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1. Local anaesthesia In the era of nanodentistry a colliodal 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 nanorobots reach the pulp via the gingival sulcus, lamina propria and dentinal tubules. 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.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 pathways used for ingress.

2. Hypersensitivity cure Dentin hypersensitivity may be caused by changes in pressure transmitted hydrodynamically to the pulp. This is based on the fact that hypersensitive teeth have 8 times higher surface density of dentinal tubules and tubules with diameters twice as large than nonsensitive teeth.Dental nanorobots could selectively and precisely occlude selected tubules in minutes, using native biological materials, offering patients a quick and permanent cure.

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3. Nanorobotic dentifrice [dentifrobots] Subocclusal dwelling nanorobotic dentifrice delivered by mouthwash or toothpaste could patrol all supragingival and subgingival surfaces atleast once a day, metabolising trapped organic matter into harmless and odorless vapors and performing continuous calculus debridement.These invisibly small dentifrobots [1-10 micon], crawling at 1-10 microns/sec, would be inexpensive, purely mechanical devices, that would safely desactivate themselves if swallowed and would be programmed with strict occlusal avoidance protocol. 4. Dental durability and cosmetics Tooth durability and appearance may be improved by replacing upper enamel layers with pure sapphire and diamond which can be made more fracture resistant as nanostructured composites, possibly including embedded carbon nanotubes.

5. Orthodontic treatment.Orthodontic nanorobots could directly manipulate the periodontal tissues, allowing rapid and painless tooth straightening, rotating and vertical repositioning within minutes to hours. 6.

Photosensitizers and carriers Quantum dots can be used as photosensitizers and carriers. They can bind to the antibody present on the surface of the target cell and when stimulated by UV light, they can give rise to reactive oxygen species and thus will be lethal to the target cell. 7. Diagnosis of oral cancer NANO ELECTROMECHANICAL SYSTEMS(NEMS) Convert (bio) chemical to electrical signal CANTILEVER ARRAY SENSORSUltrasensitive mass detection technology: Picogram (10-12)-bacterium Femtogram (10-15)-virus Attogram (10-18)-DNA MULTIPLEXING MODALITY Sensing large numbers of different biomolecules simultaneously in real time APPLICATIONS * Diagnosis of diabetes mellitus and cancer * Detection ofbacteria, fimgi and viruses 8. Treatment of oral cancer NANOMATERIALS FOR BRACHYTHERAPY BrachySilTM (Sivida, Australia) delivers 32P, clinical trial DRUG DELIVERY ACROSS THE BLOOD-BRAIN BARRIER / More effective treatment of brain tumours, Alzheimer’s, Parkinson’s in development NANOVECTORSFORGENE THERAPYNon-viral gene delivery systems Nanodentistry as top-down approach [11] 1. Nanocomposites Nanoproducts Corporation has successfully manufactured nonagglomerated discrete nanoparticles that are homogeneously distributed in resins or coatings to produce nanocomposites.

The nanofiller used includes an aluminosilicate powder having a mean particle size of 80 ran and a 1:4 M ratio of alumina to silica and a refractive index of 1. 508. Advantages * Superior hardness * Superior flexural strength, modulus of elasticity and translucency * 50% reduction in filling shrinkage * Excellent handling properties.Trade name: Filtek O Supreme Universal Restorative P Lire Nano O 2. Nanosolution Nanosolutions produce unique and dispersible nanoparticles, which can be used in bonding agents. This ensures homogeneity and ensures that the adhesive is perfectly mixed everytime. Trade name: Adper O Single Bond Plus Adhesive Single Bond 3.

Impression materials Nanofillers are integrated in vinylpolysiloxanes, producing a unique addition of siloxane impression materials. The material has better flow, improved hydrophilic properties and enhanced detail precision. Trade name: Nanotech Elite H-D 4. Nanoencapsulation.

SWRI [South West Research Institute] has developed targeted release systems that encompass nanocapsules including novel vaccines, antibiotics and drug delivery with reduced side effects. At present, targeted delivery of genes and drugs to human liver has been developed by Osaka University in Japan 2003. Engineered Hepatitis B virus envelope L particles were allowed to form hollow nanoparticles displaying a peptide that is indispensable for liver-specific entry by the virus in humans.

Future specialized nanoparticles could be engineered to target oral tissues, including cells derived from the periodontium [Yamada et al , 2003].5. Other products manufactured by SWRI a. Protective clothing and filtration masks, using antipathogenic nanoemulsions and nanoparticles b.

Medical appendages for instantaneous healing * Biodegradable nanofibres – delivery platform for haemostatic * Wound dressings with silk nanofibres in development * Nanocrystalline silver particles with antimicrobial properties on wound dressings [ ActicoatTM, UK] c. 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. 6.

Nanoneedles Suture needles incorporating nano-sized stainless steel crystals have been developed. Trade name: Sandvik Bioline, RK 91TM needles [AB Sandvik, Sweden]. Nanotweezers are also under development which will make cell-surgery possible in the near future. 7. Bone replacement materials Hydroxyapatite nanoparticles used to treat bone defects are * Ostim® (Osartis GmbH, Germany) HA * VITOSSO (Orthovita, Inc, USA) HA +TCP * NanOSSTM (Angstrom Medica, USA) HA How safe are these nanorobots? [12].The nonpyrogenicnanorobots used in vivo are bulk teflon, carbon powder and monocrystal sapphire. Pyrogenic nanorobots are alumina, silica and trace elements like copper and zinc.

If inherent nanodevice surface pyrogenicity cannot be avoided, the pyrognic pathway is controlled by invivo medical nanorobots. Nanorobots may release inhibitors, antagonists or dowmegulators for the pyrognic pathway in a targeted fashion to selectively absorb the endogenous pyrogens, chemically modify them, then release them back into the body in a harmless inactivated form. Challenges faced by nanodentistry [13].* 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 and human safety Problems for research in nanotechnology in India[13] * Painfully slow strategic decisions * Sub-optimal funding * Lack of engagement ofprivateenterprises * Problem of retention of trained manpower Future| | | Nanotechnology is foreseen to change health care in a fundamental way:* Novel methods for disease diagnosis and prevention * Therapeutic selection tailored to the patient’s profile * Drug delivery and gene therapy Conclusion| | | It sounds like science fiction, but to treat the merest trace of an oral disease, we dentists will ask the patients to rinse with a solution containing millions of microscopic machines called “nanoassemblers”. These minute workers, receiving signals from a computer controlled by the dentist, will swami to the areas of patient’s mouth and eliminate the disease and bacteria causing the disease.

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