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European Journal of Applied Sciences – Vol. 11, No. 3
Publication Date: June 25, 2023
DOI:10.14738/aivp.113.14483.
Hovhannisyan, S., Mashinyan, K. A., Torgomyan, A. L., & Hakobyan, G. (2023). Graphene Oxide: The Promising Potential in
Dentistry: A Review. European Journal of Applied Sciences, Vol - 11(3). 269-278.
Services for Science and Education – United Kingdom
Graphene Oxide: The Promising Potential in Dentistry: A Review
Hovhannisyan, S.
Department of prosthodontics,
Yerevan State Medical University after M. Heratsi, Armenia
Mashinyan, K. A.
Department of prosthodontics, Yerevan State Medical
University after M. Heratsi, Armenia
Torgomyan, A. L.
Department of Physiology,
Yerevan State Medical University after M. Heratsi, Armenia
Hakobyan, G.
Dept. of Oral and Maxillofacial Surgery
Yerevan State Medical University after M. Heratsi, Armenia
ABSTRACT
Objectives: In recent years the applications of graphene oxide (GO) have been
extensively studied in various fields of medicine, due to its antibacterial properties
and the ability to regenerate tissues. In dentistry, graphene oxide (GO) is also used
to complement existing materials due to its unique properties, however, research
on the use of graphene in dentistry is limited. What dictates a comprehensive
review of the literature on the prospects for the use of graphene in clinical dentistry.
In this review, we aim to highlight the potential of Graphene oxide, current
understanding, and knowledge gaps regarding the antimicrobial behavior and
biocompatibility of this materials. The purpose of this review article is to provide
an overview of the use of graphene oxide (GO) in dentistry. Methods: Bibliographic
databases PubMed, Embase, and Scopus were surveyed. The review focuses on the
areas of application of Graphene oxide (GO) in dentistry, mainly based on a review
of the most cited scientific papers in international peer-reviewed journals. Results:
Graphene oxide (GO) has a unique structure and properties that differentiate it
from other materials. Scope of application Graphene oxide (GO) broad in dentistry,
it is used in prosthetics and restorative dentistry to optimize polymers and
adhesives, dental implantology, to modify the surface of dental implants, to
optimize the osteogenic properties of engineered tissue scaffolds through both
surface and composite modifications, in periododntology and in endodontics
thanks to his antimicrobial behavior. Conclusion: From this review, it can be
concluded about the prospects for future developments, the use of Graphene in
dentistry. Graphene oxide (GO) has the potential for future clinical applications in
a variety of dental applications.
Keywords: Nanomaterials, biocompatibility dental materials, Graphene oxide.
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European Journal of Applied Sciences (EJAS) Vol. 11, Issue 3, June-2023
INTRODUCTION
Dental materials placed in the oral cavity must be non-cytotoxic and biocompatible, resistant
to mechanical stress. There is a strong trend towards the continuous development of dental
materials with improved properties. In the 21st century, nanotechnology plays an important
role in almost all areas of science, technology, medicine, including dentistry. Nanotechnology is
the art of creating a variety of materials with different properties and functions, which opens
up great prospects in the field of denetal materials science. Nanotechnology is usually referred
to as technology leading to the production of materials of nanometer size (10-9 microns).
Nanostructures contain nanoparticles of different sizes (zero, one-, two- and three- dimensional. 3 New materials based on nanomaterials have improved physicochemical and
mechanical properties in combination, which makes them excellent materials for some dental
procedures The use of nanotechnology in dentistry is wide and includes nanorobotics,
nanodiagnostics, nanomaterials, and thanks to these achievements, many dental problems are
solved for the better - from the diagnosis of dental diseases to more effective treatment
methods. It is clear that current developments in nanotechnology hold promising prospects for
all aspects of dentistry. This review presents a perspective advantage Graphene oxide (GO) in
dentistry. All the data and articles putted in this review are gathered from Google Scholar,
PubMed, and some dental databases. The use of Graphene oxide in dentistry is enormous and
includes prosthetics, endodontics, conservative and aesthetic dentistry, periodontics,
implantology, and regenerative dentistry. Physical and technological properties Graphene
Oxide (GO) Graphene oxide (GO) family nanomaterials was first obtained by Geim and
Novoselov in 2004 [1,2]. Graphene oxide (GO) include ultrathin graphite, multilayer graphene
(FLG), graphene oxide (GO; monolayer to multiple layers), reduced graphene oxide (rGO), and
graphene nanosheets (GNS). GO is one of the crystalline forms of carbon, which is a single
monolayer of sp2 hybridized orbitals in a tightly packed to a two-dimensional (2D) honeycomb
lattice, each carbon atom has three σ-bonds and an out-of-plane π-bond that can bind with
neighboring atoms [1]. The structure of GO consists of a single atom layer and functional groups
such as carboxylic acid, epoxide, and hydroxyl groups which could make it amphiphilic [3]. GO
can be produced by various approaches including chemical vapor deposition [4], mechanical
cleavage of graphite, and electrochemical exfoliation of graphite [5]. GO can be further wrapped
up to form zero-dimension (0D) nanomaterial like fullerenes, or rolled into nanotube (one
dimension, 1D), or manipulated into 3D graphite [6]. GO sheets exist in bi-layers and multi- layers (<10), each possessing unique properties. Further increasing the number of layers
significantly changes the properties of the material as a graphene stack with 10 layers behave
more like graphite [6], demonstrating that the interlayer structure and coupling between the
layers determinekey physical properties [7].
For instance, the stacking order, relative twist, and interlayer spacing govern the electronic,
optical, and mechanical properties of multi-layered graphene [8]. Additionally, graphene is a
free-standing two-dimensionally active carbon allotrope, where each carbon atom in the 2D
crystal is bonded to the three other adjacent carbon atoms forming a hexagonal aromatic
structure [8]. This specific structure and its periodicity result in unique electrical and
mechanical characteristics. The electron confinement in the orbitals are localized to
neighboring carbon atoms to create the covalent σ-bonds [9]. Graphene's unique physical
properties include hardness higher than diamond, elastic modulus as highas 1 TPa [10], thermal
conductivity almost 13 times higher than copper [11], and good optical transparency with
~97.7% transmittance [12].
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Hovhannisyan, S., Mashinyan, K. A., Torgomyan, A. L., & Hakobyan, G. (2023). Graphene Oxide: The Promising Potential in Dentistry: A Review.
European Journal of Applied Sciences, Vol - 11(3). 269-278.
URL: http://dx.doi.org/10.14738/aivp.113.14483.
GO has many unique physicochemical and biological properties [13]. Graphene can be easily
functionalized with bioactive compounds such as proteins, enzymes, drugs, growth factors, and
DNAvia physical interaction [14].
GO is highly biocompatible, can promote cell adhesion and proliferation, and can induce
directed stem cell differentiation [15,16].
Since there are several types of microorganisms in the oral cavity that cause caries and
periodontitis procedures in the oral cavityusing dental materials are susceptible to the action of
microbes, thereforeit is advisable to provide dental materials with antimicrobial properties.
ANTIBACTERIAL PROPERTIES GRAPHENE OXIDE (GO)
In the oral cavity, bacteria involved in caries formation are Streptococcus mutans, and bacteria
associated with periodontitis and root canal infections are Porphyromonas gingivalis and
Fusobacterium nucleatum.
GO in combination with other compounds, for example, the graphene / zinc oxide
nanocomposite, exhibits enhanced synergistic antimicrobial, antibiotic-film, and antiadhesive
activity against oral pathogens.
GO has been shown to have excellent antibacterial properties through a variety of mechanisms
[17,18].
Researchers have identified the basic mechanisms of the antimicrobial activity of Graphene
which includes physical and chemical effects.
Physical mechanism GO 's antimicrobial effect is caused by the fact that graphene materials
penetratethe cell membrane of microbes, causing leakage of intracellular substance, leading to
cell death. Thechemical antimicrobial effect of Graphene is caused by primary oxidative stress
mediated by ROS production. Excessive accumulation of intracellular ROS causes inactivation
of intracellular protein,lipid peroxidation and mitochondrial dysfunction, which in turn leads to
the gradual destruction of thecell membrane and, ultimately, cell death [19].
Lee et al. have created PMMA, including nano-sized graphene oxide (nGO), which has shown
antiadhesive effects against microbial species (C. albicans, E. coli, S. aureus and S. mutans) in
artificial saliva. They observed a persistent antimicrobial adhesive effect for up to 28 days [20].
Majority of studies find GO as most effective by damaging the microbial cells with mechanical
interaction of sharp edges as well as by the generating reactive oxygen species (ROS) [21].
The first study showed strong antimicrobial behavior of both GO and rGO by deactivating the
98.5%and 90% of Escherichia coli (E. coli) DH5α cells [22].
A study by He et al. evaluated the antibacterial activity of GO nanosheets against three common
types of bacteria Streptococci mutans - Porphyromonas gingivalis and Fusobacterium
nucleatum against oral pathogens and found that GO nanosheets are very effective in inhibiting
the growth of these pathogens. At a GO concentration of 40 μg / ml, the growth of P. gingivalis
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and F. nucleatum bacteriawas inhibited, while at a concentration of 80 μg / ml, GO completely
killed all S. mutans [23].
Subsequently, the broad-spectrum antimicrobial activity of GO was demonstrated by
evaluating the antimicrobial activity against the phytopathogen and fungal species [24].
Antibacterial role of nano-graphene oxide was investigated by Wu et al. Thus they investigated
whether the graphene oxide (GO) nanosheets could be used to enhance antibacterial activity of
ASwalR RNA for E. faecalis in periapical periodontitis. They showed that GO-PEI could
efficiently deliver the ASwalR plasmid into E. faecalis cell. GO-PEI-ASwalR significantly reduced
virulent- associated gene expressions. Furthermore, GO-PEI-ASwalR suppressed biofilm
aggregation and improved bactericidal effects [25].
GO also has the potential for drug delivery [26].
Properties such as biocompatibility and low toxicity of GO open up the scope of its application
for the delivery of therapeutic drugs in the environment of these drugs BMP-2 aspirin [27],
vancomycin
[28] and miRNA [29,30]. Many of the graphene-based drug/gene delivery systems such as
nanocomposites of GO with vascular endothelial growth factor (VEGF) or GO carrier containing
mitoxantrone have been developed as cardiac tissue regeneration systems or a therapeutic
treatment for tumors [31].
The antibacterial properties of GO can be useful for dentists in various industries.
The antibacterial properties of GO can be very helpful in suture fabrication. It has been
suggested thatcompared to conventional polyvinyl alcohol (PVA) fiber, which does not have
antimicrobial properties. A PVA matrix dispersed with mechanically exfoliated graphene
(MEG) exhibits a high antibacterial effect and thus effectively accelerates wound healing,
making PVA/MEG nanocompositefiber a promising new candidate for surgical sutures [32].
Further in-depth experimental studies are needed to further analyze the bactericidal effect of
graphenefor future clinical applications, especially with respect to dental pathogens, as these
in vivo studies are still in their infancy. Applications of Graphene Oxide (GO) in Bone Tissue
Engineering. Bone regeneration is a complex and dynamic physiological process that at the
macroscopic level includes local mechanical stability, environmental matrix and blood supply,
and microscopically includes the interaction of many cells, signaling molecules and effectors in
a spatio-temporal sequence. The bone graft materials substitute should have the following
characteristics:
1) good biocompatibility
2) suitable mechanical properties to ensure adequate durability;
3) porous structure or rough surface to facilitate the germination of cells and tissues;
4) favorable osteoconductivity and osteoinduction to stimulate the formation of new bone;
5) controlled degradability to match the rate of germination of new bone;
6) non-immunogenicity to ensure safe clinical use.
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Hovhannisyan, S., Mashinyan, K. A., Torgomyan, A. L., & Hakobyan, G. (2023). Graphene Oxide: The Promising Potential in Dentistry: A Review.
European Journal of Applied Sciences, Vol - 11(3). 269-278.
URL: http://dx.doi.org/10.14738/aivp.113.14483.
The extraordinary mechanical and electronic properties of graphene-based materials have
motivatedresearchers to use them in tissue engineering and regenerative medicine [33].
Graphene and its derivatives provide a new selection for enhancing the mechanical and surface
properties of biomaterials to regulate the cardiomyogenic, neurogenic, osteogenic and
cartilaginous abilities of stem cells [34].
It is obvious that with these key multifunctional properties, graphene derivatives have shown
their potential and became favorite materials for many biomedical scientists, to design new
materials or hybrid materials or coatings of these nanomaterials to existing biomedical devices
to overcome with the possibility of device associated infections.
Thanks to its unique characteristics, graphene quickly became a potential candidate for
biomedical use. Overall, grapheme-based materials hold great promise for application in
different fields of medicine, more specifically in dentistry [35].
Its mechanical properties, including strength, stiffness, and flexibility, make it one of the most
anticipated materials for bone engineering and may hold the promise of using Graphene in bone
regeneration.
Good electrical conductivity of GO can not only directly stimulate the osteogenic activity of cells,
butalso indirectly adsorb active factors, promoting bone formation [36].
Thus, the properties of GO fully meet the requirements of dentistry and tissue engineering.
Lee et al investigated the ability of graphene oxide (rGO) and hydroxyapatite (HAp) (rGO / HAp
NCs) to enhance osteogenesis of MC3T3-E1 preosteoblasts and new bone formation [37].
The following study conducted by Nizami et al assessed the efficacy of functionalized graphene
oxide(f-GO) nanocomposites on the decalcification of dentin, because dental caries of the root
surface is becoming one of the new problems in aged society [38]. GO-Ag and GO-Ag-CaF2
almost completelyinhibited S. mutans growth. However, they did not exhibit cytotoxicity to
epithelial cells except at the highest concentration (0.1 w/v%) of GO-Ag and GOAg-CaF2.
Furthermore, these f-GOnanocomposites exhibited less or no discoloration of dentin, although
commonly used silver diaminefluoride causes discoloration of dentin to black. Thus, these f-GO
nanocomposites are useful to protectdental caries on the tooth root that becomes a social
problem in aged society [39].
The study of osteogenic mechanisms can indicate the right direction for further research; then,
elucidating the mechanisms of degradation and metabolism will help to understand the space- time distribution of GD in vivo [40].
Ahn et al investigate the efects of mesoporous bioactive glass nanoparticle (MBN)/graphene
oxide (GO) composites on the mineralization ability and differentiation potential of human
dental pulp stemcells (hDPSCs) [41].