3D printing in dentistry: Fraunhofer looks to the future

Jeremy Booth, Dental Tribune International

Fri. 24. September 2021

save

DRESDEN, Germany: A project by the Fraunhofer-Gesellschaft aims to harness the transformative potential of additive manufacturing in the medical field. The project brings together a network of partners and encompasses a wide range of additive technologies. It seeks to pair new advancements in 3D printing with tangible and patient-oriented applications. There is a substantial focus on dentistry, and scientists in Germany and Poland are collaborating on a series of pilot projects and working in close cooperation with dental laboratories and dentists from a range of specialties.

The application-oriented research organisation announced in June that a German–Polish Fraunhofer-Gesellschaft High-Performance Center was engaged in the project Additive Technologies for Medicine and Health (ATeM). It aims to establish additive manufacturing as a useful tool in the field of medical technology, and the first demonstrations of the individual projects are expected around the third quarter of this year.

Prof. Frank Brückner, technology field manager for additive manufacturing and surface technologies at the Fraunhofer IWS in Dresden, told Dental Tribune International (DTI): “One of the main objectives of ATeM is to increase the technology readiness levels of current research activities in dentistry, for example by introducing novel materials or by integrating additional functionalities; another important goal is the transferral of these to companies—especially to small and medium-sized enterprises—in order to make the new products readily available for clinical practice.”

New functionalities in dental prostheses

In the dental field, Fraunhofer scientists are investigating new areas of application for 3D printing in dental prosthetics. “There is great potential in the use of innovative materials and the integration of additional functionalities in dental prostheses to increase the wearing comfort for the patient,” Brückner commented in a press release.

The Additive Technologies for Medicine and Health project wants to digitise the production of dental prostheses in order to make it faster, cheaper and more efficient. (Image: Christoph Wilsnack/Fraunhofer IWS)

When asked about the properties and functionalities that were being investigated, Brückner said: “The main purpose is to provide dental components with new functionalities, to improve their aesthetic appearance and to optimise present fabrication routes.” For example, new functionalities can be achieved through intelligent implants. He explained: “For this purpose, sensors for certain biomarkers are integrated into dental components during the manufacturing process. These can then provide information to the dentist regarding the healing progress or the occurrence of complications.”

Fraunhofer IWS mentioned some of the applications that are being investigated in the dental field, stating that advancements in additive manufacturing could allow for faster treatment and the printing of significantly more complex dental implants immediately after the oral cavity is scanned using an intra-oral scanner. Additive processes could also be harnessed in order to combine metal and plastic materials for improved aesthetics, and the production of dental prostheses could also be made faster and more efficient, both in terms of treatment costs and resources.

Tailoring orthodontic appliances to patients and streamlining manufacturing

Developments in additive manufacturing could also enable orthodontic treatment time to be reduced and brackets to be individualised for patients. Brückner explained: “For visible orthodontic components, such as brackets, a targeted multi-material composite design might enable the combination of functionally optimised internal structures, which could bear the mechanical load, with a patient-specific aesthetic external design. In this way, a significantly improved aesthetic appearance of the orthodontic appliances could be achieved, which is especially desirable in the anterior region.”

“One of the main objectives of ATeM is to increase the technology readiness levels of current research activities in dentistry”
– Prof. Frank Brückner, Fraunhofer IWS

Dentists well know that many dental products are still manufactured using a number of manual steps. Additive manufacturing already allows for the partial substitution of what can be expensive and time-consuming tasks, and advancement in 3D-printing processes could lead to greater savings of resources in the dental practice and laboratory. The institute explained, for example, that it is examining established process chains for the production of dental components in order to identify possibilities for the seamless integration of 3D-printing technologies. Brückner commented: “A major focus is on the end-to-end digitalisation of the process chain from data collection—for example, using an intra-oral scan—through manufacturing to application. As a result, waiting times and costs for complex dentures could be significantly reduced for the patient.”

Investigating innovative materials and data acquisition

The project is a collaboration between the Fraunhofer IWS in Dresden, the Fraunhofer Institute for Machine Tools and Forming Technology IWU in Chemnitz in Germany, and the Faculty of Mechanical Engineering and the Center for Advanced Manufacturing Technologies at Wroclaw University of Science and Technology in Poland. This network of partners implicates a wide range of additive technologies, including stereolithography or fused filament fabrication, for example, which can be used to process a wide range of polymers that offer a significantly better aesthetic appearance in the oral cavity than metals do—particularly in visible areas.

Brückner explained that metals, however, play an important role in many load-bearing applications, such as implants or prostheses, and that various processes are available for metal-based additive manufacturing. “For example, even challenging materials can be processed into highly complex, near-net-shape components. Binder jetting also enables the production of complex components, and unlike other powder bed-based processes, no support structures are required, and good surface qualities can thus be achieved in the process,” he said.

In addition to materials that are well established in the dental field, such as titanium-based and cobalt-chromium-based alloys, the scientists at ATeM are also investigating innovative materials that offer, for example, better wearing comfort for the patient, a reduced risk of plaque adhesion or the integration of sensor technologies which could be used to facilitate increased data acquisition.

Fraunhofer IWS says that additive manufacturing could shorten lead times in the production of orthodontic distractors and enable an individualised fit for the patient. (Image: Christoph Wilsnack/Fraunhofer IWS)

Additive manufacturing processes are already highly digitalised; however, scientists at ATeM are aiming to further optimise them in order to incorporate a seamless integration of these processes into digital data acquisition in dentistry. Brückner explained: “For example, dental restorations can be built up directly based on the data of an intra-oral scan. Not only does this facilitate communication between dentists and manufacturers, but also it ensures quality in decentralised production.” He said that by integrating sensor technology into dental components, such as prostheses or implants, new features could be integrated to provide information to both the dentist and the patient. “One goal in the project is therefore to derive a digital functional strand for sensor integration, data acquisition and processing across the entire process chain in order to improve user-friendliness for both the patient and the treating dentist,” Brückner said.

There is currently great interest in intra-oral scanners and 3D printing for dental applications, and both of these fields are expected to show double-digit growth in the next five years. Dr Kamran Zamanian, a market researcher in specialist dental applications and founding partner of iData Research, commented in June that the technologies are increasingly attractive to dentists owing not only to the seamless workflows that they offer in the practice but also to their ability to better control the risk of infection. In an editorial published by DTI, Zamanian said that the COVID-19 pandemic had already influenced the market for dental 3D-printing technologies. “[Sales] of 3D printers are increasing rapidly now that the pandemic is getting closer to being stabilised. In addition, digital technologies, such as 3D printers and intra-oral scanners, offer better control of contamination risk, and this has already started to drive sales and will continue to do so in the near future,” he wrote.