Digital technology is increasingly common in many of today’s dental offices, and it includes some of the slickest technology ever to hit the dental profession. Clinicians who travel the digital workflow route often report higher patient treatment acceptance, faster treatment times, an efficiency boost, enhanced precision, increased revenue, and cost savings, all while they bask in the glow of their blossoming cutting-edge reputations.
Computer-aided design/computer-aided manufacturing (CAD/CAM) is among the front-runners in 21st-century technologies. And the first step onto the CAD/CAM speedway is digital impressioning. Acquired via intraoral scanners, digital impression information can be imported into CAD platforms to enable virtual designing.1 The next stop is fabrication.
Add or Subtract?
When a prosthesis is to be milled from a block of ceramic material, the information for the digital impression is sent to the CAM part of the system. This is known as subtractive manufacturing, and is still the preferred method of manufacturing permanent ceramic restorations.2
Alternatively, depending on what is being made, the information may be sent to a three dimensional (3D) printer for additive manufacturing. A recent market forecast predicts that this technology and everything related to it will surpass $2.7 billion in 2019, and that by 2022, 500 million devices and restorations will be produced each year by additive manufacturing.3 One research firm pegs the technology’s CARG at 24.5% between 2018 and 2023.4
Restorative prostheses subject to printing typically include surgical guides for implants, models for casting or pressing, provisionals, splints, custom trays, and dentures.5,6
Three-dimensional printers utilize materials such as liquid resin, which is laid down in a series of ultrathin layers to form the resulting product. For a “high-resolution” print, layers may be as thin as 25 microns. Lasers are used during the printing process to cure each layer of resin.2,5–7
While resin is pretty much the standard material used in 3D printing, other materials include chromium cobalt, which can be sintered to create removable frameworks, copings and other structures for implants, crowns and bridges.5–7
3D Manufacturing Efficiency
One of the beauties of this technology is that it can simultaneously print multiple prostheses, identified by serial numbers, laid out on a sheet like a batch of cookies. There’s still a limit, however, as to what can be printed. But the scope of production appears to be broadening — and fast.
There are already anecdotal reports of fabrication of permanent restorations being printed out of microfill hybrid resin. There is even talk about the prospect of using printers to rebuild bone for implant placement, and create permanent teeth infused with stem cells to facilitate tissue formation.1
Keep It Clear
As promising as 3D printing is, it depends on intraoral scanning. The best scans are those that are taken in a clean, clear oral environment. A system such as Isolite can provide all this and more. Thanks to a flexible mouthpiece, insertion is easy and helps to ensure nothing goes down a patient’s throat. Plus, shadowless illumination and continual evacuation (which also helps keep scanning powder under control), work together to ensure the highest quality scans possible. And because the system doubles as a bite block, patient comfort is maximized.
As materials improve, prices drop, and more dental students are trained on 3D printers, such technology is increasingly likely to become a permanent fixture of future dental offices. Such devices, whether used a la carte or as a complement to other digital systems, can only boost workflow, clearing the path to accuracy, efficiency and excellence.
- Stone R. Go with the flow. Mentor. 2016;7(7):20–25.
- 2. Choi SK. Digital technologies for restorative care. Decisions in Dentistry. 2018;4(5):33–36
- SmarTech Analysis. SmarTech issues latest additive manufacturing in dentistry market report. Available at: https://www.smartechanalysis.com/news/smartech-issues-latest-additive-manufacturing-dentistry-market-report/. Accessed April 1, 2019.
- Market Research Future. Dental 3D Printing Market Research Report—Forecast to 2023. Available at: https://www.marketresearchfuture.com/reports/dental-3d-printing-market-6260. Accessed April 1, 2019.
- Farawati FA. Digital fabrication of dental implant prostheses. Decisions in Dentistry. 2018;4(9):22–25.
- Farawati FA, Davila E. CAD/CAM utility in dentistry. Decisions in Dentistry. 2019;5 (3):22–24.
- Alghazzawi TF.Advancements in CAD/CAM technology: options for practical implementation. J Prosthodont Res. 2016;60:72–84.