3D Printing in Prosthodontics: Additive Manufacturing Technology

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3D PRINTING IN PROSTHODONTICS

INTRODUCTION

Technological developments have made significant impact and contributions to


the field of dentistry.

Right from adaptation of lost wax technique in early 20th century for the
fabrication of crowns and bridge to the recent influence of computer aided
design and machining (CAD CAM) technology on digitisation of restorations.
Traditional fabrication of inlays, onlays and crowns uses a multistage process
which involves an indirect technique of an impression followed by laboratory
processing of the restoration. This procedure involves several steps which
increases the possibility of errors in marginal accuracy, time consumed by the
patient as well as the doctor and the treatment costs. As in many other
industries, production stages are increasingly becoming automated in dental
technology.

Principles of subtractive manufacturing have been majorly used by both lost


wax technique and CAD CAM technology .

CAD/CAM systems allow for the production of indirect restorations in a single


visit. These systems use an optical camera to take a virtual impression by
creating a three dimensional image which is forwarded to a software program.
This impression results in a virtual cast on which the restoration is designed.
The software then controls a milling process that uses prefabricated blocks of
restorative material, either ceramic reinforced composite or all-ceramic
material, to produce the restoration. The end result is chair side production of
the restoration.

However, subtractive manufacturing brings with it disadvantage of increased


wastage with removal of excess material and inability of mass production.

ADDITIVE MANUFACTURING TECHNOLOGY

Additive manufacturing on the other hand opens up new avenues for


production of dental restorations. Additive manufacturing according to the
American Society for Testing and Materials (ASTM) is the process of joining
materials to make objects from 3D model data, usually layer upon layer, as
opposed to subtractive manufacturing methodologies. The process of additive
manufacturing works on the principle of taking a 3D computer file and creating
a series of cross sectional slices. Each slice is printed one on top of the other to
create the 3 dimensional object with an advantage of minimal wastage. Today
additive manufacturing can apply for product life cycle from prototyping to full
scale manufacturing. It can be promising as it offers less time, more productive
in terms of mass production thus overall reducing cost being used more in
aerospace and automobile to develop complex geometries.

3D PRINTING OVER CAD CAM TECHNOLOGY

Subtractive methods such as CAD CAM has some limitations in relation with 3
D printing.

1. Large amount of raw material is wasted because of unused portions of the


mono-blocks which are discarded after milling and recycling of the excess
ceramic is also not feasible.

2. Milling tools are prone to heavy abrasion and wear which shortens their
cycling time.

3. Due to brittle nature of ceramic microscopic cracks can be introduced during


the process of machining.

THE MAIN COMPONENTS OF A 3D PRINTER

 3D Printer Frame: Holds the machine together


 3D Printer Head movement mechanics: moves relative to the print bed in
all directions
 3D Printer Head: Nozzle that deposits filament or applies colors and
liquid binder
 3D Build Platform or Build Bed: The part of the printer where the object
is printed
 3D Printer Stepper Motors (at least 4): Used for precise positioning and
speed control
 3D Printer Electronics: Used to drive motors, heat the extruder and much
more
 3D Printer Firmware: Permanent software used to control every aspect of
a 3D printer
 3D Printer Software: Not part of the actual printer but still needed for the
printing process
Here are the nine 3D printing types:

1. Stereolithography (SLA)
2. Digital Light Processing (DLP)
3. Fused deposition Modeling (FDM)
4. Selective Laser Sintering (SLS)
5. Selective Laser Melting (SLM)
6. Electronic Beam Melting (EBM)
7. Laminated Object Manufacturing (LOM)
8. Binder Jetting (BJ)
9. Material Jetting (MJ)

1.STEREOLITHOGRAPHY (SLA) TECHNOLOGY


Stereo lithography was introduced in 1980 by Charles Hull.

SLA is a fast prototyping process. This is a 3D printing process that’s popular


for its fine details and exactness. It works by converting liquid photopolymers
into solid 3D objects, one layer at a time. SLA printing has become a favored
economical choice for a wide variety of industries. Some of these include
automotive, medical, aerospace, entertainment, and also to create various
consumer products.It is used to make implant surgical guides because of high
mechan ical strength, obturators, surgical stents, duplication of prosthesis and
burn stents.

2) DIGITAL LIGHT PROCESSING (DLP) TECHNOLOGY


DLP is the oldest of the 3D printing technologies, created by  Larry
Hornbeck back in 1987. It’s similar to SLA , given that it also works with
photopolymers. Compared to SLA 3D printing, DLP achieves quicker print
times because it exposes entire layers at once. DLP printing technology is that it
is robust and produces high resolution models every time. It’s also economical
with the ability to use cheaper materials for even complex and detailed objects.

3. FUSED DEPOSITION MODELLING

Developed by Schott Crump

It is used mostly for modelling and prototyping applications. This technology


works on the principle of extruding a thermoplastic filament material through a
heated nozzle and the material hardens immediately after extrusion . Materials
such as acrylonitrile butyro styrene ABS, polycarbonates and poly sulfones are
used.

4.BINDER JETTING TECHNOLOGY

The Massachusetts Institute of Technology (MIT) first invented Binder Jetting


3D printing.

Also known as:

 Powder bed printing


 Inkjet 3D printing
 Drop-on-powder
 Binder jetting .

Binder jetting is a 3D printing process that uses two types of materials to build
objects: a powder-based material (usually gypsum) and a bonding agent. As the
name suggests, the “bonding” agent acts as a strong adhesive to attach (bond)
the powder layers together. The printer nozzles extrude the binder in liquid form
similar to a regular 2D inkjet printer. After completing each layer, the build
plate lowers slightly to allow for the next one. This process repeats until the
object reaches its required height.

5. SELECTIVE LASER SINTERING (SLS) TECHNOLOGY


 Dr. Carl Deckard developed SLS technology in the mid-1980s.

It’s a 3D printing technique that uses high power CO2 lasers to fuse particles
together. The laser sinters powdered metal materials .It’s a process that repeats
one layer at a time until it reaches the object’s height. SLS is quite similar to
SLA technology with regards to speed and quality.

Selective laser sintering is used in fabrication of anatomical study models,


cutting and drilling guides, dental models, and also for engineering/design
prototypes. Advantages are ease of autoclavability of the materials used, full
mechanical functionality of the printed objects, lower cost materials if used in
large volume. Disadvantages are powders are messy with increased inhalation
risk, technology is expensive, and significant climatic conditions such as
compressed air are required.

6.SELECTIVE LASER MELTING (SLM) TECHNOLOGY

Invented in 1995.Like SLA , SLM also uses a high-powered laser beam to form
3D parts. During the printing process, the laser beam melts and fuses various
metallic powders together.

As the laser beam hits a thin layer of the material, it selectively joins or welds
the particles together. After one complete print cycle, the printer adds a new
layer of powered material to the previous one. The main difference between
SLM and SLS is that SLM completely melts the powder, whereas SLS only
partly melts it (sinters). In general, SLM end products tend to be stronger as
they have fewer or no voids.

 7.ELECTRON BEAM MELTING (EBM) TECHNOLOGY


A Swedish company ,Arcam AB founded EBM in 1997. This is a 3D printing
technology similar to SLM , in that it uses a powder bed fusion technique. The
difference between the two is the power source. The SLM approach above uses
high-powered laser in a chamber of noble, or inert gas. EBM, on the other hand,
uses a powerful electron beam in a vacuum. EBM’s main use is to 3D print
metal parts. EBM also produces parts that are incredibly strong and dense in
their makeup.The features include:

 It doesn’t need extra auxiliary equipment for the 3D printing process


 It has increased efficiency using raw materials
 Lessens lead times resulting in parts getting to market faster
 Can create fully functional, durable parts on demand for wide-ranging
industries.

8) Laminated Object Manufacturing (LOM) Technology


LOM is a rapid prototyping system that works by fusing or laminating layers of
plastic or paper using both heat and pressure. A computer-controlled blade or
laser cuts the object to the desired shape. Once each printed layer is complete,
the platform moves down by about 1/16th of an inch, ready for the next layer.
The printer then pulls a new sheet of material across the substrate where it’s
adhered by a heated roller. This basic process continues over and over until the
3D part is complete.

9) MATERIAL JETTING (MJ) POLYJET AND WAX CASTING


TECHNOLOGY
also known as wax casting.
.In fact, up until recent times it’s been more of a technique than an actual
printing process. It’s something jewelers have used for centuries. Wax casting
has been a traditional process where the user produces high-quality,
customizable jewelry.  Today, MJ 3D printers produce high-resolution parts,
mainly for the dental and Jewelry industries,

Once the 3D model (CAD file) is uploaded to the printer, the printer adds
molten (heated) wax to the aluminum build platform in controlled layers. It
achieves this using nozzles that sweep evenly across the build area. As soon as
the heated material lands on the build plate it begins to cool down and solidify
(UV light helps to cure the layers). As the 3D part builds up, a gel-like material
helps to support the printing process of more complex geometries. Like all
support materials in 3D printing, it’s easy to remove it afterward, either by hand
or by using powerful water jets. Once the part is complete,no further post-curing
is necessary.

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