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    How digital dentistry and 3D printing are changing dentures

    With more patients seeking out digital dental technology, digital dentures may soon become the norm.

    Ask any expert in the dental industry about digital workflow and the manufacturing of restorations and he or she will likely tell you how fantastic it is for crowns, bridges and implants, among other things. However, he or she probably will not mention the excellent performance for dentures or removable partial dentures. Why? Because up until recently the technology couldn’t handle it.

    Dan Elfring, CDT and in-house technician at Pickle Prosthodontics, has been a technician for 40 years and making dentures for more than a decade. He says dentures are the “laggard specialty” in digital dentistry because of challenges in scanning soft tissue and moveable attachments and printing or milling around those soft tissue movements involved in dentures.

    “Most of the scanners would only scan a static object, but as your mouth moves, your tissue moves, and the functional position wouldn’t be captured. This discrepancy would cause ill-fitting dentures,” Elfring says. “But that has been changing rapidly in the last one to three years even. They are getting some very good results with digital dentures now."

    Read more: Improving accessibility with 3D printed dentures

    Josh Gall, general manager of Axi Dental Lab, agrees that while technology is improving rapidly in the area of scanning soft tissue, many dental professionals are still skeptical about making dentures from an end-to-end digital process. In digital fixed dentistry, the technology excels at capturing the detail necessary for a restoration when scanning hard tissue. The challenge is capturing an accurate scan of soft, malleable tissue like gingiva or the palette. Dental labs often get scans with distortions where the hard and soft tissue meet or scans where the camera didn’t get the area at all.

    “So if scanners had trouble accurately capturing just a little bit of soft tissue in that small area around a crown preparation, how are we going to rely on that accuracy with an entire scan of an edentulous mouth that has no teeth in it and trust that we will be able to make a denture that will fit comfortably?” Gall asks.

    Gall says that most dentures are still made from a physical model at the lab, whether the impression was taken digitally or traditionally. Since working in the patient’s mouth is impossible, a physical model of it is the next best thing. However, he says he thinks that going fully digital with no physical model is a possibility based on improvements in the scanning technology.

    “From what I have seen lately compared to a year or two ago, that accuracy is absolutely improved and this could very well become an entirely digital process,” Gall says.

    Digital denturesJustin Marks, CDT, has 15 years in the dental lab industry and a background in dentures and partials. Marks is passionate about digitizing the dental lab, particularly those that use traditional techniques that can be time-consuming and wasteful. He founded his company, Arfona, on the philosophy that 3D printing of dentures and partials should be more accessible and not as expensive as it is now.

    “The design software that is available allowed us to design dentures and partials digitally, but printing hadn’t really caught up with it yet,” Marks says. “We were in the position where it looks great on the screen after you designed it, but how do you turn that into a tangible object for delivery to a patient?”

    Trending article: How to fabricate flexible removable partial dentures

    Dental laboratories used many materials to fabricate dentures and partials, but a digital manufacturing process didn’t exist. Marks worked with a materials manufacturer to develop a method for 3D printing using their materials. Per Marks, there are many advantages to employing a digital workflow for full and partial dentures, including:

    • Facilitating faster and more collaborative communication between technician and prescribing dentist ;

    • Increasing precision with the digital design and reducing finishing and fitting efforts once processed;

    • Improving esthetics and occlusion as a result of customization opportunities for replacement teeth;

    • Streamlining tooth arrangement and grinding needed for contacts and occlusion;

    • Reducing the denture fabrication time by eliminating the model duplication, hand-waxing, flashing, boil out and injection molding steps used in traditional fabrication processes;

    • Decreasing material costs resulting from streamlined processes that no longer necessitate grinding or residual losses of material in the milling blank. 

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