The Role of 3D Printing in Custom Dental Appliances for Indian Practices

The emergence of dental 3D printing has brought about a significant change in dentistry. This innovative technique marks the beginning of a new era in the Indian dental practice. Dentists may now provide customized dental treatments like never before thanks to the capacity to develop 3D-printed dental devices that are suited to each patient's needs. Many dental professionals like orthodontists, prosthodontists, and oral-maxillofacial surgeons are taking advantage of digital dentistry and 3D Printing.

Experience cutting-edge dental solutions in India, as advanced 3D printing technology transforms traditional practices into innovative care experiences! An update on 3D printing options for dental practices is needed. Let's begin…

What Is 3D Printing ? How Is It Useful In Dentistry?

The American Society of Testing and Materials defines 3D printing, or additive manufacturing, as "the process of joining materials to make objects from 3D model data, usually layer by layer." The word 'additive manufacturing' refers to a variety of 3D printing techniques, the most widely utilized of which in dentistry include stereolithography (SLA), material jetting (MJ), selective laser sintering (SLS), and fused deposition modeling (FDM). 1 In this process, a patient's teeth are imaged or scanned and saved. Then, using a 3D printing machine, dental molds, guides, and dental appliances are constructed. 

3D printing not only makes life easier for dental providers but also delivers significant benefits to patients: customized, affordable dental solutions.

Listed below are some of the applications of 3D printing in dentistry

1. Prosthodontics- Crowns, Bridges and Dentures
   

   3D printing is actively being used in the fabrication of dentures, crowns, bridges, copings, and dental castings. A precise virtual model of the prepared tooth and dental arch can be created with intraoral optical scanners. CAD software can be used to plan treatments and design restorations in both fixed and removable prosthodontics. Implant abutments, bridge constructions, and crown or bridge copings can all be printed or milled using the CAD design and scan data. 

   Dental casting patterns are precise, three-dimensional models of a patient's teeth that are used for dentures, crowns, and fixed bridge construction in addition to being used to study the mouth.

   3D printing has the potential to make dentures more quickly and affordably than the labor-intensive and multiple dental visit traditional approach of milling from a resin basis.
   
   

2. Restorative dentistry
   
   These days, it's not always strictly necessary to print a master model at all. Conventional restoration fabrication steps, like adding veneering material, can be completed in 3D printed master mode, and restorations are frequently shown on models, even when they were created digitally. To reduce storage needs, patient model data can be digitally stored and printed only when necessary.
   
   
3. Orthodontics –Aligners and Retainers
   

   Additive manufacturing is being used to build an increasing number of dental products. This technology has not only increased manufacturing speed but also allowed for better customization, which is crucial in this industry because every mouth is unique.  Aligners (type of retainer) are appliances that help patients move or stop the movement of teeth.  

   
   In orthodontics, a digital workflow employing intraoral or laboratory optical scanning, or even CBCT to gather patient data, may be used to plan the course of treatment, build appliances, and bend wires. With the help of the Invisalign® system, the patient's teeth are digitally realigned to create a set of 3D printed models that are used to create aligners, which gradually correct the teeth over months or years. The production of 3D printed, indirect bracket-bonding splints, which are manufactured in hard and flexible materials for exact bracket insertion using orthodontic CAD software, is an example of  3D printing using various materials.
   
   
4. Dental implants
   
   Manufacturers have produced innovative dental implants with a rough or porous surface by using 3D printing technology.  While milling and machining can be used to refine the printed form, such as the implant platform, 3D printing can produce complex geometries, such as a bone-like morphology, that may not be possible with traditional methods of producing dental implants in large quantities. The capacity to print maxillofacial implants in titanium or implantable polymers---Poly ethyl ether ketone (PEEK) is currently trending.  The implanted structure can be directly printed using 3D printing, or it can be employed as a tool for indirect manufacturing through the use of traditional pressing techniques.
   
   
5. Anatomic replicas - Medical modeling
   
   Medical modeling, one of the first uses of 3D printing in surgery, can be viewed as the creation of an anatomical "study model." Another significant technology that has recently become commonplace in dentistry is CBCT, which is now commonly available in dental offices and has revolutionized diagnosis and treatment in endodontics and implant dentistry. This has made this even more accessible. Before surgery, volumetric 'picture' data can be sent to a 3D printer via ready access to CT or CBCT, which offers comparable data and is more common in a hospital setting. This allows for the creation of precise replicas of the patient's jaws. This makes it possible to thoroughly examine anatomy, especially complicated, odd, or unfamiliar anatomy, and to determine the best surgical strategy. While SLA is used to create resin models for more intricate replicas, FDM may be utilized with filament for simpler creations. Although traditional plaster-based techniques are still often used, 3D printing is starting to gain traction in this field.
   
   
   
6. Surgical guides
   
   One use of 3D printing particularly valuable for dentistry of these is the surgical guide for dental implants. Dentists have found it extremely challenging to position dental implants correctly because of the awkward angles and reduced accessibility. Many implants have been misplaced as a result, which may cause issues with dental health. Surgical guidelines have been developed to overcome these problems. In particular, the guidance assists dentists in properly and strategically placing dental implants. This one-time-use tool is meant to be positioned directly on the teeth of the patient. It has a hole that facilitates the proper placement, depth, and angle of an implant.
   
   
7. Custom trays
   
   Accurate edentulous impressions are the foundation for ensuring that the restoration has good support, retention, stability, regained function, and the capacity to preserve the health of the oral tissue. Accurate implant impressions are essential for producing prostheses. Accurate impressions may only be made if the trays are in a stable position in the mouth. Sufficient area and homogeneous thickness for imprinting materials can be achieved with precise and stable customizable trays.
   
   Image source: Sawhney, H., & Jose, A. A. (2018). 3D Printing in Dentistry - Sculpting the Way It Is.
   Journal of Scientific and Technical Research, 8(1).
   http://www.publishingindia.com/jstr

How Does 3D Printing Work?

To start, 3D printing requires a digital model or digital impression of a patient's mouth. This starts with an intraoral scan. The scanned files are stored in .STL format and forwarded to your dental lab. The labs use CAD-CAM software to design , finish and restructure the scanned data. These files are then used for 3D printing using different filaments and materials (thermoplastics, ceramics , and metals).

The given flowchart shows the steps of clinical 3D printing workflow in dentistry:

Image source: Dawood, A., Marti, B., Sauret-Jackson, V. et al. 3D printing in dentistry.

Br Dent J 219, 521–529 (2015). https://doi.org/10.1038/sj.bdj.2015.914

Benefits of Using 3D Printing In Dentistry

The dental industry has witnessed significant transformation in recent years due to advancements in digital dentistry. As per a study conducted among dental practitioners and technicians in Karnataka, awareness regarding the use of digital technology in dentistry was known by 98.9% of dental practitioners and 92.7% of dental technicians, of which 9.28% of practitioners and 17.7% of technicians were unfamiliar with 3D printing. 81.6% of practitioners considered 3D printing useful and effective for designing custom dental appliances.4

Here are the major advantages of 3D printing in dentistry compared to traditional technology:

• Customization
  

  Because traditional dentistry products are made using molds, it is impractical for manufacturers to make a new mold for every product, making it difficult to build personalized appliances using this technology. This is often the result of batch production, but with 3D printing, the output is precisely matched to the computer model created by first scanning it. This is the art of digital dentistry! 

  
  
• More precision and accuracy
  
  The precision and accuracy of dental products are increased by adding materials through additive manufacturing processes during the 3D printing process. This also leads to better predictable clinical outcomes.
  
  
• Speed
  
  3D printing is faster than traditional manufacturing processes and can reduce fabrication time and inventory of physical models.
  
  
• Patient friendly
  
  Combining digital techniques makes it possible to produce customized dental devices in record time, which in turn has benefits for patient comfort as well as treatment effectiveness
  

The cost and lack of mass fabrication are two drawbacks of 3D printing. The size of dental printed products must be constrained by the chamber sizes of the 3D printer. However, larger 3D printers are now available in the market to help with these challenges. 

Still, after years of using conventional techniques, some dentists may be hesitant to switch to 3D technologies, even though they offer many benefits. Making the transition to digital dentistry requires a certain level of trust in these systems. You also need to receive training so you can operate these devices and software smoothly. Dental practitioners can obtain digital dentistry and 3D printing certifications and training from the Institute of Digital Dentistry, Formlabs Dental, and CDE- KSD.

Conclusion

Today in dentistry, 3D printing offers countless options. More than ever, 3D printing technologies are being used in dental clinics because of how quickly and easily they can be accessed. Any dental practitioner can easily locate a 3D printing system depending on their requirements and the needs of their patients. Digital dentistry and 3D printing will only advance in their quest to improve patient care and health, boost productivity and return on investment, and improve treatment outcomes. As technology develops further, we should anticipate that 3D printing will have a big impact on how dentistry is practiced in India.

FAQ’s

1. How much does a  dental 3D Printer cost?
   
   The most common 3D printers that are used in dentistry are SLA, FDM, and DLP. Their prices in India start from 3,50,000 and so on. Print quality, build volume, 3D software, and accuracy are the main factors that affect prices. Select the printer that best suits your needs as a dental practitioner by weighing the elements that matter most to you. For inquiries visit https://www.signelbiomedical.com/or call +91 8919117478.
   
   
2. How much time is required to 3D print a dental model?
   
   Compared to more traditional methods, 3D printing allows for the much faster construction of dental models. An average dental model can be 3D printed in two to three hours. The size/volume of the scanned file, the type of printer, and the filament or material used to print it all affect the time to print.
   
   
3. What materials are used in dental 3D printing?
   
   The most common materials used in dental 3D printing are polymers [polycaprolactone (PCL), polymethyl methacrylate (PMMA), polylactic acid (PLA), poly (lactic-co-glycolic acid) (PLGA), and ultraviolet (UV) resins], ceramics/resins, and metals [titanium (Ti) and cobalt-chromium (Co-Cr) alloys]. These materials are biocompatible, accurate, and have good mechanical properties.
   
   
4. How does 3D printing improve the patient experience in your dental practice?
   
   The fabrication of dental appliances using 3D printing is fast, which minimizes the need for repeated office visits and reduces waiting periods from weeks to only a few hours. Because of the precision in dental prosthetics made possible by 3D printing, there is greater comfort and a shorter adjustment period because of the improved fit. Furthermore, patients' expectations are closely met by the customized dental treatment plans made possible by 3D printing, which promotes patient participation and satisfaction.
   Sources:
   
   1. https://www.orthodenco.com/digital-services/3d-printing/
   2. Tian, Y., Chen, C., Xu, X., Wang, J., Hou, X., Li, K., Lu, X., Shi, H., Lee, E. S., & Jiang, H. B. (2021). A Review of 3D Printing in Dentistry: Technologies, Affecting Factors, and Applications. Scanning, 2021, 9950131. https://doi.org/10.1155/2021/9950131
   3. Rezaie F, Farshbaf M, Dahri M, Masjedi M, Maleki R, Amini F, Wirth J, Moharamzadeh K, Weber FE, Tayebi L. 3D Printing of Dental Prostheses: Current and Emerging Applications. Journal of Composites Science. 2023; 7(2):80. https://doi.org/10.3390/jcs7020080
   4. Acharya, A., Chodankar, R. N., Patil, R., & Patil, A. G. (2023). Assessment of knowledge, awareness, and practices toward the use of 3D printing in dentistry among dental practitioners and dental technicians: A cross-sectional study. Journal of Oral Biology and Craniofacial Research, 13(2), 253–258. https://doi.org/10.1016/j.jobcr.2023.02.001