Saturday 30 April 2011

Gupta J. Nanotechnology applications in medicine and dentistry. J Invest Clin Dent 2011;2:81-88


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Gupta J, Page 81; Paragraph 1
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Nanotechnology is engineering of molecularly precise structures. These are the molecular machines of typically 0.1micromilimeter (µm) or smaller than that. The prefix "Nano" means ten to the minus ninth power 10-9, or one billionth. The nanoscale is about a thousand times smaller than micro, which is about 1\80,000 of the diameter of a human hair. This type of tiny science first time revolutionized by Richard Feynman at his famous talk at annual meeting of the American physical society in 1959 entitled "Theres plenty of room at the Bottom". He proposed using machine tools to make smaller machine tools, which in turn, would be used to make still smaller machine, tools and so on all the way down to the molecular levels. He suggested that such nanomachines, nanorobots and nanodevices could ultimately be used to develop a wide range of atomically precise microscopic instrumentation and manufacturing tools. Also argued that these tools could be applied to produce vast quantities of ultra small computers and various micro scale and nanoscale robots. Thus he says that this is "a development which I think cannot be avoided in modern civilization".

Nanotechnology is the engineering of molecularly precise structures. The term “nanotechnology” was coined by Professor Kerie E. Drexler, a lecturer and researcher of nanotechnology. The prefix ‘‘nano’’ means 10-9 or one billionth of a unit. The nanoscale is approximately 1000 times smaller than a microscale, which is approximately 1/80 000 the diameter of a human hair. These small scientific scales were first revolutionized by Richard Feynman at his famous speech at the Annual Meeting of the American Physical Society in 1959 entitled: “There is plenty of room at the Bottom”. He proposed that machines and tools that make smaller machine tools could in turn be used to make even smaller machines and tools, right down to molecular levels.1 He suggested that such nanomachines, nanorobots, and nanodevices could ultimately be used to develop a wide range of atomically precise microscopic instrumentation and manufacturing tools. In his historical lecture in 1959, he concluded by saying, “This is a development, which I think cannot be avoided”.2
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Gupta J, Page 2; Paragraph 2
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Nanotechnology in medicine has been recently reviewed (2002-present) from various perspectives relative to the human molecule-tissue interface.1–4
Nanotechnology in medicine has been recently reviewed (2002–present) from various perspectives relative to the human molecule–tissue interface,3–5


**Page 47 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.


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Gupta J, Page 81; Paragraph 3
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the science and technology of diagnosing, treating, and preventing disease and traumatic injury, as well as relieving pain and preserving and improving human health through the use of molecular tools and molecular knowledge of the human body; and the use of molecular machine systems to address medical problems and using molecular knowledge to maintain and improve human health at the molecular scale.


This is the science and technology of diagnosing, treating, and preventing disease and traumatic injury in order to relieve pain and preserve and improve human health through the use of nanoscale-structured materials, biotechnology, and genetic engineering, and eventually, complex molecular machine systems and nanorobots.6




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Gupta J, Page 81; Paragraph 3
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Once one considers other potential applications of nanotechnology to medicine, it is difficult to image what nanodentistry would look like
Once one considers other potential applications of nanotechnology to medicine, it is not difficult to imagine the impact on nanodentistry.
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In nanodiagnostics, the ultimate goal is to identify diseases at the earliest stage possible, ideally at the level of a single cell.
In nanodiagnostics, the ultimate goal is to identify diseases at the earliest stage possible, ideally at the level of a single cell.
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Gupta J, Page 82; Paragraph 1
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Nanotechnology-on-a-chip is a dimension of lab-on-a-chip technology. Magnetic nanoparticles bound to a suitable antibody are used to label specific molecules, structures or microorganisms.
Nanotechnology-on-a-chip is a dimension of lab-on-a-chip technology. Magnetic nanoparticles bound to a suitable antibody are used to label specific molecules, structures or microorganisms.
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Gupta J, Page 82; Paragraph 1
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Gold nanoparticles tagged with short segments of DNA can be used for the detection of genetic sequence in a sample.
Gold nanoparticles tagged with short segments of DNA can be used for the detection of genetic sequence in a sample.
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Gupta J, Page 82; Paragraph 1
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Multicolor optical coding for biological assays has been achieved by embedding different-sized quantum dots into polymeric microbeads.
Multicolor optical coding for biological assays has been achieved by embedding different-sized quantum dots into polymeric microbeads.
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Gupta J, Page 82; Paragraph 1
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'Quantum dots'' are semiconductor nanoparticles that have unique optical and electrical properties. When exposed to light, these nanoparticles emit distinctly different colors depending on their size (the smaller the quantum dots, the brighter the color). Although fluorescent dyes have been used for decades in the human body for biomedical imaging (to track the effects of cancer drugs, for instance), they are often imprecise and only visible for short time periods. Fluorescent quantum dots will provide a brighter, more precise and longer lasting alternative. Quantum dots can be injected in to cells or attached to proteins in order to track, label or identify specific biomolecules and that they offer the ''ultimate detection sensi¬tivity''.

Quantum dots are semiconductor nanoparticles that have unique optical and electrical properties. When exposed to light, these nanoparticles emit distinctly different colors depending on their size (the smaller the quantum dots, the brighter the color). Although fluorescent dyes have been used for decades in the human body for biomedical imaging (to track the effects of cancer drugs, for instance), they are often imprecise and only visible for short time periods. Fluorescent quantum dots will provide a brighter, more precise, and longer lasting alternative. Quantum dots can be injected into cells or attached to proteins in order to track, label, or identify specific biomolecules, and these offer ultimate detection sensitivity.
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Gupta J, Page 82; Paragraph 2
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Nanotechnology has been a boom in medical field by delivering drugs to specific cells using nanoparticles. The overall drug consumption and side-effects can be lowered significantly by depositing the active agent in the morbid region only and in no higher dose than needed. This highly selective approach reduces costs and human suffering. An example can be found in dendrimers and nanoporous materials. Another example is to use block co-polymers, which form micelles for drug encapsulation. They could hold small drug molecules transporting them to the desired location. Another vision is based on small electromechanical systems; NEMS are being investigated for the active release of drugs. Some potentially important applications include cancer treatment with iron nanoparticles or gold shells. A targeted or personalized medicine reduces the drug consumption and treatment expenses resulting in an overall societal benefit by reducing the costs to the public health system. Nanotechnology is also opening up new opportunities in implantable delivery systems, which are often preferable to the use of injectable drugs, because the latter frequently display first-order kinetics (the blood concentration goes up rapidly, but drops exponentially over time). This rapid rise may cause difficulties with toxicity, and drug efficacy can diminish as the drug concentration falls below the targeted range.

Nanotechnology has had a beneficial impact in medicine in that it delivers drugs to specific cells using nanoparticles. The overall drug consumption and side-effects can be lowered significantly by depositing the active agent in the morbid region only and in no higher dose than needed. This highly selective approach reduces cost and human suffering. Examples include dendrimers and nanoporous materials, as well as blocking co-polymers, which form micelles for drug encapsulation. They could hold small drug molecules, transporting them to the desired location. Small nanoelectromechanical systems are being investigated for the active release of drugs. Some potentially important applications include cancer treatment with iron nanoparticles or gold shells. Targeted or personalized medicine reduces drug consumption and treatment expense, resulting in an overall societal benefit by reducing the cost to the public health system. Nanotechnology is also opening up new opportunities in implantable delivery systems, which are often preferable to the use of injectable drugs, because the latter frequently display first-order kinetics (the blood concentration goes up rapidly, but drops exponentially over time). This rapid rise might cause difficulties with toxicity, and drug efficacy can diminish as the drug concentration falls below the targeted range.

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Gupta J, Page 82; Paragraph 3
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One of the most highly publicized areas of nanomedicine research involves gold nanoshells to detect and treat cancerous tumors. Here is a case where detection and therapy overlap:

One of the most highly publicized areas of nanomedicine research involves gold nanoshells to detect and treat cancerous tumors. This is an area where detection and therapy might overlap.
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Gupta J, Page 82; Paragraph 4
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Nanoshells are particles of silica (glass) completely coated with gold, made up of a few million atoms. They can be produced in a range of sizes, with diameters smaller than 100 nm to as large as several hundred nanometers. When injected in to the blood stream, they naturally congregate at the tumor sites and therefore no additional targeting is necessary. In order to feed their growth, tumors create many blood vessels (neoangiogenesis) very quickly, so the vessels are often defective, allowing the nanoshells to slip through vascular ''leaks'' and gain access to the tumor. Detecting and targeting tumors by exploiting their surrounding vascular defects is known as ''enhanced permeability and retention'' or EPR effect. A nanoshell captures light and focuses it around itself. By manipulating the size of the nanoshells, it is possible to change the way they absorb light. The goal in cancer detection and therapy is to ''tune'' the nanoshells to interact with near-infrared light (NIR). When exposed to NIR, the nanoshells act like ''a swarm of fire flies'' and light up the area where they have congregated (i.e., tumor sites). Once the nanoshells have completed their imaging tasks, they become therapeutic agents. The area around the nanoshells heats up and the tumor ''cooks'' until it is ablated. These claims will have to be closely scrutinized, as nanoshells will likely take up permanent resi¬dence in the body and it is not clear how or if the body could excrete them.

Nanoshells are particles of silica (glass) that are completely coated with gold, made up of a few million atoms. They can be produced in a range of sizes, with diameters smaller than 100 nm to as large as several hundred nanometers. When injected into the blood stream, they naturally congregate at the tumor sites, and therefore, no additional targeting is necessary. In order to feed their growth, tumors create many blood vessels (neoangiogenesis) very quickly, so the vessels are often defective, allowing the nanoshells to slip through vascular “leaks” and gain access to the tumor. Detecting and targeting tumors by exploiting their surrounding vascular defects is known as enhanced permeability and retention effect. A nanoshell captures light and focuses it around itself. By manipulating the size of the nanoshells, it is possible to change the way they absorb light. The goal in cancer detection and therapy is to “tune” the nanoshells to interact with near-infrared light (NIR). When exposed to NIR, the nanoshells act like a swarm of fireflies’ and light up the area where they have congregated (i.e. tumor sites). Once the nanoshells have completed their imaging tasks, they become therapeutic agents. The area around the nanoshells heats up and the tumor “cooks” until it is ablated. These claims will have to be closely scrutinized, as nanoshells will likely take up permanent residence in the body, and it is not clear how or if the body could excrete them.
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Gupta J, Page 82; Paragraph 5
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Nanotechnology can play a pivotal role in the development of cost-effective therapies for in-situ tissue regeneration. This involves not only a deeper understanding of the basic biology of tissue regeneration, but also identifying effective ways to initiate and control the regenerative process. This ‘nanobiomimetic’ strategy depends on three basic elements: intelligent biomaterials, bioactive signalling molecules, and cells. By ‘tailoring’ resorbable polymers at the molecular level for specific cellular responses, nanotechnology can assist in the development of biomimetic, intelligent biomaterials. These biomaterials are designed to react positively to changes in the immediate environment, stimulating specific regenerative events at the molecular level, directing cell proliferation, cell differentiation, and extracellular matrix production and organization. The sequential signalling of bioactive molecules, which triggers regenerative events at the cellular level, is necessary for the fabrication and repair of tissues. Nano-assisted technologies should enable the sequential delivery of proteins, peptides and genes to mimic nature’s signalling cascade. As a result, bioactive materials are produced, which release signalling molecules at controlled rates that in turn activate the cells in contact with the stimuli. Finally, a major focus of ongoing and future efforts in regenerative medicine will be to effectively exploit the enormous selfrepair potential that has been observed in adult stem cells. Nano-assisted technologies will aid in achieving two main objectives – to identify signalling systems, in order to leverage the self-healing potential of endogenous adult stem cells; and to develop efficient targeting systems for stem cell therapies. Of huge impact would also be the ability to implant cell-free, intelligent bioactive materials that would effectively provide signalling to stimulate the self-healing potential of the patient’s own stem cells.



Nanotechnology can play a pivotal role in the development of cost-effective therapies for in situ tissue regeneration. This involves not only a deeper understanding of the basic biology of tissue regeneration, but also identifying effective ways to initiate and control the regenerative process. This “nanobiomimetic” strategy depends on three basic elements: (a) intelligent biomaterials; (b) bioactive signaling molecules; (c) cells. By “tailoring” resorbable polymers at the molecular level for specific cellular responses, nanotechnology can assist in the development of biomimetic, intelligent biomaterials. These biomaterials are designed to react positively to changes in the immediate environment, stimulating specific regenerative events at the molecular level, directing cell proliferation, cell differentiation, and extracellular matrix production and organization. The sequential signaling of bioactive molecules, which triggers regenerative events at the cellular level, is necessary for the fabrication and repair of tissues. Nano-assisted technologies should enable the sequential delivery of proteins, peptides, and genes to mimic nature’s signaling cascade. As a result, bioactive materials are produced, which release signaling molecules at controlled rates that in turn activate the cells in contact with the stimuli.
Finally, a major focus of ongoing and future efforts in regenerative medicine will be to effectively exploit the enormous self-repair potential that has been observed in adult stem cells. Nano-assisted technologies will aid in achieving two main objectives: (a) to identify signaling systems, in order to leverage the self-healing potential of endogenous adult stem cells; and (b) to develop efficient targeting systems for stem cell therapies. Of huge impact would also be the ability to implant cell-free, intelligent bioactive materials that would effectively provide signaling to stimulate the self-healing potential of the patient’s own stem cells.

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Gupta J, Page 83; Paragraph 2
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Surgical nanorobots could be introduced into the body through the vascular system or at the ends of catheters into various vessels and other cavities in the human body. A surgical nanorobot, programmed or guided by a human surgeon, could act as an semi-autonomous on-site surgeon inside the human body. Such a device could perform various functions such as searching for pathology and then diagnosing and correcting lesions by nanomanipulation, coordinated by an on-board computer while maintaining contact with the supervising surgeon via coded ultrasound signals. The earliest forms of cellular nanosurgery are already being explored today. For example, a rapidly vibrating (100 Hz) micropipette with a <1 micron tip diameter has been used to completely cut dendrites from single neurons without damaging cell viability.24 Axotomy of roundworm neurons was performed by femtosecond laser surgery, after which the axons functionally regenerated.25 A femtolaser acts like a pair of “nano-scissors” by vaporizing tissue locally while leaving adjacent tissue unharmed.

Surgical nanorobots could be introduced into the body through the vascular system or at the ends of catheters into various vessels and other cavities in the human body.13 A surgical nanorobot, programmed or guided by a human surgeon, could act as a semiautonomous onsite surgeon inside the human body. Such a device could perform various functions, such as searching for pathology and then diagnosing and correcting lesions by nanomanipulation, coordinated by an onboard computer while maintaining contact with the supervising surgeon via coded ultrasound signals. The earliest forms of cellular nanosurgery are already being explored. For example, a rapidly vibrating (100 Hz) micropipette with a <1 micron tip diameter has been used to completely cut dendrites from single neurons without damaging cell viability. Axotomy of roundworm neurons was performed by femtosecond laser surgery, after which the axons functionally regenerated. A femtolaser acts like a pair of nanoscissors by vaporizing tissue locally, while leaving adjacent tissue unharmed.

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Medical nanorobots can readily treat genetic diseases by comparing the molecular structures of both DNA and proteins found in the cell to known or desired reference structures. Any irregularities can then be corrected, or desired modifications can be edited in place. In some cases, chromosomal replacement therapy is more efficient than in cytorepair. Floating inside the nucleus of a human cell, an assembler-built repair vessel performs some genetic maintenance. Stretching a supercoil of DNA between its lower pair of robot arms, the nanomachine gently pulls the unwound strand through an opening in its prow for analysis. Upper arms, meanwhile, detach regulatory proteins from the chain and place them in an intake port. The molecular structures of both DNA and proteins are compared to information stored in the database of a larger nanocomputer positioned outside the nucleus and connected to the cell-repair ship by a communications link. Irregularities found in either structure are corrected and the proteins reattached to the DNA chain, which re-coils into its original form. With a diameter of only 50 nanometers, the repair vessel would be smaller than most bacteria and viruses, yet capable of therapies and cures well beyond the reach of present-day physicians.

Medical nanorobots can readily treat genetic diseases by comparing the molecular structures of both DNA and proteins found in the cell to known or desired reference structures.14 Any irregularities can then be corrected, or desired modifications can be edited in place. In some cases, chromosomal replacement therapy is more efficient than in cytorepair. Floating inside the nucleus of a human cell, an assembler-built repair vessel performs genetic maintenance. Stretching a supercoil of DNA between its lower pair of robot arms, the nanomachine gently pulls the unwound strand through an opening in its prow for analysis. Meanwhile, the upper arms detach regulatory proteins from the chain and place them in an intake port. The molecular structures of both DNA and proteins are compared to information stored in the database of a larger nanocomputer positioned outside the nucleus and connected to the cell-repair ship by a communications link. Irregularities found in either structure are corrected, and the proteins reattached to the DNA chain, which recoils into its original form. With a diameter of only 50 nm, the repair vessel would be smaller than most bacteria and viruses, yet capable of therapies and cures well beyond the reach of present-day physicians.

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Gupta J, Page 83; Paragraph 6
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Nanoparticles (molecular units typically defined as having diameters of between 0.1 and 100 nm) of various compositions represent the most widespread use of nanoscale units in dentistry. They are currently being used in resin-based composite restorations (RBC).
Nanoparticles (molecular units typically defined as having diameters of between 0.1 and 100 nm) of various compositions represent the most widespread use of nanoscale units in dentistry. They are currently being used in resin-based composite restorations (RBC).
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Page 83; Paragraph 6
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Nanoparticles (molecular units typically defined as having diameters of between 0.1 and 100 nm) of various composition represent the most widespread use of nanoscale units in dentistry. They are currently being used in RBC restorations; two-year clinical results have been published for several of them and will be discussed.18–21 Together with the evolution of nanoparticles for dental composites, sharper focus is being applied to reformulations of interfacial silanes. These have been used for many years to coat and bond inorganic fillers into RBC matrices in dental restoratives. Considerable research related to nanocomposites is focusing on tailoring newer types of silane bonding agents for optimal use with nanoparticles in RBCs. Organosilanes such as allyltriethoxysilane have demonstrated good compatibility with nanoparticle fillers such as TiO2.22

Nanoparticles (molecular units typically defined as having diameters of between 0.1 and 100 nm) of various compositions represent the most widespread use of nanoscale units in dentistry. They are currently being used in resin-based composite restorations (RBC).







Considerable research related to nanocomposites is focused on tailoring newer types of silane bonding agents for optimal use with nanoparticles in RBC. Organosilanes,15 such as allyltriethoxysilane, have demonstrated good compatibility with nanoparticle fillers, such as TiO2.22


** Page 48 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.


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Gupta J, Page 83; Paragraph 6
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Nanoparticles and associated modifications of existing RBC systems have a considerable record of demonstrated clinical utility and widespread use.

Nanoparticles and associated modifications of existing RBC systems have a considerable record of demonstrated clinical utility and widespread use.

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** Page 48 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.


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Gupta J, Page 83; Paragraph 7
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Nanorods are of particular interest in a restorative context. Chen and colleagues have synthesized enamel-prism-like hydroxyapatite (HA) nanorods that have exhibited self-assembly properties.10 Since they are similar to the enamel rods that make up the basic crystalline structure of dental enamel, nanorods could contribute to a practical artificial approximation of such a naturally-occurring structure.

Nanorods are of particular interest in a restorative context. Chen et al. have synthesized enamel prism-like hydroxyapatite (HA) nanorods that exhibit self-assembly properties.16 Since they are similar to the enamel rods that make up the basic crystalline structure of dental enamel, nanorods could contribute to a practical artificial approximation of such a naturally occurring structure.



**Page 48 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.


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Gupta J, Page 83; Paragraph 8
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In a similar direction, such a potential transition to restorative systems that also mimic nanoscale processes already inherent in natural tooth development will also be explored in this article. Specifically, nanosphere assembly in conjunction with calcium phosphate deposition and amelogenin nanochain assembly will be discussed in a restorative context.12

Nanospheres are explored in restorative systems in conjunction with calcium phosphate deposition and amelogenin nanochain assembly to mimic the nanoprocesses already inherent in natural tooth development.

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Note: The context of re-wording. Also, there is no clarity in the sentence, which should have been noticed during peer review.

** Page 48 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.


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Gupta J, Page 83-84
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Nanotubes of various types have been investigated for dental applications in a number of interesting directions. Titanium oxide nanotubes have been shown in vitro to accelerate the kinetics of HA formation, mainly in a context of bone-growth applications for dental implant coatings.27 More recently, modified single-walled carbon nanotubes (SWCNTs) have been shown to improve flexural strength of RBCs. These SWCNTs had silicon dioxide applied to them in conjunction with specialized organosilane bonding agents.28

Nanotubes of various types have been investigated for dental applications. Titanium oxide nanotubes have been shown in vitro to accelerate the kinetics of HA formation, mainly in a context of bone-growth applications for dental implant coatings.17 More recently, modified single-walled carbon nanotubes (SWCNT) have been shown to improve the flexural strength of RBC. These SWCNT had silicon dioxide applied to them in conjunction with specialized organosilane bonding agents.18



**Page 48 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.



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Gupta J, Page 84; Paragraph 2
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Nanofibers and their uses for biomedical applications have been reviewed.29 More recently, nanofibers have been used to generate ceramics containing HA and fluor-HA.30 Nanofibrillar silicate crystals have also been recently studied in the capacity of reinforcement of dental composites, specifically a combination of the widely-used 2,2’-bis-[4-(methacryloxypropoxy)- phenyl]-propane (Bis-GMA) with triethylene glycol dimethacrylate (TEGDMA) added as a thinning agent.31,32 Added in the correct proportions32 and with uniform distribution of the fibers/crystals,31 nanofibers were demonstrated to improve the physical properties of these composites.


Nanofibers and their uses for biomedical applications have been reviewed.19 Polymer nanofibers, with diameters in the nanometer range, possess a larger surface area per unit mass and permit an easier addition of surface functionalities compared to polymer microfibers. Polymer nanofiber materials have been studied as drug-delivery systems, scaffolds for tissue engineering, and filters. More recently, nanofibers have been used to generate ceramics containing HA and fluor-HA.20 Nanofibrillar silicate crystals have also been recently studied in the reinforcement of dental composites, specifically a combination of the widely used 2,2′-bis-(4-[methacryloxypropoxy]-phenyl)-propane, with triethylene glycol dimethacrylate added as a thinning agent.21,22 Added in the correct proportions and with uniform distribution of the fibers/crystals, nanofibers have been demonstrated to improve the physical properties of these composites.

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** Page 48 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.




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Gupta J, Page 84; Paragraph 3
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Dendrimers and dendritic copolymers have been studied, albeit less extensively than other nanostructures, in relation to dental composite applications. Combinations of specific polymers to optimize efficacy of restorative applications have been reported.33–35

Dendrimers and dendritic copolymers have been studied, albeit less extensively than other nanostructures, in relation to dental composite applications. Combinations of specific polymers to optimize efficacy of restorative applications have been reported.

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** Page 49 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.


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Based on their unique capabilities and resolution, nanoscale science probes surfaces using forces, displacement resolutions and concentrations on the piconewton, nanometer and picomolar scales, respectively. Studying dental structures and surfaces from a nanoscale perspective may lead to better understanding of the structure function- physiological relationship of dental surfaces.

Based on their unique capabilities and resolution, nanoscale science probes surfaces using forces, displacement resolutions, and concentrations on the piconewton, nanometer, and picomolar scales, respectively. Studying dental structures and surfaces from a nanoscale perspective might lead to better understanding the structure and function–physiological relationship of dental surfaces.

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**Page 2524 of Shivani S et al. Nanocharacterization in dentistry. Int J Mol Sci 2010;11:2523-2545.



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Gupta J, Page 84; Paragraph 6
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Nanoscale topology and quantitative biomechanical or biophysical analysis of dental surfaces are of significant interest. In particular, using AFM techniques- diseases such as dental caries, tooth hypersensitivity, peridontitis and oral cancer can be quantified based on morphological, biophysical and biochemical nanoscale properties of tooth surface itself and dental materials or oral fluids such as saliva.

Nanoscale topology and quantitative biomechanical or biophysical analyses of dental surfaces are of significant interest. In particular, using atomic force microscopy techniques,23 diseases, such as dental caries, tooth hypersensitivity, peridontitis, and oral cancer, can be quantified based on morphological, biophysical, and biochemical nanoscale properties of the tooth surface itself and dental materials,


** Page 2538 of Shivani S et al. Nanocharacterization in dentistry. Int J Mol Sci 2010;11:2523-2545.



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Gupta J, Page 84; Paragraph 6
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may lead to better understanding of the structurefunction- physiological relationship of dental surfaces. Using nanocharacterization tools, a variety of oral diseases can be understood at the molecular and cellular levels and thereby prevented.
and might lead to better understanding the structure and function–physiological relationship of dental surfaces. Using nanocharacterization tools for oral fluids, such as saliva, a variety of oral diseases can be understood at the molecular and cellular levels, and thereby prevented.


** Page 2524 of Shivani S et al. Nanocharacterization in dentistry. Int J Mol Sci 2010;11:2523-2545.





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Gupta J, Page 84; Paragraph 8
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A common trend in this ongoing discussion is the capability to operate on a scale small enough to interact with intracellular components including DNA.5–8
Operating on a stage this minute provides a perspective to envision restoring tooth structure at a level that offers progressively closer approximation of its individual anatomic structures. The ever-shrinking size of the nanoparticles in resin-based composite (RBC) ceramic restorative systems continues in a progression that might be envisioned as “mimicking” actual tooth structure.

A common trend in this ongoing discussion is the capability to operate on a scale small enough to interact with intracellular components, including DNA. Operating on a stage this minute enables tooth structure restoration at a level that offers progressively closer approximation of its individual anatomic structures. The ever-shrinking size of the nanoparticles in RBC ceramic restorative systems continues in a progression that might be envisioned as “mimicking” actual tooth structure.
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** Page 47 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.





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Gupta J, Page 84; Paragraph 8
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This is manufactured by nanoagglomerated discrete nanoparticles that are homogeneously distributed in resins or coatings to produce nanocomposites. The nanofiller include an aluminosilicate powder having a mean particle size of about 80nm and a 1:4ratio of alumina to silica.


The nano-agglomerated discrete nanoparticles are homogeneously distributed in resins or coatings to produce nanocomposites. The nanofillers include an aluminosilicate powder with a mean particle size of approximately 80 nm and a 1:4 ratio of alumina to silica.24



**Page 5 of Abhilash M. Nanorobots. International Journal of Pharma and Bio Sciences 2010:1(Jan-Mar):1-10.




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Gupta J, Page 85; Paragraph 2
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Ormocer® is an acronym for organically modified ceramics, a registered trademark of Fraunhofer-Gesellschaft (Munich, Germany). 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.49 Ormocer® composite technology is used in conjunction with nanoparticle fillers such as ZrO2 that are widely used in nanocomposite restorative systems.

Ormoceris (Fraunhofer-Gesellschaft, Munich, Germany) 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.26 Ormocer composite technology is used in conjunction with nanoparticle fillers, such as ZrO2, that are widely used in nanocomposite restorative systems.



** Page 51 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.



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Gupta J, Page 85; Paragraph 3
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Optimal delivery of molecules that facilitate tooth structure remineralization and forestall caries is an active area of nanostructure-based research. Much of this work involves nanoparticles in conjunction with RBC systems.

Nano-sized CaPO4-incorporated composites are used in the optimal delivery of molecules that facilitate tooth structure remineralization and forestall caries is an active area of nanostructure-based research. Much of this work involves nanoparticles in conjunction with RBC systems.


** Page 55 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.




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Gupta J, Page 85; Paragraph 3
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In a similar direction, several other recent studies by Xu and colleagues25,68,69 have evaluated the incorporation of nanosized CaPO4 particles into RBCs, with a resulting improvement in stress-bearing capacity as well as ion release that could inhibit caries.68 Further investigation of this model using dicalcium phosphate anhydrous (DCPA) incorporated with nanosilica-fused whiskers found that it increased the strength of the RBC by as much as threefold whilereleasing CaPO4. This release was greater with decreasing CaPO4 particle size.25 The authors hypothesize that sucha system could provide a desirable combination of caries prevention and increased restoration strength.25,69


Recent studies by Xu et al.27–29 have evaluated the incorporation of nano-sized CaPO4 particles with RBC, with a resulting improvement in stress-bearing capacity, as well as ion release that could inhibit caries.28 Further investigation of this model using dicalcium phosphate anhydrous incorporated with nanosilica-fused whiskers found that it increased the strength of the RBC by as much as threefold while releasing CaPO4. This release was greater with decreasing CaPO4 particle size.27 The authors hypothesize that such a system could provide a desirable combination of caries prevention and increased restoration strength.27,29



**Page 55 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.



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Gupta J, Page 85; Paragraph 6
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With the combination of finishing and polishing procedures, a nanotechnology liquid polish application might provide a more glossy surface for resin composite restorations.

With the combination of finishing and polishing procedures, a nanotechnology liquid polish application might provide a more glossy surface for resin composite restorations.31






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Gupta J, Page 85; Paragraph 7
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Nanosolutions produce unique and dispersible nanoparticles, which can be used in bonding agents. This ensures homogeneity and ensures that the adhesive is perfectly mixed every time.

Nanosolutions produce unique and dispersible nanoparticles, which can be used in bonding agents. This ensures homogeneity and ensures that the adhesive is perfectly mixed every time.

No citation

**Page 64 of Saravana Kumar R et al. Nanotechnology in dentistry. IJDR 2006;17:62-65







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Gupta J, Page 85; Paragraph 8
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Perhaps the most tempting venue for speculation on the next phase of nanorestoration of tooth structure is that of nanotechnology mimicking processes that occur in nature (biomimetics), such as the formation of dental enamel. Salient research over the last six years on the theme of studying and replicating enamel formation is summarized in Table 3.
The central theme in the study of ways to mimic nature’s already-efficient use of nanotechnology surrounds the cooperative interaction between self-assembled nanospheres of the proline-rich protein amelogenin (the most abundant protein in dental enamel), and the formation and directional orientation of HA crystals that compose enamel’s hard-tissue mineral phase.
The most interesting venue for speculation on the nanorestoration of tooth structure is that of nanotechnology mimicking processes that occur in nature (biomimetics), such as the formation of dental enamel.



The central theme in the study of ways to mimic nature’s already-efficient use of nanotechnology involves the cooperative interaction between self-assembled nanospheres of the proline-rich protein amelogenin (the most abundant protein in dental enamel) and the formation and directional orientation of HA crystals that compose enamel’s hard-tissue mineral phase.32


**Page 55 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.

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Gupta J, Page 85; Paragraph 8
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A recent in vitro study by Wang and colleagues has further elucidated mechanisms of interaction among amelogenin nanospheres, nanoparticles and nanorods at critical points during the HA crystal-growth process. The result  offer further evidence for cooperativity in interfacial matching between organic and inorganic nanophases that may resemble processes that occur in actual enamel formation.77

A recent in vitro study by Wang et al.33 further elucidated mechanisms of interaction among amelogenin nanospheres, nanoparticles, and nanorods at critical points during the HA crystal-growth process. The results offer further evidence for cooperation in interfacial matching between organic and inorganic nanophases that might resemble processes that occur in actual enamel formation.
Note the context of citations.

** Page 55 of Saunders SA. Current practicality of nanotechnology in dentistry. Part I: Focus on nanocomposite restoratives and biomimetics. Clincal, Cosmetic and Investigational Dentistry 2009;1:47-61.

















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Gupta J, Page 85; Paragraph 8
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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.

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.

No citation.















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Gupta J, Page 85; Paragraph 9
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New potential treatment opportunities in dentistry might include local anesthesia, dentition renaturalization, permanent hypersensitivity cures, complete orthodontic realignments during a single office visit, covalently bonded diamondized enamel, and continuous oral health maintenance using mechanical dentifrobots. When the first micro-size dental nanorobots can be constructed, dental nanorobots might use specific motility mechanisms to crawl or swim through human tissue with navigational precision and acquire energy, sense, and manipulate their surroundings to achieve safe cytopenetration and use any of the multitude techniques to monitor, interrupt, or alter nerve impulse traffic in individual nerve cells in real time. These nanorobot functions might be controlled by an onboard nanocomputer that executes pre-programmed instructions in response to local sensor stimuli. Alternatively, the dentist might issue strategic instructions by transmitting orders directly to in vivo nanorobots via acoustic signals or other means
New potential treatment opportunities in dentistry might include local anesthesia, dentition renaturalization, permanent hypersensitivity cures, complete orthodontic realignments during a single office visit, covalently bonded diamondized enamel, and continuous oral health maintenance using mechanical dentifrobots. When the first micro-size dental nanorobots can be constructed, dental nanorobots might use specific motility mechanisms to crawl or swim through human tissue with navigational precision and acquire energy, sense, and manipulate their surroundings to achieve safe cytopenetration and use any of the multitude techniques to monitor, interrupt, or alter nerve impulse traffic in individual nerve cells in real time. These nanorobot functions might be controlled by an onboard nanocomputer that executes pre-programmed instructions in response to local sensor stimuli. Alternatively, the dentist might issue strategic instructions by transmitting orders directly to in vivo nanorobots via acoustic signals or other means.3,4



**http://www.google.co.in/search?sourceid=navclient&ie=UTF-8&rlz=1T4DKUS_enUS264IN313&q=New+potential+treatment+opportunities+in+dentistry+might+include+local+anesthesia%2c+dentition+renaturalization%2c+permanent+hypersensitivity+cures%2c+complete+orthodontic+realignments+during+a+single+office+visit%2c+covalently+bonded+diamondized+enamel%2c+and+continuous+oral+health+maintenance+using+mechanical+dentifrobots




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Gupta J, Page 86; Paragraph 3
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On reaching the dentin, the nanorobots enter dentinal tubular holes that are 1–4 μm in diameter and proceed towards the pulp, guided by a combination of chemical gradients, temperature differentials, and even the position of navigation, all under the control of the onboard nanocomputer, as directed by the dentist. There are many pathways for the nanorobots to travel from dentin to pulp. Because of different tubular branching patterns, tubular density might present significant challenges to navigation. Assuming a total path length of approximately 10 mm from the tooth surface to the pulp and a modest travel speed of approximately 100 μm/sec, nanorobots can complete the journey into the pulp chamber in approximately 100 sec.
On reaching the dentin, the nanorobots enter dentinal tubular holes that are 1–4 μm in diameter and proceed towards the pulp, guided by a combination of chemical gradients, temperature differentials, and even the position of navigation, all under the control of the onboard nanocomputer, as directed by the dentist. There are many pathways for the nanorobots to travel from dentin to pulp. Because of different tubular branching patterns, tubular density might present significant challenges to navigation. Assuming a total path length of approximately 10 mm from the tooth surface to the pulp and a modest travel speed of approximately 100 μm/sec, nanorobots can complete the journey into the pulp chamber in approximately 100 sec.








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Gupta J, Page 86; Paragraph 3
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Once installed in the pulp and having established control over nerve-impulse traffic,11 the analgesic dental nanorobots may be commanded by the dentist to shut down all sensitivity in any tooth that requires treatment. When the dentist presses the icon for the desired tooth on the hand-held controller display, the selected tooth immediately numbs (or later, on command, awakens). After the oral procedures are completed, the dentist orders the nanorobots (via the same acoustic data links) to restore all sensation, to relinquish control of nerve traffic and to egress from the tooth via similar pathways used for ingress; following this, they are aspirated. Nanorobotic analgesics offer greater patient comfort and reduced anxiety, no needles,61,62 greater selectivity and controllability of the analgesic effect, fast and completely reversible action, and avoidance of most side effects and complications.34

Once installed in the pulp, having established control over nerve impulse traffic, the analgesic dental nanorobots might be commanded by the dentist to shut down all sensitivity in the tooth that requires treatment. When the dentist passes the icon for the desired tooth on the handheld controlled display monitor, the tooth is immediately anesthetized. After the oral procedure is completed, the dentist orders the nanorobots via the same acoustic data links to restore all sensation, relinquish control of nerve traffic, to retract from the tooth via a similar path. This analgesic technique is patient friendly, as it reduces anxiety, needle phobia, and most importantly, is a quick and completely reversible action.4



    

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Gupta J; Page 86; Paragraph 4
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Dentin hypersensitivity is pathological phenomenon. It is caused by pressure transmitted hydro dynamically to the pulp. Mainly hypersensitive teeth have dentinal tubules with surface densities that are eight times higher than those of non sensitive teeth. Dental nanorobots can selectively and precisely occlude the specific tubules within a minute offering patients a quick and permanent cure.3

Dentin hypersensitivity is a pathological phenomenon. It is caused by pressure-transmitted hydrodynamically to the pulp. Mainly hypersensitive teeth have dentinal tubules with surface densities that are eight times higher than those of non-sensitive teeth. Dental nanorobots can selectively and precisely occlude the specific tubules within 1 min, offering patients a quick and permanent cure.4





Check reference 3*




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Gupta J, Page 86; Paragraph 5
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Orthodontic nanorobots could directly manipulate the periodontal tissues, including gingivae, periodontal ligament, cementum and alveolar bone, allowing rapid and painless tooth straightening, rotating and vertical repositioning within minutes to hours. This is in contrast to current molar uprighting techniques, which require weeks or months to complete.77

Orthodontic nanorobots can directly manipulate the periodontal tissue, including gingival, periodontal ligament, cemental, and alveolar tissues, allowing rapid and painless tooth straightening, rotating, and vertical repositioning within minutes to hours. This is in contrast to current molar uprighting techniques, which require weeks or months to complete.

No citation.



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Gupta J, Page 86; Paragraph 6
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Properly configured dentifrobots could identify and destroy pathogenic bacteria residing in the plaque and elsewhere, while allowing the 500 or so species of harmless oral microflora to flourish in a healthy ecosystem. Dentifrobots also would provide a continuous barrier to halitosis, since bacterial putrefaction is the central metabolic process involved in oral malodor.90

Properly configured dentifrobots could identify and destroy pathogenic bacteria residing in the plaque and elsewhere, while allowing the 500 or so species of harmless oral microflora to flourish in a healthy ecosystem. Dentifrobots would also provide a continuous barrier to halitosis, since bacterial putrefaction is the central metabolic process involved in oral malodor.34





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Gupta J; Page 86; Paragraph 7
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Dentition renaturalization procedures may become a popular addition to the typical dental practice, providing perfect treatment methods for esthetic dentistry. This trend may begin with patients who desire to have their old dental amalgams74 excavated and their teeth remanufactured with native biological materials. However, demand will grow for 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 beome indistinguishable from the original teeth.

Dentition renaturalization procedures might become a popular addition to typical dental practice, providing perfect treatment methods for esthetic dentistry. This trend might begin with patients who desire to have their old dental amalgams excavated and their teeth remanufactured with native biological materials. However, demand will grow for 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 the original teeth.

No citation.




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Gupta J, Page 87; Paragraph 2
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While nanomaterials and nanotechnologies are expected to yield numerous health and health care advances, such as more targeted methods of delivering drugs, new cancer therapies, and methods of early detection of diseases, they also may have unwanted effects. Increased rate of absorption is the main concern associated with manufactured nanoparticles.

While nanomaterials and nanotechnologies are expected to yield numerous health and health-care advances, such as more targeted methods of delivering drugs, new cancer therapies, and methods of early detection of diseases, they also might have unwanted effects. The increased rate of absorption is the main concern associated with manufactured nanoparticles.

No citation.
















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Gupta J, Page 87; Paragraph 3
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When materials are made into nanoparticles, their surface area to volume ratio increases. The greater specific surface area (surface area per unit weight) may lead to increased rate of absorption through the skin, lungs, or digestive tract and may cause unwanted effects to the lungs as well as other organs.
When materials are made into nanoparticles, their surface area:volume ratio increases. The greater specific surface area (surface area/unit weight) might lead to increased rates of absorption through the skin, lungs, or digestive tract, and might cause unwanted effects to the lungs, as well as other organs.
No citation.



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Gupta J, Page 87; Paragraph 3
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Apart from what happens if non-degradable or slowly degradable nanoparticles accumulate in organs, another concern is their potential interaction with biological processes inside the body: because of their large surface, nanoparticles on exposure to tissue and fluids will immediately adsorb onto their surface some of the macromolecules they encounter. The large number of variables influencing toxicity means that it is difficult to generalise about health risks associated with exposure to nanomaterials – each new nanomaterial must be assessed individually and all material properties must be taken into account.

Apart from what occurs if non-degradable or slowly degradable nanoparticles accumulate in organs, another concern is their potential interaction with biological processes inside the body; because of their large surface, nanoparticles, upon exposure to tissue and fluids, will immediately absorb onto their surface some of the macromolecules they encounter. However, the particles must be absorbed in sufficient quantities in order to pose a health risk. The large number of variables influencing toxicity means that it is difficult to generalize the health risks associated with exposure to nanomaterials; each new nanomaterial must be assessed individually, and all material properties must be taken into account.

No citation.






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Gupta J, Page 87; Paragraph 3
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As the use of nanomaterials increases worldwide, concerns for worker and user safety are mounting. To address such concerns, the Swedish Karolinska Institute conducted a study in which various nanoparticles were introduced to human lung epithelial cells. The results, released in 2008, showed that iron oxide nanoparticles caused little DNA damage and were non-toxic. Zinc oxide nanoparticles were slightly worse. Titanium dioxide caused only DNA damage. Carbon nanotubes caused DNA damage at low levels. Copper oxide was found to be the worst offender, and was the only nanomaterial identified by the researchers as a clear health risk.

As the use of nanomaterials increases worldwide, concerns for worker and user safety are mounting. To address such concerns, the Swedish Karolinska Institute conducted a study in which various nanoparticles were introduced to human lung epithelial cells. The results, released in 2008, showed that iron oxide nanoparticles caused little DNA damage and were non-toxic. Zinc oxide nanoparticles were slightly worse. Titanium dioxide caused only DNA damage; carbon nanotubes caused DNA damage at low levels. Copper oxide was found to be the worst offender, and was the only nanomaterial identified by the researchers as a clear health risk.35

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Gupta J, Page 87; Paragraph 3/4
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The National Institute for Occupational Safety and Health is conducting research on how nanoparticles interact with the body’s systems and how workers might be exposed to nano-sized particles in the manufacturing or industrial use of nanomaterials.

The National Institute for Occupational Safety and Health is conducting research on how nanoparticles interact with the body’s systems and how workers might be exposed to nano-sized particles in the manufacturing or industrial use of nanomaterials.

No citations.





















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Gupta J, Page 87; Paragraph 5
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As with all technologies, nanotechnology carries a significant potential for misuse and abuse on a scale and scope never seen before. Nanodevices cannot be seen, yet carry powerful capabilities. However, they also have the potential to bring about significant benefits, such as improved health, better use of natural resources and reduced environmental pollution. These truly are the days of miracle and wonder.

As with all technologies, nanotechnology carries a significant potential for misuse and abuse on a scale and scope never seen before. Nanodevices cannot be seen, yet possess powerful capabilities. They have the potential to bring about significant benefits, such as improved health, better use of natural resources, and reduced environmental pollution.
No citation perhaps because it is found in the conclusion section??????

**Page 1568 of Schleyer TL. Nanodentistry. Fact or Fiction? J Am Dent Assoc 2000;131:1567-1568.


















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Gupta J, Page 87; Paragraph 5
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At present, applied nanotechnology to medicine and dentistry is in its infancy, with most of the research at the basic science level as the field attempts to organize itself. As such, viable clinical applications are still years away, but despite this the current pace of development is impressive.

At present, applied nanotechnology to medicine and dentistry is in its infancy, with most of the research at the basic science level, as the field attempts to organize itself. As such, viable clinical applications are still years away, but despite this the current pace of development is impressive.

No citation perhaps because it is found in the conclusion section??????



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Gupta J, Page 87; Paragraph 5
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Nanotechnology has the potential to provide controlled release devices with autonomous operation guided by need. Applications of nanotechnologies in medicine are especially promising, and such areas as disease diagnosis, drug delivery targeted at specific sites in the body, and molecular imaging are being intensively investigated.

Nanotechnology has the potential to provide controlled release devices with autonomous operation guided by need. Applications of nanotechnologies in medicine are especially promising, and such areas as disease diagnosis, drug delivery targeted at specific sites in the body, and molecular imaging are being intensively investigated.

No citation perhaps because it is found in the conclusion section??????





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Gupta J, Page 87; Paragraph 6
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Nanodentistry still faces many significant challenges11 in realizing its tremendous potential. Basic engineering problems run the gamut from precise positioning and assembly of molecular- scale parts, to economical mass-production techniques, to biocompatibility and the simultaneous coordination of the activities of large numbers of independent micrometer-scale robots.

Nanodentistry still faces many significant challenges in realizing its tremendous potential. Basic engineering problems from precise positioning and assembly of molecular-scale parts to economical mass production techniques to biocompatibility, and the simultaneous coordination of the activities of a large number of independent micrometer-scale robots is being investigated.

No citation perhaps because it is found in the conclusion section??????

**Page 1563 conclusion section of Freitas RA Jr. Nanodentistry. J Am Dent Assoc 2000;131;1559-1565.


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Gupta J, Page 87; Paragraph 6
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Nanodentistry will give a new visionary to comprehensive oral health care, as now trends of oral health have been changing to more preventive intervention than a curative & restorative procedure. This science might sound like a fiction now, but Nanodentistry has strong potential to revolutionize dentist to diagnose, to treat disease in future.5 It opens up new ways for vast, abundant research work.

Nanodentistry will give a new vision to comprehensive oral health care, as trends of oral health have been changing to more preventive intervention than a curative and restorative procedure. This science might sound like a fiction now, but nanodentistry has strong potential to revolutionize dentists to diagnose and treat diseases in the future. It opens up new ways for vast, abundant research work.

No citation perhaps because it is found in the conclusion section??????



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Gupta J, Page 87; Paragraph 6
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Nanotechnology will change dentistry, health care, and human life more profoundly than other developments. However, at the same time, there will be increased social issues of public acceptance, ethics, regulation, and human safety that must be addressed before molecular nanotechnology can enter the modern medical and dental armamentarium.

Nanotechnology will change dentistry, health care, and human life more profoundly than other developments. However, at the same time, there will be increased social issues of public acceptance, ethics, regulation, and human safety that must be addressed before molecular nanotechnology can enter the modern medical and dental armamentarium.

No citation perhaps because it is found in the conclusion section??????

**Bhossreddy A et al. Nanotechnology and its applications in dentistry and medicine. J Oralfac Sci 2010;2:63-69.




THANKS FOR YOUR PAITENT READING.Plagiarism. What is it?

According to the office of research integrity’s
 (see http://ori.dhhs.gov/policies/plagiarism.shtml)1 working definition; plagiarism meant both the theft or misappropriation of intellectual property and the substantial unattributed textual copying of another’s work. The latter is interpreted as unattributed verbatim or nearly verbatim copying of sentences and paragraphs with a view to mislead the ordinary reader regarding the contributions of the authors. And it does not include the limited use of identical or closely matching phrases provided those sentences or words are pertinent to the paper in question. Furthermore, Pecorari [Pecorari D (2003) Good and original: plagiarism and patchwriting in academic second-language writing. J Sec Lang Writ 12:317–345]2 consider that copying word for word from source text rather than spontaneous composition represents text plagiarism.

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