How we will treat teeth in the future: robotic dentists and regeneration

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How we will treat teeth in the future: robotic dentists and regeneration
How we will treat teeth in the future: robotic dentists and regeneration
Anonim

Imagine the day when a new tooth will grow to replace the lost one in a dental clinic. Or when a robot will place a dental filling, and it will be possible to protect the child from caries even before his first tooth erupts. This moment is not as far away as it might seem. Dentistry is on the verge of new amazing opportunities - we will consider them today.

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One of the leading electronics manufacturers has already launched a similar toothbrush. Using Bluetooth, it connects to your smartphone, into which a special application is downloaded. It has sensors that track how you brush your teeth in real time. It all works quite simply.

While you are brushing your teeth, the smart toothbrush makes a 3D map of your mouth, which shows how and which teeth you brush. The application in the smartphone will analyze the information obtained in the process and tell you which teeth you pay little attention to, and which ones, on the contrary, brush too thoroughly. At the same time, the program will warn you if you are too zealous when brushing your teeth.

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For children, there is a play mode that will teach them to regularly and correctly brush their teeth - it seems as if a personal dentist watches daily how you and your child take care of their teeth.

Digital dentistry and artificial intelligence

Artificial intelligence has already become a reality in many areas and is expected to influence dentistry in the coming years. With the advent of digital dentistry, doctors' offices will collect significant amounts of patient health data, from electronic health records to 3D models of the oral cavity.

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This information is needed in the daily work of the dentist, but it will be even more useful in the virtual "hands" of systems built on the basis of AI. After all, they are able to analyze huge amounts of data and then suggest treatment options and predict dental problems before they occur. Thanks to artificial intelligence, tooth decay detection can become even more automated. By evaluating three-dimensional images of the oral cavity of patients, the computer program will be more efficient in detecting signs of incipient caries.

In addition, intelligent systems will ensure that the prescribed drugs or procedures are combined with other drugs taken by the patient and do not cause side effects.

Robotics

Surgical robots are already taking their place in operating theaters. Soon they will become full-fledged owners of dental surgeries. In 2017, in one of the clinics in the Chinese city of Xi'an, a robot dentist successfully performed dental surgery on a living person for the first time. Under supervision, but independently and without the participation of the medical staff, he installed two artificial teeth for the patient. Moreover, both implants were 3D printed.

The developers believe that the use of robots will solve the problem of the lack of qualified dentists in the country. In China, about a million implants are installed every year, but many patients have to go to the doctor again due to surgical errors. In addition, the use of robots will make dental procedures less invasive and help reduce healing time.

3D printing

3D printers have already made their way into dentistry. They provide invaluable assistance in dental laboratories.Previously, the manufacture of models in dental prosthetics, necessary for the creation of an individual prosthesis, was carried out manually. It was a laborious and time consuming process. Today 3D printing makes it possible to almost completely automate it.

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Naturally, you first need to conduct a 3D scan of the oral cavity and obtain data on the state of the entire jaw system using a magnetic resonance imaging machine. The obtained data is loaded into a computer, where a 3D model of the patient's dentition is created. Now the printer can print a 3D model of the jaw, dental impressions, surgical guides required for installing implants, and much more. Including a 3D printer can be used for the production of braces.

However, so far the materials used in 3D printing are not biocompatible enough to be used for a long time, and this is a prerequisite for creating implants. But it doesn't take a lot of imagination to figure it out: as a result, 3D printing will make it possible to create fully printed implants, which will only require finishing and polishing before installation.

A virtual reality

Virtual reality technology has the potential to fundamentally change the learning process for dentists, both in educational institutions and in refresher courses. The University of Pennsylvania School of Dentistry has been using VR glasses to simulate dental procedures for several years. Likewise, a practitioner in preparation for a complex operation can put on virtual reality glasses and carry out from start to finish the entire upcoming operation on a dental simulator.

As a result, patients can also take advantage of the advances in VR technologies in order to go on an exciting virtual journey during the procedure and not focus on unpleasant sensations.

In one experiment, researchers from the Netherlands and the United Kingdom recruited a group of 80 people who needed the help of a dentist. The participants were divided into three groups. The first two had to be in virtual reality glasses during the dental procedure. One group "traveled" along the sea coast, the other "walked" around the city. The third group served as a control: its participants simply stared at the ceiling.

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As it turned out, people immersed in "coastal" virtual reality after the procedure reported less stress and pain than patients traveling through the virtual cityscape, and even more so people from the control group.

Preventing tooth decay

We are already quite advanced in the field of cataloging the genomes of humans, animals and microbes. To date, the genomes of hundreds of species of bacteria that live in biofilms on tooth surfaces, in dental bacterial plaques and on implant surfaces have been sequenced. Our existing databases of the human and microbial genome provide new opportunities for effective drug therapy.

For example, Streptococcus mutans is one of the main bacteria associated with tooth decay. It plays a major role in tooth decay by converting sucrose into lactic acid. We now know that it is passed from parent to child in the first years of life.

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Genetics will help find ways to prevent this transmission. In addition, we can target gene therapy to suppress the processes within the bacteria themselves that regulate acid production, a byproduct of sugar metabolism that causes tooth decay. We can even target the selective elimination of Streptococcus mutans in oral biofilms.

Regeneration of teeth

Growing teeth has already become a scientifically based goal for the near future. Regeneration should replace prosthetics and implantation. Stem cells will come to the rescue here, because, as you know, they are able to develop into any types of cells, and can also help in the "repair" of teeth.However, even now, when dentin is damaged, the stem cells in the pulp are able to migrate into it and participate in the restoration of the tooth. But in this case, only a thin layer of dentin is created to protect the interior of the tooth. Both dentin and tooth enamel are one of the few tissues of the human body that cannot regenerate. Therefore, today, in cases of destruction and injury, the volume of the tooth is restored with the help of artificial material.

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Scientists have several ideas on how to use stem cells to regenerate teeth. Researchers from King's College London found that the drug

Tideglusib, originally developed to treat Alzheimer's disease, stimulates stem cells in the pulp to create more dentin than usual.

However, you still cannot do without drilling a tooth: the area damaged by caries must be eliminated. Then a collagen sponge soaked in medicine is inserted into the hole, and the hole itself is sealed with dental glue. After a few weeks, the sponge dissolves and the tooth is restored.

Another way to activate stem cells is to irradiate them with a low-power laser. Bioengineers from the Harvard's Wyss Institute are working in this direction.

So far, similar experiments have been carried out only on laboratory mice. There is still a lot to be done to replicate these studies on humans and understand which of the tooth regeneration technologies will show themselves and will be approved for use in dental clinics.

Synthetic tooth enamel

While some scientists are working on tooth regeneration, in China they have created artificial tooth enamel that can be applied to areas of the tooth devoid of natural enamel.

Synthetic enamel, which was created by a group of scientists from Zhejiang University under the direction of Dr. Zhaoming Liu, is identical to natural. It completely mimics its natural complex structure. Scientists were able to synthesize clusters of the main component of enamel - calcium phosphate. They turned out to be small: only one and a half nanometers in diameter. Such a small size provides an extremely dense packing of clusters into structures similar to natural tooth enamel. This has not been achieved in previous experiments. Triethylamine came to the rescue of scientists, through which it was possible to slow down the adhesion of growing clusters.

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Laboratory experiments have shown that artificial enamel can firmly adhere to crystals of hydroxyapatite - the main mineral component of bones and teeth - and form a strong film on them. After that, the enamel was tested on a volunteer whose teeth lost it due to contact with hydrocyanic acid. It took two days after the material was applied to his teeth: then a dense crystalline film with a thickness of 2, 7 micrometers formed on them, which in strength and resistance to abrasion was in no way inferior to ordinary tooth enamel.

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