Printing the future

The 21st century has not turned out exactly as predicted by the science fiction writers of the past. There aren’t flying cars filling the skies or robots walking the streets, but there are devices in our homes, like Amazon’s Alexa, which listen for our voices and carry out our commands. Companies like Boston Dynamics have taken impressive steps towards creating eerily lifelike robots and the US Navy is even testing incredibly precise laser weapons onboard its ships. 3D printing is also seeing a massive expansion in its applications, from the inspiring printing of functioning human organs to the more sinister ability to download and create working fire-arms. But where does dentistry fit into this?

Dentistry is currently undergoing a fundamental move towards digital workflows, with digital scanning, design, compatible materials and 3D printing all set to become essential parts of providing oral healthcare in the future. 3D printing especially has the capacity to largely democratise the production process of many dental appliances, and dentistry is one of the areas best suited to take advantage of the advances the technology allows for. The largest 3D printing operation in the world is carried out for Align Technology Ltd, well known in the dental industry as the creator of the Invisalign clear aligner, who utilise 3D Systems' 3D printers to print over 359,000 unique retainers every day. 3D Systems, a company co-founded by the inventor of the 3D printing process, Chuck Hull, in 1986 has clearly recognised the potential of the dental industry and recently released the NextDent5100. I spoke with Rik Jacobs, vice-president of 3D Systems’ dental business, to get his views on the past, present and future of the technology.

Rik didn’t study dentistry, instead opting to study international marketing management. He became active in the dental sales and marketing sphere around 20 years ago where he sold polymers and monomers, materials which he also sold for the hearing aid market.

Explaining this, Rik said, “I wasn’t at the forefront in the hearing aid market in those days. That market transformed from analogue into digital over a period of two or three years between 2007 and 2009, and I learned my lesson. When digital technology came to dental I wanted to be at the forefront, so I went back to school in 2009 and learnt everything I could about 3D printing.” Rik was privy to how quickly digital technologies came to dominate one market and didn’t want to miss out on the next. This affected his approach to the dental market, and in 2012 he co-founded NextDent, which focused on reformulating existing polymers into printable, biocompatible materials which would pass regulations.

Creating printable and biocompatible materials was essential for the progression of 3D printing, and the concept attracted interest from big players in the market. NextDent was acquired by 3D Systems in January 2017.

As Rik explained however, there wasn’t always a belief in the uses of 3D printing for dental applications. He elaborated, “People still had some hesitations and questions about the durability of the materials even five years ago; they weren’t sure that you could print crowns or dentures that would stay in a patient’s mouth for very long. Back then a few things still needed to happen to make 3D printing viable in dentistry; software companies needed to develop software design solutions, materials needed to be proven and more advanced 3D printers needed to be developed. I was convinced it could be done but people were very cautious, so it was only in 2018, when we were able to combine all these factors, that there was a real tipping point for 3D printing.”

Digitalisation in the dental profession and industry is an oftdiscussed topic that most agree will come to define dentistry in the near future. Every dentist will be able to find a personal use for some piece of digital technology, but the same isn’t necessarily true of a 3D printer.

3D printing’s relationship to the digital dental revolution is important however, and I asked Rik about what role the technology plays. He said, “Most dentists will find a use for an intraoral scanner as a more accurate and convenient alternative to analogue impression materials, but what gets done with that scan afterwards is important. If the patient needs a denture the dentist can send the scan to a lab so that a denture could be designed and printed, or with a 3D printer the dentist could print the denture themselves in their practice. Completely new business models are coming into the market with this technology. A one-surgery practice probably won’t have much use for a 3D printer, for example, but even the smallest of practices will benefit from outsourcing to a lab with a printer because of the higher speeds, accuracy and lower cost.” Rik explained that 3D Systems primarily sell their printers and materials to labs, but that dental practices interested in keeping some of their production in-house are increasingly purchasing 3D printers.

As complicated pieces of equipment, learning to use 3D printers to their fullest can require a fairly significant amount of training. Rik explained, “3D printing can sound a little too good to be true, but we’re sometimes faced with people that think they can start using their printer without any training and expect great results; if you put rubbish into the printer, you’ll get rubbish out. That’s something I’m always explaining and emphasising.” 

3D printing is sure to play an important part in the digital future of dentistry, and as materials become more and more advanced the applications of the technology will only grow. But printers in labs and in practice are already changing dental workflows, with labs able to provide faster, more reliable and very precise end products with incredible efficiency.

The future may not end up being characterised by a deluge of sci-fi robots and lasers, but there’s no doubt that 3D printing will play an incredibly important role in the increasingly digital profession of dentistry.