3D-Printing: Innovation in Dentistry

Sep 2020 News and Views
Authors: M. Ali & A. Hashemizadeh
Editor: J. Sanghera

M3dicube Newcastle has proudly recruited its first dentistry leads (Mohammed and Ali) as part of reaching out to a wider audience. In this article, they review the applications of 3D-printing in the field of dentistry.

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Introduction

The field of dentistry has always seen the rapid adoption of innovative technologies to deliver the best quality of care. From general practice to advanced periodontics, a huge range of equipment and materials are consumed in making models, impressions, prostheses, crowns and bridges. Many of these involve laborious processes that rely on complex techniques; 3D-printing technology provides an alternative, novel solution which could streamline existing processes and facilitate the development of new treatment strategies.

Implantology

The development of affordable tooth implants have allowed them to become the gold-standard approach for replacing missing teeth and aiding rehabilitation of head and neck cancer survivors [1]. Implant surgery necessitates the use of surgical guides which aim to control the position, inclination, angulation and depth of the implant. Traditional techniques combine models casted from impressions and measurements taken from radiographs to generate a surgical guide. This process has a degree of technical sensitivity, and inaccuracies due to human error will precipitate to affect the accuracy of the final surgical guide [2].

3D-printing technology has transformed this process by reducing the need for human input and therefore eliminating human errors; digitally-scanned models of the oral cavity with superimposed CT (computerised tomography) images allow for the dental team to design a surgical guide accurately based on all information available. More recently, Popov et al. explored how titanium bone implants can be 3D-printed to the exact specifications of a patient [3]. When implemented into clinical practice, such innovative applications could lead to a vast improvement in long-term implant prognosis and success.

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Invisalign

The story of Invisalign perfectly demonstrates the successful marrying up of dentistry and 3D-printing. This orthodontic system uses custom aligners made from medical-grade flexible thermoplastic and aims to gradually adjust the teeth [4]. The aligners are thin, discrete and replaced on a fortnightly basis [5]. By using patient-specific data such as digital impressions, simulation software can calculate movement of the teeth and anatomy of the aligner at each 2-week checkpoint. The models of the dentition are printed using stereolithography (SLA) - this acts as a mould over which a plastic material is thermoformed to generate the final aligner [6,7]. Invisalign’s success lies with its exceptional aesthetics results, simplicity of oral hygiene and improved quality of life versus standard orthodontic techniques. A cross-sectional study conducted by Azaripour et al. determined that Invisalign patients had better overall gingival health and quality of life, which they attributed to ease of cleaning [8]. 

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Conclusion

3D-printing technology is being increasingly incorporated in the field of dentistry. At present in many dental specialties, 3D-printing acts as an enhancing adjunct to traditional techniques. With greater advancements in this rapidly growing technology, our understanding of its applications and scope of use within dentistry will only grow.

References

  1. Nayar S. Current concepts and novel techniques in the prosthodontic management of head and neck cancer patients. British Dental Journal. 2019;226(10):725–737.

  2. Ramasamy M, Giri, Raja R, Subramonian, Karthik, Narendrakumar R. Implant surgical guides: From the past to the present. Journal of Pharmacy and Bioallied Sciences. 2013;5(5):98.

  3. Popov V, Muller-Kamskii G, Kovalevsky A, Dzhenzhera G, Strokin E, Kolomiets A et al. Design and 3D-printing of titanium bone implants: brief review of approach and clinical cases. Biomedical Engineering Letters. 2018;8(4):337-344.

  4. Align Technology. Invisalign for adults and teens. Available from: https://www.invisalign.com/frequently-asked-questions [Accessed on 01 May 2020].

  5. Joffee L. Invisalign®: Early Experiences. Journal of Orthodontics. 2003;30(4):348-352.

  6. Pang K. Invisalign – 9/10 dentists recommend additive manufacturing. Digital innovation and Transformation. Available from: https://digital.hbs.edu/platform-digit/submission/invisalign-9-10-dentists-recommend-additive-manufacturing/. [Accessed 01 May 2020].

  7. Wang J, Goyanes A, Gaisford S, Basit A. Stereolithographic (SLA) 3D printing of oral modified-release dosage forms. International Journal of Pharmaceutics. 2016;503(1-2):207-212.

  8. Azaripour A, Weusmann J, Mahmoodi B, Peppas D, Gerhold-Ay A, Van Noorden C, et al. Braces versus Invisalign®: gingival parameters and patients’ satisfaction during treatment: a cross-sectional study. BMC Oral Health. 2015;15(1).

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