3D printing in orthodontics: A narrative review

Abstract

Aim: Digital technology profoundly impacts every aspect of orthodontics, from diagnosis and treatment planning to appliance fabrication. Integrating computer-aided designing tools and rapid prototyping hardware has allowed orthodontic practices and laboratories worldwide to revolutionize their workflows. This narrative review aims to consolidate literature findings regarding the use of three-dimensional (3D) printing technology in orthodontics in terms of its current state of development and availability while also exploring the type of printing technology used, accuracy, and efficiency of its potential use in clinical orthodontics. Materials and Methods: 3D printing in orthodontics has been the subject of a comprehensive electronic literature search from 2010 to 2020 using PubMed and Google Scholar databases with relevant MeSH terms and keywords. Orthodontics, 3D printing, 3D-printing processes, accuracy, precision, and efficiency were used to identify studies for this review. Two calibrated reviewers separately applied inclusion and exclusion criteria to each article. Selected article references were checked to expand the article search. Types of 3D printers, assessment techniques, and examined parameters were considered for data extraction, and qualitative analysis was done for evidence synthesis. Results: The search strategy yielded 108 titles. Thirty-six articles that met our inclusion criteria were included in the qualitative analysis: 20 articles were about cast models, seven about indirect bonding, three about aligners, and six about surgical splint fabrication. The most common 3D-printed device types were models. The most commonly used 3D-printing techniques are stereolithography and digital light processing for orthodontic applications. 3D-printed clear aligners are more precise than thermoformed clear dental aligners. Digital occlusal splint and surgical templates increase accuracy, reliability, and efficiency than a conventional one. Conclusions: A 3D printer can be used by the orthodontist to create an entirely digital workflow. Although the 3D-printing technologies used for orthodontic appliance fabrication have demonstrated equal or superior accuracy to conventional models, there is insufficient evidence to conclude that one type of printing is more accurate and efficient than the others. These findings suggest that conventional impressions and stone models can be eliminated, reducing the amount of storage required in the office and improving practice efficiency, appliance fit, and model reuse. Digital 3D-printed appliances are more accurate, reliable, and efficient than conventional ones. Future research must identify potential 3D-printing technology specific to various orthodontic procedures.