nanotechnology in prosthodontics

1. NANOTECHNOLOGY IN
PROSTHODONTICS
By Dr. Divya Singh
MDS
Prosthodontics and maxillofacial
prosthesis

2. INTRODUCTION
• “Nano" is derived from the Greek word for 'dwarf' which
combines with a noun to form words such as nanometer,
nanotechnology, and nano robot.
• Nanotechnology is the science of manipulating matter on
molecular and atomic levels or of matter measured in the
billionths of meters or nanometer, roughly the size of 2 or 3
atoms
• Nano technology consists mainly of the processing, separating,
consolidating, and deforming of materials by one atom or
molecule. Since its origin, the definition of nanotechnology has
generally been extended to include features as large as 100 nm.
• The term ‘‘nanotechnology’ ’was coined by a student at the
Tokyo Science University in1974(Taniguchi, 1974).
• A nanometer is 10-9 or one billionth of a meter.

3. • In the literature, both a fairly broad as well as a rather
narrow concept of nanotechnology are employed.
• The first signifies any technology smaller than
microtechnology.
• In contrast, the latter stands for the technology to program
and manipulate matter with molecular precision and to
scale it to 3-D products of arbitrary size.
• The basic idea of nanotechnology, used in the narrow sense
of the world, is to employ individual atoms and molecules to
construct functional structures.

4. HISTORY OF NANOTECHNOLOGY
• There is much controversy regarding the history of nanotechnology. Although
some researchers believe that it is a scientific evolutionary form that did not
develop until the late 1980s, evidence of nanotechnology dates back to
1959.Others believe that humans have unwittingly employed nanotechnological
methods for thousands of years, perhaps even longer.
• During the 17th century, the idea was developed that utopian ideals, such as
control of the natural environment, a perfect society, life without disease and
pain, prolongation of life as well as enhancement of man and his characteristics
could be achieved through the further development of science. All that was
needed for that would be to organize science in a correct way and to work with
effective methods. This modern idea became a source of great enthusiasm for
nanotechnology development.
Gordijn B.Sci Eng Ethics. 2005 Oct; 11(4):521-33. Nanoethics From Utopian Dreams and Apocalyptic
Nightmares towards a more Balanced View

5. Terminology and basic idea
• Richard Feynman ,at an American Physical Society meeting in
1959, gave a lecture, ‘‘There’s Plenty of Room at the Bottom’’ and
speculated on radical forms of miniaturization
• Both practically and theoretically, significant progress in the
field of nanotechnology started only in the eighties
• 1980s: Gerd Binnig and Heinrich Rohrer, working at the IBM
research laboratory in Zurich, developed scanning tunneling
microscopy. This new technique can provide an image of the
atomic arrangement of a metal or a semiconductor surface.
Thus, using this new technique Binnig and Rohrer could, for the
first time ever, “map” the arrangement of individual atoms of
metals and semiconductors. In 1986 Binnig and Rohrer received
the Nobel Prize for their achievements.
• The atomic force microscope represents a further
development in microscopy. It enables images of materials
inaccessible to the scanning tunneling microscope, for
instance insulators, organic materials, biological
macromolecules, polymers, ceramics and glasses.
• Foster et al. 1988; Hansma et al. 1988 discovered that scanning
tunneling microscopes could also be used to manipulate
nanoscale objects

6. Theoretical development
Majorly done by Eric Drexler (1981 & 1986).
• pre-programmed maneuvering and goal directed management of
individual molecules.
• In addition, he elaborated on the future development of technical
means and methods to arrange matter at the nanoscale.
• Finally, Drexler also discussed the various fields of application
for future nanomachines (Drexler, 1981 & 1986). Drexler came up
with the idea of the assembler, a molecular machine that can be
programmed to build virtually any molecular structure or device
from simpler chemical building blocks” .
• This nanoscale construction device can position molecules in every
which way, thereby facilitating, for example, chemical reactions.
• According to Drexler, the development of universally applicable
assemblers is essential for the further development of
nanotechnology. Assemblers could also be programmed to
replicate themselves.

7. State of the field at present
• Current research is directed towards the production of a wide array of
different nanoscale structures. The fabrication techniques of these
structures can be divided into two approaches: “top-down” and
“bottom-up” (Bachmann, 1998; Freitas, 1999; Pool, 1990; Roukes, 2001;
Whitesides & Love, 2001).
• The top-down techniques that are used to manufacture nanoscale
structures are mostly extensions of methods already employed in small-
scale assembly at the micron scale, for example, photolithography. By
further miniaturization, the nanodimension is entered (Ashley, 2001). In
this way, further miniaturization of microelectronics could result in
nanoelectronics (Lieber, 2001).
• Bottom-up fabrication methods for manufacture are studied within
synthetic chemistry, which is, almost by definition, the science of
producing nanoscale structures. They are also inspired by phenomena
such as crystal growth and self-assembly. In a certain way, many bottom-
up methods try to imitate regularly occurring processes in nature. Living
nature, for example, constantly shapes complex macroscopic structures
from individual biomolecular elements.

8. 3 steps to achieving nanotechnology-
produced goods
1. Scientists must be able to manipulate individual atoms.
2. Next step is to develop nanoscopic machines, called
assemblers, that can be programmed to manipulate atoms and
molecules at will.
3.In order to create enough assemblers to build consumer
goods, some nano machines called replicators, will be
programmed to build more assemblers.
• Assemblers and replicators will work together like hands,
to automatically construct products.
• Nanotechnology is about manipulating matter, atom by
atom. Just as robots assemble cars from a set of predefined
parts, nano-robots work in a similar manner
• Current research is directed towards the production of a wide
array of different nano scale structures.

9. • The growing interest in this field is giving
emergence to new field called Nanomedicine, a
science & technology of diagnosing, treating &
preventing diseases, and preserving &
improving human health, using nanoscale
structured materials.
• Because of the growing interest in the future of
dental applications of nano technology, a new
field called nano dentistry is emerging.
• This seminar provides an early glimpse of nano
dentistry applications to explain their
potentially far reaching impacts on clinical
dental practice.
• This seminar also reviews the current status and
the potential clinical applications of
nanotechnology in nano dentistry.

10. NANODENTISTRY
LOCAL
ANAESTHESIA
TOOTH REPAIR
COSMETICS
NANOMATERIALS
NANO ROBOTS

11. NANODENTISTRY OVERVIEW
• The future holds in store an era of dentistry in which every
procedure will be performed using equipments and
devices based on nanotechnology.
• Researchers have predicted that high-tech and effective
management at the microscopic level, termed
nanotechnology, will become an important part of future
dental and periodontal health.

12. • Nano dentistry can be divided into 2 approaches: “top-
down” and “bottom-up”.
• The 'top-down' techniques that are used to manufacture
nanoscale structures are mostly extensions of methods
already employed in small-scale assembly at the micron
scale. By further miniaturization, the nanodimension is
entered.
• 'Bottom-up' fabrication methods for manufacture are the
methods used for producing nanoscale structures.
Methods used for producing nanoscale structure, through
this method nanoparticles are produced directly. Various
nanoparticles produced through bottom up method and
used in dentistry are nanopores, nanotubes, quantum dots,
nanoshells, dendrimers liposomes, nanorods, fullerenes,
nanospheres, nanowires, nanobelts, nanorings,
nanocapsules.
Rybachunk AV, Chelkman IS. Nanotechnology and nanoparticles in
dentistry. Pharmacol Pharm 2009;1:18-21.

13. Nanodentistry as bottom-up
approach
• Inducing anesthesia
• Major Tooth Repair
• Hypersensitivity Cure
• Dental Durability and Cosmetics
• Nanorobotic Dentifrice (dentifrobots)
• Tooth repositioning
• Local drug delivery
• Nanodiagnostics
• Therapeutic aid in oral diseases.

14. Nanodentistry as top down approach
• Nanocomposites
• Nano Light-Curing Glass Ionomer Restorative
Materials
• Nano Impression Materials
• Nano-Composite Denture Teeth
• Nanosolutions
• Nanoencapsulation
• Plasma Laser application
• Prosthetic Implants
• Nanoneedles
• Bone replacement materials

15. Nanodentistry as bottom-up
approach1. Local anaesthesia
Well-known alternatives, such as transcutaneous electronic nerve stimulation
(TENS), cell demodulated electronic targeted anesthesia and other
transmucosal, intraosseous or topical techniques, have proved to be of limited
clinical efficacy
A colloidal suspension containing millions of active analgesic micron-size
dental robots will be instilled on the patient's gingiva. After contacting
the surface of crown or mucosa, the ambulating nano robots reach the
pulp via the gingival sulcus, lamina propria, and dentinal tubules.
On reaching the dentin, the nanorobots enter dentinal tubule holes that
are 1 to 2 micrometer in diameter and proceed towards the pulp, guided
by a combination of chemical gradients, temperature differentials and
even positional navigation; all under the control of the on-board
nanocomputer as directed by the dentist.
Assuming a total path length of about 10 mm from the tooth surface to
the pulp and a modest travel speed of 100 micrometers per second,
nanorobots can complete the journey into the pulp chamber in
approximately 100 seconds.
Freitas,R.A.,2000.Nanodent.J.Am.Dent.Assoc.131(3),1559–1566.

16. • Once installed in the pulp, the analgesic dental
robots may be commanded by the dentist to
shut down all sensitivity in any particular tooth
that requires treatment.
• The presence of natural cells that are constantly
in motion around and inside the teeth suggests
that such journeys should be feasible by cell
sized nanorobots of similar mobility.
• After oral procedures are completed, the
dentist orders the nanorobots to restore all
sensation, to relinquish control of nerve traffic,
and to egress from the tooth by similar
simultaneously in real time pathways used for

17. Advantages
• Patient has anxiety-free and needleless
comfort.
• The anesthesia is fast acting and reversible,
with no side effects or complications
associated with its use

18. Nanorobot
• A nanorobot is a specialized nanomachine.
• It has dimensions in the order of nanometers.
• Typically 0.5 to 3 microns large with 1-100 nm
parts made of chemically inert forms of carbon.
• The possibility of nanorobots was first proposed
by Richard Feyman in his talk “There’s Plenty of
Room at the Bottom” in 1959
• Functions in dentistry
• Induces local anaesthesia.
• Avoids discomfort to the patient.
• Dentrifices (dentofrobots)
• Major Tooth Repair
• .

19. Major Tooth Repair
• Nanodental techniques for major tooth repair may evolve through several stages
of technological development, first using genetic engineering, tissue
engineering and tissue regeneration, and later involving the growth of whole
new teeth in vitro and their installation.
• Ultimately, the nanorobotic manufacture and installation of a biologically
autologous whole-replacement tooth that includes both mineral and cellular
components— that is, complete dentition replacement therapy—should
become feasible within the time and economic constraints of a typical office
visit, through the use of an affordable desktop manufacturing facility, which
would fabricate the new tooth, in the dentist’s office.
Shellart W.C., Oesterle L.J. uprighting molars without extrusion. JADA 1999;130: 381-

20. • Chen et al in 2003, took advantage of these latest
developments in the area of nanotechnology to
simulate the natural biomineralization process to
create the hardest tissue in the human body,
dental enamel, by using highly organized
microarchitectural units of nanorod-like calcium
HA crystals arranged roughly parallel to each
other.
Chen Y, Jung G-Y, Ohlberg DAA, et al. Nanoscale molecular-switch
crossbar circuits. Nanotechnology. 2003;14:462.

21. • REGENERATIVE NANOTECHNOLOGY
• Also know as Dentition renaturalization
• This procedure may become popular and provide
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,
and 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 original teeth.
• This technique may revolutionarize cosmetic
dentistry.
Freitas RA Jr. Nanodentistry. Journal of American Dental Association.
2000;131(11):1559-65

22. Hypersensitivity
It is characterised by short, sharp pain arising from exposed dentin in
response to stimuli typically thermal, evaporative, tactile, osmotic or
chemical and which cannot be ascribed to any other form of dental
defect or pathology

23. • Hypersensitivity cure
• The most common clinical cause of dentin hypersensitivity is exposed dentinal
tubules as a result of gingival recession and subsequent loss of cementum on root
surfaces.
• Conventional treatment includes
1. Desensitisation by occluding dentinal tubules
Calcium hydroxide paste
Calcium phosphate paste
Silver nitrate
Fluorides
Fluoride iontophresis
Potassium nitrate
Varnishes
Dentin adhesives
C)placement of restorations
Glass ionomer cements
Composite resins
d)use of lasers
co2 laser
Nd:yag,er:yag LASER
He:ne LASER
2. Desensitizing by blocking pulpal sensory nerves
A)potassium nitrate toothpaste

24. Nanotechnology in conventional methods for treating
hypersensitivity
• The Polyhedral Oligomeric Silsesquioaxane (POSS)
molecule can be used to reduce tooth sensitivity through
sealing the tubules with POSS nano-sized molecules, and
provide structural reinforcement, toughness, and
processability.
Using Nanorobots
• Dentin hypersensitivity may be caused by changes in
pressure transmitted hydro dynamically to the pulp. This is
based on the fact that hypersensitive teeth have eight
times higher surface density of dentinal tubules and
tubules with diameters twice as large as non sensitive
teeth.
• Dental nanorobots could selectively and precisely occlude
selected tubules in minutes, using native logical materials,
offering patients a quick and permanent cure.

25. Dental durability and cosmetics.
• Tooth durability and appearance may be improved by
replacing upper enamel layers with covalently bonded
artificial materials such as pure sapphire and diamond
which has 20-100 times more hardness and strength than
natural enamel and contemporary ceramic veneers and has
good biocompatibility. These materials are brittle and can
be made more fracture resistant as a part of
nanostructured composites, possibly including embedded,
carbon nanotubes

26. Nanotechnology toothpaste
• The small nano partices of Hydroxyapatite helps to prevent the tooth from
decaying, it also rebuilds teeth by placing a coating on the tooth to protect it
from future damage.
• Active ingredients are Patented nano technology aka Nanoxyd® which is
calcium peroxide in nano size, which penetrates into the most minute of
gaps, ensuring an optimum bleaching result.
• Enzymes (papain and bromelain) gently remove the plaque
• Co-enzyme Q10 protects against inflammation of the gums.
• Vitamin E protects the teeth and vitalises the gums.
• Fluoride combination protects against tooth decay.
• It whitens and polishes the teeth and makes it less sensitive
• It arranges itself in a way that mimics and binds to the natural enamel
structure.
• If Hydroxyapatite is swallowed it does not upset the stomach and is not as
toxic as regular toothpaste.
http://blogs.dickinson.edu/mindmeetsmatter/category/nanotechnology-toothpaste/

27. Nanorobotic dentifrice [dentifrobots]
• Sub occlusal dwelling nanorobotic dentrifice delivered by
mouthwash or toothpaste could patrol all supragingival
and subgingival surfaces at least once a day, metabolising
trapped organic matter into harmless and odorless vapors
and performing continuous calculus debridement.
• These invisibly small dentifrobots [1-10 micron], crawling
at 1-10 microns/sec, would be inexpensive, purely
manufactured non agglomerated discrete nanoparticles
mechanical devices, that would safely deactivate
themselves if swallowed and would be programmed with
strict occlusal avoidance protocol.
• Dentifrobots also would provide a continuous barrier to
halitosis since bacterial putrefaction is the central
metabolic process involved in oral malodor. With this
kind of daily dental care available from an early age,
conventional tooth decay and gingival disease will
disappear.

28. Nanodentistry as top down approach
• Nanocomposites
• Nano Light-Curing Glass Ionomer Restorative
materials
• Nano Impression Materials
• Nano-Composite Denture Teeth
• Nanosolutions
• Nanoencapsulation
• Plasma Laser application
• Prosthetic Implants
• Nanoneedles
• Bone replacement materials

29. Evolution in composites
The chronological development of the state of the art of
dental composite formulations based on filler particle
modifications.

30. Nanocomposites

31. • Nanocomposites
• Nanotechnology has had its greatest impact on
restorative dentistry by offering refinements to
already clinically proven resin based composite
systems.
• Nanohybrid and nanofilled RBCs are generally the
two types of composite restorative materials
characterized by filler-particle sizes of ≤100 nm
referred to under the term “nanocomposite”.
• Nanomers and nanoclusters are the two types of
monodispersed non agglomerated discrete
nanoparticles that are homogeneously distributed in
resins or coatings to produce nano composites.
An application of nanotechnology in advanced dental materials Sumita
b. Mitra, Dong WU, and Brain N. Holmes JADA October 2003 134(10):
1382-1390

33. Materials used to reinforce composites
• Nanomaterials available as titanium dioxide, aluminum oxide
and silica oxide are used in small amounts (1%–5%) to improve
powder flow of composites. Eg. Isopast® and Heliomolar® by
Ivoclar Vivadent
• Nanocream- Nano Aluminium Oxide Fibres
Nano-structural aluminium oxide fibers provide added strength and
improved performance to metals, plastics, polymers and composite
materials.
• Nanoporous Silica-Filled Composite
Nanoporous silica filled composite is a fairly new material still in
experimental form, proven to increase wear resistance in posterior
applications.
Nano sized porous silica fillers allow the monomer to inter- penetrate it,
through a capillary force; the monomer is drawn in and out of the filler,
reinforcing the composite and increasing the durability of the bonding
between the two phases.
By impregnating organic monomer into the pores & adding a light cure
system a solid organic/inorganic nanostructure is formed.

34. Silane bonding agents
• Together with the evolution of nanoparticles for dental
composites, sharper focus is being applied to reformulations of
interfacial silanes
• Organosilanes such as allyltriethoxysilane have demonstrated
good compatibility with nanoparticle fillers such as TiO2.
• In addition,3ethacryloxypropyltrimethoxysilane has also
been demonstrated to enhance dispersion of silica nanoparticles
(5–25 nm) within the restorative resin matrix.
• Silanization has been reported is one of several theoretical
avenues for increasing fracture toughness of nanocomposites.
• silanization increased the strength of a novel ion-releasing
calcium phosphate (CaPO4) composite, but decreased the level
of release.
Current practicality of nanotechnology in dentistry. Part 1:Focus on nanocomposite restoratives and
biomimeticsClinical, Cosmetic and Investigational Dentistry 2009:1 47–61

35. Figure 6: Sem micrograph of filtek supreme [a=x1,000 b=x2,500 magnification]
spherical nanocluster of 1 to 4 um
Trade name - filtek O supreme universal restorative pure
nano

36. SEM IMAGE
An application of nanotechnology in advanced dental materials Sumita b. Mitra, Dong WU, and
Brain N. Holmes JADA October 2003 134(10): 1382-1390

37. Advantages
• Mechanical strength and wear resistance comparable to hybrid
composites
• Superior flexural strength, modulus of elasticity, and translucency
• Superior polish and gloss resistance comparable to microfill
composites.
• 50% reduction in filling shrinkage
• Excellent handling properties
• Trade names:
• Filtek O Supreme Universal Restorative Pure Nano ,
• Premise, Kerr/Sybron, Orange, CA
• Trade name of nanohybrids: Nanohybrid NANOSIT™ nanohybrid
composite (Nordiska Dental, Angelholm, Sweden
• Trade name of nanofills: Filtek™ Supreme Plus [3M ESPE],
Estelite® Sigma [Tokuyama America, Inc., Encinitas, CA, USA])

38. Ormocers
• Ormocer® is an acronym for organically modified
ceramics.
• Ormocers represent a new technology based on sol-
gel synthesis using particles comprising silicones,
organic polymers, and ceramic glasses that is
applicable to dental composites.
• Ormocer® composite technology is used in
conjunction with nanoparticle fillers such as ZrO2
that are widely used in nanocomposite restorative
systems.
• Some ormocers (such as CeramX™ [Dentsply
International]) contain particles as small as 2–3 nm
in diameter. Admira (Voco GmBh)

39. ADVANTAGES
• Modifying ormocers with organic moieties
such as methacrylate-substituted ZrO2 or
SiO2 organosol nanoparticles was found to
improve the mechanical properties of RBCs.
• Ormocers also have decreased surface
roughness and superior strength as
compared to the other composite systems.

40. Other features of nano composites..
• Caries prevention
• Optimal delivery of molecules that facilitate tooth structure
remineralization and forestall caries.
• Fluoride (F)-releasing nanocomposite contains novel CaF2
nanoparticles in a whisker-reinforced resin matrix, and had
sustained F-release values exceeding those of conventional and
resin-modified glass ionomers.
• Dicalcium phosphate anhydrous (DCPA) incorporated with
nanosilica-fused whiskers found that it increased the strength of
the RBC by as much as threefold while releasing CaPO4.
• Zirconia-amorphous calcium phosphate RBC filler, showed
good release properties in addition to an increase in biaxial
flexural strength

41. • Nano Light-curing glass ionomer
restorative materials
• Blends Nanotechnology originally developed for Filtek™
Supreme Universal Restorative with fluoraluminosilicate (FAS)
technology.
Advantages:
1. Superb polish.
2. Excellent esthetics.
3. Improved wear resistance
Clinical Indications:
- Primary teeth restorations.
- Transitional restorations.
- Small Class I restorations.
- Sandwich restorations.
- Class III and V restorations.
- Core build-ups.

42. Impression Materials
• Nanofillers are integrated in vinylpolysiloxanes,
producing a unique addition of siloxane impression
materials.
• The material has better flow, improved hydrophilic
properties hence fewer voids at margin and better
model pouring, and enhanced detail precision.
Advantages:
1. Increased fluidity
2. High tear resistance,
3. Hydrophilic properties
4. Resistance to distortion and
heat resistance
5. Snap set that consequently reduces errors caused by
micro movements
• Trade name: Nanotech Elite H-D

43. Nano-composite denture teeth
• Conventional denture teeth have their own inherent
disadvantage.
• Porcelain is highly wear resistant, but is brittle, lacks bonding
ability to the denture base, and is not easy to polish.
• Acrylic on the other hand is to adjust, but undergo undue wear.
Nanocomposite denture teeth are made of
Polymethylmethacrylate (PMMA) and homogeneously
distributed nanofillers.
Advantages:
• Excellent polishing ability and stain-resistant
• Superb esthetics, lively surface structure
• Enhanced wear resistance and surface hardness
• Trade name: Veracia( Shofu, Kyoto, Japan) The three layered
Veracia SA teeth consist of MF-H (microfilled hybrid)
composite, reinforced with layered glass.

44. Nanosolution
Nanoadhesives
• The new bonding agents manufactured from nano
solutions contain stable nano particles
homogeneously dispersed throughout the solution.
• The silica nano filler technology contributes to
higher bond strength performance. Since the nano
particles are stable, they do not cluster nor do they
settle out of dispersion. Nano Interaction Zone"
(NIZ - <300 nm) with minimal decalcification and
almost no exposure to collagen fibres producing an
insoluble calcium compound for a better bond less
likely to deteriorate from enzymes contained in the
mouth.
• 10% 5 nm spherical silica is used as the filler.
• Trade name: Adper O Single Bond Plus Adhesive Single u
NanOss™ (Angstrom Medica, USA) HA Bond

45. Nanoadhesive – Poss
• Polyhedral Oligomeric Silse Squiox (Poss) enables the design of
additives that make plastics that are unusually lightweight,
durable, heat-tolerant and environment friendly.
• Poss combines organic & inorganic materials in molecules with
an average diameter of 1.5 nanometers. They can be used as
either additives or replacements for traditional plastics.
• Current applications of Poss include dental adhesives in which a
strength resin provides a strong interface between the teeth and
the restorative material.
• In addition, tests have shown that Poss materials are much more
resistant to radiation damage and erosion than conventional
polymers.
Rybachuk AV, Cekman IS. Nanotechnology And Nanoparticles In Dentistry.
Pharmocol Pharm 2009;1:18-21

46. Advantages:
• Broad spectrum
• Hypoallergic
• Non corroding
• Does not stain fabric
• Require no protective clothing
• Environment friendly
• Compatible with various impression materials.

47. Coating agents
• These light cured agents contain nanosized
fillers and are used as a final coating over
composite restorations, glass ionomer
restorations, jacket crowns, veneers and
provisionals. These coating agents have higher
wear resistance, preventing abrasion and
discolouration.
• Recently, a nanotechnology liquid polish
system was designed to overcome the
limitations of liquid polishers. The addition of
nanofillers provides excellent results such as a
glossy surface for direct or indirect resin
composite restorations.Atabek D, Sillelioglu H, Olmez A. The efficiency of a new polishing material:
Nanotechnology Liquid Polish. Oper Dent 2010;35:362-69. Back to cited text no.

48. NANOTECHNOLOGY IN IMPLANTS
• Researchers have experimented with implants made
of metals that look more natural than titanium.
There has been some success with the metal
zirconia and a rare metal called tantulum, was
discovered. These metals are still not widely used.
• Oral surgeons have discovered that implants that
are porous actually help with healing. So many
implants now come with tiny holes or rough
surfaces.
• Many dentists also use implants improved with
nanotechnology to create coatings that promote
healing. The biologically active coating creates a
more stable bond, according to several large studies.

49. • Application of nanotechnology to the dental
implant surface involves a two dimensional
association of surface features (across and
away from the mean surface plane)
• These nanofeatures can be arranged in an
organized manner (isotropic) or unorganized
manner (anisotropic), usually it is anisotropic.
• 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).
Advancing dental implant surface technology – From micron to

50. • First approach involves the physical method of
compaction of nanoparticles of TiO2.
• Second is the process of molecular self-assembly.
The exposed functional end group could be an
osteoinductive or cell adhesive molecule. An example
of this is the use of cell adhesive peptide domains
composed of polyethylene glycol (PEG) and applied to
the titanium implant surfaces
• A third method is the chemical treatment of different
surfaces to expose reactive groups on the material
surface and create nanoscale topography.
• NaOH treatment catalyzes the production of titanium
nanostructures outward from the titanium surface .
Treatment with a NaOH solution produces a sodium
titanate gel layer on the Ti surface while H2O2
produces a titania gel layer.
Advancing dental implant surface technology – From micron to
nanotopographyG. Mendonça et al. / Biomaterials 29 (2008) 3822–3835

51. • The NaOH treatment creates a gel-like layer over the
material allowing hydroxyapatite deposition. This
behavior has also been seen with other metals such as
zirconium and aluminum .
• The kinetics of HA formation is significantly
accelerated by the presence of the nanostructure
associated to the NaOH treatment. Both chemical
and topography changes are imparted.
• Chemical treatments (peroxidation (H2O2) or acid
oxidation, such as hydrofluoric acid) , treatment with
HCl have also been used to create nanotopography
an helps to increase the peptide deposition and
remineralization.
Advancing dental implant surface technology – From micron to
nanotopographyG. Mendonça et al. / Biomaterials 29 (2008) 3822–3835

52. • The deposition of nanoparticles onto the titanium
surface represents a fourth approach to imparting
nanofeatures to a titanium dental implant . Sol–gel
transformation techniques achieve deposition of
nanometer-scale calcium phosphate accretions to the
implant surface .
• Alumina, titania, zirconia and other materials can
also be applied. The deposition of discrete 20–40 nm
nanoparticles on an acid-etched titanium surface led to
increased mechanical interlocking with bone and the
early healing of bone at the endosseous implant surface
in a rat model.
• A fifth approach to creating nanoscale topography on
Titanium is the use of optical methods (typically
lithography) reliant on wavelength specific dimensions
to achieve the appropriate nanoscale modification.
Advancing dental implant surface technology – From micron to nanotopographyG.
Mendonça et al. / Biomaterials 29 (2008) 3822–3835

53. Nanotreatments done on the surface of
implants

54. • The determining factors for successful osseointegration are
surface contact area and surface topography . Bone growth and
increased predictability can be effectively expedited with implant
by using nanotechnology.
• The addition of nanoscale deposits of hydroxyapatite and calcium
phosphate creates a more complex implant surface for osteoblast
formation (Albrektsson etal.,2008;Goeneetal.,2007).
• These new implants are more acceptable, because they enhance
the integration of Nano coatings resembling biological materials
to the tissues
OTHER FEATURES
• Antibiotics or growth factors may be incorporated as CaP coating
is placed on Ti implants. eg: Nanotite™ Nano-Coated Implant.
• Radiopacity
• Nanoparticles may be incorporated in materials and instruments
to achieve radiopacity without affecting properties or the risk of
toxicity and carcinogenicity associated with heavy metals.

55. • Bone replacement materials
• Bone is a natural nano composite made up of organic compounds
(mainly collagen) toughened with inorganic compounds like
hydroxyapatite. This architecture should be simulated for
orthopedic and dental use. Also, with the reduction in particle
size, the surface area increases manifold. This rule has been
utilized by Nano-Bone®.
• Characteristics of nano bone graft materials are:
• Osteo inductive
• Completely synthetic
• Non-sintered
• Extremely porous
• Nano-structured
• Degradation by osteoclasts
• Excellent processability
• No products in ionic solution
• Bone targeting nanocarriers
• Calcium phosphate-based biomaterial has been developed. This
bone biomaterial is an easily flowable, moldable paste that
conforms to and interdigitates with host bone. It supports growth
of cartilage and bone cells.

56. • Various HA nanoparticles used in repairing osseous
defects are;
• • Ostim ® HA.
• • VITOSS ® HA+ TCP.
• • NanOss HA
Conventional calcium sulphate has been used to plug small osseous defects
like in post extraction sockets and periodontal bone defects and in addition
to bone graft material. A new calcium sulphate based composite has been
developed by, known as Bone Gen –TR which breaks down more slowly and
regenerates bone more effectively.

57. Challenges faced by nanodentistry
• Precise positioning and assembly of molecular scale
part.
• Economical nanorobot mass production technique
• Biocompatibility
• Simultaneous coordination of activities of large
numbers of independent micron-scale robots.
• Social issues of public acceptance, ethics,
regulation
Problems for research in nanotechnology
• Painfully slow strategic decisions
• Sub-optimal funding
• Lack of engagement of private industries
• Problem of retention of trained manpower

58. CONCLUSION
A day may soon come when nanodentistry
will succeed in maintaining near-perfect oral
health through the aid of nanorobotics,
nanomaterials and biotechnology.
“You have to be able to fabricate things, you have to
be able to analyze things, you have to be able to
handle things smaller than ever imagined in ways
not done before.” - William
Philips
Richard .P Feynman

59. The Next Big Thing Is Very Small…

60. THANK YOU

61. References
• Saravana KR, Vijayalakshmi R. Nanotechnology in
Dentistry. Indian J Dent Res 2006;17(2):62-5.
• Nanotechnology in dentistry: Present and future
Journal of International Oral Health 2014; 6(1):121-
126
• Nanorobots: Future in dentistry The Saudi Dental
Journal(2013) 25, 49–52
• International Journal of Biological & Medical
Research Nanotechnology in Dentistry - A Review
Int J Biol Med Res. 2012; 3(2): 1550-1553
• Future impact of nanotechnology on medicine and
dentistry Journal of Indian Society of
Periodontology - Vol 12, Issue 2, May-Aug 2008

62. • Current practicality of nanotechnology in
dentistry. Part 1: Focus on nanocomposite
restoratives and biomimetics Clinical,
Cosmetic and Investigational Dentistry 2009:1
47–61
• The changing face of dentistry:
nanotechnology International Journal of
Nanomedicine 2011:6 2799–2804
• ‘Nanodentistry’: Exploring the beauty of
miniatureJ Clin Exp Dent. 2012;4(2):e119-24
• Cover Story Robert A. Freitas Jr., J.D., B.S
JADA, Vol. 131, November 2000