Popular media now often present 3D printing as a widely employed technology for the production of dental prostheses. This article aims to show, based on factual information, to what extent 3D printing can be used in dental laboratories and dental practices at present. It attempts to present a rational evaluation of todays´ applications of 3D printing technology in the context of dental restorations. In addition, the article discusses future perspectives and examines the ongoing viability of traditional dental laboratory services and manufacturing processes. It also shows which expertise is needed for the digital additive manufacturing of dental restorations.

The aim of this in vitro study is to investigate the bonding properties of a 3D-printable permanent composite material in comparison to milled composite materials. The tested materials are 3D-printed BEGO VarseoSmile Crown ^plus (VA1_ab, VA1_nt, VA2_ab, VA2_nt), Vita Enamic (EN1, EN2), and 3M Lava Ultimate (UL1, UL2) (N = 64; n = 8). For this purpose, all crowns are luted to polymer tooth stumps #46 (FDI) using dual-curing luting composite, strictly according to the manufacturer’s instructions. VA1_ab and VA2_ab are additionally airborne-particle abraded. 4 groups (VA2_ab, VA2_nt, EN2, UL2) are artificially aged (1,200,000 cycles, 50 N, 10,000 thermocycles), whereby no specimen has failed. All 64 specimens undergo pull-off testing until retention loss. The mean forces of retention-loss is 786.6 ± 137.6 N (VA1_nt, *), 988.6 ± 212.1 N (VA2_nt, *, Ɨ), 1223.8 ± 119.2 N (VA1_ab, Ɨ, ǂ), 1051.9 ± 107.2 N (VA2_ab, *, Ɨ), 1185.9 ± 211.8 N (EN1, Ɨ, ǂ), 1485.0 ± 198.2 N EN2, ǂ), 1533.8 ± 42.4 N (UL1, ǂ), and 1521.8 ± 343.4 N (UL2, ǂ) (one-way ANOVA (Scheffé method); p < 0.05; *, Ɨ, ǂ: group distribution). No characteristic failure modes can be detected. In conclusion, all of the pull-off forces reflect retention values that seem to be sufficiently high for clinical use. Additional airborne-particle abrasion of VA does not result in significantly better retention but can be recommended.

The purpose of this study was to evaluate internal porosities, retentive force values and survival of cobalt-chromium (Co-Cr) alloy clasps fabricated by direct metal laser-sintering (DMLS) and compare them to conventionally cast clasps. Embrasure clasps were digitally designed fitting teeth 35 and 36 on identical metal models (N = 32). Sixteen clasps were fabricated using DMLS (group DMLS) and another sixteen clasps were additively manufactured from wax and then cast from a Co-Cr alloy (group CAST). Internal porosities were examined using micro-focus X-ray (micro-CT) and analyzed applying Kolmogorov-Smirnov test, Mann-Whitney test, and T test (significance level: p < 0.050). A universal testing machine was used to determine the retentive force values at baseline and after 1095, 5475, 10,950 and 65,000 cycles of simulated aging. Data were analyzed employing Kolmogorov-Smirnov test, one-way ANOVA, and Scheffé's post-hoc test (significance level: p < 0.050). Survival was estimated for 65,000 cycles of artificial aging using Kaplan-Meier analysis. Micro-CT analysis revealed a higher prevalence (p < 0.001), but a more homogeneous size and a significantly smaller mean (p = 0.009) and total volume (p < 0.001) of internal porosities for group DMLS. The groups showed mean initial retentive force values of 13.57 N (CAST) and 15.74 N (DMLS), which significantly declined over aging for group CAST (p = 0.003), but not for group DMLS (p = 0.107). Survival was considerably higher for group DMLS (93.8%) than for group CAST (43.8%) after 65,000 cycles of aging. Clasps made by laser-sintering could be an alternative to conventional cast clasps for the fabrication of removable partial denture frameworks.

Objectives: To present a digital approach to measure and compare material wear behavior of antagonistic first molar restorations made of an experimental CAD/CAM composite (COMP) and lithium disilicate ceramic (LS2) in patients with reconstructed vertical dimension of occlusion (VDO) after generalized hard tissue loss.Methods: A total of 12 patients underwent complete full jaw rehabilitation with full occlusal coverage restorations made either of COMP or LS2. The first molar restorations (n = 48) were chosen for wear examination. At annual recall appointments, polyether impressions were taken, and resulting plaster casts were digitalized using a laboratory scanner. Mean observation period was 371 days for first and 769 days for second year. The resulting 96 datasets were analyzed by superimposition of 3-D datasets using an iterative best-fit method. Based on the superimposition data, the wear rates of the occlusal contact areas (OCAs) were calculated.Results: For antagonistic restorations made of COMP, the average wear rate was 24.8 ± 13.3 μm/month, while for LS2, it was 9.5 ± 4.3 μm/month in first year, with significant differences (p < 0.0001) between the materials. In second year, monthly wear rates decreased significantly for both materials: COMP (16.2 ± 10.7 μm/month) and LS2 (5.5 ± 3.3 μm/month). Statistical comparison between wear time showed significant differences for both materials: COMPp < 0.037 and LS2p < 0.001. A logarithmic fit (COMPR² = 0.081; LS2R² = 0.038) of the data was calculated to estimate the wear progression.Significance: In patients with reconstructed VDO, restorations made of LS2 show a more stable wear behavior than ones out of experimental CAD/CAM composite. In cases of complete rehabilitation, load bearing CAD/CAM-composite restorations should be critically considered for application due to their occlusal wear behavior. However, when choosing a restorative material, not only the functional occlusal stability should be taken into account but also the prospect of minimally invasive treatment with maximum preservation of natural tooth structures.