Overview

Precision Dentistry is blooming in a new era of innovation, transforming treatment planning and execution with the bombarding capabilities of 3D-printing adoption. Imagine a world where dental procedures are meticulously customised to each patient's unique anatomy and requirements, kudos to the precision and efficiency of this cutting-edge technology.

Let's delve into how 3D-printing is reshaping the landscape of dentistry, offering unprecedented accuracy, customisation, and patient-centric care

What is 3D-printing?

3D-printing is used to define a manufacturing approach that builds objects one layer at a time, adding multiple layers to form an object. Integrating 3D-printing with precision dentistry allows objects and whole assemblies to be designed digitally. It is used in the production of drill guides for dental implants, the production of physical models for different treatment plans before surgery, manufacturing of dental, craniomaxillofacial and orthopaedic implants along with the fabrication of frameworks and copings for these implants for dental restorations.

How 3D-printing benefits older adults and maxillofacial patients

In the realm of cosmetic dentistry, edentulism stands as a “final marker of disease burden for oral health”. Marked as the inevitable culmination of oral diseases such as dental caries and periodontitis, the condition brings a lifetime disability unless prosthetically rehabilitated for those affected.

3D-printing technology serves as a revolutionary approach empowering precise machine-led fabrication of dental prostheses, beneficial for fully edentulous individuals. This advanced technique not only offers improved retention and mechanical properties but also preserves valuable digital records, proving especially advantageous for older adults with limited access to traditional dental care.

In the new era, 3D-printing is also used for enhancing facial aesthetics during maxillofacial surgeries. Its early intervention in the form of medical modelling in oral and maxillofacial surgeries was used in the creation of study models to provide volumetric image data to a 3D printer to produce exact replicas of the patient's jaws.

According to a study done on maxillo-facial prostheses where the hand-carved prosthetic ears were compared to those created with 3D-printing technology, the latter was found to be superior to the hand-carved prosthetic. Therefore, prosthetic ears and nasal prostheses are made using 3D-printing technology.

Additionally, bony deformities in the form of craniofacial (Le-fort) fractures brought on by trauma or tumour excision are being addressed by implant creation utilizing 3D-printing. Moreover, it is also used to create drilling guides for implant surgeries that facilitate the creation of a virtual 3D plan for doctors to be transferred to the operative site.

3D-printing in the fabrication of brackets has gained enormous popularity in enhancing aesthetics with clear aligners. Metal brackets and wires are no longer necessary to be seen on patients for teeth straightening.

Advantages of 3D-printing

Precision dentistry with the adoption of digitalised 3D-printing, is perhaps the most disruptive innovation in dentistry to date. The rapid development of digital dentistry over the past several decades has enabled clinicians to improve patient care significantly.

3D-printing seems to have an edge over traditional methods/materials, comparatively increasing the speed of design and creation; increasing the convenience or simplicity of the whole manufacturing process; and making restorations and appliances more customized and user friendly generating a perfect fit for the patients. The application of this technology offered high quality, professionalism and financial gain, as well as a continual rise in "new" and contented patients.

Moreover, 3D-printing in dentistry has increased productive capacity paradoxically. It has re-established the "value proposition" by way of digitalisation. Higher-quality material is now produced with lower product costs (lab fees). To address market competition negotiating their profitability and very existence, laboratories were forced to invest in digital technologies.

In terms of demand-side value, dentists today enjoy lower costs for their lab prosthetics, since digitalisation has replaced human labour, which is expensive in contrast to machines that can be bought for a fixed price, are reliable, faster, and can produce more in equivalent timeframes in higher volumes and fewer remakes.

Moreover, digitalised intraoral scanners offer an affordable starting point for dentists to fully integrate with new workflow models, closing the digital divide in their lab. Therefore, despite the initial financial outlays for digitalization with 3D-printing manufacturers, dental entrepreneurs see better profitability.

Many dentists are scanning an increased number of patients as part of their secure dental records, improving diagnostics, monitoring patient conditions over time, and enhancing patient communications. This has resulted in increased patient care in terms of workflow, convenience, and consistency. Patients are offered same-day treatment which is more cost-effective. Patients can rightly expect medical/dental services to be planned for and made with precision using digital imaging and virtual design.

Disadvantages

3D printing is a dynamic field, hence the materials in use are always changing. However, the adoption of 3D printing in dentistry faced three great challenges. The first challenge was whether the prosthesis was robust enough, especially for posterior teeth. The creation of restorations that seemed as natural as the original tooth posed the second challenge.

The final challenge was making dental treatment easier, quicker, and more accurate. This was revolutionized with the introduction of monolithic layered zirconia restorations. Revolutionized monolithic zirconia is highly popular due to its high ceramic strength and is advantageous for molar applications.

It can be luted with conventional cement or adhesive resins and is economical and reasonably aesthetic. Apart from zirconia, materials that can be manufactured using this approach currently include metals, porcelain, lithium disilicate, and resin materials. Glass-based restorations can also be manufactured using 3D-printing.

In terms of the supply side chain, the transition to digitalized 3D-printing dentistry has its consequences. Competition from offshore labs, dentists' downward pressure on laboratory fees due to declining reimbursements, increasing costs of adoption, upward pressure on laboratory labour costs, and a shrinking skilled labour pool were serious challenges to the profit structure for laboratories. To maintain and even increase profitability, lab businesses had to serve at a lower cost while simultaneously maintaining or even increasing the value of their services.

Understanding 3D-printing technology

The 3D printing process involves integrating CAD/CAM technology capturing non-digital data through digital impressions, converting them into a computerized format, editing as necessary, and subsequently converting them back into a physical format with the accurate dimensions and raw materials criteria specified during the digital design process.

Intra-oral scanners, a form of non-contact scanners, are used to digitize a patient’s dentition, avoiding the need for either a physical impression or a plaster study model. Once in a digital form, the structures inside the oral cavity will be displayed as a 3D image. CAD software is used to alter the size and shape of the restoration digitally.

Social implications of the big transition

Embarking on the journey of integrating 3D-printing into clinical practice unveils a diffusion-dissemination-implementation continuum: diffusion outlines the passive, untargeted, and unplanned spread of new practices; dissemination is the active and organized spread of new practices to a targeted audience; and implementation of the process of initiating new practices within a similar setting.

Although 3D-printing is now better established and less technically complex than a full-blown Computer Integrated Manufacturing (CIM) system, nevertheless for many firms the experience of implementing 3D-printing, can still prove to be technically problematic and the integrating potential of the technology is not necessarily easily achieved.

Changes in organizational-setup

Market competition for productivity gains resulted in early investments in 3D-printing technology. Concise networking and shift-working were introduced for effective utilization of the resources. Since the majority of people in the companies were making the transition from manual systems at the same time, there was a time lag in the transition, for instance, only new designs put through 3D-printing were focused on within the system, which left a residue of work still need to be done on old boards.

Furthermore, employees who were typically older would find their position increasingly marginalised from the mainstream work of the office, depending upon the pace of change in the different firms.

Financing change

Technological innovations like 3D-printing represent a major capital investment for an organization, which normally requires main board approval. Stakeholders' and investors' approval is also equally important for its adoption.

Recent advancements

Recent advancements with the introduction of AI in 3D-printing have made a significant impact on the medical device manufacturing industry. The FDA has authorized over 520 AI-enabled medical devices since 1995, many of which are based on machine learning.

Machine learning algorithms are now used to improve the performance of prosthetic devices over time as they receive more data and can interpret huge amounts of medical data quickly and accurately, simplifying the identification of patterns and trends. For instance, vibrating prosthetic devices are used to send signals to the brain, and machine learning algorithms are used to improve the quality of these signals.

AI tools have also provided new ways to improve the way we learn and research the technology behind how we use CAD and CAM to scan, design, and manufacture prosthetic and orthotic devices. Advanced digital image sensor technologies are being used to give medical professionals insights into each patient's health status, revolutionizing diagnostic medicine.

Summary

In the dynamic realm of precision dentistry, 3D printing is reshaping the way treatment planning and execution are designed, offering unparalleled accuracy, customization, and patient-centric care. Dental care is meticulously tailored to each patient's unique needs, all thanks to the precision and efficiency of cutting-edge 3D printing technology.

Future integration with AI can serve as a potentially transformative journey into the future of dental innovation.