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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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Conejo J, Han S, Atria PJ, Stone-Hirsh L, Dubin J, Blatz MB. Full digital workflow to resolve angled adjacent dental implants: A dental technique. J Prosthet Dent 2024; 132:306-309. [PMID: 36114017 DOI: 10.1016/j.prosdent.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022]
Abstract
The digital acquisition, fabrication process, and delivery of computer-aided design and computer-aided manufacture (CAD-CAM) implant-supported restorations on angled adjacent implants are described. The proximal surface of a scan post was modified for correct adaptation, permitting an accurate digital scan of adjacent implants in 1 step. Definitive screw-retained splinted implant-supported restorations were designed and milled in a zirconia material and delivered with a combined extraoral and intraoral cementation protocol.
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Affiliation(s)
- Julian Conejo
- Assistant Professor, Clinical Restorative Dentistry, and Director, Chairside CAD/CAM Dentistry, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa.
| | - Sean Han
- Chief Executive Officer of Maters' Arch, Phoenix, Ariz
| | - Pablo J Atria
- Assistant Professor, College of Dentistry, Universidad de los Andes, Santiago, Chile
| | - Leslie Stone-Hirsh
- Clinical Associate Professor, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
| | - Jay Dubin
- Clinical Associate, Department of Preventive and Restorative Dentistry, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
| | - Markus B Blatz
- Professor of Restorative Dentistry and Chairman, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa; Assistant Dean, Digital Innovation and Professional Development, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
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Diken Türksayar AA, Demirel M, Petersmann S, Spintzyk S, Donmez MB. Positional accuracy of a single implant analog in additively manufactured casts in biobased model resin. J Dent 2024; 146:105037. [PMID: 38703808 DOI: 10.1016/j.jdent.2024.105037] [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: 03/28/2024] [Revised: 04/25/2024] [Accepted: 05/01/2024] [Indexed: 05/06/2024] Open
Abstract
OBJECTIVES To evaluate the positional accuracy of implant analogs in biobased model resin by comparing them to that of implant analogs in model resin casts and conventional analogs in dental stone casts. METHODS Polyvinylsiloxane impressions of a partially edentulous mandibular model with a single implant were made and poured in type IV dental stone. The same model was also digitized with an intraoral scanner and additively manufactured implant casts were fabricated in biobased model resin (FotoDent biobased model) and model resin (FotoDent model 2 beige-opaque) (n = 8). All casts and the model were digitized with a laboratory scanner, and the scan files were imported into a 3-dimensional analysis software (Geomagic Control X). The linear deviations of 2 standardized points on the scan body used during digitization were automatically calculated on x-, y-, and z-axes. Average deviations were used to define precision, and 1-way analysis of variance and Tukey HSD tests were used for statistical analyses (α = 0.05). RESULTS Biobased model resin led to higher deviations than dental stone (all axes, P ≤ 0.031) and model resin (y-axis, P = 0.015). Biobased model resin resulted in the lowest precision of implant analog position (P ≤ 0.049). The difference in the positional accuracy of implant analogs of model resin and stone casts was nonsignificant (P ≥ 0.196). CONCLUSIONS Implant analogs in biobased model resin casts mostly had lower positional accuracy, whereas those in model resin and stone casts had similar positional accuracy. Regardless of the material, analogs deviated more towards mesial, while buccal deviations in additively manufactured casts and lingual deviations in stone casts were more prominent.
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Affiliation(s)
- Almira Ada Diken Türksayar
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - Münir Demirel
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - Sandra Petersmann
- Senior Researcher, ADMiRE Research Center, Carinthia University of Applied Sciences, Villach, Austria
| | - Sebastian Spintzyk
- Associate Professor, ADMiRE Research Center, Carinthia University of Applied Sciences, Villach, Austria
| | - Mustafa Borga Donmez
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey; ITI Scholar, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
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Hwang JY, Yoon HI. Comparative analysis of intaglio surface trueness of cement-retained implant-supported prostheses generated by a cast-free digital workflow and a three-dimensionally printed cast workflow. J Prosthet Dent 2024; 131:272.e1-272.e7. [PMID: 36180262 DOI: 10.1016/j.prosdent.2022.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 11/19/2022]
Abstract
STATEMENT OF PROBLEM Comparative analysis of the accuracy of the prostheses produced by a cast-free digital workflow and 3-dimensional (3D) printing cast workflow is lacking. PURPOSE The purpose of the present investigation was to compare the intaglio surface trueness of implant-supported prostheses fabricated by using 3 different digital workflows: cast-free computer-aided design (CAD), 3D printed cast CAD (direct insert), and 3D printed cast CAD (indirect insert). MATERIAL AND METHODS The laboratory data of 11 partially edentulous arches for prosthetic implant treatment were obtained. Three different workflows were tested to produce the cement-retained prostheses: cast-free CAD (Group CF), 3D printed cast CAD with direct insert (Group PD), and 3D printed cast CAD with indirect insert (Group PI). The intaglio surfaces of the prosthesis CAD data from Groups CF, PD, and PI were superimposed with 3D printed prosthesis scan data from Group CF to measure 3D surface deviation. Using the prosthesis CAD data from Group CF as a reference, those from Groups PD and PI were compared by superimposition analysis. The root mean square (RMS) estimates, positive average deviations, and negative average deviations were measured. The Kruskal-Wallis test and Dunn test with Bonferroni correction, and the Wilcoxon rank sum test were used for statistical analyses (α=.05). RESULTS Significant differences were found among the 3 groups when the 3D printed prosthesis scan data were referenced (P<.05). Group CF showed the lowest RMS, positive average deviation, and negative deviation values, while Group PI showed the highest values. Significant differences in the RMS, positive average deviation, and negative average deviation values were found between Groups PD and PI when the prosthesis CAD data (Group CF) were referenced (P<.05). CONCLUSIONS Among the 3 different workflows tested, the prostheses generated from the cast-free CAD flow showed significantly lower intaglio surface deviation than those generated from the 3D printed cast CAD flows, regardless of the insertion method of the implant replicas.
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Affiliation(s)
- Ji-Yu Hwang
- Graduate student, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Hyung-In Yoon
- Associate Professor, Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
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Tan S, Tan MY, Wong KM, Maria R, Tan KBC. Comparison of 3D positional accuracy of implant analogs in printed resin models versus conventional stone casts: Effect of implant angulation. J Prosthodont 2024; 33:46-53. [PMID: 36639956 DOI: 10.1111/jopr.13647] [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: 09/11/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023] Open
Abstract
PURPOSE To study the effect of implant angulation on 3D linear and absolute angular distortions of implant analogs in printed resin models and conventional stone casts. MATERIALS AND METHODS Three sectional master models with two implants with total inter-implant angulations of 0°, 10°, and 20° were fabricated. For each master model, five conventional stone casts (CS) and printed resin models (PM) were fabricated (n = 5). Test models were made with nonsplinted impression copings and open tray polyether impressions for the CS groups and scan bodies scanned using an intraoral scanner for the PM groups. The physical positions of the implants and implant analogs were measured with a coordinate measuring machine. 3D linear distortion (ΔR) and absolute angular distortion (Absdθ) defined the 3D positional accuracy of the analogs in the test models. Univariate ANOVA was used to analyze data followed by post hoc tests (Tukey HSD, α = 0.05). RESULTS Mean ΔR was significantly greater for PM10 (73.5 ± 8.9 µm) and PM20 (65.5 ± 33.3 µm) compared to CS0 (16.8 ± 14.1 µm), CS10 (22.2 ± 13.0 µm), CS20 (15.6 ± 19.9 µm), and PM0 (23.9 ± 16.1 µm). For Absdθ, there were no significant differences between test groups. CONCLUSIONS With conventional stone casts, implant angulation had no significant effect on 3D linear and absolute angular distortions. Amongst printed resin models test groups, angulated implants had significantly greater ΔR. Amongst angulated implants test groups, printed resin models had significantly greater ΔR than conventional stone casts. Compared to the master model, all test groups, regardless of inter-implant angulation, produced greater inter-analog distances.
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Affiliation(s)
- Shaun Tan
- Department of Restorative Dentistry, National Dental Centre of Singapore, Singapore, Republic of Singapore
| | - Ming Yi Tan
- Faculty of Dentistry, National University of Singapore, Singapore, Republic of Singapore
| | - Keng Mun Wong
- Faculty of Dentistry, National University of Singapore, Singapore, Republic of Singapore
| | - Rahmat Maria
- Department of Restorative Dentistry, National Dental Centre of Singapore, Singapore, Republic of Singapore
| | - Keson Beng Choon Tan
- Faculty of Dentistry, National University of Singapore, Singapore, Republic of Singapore
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Huang S, Wei H, Li D. Additive manufacturing technologies in the oral implant clinic: A review of current applications and progress. Front Bioeng Biotechnol 2023; 11:1100155. [PMID: 36741746 PMCID: PMC9895117 DOI: 10.3389/fbioe.2023.1100155] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/11/2023] [Indexed: 01/21/2023] Open
Abstract
Additive manufacturing (AM) technologies can enable the direct fabrication of customized physical objects with complex shapes, based on computer-aided design models. This technology is changing the digital manufacturing industry and has become a subject of considerable interest in digital implant dentistry. Personalized dentistry implant treatments for individual patients can be achieved through Additive manufacturing. Herein, we review the applications of Additive manufacturing technologies in oral implantology, including implant surgery, and implant and restoration products, such as surgical guides for implantation, custom titanium meshes for bone augmentation, personalized or non-personalized dental implants, custom trays, implant casts, and implant-support frameworks, among others. In addition, this review also focuses on Additive manufacturing technologies commonly used in oral implantology. Stereolithography, digital light processing, and fused deposition modeling are often used to construct surgical guides and implant casts, whereas direct metal laser sintering, selective laser melting, and electron beam melting can be applied to fabricate dental implants, personalized titanium meshes, and denture frameworks. Moreover, it is sometimes required to combine Additive manufacturing technology with milling and other cutting and finishing techniques to ensure that the product is suitable for its final application.
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Affiliation(s)
| | - Hongbo Wei
- *Correspondence: Hongbo Wei, ; Dehua Li,
| | - Dehua Li
- *Correspondence: Hongbo Wei, ; Dehua Li,
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Mata-Mata SJ, Donmez MB, Meirelles L, Johnston WM, Yilmaz B. Influence of digital implant analog design on the positional trueness of an analog in additively manufactured models: An in-vitro study. Clin Implant Dent Relat Res 2022; 24:821-830. [PMID: 36196856 DOI: 10.1111/cid.13137] [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: 06/23/2022] [Revised: 08/19/2022] [Accepted: 09/14/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Limited evidence exists regarding the accuracy of implant analog position in printed models, particularly when implant analogs with varying designs are used. PURPOSE To evaluate the effect of digital implant analog (DIA) design on the trueness of their position in additively manufactured digital implant models (DIMs) and to compare with that of a conventional implant analog in a stone cast. MATERIALS AND METHODS A dentate maxillary model with a conventional implant analog (Nobel Biocare Implant Replica 4.3 mm CC RP) at left second premolar site was digitized by using a laboratory scanner (3Shape D2000) and a (SB) scan body to generate the master standard tessellation language (STL) file (M0). 12 custom trays were fabricated on M0 file and conventional polyvinylsiloxane impressions of the model were made. All impressions were poured after inserting conventional implant analogs (Nobel RP Implant Replica) (Group A). Model was then digitized with an intraoral scanner (TRIOS 3) and the same SB, and DIMs with three different DIA designs (Nobel Biocare [Group B], Elos [Group C], and NT-trading [Group D]) were generated (Dental System-Model Builder). 12 DIMs of each design were additively manufactured and corresponding DIAs were inserted. All models were digitized by using the same laboratory scanner and SB, and these STLs were transferred to a 3D analysis software (Geomagic Control X), where the STL files of the models were superimposed over M0. Linear and 3D deviations at three selected points on SB (implant-abutment connection, most cervical point on SB, and most coronal point on SB) as well as angular deviations on two planes (buccolingual and mesiodistal) were calculated. Analysis of variance (ANOVA) and Bonferroni corrected t-tests were used to analyze the trueness of implant analog positions (α = 0.05). RESULTS The interaction of main effects significantly affected linear (p < 0.001) and angular deviations (p = 0.020). At point 1, group D had higher deviations than groups A and B (p ≤ 0.015). In addition, groups A and D had higher deviations than group B at point 4 (p < 0.001). While group C had similar linear deviations to those of other groups at point 1 and point 4 (p ≥ 0.192), the differences among test groups at point 2 were nonsignificant (p ≥ 0.276). Group B had lower angular deviations than groups C (p = 0.039) and D (p = 0.006) on buccolingual plane. CONCLUSIONS Analog design affected the trueness of analog position as proprietary, pressure/friction fit DIA (group B) had higher linear trueness than screw-retained DIA (Group D) and conventional implant analog (group A). In addition, pressure/friction fit DIA had the highest angular trueness among tested DIAs.
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Affiliation(s)
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Prosthodontics, Faculty of Dentistry, Istinye University, İstanbul, Turkey
| | - Luiz Meirelles
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - William Michael Johnston
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio, USA.,Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
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Parize H, Dias Corpa Tardelli J, Bohner L, Sesma N, Muglia VA, Cândido Dos Reis A. Digital versus conventional workflow for the fabrication of physical casts for fixed prosthodontics: A systematic review of accuracy. J Prosthet Dent 2021; 128:25-32. [PMID: 33551140 DOI: 10.1016/j.prosdent.2020.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 02/07/2023]
Abstract
STATEMENT OF PROBLEM A consensus on the accuracy of additively manufactured casts in comparison with those fabricated by using conventional techniques for fixed dental prostheses is lacking. PURPOSE The purpose of this systematic review was to determine the accuracy of additively manufactured casts for tooth- or implant-supported fixed dental prostheses in comparison with that of gypsum casts. MATERIAL AND METHODS This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database (CDR42020161006). Eight databases were searched in December 2019 and updated in September 2020. Studies evaluating the dimensional accuracy of additively manufactured casts for fixed dental prostheses in comparison with that of gypsum casts were included. An adapted checklist for reporting in vitro studies (Checklist for Reporting In vitro Studies guidelines) was used to assess the risk of bias. RESULTS Eight studies evaluating tooth-supported fixed dental prosthesis casts and 7 studies evaluating implant-supported fixed dental prosthesis casts were eligible for this review. Gypsum casts showed greater accuracy (trueness and precision) in most studies, although additively manufactured casts also yielded highly precise data. One study was associated with a low risk of bias, 9 with a moderate risk of bias, and 5 with a high risk of bias. CONCLUSIONS In vitro studies showed that additively manufactured casts and gypsum casts share similar accuracy within the acceptable range for the fabrication of casts. The quality of scanned data, additive manufacture technology, printing settings, and postprocessing procedures plays an essential role in the accuracy of additively manufactured casts. Clinical studies are required to confirm these findings.
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Affiliation(s)
- Hian Parize
- Postgraduate student, Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP-USP), Ribeirão Preto, Brazil
| | - Juliana Dias Corpa Tardelli
- Postgraduate student, Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP-USP), Ribeirão Preto, Brazil
| | - Lauren Bohner
- Assistant Professor, Department of Cranio-Maxillofacial Surgery, University Hospital Muenster (UKM), Muenster, Germany
| | - Newton Sesma
- Assistant Professor, Department of Prosthodontics University of São Paulo School of Dentistry (FO-USP), São Paulo, Brazil
| | - Valdir Antônio Muglia
- Associate Professor, Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP-USP), Ribeirão Preto, Brazil
| | - Andréa Cândido Dos Reis
- Associate Professor, Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP-USP), Ribeirão Preto, Brazil.
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