surfaces represent a new generation of surface treatments. The addition of nano-scale deposits of hydroxyapatite and calcium phosphate creates a more complex implant surface for the osteoblasts to form on. The nanoengineered implant surface may play a key role in accelerating and enhancing the osseointegration process. On the Horizon The era of nanodentistry promises to bring a number of innovative treatment modalities into practice. Anesthesia may be delivered by placing a colloidal suspension of nanorobot particles on the patient’s gingiva. The nanorobots—controlled acoustic data links from the clinician—would eventually enter the dentinal tubules and proceed to the pulp and control the nerve impulse traffic. Once the procedure is complete, the nanorobots would receive data to restore all sensation. Dentin hypersensitivity may be treated by launching reconstructive nanorobots to selectively occlude open dentinal tubules. Programmable orthodontic nanorobots may be responsible for manipulating the periodontal tissues to allow for rapid repositioning of the teeth.2 Sound like a dream world? Maybe, but then who would have thought that all the information on a mainframe computer from the 1950s could be stored on a 12-inch laptop? Stay tuned to experience all the benefits of nanotechnology. Cathy Draper, RDH, MS, has been practicing dental hygiene since 1975 in Mountainview, Calif. as well as in Munich, Germany. She is currently an adjunct faculty member at Foothill College, in Los Altos HIlls, Calif. An active member of ADHA, she frequently presents continuing education courses on technology and implant dentistry to practicing clinicians as well as students. References 1. Whitesides GM, Christopher Love J. The art of building small. Sci Am 2001;285(3):38-47
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