3D-printed ceramics show promise for dental restorations

Dental Tribune International

Fri. 14. February 2025

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AMSTERDAM, Netherlands: Additive manufacturing is gaining traction as an alternative to milling for fabrication of ceramic restorations. However, experimental and clinical data on the mechanical properties and overall performance of 3D-printed ceramics remain limited. A recent systematic review has provided new insights into this issue and reported significant improvements in the mechanical properties of 3D-printed ceramics. However, the authors have cautioned that factors such as long-term reliability, the impact of printing layer orientation and overall clinical performance require further investigation.

Milling has several limitations, including restricted ability to replicate intricate geometries, significant material wastage, potential formation of microcracks that weaken restorations and frequent wear of milling tools. Additionally, milling offers limited efficiency in mass production. 3D printing, however, offers the ability to produce complex geometries with greater efficiency while reducing material waste. Despite these advantages, the application of ceramic materials in 3D printing remains limited. A primary concern is the mechanical performance of 3D-printed ceramics, as their clinical success depends on factors such as initial strength and resistance to humidity, fatigue and occlusal wear in the oral environment.

“The rapid advancements in additive manufacturing for dental restorations, particularly ceramics, prompted my team to explore the topic further. With the growing interest in 3D-printing technologies, we aimed to evaluate whether 3D-printed ceramics could match or even exceed the mechanical properties of conventionally produced ceramics. Ultimately, our goal is to develop durable, long-lasting restorations for our patients,” co-author Dr João Paulo Mendes Tribst, head of the section of restorative and reconstructive oral care at Academic Centre for Dentistry in Amsterdam, told Dental Tribune International.

The systematic review included 40 studies examining ceramic materials such as zirconia, alumina, alumina–zirconia composites, lithium disilicate, porcelain and fluorapatite glass-ceramic. Researchers evaluated the mechanical properties of 3D-printed ceramics based on material type and processing technique, focusing on key factors such as density, flexural strength, fracture toughness, Young’s modulus, hardness and overall performance. Additionally, the studies examined common processing defects, including porosity, agglomerates, cracks and surface roughness.

Mechanical properties show improvement but reliability issues persist

The findings indicate a general improvement in the mechanical properties of 3D-printed ceramics, bringing them closer to the performance of milled ceramics. However, the authors of the review noted that 3D-printed ceramics still exhibit less reliability compared with milled ceramics. The mechanical properties of the ceramics also varied greatly depending on the specific 3D-printing technique, composition of the material and post-processing treatments used. Among the materials studied, 3Y-TZP emerged as the most developed and studied 3D-printed ceramic.

Co-author Dr João Paulo Mendes Tribst believes that 3D-printed ceramics could become a viable alternative to milling. (Image: João Paulo Mendes Tribst)

“We observed an upward trend in mechanical strength across various ceramic materials, including zirconia, alumina, lithium disilicate and glass-ceramics. However, we identified significant defects in 3D-printed restorations not present in milled ones, such as porosity, cracks and layer orientation issues, which affect fatigue performance. Therefore, it is important to consider how the restoration will be produced based on its intended use in the mouth,” Dr Tribst explained.

“Our findings suggest that 3D-printed ceramics hold great potential for dental restorations, particularly for customised prostheses. With further improvements in processing techniques, they could become a viable alternative to milling, offering greater design flexibility while reducing material waste,” Dr Tribst said.

The study concluded that, while additive manufacturing presents exciting opportunities for advancing dental restoration techniques, further research and development are essential to address current limitations and fully integrate 3D-printed ceramics into clinical practice. “We still face challenges in optimising printing parameters and post-processing techniques. Future research should focus on refining sintering protocols, optimising layer orientations and enhancing surface finishing techniques to improve long-term clinical outcomes,” Dr Tribst concluded.

The study, titled “Additive-manufactured ceramics for dental restorations: A systematic review on mechanical perspective”, was published online on 10 February 2025 in Frontiers in Dental Medicine.