Knowledge Base

3D Printing in Dentistry

Introduction to 3D Printing

Additive Manufacturing, also called 3D Printing, involves adding layers of material over a base platform. Introduced in 1980’s, 3D Printing as an industry has grown by leaps and bounds. The growth of 3D Printing in India and indeed the rest of the world has been driven by the country's desire to produce superior products at a lower overall operational cost. 3D Printing involves taking CAD drawings and slicing them into layers, printing layer by layer. The 3D Printing market was valued at USD 13.7 billion in 2020 and is expected to reach a value of USD 63.46 billion (Rs.4,63258 crores, assuming a dollar to rupee conversion rate of 73) by 2026, at a CAGR of 29.48% over the forecast period (2021 - 2026). [Source: https://www.mordorintelligence.com/industry-reports/3d-printing-market] That is big. It is a certain sign that enterprises are looking at 3D Printing as a viable technology to propel their growth in the future. As the world struggles to cope with the economic havoc wreaked by the Covid pandemic, companies are looking to optimize production, and 3D Printing offers many advantages over traditional means of manufacturing. There are various 3D technologies available today. A few salient technologies include Stereolithography (SLA), Fused Deposition Modeling (FDM), Polyjet (PJ), Digital Light Processing (DLP), Selective Laser Sintering (SLS), Selective Laser Melting (SLM), and Electronic Beam Melting (EBM). Each has its merits and demerits, and the choice of technology depends upon the end application. 3D Printing has been successfully embraced by many manufacturing sectors like aerospace, automobile and electronics. Automobile and aerospace especially were one of the first sectors to utilize 3D Printing, mostly for parts that were meant to be lightweight, and had complex geometries. Today, 3D Printing has also made inroads into the medical field and in dentistry. In this article, we will briefly introduce 3D Printing pertaining to dental care.

Dental 3D Printing
The overarching goal of the medical profession, including dentists, is to maintain or improve a patient's health. Dentistry involves preventive, corrective and restorative procedures. However, a majority of dental procedures are restorative (procedures that involve the replacement or alteration of tooth structure), and 3D Printing is extremely beneficial in fulfilling the requirements of dentists. Today, dentists are finding newer ways to make patient treatment comfortable. 3D Printing is part of the newer technology that dentists have adopted, and India is no exception. The most important advantage 3D Printing offers dentists is the ability to customize each and every aspect of the treatment. This is a very important consideration. Take the example of dental abutments. Abutments rest at the gum line of permanent dental implants. If they are not fitted properly, abutments can wear on the gum line, causing it to recede. This can allow bacteria to get underneath the implant, which will eventually cause decay and the implant to fail. Customized 3D printed abutments fit better in the patient’s mouth as they are tailor made as per specific measurements, and can minimize the wear between the implant and the gum line, improving patient comfort and implant success rates. Today, it is possible to 3D Print dentures, implants, aligners and dental prosthetics like crowns and bridges. Dental and orthodontic laboratories are able to produce crown & bridge models, surgical guides, stone models, clear aligners, orthodontic models, implant cases, indirect bonding tray, partial frameworks and various other dental appliances by methods that combine oral scanning, 3D Printing, and CAD / CAM design. In fact, computerized scanning systems and 3D Printing systems have come largely to replace traditional dental manufacturing techniques. Specialized software create CAD / CAM files and work with built-in libraries of objects to custom manufacture prosthodontics from computerized scans of impressions / models of teeth and 3D print them. Depending upon the procedure, dental 3D Printing uses different printing processes – Selective Laser Sintering, Fused Deposition Modelling, Polyjet, DLP, SLM etc., and Commercial 3D printers have introduced an array of 3D printers – available in India too – that can be used for specific procedures. And their tribe is increasing with innovations in 3D Printing technology. What is more, the choice of 3D Printing material that is suitable for teeth has increased tremendously everywhere, and India too stands to gain from it. One of the latest exciting advances in medical 3D Printing is bioprinting. It involves the use of tissue engineering in combination with 3D Printing technology to generate organic cell structures that would allow for the production of replacement human tissues, organs, and blood vessels. Once the technology advances, dentists too will benefit in producing tooth replacement that is extremely close to the natural human tooth.

But all said and done, at the end of the day, it's the patients who stand to gain the most from the advances in 3D printing.

Benefits and Challenges
In general, 3D Printing offers many benefits over traditional manufacturing:

  • Environment friendly - wastes less material.
  • 100% customization possible
  • Possible to achieve complex geometries such as lattice structures and bionic designs
  • Part Consolidation to eliminate assembly process
  • Single step process for time and cost effective manufacturing.
  • Cost effective for production of small batches - Possible to manufacturer large parts in a single process
  • Variety of raw materials with multi material printing on a single part which is not possible in traditional manufacturing

3D printing benefits both for the Dentists and Patients are:

Dentists:               

  • Precise treatments, with less adjustment and grinding during seating
  • Improved accuracy and clinical results 
  • Faster than traditional impression taking 
  • Reduced need for retakes
  • No impression materials and mess                                                                  

Patients:

  • Quick and comfortable experience
  • Better restoration fits and minimal grinding
  • Improved clinical results
  • Reduced number of appointments due to fewer retakes
  • Reduced over-all chair-time

However, there are still a few hurdles to overcome for 3D printing to gain complete acceptance, especially in developing countries like India. A few challenges include:

  • high 3D printer cost - slow printing time
  • high cost of raw materials

Rapid advances in 3D Printing technology has however, mitigated this shortcomings. High end 3D printers that cost a lot of money in India a decade back are available at a fraction of that cost. Printing times have been reduced, and the cost of raw material is also coming down as more and more 3D printers manufacturers are looking at the huge potential India offers.  Market leaders in 3D Printing technology like Stratasys have introduced newer dental models in India, which can print bio compatible multi material, full-color multi material parts without sacrificing patient specific accuracy.