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Pradíes G, Morón-Conejo B, Martínez-Rus F, Salido MP, Berrendero S. Current applications of 3D printing in dental implantology: A scoping review mapping the evidence. Clin Oral Implants Res 2024; 35:1011-1032. [PMID: 37929684 DOI: 10.1111/clr.14198] [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: 07/26/2023] [Revised: 09/18/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES This scoping review aimed to identify the available evidence in the use of 3D printing technology in dental implantology. Due to the broad scope of the subject and its application in implantology, three main areas of focus were identified: (1) customized dental implants, (2) manufacturing workflow for surgical implant guides, and (3) related implant-supported prostheses factors, which include the metallic primary frameworks, secondary ceramic or polymer superstructures, and 3D implant analog models. MATERIALS AND METHODS Online databases (Medline, Cochrane, Embase, and CINAHL) were used to identify the studies published up to February 2023 in English. Two experienced reviewers performed independently the screening and selection among the 1737 studies identified. The articles evaluated the additive manufacturing (AM) technology, materials, printing, and post-processing parameters regarding dental implantology. RESULTS The 132 full-text studies that met the inclusion criteria were examined. Thirteen studies of customized dental implants, 22 studies about the workflow for surgical implant guides, and 30 studies of related implant-supported prostheses factors were included. CONCLUSIONS (1) The clinical evidence about AM titanium and zirconia implants is scarce. Early data on survival rates, osseointegration, and mechanical properties are being reported. (2) 3D printing is a proven manufacturing technology to produce surgical implant guides. Adherence to the manufacturer's instructions is crucial and the best accuracy was achieved using MultiJet printer. (3) The quality of 3D printed prosthetic structures and superstructures is improving remarkably, especially on metallic alloys. However, better marginal fit and mechanical properties can be achieved with milling technology for metals and ceramics.
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Affiliation(s)
- Guillermo Pradíes
- Department of Conservative and Prosthetic Dentistry, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Belén Morón-Conejo
- Department of Conservative and Prosthetic Dentistry, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Francisco Martínez-Rus
- Department of Conservative and Prosthetic Dentistry, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - María Paz Salido
- Department of Conservative and Prosthetic Dentistry, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Santiago Berrendero
- Department of Conservative and Prosthetic Dentistry, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
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Aldesoki M, Bourauel C, Elshazly TM, Schkommodau E, Keilig L. Evaluation of micromotion in multirooted root analogue implants embedded in synthetic bone blocks: an in vitro study. BMC Oral Health 2024; 24:99. [PMID: 38233794 PMCID: PMC10792929 DOI: 10.1186/s12903-024-03854-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND While conventional threaded implants (TI) have proven to be effective for replacing missing teeth, they have certain limitations in terms of diameter, length, and emergence profile when compared to customised root analogue implants (RAI). To further investigate the potential benefits of RAIs, the aim of this study was to experimentally evaluate the micromotion of RAIs compared to TIs. METHODS A 3D model of tooth 47 (mandibular right second molar) was segmented from an existing cone beam computed tomography (CBCT), and a RAI was designed based on this model. Four RAI subgroups were fabricated as follows: 3D-printed titanium (PT), 3D-printed zirconia (PZ), milled titanium (MT), milled zirconia (MZ), each with a sample size of n = 5. Additionally, two TI subgroups (B11 and C11) were used as control, each with a sample size of n = 5. All samples were embedded in polyurethane foam artificial bone blocks and subjected to load application using a self-developed biomechanical Hexapod Measurement System. Micromotion was quantified by analysing the load/displacement curves. RESULTS There were no statistically significant differences in displacement in Z-axis (the loading direction) between the RAI group and the TI group. However, within the RAI subgroups, PZ exhibited significantly higher displacement values compared to the other subgroups (p < 0.05). In terms of the overall total displacement, the RAI group showed a statistically significant higher displacement than the TI group, with mean displacement values of 96.5 µm and 55.8 µm for the RAI and TI groups, respectively. CONCLUSIONS The RAI demonstrated promising biomechanical behaviour, with micromotion values falling within the physiological limits. However, their performance is less predictable due to varying anatomical designs.
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Affiliation(s)
- Mostafa Aldesoki
- Dental School, Oral Technology, University Hospital Bonn, Welschnonnenstr.17, 53111, Bonn, Germany.
| | - Christoph Bourauel
- Dental School, Oral Technology, University Hospital Bonn, Welschnonnenstr.17, 53111, Bonn, Germany
| | - Tarek M Elshazly
- Dental School, Oral Technology, University Hospital Bonn, Welschnonnenstr.17, 53111, Bonn, Germany
| | - Erik Schkommodau
- Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
| | - Ludger Keilig
- Dental School, Oral Technology, University Hospital Bonn, Welschnonnenstr.17, 53111, Bonn, Germany
- Department of Prosthodontics, Dental School, University Hospital Bonn, Bonn, Germany
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Su G, Zhang Y, Jin C, Zhang Q, Lu J, Liu Z, Wang Q, Zhang X, Ma J. 3D printed zirconia used as dental materials: a critical review. J Biol Eng 2023; 17:78. [PMID: 38129905 PMCID: PMC10740276 DOI: 10.1186/s13036-023-00396-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
In view of its high mechanical performance, outstanding aesthetic qualities, and biological stability, zirconia has been widely used in the fields of dentistry. Due to its potential to produce suitable advanced configurations and structures for a number of medical applications, especially personalized created devices, ceramic additive manufacturing (AM) has been attracting a great deal of attention in recent years. AM zirconia hews out infinite possibilities that are otherwise barely possible with traditional processes thanks to its freedom and efficiency. In the review, AM zirconia's physical and adhesive characteristics, accuracy, biocompatibility, as well as their clinical applications have been reviewed. Here, we highlight the accuracy and biocompatibility of 3D printed zirconia. Also, current obstacles and a forecast of AM zirconia for its development and improvement have been covered. In summary, this review offers a description of the basic characteristics of AM zirconia materials intended for oral medicine. Furthermore, it provides a generally novel and fundamental basis for the utilization of 3D printed zirconia in dentistry.
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Affiliation(s)
- Guanyu Su
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Yushi Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Chunyu Jin
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Qiyue Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Jiarui Lu
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Zengqian Liu
- Shi-Changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang, 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, Hefei, 230026, China
| | - Qiang Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Xue Zhang
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China.
| | - Jia Ma
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China.
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Shinkai RSA, Biazevic MGH, Michel-Crosato E, de Campos TT. Environmental sustainability related to dental materials and procedures in prosthodontics: A critical review. J Prosthet Dent 2023:S0022-3913(23)00370-0. [PMID: 37709614 DOI: 10.1016/j.prosdent.2023.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 09/16/2023]
Abstract
This article aims to review the status, challenges, and directions of environmentally sustainable oral healthcare by focusing on the dental materials and procedures used in prosthodontics. Sustainable development is a global priority and requires a systemic, integrative approach from all sectors of society. The oral healthcare sector is responsible for substantial greenhouse emissions throughout its value chain, including raw material extraction, industrial production, supply distribution, clinical practice, and management of waste. Of all dental specialties, prosthodontics has been one of the main generators of carbon emissions by fabricating a single product such as dentures or crowns in multiple steps. Dental prosthetic procedures involve chemicals and materials such as polymers, ceramics, metals, gypsum, and wax, which are often used in large quantities and for a single use. Thus, environmental risks and socioeconomic burdens can result from residuals and improper disposal, as well as waste and the embedded costs of unused materials retained by manufacturers, retail suppliers, dental laboratories, and dental clinics. To mitigate the environmental impact generated by conventional prosthodontics, we urge awareness and the adoption of sustainable good practices in the daily routine of dental clinics and laboratories. Capacity building and investment in a circular economy and digital technology can reduce the carbon footprint of prosthetic dentistry and improve the quality of life for present and future generations.
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Affiliation(s)
- Rosemary Sadami Arai Shinkai
- Senior Researcher, Department of Community Dentistry and Department of Prosthodontics, School of Dentistry (FOUSP), University of São Paulo (USP), São Paulo, Brazil.
| | - Maria Gabriela Haye Biazevic
- Associate Professor, Department of Community Dentistry, School of Dentistry (FOUSP), University of São Paulo (USP), São Paulo, Brazil
| | - Edgard Michel-Crosato
- Associate Professor, Department of Community Dentistry, School of Dentistry (FOUSP), University of São Paulo (USP), São Paulo, Brazil
| | - Tomie Toyota de Campos
- Full Professor, Department of Prosthodontics, School of Dentistry (FOUSP), University of São Paulo (USP), São Paulo, Brazil
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Chen J, Gui X, Qiu T, Lv Y, Fan Y, Zhang X, Zhou C, Guo W. DLP 3D printing of high-resolution root scaffold with bionic bioactivity and biomechanics for personalized bio-root regeneration. BIOMATERIALS ADVANCES 2023; 151:213475. [PMID: 37267749 DOI: 10.1016/j.bioadv.2023.213475] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/14/2023] [Accepted: 05/12/2023] [Indexed: 06/04/2023]
Abstract
Digital light projection (DLP) printing of hydroxyapatite (HAp) bioceramic provides a promising strategy for fabrication of complex personalized bio-tooth root scaffold with high-resolution. However, it is still a challenge to fabricate bionic bio-tooth root with satisfied bioactivity and biomechanics. This research studied the HAp-based bioceramic scaffold with bionic bioactivity and biomechanics for personalized bio-root regeneration. Compared to natural decellularized dentine (NDD) scaffolds with unitary shape and restricted mechanical properties, those DLP printing bio-tooth roots with natural size, high precision appearance, excellent structure, and a smooth surface were successfully manufactured, which met various shape and structure requirements for personalized bio-tooth regeneration. Moreover, the bioceramic sintering at 1250 °C enhanced the physicochemical properties of HAp and exhibited good elastic modulus (11.72 ± 0.53 GPa), which was almost twice of early NDD (4.76 ± 0.75 GPa). To further improve the surface activity of sintered biomimetic, the nano-HAw (nano-hydroxyapatite whiskers) coating deposited by hydrothermal treatment increased the mechanical properties and surface hydrophilicity, which indicated positive effects on dental follicle stem cells (DFSCs)' proliferation and enhanced the DFSCs osteoblastic differentiation in vitro. Subcutaneous transplantation in nude mice and in-situ transplantation in rat alveolar fossa proved that the nano-HAw-containing scaffold could promote the DFSCs differentiate into periodontal ligament-like enthesis formation. In conclusion, by combining the optimized sintering temperature and modified nano-HAw interface through hydrothermal treatment, the DLP-printing of HAp-based bioceramic with favorable bioactivity and biomechanics is a promising candidate for personalized bio-root regeneration.
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Affiliation(s)
- Jie Chen
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xingyu Gui
- National Engineering Research Center for Biomaterials and College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
| | - Tao Qiu
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yun Lv
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials and College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials and College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
| | - Changchun Zhou
- National Engineering Research Center for Biomaterials and College of Biomedical Engineering, Sichuan University, Chengdu 610064, China.
| | - Weihua Guo
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Sutejo IA, Kim J, Zhang S, Gal CW, Choi YJ, Park H, Yun HS. Fabrication of color-graded feldspathic dental prosthetics for aesthetic and restorative dentistry. Dent Mater 2023:S0109-5641(23)00089-1. [PMID: 37088587 DOI: 10.1016/j.dental.2023.03.021] [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: 01/03/2023] [Revised: 03/22/2023] [Accepted: 03/31/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVE Feasibility investigation of natural teeth shades replication on dental prosthetics fabricated via functionally graded additive manufacturing (FGAM) using combination of feldspathic porcelain (FP) and yttrium aluminum garnet cerium (Y3Al5O12:Ce, YAG:Ce) as a promising esthetic restoration option. METHODS Color-graded feldspathic crown fabrication parameter through FGAM method was comprehensively examined from the slurry rheology, cure depth, debinding to sintering temperature. Effect of light absorbent also checked towards overcuring reaction during UV exposure by the shape comparison. Lastly, the flexural bending strength measured following ISO 6872:2015 to assure the applicability. Applying the studied parameter, natural teeth shades then imitated and investigated by alteration of FP and FP + 0.1 wt% YAG:Ce (Y-FP). Generated color across the structure captured through mobile camera, interpreted through the CIELAB coordinate and the gradation confirmed by the color differences (ΔE00) calculated using CIEDE2000 formula. RESULT Parameter study indicated that 70 wt% of FP slurry with 3 wt% dispersant and 0.2 wt% light absorbent is favored. It produces excellent flowability in our FGAM system with less overcuring justified by edge margin reduction from 95.65° to 90.00° after UV exposure on rectangle shapes masking. The obtain structure also offers adequate flexural bending strength of 106.26 MPa (FP) and 101.36 MPa (Y-FP) after sintering at 780 °C. This validated the materials as class 2 dental prosthetics citing ISO 6872:2015. Color gradation was verified by the yellow b* value reduction (14.8 to -3.33) as it shifted from cervical to incisal area while ΔE00 further affirmed the differences from each segment in comparison with the FP and Y-FP. SIGNIFICANCE Color gradation was successfully replicated by FP and YAG:Ce composition shift via FGAM technique. This result highlights the potential of FGAM as an alternative for fabricating dental prosthetics with high efficiency and improved esthetic appeal.
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Affiliation(s)
- Imam Akbar Sutejo
- Korea Institute of Materials Science (KIMS), Changwon, Republic of Korea,; University of Science and Technology (UST), Daejeon, Republic of Korea
| | - Jeehwan Kim
- Korea Institute of Materials Science (KIMS), Changwon, Republic of Korea,; Pusan National University (PNU), Busan, Republic of Korea
| | - Sinuo Zhang
- Korea Institute of Materials Science (KIMS), Changwon, Republic of Korea,; University of Science and Technology (UST), Daejeon, Republic of Korea
| | - Chang Woo Gal
- Korea Institute of Materials Science (KIMS), Changwon, Republic of Korea
| | - Yeong-Jin Choi
- Korea Institute of Materials Science (KIMS), Changwon, Republic of Korea
| | - Honghyun Park
- Korea Institute of Materials Science (KIMS), Changwon, Republic of Korea
| | - Hui-Suk Yun
- Korea Institute of Materials Science (KIMS), Changwon, Republic of Korea,; University of Science and Technology (UST), Daejeon, Republic of Korea.
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Aldesoki M, Keilig L, Dörsam I, Evers-Dietze B, Elshazly TM, Bourauel C. Trueness and precision of milled and 3D printed root-analogue implants: A comparative in vitro study. J Dent 2023; 130:104425. [PMID: 36646269 DOI: 10.1016/j.jdent.2023.104425] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/03/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES The present study aimed to evaluate the accuracy (trueness and precision) of titanium and zirconia multi-rooted root analogue implants (RAIs) manufactured by milling and 3D-printing. METHODS A multi-rooted RAI was designed based on a mandibular second molar segmented from cone-beam computed tomography (CBCT). The manufactured RAIs were divided into four groups: 3D-printed titanium (PT) and 3D-printed zirconia (PZ) (n=10 each), as well as milled titanium (MT) and milled zirconia (MZ) (n=5 each). The specimens were scanned with a high-precision scanner, and the scanned data were imported into 3D-measurement software to evaluate the precision and trueness of each group. Root mean square (RMS) deviations were measured and statistically analysed (One-way ANOVA, Tukey's, p≤0.05). RESULTS PZ showed the highest precision with RMS value of 21±6 µm. Nevertheless, there was no statistically significant difference in precision among the other groups. Regarding trueness, MZ showed the highest trueness with RMS value of 66±3 µm, whereas MT showed the lowest trueness result. Inspection sections showed that MT had significantly high RMS deviation in the furcation area (612±64 µm), whereas PZ showed significantly high RMS deviation at the apical area (197±17 µm). CONCLUSIONS The manufacturing process significantly influenced the RAI accuracy. PZ exhibited the highest precision, whereas MZ exhibited the highest trueness, followed by PT. Finally, our results suggest that 3D-printing can reproduce concave surfaces and less accessible areas better than milling. CLINICAL SIGNIFICANCE Milled and 3D-printed RAIs showed promising results in terms of precision and trueness. However, further clinical research is needed to advocate their use as immediate implants. Additionally, the inherent volumetric changes of the various materials during manufacturing should be considered.
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Affiliation(s)
- Mostafa Aldesoki
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany.
| | - Ludger Keilig
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany; Department of Prosthodontics, Dental School, University Hospital Bonn, Bonn, Germany
| | - Istabrak Dörsam
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany; Department of Prosthodontics, Dental School, University Hospital Bonn, Bonn, Germany
| | - Bernd Evers-Dietze
- Department of Electrical Engineering, Mechanical Engineering and Technical Journalism (EMT), Bonn-Rhein-Sieg University of Applied Sciences, Sankt Augustin, Germany
| | - Tarek M Elshazly
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
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Kang JH, Sakthiabirami K, Kim HA, Hosseini Toopghara SA, Jun MJ, Lim HP, Park C, Yun KD, Park SW. Effects of UV Absorber on Zirconia Fabricated with Digital Light Processing Additive Manufacturing. MATERIALS (BASEL, SWITZERLAND) 2022; 15:8726. [PMID: 36556530 PMCID: PMC9783351 DOI: 10.3390/ma15248726] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
This study evaluated the effect of UV absorbers on the dimensional accuracy of zirconia specimens fabricated by additive manufacturing using a digital light process. Zirconia suspension for additive manufacturing was prepared by setting the volume fractions (0, 0.005, 0.05, and 0.1%) of various UV absorbers. The effect of UV absorber content was evaluated through curing thickness, geometric overgrowth model design, linear deviation, and microstructure evaluation before and after sintering. Statistical analysis was performed by Kruskal-Wallis H and post-tested by the Bonferroni correction method. There was no significant difference in the cure depth according to the presence or absence of the UV absorber, the difference in geometric overgrowth was from 2.1 to 12.5%, and the overgrowth significantly decreased as the amount of added UV absorber increased. This result may contribute to improved precision of 3D multilayer ceramic products.
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Affiliation(s)
- Jin-Ho Kang
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Kumaresan Sakthiabirami
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju 61186, Republic of Korea
- Biomedical Evaluation and Research Centre, School of Dentistry, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Hyun-Ah Kim
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju 61186, Republic of Korea
| | | | - Mee-Jin Jun
- Department of Dental Hygiene, Gwangju Health University, Gwangju 62287, Republic of Korea
| | - Hyun-Pil Lim
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Chan Park
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Kwi-Dug Yun
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Sang-Won Park
- Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju 61186, Republic of Korea
- Biomedical Evaluation and Research Centre, School of Dentistry, Chonnam National University, Gwangju 61186, Republic of Korea
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Buj-Corral I, Tejo-Otero A. 3D Printing of Bioinert Oxide Ceramics for Medical Applications. J Funct Biomater 2022; 13:155. [PMID: 36135590 PMCID: PMC9505679 DOI: 10.3390/jfb13030155] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/23/2022] Open
Abstract
Three-dimensionally printed metals and polymers have been widely used and studied in medical applications, yet ceramics also require attention. Ceramics are versatile materials thanks to their excellent properties including high mechanical properties and hardness, good thermal and chemical behavior, and appropriate, electrical, and magnetic properties, as well as good biocompatibility. Manufacturing complex ceramic structures employing conventional methods, such as ceramic injection molding, die pressing or machining is extremely challenging. Thus, 3D printing breaks in as an appropriate solution for complex shapes. Amongst the different ceramics, bioinert ceramics appear to be promising because of their physical properties, which, for example, are similar to those of a replaced tissue, with minimal toxic response. In this way, this review focuses on the different medical applications that can be achieved by 3D printing of bioinert ceramics, as well as on the latest advances in the 3D printing of bioinert ceramics. Moreover, an in-depth comparison of the different AM technologies used in ceramics is presented to help choose the appropriate methods depending on the part geometry.
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Głowacki M, Mazurkiewicz A, Słomion M, Skórczewska K. Resistance of 3D-Printed Components, Test Specimens and Products to Work under Environmental Conditions-Review. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6162. [PMID: 36079539 PMCID: PMC9458170 DOI: 10.3390/ma15176162] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 05/27/2023]
Abstract
The development of additive manufacturing methods known as "3D printing" started in the 1980s. In these methods, spatial models are created from a semi-finished product such as a powder, filament or liquid. The model is most often created in layers, which are created from the semi-finished product, which is most often subjected to thermal treatment or using light or ultraviolet rays. The technology of additive manufacturing has both advantages and disadvantages when compared to the traditionally used methods of processing thermoplastic materials, such as, for example, injection or extrusion. The most important advantages are low cost, flexibility and speed of manufacturing of elements with different spatial shapes. From the point of view of the user of the product, the most important disadvantages are the lower mechanical properties and lower resistance to environmental factors that occur during the use of the manufactured products. The purpose of this review is to present current information and a compilation of features in the field of research on the effects of the interactions of different types of environments on the mechanical properties of 3D-manufactured thermoplastic products. Changes in the structure and mechanical properties of the material under the influence of factors such as humidity, salt, temperature, UV rays, gasoline and the environment of the human body are presented. The presented article enables the effects of environmental conditions on common materials used in 3D printing technology to be collated in one place.
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Affiliation(s)
- Marcin Głowacki
- Department of Mechanical Engineering, Bydgoszcz University of Sciences and Technology, Kaliskiego 7 Street, 85-789 Bydgoszcz, Poland
| | - Adam Mazurkiewicz
- Department of Mechanical Engineering, Bydgoszcz University of Sciences and Technology, Kaliskiego 7 Street, 85-789 Bydgoszcz, Poland
| | - Małgorzata Słomion
- Department of Management, Bydgoszcz University of Sciences and Technology, Kaliskiego 7 Street, 85-789 Bydgoszcz, Poland
| | - Katarzyna Skórczewska
- Faculty of Technology and Chemical Engineering, University of Sciences and Technology, Seminaryjna 3, Street, 85-326 Bydgoszcz, Poland
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Liu M, Wang Y, Zhang S, Wei Q, Li X. Success Factors of Additive Manufactured Root Analogue Implants. ACS Biomater Sci Eng 2022; 8:360-378. [PMID: 34990114 DOI: 10.1021/acsbiomaterials.1c01079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Dental implantation is an effective method for the treatment of loose teeth, but the threaded dental implants used in the clinic cannot match with the tooth extraction socket. A root analogue implant (RAI) has the congruence shape, which reduces the damage to bone and soft tissue. Additive manufacturing (AM) technologies have the advantages of high precision, flexibility, and easy operation, becoming the main manufacturing method of RAI in basic research. The purpose of this systematic review is to summarize AM technologies used for RAI manufacturing as well as the factors affecting successful implantation. First, it introduces the AM technologies according to different operating principles and summarizes the advantages and disadvantages of each method. Then the influences of materials, structure design, surface characteristics, implant site, and positioning are discussed, providing reference for designers and dentists. Finally, it addresses the gap between basic research and clinical application for additive manufactured RAIs and discusses the current challenges and future research directions for this field.
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Affiliation(s)
- Minyan Liu
- Department of Industry Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Yanen Wang
- Department of Industry Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Shan Zhang
- Department of Industry Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Qinghua Wei
- Department of Industry Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Xinpei Li
- Department of Industry Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an 710072, China
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3D Printing of Ceramic Biomaterials. ENGINEERED REGENERATION 2022. [DOI: 10.1016/j.engreg.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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13
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Khanlar LN, Salazar Rios A, Tahmaseb A, Zandinejad A. Additive Manufacturing of Zirconia Ceramic and Its Application in Clinical Dentistry: A Review. Dent J (Basel) 2021; 9:dj9090104. [PMID: 34562978 PMCID: PMC8469515 DOI: 10.3390/dj9090104] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 12/02/2022] Open
Abstract
Additive manufacturing (AM) has many advantages and became a valid manufacturing technique for polymers and metals in dentistry. However, its application for dental ceramics is still in process. Among dental ceramics, zirconia is becoming popular and widely used in dentistry mainly due to its outstanding properties. Although subtractive technology or milling is the state of art for manufacturing zirconia restorations but still has shortcomings. Utilizing AM in fabricating ceramics restorations is a new topic for many researchers and companies across the globe and a good understanding of AM of zirconia is essential for dental professional. Therefore, the aim of this narrative review is to illustrate different AM technologies available for processing zirconia and discus their advantages and future potential. A comprehensive literature review was completed to summarize different AM technologies that are available to fabricate zirconia and their clinical application is reported. The results show a promising outcome for utilizing AM of zirconia in restorative, implant and regenerative dentistry. However further improvements and validation is necessary to approve its clinical application.
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Affiliation(s)
- Leila Nasiry Khanlar
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
- Correspondence:
| | - Alma Salazar Rios
- College of Dentistry, Texas A&M University, Dallas, TX 75246, USA; (A.S.R.); (A.Z.)
| | - Ali Tahmaseb
- Department of Oral Maxillofacial Surgery Erasmus Medical Centre, 3015 Rotterdam, The Netherlands;
| | - Amirali Zandinejad
- College of Dentistry, Texas A&M University, Dallas, TX 75246, USA; (A.S.R.); (A.Z.)
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Li W, Wang M, Mille LS, Antonio Robledo J, Huerta V, Uribe T, Cheng F, Li H, Gong J, Ching T, Murphy CA, Lesha A, Hassan S, Woodfield T, Lim KS, Shrike Zhang Y. A Smartphone-Enabled Portable Digital Light Processing 3D Printer. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2021; 33:e2102153. [PMID: 34278618 PMCID: PMC8416928 DOI: 10.1002/adma.202102153] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/21/2021] [Indexed: 05/30/2023]
Abstract
3D printing has emerged as an enabling approach in a variety of different fields. However, the bulk volume of printing systems limits the expansion of their applications. In this study, a portable 3D Digital Light Processing (DLP) printer is built based on a smartphone-powered projector and a custom-written smartphone-operated app. Constructs with detailed surface architectures, porous features, or hollow structures, as well as sophisticated tissue analogs, are successfully printed using this platform, by utilizing commercial resins as well as a range of hydrogel-based inks, including poly(ethylene glycol)-diacrylate, gelatin methacryloyl, or allylated gelatin. Moreover, due to the portability of the unique DLP printer, medical implants can be fabricated for point-of-care usage, and cell-laden tissues can be produced in situ, achieving a new milestone for mobile-health technologies. Additionally, the all-in-one printing system described herein enables the integration of the 3D scanning smartphone app to obtain object-derived 3D digital models for subsequent printing. Along with further developments, this portable, modular, and easy-to-use smartphone-enabled DLP printer is anticipated to secure exciting opportunities for applications in resource-limited and point-of-care settings not only in biomedicine but also for home and educational purposes.
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Affiliation(s)
- Wanlu Li
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Mian Wang
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Luis Santiago Mille
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Juan Antonio Robledo
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Valentín Huerta
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Tlalli Uribe
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Feng Cheng
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Hongbin Li
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Jiaxing Gong
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Terry Ching
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Caroline A. Murphy
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE) Group, Department of Orthopaedics Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Christchurch 8011, New Zealand
| | - Ami Lesha
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Shabir Hassan
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Tim Woodfield
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE) Group, Department of Orthopaedics Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Christchurch 8011, New Zealand
| | - Khoon S. Lim
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE) Group, Department of Orthopaedics Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Christchurch 8011, New Zealand
| | - Yu Shrike Zhang
- Division of Engineering Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA 02139, USA
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DEMİRALP E, DOĞRU G, YILMAZ H. ADDITIVE MANUFACTURING (3D PRINTING) METHODS AND APPLICATIONS IN DENTISTRY. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2020. [DOI: 10.33808/clinexphealthsci.786018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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16
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Nesic D, Schaefer BM, Sun Y, Saulacic N, Sailer I. 3D Printing Approach in Dentistry: The Future for Personalized Oral Soft Tissue Regeneration. J Clin Med 2020; 9:E2238. [PMID: 32679657 PMCID: PMC7408636 DOI: 10.3390/jcm9072238] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 12/21/2022] Open
Abstract
Three-dimensional (3D) printing technology allows the production of an individualized 3D object based on a material of choice, a specific computer-aided design and precise manufacturing. Developments in digital technology, smart biomaterials and advanced cell culturing, combined with 3D printing, provide promising grounds for patient-tailored treatments. In dentistry, the "digital workflow" comprising intraoral scanning for data acquisition, object design and 3D printing, is already in use for manufacturing of surgical guides, dental models and reconstructions. 3D printing, however, remains un-investigated for oral mucosa/gingiva. This scoping literature review provides an overview of the 3D printing technology and its applications in regenerative medicine to then describe 3D printing in dentistry for the production of surgical guides, educational models and the biological reconstructions of periodontal tissues from laboratory to a clinical case. The biomaterials suitable for oral soft tissues printing are outlined. The current treatments and their limitations for oral soft tissue regeneration are presented, including "off the shelf" products and the blood concentrate (PRF). Finally, tissue engineered gingival equivalents are described as the basis for future 3D-printed oral soft tissue constructs. The existing knowledge exploring different approaches could be applied to produce patient-tailored 3D-printed oral soft tissue graft with an appropriate inner architecture and outer shape, leading to a functional as well as aesthetically satisfying outcome.
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Affiliation(s)
- Dobrila Nesic
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, CH-1211 Geneva 4, Switzerland; (Y.S.); (I.S.)
| | | | - Yue Sun
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, CH-1211 Geneva 4, Switzerland; (Y.S.); (I.S.)
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, CH-3010 Bern, Switzerland;
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, CH-1211 Geneva 4, Switzerland; (Y.S.); (I.S.)
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Guo F, Hu M, Wang C, Huang S, Lou M, Liu C. Studies on the Performance of Molar Porous Root-Analogue Implant by Finite Element Model Simulation and Verification of a Case Report. J Oral Maxillofac Surg 2020; 78:1965.e1-1965.e9. [PMID: 32628934 DOI: 10.1016/j.joms.2020.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/23/2020] [Accepted: 06/05/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effect of porous layer thickness in a 3-dimensionally printed 1-piece molar porous root-analogue implant (RAI) on the biomechanical properties of the peri-implant bone and the clinical efficacy of one such implant in a patient. MATERIALS AND METHODS Three RAIs with different superficial porous layer thicknesses (0.5 mm, 1 mm, and fully porous) were designed and assembled using a mandible model and then solidified to obtain 3 finite elements models, denoted A, B, and C. Finite element analysis was performed to analyze the stress on the solid and porous structures of the RAIs and the stress and strain experienced by the bone surrounding the implant. RAIs were fabricated by selective laser melting. An unrepairable molar in a single patient was selected for replacement. An RAI was designed and prepared and then implanted into the alveolar bone immediately after minimally invasive extraction of the damaged tooth. Definitive restorations were placed after a 3-month period of uninterrupted healing. RESULTS The stress concentration observed in the 3 types of RAI was principally between the solid and porous interface contact points, with maximum stress on the solid and porous structures smaller than that of the respective yield strength. The introduction of a porous structure on the surface of the RAIs increased peri-implant bone stress, which increased with thickness of the porous layer. The 3-dimensionally printed porous RAI exhibited excellent initial stability immediately after implantation. After continual observation for 6 months, it was found that bone surrounding the root had infiltrated into the RAI, achieving good osseointegration. CONCLUSIONS Stress shielding can be reduced by decreasing the elastic modulus of the implant, with the interface between implant and bone allowing more appropriate stress conduction. A 1-piece porous RAI fabricated using 3-dimensional printing establishes a new indication for immediate implantation after extraction.
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Affiliation(s)
- Fang Guo
- Lecturer and Attending Physician, Department of Oral and Maxillofacial Surgery, School of Stomatology, Xi'an Medical University, Xi'an, China
| | - Min Hu
- Professor, Department of Stomatology, General Hospital of PLA, Beijing, China
| | - Chao Wang
- Professor, Stomatological Hospital, Chongqing Medical University, Chongqing, China
| | - Shuo Huang
- Lecturer, Attending Physician, Department of Oral and Maxillofacial Surgery, School of Stomatology, Xi'an Medical University, Xi'an, China
| | - Ming Lou
- Associate Professor, Department of Oral and Maxillofacial Surgery, School of Stomatology, Xi'an Medical University, Xi'an, China
| | - Changkui Liu
- Professor, Department of Oral and Maxillofacial Surgery, School of Stomatology, Xi'an Medical University, Xi'an, China.
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Branco A, Silva R, Santos T, Jorge H, Rodrigues A, Fernandes R, Bandarra S, Barahona I, Matos A, Lorenz K, Polido M, Colaço R, Serro A, Figueiredo-Pina C. Suitability of 3D printed pieces of nanocrystalline zirconia for dental applications. Dent Mater 2020; 36:442-455. [PMID: 32001023 DOI: 10.1016/j.dental.2020.01.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/05/2019] [Accepted: 01/14/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The main goal of this work is to evaluate the suitability of nanostructured zirconia pieces obtained by robocasting additive manufacturing (AM), for dental applications. METHODS The density, crystalline structure, morphology/porosity, surface roughness, hardness, toughness, wettability and biocompatibility of the produced samples were compared with those of samples obtained by conventional subtractive manufacturing (SM) of a similar commercial zirconia material. Chewing simulation studies were carried out against dental human cusps in artificial saliva. The wear of the material was quantified and the wear mechanisms investigated, as well as the influence of glaze coating. RESULTS AM samples, that revealed to be biocompatible, are slightly less dense and more porous than SM samples, showing lower hardness, toughness and wettability than SM samples. After chewing tests, no wear was found both on AM and SM samples. However, the dental wear was significantly lower when AM samples were used as counterbody. Concerning the glazed samples, both coated surfaces and dental cusps suffered wear, being the cusps' wear higher than that found for unglazed samples. More, cusps tested against AM coated samples suffered less wear comparatively to those opposed to SM coated samples. SIGNIFICANCE Overall, the results presented in this paper show that AM processed nanostructured zirconia can be used in dental restorations, with important advantages from the point of view of processing and tribological performance. Moreover, the option for glaze finishing should be carefully considered both in SM and AM processed specimens.
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Zhang J, Hu Q, Wang S, Tao J, Gou M. Digital Light Processing Based Three-dimensional Printing for Medical Applications. Int J Bioprint 2019; 6:242. [PMID: 32782984 PMCID: PMC7415858 DOI: 10.18063/ijb.v6i1.242] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 10/29/2019] [Indexed: 02/08/2023] Open
Abstract
An additive manufacturing technology based on projection light, digital light processing (DLP), three-dimensional (3D) printing, has been widely applied in the field of medical products production and development. The precision projection light, reflected by a digital micromirror device of million pixels instead of one focused point, provides this technology both printing accuracy and printing speed. In particular, this printing technology provides a relatively mild condition to cells due to its non-direct contact. This review introduces the DLP-based 3D printing technology and its applications in medicine, including precise medical devices, functionalized artificial tissues, and specific drug delivery systems. The products are particularly discussed for their significance in medicine. This review indicates that the DLP-based 3D printing technology provides a potential tool for biological research and clinical medicine. While, it is faced to the challenges of scale-up of its usage and waiting period of regulatory approval.
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Affiliation(s)
- Jiumeng Zhang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610065, China
| | - Qipeng Hu
- Department of Thoracic Oncology, West China Hospital of Sichuan University, 610041, Chengdu, Sichuan, China
| | - Shuai Wang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610065, China
| | - Jie Tao
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610065, China
| | - Maling Gou
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610065, China
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Galante R, Figueiredo-Pina CG, Serro AP. Additive manufacturing of ceramics for dental applications: A review. Dent Mater 2019; 35:825-846. [PMID: 30948230 DOI: 10.1016/j.dental.2019.02.026] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 10/15/2018] [Accepted: 02/13/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The main goal of this review is to provide a detailed and comprehensive description of the published work from the past decade regarding AM of ceramic materials with possible applications in dentistry. The main printable materials and most common technologies are also addressed, underlining their advantages and main drawbacks. METHODS Online databases (Web of knowledge, Science Direct, PubMed) were consulted on this topic. Published work from 2008 to 2018 was collected, analyzed and the relevant papers were selected for inclusion on this review. RESULTS Ceramic materials are broadly used in dentistry to restore/replace damaged or missing teeth, due to their biocompatibility, chemical stability and mechanical and aesthetic properties. However, there are several unmet challenges regarding their processing and performance. Due to their brittleness nature, a very tight control of the manufacturing process is needed to obtain dental pieces with adequate mechanical properties. Additive manufacturing (AM) is an emerging technology that constitutes an interesting and viable manufacturing alternative to the conventional subtractive methods. AM enables the production of customized complex 3D parts in a more sustainable and less expensive way. AM of ceramics can be achieved with an extensive variety of methods. SIGNIFICANCE There is no perfect technology for all materials/applications, capable alone of fulfilling all the specificities and necessities of every patient. Although very promising, AM of ceramic dental materials remains understudied and further work is required to make it a widespread technology in dentistry.
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Historical development of root analogue implants: a review of published papers. Br J Oral Maxillofac Surg 2019; 57:496-504. [PMID: 31085016 DOI: 10.1016/j.bjoms.2019.01.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/07/2019] [Indexed: 02/04/2023]
Abstract
The timetable for placing a dental implant can be crucial in the reduction of resorption of the socket after an extraction. The association of immediate implantation with an implant that copies the anatomy of the extracted root seems to add benefits in limiting the hard and soft tissue changes that may occur. The purpose of this paper is to provide an overview of the historical development of all types of root analogue implants from their beginning to the present day. To our knowledge the first individualised ones were described in 1969. Later, the use of titanium instead of the polymers that were used to start with offered better bony integration, and showed that the selection of materials was a key factor in their success. Root analogue implants made from zirconia were also described when attempts were being made to improve aesthetics in the anterior regions. The more recent introduction of digital technology such as DICOM has allowed the fabrication of these implants in less time, and the combination with digital diagnostic options such as cone-beam computed tomography facilitated the fabrication of some types of implants before extraction that could be inserted immediately into the alveolar socket with optimal and safe 3-dimensional positioning. Currently digital planning allows the clinician to design the ideal implant and abutment, which reduces the need for tissue grafting in the surgical phase and gingival conditioning in the prosthetic phase.
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Pessanha-Andrade M, Sordi MB, Henriques B, Silva FS, Teughels W, Souza JCM. Custom-made root-analogue zirconia implants: A scoping review on mechanical and biological benefits. J Biomed Mater Res B Appl Biomater 2018; 106:2888-2900. [PMID: 30070423 DOI: 10.1002/jbm.b.34147] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/18/2018] [Accepted: 04/09/2018] [Indexed: 12/26/2022]
Abstract
The aim of this study was to conduct a literature review on the potential benefits of custom-made root-analogue zirconia implants. A PubMed and ScienceDirect bibliographical search was carried out from 1969 to 2017. The increased interest in zirconia-based dental structures linked to aesthetic and biological outcomes have been reported in literature. Recent technological advances have focused on novel strategies for modification of zirconia-based surfaces to accelerate osseointegration. However, only a few studies revealed mechanical and biological benefits of custom-made root-analogue zirconia implants and therefore further studies should investigate the influence of different design and surface modification on the performance of such implants. Custom-made root-analogue zirconia implants have become a viable alternative to overcome limitations concerning stress distribution, aesthetics, and peri-implantitis induced by biofilms. However, further in vitro and in vivo studies on surface-bone interactions and mechanical behavior of zirconia should be evaluated to reduce clinical issues regarding mechanical failures and late peri-implant bone loss. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2888-2900, 2018.
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Affiliation(s)
- Miguel Pessanha-Andrade
- Division of Oral Implantology, School of Dentistry, Universidade Fernando Pessoa (UFP), Porto, Portugal
| | - Mariane B Sordi
- Post-graduate Program in Dentistry (PPGO), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Bruno Henriques
- Center for Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, Portugal
| | - Filipe S Silva
- Center for Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, Portugal
| | - Wim Teughels
- Department of Oral Health Sciences, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Júlio C M Souza
- Center for Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, Portugal
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Aboushelib MN, Shawky R. Osteogenesis ability of CAD/CAM porous zirconia scaffolds enriched with nano-hydroxyapatite particles. Int J Implant Dent 2017; 3:21. [PMID: 28527036 PMCID: PMC5438327 DOI: 10.1186/s40729-017-0082-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 05/08/2017] [Indexed: 11/19/2022] Open
Abstract
Background The aim of this study was to evaluate osteogenesis ability of CAD/CAM porous zirconia scaffolds enriched with hydroxy apatite used to augment large boney defects in a dog model. Methods Surgical defects were made bilaterally on the lower jaw of 12 Beagle dogs. Cone beam CT images were used to create three dimensional images of the healed defects. Porous zirconia scaffolds were fabricated by milling custom made CAD/CAM blocks into the desired shape. After sintering, the pores of half of the scaffolds were filled with a nano-hydroxy apatite (HA) powder while the other half served as control. The scaffolds were inserted bilaterally in the healed mandibular jaw defects and were secured in position by resorbable fixation screws. After a healing time of 6 weeks, bone-scaffold interface was subjected to histomorphometric analysis to detect the amount of new bone formation. Stained histological sections were analyzed using a computer software (n=12, α=0.05). Mercury porosimetery was used to measure pore sizes, chemical composition was analyzed using energy dispersive x-ray analysis (EDX), and the crystal structure was identified using x-ray diffraction micro-analysis (XRD). Results HA enriched zirconia scaffolds revealed significantly higher volume of new bone formation (33% ± 14) compared to the controls (21% ± 11). New bone deposition started by coating the pore cavity walls and proceeded by filling the entire pore volume. Bone in-growth started from the surface of the scaffold and propagated towards the scaffold core. Islands of entrapped hydroxy apatite particles were observed in mineralized bone matrix. Conclusions Within the limitations of this study, hydroxy apatite enhanced osteogenesis ability of porous zirconia scaffolds.
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Affiliation(s)
- Moustafa N Aboushelib
- Dental Biomaterials Department, Faculty of Dentistry, Alexandria University, Champollion st, Azarita, Alexandria, Egypt.
| | - Rehab Shawky
- Oral Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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