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    Achieving printing perfection with the Form 2

    Why one doctor uses this 3D printer to create his surgical guides.

    Like any implant dentist, Dr. Ken Kim, DMD, from Plainview, New York, wants the best results from his surgeries. While some doctors place their implants freehand, Dr. Kim prefers the reliable, accurate outcomes achieved from using surgical guides. And the best quality surgical guidance, he says, are achieved when using his Formlabs Form 2 3D printer.

    Prior to his Form 2 printer, he used a milling machine to create his guides. And the two fabrication methods are quite different.

    “Milling is a little bit different than 3D printing,” he observes. “With milling, you’re cutting something down from a block of material. But with 3D printing, you’re creating something from nothing.”

    Related reading: Formlabs announces faster biocompatible materials for long-term use

    Best tool for the job

    The reason for the switch in technologies is because while the milling machine got the job done, it wasn’t ideally suited for the task, Kim explains.

    “That was a little bit messy and it was taking a toll on my milling machine,” he says. “That was really designed to mill a crown. I found a better way to print my surgical guides, which was to use the Form 2 printer.

    “The reason why I got into this whole 3D business is because I didn’t like the way my implants were going,” he continues. “I’m pretty sure a lot of dentists out there probably share a similar frustration because you’re trying to deliver a 3D object in a patient’s jaw, and you want to do a good job every time. It’s very difficult because we are only human. You can’t draw a perfect circle every time.”

    His efforts to find the perfect system first led him to a milling machine.

    “It was through my quest to actually figure out the way to do it perfect every time that I came to milling of the surgical guide,” Dr. Kim says. “That was the first thing that I was introduced to. And it was good for a while, but the only problem was it was taking a toll on my very expensive milling unit, which was like $70,000-$80,000. Afterward, it used to leave a big mess in my milling unit.”

    Milling, while getting the job done, turned out to be expensive and create less-than-perfect results.

    “Milling was $60 or $70 for a surgical guide,” Dr. Kim explains. “The fit wasn’t all that great either; it was a little bit rocky in the mouth. The ultimate reason for changing to a 3D printer was that the milling only allowed me to do one implant at a time. If I wanted to do two implants in a row, I would have to mill two different surgical guides, and that was not really what I was looking for. I was dealing with that for a while, and then eventually I found out about the Form 2. And with the Form 2, I can do any number of surgical guides at a very low cost, which is somewhere between $20 and $25. So, it’s a no-brainer that you should be doing it this way.”

    Form 2And while doctors can place implants without surgical guides, Dr. Kim believes that they ensure consistent reliability and success.

    “I do see this as the standard of care,” he explains. “I tell doctors in my lectures, ‘This is the standard of care, you just don’t know it yet.’ Look at it from the patient’s perspective: You need an implant and you have Doctor A, who can do it perfect, and Doctor B who has 20 years of experience but can’t guarantee that it will go in straight. What’s the right thing to do? Now that we have the technology, I think it’s kind of wrong to place it freehanded.”

    The process

    Optimally placing dental implants is greatly aided by use of a surgical guide. That guide, when placed in the patient’s mouth, allows the doctor to locate the ideal position, angle and depth for a successful outcome.

    Dr. Kim describes the method for designing an implant and surgical guide.

    “The first thing I do is run you through a CBCT scanner,” he explains. “As compared to a regular X-ray, this is a 3D image of your jawbone. We need that because in order to design a treatment plan for an implant case, we need a 3D jawbone where you are actually going to place the implant.

    More from the author: Top 10 worst states to be a dentist

    “Then, I use an intraoral scanner and scan your edentulous area,” Dr. Kim continues. “Wherever you are missing a tooth, I scan that area, along with some other adjacent teeth, maybe two or three other teeth. The reason why I use a digital scanner is because the cone beam scan alone is not accurate enough for a surgical guide to fit on.”

    From there, he uses specialized software to merge the two scans.

    “Then, we overlay that on top of the CT scan, and the software I use allows me to do that,” he continues. “They have implant treatment planning software that allows you to put the two together in the same place they belong in the 3D space. And then, using that software, I can actually design a surgical guide, and that file gets exported out of the software and into a Form 2. Then, I can print it.”

    Being able to do all of this in his office allows for a fast turnaround time.

    “All this happens within the first hour the patient comes in,” Dr. Kim says. “By the time you leave, I am pressing ‘print’ on my computer.”

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    Robert Elsenpeter
    Robert Elsenpeter is a freelance writer and frequent contributor to Dental Products Report and Digital Esthetics. He is also the author ...


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