One of the most important aspects of implant dentistry is the surface topography of the dental implant itself. Dental implant surfaces are often modified using a variety of techniques and additives in an effort to improve healing and osseointegration by improving retention of the implant in the bone formation. One way to modify the surface topography of a dental implant is to sandblast it. Another way that is being used more often in the industry is adding different materials to the surface of an implant to change its texture. For example, an acid-etched implant is one form of added surface implant. However, there are a wide variety of added surface implants available and which type is used during a dental implant procedure largely depends on the preference of the treating periodontist and the unique needs of the patient, such as where the implant will be placed and the bone quality in that area.
Additive manufacturing is another term used for 3D printing and this technology has revolutionized the dental implant industry. Implants that have been produced using additive fabrication often have better retention rates and can promote healing and osseointegration even in areas with poor bone quality. Additive fabrication or additive manufacturing is commonly used in the area of dental prosthetics, especially for the purpose of producing cost-effective dentures. When used in the dental implant industry, additive manufacturing can help reduce the cost of dental implants and create more customized implant solutions. 3D printing or additive fabrication can be used to create completely custom implants for patients with shallow bone or poor bone quality, as well as creating crowns that are designed to perfectly match the patient’s existing teeth for the most natural look possible. Most periodontists today use components during their dental implant procedures that were created with the use of additive fabrication technology.
Additive manufacturing (AM) is defined by the American Society for Testing and Materials (ASTM) as the layer-upon-layer process of joining materials to create objects from STL files and 3D model data. Additive manufacturing does not use the traditional machining processes associated with subtractive manufacturing. The term additive manufacturing encompasses many technologies including subsets like 3D Printing, Rapid Prototyping (RP), Direct Digital Manufacturing (DDM), layered manufacturing and additive fabrication. In the dental industry, AM allows for the building of dentures, crowns, bridges, and other dental structures for oral repair and maintenance. Using a 3D model of the patient’s mouth, a dental appliance is created through AM to match the patient’s oral anatomy. Such appliances are often made of ceramic due to the material’s biocompatibility, aesthetics, mechanical function, and chemical stability. Utilizing AM allows dental professionals to provide safe and effective oral prostheses in a more cost effective and sustainable way.
An additive manufacturing file (AMF) is a data format that can be used in additive manufacturing. It was proposed by the American Society of Testing and Materials (ASTM). An AMF contains information that describes the shape and composition of any 3D object that will be fabricated on a 3D printer. Unlike the STL format, AMF has native support for color, materials, lattices, texture, and constellations. An additive manufacturing file contains a 3D image of a patient’s oral anatomy and allows for the 3D printing of a precise dental implant or prostheses. This means each patient will receive a prosthesis that has been custom created to match the unique features of his or her mouth. The use of an AMF and the additive manufacturing process provides patients and dental professionals with a more sustainable, reliable, and biocompatible product. This can reduce the number of fittings, adjustments, and physical discomfort a patient may experience.
Additive manufacturing or 3D printing requires the use of specialized technology to create solids by injecting materials into preplanned, precise points in space. This is done with computer software that controls a 3D printing machine. To print a customized object, such as a dental implant, a certain file type must be used. This is called an Additive Manufacturing File and the format is considered the standard for describing an object for the additive manufacturing process. The data format for this type of file has been proposed by the American Society of Testing and Materials (ASTM) and will communicate to the 3D printer the shape, size, color, texture, materials, and composition of the object to be created. Although this file is considered standard for all types of additive manufacturing or 3D printing, it is used frequently in the dental implant industry to create customized implants for patients with unique needs.
A crucial component of implant dentistry is the topography of the dental implant surface. The texture of a dental implant surface can be modified in a variety of ways with the addition or removal of a material or chemical. Additive surface treatment occurs when a material or chemical is added to a dental implant to change the topography of the surface. Different surface textures can help increase the rate of healing and osseointegration and reduce the risk of dental implant failure. One example of additive surface treatment is acid-etching. An acid-etched implant has been treated with acid to change the implant topography and ideally improve retention of the implant once it is placed. What type of additive surface implant is used for a procedure depends on the patient’s unique needs, their bone quality in the area receiving the implant, and the preferences of the treating periodontist.