A fully digital workflow boosts accuracy, flexibility and efficiency. But how does a 3D printer contribute to making this possible? The following clinical case discusses the role of a 3D printer in a digital workflow.
By Simone Fedi
A fully digital workflow has been the subject of discussion and debate within the dental industry for years. Today, thanks to the development of cutting-edge technologies, it is finally possible to approach this working methodology to allow the clinician, dental technician and most importantly the patient, to rely on a predictable treatment with reduced time and costs.
Within this workflow, the role of the 3D printer assumes considerable importance, both for the production of classic artefacts such as models, gingiva, surgical guides and temporary elements. It also offers the option of adopting alternative approaches and creating, for example, aesthetic and functional wax-ups.
On one hand, 3D printer allows the dental technician and clinician to match what was digitally designed to what was created instantly. On the other hand, it helps the patient to have a clearer understanding of the treatment.
This process allows the professional to adopt an approach considering not only the clinical and functional side but also the psychological impact of the treatment, particularly in the case of rehabilitation of total edentulism.
The following clinical case fits precisely within this context:
- a fully-digital rehabilitation of the maxillary arch with the aid of radiographic images from cone-beam computed tomography (CBCT) to obtain the data necessary for implant planning
- .stl files acquired through intraoral scanning
- photographs for the design of the final prosthesis and smile design, respectively
After acquiring the necessary clinical data, performing the implant planning and the subsequent surgery, we designed the final prosthesis (Fig. 1).
Consisting of a bar screwed onto implants (made by CNC) and its counter-bar with an abutment structure (made using laser metal fusion 3D printing technology), the dental element was cemented as a single piece — for greater versatility and easier maintenance over time.
Before proceeding with the production of the final counter-bar, the files relating to the counter-bar and the individual elements are merged into a single .stl file that is printed in EVERES TEMPORARY resin using EVERES UNO by SISMA.
The accuracy and speed of the printer created an aesthetic wax-up in a short time, perfectly matching the dimension and geometry of the digital design.
This allows the team, made up of clinician and dental technician, to present the final result to the patient effectively, without the need for modified images displayed on the screen (Figs. 2-5).
The approach makes it possible to verify the matching between what has been designed and what was created before proceeding with the production of the final prosthesis – allowing for changes and corrections without incurring further costs or time lengthening, which reduces the number of required sessions for the patient.
From this clinical case, it is clear how a professional-level 3D printer allows practitioners to approach treatments innovatively. It reduces the time and number of appointments needed for the completion of the treatment. 3D printing introduced a simplified protocol both in terms of flexibility and variations with zero impact.
About the author
Simone Fedi graduated with 60/60 in dental technology in 1997 at the Istituto Professionale Statale Istruzione Superiore (IPSIA) Gaslini in Italy. In 2003, he joined the company of his current laboratory. He specialised first in total prosthesis, following courses on the Gerber and Passamonti method, proceeding to techniques of reverse layering in composite courses in Bredent and casting using traditional techniques. Expert in CAD/CAM techniques in fixed and removable prosthesis solutions, he won the competition organised by Trasformer system regarding the protocol on injection prostheses in 2015.