NANOTECHNOLOGY-BASED DENTAL THERAPEUTICS AND THEIR RENAL SAFETY IMPLICATIONS

Abstract

Nanotechnology-based dental therapeutics have gained widespread clinical adoption due to enhanced antimicrobial activity, improved mechanical performance, and the ability to enable targeted drug delivery within oral tissues. Despite these advantages, accumulating evidence indicates that nanoscale dental materials may access systemic circulation through oral mucosal absorption, ingestion, procedural vascular entry, and chronic low-dose release from restorative interfaces, raising concerns regarding renal biodistribution and nephrotoxicity. This review synthesizes current experimental, preclinical, and translational evidence addressing systemic exposure routes, renal handling mechanisms, and kidney-related safety risks associated with dental nanotherapeutics. A comprehensive narrative evaluation was undertaken focusing on physicochemical determinants of nanoparticle behavior, including size, surface charge, composition, and protein corona formation, which collectively influence renal filtration, tubular uptake, and clearance. Findings from in vitro renal cell models and animal studies consistently identify oxidative stress, inflammatory activation, mitochondrial dysfunction, and tubular injury as central mechanisms underlying nanoparticle-induced renal toxicity. Evidence further suggests that renal accumulation and functional impairment are dose- and exposure-duration-dependent, with heightened vulnerability observed in patients with chronic kidney disease and renal transplant recipients. Limited long-term human clinical data underscore the need for cautious translational interpretation and targeted safety evaluation. Integrating nephrology-focused risk assessment into dental nanomedicine development, alongside interdisciplinary collaboration and nephroprotective material design, is therefore essential to support responsible clinical translation and safeguard kidney health.