When it comes to 3D printing, many dentists have questions about where to start. Incorporating new technology can be somewhat daunting, but choosing the right applications — and applying the right workflows — can help set your practice up for success. Dr. Alan Jurim, director of digital dentistry with Touro College of Dental Medicine and founder of CADPRO Academy, recently shared some helpful guidance in his webinar, “The 3 Beginner Applications in Dental 3D Printing: Surgical Guides, Models and Splints.” Here’s what you need to know.
Elements of 3D printing
3D printing essentially involves three steps: Inputting information, processing information and outputting that information.
- Inputting information: Intraoral scanners, as well as devices such as 3D X-rays and photogrammetry scanners, are used to create digital impressions of patients.
- Sharing information: Processing and analyzing data is where the real value of 3D printing comes in. Digital dentistry allows for a more collaborative process. With 3D printing and digital dentistry, information can be sent instantly, seen by many stakeholders (such as labs, general practitioners and surgeons) and prototyped in the office. Refinements can then be sent back to the lab for the final output of information.
- Outputting information: Traditionally, outputs were created through milling systems. 3D printing is surpassing milling in some areas, because it offers better predictability. The ease of printing and the flexibility is far better than with milling.
Choosing your 3D printing solution
To create a seamless workflow, it’s best to work with a vendor that offers a complete 3D printing solution. Some companies manufacture 3D printers, but don’t offer the software to use it or the materials needed for printing. Linking a workflow from start to finish — from taking a scan to printing a model — is the best approach. Working with a single-source vendor also simplifies processes if a maintenance issue arises.
Another important element to consider with your 3D printing platform: the steps involved once prints are finished, since every printed material will need to be post-processed. This involves rinsing off any excess resin, cleaning the part, curing it, polymerizing it and completing the curing of the resin to achieve the optimum results of that material. One way to streamline these steps is to ensure the platform used comes with materials that can be easily loaded into the printer. Having resins in a closed system eliminates the need to physically touch a lot of the materials.
Once you’ve incorporated a 3D printing system, a best practice to follow is to scan patients each time they come in, making it possible to build a patient library. Those scans can be used to make diagnoses and to tailor treatments based on each patient’s expectations and goals.
Three of the best applications to start out with are digital dental models, surgical guides and splints.
Producing a dental model involves taking an intraoral scan to design a new digital smile or digital proposal, and then sending it directly to the printer. This is a powerful part of digital dentistry. This approach makes it possible to virtually design a smile in a patient’s dental facial profile that can be digitally produced to deliver more predictable results. Unlike milling, where a solid block of material is cut back until the end product is produced, 3D printing uses an additive manufacturing process that consists of creating layer by layer images, and then stitching them together into a 3D model. It’s a more precise process.
Whether you’re producing digital dentures, screw-retained implant bridges or provisional bridges, models can be generated throughout the process of actually creating the smile. The digital information is used to ensure that the design is accurate before moving forward to the final restoration. Printed models are often used in esthetic cases. This enables the technician to have a model to orient the veneer so that they know how to build up the porcelain.
In addition, if the dental practice is working with a laboratory that’s printing the models, the lab can also generate the models in a way that enables the unit to fit on a working cast. With these optimized models, the technician can have confidence that the unit will seat perfectly on the model.
For example, a technician can scan a patient and show them their virtual images to confirm that they like their provisionals. Those images can be digitally sent to the lab along with the printed model. The lab can use this as a reference as they’re finishing the case, enabling them to physically see what the patient approved. This technique improves the quality of the end product.
Surgical guide production is one of the driving factors for 3D printing’s popularity in dentistry. It makes guide production more predictable and makes it safer for patients as well. The process of creating a surgical guide begins with aligning two data sets: the surface scan of the patient’s jaw and the new 3D bone information. After recording this data and aligning the different data sets, the next step is to virtually plan an implant, and then produce the 3D design for the surgical guide. The 3D design helps the dentist visualize the complexity of the surgery and use these insights to create the final restoration.
For many practices, creating 3D splints is a tremendous way to increase production. Producing these digitally brings the cost down and allows for faster production. The fit of the splint in the patient’s mouth can be easily adapted, depending on whether more or less retention is needed. With virtual articulation, the dentist can even reinstate some protective elements that the patient may have lost over time.
One attractive element of virtual articulation is that there are different systems that make it possible to record the patient’s actual jaw movement. Using a virtual articulator with generic settings, it’s possible to use a patient’s pre-recorded motion with an intraoral scanner to help design a restoration of a bite splint that is more effective.
By optimizing the design, the device fits more comfortably in the patient’s mouth. It’s also common to print multiple sets at the same time, so patients can keep them at multiple locations or can have a backup if they lose the original.
For each application, 3D printing offers the ability to know exactly what will be created before actually producing anything permanently. It also helps guide the process toward a better end result, by systematically recording the right information, and sharing it with the patient and with the laboratory. Digital dentistry enables practices to not only perform dentistry at a lower cost, but to do so with better results. Having more predictability makes each step in the process go smoother, and ultimately makes patients and practitioners happier as well.
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