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Dentistry or stomatology is related to the research, prevention, diagnosis, and treatment of oral-related diseases. Recently, scientists are conducting extensive research on graphene-based nanoparticles related to dentistry.
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A common dental condition is the oral cavity, which is usually filled with dental material. These materials maintain complete contact with gingival crevicular fluid, saliva and water. In addition, they are subject to high chewing force, elevated temperature and different wear, which can lead to mechanical failure.
Therefore, as time goes on, dental materials often need to be repaired or replaced. Therefore, effective and long-lasting dental surgery requires dental materials with excellent properties. Graphene nanomaterials have many unique mechanical, optical, and physical and chemical properties, and have recently been used in dental research.
Graphene is a carbon-based nanomaterial. It is a two-dimensional single-layer structure with sp2 hybridized carbon atoms filled with a hexagonal structure. Graphene nanomaterials come in many forms, such as few-layer graphene (FLG), ultra-thin graphite, graphene oxide (GO), reduced graphene oxide (rGO), and graphene nanosheets (GNS).
These graphene nanomaterials are different from each other in the number of layers, surface properties, and size.
Among the members of the graphene family of nanomaterials (GFN), GO is most widely used due to its excellent properties. It has many chemically reactive functional groups on its surface, which can promote the interaction with DNA, proteins, polymers and biomolecules.
Reduced graphene oxide (rGO) has heterogeneous electron transfer properties and is obtained by reducing graphene oxide through chemical, thermal or electrochemical processes. Fluorinated graphene (FG) is another member of graphene nanomaterials with good biocompatibility.
It also exhibits neuroinduction through spontaneous cell polarization and enhances mesenchymal cell proliferation by providing a scaffold for its growth.
This article focuses on the potential applications of graphene in dentistry. Some important aspects of graphene applications in dentistry are discussed below.
When developing new biomedical materials, biocompatibility is a major aspect that needs to be considered. The cytotoxicity of GFN depends on many factors, such as morphology (size, shape, and sharp edges), dispensability, surface charge, aggregation state, purity, synthesis method, number of layers, and surface functionalization.
Scientists have conducted studies to determine the toxicity level of GFN; for example, in the case of GO, 50ug/ml may be the toxicity threshold for normal mammalian cells. They observed that GO concentrations higher than 50ug/ml had an adverse effect on human fibroblasts and T lymphocytes.
Surface structure (such as wettability) also contributes to the toxicity of GFN. Generally, hydrophilic (higher degree of oxidation) graphene nanoparticles are considered to be more cell-compatible than hydrophobic graphene nanoparticles. Due to the presence of oxygen-containing functional groups on its base surface, GO is slightly hydrophilic. A recent study showed that GO showed minimal cytotoxicity and minimal damage to human dental follicle stem cells.
One of the challenges of dental treatment is to repair missing teeth. Some of the materials used in this process help to cultivate and regenerate damaged tissues in the periodontal structure. Most of the available artificial biomaterials lack tissue-inducing activity, which makes healing and functional reconstruction slow for many patients.
The GO scaffold is applied to the extraction socket of the dog, so that the bone formation speed is five times faster than the collagen scaffold. Interestingly, GO also exhibits a non-cytotoxic response and accelerates the proliferation and differentiation of human mesenchymal stem cells (hMSCs) into bone cells.
GFN has been used as a potential antibacterial agent in nanomedicine. Although the antibacterial mechanism related to GFNs is still in its infancy, based on many studies, three modes of action have been proposed, namely physical damage, photothermal ablation, and chemical action.
In the oral cavity, the bacteria associated with the formation of dental caries are Streptococcus mutans, and the bacteria associated with periodontitis and root canal infections are Porphyromonas gingivalis and Fusobacterium nucleatum.
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According to reports, GO nanosheets are extremely effective in inhibiting the growth of all the aforementioned dental pathogens. Importantly, graphene combined with other compounds (for example, graphene/zinc oxide nanocomposite) exhibits enhanced synergistic antibacterial, anti-biofilm, and anti-adhesion activities against oral pathogens.
During dental implantation, fiber-osseointegration occurs between the host biological system and the dental implant. Leakage of seals at the hard tissue interface or soft tissue interface may lead to bacterial infection, which may result in the need to damage osteogenesis and lead to bone loss.
Therefore, it is necessary to speed up the healing process and prevent bacterial colonization. When graphene is coated with a titanium substrate, its hydrophobic properties give its surface a self-cleaning effect, thereby reducing the adhesion of dental pathogens.
In addition, graphene has osteogenic properties, which can increase the expression of osteogenic genes (such as RUNX2, COL-I and ALP), thereby enhancing the deposition of mineralized matrix.
Root canal treatment involves cleaning the infected root canal system; however, in some cases, persistent infection in the root canal can lead to pulp failure. In endodontics, bioactive cement is used to treat perforations, pulp capping, and retrograde root filling. Graphene nanosheets improve the mechanical properties of biocement and significantly reduce the setting time.
Glass ionomer (GI) is commonly used in restorative dentistry. When graphene (such as fluorinated graphene) is combined with GI, it can significantly enhance the mechanical, friction and antibacterial properties of GI. This combined material also reduces micro-cracks in the internal structure and protects it from corrosion and decomposition by microbial invasion.
An animal study demonstrated the ability of GO scaffolds to heal periodontal wounds in dogs with category II bifurcation defects.
Bansode, vice president, etc. (2020) Graphene: a promising biomaterial in endodontics and restorative dentistry: a review. IOSR Journal of Dental and Medical Sciences. 19 (4). Pages 21-24 https://www.iosrjournals.org/iosr-jdms/papers/Vol19-issue4/Series-3/E1904032124.pdf
Nizami, IZM, etc. (2020) Graphene oxide: a new direction in dentistry. Applied materials today. 19, 100576. https://doi.org/10.1016/j.apmt.2020.100576
Ge, Z. etc. (2018) Graphene family of nanomaterials: characteristics and potential applications in dentistry. International Journal of Biomaterials. 1539678. Page 12. https://doi.org/10.1155/2018/1539678
Malik, S. et al. (2018) Graphene composite material with dental and biomedical applicability. Beilstein Journal of Nanotechnology. 9. Pages 801-808. https://doi.org/10.3762/bjnano.9.7
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Priyom has a PhD. Bachelor of Plant Biology and Biotechnology, University of Madras, India. She is an active researcher and experienced science writer. Priyom has also co-authored several original research articles, which have been published in well-known peer-reviewed journals. She is also an avid reader and amateur photographer.
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