In 2015, Amos Dudley, a student at New Jersey Institute of Technology, grew tired of his smile. A few of his top teeth ran slightly askew, but as a college undergrad, he didn’t have the disposable funds to shell out for orthodontic treatments. What he did have were his school’s top-tier 3D printing tools. “What is to stop someone, who has access to a 3D printer, from making their own orthodontic aligners?” Dudley later wrote on his blog.
After extensive research, Dudley took matters into his own hands and began printing a series of aligners (clear, Invisalign-style braces) to whip his teeth into shape. With professional-grade materials and equipment, Dudley took molds and castings of his teeth, which he then scanned to create the digital models he printed. Finally, using retainer plastic, he created the aligners. He wore them for 16 weeks with notable success. “As far as I know,” he wrote, “I’m the first person to have tried DIY-ing.”
While no orthodontist would endorse Dudley’s rogue approach to teeth-straightening, credentialed dental professionals are making use of 3D printing. In fact, the practice is emerging as a time-saving trend for patients.
According to analytics and research firm Transparency Market Research, the dental 3D-printing industry was valued at $903 million in 2016, with 16.5 percent growth expected by 2025. EnvisionTEC, a manufacturer of 3D printers, reported a 75 percent yearly increase in dental printer sales in 2016. From dentures to clear aligners, the technology has become part of many aspects of dentistry, but is this something the average patient can — and should — sink their teeth into?
Despite seeming uber-futuristic, 3D printing technology has probably been used in dental procedures for most patients, says John Fernandez, director of sales and business development at SprintRay, a dental 3D printer manufacturer. For instance, when a dentist takes a mold of a patient’s mouth for an operation like a dental implant, the doctor sends that mold to an offsite lab where the implant is sometimes created by a 3D printer. “I think patients are getting use out of 3D printed appliances and they don’t even know it,” Fernandez said.
After all, if the machine isn’t in front of you, how would you ever know? According to market research group SmarTech Publishing, 88 percent of dental printers currently reside in outside laboratories. By 2027, they estimate a huge shift: Fifty-four percent of printers will be housed in dental offices themselves. “Having a printer in the office eliminates the doctor’s need to outsource the appliances that are used in certain procedures,” Fernandez said. “Ultimately what it does is empower the doctor to get some of the tools they need quicker.”
New York City dentist Dr. Sharde Harvey has been using new tech in her practice since 2005. She relies on a contemporary of 3D printing called CEREC (Chairside Economical Restoration of Esthetic Ceramics), which entails digitally scanning, designing and milling (carving a new item out of material) a tooth or crown. Having an in-office CEREC machine, which Harvey says costs about $80,000, lets her offer a service called the “Lunchtime Crown.” If a patient breaks a tooth, Harvey can scan and create a crown in a matter of 90 minutes, without anyone having to leave the office. She can even make on-the-spot adjustments to color and shape in the event of an incorrect fit. This could take weeks if she had to outsource the crown manufacturing. Harvey likes the level of control CEREC gives her throughout the entire process. “When a patient comes in,” she said, “I’m the lab tech and I’m the dentist.”
Should patients worry that care is compromised when dentists take on dual roles? Is a quickly printed dental appliance as well-made as one that takes longer to produce? Harvey is optimistic: The tech is meant to reduce human error by cutting down on the number of people involved in producing dental appliances, and to make higher-quality crowns and veneers. Offering technology-assisted services, Harvey says, has assuaged a lot of patients’ dental fears; emergency tooth-chippers with upcoming vacations or events find comfort in knowing she provides a quick fix. It’s also attracted new patients to her practice. “I have the Mercedes of equipment in my office,” she said. “I think that a patient should always look for a doctor that’s invested in technology. It shows they’re passionate about what they’re doing.”
However, it’s wise to do your homework. Patients should ask about insurance coverage for procedures involving printed dental implants. The American Dental Association also recommends asking about a clinician’s experience and past success with the technology. Can they provide information on the durability of printed implants created for other patients? Research suggests they should last years: In one 2016 study, researchers followed up with 82 patients who’d received printed titanium implants three years earlier and found that 95 percent were going strong.
Of course, no treatment comes without drawbacks, especially in emerging technology. In a 2017 clinical review published in the Journal of Interdisciplinary Medicine, authors mention the cost of the technology (one popular model costs about $16,000), as well as the possibility that the resin used in printing can cause skin irritation. The article concludes that “even after all the technological developments in 3D printing, these methods cannot act as substitutes for the classical techniques that have been established in dental manufacturing,” with authors reasoning that no computer has the hands-on expertise of a trained clinician.
Harvey, though, sees the allure of high-tech dentistry in the way it combines computer capability with human care. One of her patients referred a relative who’d flown to New York from the Dominican Republic and needed four teeth repaired in as many days. “Before she left, everything had to be perfect,” Harvey recalled. While the crowns had to endure a series of tweaks, Harvey was able to complete the process quickly because she had access to both the patient and the CEREC machine. “That interaction is really an important piece for patient satisfaction.”