Doug Watt, principal dentist for Euston Place Dental Practice, discusses 3D printing and the benefits it offers to both practice and laboratory as an accurate, affordable, and accessible technology.
Restorative dentistry has been transformed in recent years thanks to the growth of digital technology, with the global market for restoratives expected to grow by 8.6% by 2028. Digital solutions are credited as one of the driving factors behind this growth, with intraoral scanners, CBCT and Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) leading the way.
3D printing technology has been slower than some others to touch dentistry, but it is now much more established. The technology was first developed over 30 years ago but has not been widely used for the fabrication of restorations until now. The sluggishness was mainly due to a lack of suitable materials and issues with accuracy and cost, meaning that early machines were limited to the largest commercial dental laboratories.
But technological advancements in the last few years have changed that and now 3D printing can do both: streamline workflows and save money for all dental professionals across multiple sectors.
3D printing in dentistry
In simple terms, 3D printing starts with the patient in the practice during treatment planning. The dentist takes images, such as intraoral scans and photographs, and perhaps also creates a smile mock-up. They then send the data to their laboratory, be that in-house or third party. The restoration is designed in the laboratory as usual and then the 3D printing option really comes into its own. Today’s 3D printers can accommodate a range of materials and are ideal for printing temporaries, trial smiles, models, crown lengthening guides or surgical guides for implants, all of which improves treatment outcomes.
Once the printing has been completed, the fabrication is sent back to the dentist who transfers it into the patient’s mouth. This is what we mean by ‘from lab to mouth’.
Fit for the digital age
3D printing has become an affordable, accurate process that completes the digital workflow. The investment is no longer a barrier to labs entering this market and in fact it opens up a whole new way of working in a digital age. The accuracy of today’s 3D printing hardware and software helps to ensure reliable results, with tried and tested ways of using the technology. These workflows have been developed over recent years with the help of wider advances in digitisation to create streamlined processes which benefit dental professionals and their patients.
The improvements in the strength of composite materials have added to the predictability of results. The increased accuracy of 3D printing now means that it’s possible to print complex structures like complete dentures, or surgical guides for implants that are autoclavable. The more mass-produced these materials are and the better the availability of biocompatible resins, the more affordable it becomes. With so much choice in materials, the possibilities for 3D printing are extending. Everything is a lot neater now, with seamless workflows that facilitate the use of 3D printing across different appliances that can be used safely in the mouth. With the cost of materials reducing in recent years, using this technology can save a significant amount of money on essentials like designing and manufacturing surgical guides.
Choosing a printer
I recently purchased the SprintRay Pro 95 which is available from Henry Schein, having trialled it and been really impressed. I use it primarily for model and surgical guide printing. The benefit of this is that I find the software more intuitive and easier to use than some other models I have tried. The SprintRay is pretty much ‘plug and play’ so it’s very easy and quick to get started. I also have experience using the RapidShape D20 II which I’ve used for around five years. Both the RapidShape and the SprintRay are Digital Light Projection (DLP) printers, meaning they project an image with a digital light source into a resin bath. This sets a layer onto a build platform, which then shifts and the process is
repeated to form a new layer.
Further types of 3D printers
Aside from DLP printers, there are also LED and SLA (stereolithography) models. LED printers work in a similar way to DLP printers, and SLA models use a laser and a mirror to individually trace each layer. This usually takes longer to print as each layer is constructed by the laser, rather than using a projection of the image in one shot. This is an important consideration, as the speed of an SLA printer is limited by the number of items being built at the same time. The more items, the longer the printing takes. DLP does not have this limitation; however, printing can take some time with DLP printers if it is trying to accommodate very tall prints.
The future
A significant advantage of 3D printing is the way it layers, enabling it to print in different materials, shades, and colours. There are multicolour 3D printers available now, which are being used to print dental models with gum and tooth colours in detail. What I’d love to see is a way for an intraoral scanner to analyse the colour throughout a tooth and then, through Artificial Intelligence (AI) analysis, to 3D-print a restoration that reflects the appearance of a natural tooth complete with varying layers of translucency and shades of dentin. That is something yet to be seen, but all the advancements I have seen so far make it a future possibility. 3D printing is an exciting technology that yields results and adds another level of enjoyment to the day.
The importance of tech support
I obtained both my 3D printers through Henry Schein, and they’ve been extremely responsive throughout. The intuitive nature of the equipment meant that my team did not need extensive technical support to set them up, but Henry Schein still got in touch to check if we were happy with the printers and to find out if we needed anything further. This after-sales support has given us the confidence we need to embrace the technology that is transforming the way we do dentistry.