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Traditional dentistry to a full digital work�ow

Our first software CA DENTAL for orthodontic design and the equipment needed to complete the workflow was purchased in 2009. It was a troubled decision because of the economic commitment and also starting along a new digital path with the potential of a heavy learning curve. But from the outset, we have believed strongly in these new technologies, especially in the potential that 3D printing could offer and not only for the production of dental aligners.

LTO Nappo Antonio staff with their PRO2 75 UV.

This new goal was to transition the production of orthodontic and prosthetic devices to 3D printing, keeping manual operator activities to a minimum. CAD/CAM systems accelerated and greatly enhanced our design.

The two main obstacles that impeded this idea and needed to be overcome are described below:

1. Review of the current orthodontic devices, adapt and redesign for 3D printing.

2. 3D printing materials that had suitable mechanical properties and were controlled with the necessary medical certification.

The transition from analogue to digital was already becoming a reality for dental technicians so we decided to invest and to pursue this digital transition.

LTO NAPPO ANTONIO SNC is active dental laboratory with a focus on the manufacture of custom-made medical devices for orthodontic use.

In 2004, we introduced the production of dental aligners to our existing traditional activities which kick-started a learning and development process to achieve the quality of product we manufacture today. The initial processing was artisanal which imposed great limitations. Some of these limitations included the precision of the device, the complexity behind storing patient data but above all the limitation of producing volume. Our digital adventure then began in 2009.

© Asiga Pty Ltd 2017

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© Asiga Pty Ltd 2017

In 2014 we founded a start-up company, La 3DO srl, which deals exclusively with research and development and designof orthodontic devices with additive manufacturing and, where possible, secure intellectual property around these devices. It was surprising to us that there were no guidelines on the digital design and manufacture of orthodontic devices.

This study presents some of the devices we make daily in our laboratory. We currently use an Asiga PRO2 75, supplied by HI TECH + SRL (Italy), which we believe (after testing many 3D printers) is an excellence solution for the dental market. We use Detax Freeprint Ortho and Medicalprint which are certified to Class IIa according to EEC directive 93/42.

These materials are classified for long term use in the oral cavity, so they can be used to manufacture dental prostheses, orthodontic and many more dental devices.

The following pages show 3 dental case studies.

Technologies used in this case study:

3D ScannerOpen Technologies - Optical Revenge

3D Design softwareRhinoceros

3D PrinterAsiga PRO2 75 UV

3D printing materialsDetax FreePrint Ortho UVDetax MedicalPrint UV

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PLAQUES PREPARED FOR PRINTING IN ASIGA COMPOSER USING AUTO-SUPPORTS

© Asiga Pty Ltd 2017

Device 1Orthodontic Class III plaques

Orthodontic Class III plaques are used when the lower jaw is in a more advanced position compared to the upper jaw, with the incisors having a "head-to-head" ratio or, in a more serious case of bite reversal.

Intermaxillary elastic bands can be installed to this Orthodontic Class III plaque or alternatively the upper plaque can be combined with a Delaire mask. We have prepared the upper plaque for both solutions.

Conclusion. Able to demonstrate the possibilities to the dentist remotely. Receive data from dentist, digitize and return to the dentist for review prior to production.- Simple to modify if changes are required- Minimal waste material by 3D printing devices- Accuracy maintained

PLAQUES PRINTED 40 MICRONS AND FINISHEDPLAQUES PREPARED FOR PRINTING IN ASIGA COMPOSER USING AUTO-SUPPORTS

PLAQUES ON GYSPSUM MODEL OCCLUSION VIEW

PLAQUE FRONTAL VIEW / PLAQUE WITH ELASTIC CLASS III /PLAQUES IN PERFECT OCCLUSION/SHINING AND BRIGHTNESS OF PLAQUES

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© Asiga Pty Ltd 2017

Device 2The clinician wanted to treat this patient with aligners to solve the malocclusion. The rotation of elements 14 and 24 would have involved a considerable number of aligners as well as being a distance too large to move with traditional aligners. An added complication was that the patient reported an allergy to nickel, and therefore metal elements were unsuitable.

It was decided to make an orthodontic plaque with grips in such a way to apply a force on each side. Treatment was complete two months after the application of the device.

We thank Dr. Carmen Capone for the granting of intraoral photos.

Conclusion. The time taken to achieve alignment was very short - adjustment taking only 2 months. By using traditional aligners it would be taken almost 12 months to achieve full adjustment.

MODELING OF DEVICE OCCLUSION VEW / PARTICULAR OF MODELING OF DEVICE

DEVICE PRINTED PERFECT FITTING ON MODEL, NEITHER DISTORTION OR SHRINKAGE / ELASTICS / APPLYING OF VESTIBULAR ELASTICS FOR OBTAINING COUPLE OF POWERS / PARTICULAR OF DEVICE

INTRAORAL VIEW: ELEMENTS 14 AND 24 ARE ROTATED INTRAORAL VIEW AFTER 2 MONTHS: DEROTATION ALMOST FINISHED

DEVICE AUTO-SUPPORTED IN COMPOSER AND PRINTED AT 40 MICRON LAYERS ON PRO2 75 UV

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© Asiga Pty Ltd 2017

Device 3This is a functional device that can be manufactured according to a clinical prescription. The modules that can be added are borrowed from the various functional devices. The assembly of the numerous components makes possible a great variety of solutions.

DESIGNING OF DEVICE FRONTAL VIEW / LATERAL VIEW / UPPER VIEW / LOWER VIEW.

DEVICE IN ASIGA COMPOSER PREPARED FOR PRINTING AT 80 MICRON LAYERS. DEVICE BEING PRINTED WITH PRO2 75 UV IN DETAX MEDICAL PRINT

POST CURING OF DEVICE / PARTICULAR OF DEVICE AND SUPPORTS

DEVICE ON LOWER MODEL / DEVICE ON MODEL LATERAL VIEW / DEVICE ON MODEL FRONTAL VIEW / UPPER VIEW

DEVICE FINISHED LIKE A REAL JEWEL

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© Asiga Pty Ltd 2017

Device 3 continued

Conclusion: This device is constructed in multiple pieces but printed on the same 3D printer. A single part component is more attractive and easier to maintain by the patient. Device is easily customizable to suit other patients.

DEVICE IN THE MOUTH DETAIL SHOWING BITE IN THE MOUTH

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© Asiga Pty Ltd 2017

We would like to thank:

LTO Nappo Antonio Italy for creating and sharing this study with us.http://www.ltonappoantonio.it

3DO s.r.lhttp://www.3dosrl.it

Italy reseller – Hi Tech Plus s.r.lhttps://www.hitechplussrl.com/ht+

For more information on Asiga 3D printers visit:

www.asiga.com