editorial commentary

APPLICATIONS OF NANOTECHNOLOGY
Douglas A. Terry, DDS*

anotechnology, or nanoscience, refers to the research and development of an applied science at the atomic, molecular, or macromolecular levels (ie, molecular engineering, manufacturing).1 The prefix nano is defined as a unit of measurement in which the characteristic dimension is one- billionth of a unit.2,3 Although the nano scale is small in size, its potential is vast. Recent advances by scientists and engineers in manipulating matter at this small magnitude indicate potential applications of this nanoscience through developments of materials and systems in every economic arena (eg, telecommunications, aerospace, computers, textiles, homeland security, microelectronics, biomedical, dental).2

Advanced Restorative Biomaterials

The Polyhedral Oligomeric Silsesquioaxane (POSS) molecule can be used in dental applications to improve adhesion at the interface between the restorative material and the tooth structure, reduce tooth sensitivity through sealing the tubules with POSS nano-sized molecules, and provide structural reinforcement, toughness, and processability.4 Novel self-etch adhesive systems (eg, NanoBond, Pentron Clinical, Wallingford, CT) use this functional POSS molecule to reinforce the resin and provide an increased modulus of elasticity while maintaining the stress and strain characteristics of the resin. Current composite systems also utilize nanotechnology in their development (eg, Filtek Supreme, 3M ESPE, St. Paul, MN). This advanced restorative system uses synthetic chemical processes to develop building blocks on a molecular scale. The nanocomposite is composed of nanomeric particles and nanoclusters.5,6 This nanocomposite system uses an optimal combination of these nanofillers in a resin matrix (Figure 1). The use of spheroidal nanocluster fillers with a broad particle distribution provides a higher filler load, desirable handling characteristics, and physical properties comparable with conventional hybrid composites. During abrasive wear, the nano-sized primary particles in the nanocluster are suggested to wear by breaking off individual primary particles resulting in wear surfaces which have smaller

Nanotechnology with Composite Resin

In composite resin technology, particle size and the amount of particles represent crucial information in determining how best to use the composite materials. Alteration of the filler component remains the most significant development in the evolution of composite resins.4 And it is this alteration in filler size and loading that is responsible for the composite resin performance for both polishability and wear and fracture resistance. Nanotechnology may provide composite resins with a dramatically smaller filler particle size that can be dissolved in higher concentrations and polymerized into the resin system. The molecules in these materials can be designed to be compatible when coupled with a polymer and provide unique characteristics (ie, physical, mechanical, optical). Currently, the particle sizes of conventional composites are so different from the structural sizes of hydroxyapatite crystals, dental tubules, and enamel rods, compromises in adhesion between the macroscopic (40 nm to 0.7 nm) restorative material and the nanoscopic (1 nm to 10 nm in size) tooth structure are potential.5 Nanotechnology can, however, improve this continuity between the tooth structure and the nanosized filler particle and provide a more stable and natural interface between the mineralized hard tissues of the tooth and these advanced restorative biomaterials.

Figure 1. The SEM reveals the nanomeric particles and nanoclusters within the resin matrix at 200,000 .

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Figure 3A. A rubber dam was positioned. 3B. The Class III tooth preparation was completed using a minimally invasive approach.

A
Figure 2. Preoperative occlusal view of a Class II defect. Direct restoration with a nanocomposite system was scheduled for development of optimal aesthetics.

Figure 4A. Incremental composite buildup was performed using a nanocomposite system. 4B. Postoperative appearance of the definitive composite restoration.

defects and thus better gloss retention. In comparison, the wear of hybrids and microhybrids has larger discrete filler particles and thus larger defects and therefore has less polish retention. In addition, these nanocomposites can provide optimal optical characteristics since the size of the nanomeric particle is below the wavelength of light. This is relevant because the size is not measurable by the refractive index that can result in formulations that have a broad specrum of shade and opacity. The suggested clinical indications for use with this nanocomposite system (Filtek Supreme, 3M ESPE, St. Paul, MN) include all posterior and anterior restorative applications (Figures 2 through 4).6 A recently formulated composite restorative system uses nanotechnology in its development (Premise, Kerr/Sybron, Orange, CA) and chemical processes to develop building blocks on a molecular scale. The nanocomposite is composed of three different types of filler components: nonagglomerated discrete silica nanoparticles, barium glass, and prepolymerized filler. The nanoparticles are monodispersed discrete nonaggregated and nonagglomerated nano-sized silica particles which are spheroidal in shape and 20 nm in diameter. This nanocomposite system uses an optimal combination of these nanofillers with barium glass and

Figure 5. SEM view of nanofillers with barium glass and prepolymerized filler in a resin matrix at 200,000 .

prepolymerized filler in a resin matrix that is the same proprietary mixture used in Point 4 (Figures 5 and 6). The introduction of these nano-sized particles with the other two inorganic fillers allows for increased filler loading, which provides improved clinical performance through an increased polishability, increased wear resistance, reduced polymerization shrinkage, and increased fracture resistance. These discrete nanoparticles allow reduced viscosity in the resin matrix, thus the filler loading that can be attained is 69% by volume and 83.5% by weight, which results in reduced polymerization shrinkage and shrinkage stress.7 Although the polymerization

PPAD

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Figure 6. Preoperative occlusal view demonstrates the presence of Class II interproximal caries.

Figure 9. Postoperative occlusal view of the definitive restoration. The Class II defect is no longer visible, and a harmonious appearance is evident.

The manufacturer and scientist claim that long-term polishing retention arises from the exposed and detached nanoparticle fillers in the resin matrix during wear, toothbrushing, or polishing. The fillers act as a nano-polishing medium on the surface of the composite (Figures 7 through 9).

Conclusion
Figure 7. Initial tooth preparation was performed following rubber dam isolation, and an adhesive agent was applied.

The ultimate goal of continuous material research and development is to enhance the practice of dentistry. As nanotechnology expands in other fields, clinicians, scientists, and manufacturers will work to discover the uses and advances for dentistry. Applications of nanotechnology in dentistry have only approached the horizon with opportunities and possibilities for the future that can only be limited by our imagination. Although the long-term benefits of these nanocomposites remain to be determined through clinical studies, the laboratory findings suggest a promising future.

Figure 8A. The nanocomposite material was applied. 8B. Tints were applied to provide surface detail.

References
1. Kirk RE, Othmer DF, Kroschwitz J, Howe-Grant. Encyclopedia of Chemical Technology. 4th ed. New York: John Wiley and Sons, 1990. 2. Myshko D. Nanotechnology Its a Small World. Pharma Voice, February 2004; 34-39. 3. Rh Value Publishing. Webster Universal College Dictionary. Gramercy, 1997. 4. Muselmann M. Composites make large difference in small medical, dental applications. Comp Tech 2003:24-274. 5. Davis N. A nanotechnology composite. J Am Dent Assoc 2003; 662-670. 6. Mitra SB, Wu D, Holmes BN. An application of nanotechnology in advanced dental materials. J Am Dent Assoc Oct 2003; 134 (10):1382-1390. 7. Albers HF. Tooth-Colored Restoratives: Principles and Techniques. 9th ed, BC Decker Publishing 2002. 8. Macosko CW. Rheology: Principles, Measurements, and Applications. VCH Publishers 1993.

shrinkage is reported to be 1.4% to 1.6%, the manufacturer and scientist suggest that it is reasonable to consider it approaching zero if the effect of hydrolytic expansion in the oral cavity is factored into the equation. As the interparticle dimension decreases, the load-bearing stress on the resin is reduced, inhibiting crack formation and propogation.8 The spheroidal shape provides smooth and rounded edges distributing stress more uniformly throughout the composite resin. This phenomenon has been termed the roller bearing effect, and is said to improve the sculptability and handling characteristics.

*Faculty Member, UCLA Center for Esthetic Dentistry, Los Angeles, California; private practice, Houston, Texas.

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