Milling or printing? The reliable path to definitive restorations

In deciding on the appropriate equipment, the first consideration should be the intended application. 3D printers enable the large-scale and rapid production of diagnostic and working models, surgical guides and provisional restorations. However, for restorations intended for definitive placement, other factors are decisive: durability, biocompatibility and maximum precision for optimal fit. This is where milling technology has clear advantages.

Long-term studies confirm clinical reliability

Clinical validation gives patients, clinicians and laboratories confidence in the choice of technologies and materials. Materials used for milled restorations have a clear advantage in this respect: milled and ground dental ceramics have a clinical track record of more than 40 years of successful use. Long-term studies on lithium disilicate and zirconia crowns have confirmed their durability and clinical reliability.^1, 2 In these studies, ceramic crowns demonstrated survival rates of more than 90% even after ten years. Comparable long-term clinical data for 3D-printed restorations remains limited, and direct comparisons over similar observation periods are not yet possible.

Biocompatibility is a crucial factor

From the patient’s perspective, biocompatibility is arguably the most important factor. Both milling blanks and 3D-printing materials are specifically developed for dental applications and certified accordingly. However, their processing requirements differ significantly. 3D-printing resins often contain reactive components, such as acrylate monomers, and may also contain isocyanate-based components. In their liquid or insufficiently polymerised state, these materials may be toxic, irritating or sensitising. Precise and complete post-polymerisation is therefore essential, since insufficiently polymerised resin is considered a potential health risk. Moreover, in vitro studies have reported that certain 3D-printed resin materials may exhibit cytotoxic effects, depending on their composition and processing.³

Ceramic restorations remain the benchmark for quality and aesthetics

By contrast, materials used for milling and grinding have clinically proven biocompatibility: ceramic and metallic blanks are generally chemically stable. Milled restorations also provide an excellent surface finish, helping to minimise plaque accumulation. A properly milled and finished ceramic crown offers long-lasting aesthetics as well as the mechanical strength to reliably withstand daily functional loads—properties that 3D printing cannot currently match.

“All these considerations strongly support our commitment to continuously advancing milling technology,” said Tim Zinser, dental product manager at vhf camfacture. “Milled restorations deliver reliable, clinically proven results for laboratories and practices and their patients. Building on decades of development and manufacturing expertise, we remain committed to advancing our dental milling machines to ensure maximum precision and reliability today and in the future,” he continued.

According to Zinser, 3D printing can be a valuable addition to digital workflows in many cases and contributes to efficiency, particularly in the fabrication of guides and provisional restorations. He emphasised, however, that “when it comes to definitive restorations, milling technology using ceramic materials remains the undisputed benchmark”.