Effect of wall thickness of 3D-printed models on resisting deformation from thermal forming in-office aligners.

Abstract

Fabricating clear aligners by thermoforming three-dimensional printed dental models requires a high degree of accuracy. It is unknown whether model thickness affects the accuracy when used to thermoform aligners. This research utilizes three-dimensional printed models made with differing wall thicknesses to determine its effect on their ability to withstand deformation during aligner fabrication. A total of 50 models of different wall thickness (10 each of 0.5, 1.0, 1.5, 2.0 mm, and solid) were printed using model resin (Model V2, Formlabs) on a low-force stereolithography printer (Form 3B, Formlabs). Aligners were then fabricated using a thermal pressure forming machine (Biostar V, Great Lakes Dental Technologies) utilizing 25 s cycles to adapt 0.030″ acrylic sheets (Invisacryl, Great Lakes Dental Technologies), then removed from the models and sprayed with a contrast powder (Optispray, Dentsply Sirona) to aid in scanning with an intraoral scanner (CEREC Primescan, Dentsply Sirona). Each aligner's data was then compared to the original file used for printing with 3D comparison software (Geomagic Control X, 3D Systems). The results show model thickness greater than or equal to 2.0 mm produced clinically acceptable results within the margin of error (0.3 mm). A total of 0.5 mm thickness failed to withstand thermal forming in 4 of the 10 trials. A total of 0.5 mm produced 27.56% of results in tolerance, 1.0 mm produced 75.66% of results in tolerance, 1.5 mm had 80.38% of results in tolerance, 86.82% of 2 mm models were in tolerance, and solid had 96.45% of results in tolerance. Hollow models of thicknesses 2.0 mm and solid models produced clinically acceptable aligners while utilizing less resin per unit compared to solid models, thus being more cost effective, time efficient and eco-friendly. Therefore, a recommendation can be made to print hollow models with a shell thickness of greater than 2.0 mm for aligner fabrication.