SUMMARY
Three-dimensional (3D) printing is a rapidly developing technology that has gained widespread acceptance in dentistry. Compared to conventional (lost-wax technique) and subtractive computer numeric controlled methods, 3D printing offers process engineering advantages. Materials such as plastics, metals, and ceramics can be manufactured using various techniques. 3D printing was introduced over three decades ago. Today, it is experiencing rapid development due to the expiration of many patents and is often described as the key technology of the next industrial revolution. The transition to its clinical application in dentistry is highly dependent on the available materials, which must not only provide the required accuracy but also the necessary biological and physical properties. The aim of this work is to provide an up-to-date overview of the different printing techniques: stereolithography, digital light processing, photopolymer jetting, material jetting, binder jetting, selective laser sintering, selective laser melting, and fused filament fabrication. Additionally, particular attention is paid to the materials used in dentistry and their clinical application.
The presented workflow is feasible for any dental educational institution who has access to a CBCT unit and a stereolithographic printer. The accuracy of the printing process is suitable for the production of tooth replicas for endodontic training. Undergraduate students favoured the availability of these replicas and the fairness they ensured in training due to standardization.
Objectives The aim of this study was to investigate the accuracy of CAD/CAM-fabricated bite splints in dependence of fabrication method (milling vs 3D printing), positioning (horizontal vs vertical), selection of material, and method of deviation measurement. Materials and methods Bite splints were 3D-printed in either horizontal or vertical position (n = 10) using four different resins (Dental LT, Ortho Clear, Freeprint Splint, V-Splint). As control, ten bite splints were fabricated by CNC milling (ProArt CAD Splint). The splints were scanned and deviations between the CAD-file (trueness) and between each other within one group (precision) were measured by two different software applications and methods (cloud-to-cloud vs cloud-to-mesh). Data were analyzed using univariate analysis, Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. Results The highest impact on accuracy was exerted by the selection of the material (trueness: η P 2 = 0.871, P < 0.001; precision: η P 2 = 0.715, P < 0.001). Milled splints showed the highest trueness (P < 0.01) but not the highest precision at the same time. Horizontally positioned 3D-printed bite splints showed the least deviations in terms of trueness while vertical positioning resulted in the highest precision. The cloud-to-cloud method showed higher measured deviations than the other methods (P < 0.001-P = 0.002). Conclusion Milled splints show higher trueness than 3D-printed ones, while the latter reveal higher reproducibility. The calculated deviations vary according to the measurement method used. Clinical relevance In terms of accuracy, milled and 3D-printed bite splints seem to be of equal quality.
For a reliable bond of CAD/CAM resin composites to the luting composite, air abrasion and a special pretreatment strategy are necessary in order to achieve promising long-term results.
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