Additive manufacturing (AM) technologies can enable the direct fabrication of customized physical objects with complex shapes, based on computer-aided design models. This technology is changing the digital manufacturing industry and has become a subject of considerable interest in digital implant dentistry. Personalized dentistry implant treatments for individual patients can be achieved through Additive manufacturing. Herein, we review the applications of Additive manufacturing technologies in oral implantology, including implant surgery, and implant and restoration products, such as surgical guides for implantation, custom titanium meshes for bone augmentation, personalized or non-personalized dental implants, custom trays, implant casts, and implant-support frameworks, among others. In addition, this review also focuses on Additive manufacturing technologies commonly used in oral implantology. Stereolithography, digital light processing, and fused deposition modeling are often used to construct surgical guides and implant casts, whereas direct metal laser sintering, selective laser melting, and electron beam melting can be applied to fabricate dental implants, personalized titanium meshes, and denture frameworks. Moreover, it is sometimes required to combine Additive manufacturing technology with milling and other cutting and finishing techniques to ensure that the product is suitable for its final application.

Although percutaneous titanium implants have become one of the best choices as retainers in the facial defects, peri-implantitis still occurs at a significant rate. This unwanted complication occurs due to adhesion of bacteria and subsequent biofilm formation. To solve this problem, we have developed a novel antibiotic nanodelivery system based on self-decomposable silica nanoparticles. In this study, silica-gentamycin (SG) nanoparticles were successfully fabricated using an innovative one-pot solution. The nanoparticles were incorporated within a gelatin matrix and cross-linked on microarc-oxidized titanium. To characterize the SG nanoparticles, their particle size, zeta potential, surface morphology, in vitro drug release, and decomposition process were sequentially evaluated. The antibacterial properties against the gram-positive Staphylococcus aureus, including bacterial viability, antibacterial rate, and bacteria morphology, were analyzed using SG-loaded titanium specimens. Any possible influence of released gentamycin on the viability of human fibroblasts, which are the main component of soft tissues, was investigated. SG nanoparticles from the antibacterial titanium coating continuously released gentamycin and inhibited S. aureus growth. In vitro investigation showed that the obtained nanodelivery system has good biocompatibility. Therefore, this design can be further investigated as a method to prevent infection around percutaneous implants.

Alveolar ridge restoration and augmentation is a challenge in dental implantology. 3D printing allows the manufacture of scaffolds with controlled complex structure and adjustable pore size and percentage. HA/β-TCP is the most commonly used ceramic in 3D printing for its ideal biocompatibility, osteoconductivity, biodegradability, and lack of risk from infection or rejection. However, the effect of composition and macropore percentage (P_macro) on the mechanical and biological properties of 3D printed HA/β-TCP scaffolds is debatable. In this study, HA/β-TCP scaffolds with various compositions (weight ratio (wt%) of HA varied at 0, 20, 40, 60, 80 and 100%) and P_macro (0%, 30% and 50%) were fabricated via 3D printing. The effect of composition and P_macro on the scaffold was investigated. The results showed compressive strength (CS) values, elastic modulus, degradation and biocompatibility in vitro were significantly affected by both the composition and P_macro, which exhibited an interactive effect. Biphasic calcium phosphate ceramics demonstrated higher CS values, elastic modulus, seeding efficiency, cell proliferation and differentiation capability compared to pure HA or pure β-TCP scaffolds. The degradation of scaffolds decreased as HA wt% increased or P_macro decreased. In conclusion, scaffolds with HA wt% of 40% and P_macro of 50% performed optimum cell proliferation, while scaffolds with HA wt% of 60% and P_macro of 30% exhibited optimum osteogenic differentiation. The results provide some useful insights on applying 3D printed HA/β-TCP scaffolds for augmenting absorbed alveolar ridges.