This document discusses additive manufacturing (3D printing) technologies and their applications in dentistry. It provides definitions of additive manufacturing and describes several common 3D printing techniques like material jetting, binder jetting, digital light processing, laser sintering, and fused deposition modeling. It also discusses how these techniques can be used to create dental models, surgical guides, crowns, bridges, and implants as well as applications in endodontics, periodontics, and prosthodontics. The document traces the history of 3D printing and provides an overview of its use in dentistry.

2. Dr P. S. Prabu MDS
Malabar Dental College & Research
Centre

5. A change according
the modernization

6.  Introduction
 Defintion
 History
 Synonyms
 Uses in dentistry
 Fundamentals of 3d printing
 At one glance
 Currently available AM Technologies
 Description of some AM Technologies
◦ Material jetting
◦ Binder jetting
◦ Digital light processing
◦ Laser sintering technique
◦ Fused deposition modelling
◦ Robocasting
◦ electron bean melting
◦ Sheet lamination and directed energy
depostion
 Applications
◦ Prosthoodntics
◦ Endodontics
◦ Periodontics
Bioprinting
CONCLUSION
References

7.  Created by laying down successive layers of material.
 Rapid prototyping, is a mechanized method
 3D objects quickly reasonably sized machine computer ---blueprints for the
object.
 Exciting to nearly everyone.
 Inkjet technology
saves time
cost by

8.  Complete model in a single process.
 The basic principles include materials cartridges, flexibility of output, and
translation of code into a visible pattern.
 3D Printers are machines that produce physical 3D models from digital data by
printing layer by layer.
 It can make physical models of objects either designed with a CAD program or
scanned with a 3D Scanner.
 Variety of industries including
◦ jewelry,
◦ footwear,
◦ industrial design,
◦ architecture,
◦ engineering and construction,
◦ automotive,
◦ aerospace,
◦ dental and medical industries,
◦ education
◦ consumer products.

9.  It is a process in which multiple layers of materials are
added one by one under computer control to create 3 D
objects

10.  The first 3D printer as invented by Hideo kodama of Nagoya , japan.
 In 1984, Charles hull of 3D systems corporation further refined the
process and named and stereolithography.
HISTORY

11.  similar technologies such as Fused Deposition Modeling
(FDM) and Selective Laser Sintering (SLS) were introduced
 In 1993, Massachusetts Institute of Technology (MIT)
patented another technology, named "3 Dimensional Printing
techniques", which is similar to the inkjet technology used in
2D Printers.
 In 1996, three major products, "Genisys" from Stratasys,
"Actua 2100" from 3D Systems and "Z402" from Z
Corporation, were introduced.

12.  As the technology developed it encompassed a wider variety
of technologies and materials including metals,
waxes,polymers , paper , ceramics , etc.
 By 2000, the umbrella term additive manufacturing (AM)
technologies was used to describe all processes involving the
CAD based production of objects through sequential layering.

13. Other terms are:
 three-dimensional printing,
 desktop manufacturing,
 rapid manufacturing,
 additive fabrication,
 additive layer manufacturing,
 layer manufacturing and
 freeform fabrication,
 rapid prototyping, etc.

14. Using data from oral scans and CAD designs, 3D printing can be used to produce
 .

15. The fundamentals of additive manufacturing includes
 Scan data input
 Computer –aided design
 Computer aided (additive ) manufacturing

16.  3D printable models may be created with a computer aided
design (CAD ) package or
 via a 3D scan of the mouth, impression or model.
 CT or MRI data can also be used.
 The computer corrects errors in the scan data called fix- up.
 The 3D model which is in .skp,. dae,.
 3Ds or some other formats that needs to be converted to either
a. STL or a .OBJ format,
 to allow the printers software to be able to read it.

17.  The STL file needs to be processed by a piece of software called a “slicer”
 Which converts the model into a series of thin layers and produces a G-
code files containing instructions for the specific type of 3D printer used.
 The 3D printer follows the G-code instructions to lay down successive
layers of liquid, powder, binder, paper or sheet material to build the model
from a series of cross sections.

19. Material
extrusion
Fused filament fabrication
(FFF) also called fused
deposition modelling
(FDM)
Robocasting
Thermoplastics (eg. PLA, ABS, HIPS, nylon),
HDPE, metals, edible materials, rubber
(sugru), modelling clay, plasticine, RTV
silicone, porcelain, metal clay, etc
Ceramic metal alloy, cermet, metal matrix
composite, ceramic matrix composite
TYPES TECHNOLOGIES MATERIALS

20. Powder bed fusion Direct metal laser sintering
(DMLS)
Electron beam melting (EBM)
Selective laser melting (SLM)
Selective laser sintering (SLS)
Almost all metal alloy
Almost any metal alloy
including titanium
Titanium, cobalt chromium,
stainless steel.
Thermoplastics, metals,
ceramics, glass
TYPES TECHNOLOGIES MATERIALS

21. Binder jetting Binder jetting
Plaster based 3D printing
(PP)
Polymer, ceramic
materials, metals
Plaster
Material jetting Material jetting (u-v) Wax, plastics (PMMA)
Sheet lamination Laminated object
manufact-uring (LOM)
Paper, metal, foil, plastic
film
VAT-based Stereolithography (SLA) Photopolymer

22. photopolymerization
Digital light processing
(DLP)
Continuous liquid interface
production
Digital light processing
(DLP)
Continuous liquid interface
production
Direct energy deposition Electron beam free form
fabrication (EBF3)
Laser cladding
Laser engineered net shaping
(LENS)
Direct metal deposition
(DMD)
Almost any metal alloy in
wire form
Almost any metal alloy in
powder form
Almost any metal alloy in
powder form
Almost any metal alloy in
powder form

23. DESCRIPTION OF SOME ADDITIVE
MANUFACTURING (AM) TECHNOLOGIES

24.  Material jetting is a 3D printing process whereby the actual build materials (in
liquid or molten state) are selectively jetted through multiple jet heads (with
others simultaneously jetting support materials).
 The materials tends to be liquid photopolymers, which are cured with a pass
of uv light as each layer is deposited.
 Material jetting is the only additive manufacturing technology that can
combine different print materials within the same 3D printed model in the
same print job.

26.  In binder jetting, the material being jetted is a binder.
 It is selectively sprayed into a powder bed to fuse it a layer at a time to
create the required part,
 As is the case with other powder bed systems, once a layer is completed,
the powder bed drops incrementally and a roller or blade smooths the
powder over the surface of the bed, prior to the next pass of the jet heads

28.  A similar process to stereolithography in that it is a 3D printing process that works
with photopolymers.
 The major difference is the light source.
 DLP uses a more conventional light source, such as an arc lamp,
◦ with a liquid crystal display panel or a deformable mirror device,
◦ which is applied to the entire surface of the of photopolymer resin in a single
pass, generally making it faster than SL.
 One advantage of DPL over SL -shallow vat of resin is required
 So less waste and lower running costs.

30.  SLS is an additive manufacturing technique that
 uses a high power laser (for example, a carbon dioxide laser)
 to fuse small particles of plastic, metal (direct metal laser sintering),
 ceramic or glass powders into a mass that has a desired 3-dimensional
shape).

32.  Laser sintering and laser melting are interchangeable terms that
refers to laser-based 3D printing process that works with
powdered materials.
 The laser is trased across a powder bed of tightly compacted
powdered material.
 As the laser interacts with the surface of the powdered material it
sinters,or fuses,the particles to each other forming a solid.
 As each layer is completed the powder bed drops incrementally
and a roller smooths the powder over the surface of the bed prior
to the next pass of the laser for the subsequent layer to be formed
and fused with the previous layer.
 The built chamber is completely sealed as it necessary to
maintain a precise temperature during the process.
 Once finished,the excess powder is removed to leave the ‘printed
‘parts.

33.  Because of the high temperatures required for laser sintering,cooling times
can be considerable.
 Furthermore,porosity has been a issue with this process,
 and while there has been significant improvements towards fully dense
parts,
 some applications still necessitated infiltration with another material to
improve mechanical characteristics

34.  3D printing utilizing the extrusion of thermoplastic material is
probably the most common and recognizable 3D printing process.
 Fused filament fabrication( FFF) .
 The process works by melting plastic filament that is deposited,
 via a heated extruder, a layer at a time,
 onto a build platform.
 Each layer hardens as it is deposited and bonds to the previous layer
 . System have evolved and improved to incorporate dual extrusion
heads.

36.  Robocasting or direct ink writing (DIW) is an additive
manufacturing technique in which a filament of ‘INK’is extruded
from a nozzle, forming an object layer by layer.
 The technique was first developed in the united state in 1996 as
a method to allow geometrically complex ceramic green bodies
to be produced.
 A fluid (typically a ceramic slurry), referred to as an ‘INK’ , is
extruded through a small nozzle, drawing out the shape of each
layer of the CAD model.
 The ink exits the nozzle in a liquid like state but retains its shape
immediately, exploiting the rheological property of shear
thinning.
 It is distinct from fused deposition modelling (FDM) as it does
not rely on the solidification or drying to retain its shape after
extrusion.

37.  To date the most researched application for robocasting is in the production
of biologically compatible tissue implants (bioprinting).
 Lattice structures can be formed quite easily which allow bone and other
tissues in the human body to grow and eventually replace the transplant.
 With various medical scanning techniques the precise shape of the missing
tissue is established and input into 3D modelling software and printed

39.  developed by Swedish company Arcam.
 very similar to the direct metal laser sintering (DMLS) process in
terms of the formation of the parts from metal powder.
 The key difference -heat source
 , which necessitates that the procedure is carried out under
vacuum conditions.
 EBM has the capability of creating fully-dense parts in a variety
of metal alloys, even to medical grade, and as a result the
technique has been particularly successful for a range of
production application in the medical industry, particularly for
implants.
 other hi-tech sectors, such as aerospace and automotive have also
looked to EBM technology for manufacturing fulfilment.

41.  Sheet lamination processes include ultrasonic additive
manufacturing (UAM) and laminated object manufacturing
(LOM).
 The ultrasonic additive manufacturing process uses sheets
or ribbons of metal, which are bound together using
ultrasonic welding.

43.  (DED) covers a range of terminology like a laser engineered
net shaping, direct light fabrication, direct metal deposition,
3D laser cladding it is a more complex printing process
commonly used to repair or add additional material to existing
components.
 In this class of technology metal or alloy powder is actually
deposited on the work surface and sintered or melted using
various means.

45.  MFP

48.  3dMD face™ system (3dMD, Atlanta, GA) records
the impression of soft tissue digitally creating a 3D
surface image without contacting the impression area.
 No discomfort to the patient
 No distortion to the soft tissue.

49.  In 2003, Wolfaardt et al. suggested rapid
prototyping as an adjunctive tool in digitally
designing maxillofacial prosthesis in head and neck
construction.

50.  Nasal prosthesis should be
for both cosmetic purpose
and functional.
 Intra anatomy airway
replicationdesign.
 Reduces chances of
displacement of prosthesis.
 It also maintains voice resonance.
 Intra anatomy designs with its bone-like alloplastic
removable implant act as a retentive scaffold.

51.  Laser scanning, computer-aided
design/computer-aided manufacturing, and rapid
prototyping technique.
 Restores esthetics till the patient receives a definitive
prosthesis.

54. lace

61. 
 .

65. Maxillary working model.
Maxillary working model
with acrylic base and wax
rim.

68. 144 QDT

69. 10

71. 17h

73.  The first step in guided implant surgery is to run a cone beam scan on the
patient, which provides a wealth of information on the bone, bone density,
soft tissue, location and nerves
 The DICOM file, or rendering of the patient’s anatomy, is integrated into a
guided surgery software program.
 There, the clinician and/or dental technician can virtually place an implant
and run a series of tests to ensure its best location outcomes.
 An impression of the patient’s mouth is captured, either digitally with an
intraoral scanner or with the analog PVS method, from which a model is
created and scanned.

75.  This creates an optical
scan that provides an STL
file that can quickly and
simply be overlaid
 onto the DICOM (cone
 beam) file and provide a
 comprehensive STL file
 to be imported in to the
guided surgery software.
 The clinician chooses the
type of implant system
and the implant size.

78.  Medical uses for 3-D printing can be categorized into three segments.

 • Bioprinting tissue and organ;

 • Creation of customized prosthetics, implantable devices and medical models

 • Pharmaceutical drug dosage forms delivery and
 discovery.

79.  In fact, the field of oral and maxillofacial surgery has sought to
apply a simple rudimentary form of 3D printing technique for a long
time.
 Use of 3D-printed rapid prototyped models before oral cancer
surgery or orthognathic surgery for treatment planning and
simulation has been established to assure more precise and safe
surgeries
 easier production of customized and reconstruction plates and
morphologic reconstruction of bony defect areas are possible uses of
3D printing in fracture surgery or reconstructive surgery
 Moreover, surgical stents are fabricated using computed
tomography (CT) images in the field of dental implantology

82. following applications:
 guided endodontic access- Access guides were printed and
utilized to target burs to otherwise elusive canal spaces
without perforation.
 autotransplantation,
 Educational models and clinical simulation



83. Planning of a directional guide.
A cylinder is used to depict the
direction of the drill necessary
to locate the root canal system.
Other cylinders are
automatically aligned with the
directional cylinder. Those
cylinders are used for the
design of the directional guide.

84.  (b) The final directional guide design.
 After the rapid prototyping of the guide a metal tube is placed in the corresponding hole.
 The metal tube has an inner diameter that is slightly larger than the bur used during the
location of the root canal system.
 (c) The directional guide in place, whilst a bur is used to gain access to the canal system.
 As can be seen, the direction of the bur is not exactly parallel to the long axis of the
tooth during preparation.
 This coincides with the 3D planning
 (d) Working length radiograph after the root canal system had been located with the aid
of a directional guide.

86.  computer aided rapid prototyping (CARP) was used to print
replicas of teeth such that manipulation of the recipient bone
sites could be completed prior to extraction of the transplanted
teeth without PDL damage from repeated insertion and
removal

91.  Three dimensional (3D) bioprinting is the utilization of 3D printing
techniques to combine cells, growth factors, and biomaterials to fabricate
biomedical parts that maximally imitate natural tissue characteristics.
 Generally, 3D bioprinting utilizes the layer-by-layer method to deposit
materials known as Bioinks to create tissue-like structures that are later
used in medical and tissue engineering fields.

93. Advantages :
1. Creating detailed biomimetic 3D structures.
2. Ability to imitate the extracellular matrix (ECM).
Disadvantages:
1. The availability of biomaterials with the stability and desired
properties for 3D printing of scaffolds is restricted depending on
the printing technology used.
2. Production time that it takes to fabricate scaffolds,which
dramatically increases as the scaffold design becomes more
precise

95.  A clinical report shows an early application of a
 directly printed silicone prosthesis for the rehabilitation of a
nasal defect.
 Two extra oral scanning systems were used to capture the face
and the defect.
 The virtual construction of then asal prosthesis was performed
with free-form software.
 Two prostheses were printed in silicone and post-processed by
manual sealing and coloring.
 The clinical outcome was acceptable for an interim prosthesis

96.  Did a study on 3D-PRINTED MEMBRANE FOR GUIDED
TISSUE REGENERATION
 A soft membrane composed of gelatin, elastin and sodium
hyaluronate is fabricated by 3Dprinting.
 The method has produced a soft membrane with well-defined
and varied pore structures atdifferent layers.
 The optimized membrane is suitable for guided tissue
regeneration due to its different pore structures on different
sides

97.  Did a research on evaluation of dimensional changes of 3D
printed models after Sterilization: A pilot study
 He concluded that sterilization of dental objects to be used in a
clinical setting may lead to deformation of the printed model,
especially for heat sterilization

98.  Done a review on Recent advances in the reconstruction of
cranio-maxillofacial defects using computer-aided
design/computer-aided manufacturing .
 And concluded by selecting the appropriate design method,
manufacturing process, and implant material according to the
case,
 more accurate procedure,
 reduced surgical time,
 prevention of various complications.

99.  Did a research on 3D Printed Surgical Simulation Models as
educational tool by maxillofacial surgeons
 The study demonstrated that 3D printing with inexpensive
printing filaments is a promising method for training oral and
maxillofacial surgery residents or dental students in selected
surgical procedures.
 With a simple and cost-efficient manufacturing process,
models of actual patient cases can be produced on a small
scale, simulating many kinds of surgical procedures.

100.  Using virtual ridge augmentation and 3D printing to fabricate
a titanium mesh positioning device
 Digitally designing the guided bone regeneration based on the
final prosthetic outcome can allow the clinician to precisely
augment a defect.
 The ability to 3D print a model also allows the clinician to
perform a model-based surgery in order to preform the TiMe
and fabricate a positioning jig to aid in placement and
stabilization of the membrane.

101.  Developments in science and technology might look fictional
but it could impedingly disrupt our future.
 Though the experiments are in a naïve phase, additive
manufacturing technology has potential in terms of cost,
productivity and time.
 Mechanical testing and evidence of its efficacy are more
needed to explore for dental applications.

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