Nanorobotic wonders: A revolutionary era in periodontics

Pratiksha Bordoloi; Sheikabba Shahira; Amitha Ramesh; Biju Thomas

doi:10.4103/ijmd.ijmd_29_18

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Year : 2018 | Volume : 8 | Issue : 2 | Page : 101-105

Nanorobotic wonders: A revolutionary era in periodontics

Pratiksha Bordoloi, Sheikabba Shahira, Amitha Ramesh, Biju Thomas
Department of Periodontics, A B Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India

Date of Web Publication

31-Dec-2018

Correspondence Address:
Dr. Pratiksha Bordoloi
Department of Periodontics, A B Shetty Memorial Institute of Dental Sciences, Mangalore - 575 018, Karnataka
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/ijmd.ijmd_29_18

Abstract

Greatness does not come in size. Surprises come in small packages. Robots have recently been introduced to undertake basic surgical procedures, and with the help of nanobiotechnology, another dimension of robotics has been developed as NANOROBOTS. Oral cavity is the mirror of the overall health of an individual. The various chronic inflammatory oral diseases influence the systemic health of an individual and vice versa. Various treatment modalities have been introduced for the prevention and management of periodontal disease. The introduction of nanorobots may possibly maintain the comprehensiveness of oral health. The dental application of nanorobots is leading to the emergence of nanodentistry. Nanorobots induce oral analgesia, desensitize tooth, and are also used in preventive, restorative, and curative procedures and major tooth repair. Treatment opportunities in periodontics are hypersensitivity cure, dentiforobots, bone replacement materials, nanoimplants, nanolasers, etc. Hence, the aim of this review article is to emphasize the use and the future scope of nanorobotics in periodontics.

Keywords: Hypersensitivity; nanobiotechnology; nanodentistry; nanorobots; periodontal disease

How to cite this article:
Bordoloi P, Shahira S, Ramesh A, Thomas B. Nanorobotic wonders: A revolutionary era in periodontics. Indian J Multidiscip Dent 2018;8:101-5

How to cite this URL:
Bordoloi P, Shahira S, Ramesh A, Thomas B. Nanorobotic wonders: A revolutionary era in periodontics. Indian J Multidiscip Dent [serial online] 2018 [cited 2023 May 29];8:101-5. Available from: https://www.ijmdent.com/text.asp?2018/8/2/101/249118

Introduction

Nanotechnology (nano = 10^–9) is the study of very small materials or structures (Duke, 2003). Richard P Feynman^[1] in 1960 had the first notion of how nanotechnology could be applied to health sciences. The nanorobotic theory says that they are computer-controlled microscopic devices that require a large number of them to work together to perform both microscopic and macroscopic errands.”^[2],[3] Few of these nanorobots have been developed in the recent years, but a complete working model is yet to be developed.^[4] They are being widely used in dentistry, especially in periodontics for the prevention and treatment of diseases.

History

The first observations and size measurements of nanoparticles were made during the first decade of the 20^th century by Zsigmondy, 1914.^[5] The Nobel Prize-winning physicist Richard Feynman, in 1959, explored the implications of matter manipulation. In his historic lecture, “There is plenty of room in the bottom” at American Physical Society in 1959, he concluded saying, “this is a development which I think cannot be avoided.” The true founder of nanotechnology was, though, Eric Drexler, who published “Engines of Creation: The Coming Era of Nanotechnology” in 1986.^[6] He stated that in the near future this kind of technology will be used to assemble atoms and molecules in order to build nanocircuits and nanomachines. The molecular instruments will create connections between molecules in order to create pinions, engines, manipulating arms, and minute covers that will be assembled into complex machines. The first scientist who described the medical applications of nanotechnology and nanorobots was Robert Freitas Jr. In an article published by the Journal of American Dental Association, he defined nanomedicine as the science and technology of diagnosing, treating, and preventing disease and traumatic injury; of relieving pain; and of preserving and improving human health, through the use of nanoscale-structured materials, biotechnology, and genetic engineering, and eventually complex molecular machine systems and nanorobots. In the same article, Freitas introduced the concept of nanodentistry, which he defines as the science and technology that will make possible the maintenance of near-perfect oral health through the use of nanomaterials and biotechnology, including tissue engineering and nanorobotics.^[7]

Mechanism of Action

The powering of nanorobots is expected to be done by the metabolism of:

Local glucose
Oxygen
Externally supplied acoustic energy.

They can be made to work under control by on-board computers capable of performing around 1000 or more computations per second. Communication with the device can be obtained by acoustic signaling navigational network installed in the body that would provide high positional accuracy to all passing nanorobots and help in keeping track of various devices in the body. When the task of the nanorobots is completed, they can be retrieved by allowing them to effuse themselves via the usual human excretory channels. These can also be removed by active scavenger systems.^[8]

Freitas in 1999 described how medical nanorobots might use specific motility mechanisms to crawl or swim through human tissues with:^[9]

Navigational recession
Cytopenetration
Use any of multitudes of techniques to monitor, interrupt, or alter nerve impulse traffic in individual nerve cells.

According to the present-day theories, dental nanorobots should have at least the following two means of communication:

Both with the doctor who coordinates it
With the other nanorobot he teams up with.

The following two possible ways of communicating between nanorobots are being considered:

By means of light signals through optical nanosensors^[10]
By chemical signals through chemical nanosensors (i.e., nanorobots monitoring the glucose level).^[11]

Composition

The principal element in the exterior surface of the nanorobots is the carbon (C) which is in the form of diamond. Other elements include hydrogen (H), sulfur (S), oxygen (O), nitrogen (N), fluorine (F), and silicon (Si), which are used in nanoscale gears and other components.^[4] Glucose or its other natural substitutes and oxygen could be the source of propulsion in the body. Depending on the specific task to be performed, they have specific biochemical or molecular parts.^[12]

Components

Nanorobots will have a dimension of about 1–100 nm and a diameter of approximately 0.5–3 μ. Several designs of nanorobots have been proposed, of which a multiple manipulating armed spider-like configuration is thought to be the most ideal design as it enables rapid motility and multitasking capability.^[13] The surface should be super smooth so that when the nanorobots are introduced in the body, they will prevent the triggering of body's immune system, thus allowing them to work efficiently.

The four major parts in a nanorobot are as follows:

Camera
Payload
Capacitor
Swimming tail.

Manufacturing them will also involve sensors, actuators, control, power, communications, and interfacing across spatial scales and between organic/inorganic as well as biotic/abiotic systems.

Nanostructures Used in Dentistry

Nanoparticles
Nanorods
Nanospheres
Nanotubes
Nanofibers
Dendrimers and dendritic copolymers
Nanopores
Nanoshells.

Others: Various other nanostructures which are used in health-care fields are as follows:

Liposomes
Quantum dots
Fullerenes
Nanowires
Nanobelts
Nanorings
Nanocapsules.

Current Applications in Periodontics

The two most common approaches used in assembling and making the nanorobots are as follows:

Bottom-up approach
Top-down approach.

Bottom-up approach

The sophisticated nanorobots are made by assembling and arranging smaller components to form larger units. Some examples of nanoparticles used in dentistry which are produced by bottom-up approach are nanoshells, nanospheres, quantum rods, nanopores, fullerenes, nanotubes, nanobelts, nanorings, nanocapsules, etc.

Hypersensitivity cure: The prime cause of dentin hypersensitivity is the change in the hydrodynamic pressure of the pulp (hydrodynamic theory). The best way to deal with it is by occluding the tubules. In the future, nanorobots could selectively and precisely occlude selected tubules in minutes, using native biological materials, offering patients a quick and permanent cure
Nano-anesthesia: A colloidal suspension containing thousands of active analgesic nanorobots will be instilled on the patient's gingiva and will reach the pulp via the gingival sulcus, lamina propria, and dentinal tubules
As they are installed in the pulp, they may be commanded by the dentist to shut down all sensitivities in the tooth that require treatment. After the procedures are completed, the dentist orders the nanorobots to restore back all the neural sensations.
Self-assembly: It is an autonomous and spontaneous organization of different components into patterns or structures without human intervention. Recent advancements in nanorobots have this property and can direct mineralization of hydroxyapatite (HA) to form a composite crystalline structure where the long axes mimic the periodontium
Antimicrobial photodynamic therapy (aPDT): Nanorobots consisting of photosensitizer or dye associated with a light source of specific wavelength (805 nm) comprise of aPDT which is used for the treatment for the removal and control of infection
Nanotissue engineering: Chan et al. recreated dental enamel, the hardest tissue in the human body, by using highly organized microarchitectural units of nanorods, which was based on the principles of complete dentition replacement.^[14] It refers to the replacement of the whole tooth, including the cellular and mineral components. It is possible through a combination of nanotechnology, genetic engineering, and tissue engineering
Nanotherapeutics: Nanorobots help in achieving the therapeutic effects of the drug. Drugs are loaded with nanoparticles which will enhance the properties of the drug such as sustained release and effective low dosage. It could be helpful in local drug delivery systems for treating periodontitis.

Top-down approach

Contrary to the previous approach, larger units are directed in order to create smaller devices. This is a process of making tinier version of the nanorobots.

Dentiforobots: They are made up of nanosized HA molecules. They dwell subocclusally which are delivered by mouthwash or toothpaste. They metabolize trapped organic matter into harmless and odorless vapors and perform continuous calculus debridement by keeping a check on the supragingival and subgingival surfaces at least once a day^[15]
Nanoencapsulation: Nanoencapsulations were developed by South West Research Institute, which are targeted release systems including novel vaccines, antibiotics, and drug delivery with reduced side effects. In future, specialized nanoparticles could be engineered to target oral tissues, including cells derived from the periodontium
Nanoimplants: Titanium endosseous implant surfaces coated with nanoscale topography are used which can alter the cellular and tissue responses that benefit dental implant therapy. Diamond (improves hardness, toughness, and low friction), HA (increases osteoblast adhesion proliferation and mineralization), and graded metalloceramics (ability to overcome adhesion problems) are the nanostructured implant coatings being used currently^[16]
Bone replacement materials: Bone is a natural nanostructure that is composed of organic and inorganic compounds. Nanorobotics aims to maintain its nanostructure for its application in dentistry and orthopedics. Bone defects can be treated by using the HA nanoparticles
Some of the hydroxyapatite nanoparticles used to treat bone defects are as follows:^[17]

Ostim^® HA (Osartis GmbH & Co. KG, Dieburg, Germany)
Vitosso (Orthovita, Inc., USA) HA + tricalcium phosphate
NanOSSTM HA (Angstrom Medica, USA).

Nanoneedle: Suture needles with nanosized stainless steel crystals controlled by nanorobots have been developed which help in precise suturing techniques and less tissue reactions
Nanolasers: Nanorobots release pulsating laser ablation consisting of multimaterial nanoparticles which are used for drug and gene delivery purposes. Laser incorporated with nanoparticles has improved the properties of endothelization for the development of novel biomedical implants. For dentinal tubular occlusion, laser-induced nanogold particles are used.

Challenges

Engineering challenges

Feasibility of mass production technique
Precise positioning and assembly of molecular scale parts
Manipulating and coordinating activities of various microscale robots.

Biological challenges

Development of bio-friendly nanomaterials
Biocompatibility with all intricate of the human body.

Social challenges

Ethics
Public acceptance
Regulation and human safety.

Problems for Research in Nanorobotics in India

Painfully slow strategic decisions
Suboptimal funding
Lack of engagement of private enterprises
Problem of retention of trained workforce.^[18]

Nanohazards

Numerous issues and concerns need to be addressed since nanotechnology and nanorobotics is a very recent discovery and is only just being put in to us. As the long-term effects of nanorobots are not known, their future prospective is still questionable. Nanomaterials released by the nanorobots in the environment can be modified by temperature, pH, and different biological conditions, and the presence of other pollutants can have hazardous and irreversible effects on human health and the environment.^[19]

Future

Newer methods for better disease diagnosis, prevention, and treatment planning
Controlled and more accurate drug delivery systems
Gene therapy.

Conclusion

With the advancement in nanotechnology, human lives have been influenced to a great extent and so has the field of health and dental sciences. Nanodentistry is a revolutionary era for the diagnosis, treatment, and prevention of various oral diseases. Dr. Gregory Fahy described nanorobots as “living organisms, naturally existing, fabulously complex systems of molecular nanotechnology.”^[20] As with all technologies and inventions, nanorobotics too possesses a potential threat for its misuse as a very thin demarcation is present between its harmonious and judicious use and deleterious misuse. The recent advancements in the field of nanodentistry, particularly of nanoparticles and nanotubes for periodontal management, and the materials developed such as the hollow nanospheres, core shell structures, nanocomposites, nanoporous materials, and nanomembranes will play a growing role in material development for the dental industry.^[21] Nanomedicine needs to overcome the various challenges for its application, to improve the understanding of pathogenesis of disease, bring more promising and precise diagnostic opportunities, and yield more effective therapies and preventive properties.^[22] Molecular technology is destined to become the core technology underlying all of the 21^st-century medicine and dentistry.^[23]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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