- The innovative dental treatment consists of a biodegradable space maintainer that prevents infections and helps the correct alignment of the new permanent pieces.
- It is directed for those who lost teeth and teeth due to cavities.
- Malocclusion is the second most frequent disease in minors, after caries.
In Mexico, the incidence rate of child caries is 75 percent. The most damaged pieces are the primary molars. To attend to the problem that your loss or damage represents, at the Iztacala Faculty of Higher Studies (FES) of the UNAM, a novel dental treatment consisting of a space maintainer that would have several advantages.
The head of the Section of the Acatlán Dental Clinic of that university entity, Cecilia Carlota Barrera Ortegaexplained that the Laboratory works with a commercial synthetic polymer called polycaprolactone, which is biodegradable and biosynthetic.
Advantages of this new dental treatment
Its advantages are: being made with a novel, aesthetic, functional material, with a lower cost, which could be placed in a single appointment, without the need to have it manufactured in a dental laboratory. This material becomes functional by adding nanoparticles of different metal oxides.
“In the Dental Nano and Biomaterials Research Laboratory, we carry out the synthesis of such nanoparticles (tiny, approximately 25 nanometers) to give this kind of scaffold the property of being antimicrobial and radiopaque (that is, since it does not pass through by X-rays, it is visible on the radiograph as a white area).
The goal is to obtain a space maintainer for those little ones who lost teeth or molars due to early caries and that must be replaced because otherwise, when the permanent teeth come in, a malocclusion (or incorrect alignment of the teeth) will occur, which It is the second most frequent disease in minors, after caries.
The scaffolds are designed to be placed in an environment where bacteria are abundant. These polymers degrade over time and when they do so they release nanoparticles that have no toxic effects but have antimicrobials to help reduce cavities in the first place. They also help the biofilm commonly known as dental plaque.
In the scientific literature there are numerous metal oxide nanoparticles with this capacity; however, not all of them are useful. Copper ones, for example, have good antimicrobial properties, but they stain black and it would be unaesthetic to place them in a patient’s mouth. For this reason, those of zinc, magnesium and bismuth oxide were chosen.
The specialist in pediatric dentistryand teacher and doctor of sciences, pointed out that this is the first time that an application of this type has been attempted for these materials.
“Polycaprolactone has been used to make electrospinning; that is, meshes so that the cells can ‘walk’. What we are developing is a bulk or block, to which different nanoparticles are added to see their antimicrobial effect for several days and then put it in a biological medium”.
In the first phase, the research consists of “doping or functionalizing” the polymer with nanoparticles and testing it with cells. Then, it will be put in contact with bacteria, later it would be tested in an animal model until it is used in patients.
A non-invasive intramucosal space maintainer is required when the child has an infectious process, but cannot take antibiotics for a long time, so the piece needs to be removed to avoid complicating the situation.
In infants from the age of three or four, this scaffolding may be required, so that the space remains available for the permanent molar that is not yet going to erupt, and that when the replacement comes, it can be done in the normal way. In this case, the advantage would be to have a maintainer that degrades over time and prevents infection.
The polycaprolactone it has one more advantage: it can be manipulated because its melting point occurs at 60 degrees Celsius; “We don’t burn ourselves, and already with the embedded nanoparticles, we could place it in the patient in a single appointment; according to their craniofacial growth and based on a previous X-ray, it is designed at that very moment”.
Until now metal space maintainers are used and two appointments are required because they are sent to be made in a laboratory. In this case, the behavioral management of the pediatric patient is not trivial, stressed Barrera Ortega, and even less so if they are in pain or have poor previous treatment.
In this situation it would be unnecessary to change the scaffold while the final tooth erupts; it could only be monitored radiographically, as established by the ISO-4049 standard. “By using the polymer with the metal oxide nanoparticles, through an x-ray, we will be able to know the condition of the material over time,” he explained.
The study at the Dental Nano and Biomaterials Research Laboratory -where excellent human resources are trained, especially in pediatric dentistry, and students from dental surgeon, engineering, physics and chemistry are housed-, is in the science phase basic, functionalization and physical, chemical and biological characterization.
“We already know a lot about the physical characteristics of the nanomaterial, in terms of hardness, elasticity and roughness. Their chemical characterization has also been carried out: with X-ray diffraction it has been confirmed that the nanoparticles placed are the ones desired and that they have the appropriate size; likewise, infrared techniques and Raman spectroscopy have been used”.
The biological characterization of the material follows with the Staphylococcus aureus bacterium and with stem cells of mesenchymal origin (multipotent). The goal is to help the population to have an economic scaffold, avoid traumatic management of pediatric patients and prevent malocclusion.
The university recommended that parents take their children every six months for a dental check-up with a pediatric dentist, an expert in treating them. Also, support them in brushing and be an example so that, when they see them perform oral hygiene, they will acquire this habit.
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