3D printing Preview 2021
Cover
/ Editorial
/ Content
/ How 3D printing has transformed dental care
/ Study highlights benefits of in-house 3D printing for immediate dental implant placement
/ Printing clear aligners in-house—how accessible is it?
/ 3D-printed indirect bonding tray resin aims to halve orthodontic chair time
/ Digital orthodontics company raises funds for 3D-printed brackets
/ 3D Printing: Changing the game
/ Guided applications for partial extraction therapy, by Drs Scott D. Ganz & Isaac Tawil, USA
/ Dental 3D printing adoption across Asia Pacific: Top three trends and forecast, by Kiavash Bakrani & Dr Kamran Zamanian, Canada
/ International events
/ Submission guidelines
/ Imprint
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[1] =>
1/21
issn 2193-4673 • Vol. 1 • Issue 1/2021
3D printing
international magazine of
dental printing technology
w
e
i
v
e
pr
news
Benefits of in-house 3D printing
clinical
Guided applications for partial extraction therapy
industry report
3D printing: Changing the game
[2] =>
Digital Transformation
Made Accessible
An advanced desktop 3D printing ecosystem,
optimized for dental workflows from a
trusted leader in additive manufacturing.
North American Sales Inquiries
dental@formlabs.com
+1 (617) 702 8476
dental.formlabs.com
Europe Sales Inquiries
dental@formlabs.com
+49 30 8878 9870
dental.formlabs.com/eu
International Sales Inquiries
Find a reseller in your region:
formlabs.com/find-a-reseller
[3] =>
editorial
|
Dr George Freedman
Editor-in-chief
3D printing in dentistry:
Revolution in progress
3D dental printing today is reminiscent of cosmetic dentistry
in the early 1980s: the needs are many, the technologies are
numerous, the applications almost unlimited and the potential open-ended. Just as cosmetic materials and techniques
brought aesthetic restorative dentistry into the hands of every
practitioner, 3D printing promises to bring the functional and artistic control of the restorative process into the chairside setting.
Stereolithography, first developed in the 1980s, was soon followed by additive manufacturing, the deposition of material in
increments. Dental applications are more recent. 3D printing
has been utilised for rapid prototyping and modelling for more
than a decade. The size and cost of the earlier printers meant
that they were limited to larger laboratories.
The digital transformation of dentistry, including CBCT, intraoral and extra-oral scanning, milling of ceramic and composite materials, and robotic implant placement, is firmly established. Linking with these advances, the most recent desktop
printers have a much smaller footprint, are easily affordable
for the single practitioner, communicate with existing software
platforms and offer high levels of precision with a wide range
of materials.
Current 3D printers are fully capable of managing the great demand for temporary, transitional, and permanent restorations
and appliances and of achieving the clinical excellence required by the dental profession. Consequently, there has been
a growing acceptance of this transformative technology. Increasingly, 3D printing is viewed as an industry game-changer
and a forecast of the future direction of the dental practice.
3D-printing techniques include stereolithography, fused deposition modelling, selective laser sintering, powder binder printing, photopolymer jetting, electron beam melting and direct
light processing. These currently unfamiliar names will soon
become standard dental terminology.
The documented, wide-ranging 3D printing applications can
be grouped by treatment category:
– Fixed prosthodontics: Permanent and provisional indirect
restorations (crowns, onlays, inlays, bridges) and permanent
monobloc direct restorations can all be custom-fabricated
chairside within minutes of scanning the preparation.
– Removable prosthodontics: Both complete and partial dentures,
including digital occlusal design, are deliverable within hours.
– Implant dentistry: 3D printing of surgical guides has facilitated
ideal implant positioning. Biomimetic custom 3D-printed
bone implants replace missing segments, minimising stress
transfer to the remaining bone.
– Orthodontics: Aligners, designed using CBCT data and artificial intelligence extrapolation of tooth movement over time,
are 3D-printed.
– Endodontics: The pioneering 3D-printed endodontic access
guide, utilising CBCT data, translates pre-surgical planning
into clinical success.
– Maxillofacial surgery: Custom-designed bone grafts and fixation plates expedite both the surgical procedure and the
healing process.
– Periodontics: 3D-printed guides that relieve and retract gingival margins offer aesthetic gingival correction. Soft-tissue
printing is currently in the research phase.
3D-printing techniques and procedures are high-quality, high
precision and accurate and significantly lower in cost than conventional treatment options. Dentists save money: many desktop printers cost between US$3,000 and US$10,000, and dental 3D-printing materials cost pennies per tooth. Patients save
money, by the elimination of intermediate procedures and transportation costs. Treatment is faster, typically same-day services.
Welcome to 3D printing! Welcome to the future of dentistry.
Dr George Freedman
Editor-in-chief
3D printing
1 2021
03
[4] =>
| content
editorial
3D printing in dentistry: Revolution in progress
03
Dr George Freedman
interview
How 3D printing has transformed dental care
06
An interview with Georgio Haddad
page 6
news
Study highlights benefits of in-house 3D printing for immediate
dental implant placement
08
Iveta Ramonaite
industry news
Printing clear aligners in-house—how accessible is it?
10
Jeremy Booth
3D-printed indirect bonding tray resin aims to halve orthodontic chair time 12
Jeremy Booth
page 10
trends & applications
Digital orthodontics company raises funds for 3D-printed brackets
14
Jeremy Booth
opinion
3D Printing: Changing the game
16
Dr Florin Lăzărescu
case report
page 18
Guided applications for partial extraction therapy
18
Drs Scott D. Ganz & Isaac Tawil
industry
Dental 3D printing adoption across Asia Pacific
Top three trends and forecast
26
Kiavash Bakrani & Dr Kamran Zamanian
meetings
International events
Cover image courtesy of
Marina Grigorivna/Shutterstock.com
1/21
issn 2193-4673 • Vol. 1 • Issue 1/2021
3D printing
international magazine of
dental printing technology
w
previe
news
Benefits of in-house 3D printing
clinical
Guided applications for partial extraction therapy
industry report
3D printing: Changing the game
04 3D printing
1 2021
28
about the publisher
submission guidelines
international imprint
29
30
[5] =>
YES ! THIS YEAR WE GO DIGITAL. SO MUCH DIGITAL: SCAN, PLAN, PRINT, MATERIALS,
DIGITAL SMILE DESIGN, PINGPONG.BLUE … AND THEN … SUPER ANALOG … MATERIALS, TOOLS
AAAND MORE MATERIALS. ALL IN BEST *****ANAXQUALITY. FULL STOP. BRIGHT SMILE.
anax dent GmbH Olgastr. 120a D-70180 Stuttgart +49 711 62 00 92 0 anaxdent.com
[6] =>
| interview
How 3D printing
has transformed dental care
By Iveta Ramonaite, Dental Tribune International
3D printing offers a high level of customisation of dental products, is highly efficient and cost-effective, and has many applications across a wide range of
industries, including dentistry. (Image: © Formlabs Dental)
Dentistry has come a long way since the first introduction of digital technology. Georgio Haddad is an intrapreneur who is in charge of the development of dental
strategic partnerships and initiatives at Formlabs. Haddad
spoke to Dental Tribune International about the various
applications of 3D printing in dentistry, reflected on how
3D printing has reshaped the dental industry and weighed
the risks associated with embracing the technology.
How has the introduction of digital dentistry facilitated the carrying out of dental procedures, and
why should dental professionals consider investing
in new technology?
Digital technology has changed the way we deliver dental
care. With advanced imaging, case diagnoses have improved significantly, and treatments are now more predictable. With milling and 3D printing, professionals can produce extremely high-accuracy dental products in order to
offer their patients the best results. As technology continues
to evolve, these products are produced faster and become
more cost-effective, improving the end result for the patient.
3D printers offer an infinite number of applications.
How is 3D printing used in dentistry, and what are
some of the advantages of 3D printing for dentistry?
3D printing is used in many areas of dentistry. There are
three basic categories:
– Applications that would not be possible or would not
make sense without 3D printing. These products cannot efficiently be made differently and include surgical
guides, models for aligner thermoforming and indirect
bonding trays.
– Applications for which 3D printing improves on traditional manufacturing methods. These products can be
made without 3D printing, but printing offers increased
accuracy and control, and shorter delivery times. This
category includes castable and pressable frameworks,
temporary restorations, splints and custom trays.
– Novel applications for which 3D printing offers a disruptive alternative. These are the real cutting-edge
use cases, such as fully 3D-printed dentures and permanent restorations. They are not the most common
uses, yet, but indeed some of the most exciting.
Dental professionals are lucky to be in such a dynamic
field. Staying curious and investing in new technology is
a must in order to keep up with the increasingly high
standards of patient care.
3D printing offers advantages beyond opening up new
applications. Products are more accurate, turnaround
time is shorter, and it allows for a more flexible and open
communication between the practice and the laboratory.
06 3D printing
1 2021
[7] =>
interview
|
3D printing is a powerful technology on its own, but
the real impact comes from the people who use it. We
see new 3D printing applications all the time, whether
they are born of necessity or innovation. That is why
Formlabs is committed to increasing access to powerful
digital technology.
What are some of the criticisms of dental 3D printing,
and do the benefits offered by using 3D printing outweigh the associated risks?
Ten years ago, the biggest problem with 3D printing was
the prohibitively high cost of a printer. Luckily, with the
success of manufacturers such as Formlabs in the market, printers are more affordable, more reliable and easier
to use than ever before.
Now, the only risk lies in having false expectations.
A 3D printer is a piece of equipment, and learning to use
a desktop unit like the Form 3B is easy, but it does take
some time. Those who choose to adopt digital technology should embrace the learning curve, ask for advice
from their peers and seek out professional development
opportunities.
Moving forward, 3D printing needs to overcome the dental industry’s skepticism about novel printing materials
and applications such as printed dentures and permanent restorations. Manufacturers like Formlabs need to
be proactive about teaching experts and validating new
technology in the industry in order to achieve a mindset
shift. But it will eventually happen. We have already seen
it many times in the dental industry. Implants, zirconia,
intraoral scanners, chairside milling and many other materials and technologies overcame the initial skepticism.
I am glad to be part of the movement that is leading and
revolutionising digital dentistry.
Georgio Haddad, dental strategic partnerships and initiatives lead at Formlabs,
a 3D-printing technology developer and manufacturer. (Image: © Georgio Haddad)
“3D printing is a powerful
technology on its own, but
the real impact comes from
the people who use it.”
Editorial note: The Formlabs Dental webinar, titled “Revolutionizing digital dentistry with 3D printing—accessible
solutions and new applications,” is available on demand
at www.dtstudyclub.com. Registration is free of charge.
Formlabs’ Form 3B printer. (Image: © Formlabs Dental)
3D printing
1 2021
07
[8] =>
© Dmitry Markov152/Shutterstock.com
| news
3D printing continues to revolutionise dentistry, and recent evidence suggests that dental professionals can greatly benefit from printing 3D dental prostheses in-house.
Study highlights benefits of
in-house 3D printing for immediate
dental implant placement
By Iveta Ramonaite, Dental Tribune International
Owing to the growing popularity of point-of-care 3D printing and the subsequent creation of 3D-printing laboratories,
a recent study aimed to compare the benefits of printing
dental prostheses for fibula and implant reconstructions inhouse with those of using traditional techniques that involve
outsourcing to dental laboratories. The researchers found
that in-house printing offers considerable benefits, such
as reducing the waiting period before surgery, but that it
requires an initial investment in 3D-printing equipment.
3D printing has recently helped to save the lives of many health
care professionals fighting on the front line against COVID-19.
It was seemingly impossible to comply with the updated
08 3D printing
1 2021
recommended infection control practices in light of the shortage of proper personal protective equipment, and 3D-printed
masks and face shields were produced to assist in this situation. Dental Tribune International (DTI) has also previously
reported on the advantages of using a fully digital workflow
and printing clear aligners in-house. The benefits of 3D printing are manifold, and so are its applications for medical use.
The present study included 12 patients who underwent free
fibula reconstruction of the mandible or maxilla with immediate implants and immediate restoration. The restorations
were created before surgery, and the first five patients each
received a prosthesis that was fabricated by a dental labo-
[9] =>
ratory after virtual surgical planning. The remaining patients
each received a prosthesis that was designed by a surgeon
and 3D-printed via the in-house laboratory.
The researchers fabricated a dental prosthesis using pointof-care 3D printing within 24 hours of the virtual surgical planning session. The time required to generate the
in-house 3D-printed prostheses was significantly shorter
when compared with dental laboratory-fabricated prostheses, which typically take weeks. Additionally, the procedure
was more cost-effective. Whereas the prostheses created
by an off-site dental laboratory averaged $617.00, each
in-house 3D-printed prosthesis cost an average of $8.34
for resin, and the researchers noted that a full-arch prosthesis 3D-printed in NextDent Micro Filled Hybrid costs
under $50.00. The price includes the costs for the resin and
the export fee for Blue Sky Plan, a 3D-printing software.
“The study describes a digital workflow to design and 3D-print
an immediate provisional dental prosthesis to be placed during
jaw reconstruction when using a fibular free flap. This surgery
has been called ‘Jaw in a Day.’ Previous methods involved
third-party dental laboratories which require additional time,
laboratory expertise and are more expensive. Our technique
allows surgeon-guided virtual planning, just like we do with
the jaw and fibula,” Dr Fayette C. Williams, fellowship director
in the Division of Maxillofacial Oncology and Reconstructive
|
Surgery at John Peter Smith Health Network, told DTI. “Creating
a 3D-printed dental prosthesis in-house allows more control
for the surgeon to create the occlusal scheme. It is also much
quicker. I can generate this prosthesis in one day, whereas
dental laboratories can take two or more weeks,” he added.
According to the researchers, outsourcing dental prostheses
to a dental laboratory has previously created a delay in the
treatment, which has limited its usefulness to benign conditions. In the present study, the digital workflow used allowed
for immediate dental restoration for patients with malignant
disease. “This time is significant for a patient with cancer
waiting to get their surgery to remove their jaw and tumor,”
Williams explained. Despite its clear advantages, the researchers believe that the digital workflow presented in the
study is most suitable for patients with teeth in place preoperatively that will be removed with their tumor. For more
complex cases, it is necessary to familiarise oneself with
image manipulation and prosthesis planning. Additionally, the
researchers calculated that the total initial cost of a 3D printer
and post-processing supplies can reach around $3,000.00,
plus additional costs associated with using the software.
Editorial note: The study, titled “Immediate teeth in fibulas:
Planning and digital workflow with point-of-care 3D printing,”
was published on 1 August 2020, in the Journal of Oral and
Maxillofacial Surgery.
© belekekin/Shutterstock.com
© Dmitry Markov152/Shutterstock.com
news
“The time required
to generate the
in-house 3D-printed
prostheses was
significantly shorter when
compared with dental
laboratory-fabricated
prostheses (...)”
A recent study found that printing dental prostheses for fibula and implant reconstructions in-house eliminates the additional waiting period before surgery,
making the treatment suitable for patients with malignant disease.
3D printing
1 2021
09
[10] =>
Printing clear
aligners
in-house—
how accessible
is it?
By Jeremy Booth, Dental Tribune International
A growing number of dental practices are choosing to manufacture their own clear aligners in-house using 3D-printing technology.
Bellevue Orthodontics says that its patients can walk
out of their first appointment with a set of fully customised
clear aligners. Utilising an all-digital workflow, Bellevue
has joined the 3D-printing revolution that has seen private
dental practices begin producing clear aligners in-house.
The founders of the practice have also launched an educational community to help dentists and team members
incorporate 3D-printing technology into their workflow.
But what exactly is required and what advantages does
in-house production offer?
The clear aligner market leader Invisalign is facing increased competition from smaller, localised manufacturers. Dentists wishing to offer clear aligner treatment have
a number of options. Manufacturing and selling an inhouse brand directly to patients is one option that a
growing number of practices are choosing.
A dental practice requires an intra-oral scanner, a suitable
3D printer and photopolymer dental resins for 3D-printing
applications, a thermoforming machine for adapting the
aligner material to printed models, and a digital workflow
in order to bring it all together. Practice owners need to
invest in material resources, but they also need to invest
in education to help their team implement a 3D-printing
workflow.
10 3D printing
1 2021
3D printing offers workflow control
Dr Christopher Riolo founded Bellevue Orthodontics in
2019 after a decade of providing orthodontic treatment
to patients in the Seattle area from his downtown Riolo
Orthodontics clinic. In the clear aligner category, Bellevue
offers its patients Invisalign but also its own in-house
product.
According to the practice, the benefits offered by making
its own aligners in-house include a lower treatment cost
for patients owing to factors such as the ease of making
3D-printed retainers. A lifetime retainer policy is offered
to patients, for example, which lowers the overall cost of
treatment. The practice also points out that many patients
nowadays are conscious of the impact of their treatment
on the environment and that its in-house aligners result
in a lower environmental impact because shipping and
handling are not required. It says that having a better
understanding of the materials used to make its own
aligners means that staff can offer patients greater peace
of mind.
Clinic Manager Cali Kaltschmidt told Dental Tribune
International that the benefits of offering an in-house
brand also include an expedited start to treatment, the
© Ancapital/Shutterstock.com
| industry news
[11] =>
industry news
possibility of same-day replacements and improved
compatibility with fixed appliances for hybrid treatments.
“The ability to provide aligners on the same day or even
in the same week is huge. Our busy adult clientele love it,”
Kaltschmidt explained. She said that integrating 3D printing is inevitable once a practice has begun using intraoral scanners and that doing so has allowed Bellevue to
take control of its workflow.
“3D printing has allowed us to be in control of our own
workflow, and with that, the possibilities are endless.
We are able to provide aesthetic treatment options for
our patients and keep the cost down by not accruing
large laboratory fees from third-party companies. This
includes in-house clear aligners, lingual braces and hybrid treatment using a combination of both. 3D printing
has truly changed the way we practice,” Kaltschmidt
said.
“We’re so used to next-day delivery with Amazon and
other services, why should straightening teeth be any
different?” Riolo asked in a press note. “Orthodontists
have the technology and clinical expertise to expedite
care in ways that major corporations cannot deliver.
This is why we decided to adopt these technologies
early on.”
© belekekin/Shutterstock.com
“The investment for orthodontists and dental professionals to get started (with a 3D printer) can be anywhere from $500 to $20,000 or more,” Kaltschmidt said.
“Technology is advancing so quickly, and the cost of 3D
printers will continue to come down. Our advice for those
interested in getting started with 3D printing is to spend
less on the printer and invest more time into refining your
digital workflow. You will begin to notice the differences
when you go from analog to digital.”
“Orthodontists can definitely brand their own aligners
and they absolutely should,” Kaltschmidt continued.
“The product you design and manufacture in your office
as an orthodontist is a superior product in the end,
and you should package and brand your aligners to
reflect that. In-house aligners give the practitioner full control over workflow, time to delivery, trim line and choice of
aligner materials.”
Last year, Riolo and Kaltschmidt founded the Tooth
Movement 3D-printing educational community in order
to share their expertise on using 3D-printing technology
for orthodontic applications like clear aligner therapy.
Kaltschmidt said that demand from within the dental
community for the limited courses on offer has been
significant and that she and Riolo have worked mostly
with orthodontists, members of the treatment team and
recent graduates. “Many residents do not have any exposure to 3D printing while in their schooling,” she pointed
out.
|
Manufacturers are bullish on adoption of
3D printing in dentistry
Advancements in 3D-printing technology have seen the
quality of desktop models for dentistry climb while costs
have fallen.
According to Dr Baron Grutter, who owns a dental practice in Kansas City, being able to offer clear aligner treatment at a lower cost has improved case acceptance at
his practice for a product that is known for its high earning potential. Grutter was an early adopter of 3D-printing
technology in the dental practice and has manufactured
his own clear aligners in-house for some time. He told the
“Orthodontists have the
technology and clinical
expertise to expedite care in
ways that major corporations
cannot deliver”—
Dr Christopher Riolo,
Bellevue Orthodontics
manufacturer SprintRay in its Practice Insights series last
year that a return on the investment of a 3D-printing workflow can be made by selling as few as three or four cases.
Growing demand for this technology from dentists is
being met by companies manufacturing solutions that
are tailored to a number of dental applications, including
making clear aligners. Manufacturers predict that sales
will climb this year and that integrated digital workflows
will make the technology even more accessible.
Lee Kwang Min, vice president of the Korean 3D-printer
manufacturer Carima, told the online trade journal
3D Printing Industry in 2019 “[2020] will be a full-scale digital dentistry year. The emergence of a variety of 3D scanning solutions with an affordable price range, which has
been an obstacle to the spread of digital dentistry, will replace the milling machines in the market and, furthermore,
(will accelerate) the rapid adoption of 3D printers.” Min said
that he expects that a collaborative approach between
individual manufacturers of 3D printers, software and
scanners will act to increase the accessibility and adoption of the technology by dentists.
3D printing
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[12] =>
3D-printed indirect bonding
tray resin aims to halve
orthodontic chair time
By Jeremy Booth, Dental Tribune International
time-consuming process of individually placing the
brackets can now be done with a custom appliance
that saves the orthodontist’s time by cutting patient
chair time in half.”
He explained that the company had worked with
leading orthodontists during the development of the
IBT resin. Trays made using the resin are flexible and
provide for easy insertion and removal, but are firm
enough to hold the brackets in place, Wainwright said.
“The superb fitment and ease of 3D printing these
appliances on the Form 3B, Wash and Cure make
efficient orthodontic bracket placement accessible to
any orthodontic practice,” he added.
Launched this year Formlab’s new indirect bonding tray (IBT) resin is Class I
compliant and biocompatible. (Image: © Formlabs)
Formlabs has launched a new indirect bonding tray
(IBT) resin that it says will bring the benefits of 3D printing to orthodontic practices by streamlining workflows
and drastically reducing patient chair time. The company’s dental product manager, Sam Wainwright, says
that the IBT resin provides an attractive alternative to
traditional methods of placing brackets.
An appliance found in most orthodontic practices, the
IBT allows dentists to place in one procedure multiple
brackets that precisely fit a patient’s dentition and prescription. The process of individually placing the brackets can be time-consuming, and Formlabs says that
orthodontists can drastically reduce patient chair time
by using 3D printing and its new resin when working
with IBTs.
Speaking to Dental Tribune International (DTI), Wainwright
said: “With 3D printing and the new IBT resin, the
12 3D printing
1 2021
The IBT resin offers a completely digital workflow, and
treatment planning is done using advanced orthodontic
CAD software. Wainwright says that the workflow can
result in a more efficient process, that it improves communication and that it can result in an easier exchange
between dental practices and laboratories.
“Once the appliance has been designed, the file is
ready to print, and the Form 3B’s industry-leading
ease of use makes this process as simple as possible.
And once the appliance is ready to use, the process of
placing brackets becomes so much easier than traditional methods. The brackets can be inserted into the
appliance before the patient arrives, the appliance is
easily inserted over the teeth, and every bracket is then
held precisely in position,” Wainwright said.
Launched on 16 February, the IBT resin is Class I compliant and biocompatible. DTI recently reported on a study
that called into question the safety of 3D-printable resins used to manufacture oral retainers, including certain resins marketed by Formlabs as biocompatible.
According to company information, Formlabs’ biocompatible resins are developed in accordance with a
number of ISO standards, and pass the requirements
of those standards.
© Ancapital/Shutterstock.com
| industry news
[13] =>
VOXELTEK FLOW
Digital Dental System
[14] =>
| trends & applications
Digital orthodontics company raises
funds for 3D-printed brackets
By Jeremy Booth, Dental Tribune International
Dr Alfred Griffin III said that LightForce brackets reduce practice visits—a crucial factor for patients and orthodontists and their teams during the pandemic.
LightForce Orthodontics is a digital dentistry platform
that provides orthodontists with fully customised 3Dprinted tooth-moving tools. Its customisable 3D brackets
are the first of their kind on the market, and they are
designed to reduce patient visits and treatment duration.
The company launched LightForce this year, after five
years of research and development, and has now raised
$14 million (€12 million) in funding for the further development and commercialisation of the system.
The LightForce treatment process begins with the orthodontist sending a scan of a patient’s teeth and a treat-
3D-printed brackets that can adapt to achieve a desired final tooth position for that unique patient. (All images: © LightForce Orthodontics)
14 3D printing
1 2021
[15] =>
trends & applications
|
ment plan to the company’s technicians, who then create
customised brackets and trays. The system uses ceramic
material that is specially formulated for 3D printing,
but which is otherwise virtually identical to that used in
injection-molded brackets.
The founder of the company, Dr Alfred Griffin III, told
Dental Tribune International that the digital workflow
resembles that used in clear aligner therapy. “LightPlan
is the proprietary treatment software developed by
LightForce that enables mass-customised braces,”
he said. “Doctors have complete control over every aspect
of the treatment plan and can utilise a simple cloudbased interface for adjustments and approvals.”
“Our treatment plans are unique to each individual patient
and largely follow the clear aligner workflow,” Griffin continued. “Where our technology diverges is when the orthodontist uploads the patient’s scan to our LightPlan software, which enables the doctor to adjust the teeth virtually
in order to create a perfect smile and bite for that unique
patient, enabled by automatically designed braces.”
Griffin explained that the LightPlan software generates
bracket files, which are then printed at LightForce’s centralised manufacturing plant in Cambridge. The brackets are
then delivered to the orthodontist’s office about a month later.
Increased personalisation using digital tools
LightForce says that orthodontists should “move teeth, not brackets.”
LightForce aims to provide treatment for malocclusion,
which is as individual as each patient is. “A person’s lips,
jaws, teeth and smile are individual, and it’s important to
customise the tools that impact his or her face,” Griffin explained. “3D printing provides the ideal solution for patients,
as it allows for customisation and uses modern technology
to address an age-old problem. We’ve found 3D printing to
be the best solution for orthodontic applications because it
enables complete personalisation for each patient—it can
print complex geometries, in this case unique tooth morphology that would otherwise be unavailable to patients.”
“Our treatment plans are
unique to each individual
patient and largely follow the
clear aligner workflow.”
He added: “On the one hand, we believe that the days
of bracket prescriptions are numbered; on the other
hand, we welcome the days of ‘tooth prescriptions’ for
mass-customised appliances like aligners and 3D-printed
brackets that can adapt to achieve a desired final tooth
position for that unique patient.” Griffin said that, in the
future, he expects that there will be a rapid expansion of
3D-printing technology within the dental industry.
LightForce Orthodontics was founded in 2015. Over
the last five years, Griffin and his team have undertaken
extensive research and development for what is now
the company’s eponymous treatment platform. No one
could have predicted that the 2020 launch of the bracket
system would take place in the midst of a global pan-
demic, but it seems that the outbreak of SARS-CoV-2
has not hampered the company’s plans.
“In light of the ongoing pandemic, technology that
reduces in-person dental visits is crucial not only for
patients but also for the orthodontists and their teams
that are caring for them,” Griffin said.
Hundreds of orthodontists throughout the US are already
providing treatment using LightForce brackets. Griffin said
that the company will use its newly acquired funds to further develop its technology and product offerings and to
scale its operations in order to meet what he called a recent
surge in demand for more efficient dental technologies.
The funds were raised in a Series B funding round that was led
by investors Tyche Partners, Matrix Partners and AM Ventures.
3D printing
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[16] =>
© Ross Helen/Shutterstock.com
| opinion
3D Printing: Changing the game
Dr Florin Lăzărescu, Romania
When I discovered CAD/CAM technology more than
10 years ago, I was amazed at the technological world
that I was entering. It was novel and it was creative; but it
was also rather daunting. My student years had provided
some abstract images of various scanners and milling
machines that were available at that time, but no actual
cases employing these technologies. Once I graduated,
the systems were far too expensive for the small office
where I was practicing initially.
After I made the decision to purchase a complete in-office
system, I discovered an exciting new world, one that I could
not have imagined previously. As suggested, I allowed
myself a comfortable learning curve at the beginning,
starting with easy cases, gradually gaining experience and
familiarity with the process, until I was confident enough to
push for more. CAD/CAM systems have evolved rapidly,
and during the past 10 years I have been witness to an
accelerated evolution of three generations of scanners
and milling machines. Today, I would not even consider
opening a new office without, at the very least, a scanner,
and preferably, a complete in office CAD/CAM system.
16 3D printing
1 2021
I remember that when I explained the benefits of CAD/
CAM technology to my patients a decade ago, I could not
help wondering what lay ahead for dentists, and where
the future of the profession would lead us.
As I look at the rapidly developing field of 3D printing,
I get the same game-changing feeling that I had when I
first discovered CAD/CAM technology. The mainstream
dental 3D printing boom began in 2015, following important technological milestones such as the first dental 3D
printing in 2000, digital impressions for an analog world
in 2005, and the introduction of all-ceramic restorations
and desktop scanners in 2010.
There are 3 distinguishable types of 3D printing that can
be categorised from a technological perspective1:
1. Photopolymerisation with thermoset plastics. A thermosetting polymer, resin, or plastic is a polymer that
is irreversibly hardened by curing from a soft solid or
viscous liquid prepolymer or resin. Curing is induced
by heat or suitable radiation and may be promoted
[17] =>
opinion
by high pressure or mixing with a catalyst. It is also
known as Stereolithography, and commonly referred
to as SLA.
2. Laser sintering with both for metals and thermoplastics is an Additive Manufacturing process that belongs to the Powder Bed Fusion family. A laser selectively sinters the particles of a polymer powder, fusing
them together and building a part, layer-by-layer. It is
known as Selective Laser Sintering and commonly
referred to a SLS or SLM. Laser sintering is very expensive, with high maintenance costs, but delivers
amazing results.
3. Extrusion is a 3D printing process that uses a continuous filament of a thermoplastic material. It is known
as Fused Filament Fabrication or Fused Deposition
Modeling and commonly referred to as FDM. This
technology is based on feeding a modelling filament
through a heated nozzle, and printing layer by layer.
While very affordable, FDM’s accuracy and service
quality are quite limited with respect to dental applications.
Various companies utilise differing photopolymerisation
technology categories:
1. SLA—Stereolithography printing exposes the liquid
resin to a laser light source.
2. LFS—Low Force Stereolithography can be described
as SLA’s successor. It uses a flexible tank and linear
illumination to polymerise liquid resin.
3. DLP—Digital Light Processing exposes the liquid resin
to a DLP projector light source.
4. LED—New technology that uses LED instead of laser
light sources for the additive manufacturing of metal
parts and optimises 3D metal printing.
However, the underlying principle is the same: a polymerising light hardens the resin to a solid-state layer by layer.
DLP or LED techniques offer faster results, while SLA and
LFS modes provide smoother and finer details, but the
process is significantly slower.
There are numerous dental applications for 3D printing.2
In fact, there are many applications that are not possible
without 3D printing (aligner thermoforming models, indirect bonding trays). 3D printing can enhance traditional
techniques such as surgical guides, custom impression
trays, diagnostic models, splints, restorative models, and
provisionals. And there are novel 3D printing opportunities
such as full dentures and permanent indirect and direct
restorations.
In my daily practice I find many situations where 3D printing allows me to offer existing services more predictably
and rapidly. Currently available options include: provisional crown and bridge restorations, inlays, onlays and
veneers.
|
The ability to print splints represents a tremendous advantage; a reliable inhouse splint can be completed in
a single appointment whereas sending the case to a
dental laboratory is far less efficient and much more expensive. The routine use of rapidly printed surgical guides
improves the patient’s perception of surgical procedures,
speeds treatment, and assists in predictable results for
every case. 3D inhouse printing reduces the waiting time
before surgeries.3
In the past, it was extremely difficult to treat totally edentulous patients with significant bone loss. Ultimately, the
limitations of dentist–technician communications made
the process long and tedious, and results were often less
than satisfactory. It was also frustrating that during this
time-consuming ordeal the patient had no access to provisional dentures. 3D printed full dentures, available the
same day, offer a practical solution to both patient and
dentist. Scanner, 3D printer and an in-house technician
are the ideal.
As with any new technology, 3D printing has a learning curve. It is highly recommended that the practitioner
begin with simpler procedures, and then tackle more
complex ones as experience and confidence are accumulated. 3D printing technology is a game changer in
the dental industry that will greatly influence and modify
patient treatment in the years to come.
3D printing, taken together with CAD/CAM and CBCT,
creates a comprehensive shift to digital dentistry, a trend
that is rapidly redefining the dental profession.
Editorial note: A list of references is available from the
publisher. This article originally appeared in Oral Health
Magazine, and an edited version is provided here with
permission from Newcom Media.
about
Dr Florin Lăzărescu owns a
private dental practice in Bucharest
in Romania and in his work focuses
on aesthetic dentistry with an
emphasis on all-ceramic and implant
restorative procedures. He is the
author of numerous publications on
dentistry, and he is the editor of and
a contributing author to the Romanian
book Incursiune în Estetică Dentara (Immersion in Esthetic
Dentistry, Society of Esthetic Dentistry in Romania, 2013)—
republished in English as Comprehensive Esthetic Dentistry
(Quintessence, 2015) and in Chinese (Qiuntessence China, 2017).
He is editor-in-chief of Dental Tribune Romanian Edition.
Dr Lăzărescu is the president of the European Society of
Cosmetic Dentistry and a founding member and director
of the Society of Esthetic Dentistry in Romania.
3D printing
1 2021
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[18] =>
| case report
Guided applications for
partial extraction therapy
Drs Scott D. Ganz & Isaac Tawil, USA
1
2
3a
3b
Fig. 1: The patient presented with a horizontally fractured clinical crown, an indication for a partial extraction therapy procedure. Fig. 2: The trajectory of the root
in relation to the alveolus can be visualised with a cross-sectional image. Fig. 3a: Planning the initial drill path using a custom implant design (red) to match the
diameter of the initial drill to reach the tooth apex. The abutment projection is shown in yellow. Fig. 3b: The simulated implant within the Triangle of Bone (red),
placed to avoid the root fragment seen in yellow (white arrows).
Dental implants to replace missing teeth have become
an integral part of current conventional dentistry. Accepted
protocols now include two-stage delayed loading, onestage delayed loading, immediate loading in a healed
receptor site, tilted implant placement, immediate loading
in fresh extraction sites, partial extraction therapy (PET),
socket shield technique and root membrane concept.
Technology has provided clinicians with enhanced tools
for diagnosis and treatment planning, instrumentation
for surgical intervention, improved implant surface treatments and thread design, improved abutment-to-implant
connections, sophisticated dental laboratory software
4
5a
and CAD/CAM applications, a greater selection of transitional and definitive restorative materials, static and
dynamic navigation, and changes in drill designs and drilling protocols. Dental implant procedures are predictable,
effective and essential to address the needs of patients.
Partial extraction procedures in their various formulations
have been demonstrated to be proven methodologies
for preserving bone and soft-tissue volume.1–7 Our 2017
article (The Root Membrane Concept: In the Zone With the
“Triangle of Bone”, Dentistry Today CE, October 2017)
reviewed 3D diagnostic tools for planning and executing root membrane and PET procedures based on the
5b
Fig. 4: The segmented root (white) and the root fragment (brown) within the sectioned maxillary surface model. Fig. 5a: Virtual sectioning of the segmented root
using Meshmixer with a simulated custom implant to reach the root apex. Fig. 5b: The apical portion of the simulated AnyRidge implant can then be positioned
so as not to touch the root fragment while engaging in host bone for stability.
18 3D printing
1 2021
[19] =>
case report
6a
|
6b
Figs. 6a & b: Two 3D-printed templates designed on the digitised model (green): one for the initial drill to section the tooth at the root apex (a) and the second
for using sequential guided drills to drill through the root itself (b).
“Triangle of Bone” concept and specific instrumentation
to achieve successful outcomes.5
The ability to perform the procedures requires careful diagnosis, treatment planning and excellent control
of the drilling process to ensure that the root fragment
will be maintained while maximising implant stability.
In many cases, it may also be possible to provide immediate transitional restorations when high implant stability
is achieved. However, complications can also arise when
the root fragment is lost or the implant fails to integrate. It
should be noted that PET has mainly been accomplished
with a diagnostic freehand method for sectioning roots,
osteotomy preparation and implant placement. The current article describes methods of providing PET procedures using full-template guidance based on a thorough
appreciation of the existing anatomical structures utilising advanced state-of-the-art treatment planning tools,
3D design software, 3D printing and/or CAD/CAM surgical templates.
7a
7b
8a
8b
Fig. 7a: A sleeveless guide to accommodate a 2 mm long pilot drill that was used to reach the root apex. Fig. 7b: Removing the guide allowed for inspection of
the drill embedded within the tooth. Figs. 8a & b: Using drill guides with long shanks to engage the sleeveless template allowed for sequential and accurate
drilling of the tooth and subsequent bone for implant placement.
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| case report
9
10
11
Fig. 9: The cylindrical tooth preparation resulted in the desired crescent shape of the root fragment to provide adequate space for the implant. Fig. 10: The
implant was placed into the osteotomy through the template using a special manufacturer-specific carrier. Fig. 11: The stackable tooth-borne guide and
the three other separate components seen in Figures 15a–c.
One indication for PET is when a patient presents with
a horizontally fractured clinical crown (Fig. 1). While a 2D
radiograph will reveal the extent of the horizontal fracture,
length of the remaining root and approximation of the
bone apical to the root, there is not enough information to
plan for a PET procedure. A CBCT scan is recommended
in order to fully appreciate the root position within the
alveolus and the potential difference between the trajec-
tory of the bone and the trajectory of the root as can be
visualised with a cross-sectional image (Fig. 2).
12a
12b
13
14a
Utilising interactive treatment planning software makes it
possible to plan the initial drill path to accurately section
the root to its apex (Fig. 3a). This can be accomplished by
creating a custom implant design to match the diameter
of the initial drill with an abutment projection in order to
14b
Fig. 12a: A post fracture presenting in the left central incisor, requiring extraction. Fig. 12b: The occlusal view illustrated the cervical tissue volume and
contours. Fig. 13: The pre-op periapical radiograph revealed an existing implant-supported metal–ceramic restoration for the adjacent region #11. Fig. 14a:
The CBCT cross-sectional image revealed a favourable pre-op condition for a PET procedure. Fig. 14b: Using the native Carestream 3D Imaging Software,
a simulated implant (red outline) and abutment projection (yellow outline) was positioned within the available bone to avoid the root fragment.
20 3D printing
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case report
15a
15b
|
15c
Fig. 15a: The base template was designed to seat firmly on the adjacent teeth, incorporating buccal and lingual hexagonal offsets to engage the different drill
guide inserts. Figs. 15b & c: Separate inserts were fabricated for the initial drill guide to reach the root apex to accommodate sectioning, followed by a second
guide for final osteotomy drilling and implant placement.
fully appreciate the trajectory through the clinical crown
(Blue Sky Plan, Blue Sky Bio). It is important to visualise
the root fragment that will remain in order to properly simulate the position of the implant in the alveolus (Fig. 3b).
The apical portion of the implant can be positioned
to gain stability in host bone using the Triangle of Bone.
It is important to note that a cross-sectional slice may
only be 0.125 mm in thickness based on the CBCT acquisition, and therefore all images in all views must be
visualised to confirm the plan. Utilising 3D segmentation
(separating objects by density values), it is possible to
define each root and further assess the simulated position of the implant with a sagittal cut through the 3D reconstructed volume (Fig. 4).
Planning with such precision is predicated on the acquisition of a satisfactory CBCT scan with a proper field of
view and the incorporation of occlusal surface data STL
files of the arch form, digitised through either an intra-oral
scan or a desktop scanner imported into the software.
Two 3D-printed templates were then designed on the
accurate digitised surface model, one for the initial drill
to section the tooth at the root apex and the second to
use sequential guided drills to drill through the root itself
(Fig. 6).
The ability to export volumes in STL format allows these
objects to be edited and utilised in other software applications, such as Meshmixer (Autodesk). The STL file of
the root image was imported into Meshmixer, and the
root was virtually sectioned using Boolean difference to
mimic the crescent shape for PET (Fig. 5a). The apical
portion of the simulated implant can then be positioned
so as not to touch the root fragment while engaging in
host bone for stability (Fig. 5b).
A 2 mm pilot drill, which was long enough to reach the
root apex with the tooth-borne surgical guide in place,
was utilised with a sleeveless guided approach (Fig. 7a).
Removing the guide allowed for inspection of the drill
through the tooth (Fig. 7b). Using guided drills with
long shanks in a sleeveless guide allowed for sequential and accurate removal of the tooth and subsequent
bone beyond the apex of the natural tooth root (R2Gate,
MegaGen; Fig. 8). The cylindrical tooth preparation/osteotomy resulted in the desired crescent shape to provide
space for the implant (Fig. 9). The root was then sectioned
mesiodistally using specialised drills (Root Membrane Kit,
MegaGen) and the palatal section removed. Utilising
16a
16b
Figs. 16a & b: The accuracy of the implant and template design allows for true restoratively driven planning combined with CAD/CAM applications for the design
and fabrication of a patient-specific abutment and transitional restoration.
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| case report
26a
17a
17b
19a
19b
18
20
21
Figs. 17a & b: Utilising the tooth-borne template and the first insert, initial long shaper drills were used to reach the apex of the root. Fig. 18: A periapical radiograph
with a drill in place confirmed that the apex length had been reached and that all the gutta-percha had been removed. Figs. 19a & b: The second metal cylinder insert
allowed for the long, round diamond drills to shape the root into the desired crescent shape (a). The insert was removed to access the palatal root (b). Fig. 20: The
sectioned palatal root was carefully removed. Fig. 21: A periapical radiograph confirmed that the palatal root and all the gutta-percha had been completely removed.
22a
22b
23
24a
24b
25
Figs. 22a & b: The final insert was designed to receive the guided sleeveless drills for accurate osteotomy preparation (a). The osteotomy was prepared to avoid
proximity to the remaining root fragment while leaving sufficient restorative space as previously planned (b). Fig. 23: The implant, seen prior to placement,
using the R2Gate surgical carrier for full-template guidance through the sleeveless guide. Figs. 24a & b: Depth control and rotational positioning were accurately confirmed with the notch indicator on the template corresponding with the insertion tool (a). The occlusal view illustrated that the anti-rotational internal
conical–hexagonal connection was positioned towards the facial aspect (b). Fig. 25: Using an implant-specific SmartPeg, a baseline ISQ value of 76 confirmed
sufficient initial stability to place an immediate restoration.
22 3D printing
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[23] =>
case report
26a
26b
26c
|
26d
Figs. 26a–d: The prefabricated CAD/CAM abutment and transitional crown (a). A post-op periapical radiograph confirmed successful sub-crestal placement of
this platform-switched design (b). The abutment in place (c). The soft-tissue contours were excellent; no sutures were required for the transitional restoration (d).
the template, the implant was placed into the osteotomy
using the correct implant carrier to achieve full-template
guidance and stability measured using resonance frequency analysis (RFA) to obtain the implant stability quotient (ISQ; Fig. 10).
tooth-borne guide); (2) a pilot drill guide for the root apex
(APEX STACK); (3) a crescent-shaped guide for shaping
root fragments (PET Shaper STACK); and (4) a guide for
osteotomy drilling and placing the implant through the
guide (Surgical Guide STACK; Fig. 11).
The concept of drilling through the root is not new and
has been reported in the literature.8 Using guided methods for the socket shield technique has also been reported using a CAD/CAM-fabricated template.9 However,
the ability to use technology to plan and execute a fully
guided procedure for a PET, socket shield technique and
root membrane technique illustrates additional methodology to aid clinicians in successful outcomes.
Case report
The first concept described the use of two separate
templates, one for separating the root at the apex and
the second for drilling through the tooth and placing the
implant. Continuing the evolution, we present a second
option, which does not require the removal of the base
template, but has inserts to allow for the different drills
and angulation required for the PET technique: the stackable tooth-borne guide. The new technique has four
separate components: (1) a base template (stackable
27a
A 62-year-old male patient presented with a hopeless
prognosis for a post fracture in the left central incisor
requiring extraction (Figs. 12a & b). The preoperative periapical radiograph revealed an existing implant supporting a metal–ceramic restoration for the adjacent region
#11 (Fig. 13). The CBCT (CS 9600, Carestream Dental)
cross-sectional image revealed a favourable preoperative
condition relating to the trajectory of the endodontically
treated root to the alveolus for a PET procedure (Fig. 14a).
Using the native Carestream 3D Imaging software, a
simulated implant and abutment projection was positioned within the available bone to avoid the root fragment (Fig. 14b).
The final positioning of the implant, as determined by the
restorative requirements, and design and fabrication of
27b
Figs. 27a & b: The post-op CBCT scan axial view revealed the intact crescent shape of the root membrane (a), as outlined in red in facial to the opaque
implant position (b).
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[24] =>
| case report
28a
28b
Figs. 28a & b: The post-op cross-sectional view clearly illustrated the position of the implant (a), the definitive restoration located palatal to the root membrane (b),
as outlined in yellow (red arrows).
the tooth-borne stackable surgical template, was accomplished using dedicated interactive treatment planning software (360dps, 360Imaging). The base template
was designed to seat firmly on the adjacent teeth, incorporating buccal and lingual hexagonal offsets to engage
the different drill guide inserts (Fig. 15a). Separate inserts
were then fabricated for the initial drill guide to reach
the root apex to accommodate sectioning, followed by
a second guide for final osteotomy drilling and implant
placement (Figs. 15b & c). The accuracy of the implant
and template design provides the opportunity for true restoratively driven planning, which can then be combined
with CAD/CAM applications to also design and fabricate
a patient-specific abutment and transitional restoration in
advance of the surgical intervention (Fig. 16).
Prior to the guided drilling, a Gates–Glidden drill was
used to remove any gutta-percha within the root. Utilising
the tooth-borne template and the first insert, initial long
29
30a
shaper drills (IS1, IS2 from the Root Membrane Kit, MegaGen)
were used to reach the apex of the root (Root Membrane
Kit; Fig. 17). A periapical radiograph confirmed that the
apex length had been reached and that all the guttapercha had been removed (Fig. 18). The second insert
had a metal cylinder that allowed for the long, round
diamond drills to shape the root into the desired crescent shape (Fig. 19a). The insert was removed to access
the palatal root (Fig. 19b). Using appropriate instrumentation such as periotomes, elvatomes or FRINGS forceps
(both TBS Dental), the palatal portion of the root was
carefully removed (Fig. 20). A periapical radiograph confirmed that the palatal root had been completely removed
(Fig. 21). The next insert contained the final diameter to
receive the guided sleeveless drills for osteotomy preparation (Fig. 22a). The osteotomy was prepared to avoid
proximity to the remaining root fragment while leaving
sufficient restorative space, as previously planned in
the software simulation (Fig. 22b). Implant placement
30b
Fig. 29: The definitive restoration exhibited excellent retention of the soft-tissue profile. Figs. 30a & b: The occlusal view revealed the volume maintained with
the soft-tissue cervical contours (a), and the lateral retracted view revealed an excellent soft-tissue emergence profile (b).
24 3D printing
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[25] =>
case report
(AnyRidge, MegaGen) was facilitated by the R2Gate
surgical carrier for full-template guidance at the appropriate torque values (Fig. 23). Depth control and rotational
positioning were accurately confirmed with the notch
indicated on the template to correspond with the insertion tool (Fig. 24).
The initial plan was for immediate extraction, immediate
placement and immediate restoration. Therefore, it was
essential to measure the implant’s stability with an objective technology, RFA, which provides an ISQ value utilising an implant-specific SmartPeg (Osstell; MEGA ISQ,
MegaGen). The baseline ISQ value (76) confirmed sufficient initial stability to place an immediate restoration
(Fig. 25). The prefabricated CAD/CAM abutment was
then secured to the implant, and a postoperative periapical radiograph confirmed successful sub-crestal
placement for this platform-switched design (Fig. 26a).
The transitional acrylic restoration was then placed
and examined for any occlusal interferences (Fig. 26b).
It was important that the restoration be out of occlusion
to avoid premature forces that could complicate integration. The soft-tissue contours were excellent, and
no sutures were required, since no flap was raised
(Figs. 26c & d). After a period of eight weeks, the implant stability was measured to be at 80 ISQ, confirming
that the integration process had continued to progress
successfully and that the implant was ready for the definitive restoration. An intra-oral scanner and scanning
abutment were then utilised to capture the position of
the implant and soft-tissue emergence profile. The postoperative CBCT scan revealed the intact crescent shape
of the root membrane (Figs. 27 & 28). The definitive
restoration was then delivered and exhibited excellent
retention of the soft-tissue profile (Figs. 29 & 30).
Conclusion
PET, root membrane and socket shield concepts have
gained popularity as the techniques have been refined
and their efficacy proved in published long-term studies. The purpose of retaining the root is to maintain the
periodontal ligament attachment to the bony walls of the
socket in order to prevent subsequent resorption and
loss of tissue volume which often occurs after tooth extraction. PET has been proved to preserve bundle bone
and tissue volume with and without immediate implant
placement, yet this minimally invasive treatment modality is highly technique-sensitive and may result in complications if proper protocols are not followed. Therefore,
a complete understanding of the 3D anatomical presentation is essential for preliminary diagnosis, treatment
planning and execution of the procedure. The present
article has described two alternatives that maximise the
diagnostic phase using state-of-the-art CBCT imaging
and planning software to provide full-template guidance
with a new stackable tooth-borne guide with specific in-
|
serts for the root preparation as well as the osteotomy
preparation and delivery of the implant. As with most
techniques, further clinical trials are recommended to
provide additional long-term data to validate these treatment modalities.
Acknowledgement: The authors would like to thank
Dr Barry Kaplan of Morristown in New Jersey in the US
for his expertise and assistance in the preparation of
this article.
Editorial note: This article originally appeared in
Dentistry Today in September 2020, and an edited version is provided here with permission from Dentistry
Today. A list of references is available from the publisher.
about
Dr Scott D. Ganz received his
specialty certificate in maxillofacial
prosthetics and prosthodontics, and
this led to his focus on the surgical and
restorative phases of implant dentistry
and his subsequent contribution
to 15 implant-related textbooks.
He is a fellow of the Academy
of Osseointegration, a diplomate
of the International Congress of Oral Implantologists (ICOI),
US ambassador of the Digital Dental Society, president
of the US branch of the Digital Dentistry Society (DDS) and a
co-director of Advanced Implant Education (AIE). Dr Ganz is on
the teaching staff of the Rutgers School of Dental Medicine in
Newark in New Jersey and maintains a private practice in Fort Lee
in New Jersey. He can be reached at drganz@drganz.com.
Dr Isaac Tawil sits on the Digital
Dental USA Society Board of Directors,
and is a diplomate of the International
Academy of Dental Implantology,
the IADFE, a fellow of the Advanced
Dental Implant Academy, and the
ICOI. He is one of Dentistry Today’s
Top Leaders in CE, a faculty member
of the Osseodensification Academy,
Brighter Way educational director (Phoenix, Arizona), and
digital director of Guided Smile. Dr Tawil is an ambassador of
MegaGen International Network of Education and Clinical Research,
a member of MINEC USA and an ambassador for the
Slow Dentistry initiative. A recipient of the Pierre Fauchard
award and the Presidential Service Award for outstanding
achievements in dentistry. He is the founder and co-director
of Advanced Implant Education, a partner in TBS instruments,
and Universal Shapers LLC, and a new product consultant for
dental industry. Dr Tawil has held main podium sessions and
workshops globally and maintains a private practice in Brooklyn,
New York. He can be reached at iketawil@mac.com.
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[26] =>
| industry
Dental 3D printing adoption
across Asia Pacific
Top three trends and forecast
By Kiavash Bakrani & Dr Kamran Zamanian, Canada
Trend #1: Technological advancements lead
to growth opportunities
Dental 3D printing allows for significant time savings for
a variety of applications, which is a common feature of
most digital dentistry technology. Production of models, surgical guides, night guards and other products is
extremely rapid and requires minimal labour. Models, in
particular, are often quite laborious to produce traditionally, making this a significant opportunity for time savings.
The enhanced productivity offered by digital workflows
will continue to drive growth in the dental 3D printing
market. Ongoing regulatory approvals of materials for new
indications will result in significant growth in the dental
3D printer market. Whereas 3D-printed dental prosthetics
are not yet available in many Asia Pacific countries, such
approval is likely to induce significant market value growth
when it occurs. A single dental 3D printer from a major
manufacturer is generally capable of producing surgical
guides, models, night guards, dentures and temporary
crowns; the technology is, therefore, very versatile, and
growth hinges largely on the materials approved for use.
Fig. 1: Asia Pacific, US and European 3D printer markets.
The digital dentistry market in Asia Pacific has started
to gain traction because of technological advances and
the demand for improved precision, although the markets
lag severely behind North America and Europe.
Dental 3D printing has rapidly become an important part
of many digital dentistry workflows in countries such
as Australia, Japan and South Korea. Dental 3D printers are now an increasingly popular tool in dental laboratories, dental practices and orthodontic practices and
have many uses, including the production of crown and
bridge models and final prostheses. Whereas the dental
3D printer segment is the smallest segment of the digital
dentistry market, it has grown the most rapidly in recent
years. Countries such as China and India, who lag behind in terms of novel technology, have not seen nearly
as much advancement.
26 3D printing
1 2021
Trend #2: Technological learning curves and
regulatory approvals delay market growth
Dental 3D printers are still relatively new technology and
tend not to be overly user friendly. A steep learning curve
is often involved in the incorporation of dental 3D printing
into a digital workflow, limiting access for less technologically adept dentists and dental laboratory technicians.
Similar issues limited the growth of the chairside CAD/
CAM system market in Asia Pacific; significant time must
be invested in learning the technology, and strong customer support from manufacturers is key to success.
As dental 3D printers become more user-friendly, this
issue will be mitigated, but for the time being, it limits
the potential for growth in the Asia Pacific market.
Regulatory approvals for new indications are required for products in the Asia Pacific market. Currently, many of the newest
innovations in the CAD/CAM material market are unavailable
in Asia Pacific, and it is unknown when they will be approved. This uncertainty limits the potential for market growth.
[27] =>
industry
|
Fig. 2: Impact of COVID-19 on the 3D printer market in Asia Pacific.
Trend #3: COVID-19’s impact
on the Asia Pacific market
The global dental market was significantly affected by the
COVID-19 pandemic, and Asia Pacific was no exception.
The markets for dental prosthetics as well as CAD/CAM
devices and materials are interdependent and have,
therefore, also been similarly affected. The overall market value for dental prosthetics decreased dramatically
compared with the previous year because of the elective
nature of the procedures and the tight regulations that
led to the closure of many dental clinics. Owing to its high
price point, the premium market was impacted the most
notably. The total market is expected to recover in 2021
and continue to grow at a moderate pace.
3D dental printers market forecast
Overall, the dental 3D printer market in Asia Pacific experienced a decline in 2020 because of reduced dental
spending across the nation. This decline is temporary,
and the market will return to normal unit sales forecasts
by 2022. For the remainder of the forecast period, the
dental 3D printer market in Asia Pacific is expected to
experience strong unit sales growth; as more laboratories go digital and more CAD/CAM materials receive
regulatory approval, the demand for 3D printers will
increase.
Sources:
iData Research. 2021 China Market Report Suite for Digital Dentistry |
MedSuite | With impact of COVID-19 (https://idataresearch.com/product/
digital-dentistry-market-china/)
iData Research. 2021 India Market Report Suite for Digital Dentistry |
MedSuite | With impact of COVID-19 (https://idataresearch.com/product/
india-digital-dentistry-market/)
iData Research. 2021 Japan Market Report Suite for Digital Dentistry |
MedSuite | With impact of COVID-19 (https://idataresearch.com/product/
japan-digital-dentistry-market/)
iData Research. 2021 South Korea Market Report Suite for Digital Dentistry |
MedSuite | With impact of COVID-19 (https://idataresearch.com/product/
digital-dentistry-market-south-korea/)
iData Research. 2021 Australia Market Report Suite for Digital Dentistry |
MedSuite | With impact of COVID-19 (https://idataresearch.com/product/
digital-dentistry-market-australia/)
about
Kiavash Bakrani is a senior
research analyst at iData Research.
He has been involved in the global
research of dental prosthetics
and digital dentistry markets,
publishing the reports
on the Asia Pacific market.
Dr Kamran Zamanian is the
CEO and founding partner of iData
Research. He has spent over 20 years
working in the market research
industry with a dedication to the study
of dental and medical devices
used in the health of patients
all over the globe.
3D printing
1 2021
27
[28] =>
| meetings
International events
22–25 September 2021
(on-site and online event)
Cologne, Germany
www.ids-cologne.de
EAO Digital Days
14–16 October 2021 (online event)
Italy
www.eao.org/congress
FDI World Dental Congress
Dentex—International Dental
Equipment Exhibition
26–29 September 2021 (online event only)
Sydney, Australia
www.fdiworlddental.org/fdi-world-dental-congress
21–23 October 2021
Brussels, Belgium
www.dentex.be/en
Dental-Expo
AAP Annual Meeting
27–30 September 2021
Moscow, Russia
www.en.dental-expo.com/dental-expo-en
4–7 November 2021
Miami, US
www.perio.org
CEDE—Central European Dental
Exhibition
ADF—Conference and Exhibition
7–9 October 2021
Łódź, Poland
www.cede.pl/en
23–27 November 2021
Paris, France
www.adfcongres.com/en
31st Annual NYU/ICOI
Implant Symposium
GNYDM
9–10 October 2021
New York, US
www.icoi.org/events
28 November–1 December 2021
New York, US
www.gnydm.com
28 3D printing
1 2021
© 06photo/Shutterstock.com
IDS—
International Dental Show
[29] =>
|
© 32 pixels/Shutterstock.com
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30 3D printing
1 2021
[31] =>
[32] =>
What if you could experience the
next 100 years of dentistry today?
3D printing in dentistry is much more than just a new technology: it has the potential
to control costs, improve flexibility, and expand the scope of patient care. To deliver on
this potential, SprintRay products make it easy to bring digital dentistry and 3D printing
together in your practice.
WANT TO LEARN MORE?
Meet us in Hall 3.1
Booth J-018-L-019
SprintRay Europe GmbH | Brunnenweg 11 | 64331 Weiterstadt | info.eu@sprintray.com | en.sprintray.com | +49 6150 978948-0
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[title] => Study highlights benefits of in-house 3D printing for immediate dental implant placement
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[title] => Printing clear aligners in-house—how accessible is it?
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[title] => 3D-printed indirect bonding tray resin aims to halve orthodontic chair time
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[title] => Digital orthodontics company raises funds for 3D-printed brackets
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[title] => 3D Printing: Changing the game
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[title] => Guided applications for partial extraction therapy, by Drs Scott D. Ganz & Isaac Tawil, USA
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[title] => Dental 3D printing adoption across Asia Pacific: Top three trends and forecast, by Kiavash Bakrani & Dr Kamran Zamanian, Canada
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/ Editorial
/ Content
/ How 3D printing has transformed dental care
/ Study highlights benefits of in-house 3D printing for immediate dental implant placement
/ Printing clear aligners in-house—how accessible is it?
/ 3D-printed indirect bonding tray resin aims to halve orthodontic chair time
/ Digital orthodontics company raises funds for 3D-printed brackets
/ 3D Printing: Changing the game
/ Guided applications for partial extraction therapy, by Drs Scott D. Ganz & Isaac Tawil, USA
/ Dental 3D printing adoption across Asia Pacific: Top three trends and forecast, by Kiavash Bakrani & Dr Kamran Zamanian, Canada
/ International events
/ Submission guidelines
/ Imprint
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