Review Article DOI: 10.18231/2455-8486.2016.

0001

Recent Trends of 3-D Printing in Dentistry- A review

Reeta Jain1,*, Supriya2, Shweta Bindra3, Kimmi Gupta4
1Professor & HOD, 2,3,4PG Student, Dept. of Prosthodontics, Genesis Institute of Dental Sciences & Research, Punjab

*Corresponding Author:
Email: [email protected]

Abstract
3D printing has been acclaimed as a disruptive technology which will change manufacturing. This technology is used in vari
ous fields such as aerospace, defense, art. Recently it has become a subject of great interest in virtual surgical planning. The techn
ology has a particular resonance with dentistry. It has become of great importance with advancement in 3D imaging and modellin
g technologies such as CBCT, intraoral scanning and CAD CAM in dentistry. Uses of 3D printing include the production of drill
guides for dental implants, the production of physical models for prosthodontics, orthodontics and surgery, the manufacture of de
ntal, craniomaxillofacial and orthopedic implants and the fabrication of copings and frameworks for implant and dental restoratio
ns. This paper reviews the types of 3D printing technologies available and their various applications in dentistry and in maxillofac
ial surgery.

Keywords: Three-dimensional printing, Rapid additive manufacturing, Selective laser sintering, Stereo lithography

Introduction o make implant surgical guides because of high mechan

3D printing is also known as additive manufacturin ical strength, obturators, surgical stents, duplication of p
g (AM), rapid prototyping, layered manufacturing or sol rosthesis and burn stents. The curing time and the thickn
id free form fabrication. It is the process in which multi ess of the layer polymerized is affected by the dynamics
ple layers of material is added one by one under comput involved in the entire procedure. The kinetics can be co
er control to create three-dimensional object. The key id ntrolled by the power of the light source, the scanning s
ea of this innovative method is that the three dimension peed and the chemistry and amount of the monomer and
al model is sliced into many thin layers and the manufac photo initiators. In addition, UV absorbers can be adde
turing equipment uses this geometric data to build each d to the resin to control the depth of Polymerization. Th
layer sequentially until final desired product is complete e main disadvantage of SLA is the scarcity of biocompa
d. It all starts with creation of a virtual design of the obj tible resins with proper SLA processing properties. Add
ect. Scanner may be used to scan buildings, rock format itional challenges are the use of photo initiators and radi
ions, etc., to produce a 3D model. The 3D model is slice cals which may be cytotoxic (with long processing time
d and then it is ready to feed into the 3D printer of comp s), entrapment of unreacted monomer and residual phot
atible brand and type. This can be done via USB, SD or o initiator, and inability to create compositional gradient
Wi-Fi. When a file is uploaded in a 3D printer, the obje s along horizontal planes.(1,3,4) (Fig. 1)
ct is ready to be 3D printed layer by layer. The 3D print
er reads every slice (2D image) and creates a three dime
nsional object. Objects of any geometry can be made by
this technology. This is what we call slicing.(1-2)

3D printing over CAD CAM technology

1. Subtractive methods such as CAD CAM has some
limitations in relation with 3 D printing.
2. Large amount of raw material is wasted because of
unused portions of the mono-blocks which are
discarded after milling and recycling of the excess
ceramic is also not feasible.
3. Milling tools are prone to heavy abrasion and wear
which shortens their cycling time.
4. Due to brittle nature of ceramic microscopic cracks
can be introduced during the process of machining. Fig. 1: Stereo Lithography

Stereolithography Fused Deposition Modelling

History of Stereo lithography dates back to 1980 an Fused Deposition Modelling developed by Schott C
d was introduced by Charles Hull. Principle of making s rump. A thermoplastic filament material is extruded thr
olid objects involves successive printing of thin layers o ough a nozzle controlled by temperature and the materia
f UV curable photopolymer layer by layer. T It is used t l hardens immediately (within .1 sec) after extrusion. Th
Annals of Prosthodontics & Restorative Dentistry, October-December 2016:2(4):101-104 101
Reeta Jain et al. Recent Trends of 3-D Printing in Dentistry- A Review

e motion of the nozzle head is controlled by a processor

and traces and deposit the material in extremely thin la
yer on to a subsidiary platform. Materials such as acrylo
nitrile butyro styrene ABS, polycarbonates and poly sul
fones are used. Building complex geometries usually ne
cessitates the usage of a second extruder – for example,
might extrude a water soluble support material.(5) Accur
acy will depend upon the speed of travel of the extruder
, as well as the flow of material and the size of each ‘ste
p’. This is the process that is used by most low cost ‘ho
me’ 3D printers. It allows for the printing of crude anato
mical models without too much complexity, for exampl
e, printing an edentulous mandible.(6,7) (Fig. 2)

Fig. 3: Selective Laser Sintering

Photopolymer Jetting
 This technology uses either a stationary platform
and dynamic print head or a stationary print head
and dynamic platform. Light sensitive polymer is
jetted onto a build platform from an inkjet type print
head, and cured layer by layer on an incrementally
descending platform. A support structure is laid
down in a friable support material. A wide range of
resins and waxes for casting, as well as some
silicone-like rubber materials can be printed. This
technology gives the resolution of apprx.16 microns
and gives the easy access for making complex and
fine detailed objects.(1)
Fig. 2: Fused Deposition Modelling  They are useful for printing dental or anatomical
study models. Implant drill guides may be quickly
Selective Laser Sintering and cheaply produced with this technology as they
This technology has been brought into usage since are less bulky. 3D Jet printers may have a single
mid-1980s and was developed by university of Texas. A print head like a computer printer, or they may have
fine material powder is fused by scanning laser, to buil multiple heads to cover the width of the working
d up structures incrementally. As a powder bed drops do platform. Either the print head moves across the
wn, a new fine layer of material is spread uniformly ove working platform, or the platform moves back and
r the surface. A high (60μm) level of resolution may be forth under stationary print head(s). The 3D systems
obtained. No support material is required as the structur and printers use a UV lamp or a light source to
es that are printed are supported by the surrounding pow harden the resin or wax after each layer is jetted.(1,6)
der.(8) Production of facial prosthesis makes use of poly Advantages are this technology is fast and cost
mers scaffolds (poly amide or poly Caprolactone). Selec effective, resolution is high, high-quality finish is
tive laser sintering is used in fabrication of anatomical s possible. Disadvantages are tenacious support
tudy models, cutting and drilling guides, dental models, material can be difficult to remove completely,
and also for engineering/design prototypes.(9) Advantag support material may cause skin irritation, cannot be
es are ease of autoclavability of the materials used, full heat sterilised, materials cost is high.(3,6) (Fig. 4)
mechanical functionality of the printed objects, lower co
st materials if used in large volume. Disadvantages are p
owders are messy with increased inhalation risk, techno
logy is expensive, and significant climatic conditions su
ch as compressed air are required.(9,10) (Fig.3)

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Reeta Jain et al. Recent Trends of 3-D Printing in Dentistry- A Review

Conclusion
There is huge impact of 3D imaging and modelling,
and CAD technologies on all aspects of dentistry. With
the help of digital data it is possible to make accurate, p
recise and complex geometrical forms in a variety of ma
terials, locally or in industrial centers through 3 dimensi
onal printing. Although everything we make for our pati
ents can be made by a 3D printer, but still single technol
ogy is not sufficient to fulfill all the needs of our patient
. Recent advances have an ability to produce lower stiff
ness scaffolds with high resolution features that allows i
ts application in soft tissue engineering .The technology
is gaining importance also in the fields of orthodontics
and restorative dentistry with the increase in usage of in
traoral scanning systems.
Fig. 4: Photopolymer Jetting Different 3D printing techniques have become imp
erative in maxillofacial and implant surgery, to assist th
Powder Binder Printer e complex treatment planning by constructing virtual an
This apparatus uses a modified inkjet head to print. atomical models. It is widely acknowledged that surgery
Liquid droplets are made to infiltrate a uniform and sing may be less invasive and more predictable with the use
le layer of powder one after the other. Powder bed drops of surgical guides printed in resins (commonly) or autoc
incrementally and a final model is ready which is built lavable nylon. With the evolution of 3D printing it has b
of many layers and a new fine layer of powder is swept ecome possible to replicate desired geometry without an
over the surface. The un-infiltrated powder supports the expensive mold and tooling which were not feasible wi
model, and so no support material is essential. In order th conventional techniques. 3D printers are becoming ac
to improve the strength and surface hardness in delicate cessible and affordable but the cost of running, material
printed model, a cyanoacrylate or epoxy resin is infiltrat s, maintenance, and skill of operators must be taken into
ed during post processing procedures. Although models consideration. Health and safety protocols must be stric
are fragile and its accuracy is limited but still models ar tly followed.3Dprinting takes the efficiencies of digital
e useful as study models or visual prototypes. This tech design to the production stage. The congruence of scann
nology proved to be an efficient means of constructing a ing, visualization, CAD, milling and 3D printing, along
n object in full contour. Models are difficult to sterilize with the professions innate curiosity and creativity mak
which proves to be a major drawback from a surgical pe es this an exceptionally exciting time to be in dentistry.
rspective. Advantages are the machines and materials ar
e lower cost, but still less expensive. Lower cost materia References
ls and technology, can print in colour, Un-set material p 1. Dawood A, Marti Marti B, Sauret-Jackson V, Darwood A.
rovides support, process is relatively fast and materials 3D Printing in Dentistry. British Dental Journal.
are safe to use. Low resolution, messy powder, Low stre 2015;219(11):521-25.
2. Liu Q, Leu M C, Schmitt S M. Rapid prototyping in
ngth, difficult to heat sterilize are major disadvantages o dentistry: technology and application. Int J Adv Manuf
f this process.(1,2,3) (Fig. 5) Technol. 2006;29:317–35.
3. Helena N Chia, Benjamin M Wu. Recent advances in 3D
printing of biomaterials. Journal of Biological Engineering.
2015;9:4.
4. Melchels FP, Feijen J, Grijpma DW. A review on
stereolithography and its applications in biomedical
engineering. Biomaterials. 2010;31:6121–30.
5. Zein I, Hutmacher DW, Tan KC, Teoh SH. Fused
deposition modeling of novel scaffold architectures for
tissue engineering applications. Biomaterials.
2002;23:1169–85.
6. van Noort R. The future of dental devices is digital. Dent
Mater. 2012;28:3–12.
7. Subburaj K, Nair C, Rajesh S, Meshram SM, Ravi B.
Rapid development of auricular prosthesis using CAD and
rapid prototyping technologies. Int J Oral Maxillofac Surg.
2007 Oct;36(10):938–43.
8. Pattanayak DK, Fukuda A, Matsushita T, Takemoto M,
Fujibayashi S, Sasaki K. Bioactive Ti metal analogous to
human cancellous bone: fabrication by selective laser
Fig. 5: Powder Binder Printer melting and chemical treatments. Acta Biomater.
2011;7:1398–406.
Annals of Prosthodontics & Restorative Dentistry, October-December 2016:2(4):101-104 103
Reeta Jain et al. Recent Trends of 3-D Printing in Dentistry- A Review

9. Chen J, Zhang Z, Chen X, Zhang C, Zhang G, Xu Z. 10. Xiong Y, Qian C, Sun J. Fabrication of porous titanium im
Design and manufacture of customized dental implants by plants by three-dimensional printing and sintering at diffe
using reverse engineering and selective laser melting rent temperatures. Dent Mater J 2012;31(5):815–20.
technology. J Prosthet Dent 2014;112:1088-1095.

Annals of Prosthodontics & Restorative Dentistry, October-December 2016:2(4):101-104 104