Innovations in Dentistry: Navigational Surgery, Robotics, and Nanotechnology

** Note to Readers: With more than a few ‘dental people connections’ in the family, please indulge us this ‘nano-departure’ from our normal Posts on Renewable Energy (Green Hydrogen, Nano-Enhanced Battery Materials & Storage), Nano-Bio Medicine (Nano-Enhanced Cancer Research & Treatment) and Water Treatment (Nano-Enhanced Membranes and Nanoparticles). We hope you can “sink your teeth” into these amazing advances in Technology making our lives a little better. – Team GNT

A Dental Story

Reggie falls and loses two of his teeth. He soon finds it difficult to chew correctly and realizes he might visit the dentist for implants. Coincidentally, his grandmother had to get implants years ago. He remembers how they had to take multiple visits to the dentist and how long it took to fix her smile. Ultimately, Reggie gets discouraged and postpones his visit to the dentist.

This story typically depicts one of the drawbacks of traditional dental procedures, which has been corrected by technological advancements in dentistry over the years. Most dental experts today, like the dentist Steven Shapiro, DMD attests to the benefits of advanced technology such as nanotechnology and robotics in dental surgeries and procedures.

It has also been established that, because of these innovations, there is higher accuracy in surgeries, reducing the risk of complications which is a big win for the dental industry today. This is not to mention the increased convenience for the patient. So, Reggie might not have to wait that long to get his dental implants anymore.

Here are some of the technology innovations that have rocked the world of dentistry over the years.

Navigational dentistry

Navigation surgery in dental procedures is associated with better accuracy, improved reliability, and convenience. These techniques are often linked with imaging systems like cone-beam computed tomography. This ensures better safety as compared with conventional dental procedures. There’s also a generally reduced failure rate, especially for dental implants, since less invasive methods are used. Therefore, there’s an increased success rate of such surgeries and fewer major complications.

Robotics-assisted dental surgeries

Advanced artificial intelligence in robotics is now used in navigational surgery for many dental procedures such as implant treatment periodontics, orthodontics, endodontics, and so much more. Increased precision and better dental care are made available using robotics over traditional freehand techniques. Dental clinicians can also use artificial intelligence to create new methods of diagnosing and treatment.

Complications of traditional implant surgery vs use of robotics

Several things could go wrong during implant surgery. These include:

• Injuries are caused by incision or perforation of the lingual plate, inferior border, inferior alveolar canal, and so on;
• Tissue necrosis or death;
• Implant Dehiscence defect; and
• Damage to a nerve.

The above kinds of injury can cause complications and severe infections. Other factors can lead to complications such as lack of adequate dental expertise, patient-related or underlying conditions, and implant location.

A surgical guide should help the dentist navigate during traditional dental surgeries, but there could be specific errors, such as fitting and angulation. With robotics, the clinician can change direction during the implant procedure, unlike surgical guides, which don’t allow any adjustments. Other benefits of using robotics in surgical implant treatment are:

• Imaging during the preoperative phase to enable the dentist properly views the anatomical features.
• It hands over control to the dentist after its job is done.
• It makes use of sensory feedback for correct angulation and positioning.
• It provides navigational guidance to the dental clinician.
• It is more convenient for the patient.

Use of microrobots

Microrobots can be used in endodontic therapy. In this procedure, the microrobot is placed on the tooth. It carries out the root canal procedure, including cleaning and drilling, to reduce errors and improve the reliability of the process.

Nanotechnology

Nanotechnology is simply the branch of engineering and technology concerned with building and designing nanobots. These nanobots are tiny machines that can interact with specific cells in the body. This interaction can lead to changes in treatment delivery and overall therapeutic effect.

Nano dentistry is the application of nanotechnology in the field of dentistry. Due to its small size(nanometers), it is used at the cellular or molecular level to manage all complicated cases and reduce the failure rate of dental procedures. Nanotech is used in restorative surgeries, periodontics, bone replacement, and drug delivery.

More beneficial than conventional methods

In summary, artificial intelligence and nanotechnology are more beneficial than conventional methods but are slowly used in dentistry compared to other areas of medicine. Dentists must play a massive role in adopting these techniques and increasing their knowledge about these technological advancements.

Since the goal of patient care is optimum treatment, tech advancements have been proven to provide a better quality of treatment and are worth giving a shot. Conventional dental procedures are time-consuming and are also largely inconvenient.

Still, technology can take all these disadvantages away by saving time, improving precision and accuracy, improving reliability, reduce complications and failure rates for dental procedures.

The “Nano-Tooth Fairy” – Nanoparticles Release Drugs to Reduce Tooth Decay

Therapeutic agents intended to reduce dental plaque and prevent tooth decay are often removed by saliva and the act of swallowing before they can take effect. But a team of researchers has developed a way to keep the drugs from being washed away.

Dental plaque is made up of bacteria enmeshed in a sticky matrix of polymers—a polymeric matrix—that is firmly attached to teeth. The researchers, led by Danielle Benoit at the University of Rochester and Hyun Koo at the University of Pennsylvania’s School of Dental Medicine, found a new way to deliver an antibacterial agent within the plaque, despite the presence of saliva.

Their findings have been published in the journal ACS Nano.

“We had two specific challenges,” said Benoit, an assistant professor of biomedical engineering. “We had to figure out how to deliver the anti-bacterial agent to the teeth and keep it there, and also how to release the agent into the targeted sites.”

To deliver the agent—known as farnesol—to the targeted sites, the researchers created a spherical mass of particles, referred to as a nanoparticle carrier. They constructed the outer layer out of cationic—or positively charged—segments of the polymers. For inside the carrier, they secured the drug with hydrophobic and pH-responsive polymers.

The positively-charged outer layer of the carrier is able to stay in place at the surface of the teeth because the enamel is made up, in part, of HA (hydroxyapatite), which is negatively charged. Just as oppositely charged magnets are attracted to each other, the same is true of the nanoparticles and HA. Because teeth are coated with saliva, the researchers weren’t certain the nanoparticles would adhere. But not only did the particles stay in place, they were also able to bind with the polymeric matrix and stick to dental plaque.

Since the nanoparticles could bind both to saliva-coated teeth and within plaque, Benoit and colleagues used them to carry an anti-bacterial agent to the targeted sites. The researchers then needed to figure out how to effectively release the agent into the plaque.

Farnesol is released from the nanoparticle carriers into the cavity-causing dental plaque. Credit: Michael Osadciw/University of Rochester 

A key trait of the inner carrier material is that it destabilizes at acidic—or low pH—levels, such as 4.5, allowing the drug to escape more rapidly. And that’s exactly what happens to the pH level in plaque when it’s exposed to glucose, sucrose, starch, and other food products that cause tooth decay. In other words, the nanoparticles release the drug when exposed to cavity-causing eating habits—precisely when it is most needed to quickly stop acid-producing bacteria.

The researchers tested the product in rats that were infected with Streptococcus mutans—a microbe that causes tooth decay. “We applied the test solutions to rats’ mouths twice daily for 30 seconds, simulating what a person might do using a mouth rinse morning and night,” said Hyun Koo, a professor in the Department of Orthodontics and co-senior author of the work. “When the drug was administered without the nanoparticle carriers, there was no effect on the number of cavities and only a very small reduction in their severity. But when it was delivered by the nanoparticle carriers, both the number and severity of the cavities were reduced.”

Plaque formation and tooth decay are chronic conditions that need to be monitored through regular visits to the dental office. The researchers hope their results will someday lead to better—and perhaps permanent—treatments for dental plaque and tooth decay, as well as other biofilm-related diseases.