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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 17  |  Issue : 1  |  Page : 89-94

Assessment of knowledge about nanotechnology in dentistry amongst dental post graduate students in India: An online cross-sectional survey


Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India

Date of Submission02-Dec-2021
Date of Decision06-Jan-2022
Date of Acceptance16-Feb-2022
Date of Web Publication25-Jul-2022

Correspondence Address:
Dr. Shweta Dharmatti
Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara - 591 760, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_442_21

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  Abstract 


Introduction: Nanodentistry is one of the most emerging and widely expanding branches in the field of dentistry. The maintenance of near perfect oral health through the use of nanomaterials, biotechnology, including tissue engineering, and nanorobotics can be made possible. Aim: The present study aimed to assess the knowledge about nanotechnology in dentistry among postgraduate dental students in India on the basis of questionnaire. Materials and Methods: A structured 20 questionnaire was validated by subject experts in the field of dentistry. The postgraduate students in the field of dentistry in India were approached and were provided with the validated questionnaire for an online survey. The questionnaire was randomly distributed among various postgraduate dental students across India, which evaluated 328 students in total. Descriptive and inferential statistical analyses were carried out in the present study. Results: On assessing the data statistically, out of 328 participants, 44.80% were from I MDS, 35.40% were from II MDS, and 19.80% were from III MDS. The postgraduate dental students in India had adequate knowledge regarding fourteen out of twenty questions. The students, however, did not have adequate knowledge regarding six questions which comprised history, tools, and techniques about nanotechnology in dentistry. Conclusion: The study was able to assess that postgraduate dental students in India had adequate knowledge regarding nanomaterials used in dentistry; however, knowledge regarding techniques and tools in nanotechnology was not satisfactory.

Keywords: Biotechnology, nanoneedles, nanocomposites, nanomaterial, nanomedicine, nanoparticles, nanostructures


How to cite this article:
Dharmatti S, Bargale S, Dave B, Deshpande AN, Khandelwal JR, Jain S. Assessment of knowledge about nanotechnology in dentistry amongst dental post graduate students in India: An online cross-sectional survey. J Datta Meghe Inst Med Sci Univ 2022;17:89-94

How to cite this URL:
Dharmatti S, Bargale S, Dave B, Deshpande AN, Khandelwal JR, Jain S. Assessment of knowledge about nanotechnology in dentistry amongst dental post graduate students in India: An online cross-sectional survey. J Datta Meghe Inst Med Sci Univ [serial online] 2022 [cited 2022 Aug 16];17:89-94. Available from: http://www.journaldmims.com/text.asp?2022/17/1/89/352240




  Introduction Top


Curiosity, wonder, and ingenuity are human attributes that have existed since the dawn of time. For many years, people all throughout the world have channeled their curiosity into scientific investigation and methods.

“You must be capable to create things, analyse things, and perform things smaller than ever illusioned in ways that have never been done before,” Winfred Philips, DSc, remarked.[1]

Science is undergoing yet another transformation to assist humanity in entering a new era, the era of nanotechnology, which is rapidly coming and was unimaginable just two decades ago. Advances in nanotechnology will have an impact on all aspects of human life in years ahead.[2]

“Nano” is a Greek word from nan(n)os, which means “dwarf, little old man”

The prefix “nano” denotes a billionth to the minus ninth power (10−9) or ten to the minus ninth power (10−9). The term “nano” comes from the Greek word “nano,” which means “dwarf,” and is generally coupled with a noun to make phrases such as nanometer, nanotechnology, or nanorobot.[3] The science and engineering involved in the synthesis, design, characterization, and application of devices and materials whose smallest functional organization in at least one dimension is on the nanoscale can be characterized as nanotechnology.[4],[5]

Nanomedicine (including nanodentistry) is a novel arena that combines nanoscale-structured materials, biotechnology, genetic engineering, and ultimately complex molecular machine and nanorobots to diagnose, treat, and prevent disease and trauma; relieve pain; and preserve and improvise human health.[2]

It is experiencing yet another transformation to assisting humanity, with the assistance of nanotechnology along with nanomaterials, biotechnology, and other technologies.

Nanodentistry allows comprehensive oral health care using nano devices, which encompasses controlled oral analgesia, dentine replacement therapy, permanent hypersensitivity cure, complete orthodontic realignment, and other procedures to be completed in one visit.[2]

Nanotechnology is a novel arena that has aided in the development of new therapeutic and diagnostic agents, with the added benefit of improving drug accretion when minimizing the negative effects that small-molecule medications have. The enclosed molecules' tiny size, increased chemical stability, and apparent solubility, along with the multifunctionality of nanoparticles, are features that open up new perspectives for biological research.

Nanoparticles have a substantially higher surface area per unit mass than larger particles owing to their small size. Furthermore, in the nanoscale, quantum effects become more prominent. Nanotechnology in dentistry has several drawbacks, including high product costs and a lack of understanding regarding the effectiveness. Nanotechnology and nanodentistry are hardly mentioned in the curriculum at various dental school levels.

This survey is a novel survey conducted in India on knowledge regarding nanotechnology in dentistry.


  Materials and Methods Top


A cross-sectional study based on a self-administered online questionnaire was distributed through the link shared (Google Forms portal) to the postgraduate dental students in India circulated via mails and social media platforms. A reminder mail was sent twice every week regarding the online questionnaire to be filled.

The ethical approval (SVIEC/ON/Dent/SRP/20125) was obtained. The data were collected from November 26, 2020, to May 20, 2021. The participants who were not willing to participate were excluded from the study. Copyright for the novel questionnaire was obtained (L-104316/2021).

A formula was used to calculate the sample size; a sample size of 354 was derived at 95% confidence interval. The questionnaire formulated was validated by subject experts in the field of dentistry. The concurrent validity was assessed with 12 postgraduate students. The purpose was to depict those items with a high degree of agreement among experts. Aiken's V was used to quantify the concordance between experts for each item. The Aiken's V values obtained were 0.88. The panel of experts recommended modifying the wording of some questions. To assess the reliability of questions, similar questions were grouped and Cronbach's alpha was calculated. The correlations between the items ranged from 0.77 to 0.83.

The postgraduate dental students were provided with online consent form and participant's information sheet. After gaining participant's consent, he/she was provided with online questionnaire through Google Form portal. The online questionnaire consisted of 20 questions, which was of closed-ended type. The first section consisted of demographic data such as name, age, gender, and qualification. The second section consisted of 6 questions related to awareness and 14 questions related to knowledge about nanotechnology.

The data of participant's answers were entered into Excel sheet for statistical analysis. The collected data were entered into a computer and analyzed using the IBM SPSS software software version 17.0, (NY, USA). Descriptive and inferential statistical analyses were carried out in the present study. The results on continuous measurements were presented on mean ± standard deviation and the results on categorical measurements were presented in number (%). The level of significance was fixed at P = 0.05 and any value less than or equal to 0.05 was considered statistically significant.


  Observations and Results Top


From 354 postgraduate dental students, 328 participated in the study. Twenty-six postgraduate dental students were excluded from the study as they had not given consent to fill the forms and incomplete forms submitted.

Out of the 328 participants, 235 were female and 93 were male. Their ages ranged from 23 to 31 years with a mean of 25.4 years.

[Table 1] indicates the distribution of postgraduate dental students according to the year of the study. Out of 354 postgraduate dental students, I MDS, II MDS, and III MDS were 147, 116, and 65, respectively.
Table 1: Distribution of postgraduate dental students according to the year of study

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[Table 2] shows postgraduate dental students responding to 15 questions of nanotechnology in dentistry. The following are elaborated responses given by the students.
Table 2: Questions depicting adequate knowledge response about nanotechnology in dentistry of postgraduate dental students

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Out of 354 postgraduate dental students, about 326 responded that Nanos is a Greek term for dwarf, little man. About 196 postgraduate dental students responded that the word nanotechnology was set up by Erik Drexler. About 308 postgraduate dental students responded that nanoparticles in dentistry are particles less than 100 nm in size. About 311 students responded that nanotechnology has its applications in both medicine and dentistry. About 318 students responded that nanotechnology tools can be used to diagnose a disease,[9] cure diseases, and improve dental materials. Two hundred and sixty-four students know about the approaches in nanotechnology, which is bottom-up and top-down approaches. About 282 participants responded that EQUIA was a second-generation glass ionomer restorative nanomaterial. Two hundred and ninety-five participants responded that quantum dots are nanomaterials that glow very brightly when illuminated by UV light. One hundred and eighty-nine participants responded that nanoneedles are suture needles incorporating nano-sized stainless steel crystals. About 228 participants responded to OFNASET which is a technology is used for multiple detection of salivary biomarkers for oral cancer. Two hundred and eighty-four participants responded that nanosolutions used in restorative dentistry are solutions that can be added to various solvents, paints, and polymers, in which they are dispersed homogeneously. Two hundred and sixty-seven participants responded that nanofillers producing a unique addition of siloxane impression materials are integrated with polyvinyl siloxanes. Two hundred and ninety-eight participants responded that nanofillers have increased fluidity and high tear resistance as their advantage. Two hundred and seventy-five participants responded that the main obstacle to implement nanotechnology in dental practice is allergy due to some nanomaterials and lack of awareness. Three hundred and sixteen participants responded that the ways to increase knowledge of nanotechnology in dentistry are journals, conferences and CDE programs, inclusion in academic curriculum in dental schools, advertisements, and public notice.

[Table 3] shows that about 251 postgraduate students did not know when the concepts of nanotechnology were discussed. One hundred and sixteen participants responded that early versions of scanning probes that launched nanotechnology are scanning probe microscopes. Two hundred and thirty-six participants were not aware of the bottom-up approach in nanotechnology. Two hundred and sixty-six participants responded that they were not aware about the top-down approach in nanodentistry. Two hundred thirteen participants were not aware that nanoparticles are dangerous for human health.
Table 3: Questions depicting inadequate knowledge response about nanotechnology in dentistry of postgraduate dental students

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  Discussion Top


Dentistry has advanced in terms of technology over time, making it more accessible. Dentistry has transitioned through several years. It is experiencing yet another transformation in terms of assisting humanity, this time using nanotechnology in conjunction with nanomaterials, biotechnology, and nanorobotics.

According to Saravana and Vijayalakshmi,[6] Nanos is the Greek word for dwarf, little man. Here, 326 postgraduate dental students responded that Nanos is a Greek word for dwarf, little man, which is the correct response.

The concept “nanotechnology” was set up by a physicist Richard Feynman in 1959. Although Feynman did not apply the term “Nanotechnology or Nanosciences,” he described the novel process in which a scientist can manipulate materials at atomic or molecular levels. The idea of nanotechnology was further probed in depth and promoted by Dr. Drexler and published a book titled “Engines of Creation-The Coming Era of Nanotechnology” around late 1980s. About 196 postgraduate students responded that the term nanotechnology was set up by Erik Drexler.

The term nanotechnology was coined by Dr. Erik Drexler in 1980; however, the concept was first discussed by Dr. Richard Feynmann in 1959. About 251 participants did not know who had first discussed the term nanotechnology.

According to Mitra et al.,[7] nanoparticles in dentistry are particles ranging from 0.1 nm to 100 nm in size. About 308 postgraduate dental students responded that nanoparticles are particles <100 nm.

Nanotechnology has its applications in both medicine and dentistry. About 311 postgraduate dental students responded that nanotechnology has its applications in both medicine and dentistry. The development of nanodentistry will allow nearly perfect oral health by the use of nanomaterials and biotechnologies including tissue engineering and nanorobots. Advances in biomaterials and biotechnology have resulted in the formation of a new field called nanomedicine,[8] which was first put forward in 1993 by Robert A. Freitas Jr. Nanomedicine is the science of preventing, diagnosing, and treating disease using nano-sized particles.

Nanotechnology tools can be used to diagnose a disease, cure diseases, and improve dental materials. About 318 participants responded that nanotechnology can be used in diagnosing and curing a disease as well as improving dental materials. According to Sharma et al., a variety of oral diseases can be understood at the molecular and cellular levels and can be thereby prevented using nano characterization tools.

The early versions of scanning probes that launched nanotechnology are atomic force microscope and scanning tunneling microscope (STM). One hundred and sixteen postgraduate dental students responded that early versions of scanning probes that launched nanotechnology are scanning probe microscopes. According to Poggi et al.,[10] scanning probe microscope is a family of related techniques that provide information about atomic scale structure and processes. The first of these to be developed was the STM by Gerd Binning and Heinrich Rohrer at IBM Zurich in 1981. According to Karova,[11] atomic force microscopy is a frequently used method for imaging of dentin, demineralization of dental hard tissues, observation of dentinal surface and collagen network, bacterial cells and biofilms, dental materials, and appliances.

Local anesthesia, diagnosis of oral cancer, and tooth repair are included in bottom-up approach of nanodentistry.[12] About 236 postgraduate dental students did not have adequate knowledge about bottom-up approach in nanodentistry. Bottom-up approaches seek to arrange smaller components into more complex assemblies. According to Sahoo et al., bottom-up approach does not include nanocomposite.[13]

According to Kumar et al.,[14] microfill composites and core materials are manufactured using a “top-down” approach, which means that the materials used to make them, such as ceramics, quartz, and glasses, start out in bulk form and are pulverized in a grinding mill.

However, the milling process cannot reduce the particle size below 100 nm.

Conversely, because the particles in nanocomposite materials are so minuscule (1 nm = one billionth of a meter), they have to be synthesized using a “bottom-up” approach that starts at the molecular level, via various chemical processes.

Nanoencapsulation, plasma laser application, and prosthetic implants are included in top-down approach of nanodentistry.[15] About 266 postgraduate dental students approach in nanodentistry. Top-down approaches seek to create smaller devices using larger ones to direct their assembly. According to Sahoo et al.,[13] top-down approach does not include local anesthesia.

EQUIA is a second-generation glass ionomer restorative nanomaterial. About 282 postgraduate dental students responded that EQUIA is a second-generation glass ionomer restorative nanomaterial. EQUIA (GC America) utilizes a packable, second-generation GI restorative material (GC Fuji IX GP EXTRA [GC America]) and a nanofilled, light-curable resin coating (G-COAT PLUS, [GC America]).[16] It is available in various shades Vita® A1, A2, A3, A3.5, B1, B2, B3, and C4.[17] EQUIA Forte, a new encapsulated glass ionomer cement (GIC) with glass hybrid technology with improved physical and mechanical properties, becomes an apt material of choice in restoration of load-bearing areas. Moreover, application of EQUIA Forte Coat, a clear self-adhesive light-cured resin coat, increases surface hardness and wear resistance.

Another study done by Poornima et al. and Kutuk et al.[18],[19] clinically evaluated the performance of a glass hybrid GIC, EQUIA Forte (GC India), and a bulk fill composite, Tetric N Ceram (Ivoclar Vivadent) in restoration of class II carious lesions in primary molars for a period of 12 months. They concluded that EQUIA Forte can be an acceptable restorative material in small-to-medium-sized class II cavities in primary molars considering the ease of application in pediatric patients. EQUIA Forte can be the choice of restoration in carious primary molars, which are expected to exfoliate within 6 months.

Quantum dots bind themselves to proteins unique to cancer cells, literally bringing tumors to light. Two hundred and ninety-five postgraduate dental students responded that quantum dots are nanomaterials that glow very brightly when illuminated by ultraviolet light.

Nanoneedles are suture needles incorporating nano-sized stainless steel. About 189 postgraduate dental students responded that nanoneedles are suture needles incorporating nano-sized stainless steel crystals. According to Mariappan, needles are made of stainless steel and nano sized particles of 1–10 nm in size quasi crystals by thermal aging techniques.[20]

OFNASET is a technology which is used for multiple detection of salivary biomarkers for oral cancer. According to Al,[21] it has been demonstrated that the combination of two salivary proteomic biomarkers (thioredoxin and interleukin [IL]-8) and four salivary mRNA biomarkers (SAT, ODZ, IL-8, and IL-1b) can detect oral cancer with high specificity and sensitivity. About 228 postgraduate dental students responded that OFNASET is used for a gene coding system, drug delivery device, and multiple detection of salivary biomarkers for oral cancer.

According to Lakshmi et al.,[22] oral fluid-based biosensors are the biosensors which use GCF and saliva as the biomedia. It is used in the detection of oral cancer, dental caries, hormone disorders, cardiovascular diseases, obesity, etc.

Nanosolutions used in restorative dentistry are solutions that can be added to various solvents, paints, and polymers, in which they are dispersed homogeneously. About 284 postgraduate dental students responded that nanosolutions used in restorative dentistry are solutions that can be added to various solvents, paints, and polymers in which they are dispersed homogeneously.

About 267 dental postgraduate students responded that nanofillers producing a unique addition of siloxane impression materials are integrated with polyvinyl siloxanes.

About 298 postgraduate dental students responded that nanofillers have increased fluidity and high tear resistance as its advantage. According to Chandki et al, increased fluidity, high tear resistance, hydrophilic properties, resistance to distortion, heat resistance and Snap set reduces the errors caused by micro movements of nanofillers.

Nanoparticles are dangerous for human health. About 213 postgraduate dental students were not aware that nanoparticles are dangerous for human health. According to Kumar and Vijayalakshmi,[23] significant environmental, health, and safety issues might arise with development in nanotechnology since some negative effects of nanoparticles in our environment might be overlooked. Such issues include potential occupational safety and health concerns for those involved in the manufacture of nanotechnologies. However, nature itself creates all kinds of nano-objects, so probable dangers are not due to the nanoscale alone, but due to the fact that toxic materials become more harmful when ingested or inhaled as nanoparticles.

The main obstacle to implement nanotechnology in dental practice is allergy due to some nanomaterials and lack of awareness. About 275 postgraduate dental students responded that the main obstacle to implement nanotechnology in dental practice is allergy due to some nanomaterials and lack of awareness.

The ways to increase knowledge of nanotechnology in dentistry are journals, conferences and CDE programs, inclusion in academic curriculum in dental schools, advertisements, and public notice. About 316 participants responded correctly to question.


  Conclusion Top


Nanotechnology advancements should be evaluated in the perspective of other oral health-related discoveries projected in the next decades. Much faster than nanotechnology, biological technologies such as tissue and genetic engineering will offer new diagnostic and therapeutic treatments. Dental care will continue to improve as traditional treatments are refined, sophisticated restorative materials are developed, and novel drugs and pharmacological approaches are developed. The dentist's function will continue to evolve in line with current trends. The contemporary den has the best technical ability, professional judgment, and good interpersonal skills.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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