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Burkhardt F, Handermann L, Rothlauf S, Gintaute A, Vach K, Spies BC, Lüchtenborg J. Accuracy of additively manufactured and steam sterilized surgical guides by means of continuous liquid interface production, stereolithography, digital light processing, and fused filament fabrication. J Mech Behav Biomed Mater 2024; 152:106418. [PMID: 38295512 DOI: 10.1016/j.jmbbm.2024.106418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
Different printing technologies can be used for prosthetically oriented implant placement, however the influence of different printing orientations and steam sterilization remains unclear. In particular, no data is available for the novel technology Continuous Liquid Interface Production. The objective was to evaluate the dimensional accuracy of surgical guides manufactured with different printing techniques in vertical and horizontal printing orientation before and after steam sterilization. A total of 80 surgical guides were manufactured by means of continuous liquid interface production (CLIP; material: Keyguide, Keyprint), digital light processing (DLP; material: Luxaprint Ortho, DMG), stereolithography (SLA; Surgical guide, Formlabs), and fused filament fabrication (FFF; material: Clear Base Support, Arfona) in vertical and horizontal printing orientation (n = 10 per subgroup). Spheres were included in the design to determine the coordinates of 17 reference points. Each specimen was digitized with a laboratory scanner after additive manufacturing (AM) and after steam sterilization (134 °C). To determine the accuracy, root mean square values (RMS) were calculated and coordinates of the reference points were recorded. Based on the measured coordinates, deviations of the reference points and relevant distances were calculated. Paired t-tests and one-way ANOVA were applied for statistical analysis (significance p < 0.05). After AM, all printing technologies showed comparable high accuracy, with an increased deviation in z-axis when printed horizontally. After sterilization, FFF printed surgical guides showed distinct warpage. The other subgroups showed no significant differences regarding the RMS of the corpus after steam sterilization (p > 0.05). Regarding reference points and distances, CLIP showed larger deviations compared to SLA in both printing orientations after steam sterilization, while DLP manufactured guides were the most dimensionally stable. In conclusion, the different printing technologies and orientations had little effect on the manufacturing accuracy of the surgical guides before sterilization. However, after sterilization, FFF surgical guides exhibited significant deformation making their clinical use impossible. CLIP showed larger deformations due to steam sterilization than the other photopolymerizing techniques, however, discrepancies may be considered within the range of clinical acceptance. The influence on the implant position remains to be evaluated.
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Affiliation(s)
- Felix Burkhardt
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Leon Handermann
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Severin Rothlauf
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Aiste Gintaute
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Kirstin Vach
- Medical Center - University of Freiburg, Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg, Germany
| | - Benedikt C Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Jörg Lüchtenborg
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
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Narongdej P, Hassanpour M, Alterman N, Rawlins-Buchanan F, Barjasteh E. Advancements in Clear Aligner Fabrication: A Comprehensive Review of Direct-3D Printing Technologies. Polymers (Basel) 2024; 16:371. [PMID: 38337260 DOI: 10.3390/polym16030371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Clear aligners have revolutionized orthodontic treatment by offering an esthetically driven treatment modality to patients of all ages. Over the past two decades, aligners have been used to treat malocclusions in millions of patients worldwide. The inception of aligner therapy goes back to the 1940s, yet the protocols to fabricate aligners have been continuously evolved. CAD/CAM driven protocol was the latest approach which drastically changed the scalability of aligner fabrication-i.e., aligner mass production manufacturing. 3D printing technology has been adopted in various sectors including dentistry mostly because of the ability to create complex geometric structures at high accuracy while reducing labor and material costs-for the most part. The integration of 3D printing in dentistry has been across, starting in orthodontics and oral surgery and expanding in periodontics, prosthodontics, and oral implantology. Continuous progress in material development has led to improved mechanical properties, biocompatibility, and overall quality of aligners. Consequently, aligners have become less invasive, more cost-effective, and deliver outcomes comparable to existing treatment options. The promise of 3D printed aligners lies in their ability to treat malocclusions effectively while providing esthetic benefits to patients by remaining virtually invisible throughout the treatment process. Herein, this review aims to provide a comprehensive summary of studies regarding direct-3D printing of clear aligners up to the present, outlining all essential properties required in 3D-printed clear aligners and the challenges that need to be addressed. Additionally, the review proposes implementation methods to further enhance the effectiveness of the treatment outcome.
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Affiliation(s)
- Poom Narongdej
- Department of Mechanical and Aerospace Engineering, California State University Long Beach, Long Beach, CA 90840, USA
- Institute of Mathematical Sciences, Claremont Graduate University, Claremont, CA 91711, USA
| | - Mana Hassanpour
- Department of Chemical Engineering, California State University Long Beach, Long Beach, CA 90840, USA
| | - Nicolas Alterman
- Department of Mechanical and Aerospace Engineering, California State University Long Beach, Long Beach, CA 90840, USA
| | | | - Ehsan Barjasteh
- Department of Mechanical and Aerospace Engineering, California State University Long Beach, Long Beach, CA 90840, USA
- Department of Chemical Engineering, California State University Long Beach, Long Beach, CA 90840, USA
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Robles M, Jurado CA, Azpiazu-Flores FX, Villalobos-Tinoco J, Afrashtehfar KI, Fischer NG. An Innovative 3D Printed Tooth Reduction Guide for Precise Dental Ceramic Veneers. J Funct Biomater 2023; 14:216. [PMID: 37103306 PMCID: PMC10146615 DOI: 10.3390/jfb14040216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/16/2023] [Accepted: 04/09/2023] [Indexed: 04/28/2023] Open
Abstract
Tooth reduction guides allow clinicians to obtain the ideal space required for ceramic restorations. This case report describes a novel design (CAD) for an additive computer-aided manufactured (a-CAM) tooth reduction guide with channels that permitted access for the preparation and evaluation of the reduction with the same guide. The guide features innovative vertical and horizontal channels that permit comprehensive access for preparation and evaluation of the reduction with a periodontal probe, ensuring uniform tooth reduction and avoiding overpreparation. This approach was successfully applied to a female patient with non-carious lesions and white spot lesions, resulting in minimally invasive tooth preparations and hand-crafted laminate veneer restorations that met the patient's aesthetic demands while preserving tooth structure. Compared to traditional silicone reduction guides, this novel design offers greater flexibility, enabling clinicians to evaluate tooth reduction in all directions and providing a more comprehensive assessment. Overall, this 3D printed tooth reduction guide represents a significant advancement in dental restoration technology, offering clinicians a useful tool for achieving optimal outcomes with minimal tooth reduction. Future work is warranted to compare tooth reductions and preparation time for this guide to other 3D printed guides.
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Affiliation(s)
- Manuel Robles
- Department of Restorative Dentistry, Facultad de Odontologia, Universidad Vizcaya de las Americas, Hermosillo 83240, Mexico
| | - Carlos A. Jurado
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - Francisco X. Azpiazu-Flores
- Department of Restorative Dentistry, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Jose Villalobos-Tinoco
- Postgraduate Program in Periodontology and Implant Surgery, Facultad de Odontologia, Universidad Nacional de Rosario, Rosario S2002KTT, Argentina
| | - Kelvin I. Afrashtehfar
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City P.O. Box 346, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Nicholas G. Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, MN 55108, USA
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Lanis A, Gallucci G, Pedrinaci I. Full mouth oral rehabilitation of a severely worn dentition based on a fully digital workflow. J ESTHET RESTOR DENT 2023; 35:596-608. [PMID: 36715027 DOI: 10.1111/jerd.13020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To demonstrate the use of a complete digital workflow for a full mouth rehabilitation in a severely worn dentition. CLINICAL CONSIDERATIONS The present case report successfully rehabilitated a full-mouth case of a severely worn dentition based on the use of digital technologies, making the diagnosis and treatment process faster, accurate and less expensive. A long-lasting esthetic and functional result are showed after 30-months follow up. CONCLUSIONS An appropriate knowledge on dental erosion and oral rehabilitation, combined with a digital dentistry approach could lead the clinician to deliver a fast, accurate and predictable noninvasive restorative treatment in cases like the one described. CLINICAL SIGNIFICANCE Bruxism-based severely worn dentition is being found more often in population. In this situation, a detailed diagnosis and tailored treatment are mandatory to obtain a predictable treatment outcome. In this sense, the development of adhesive dentistry, new restorative materials and the incorporation of digital technologies can create a predictable synergy to rehabilitate these types of patients with a modern and less invasive approach.
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Affiliation(s)
- Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Ignacio Pedrinaci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Section of Graduate Periodontology, School of Dentistry, Complutense University of Madrid, Madrid, Spain
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