The Next Big Thing in Dentistry is 3D Printing

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Written by Dr. John Flucke, Chief Dental Editor and Technology Editor for Dental Products Report

3D printing is poised to make a huge impact in our profession, similar to the arrival of artificial intelligence.  In the last year, artificial intelligence has taken dentistry by storm.  However, in the years preceding its arrival, it was developed and fine tuned under the radar of most practitioners.

3D printing is at a similar spot right now.  Many dentists are aware of the existence of 3D printing, but haven’t really seen many practical applications until recently.  In the next 12-18 months, the technology of 3D printing will change dentistry in incredible ways.  Whenever a new and game changing technology comes to market there is a fairly predictable ‘adoption curve’ sometimes referred to as the ‘technology adoption lifecycle’.

The cycle is a bell shaped curve that is normally represented by five groups.

1. Innovators – people who see promise and are willing to struggle to learn.  Usually these are people who know using a new technology will be difficult and results may initially be disappointing
2. Early adopters – people who understand a technology is maturing and can expect good results with much less effort than Innovators
3. Early majority – people who enter into a technology knowing that it has proved itself and is a reliable solution
4. Late majority – people who realize a technology has gone mainstream and realize that failure to adopt it will leave them behind
5. Laggards – people who are very conservative in their adoption and realize they are behind.  They move to keep up.

I mention this because the use of 3D printing has been building over the last 5 years and is poised to be leaving the early adopter phase soon.  Many doctors are aware of the technology but have been hesitant to enter the market thinking that it is a niche product or that there are simply not enough uses for mainstream dentistry.

However, the entire product category of 3D printing has evolved immensely in the last few years and now practical applications for 3D printed materials abound.  I predict that in 10 years the concept of the “dental office laboratory” will join the concept of the “dental office darkroom”.  Just like digital radiography eliminated films and chemistry, digital printing will eliminate the need for plaster, stone, mixing bowls, and model trimmers.

3D printers are faster, more accurate, and easier to use than their analog counterparts and don’t create near the mess.  Most dental offices keep their lab area behind closed doors… and for good reason.  The materials create a mess and no lab is the kind of place we want to ‘show-off’ to our patients.

I’ll be the first to say that tidiness is not a solid reason to move to 3D printing, yet I am a big believer in moving in that direction.  Statistics say that more than 30% of offices are now using an intraoral scanner and the adoption of scanners fits well with printing.  Being able to go directly from scanning to fabricating appliances allows an office to have a truly digital workflow and 3D printers can fabricate a variety of things.  These include (but are not limited to):

• Bleaching trays
• Models
• Occlusal guards
• Implant surgical guides
• Orthodontic retainers
• Custom transitional partial dentures
• Temporary restorations for full arch or full mouth rehabilitation

When you consider how much time and energy goes into creating those simple, everyday products, 3D printing is a terrific option.  I feel it’s also important to bring up one technical detail to help with decision making. 3D printers work in a way similar to composites, in that they are light cured using a specific wavelength of light. There are currently two wavelengths being used in 3D printing.  They are 385nm and 405nm.

Again, similar to composites, 3D resins are cured in layers.  The 385nm printers deliver better precision, faster results, create more transparency when creating a ‘clear’ appliance, and is the wavelength where the market is migrating to. Also, not all resins work in all printers, wash, and curing units; so printer and resin selection & validation is critical.

Another point that I think should be made is how easy these projects are to create.  Many doctors are concerned with learning new systems and trying to integrate those into the normal practice operating system.  Confusion in this realm can be incredibly reduced in a couple of different ways.  The first is to find a company that offers a ‘turn-key’ system for 3D printing.  Some companies sell 3D printers, but don’t sell the design software.  Some only sell resins.  That means the doctor has to spend more time evaluating multiple vendors and it slows down the decision making process.

A company such as DMG America sells a complete system that offers everything to begin integrating 3D printing into your practice.  This also helps streamline things from a support perspective.  When a hiccup occurs, having ONE company to contact for EVERY step of the process makes integration easier and less stressful.  Whether it is design, resin choice, printing, washing, post-curing, or finishing, having only one vendor to contact makes things easier.  Also, knowing that each piece of the workflow has been validated to work with every other piece, allows the doctor to begin 3D printing with greater confidence.

Doctors are also concerned with finding the time in an already busy schedule to sit at a computer designing things when their time could be better spent treating patients.  The answer to that is to include your staff as your office integrates anything new, but especially 3D printing.

Just like most doctors don’t create their own occlusal guards, there is no reason for a doctor to spend their time designing.  If you haven’t ever explored 3D printing or even if you have, but haven’t lately, you’ll be amazed at the way digital design has evolved.  There is no longer any need to wait two weeks for an occlusal guard to come back from the lab or a few days for the staff to make bleaching trays.  It’s not uncommon to print and deliver on the same day.

Many companies now on the market offer design software that is aided by artificial intelligence.  This makes designing fast and predictable.  In many cases a few mouse clicks is all that is needed to move from start to finished appliance.  This can help the doctor transition many tasks from a commercial lab to in-office fabrication by letting the majority of cases be handled by a qualified dental assistant.

As we all know, in the post-pandemic world it is difficult to keep good employees.  Many assistants have a desire to learn more and to do more.  By incorporating the team into the process, more gets done and job satisfaction goes up.  Often when delivering something we have created in the office, I make a point to let the patient know the team member assisting me was the one that created it.  This lets the patient know about our commitment to better treatment through technology and also gives the assistant credit for their hard work since many patients truly don’t understand how important our assistants are to their care.

However, for some busy offices, delegating may be difficult.  For those offices there are several digital design services.  These ‘digital dental labs’ allow you to send them the case directly from your digital scanner.  They can then create the file needed and send it back to the dental office where that file can then be sent to the printer and created in-office.

When it comes to quality, digital provides incredible fit and function.  Many printers can create projects with an accuracy of 50 microns and pairing that with the similar accuracy of a digital scanner, projects go to place easily and function as expected.  Manufacturers have created resins for practically every application imaginable and those resins work as well or better than the traditional analog materials we have used for decades.

If you have not yet moved to 3D printing in your office, the time to explore this incredible technology is now.  Dentistry is right on the brink of another game changing technology that is reliable, high quality, easy to use, and provides outstanding clinical outcomes.  This is definitely an opportunity you don’t want to miss.

 

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