3D Printing in Dentistry

A revolution is underway in dentistry: 3D printing. Today, temporary crowns and bridges are already produced using 3D techniques. Important challenges remain before permanent teeth can be printed.

“It begins with the intraoral scanner that replaces the traditional dental impression,” explained Gil Lavi, Vice President for Sales and Business Development at Roboze, a young Italian 3D printing company. The digital files from these scans are the first step in a digital workflow terminating in a printed dental element.

Today, models, aligners and temporary crowns and bridges are produced using 3D techniques.

Permanent teeth are a much greater challenge, said Lavi, because today’s materials and the medical approvals that are needed for long periods of in-mouth placement are not yet available. And printing ceramics, in the context of dental applications, is still in its early stages and currently not mature enough for printing the final end parts, meaning the final patients teeth.

Nevertheless, Steffen Mueller, General Manager for Dental Solutions at Stratasys, a leading company in 3D printing, sees huge potential for 3D printing in dentistry.

We identified it as a key market and expect it to double by 2020.

Using 3D Printing for Dental Education

This prognosis creates room for new business ideas. Dr. Dirk Mohn, chemical engineer at the renowned ETH Zurich University, put one of them into practice. With Smartodont, a spin-off from ETH Zurich, and the Center of Dental Medicine, University of Zurich, he focuses on using 3D printing for dental education and training.

“The big advantage is that it makes it easier to compare students’ work as all the models are exactly the same and can be reproduced on demand,” explained Dr. Mohn.

Smartodont also trains dentists. Transparent models are used to facilitate analyzing the movements of the dental instrument. Mohn concedes, however, that not all simulations can be conducted with printed models.

Teeth with caries for instance, cannot yet be printed. But I am optimistic that it will be possible in the next five to ten years.

A Challenge to Dental Laboratories?

A common criticism is that 3D printing endangers dental technician jobs. But, as Dr. Mohn pointed out, most printed parts still require manual post-processing.

Still, the introduction of automated digital workflow and 3D printers challenges dental laboratories. Dental technician Markus Dohrn knows why. His digital dental lab in Frankfurt purchased an intraoral scanner and a 3D printer in 2011.

“We were a traditional manual dental lab at that time, but we believed that digitizing would become the breakthrough in dentistry,” said Dohrn. “We wanted to be able to offer the whole production procedure in-house.”

However, his existing clientele were not ready or willing to deliver digital files.

So we needed to change our business model and acquire new clients. This is how we became a digital printing center.

Additional staff with significant IT and dental knowledge was hard to find.

Today, Dental Consulting Dohrn offers training, even for outside technicians. Dohrn is optimistic that this technology will prevail.

But dentists still need to realize that no human can work as accurately as a printer when creating a model. I believe that the attitude of dentists toward 3D printing will change when younger dentists take over in the next 10 to 20 years.

3D Printers Remain Very Expensive

Dentists’ statements show that attitudes to 3D printing differ greatly. Matthäus Gajda, a young dentist specializing in computer aided dentistry, is rather skeptical that the technique will replace man-made dental prostheses. In contrast, Prof. Peter Jöhren, Head of the Dental Clinic in Bochum, Germany, just purchased their first intraoral scanner for the in-house laboratory. Both dentists agree on two issues.

First, the acquisition cost of a 3D printer is still very high. According to Gil Lavi, the entry level solutions start from 6,000€ for small dental labs doing mostly aligner applications and the prices can go all the way up to 500,000€.

Second, the ability to store files digitally and print a model on demand will be the  ultimate solution to the storage problemsfaced by dentists and dental labs. They are now obliged to keep patient dental models for years. Dr. Jöhren explained:

It is a huge task for a dentist to reorganize his workflow from manual to digital. This is what most of us are afraid of.

“But I see one big advantage,” he added. “If digital printing centers opened here and offered good quality products, low-wage countries would no longer be able to undercut local labs. I don’t want to order prostheses from China, but I still want to offer affordable prostheses to patients.”

Still, his biggest concern is that it is too early for teeth out of the printer.”

Before we begin to use 3D printed parts, I want to read long-term studies. And those don’t exist yet.