Tuesday, July 17, 2018
An industry that is known for quickly adopting new technologies, dentistry is often ahead of the curve when it comes to space-age advancements. When 3D printing began to appear on the cover of technology magazines, it was heralded as the next big thing in manufacturing and creative industries. The technology has evolved significantly since the turn of the decade as printers are now less costly, more user-friendly, and physically smaller. This new wave of additive manufacturing—dubbed desktop 3D printing—is igniting its own revolution in dentistry.
Closing the Loop
Digital dentistry has conventionally been conceived as a set of in-office technologies: 3D scanners that capture models of patients’ anatomical information on one hand, and CAD/CAM software on the other. This digitization process meant that dentists could leave behind the clunky method of traditional casting. It also expanded versatility: they could leverage 3D scans to treatment-plan more accurately. Orthodontists could utilize CAD software to precisely plan where to place brackets for braces. Oral surgeons could pre-plan exactly where they would need to drill. Prosthodontists could model dentures and crowns, sculpting them to fit perfectly with a patient’s existing anatomy.
But when it came to the actual outputting of dental appliances, the technology of choice has been far from clear. Chairside milling, though convenient and fast, is costly and requires the dentist to play the role of technician, taking away from patient face time. Due to its drawbacks, this production method has never achieved widespread use. For most dentists, the production of dental appliances is outsourced to labs. This process, though improved by the advent of scanners and CAD software, still led to long, costly lead times. Patients had to conduct two office visits: one to capture information and plan treatment, and another for the procedure once the appliance had been shipped from the lab.
While the proliferation of oral scanners and CAD/CAM software have expanded the versatility of digital dentists, chairside milling left much to be desired. Digital dentistry, though it had taken great strides, hadn’t produced the right fabrication method to close the treatment loop.
A Fully Digital Workflow
There is no longer a need to wait weeks for labs to fabricate common dental applications like surgical guides, monolithic dentures, crowns and bridges, indirect bonding trays, clear aligners, dental models, and more. The proliferation of affordable, reliable, and fast machines like SprintRay’s line of 3D printers means that dentists can provide single-visit care for treatment that formerly required multiple visits over the course of weeks or months.
With a fully digital workflow, clinicians can capture a patient’s anatomy, pre-plan using CAD/CAM software, 3D print the required appliances, and conduct treatment all in a single visit.
But the benefits of this technology expand beyond simply reduced wait times. The cost savings are tremendous, allowing for expanded treatment options for patients. Guided surgery, commonly accepted as a better experience for both patient and doctor, can be undertaken at a fraction of the cost, as the surgical guides can be 3D printed in around a half-hour at a fraction of the materials cost that a lab would charge. Patients who might otherwise have to undergo unguided surgery can now opt for affordable guided surgery, bringing them treatment options that could otherwise be outside of their budget.
For those who can’t afford traditionally-fabricated dentures, prosthodontists can now fully 3D print economical, monolithic dentures for a fraction of the cost that can be worn for up to one year. Not only does the patient experience new treatment options, but they also don’t have to wait weeks for their new dentures to arrive. With the 3D printing of monolithic dentures, patients can go from wax-up to fitting in a matter of hours. If the fit is correct, the monolithic try-in can be finished and worn while they wait for the final product to be fabricated.
The Physical Era of Digital Dentistry
One big objection to the invasion of 3D printing is accuracy. The fit and finish of dental appliances, especially those that are going to live in the mouth, must be exceptional. Can 3D printers really compete with the polish and quality of lab-delivered appliances?
Han Kim, national sales manager for SprintRay Inc., is used to dealing with this question. SprintRay addresses this concern by offering free samples to interested dentists: 3D printed surgical guides, clear aligners, dental models, denture bases, and more, printed and shipped from their Los Angeles headquarters to anywhere in the United States. He says that the quality of these parts is on par with lab-produced appliances. SprintRay has also conducted their own accuracy studies, finding the accuracy across a 3D printed full-arch to be within +/- 100 microns over 93% of surfaces.
Since digital imaging is much more precise than traditional dental impressions, 3D printed parts produced from intraoral scans often fit better than those cast and manufactured traditionally. The process of printing on a machine like SprintRay’s 3D printer works like a CAT scan by printing materials in layers. Using FDA approved resins, dental appliances can be fabricated in a matter of minutes or hours rather than weeks or days and can be placed in a patient’s mouth after around an hour of post-processing.
Han has found that both dentists and patients are fascinated with the 3D printing process and love the convenience that it provides. He sees more and more dentistry professionals bring 3D printing into their practice, and believes that it’s only a matter of time before patients begin asking for the flexibility in restorative treatment offered by 3D printing. 3D printed parts as part of their treatment. As the technology continues to expand and the general public catches wind of the variety of new, affordable treatment options offered by in-office 3D printing, early-adopters will be positioned for big growth. And with 3D printing in dentistry projected to become a $9.5 billion industry by 2027, it’s hard to argue with him.