‡Plymouth University Peninsula Dental School, University of Plymouth, John Bull Building, Tamar Science Park, Plymouth PL6 8BU, U.K.
ACS Nano. 2015 Mar 24;9(3):2255-89. doi: 10.1021/nn505015e. Epub 2015 Feb 12.
Interest in the use of engineered nanomaterials (ENMs) as either nanomedicines or dental materials/devices in clinical dentistry is growing. This review aims to detail the ultrafine structure, chemical composition, and reactivity of dental tissues in the context of interactions with ENMs, including the saliva, pellicle layer, and oral biofilm; then describes the applications of ENMs in dentistry in context with beneficial clinical outcomes versus potential risks. The flow rate and quality of saliva are likely to influence the behavior of ENMs in the oral cavity, but how the protein corona formed on the ENMs will alter bioavailability, or interact with the structure and proteins of the pellicle layer, as well as microbes in the biofilm, remains unclear. The tooth enamel is a dense crystalline structure that is likely to act as a barrier to ENM penetration, but underlying dentinal tubules are not. Consequently, ENMs may be used to strengthen dentine or regenerate pulp tissue. ENMs have dental applications as antibacterials for infection control, as nanofillers to improve the mechanical and bioactive properties of restoration materials, and as novel coatings on dental implants. Dentifrices and some related personal care products are already available for oral health applications. Overall, the clinical benefits generally outweigh the hazards of using ENMs in the oral cavity, and the latter should not prevent the responsible innovation of nanotechnology in dentistry. However, the clinical safety regulations for dental materials have not been specifically updated for ENMs, and some guidance on occupational health for practitioners is also needed. Knowledge gaps for future research include the formation of protein corona in the oral cavity, ENM diffusion through clinically relevant biofilms, and mechanistic investigations on how ENMs strengthen the tooth structure.
人们对将工程纳米材料（ENMs）用作临床牙科中的纳米药物或牙科材料/器械的兴趣日益浓厚。本综述旨在详细介绍在与 ENMs 相互作用的情况下，包括唾液、黏膜层和口腔生物膜，牙齿组织的超微结构、化学成分和反应性；然后描述了 ENMs 在牙科中的应用，包括其在带来有益临床效果的同时存在的潜在风险。唾液的流速和质量可能会影响 ENMs 在口腔中的行为，但形成于 ENMs 上的蛋白质冠如何改变其生物利用度，或与黏膜层的结构和蛋白质以及生物膜中的微生物相互作用，目前尚不清楚。牙釉质是一种致密的晶体结构，可能会阻止 ENM 渗透，但下方的牙本质小管则不会。因此，ENMs 可用于增强牙本质或再生牙髓组织。ENMs 在牙科中有抗菌作用，可用于感染控制；作为纳米填料可提高修复材料的机械性能和生物活性；也可作为牙科植入物的新型涂层。牙膏和一些相关的个人护理产品已经可用于口腔健康应用。总的来说，在口腔中使用 ENMs 的临床益处通常大于危害，后者不应阻止纳米技术在牙科中的负责任创新。然而，牙科材料的临床安全法规尚未专门针对 ENMs 更新，也需要一些针对从业人员的职业健康指导。未来研究的知识空白包括口腔中蛋白质冠的形成、ENMs 通过临床相关生物膜的扩散，以及 ENMs 如何增强牙齿结构的机制研究。
