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| EDITORIAL |
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| Year : 2022 | Volume
: 14
| Issue : 1 | Page : 1-2 |
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Three-dimensional technology in dentistry and its fourth dimension
Sonali Vijay Deshmukh
Department of Orthodontics and Dentofacial Orthopedics, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, DPU, Pune, Maharashtra, India
| Date of Submission | 03-May-2022 |
| Date of Decision | 05-May-2022 |
| Date of Acceptance | 07-May-2022 |
| Date of Web Publication | 4-Jul-2022 |
Correspondence Address:
Sonali Vijay Deshmukh
Department of Orthodontics and Dentofacial Orthopedics, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, DPU, Pune, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jicdro.jicdro_28_22
How to cite this article:
Deshmukh SV. Three-dimensional technology in dentistry and its fourth dimension. J Int Clin Dent Res Organ 2022;14:1-2 |
In recent times with the advent of computer technologies, the medical field in general and dentistry in particular has seen tremendous development in digital technology. So far, the digital technology available for dentistry is digital radiology, computerized case presentations, digital prescriptions, digitally based surgical guides, imaging for implant placement, and digital impressions. Apart from this, smile simulation technologies which are based on artificial intelligence and machine learning, intraoral scanners, digital X-rays, three-dimensional (3-D) imaging with cone-beam computed tomography, etc., have revolutionized the way modern dentistry is working in today's time.
The natural succession of these imaging technologies was 3D printing. In 1986, Charles Hull introduced the first 3D printing (3DP) technology, and the industry developed many different manufacturing technologies, which have been applied to numerous fields.[1] In 1986, Hull patented stereolithography and built and developed a 3DP system. In 1990, Scott Crump received a patent for fused deposition modeling.[2] Since then, 3DP has been increasingly progressing. 3DP, the alias of additive manufacturing (AM), is an advanced manufacturing technology.[3] It is based on computer-aided design (CAD) digital models, using standardized materials to create personalized 3D objects through specific automatic processes. It is used for rapid prototyping, which has been widely used in industry, design, engineering, and manufacturing fields for nearly 30 years. With the rapid development of new materials, printing technologies, and machines, 3DP is likely to completely change the traditional teaching and experimental modes.[4],[5]
Digital technology such as CAD and computer-aided manufacture (CAD/CAM) is rapidly expanding and transforming dentistry at an unprecedented pace. CAD/CAM technology in dentistry can be classified as either “subtractive” or “Additive” manufacturing methods. Subtractive manufacturing methods include machining and milling (CAM) and laser ablation technologies, while AM methods include 3DP and laser melting technologies. AM processes build objects by adding material layer by layer, while subtractive manufacturing removes material to create parts, the advantages of using CAD/CAM in dental applications in comparison of the conventional dental laboratory are high accuracy, standardized manufacturing process, efficient quality control system, increased production capacity, fast production, enable the new material such as zirconia and titanium, and transforming laboratories from simple fabrication sites into computerized production centers.
With the incorporation and development of intraoral scanners, computer-aided design (CAD) software, and AM technologies, a complete digital workflow for diagnostic treatment planning can be achieved. Digital impressions and CAD tools provide for a potent virtual diagnostic assessment for restorative planning that can be realized through AM technology. the digital workflow is more efficient than the conventional ones in terms of cost and time, as well as being better acceptance from patients.[6]
In dentistry, digital technology is making its presence felt strongly. With every new emerging technology, be it smartphones to computers to new generation cars, there is a steep learning curve to adopt and adapt this newer technology. Field of dentistry is also full of newer emerging digital technology, and to cope up with these technologies, dentists have to be at the top of their game to adopt and adapt these digital technologies. This at times could be added burden in terms of time, learning resources, and finances. A recent survey conducted by Nayakar et al. regarding knowledge and awareness regarding digital dentistry revealed that those in academics have the maximum knowledge and awareness followed by practitioners and students. Thus, there is a need to prepare our young dentists to be future ready by means of incorporating digital dentistry in curriculum itself as well as exposing practitioners and students to various symposiums and seminars.[7]
Assuming that the advent of Digital dentistry will have a tremendous positive impact on dental practice and research, much of the work and research is needed to ascertain its effectiveness, user-friendly interface, and final cost to dentist as well as the patient. Another issue that is in its infancy and very scarcely discussed is its effect on the environment. So far, the process of 3DP was restricted to dental laboratories. The recent democratization of manufacturing, especially encouraged by personal digital fabrication, enables some consumers to meet their own production needs. Digital fabrication technologies, of which 3DP or AM is the most popular form. There is a sudden mushrooming of do it yourself dental practitioners. Considering the potential of these dentist to plunge into digital dentistry and 3DP domain, it is important to gain insight into the environmental impact of 3DP too. There is no doubt 3DP promises benefits such as shorter turnover time, cost, etc., but it also generates significant waste in terms of resins, thermoplastic materials, etc. There is a need of parallel research regarding the recycling of these 3D printed waste. For example, in orthodontic in-house aligners, the step of printing stepwise models to print aligners creates unnecessary waste of resin models which are of no use once aligners are printed. Aligners itself being thermoplastic materials create a large amount of biomedical waste. There is no available literature that puts a light on this topic. According to Dr. Gerald W. Wesley, aligner therapy is such that the aligners are in increments and with each passing week or 15 days, the aligners are changed or thrown; this is a waste along with some unworn aligners. Most of the plastic is numbered 1–7 according to their recycling parameters, but some multilayer aligners make it extremely difficult to do their recycling as its almost impossible to segregate them according to their recycling classification. The only option so far is to use them as fillers in industrial buildings, speed breakers, insulators, egg cartons, etc., The probable solution to this issue is direct 3D-printed aligners without printing models. While the current state of published literature about directly printed clear aligners shows that such a process is technically possible, no approved material marketed for this purpose exists, and software tailored to this aim has to be developed.[8]
Thus, the fourth dimension to newly adopted 3D technology along with 3DP is its sustainability and its impact on the environment, which is the major global concern. More and more targeted research has to be done regarding the same. We as global dentists have fared ourselves far better than dentistry 20 years back. But as it goes, “With greater power comes greater responsibility.”
 References | |  |
| 1. | Tian Y, Chen C, Xu X, Wang J, Hou X, Li K, et al. A review of 3D printing in dentistry: Technologies, affecting factors, and applications. Scanning 2021;2021:9950131.  |
| 2. | Gross BC, Erkal JL, Lockwood SY, Chen C, Spence DM. Evaluation of 3D printing and its potential impact on biotechnology and the chemical sciences. Anal Chem 2014;86:3240-53. |
| 3. | Lukić M, Clarke J, Tuck C, Whittow W, Wells G. Printability of elastomer latex for additive manufacturing or 3D printing. J Appl Polym Sci 2016;133:42931. |
| 4. | Lin L, Fang Y, Liao Y, Chen G, Gao C, Zhu P. 3D printing and digital processing techniques in dentistry: A review of literature. Adv Eng Mater 2019;21:1801013. |
| 5. | Alharbi N, Alharbi S, Cuijpers VM, Osman RB, Wismeijer D. Three-dimensional evaluation of marginal and internal fit of 3D-printed interim restorations fabricated on different finish line designs. J Prosthodont Res 2018;62:218-26. |
| 6. | Revilla-León M, Sánchez-Rubio JL, Besné-Torre A, Özcan M. A report on a diagnostic digital workflow for esthetic dental rehabilitation using additive manufacturing technologies. Int J Esthet Dent 2018;13:184-96. |
| 7. | Nayakar R, Sardesai P, Killedar S, Patil A, Kakodker M. Knowledge, Awareness and Practices of the use of Digital Technology in Dentistry among Postgraduate Students and Dental Practitioners in India: A Cross-sectional StudyJ Clin of Diagn Res 2022;16(2). |
| 8. | Tartaglia GM, Mapelli A, Maspero C, Santaniello T, Serafin M, Farronato M, et al. Direct 3D printing of clear orthodontic aligners: Current state and future possibilities. Materials (Basel) 2021;14:1799. |
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