3D PRINTING IN DENTISTRY – By Dr. Triveni Padale

3D printing is an additive process which creates multiple layers of any object and synthesizes it in three dimensions. First 3D printers were introduces in early 1980s and from that time drastic changes can be seen in technology and materials used in 3 dimensional printing.
The process of 3D printing is completed using computer software which helps in making this kind of printing possible; this process is also called CAD (computer aided design).
There are various categories of 3D printers which mainly use resins, metals and some other materials to print a 3D objects
  • Vat Photo polymerization
  • Binder Jetting
  • Material Jetting
  • Sheet Lamination
  • Material Extrusion
  • Powder Bed Fusion
  • Directed Energy Deposition

Where can we use 3D printers in Dentistry?

Currently 3D printing is contributing fast and accurate fabrication of various models, surgical stents, dentures etc.
With new technological advancements in the field of 3D printing and introduction of newer materials, new and innovative applications are emerging.
Due to high degree of accuracy more and more labs are shifting to 3D printing even for casting procedures.

How 3D printing works?

To simplify the working of a 3D printer, we can compare it as an inkjet printer which prints in 3 dimensions instead of 2. Most popularly used printer synthesizes the object by depositing multiple layers of a material. The printing process is executed and regulated by computer software which enables virtual designing of an object and then prints it.
One of the most common process used in Dentistry is DLP(Direct Light Processing) 3D printing which resin material is cured by a DLP projector inside the printer, these type of DLP printers are widely used for dental applications as each layer of resin gets cured in a couple of seconds and this makes the process much faster than conventional techniques like Steriolithography(SLA).
Metallic restorations, frameworks and other objects cannot be printed like we print resins in DLP, therefore a process known as SLS(Selective Laser Sintering) which uses powdered material and a laser to create an object, this process can use raw materials like powdered metals. glass and plastic to fabricate objects.
A simplified example of 3D printing process for making dental models :

A dental office can own a small 3D printer for their day-to-day model printing as with help of new advancements; 3D printer and printing costs are decreasing.

Advantages of using 3D printing for dental office

  • Improved accuracy and consistency in synthesizing
  • Faster process than hand fabrication.
  • Minimization of the material wastage like that of milling process.
  • Elimination of the need to transport impressions or models from office to lab, all information can be sent digitally.
  • 3D printing of multiple objects is possible.
  • Decreased cost for the lab, dental office and patient.

Scope of 3D printing

What all can be done in dentistry using this technology:
  • Removable Dentures
  • Surgical Guides
  • Maxillary and mandibular Models
  • Patient specific implant devices
  • Reconstruction of maxillofacial structures
  • Maxillofacial prosthetic devices
  • Wax patterns
  • Treatment planning for cleft lip & palate
  • Mock up surgery models.

Regulation of quality

All the materials to be used as medical device should be priory approved by FDA, although dental model are not considered as medical device therefore any material can be used to synthesise a dental model this enables a dental office to own a low-priced 3D printer to produce dental models at a faster rate than getting it produced in the lab.

Limitations of 3D printing

Printing in 3 dimensions is indeed a new process for both the dentist and the lab hence there is a learning curve which limits the process in the beginning but once a person gets used to the software, material and process.
Other than that, following limitations are often associated with 3D printing
  • Lack of choice of materials which can be used as medical devices.
  • Equipment cost
  • Limited labs which use 3D printing
  • Long term studies are not available for the newly emerged materials and devices made with them.
  • Size of the produced article is limited depending upon the 3D printing machine.
  • Lack of designs for dental devices.

Cost!!

Although 3D printers are available in market for as low as $100, but for dental application FDA approved material and good quality printer must be used to ensure proper synthesis of articles used in a dental office.
With new materials and printers, some experts suggest a single tooth temporary prosthesis in future can cost around $1-2 to the lab which means reduced cost for lab, patient and dentist.

Bio-Printing!!

This area of application is still under development/research but printing dental hard tissues using stem cells looks very promising. Majority of research is to be done for synthesising materials like enamel or dentine, but practical applications are years away.

Conclusion

Three dimensional printing offers a lot to the dental sciences, but as of now its application is not widespread as conventional techniques due to the learning curve, equipment cost and limitations in available raw materials.
But with recent advancements and promising quality work offered by 3D printers, conventional methods of fabrication will soon be taken over by the process of 3D printing.

Dr. Triveni Padale

B.D.S, India.

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