Bridging the Lab-Clinical Gap in Nano dentistry: Causes and Novel Solutions

Despite significant advancements in dental nanomaterials, there has been an increase in clinical reports of unexpected complications, such as chronic peri-implant inflammation and post-restorative sensitivities. This gap between promising laboratory results and adverse clinical outcomes is primarily due to the inadequacy of traditional biocompatibility assessment methods. This review article, by analyzing ۴۲ studies published between ۲۰۲۰ and ۲۰۲۴, identifies and examines three main reasons for this discrepancy: (۱) The microbial gap, or the neglect of the complex, biofilm-based oral ecosystem; (۲) The mechanical gap, or overlooking the dynamic, cyclic forces from mastication; and (۳) The temporal gap, involving short-term evaluations versus the requirement for long-term material longevity. In response to these challenges, four novel laboratory approaches are presented to enhance predictive capability: the use of advanced co-cultures to model the tripartite interaction of material, bacteria, and host cells; the employment of three-dimensional (۳D) tissue models for more accurate simulation of oral tissue microenvironments; the application of mechanical bioreactors to simulate loading and wear conditions; and the implementation of comprehensive safety panels that assess immune system response beyond mere cellular toxicity. Building on these solutions, a four-stage operational framework titled FOUR-D (Four-Dimensional Dental Nanomaterial Evaluation) is proposed to guide the assessment process from initial screening to integrated data analysis and final decision-making. The final conclusion emphasizes that continuing to rely on outdated evaluation paradigms wastes resources and endangers patient safety. To ensure a safe future for nanodentistry, scientific journals, regulatory bodies, and researchers must collectively embrace new standards and more advanced assessment tools. Only by aligning laboratory methods with the complexities of the oral environment can the predictive gap be significantly reduced, paving the way for the development of dental nanomaterials that remain innovative while being reliable and safe.

کلیدواژه ها:

Dental nanomaterials ، Predictive gap ، Biocompatibility ، Co-culture ، ۳D model ، Mechanical bioreactor ، Safety assessment