case report Same-day conservative aesthetic rehabilitation with Permanent Crown Resin opinion 3D printing drives innovation buyer’s guide Resins in 3D printing in dentistry 3D printingissn 2193-4673 • Vol. 2 • Issue 2/20222/22international magazine of dental printing technology

editorial | Dr George Freedman Editor-in-chief 3D printing in dentistry: The need for leadership 3D dental printing is harmonious with the continuing positive evolution of dentistry. As a field of study and practice, it is clearly distinct from prior dental technol- ogies and techniques yet totally in sync with the arc of dental development. The rapid acceptance and uptake of 3D-printing technologies in a wide range of dental procedures points to the need for an organisational structure to set manufacturing, laboratory and clinical standards and to begin the formulation of a comprehen- sive educational platform that will serve to train dentists and technicians worldwide. Because 3D dental printing is so innovative, so prom- ising and so disruptive, it is unlikely to find a truly ac- commodating niche, one that would nurture its growth and progress, within existing, and necessarily compet- itive, dental organisations. For the very same reasons that cosmetic dentistry could not have flourished as it did within the confines of prosthodontics or traditional restorative dentistry 40 years ago, 3D printing must en- gage open minds and imaginative spirits and empower science-based risk-takers who will challenge conven- tional wisdom and established practice. Thus, it is es- sential that a new organisation dedicated solely and exclusively to 3D dental printing be convened, at the earliest opportunity. Ideally, this will be an organisation that will offer an open forum for free discussions and timely presentations of new ideas (even if they seem far-fetched), an open membership that is affordable and one that will not only attract and collect information and clinical feedback, but effectively disseminate this infor- mation around the globe. What groups of experts are required to lay the foundation for the next major leap in dentistry? They must include: – hardware experts (who develop the printing technol- ogies and devices); – software experts (who drive the hardware and link clinicians, laboratory technicians and patients); – technicians (who use the technology to turn raw mate- rials into restorations etc.); and – dental professionals (who diagnose, plan treatment and deliver restorations to patients). And would it not be interesting, and ultimately appropri- ate, to have this convening meeting at the International Dental Show, where so many of the world’s experts in the fields mentioned gather? The show is celebrating its 100th anniversary, and it would be fitting to initiate its second century by inaugurating this most fundamental transformation of the dental profession. Dr George Freedman Editor-in-chief 3D printing 2 2022 03

S y s t e m i a l O p e n M a t e r i d a t e d R e s i n s 2 0 0 V a l t y M a x i m u m F l e x i b i i d a t e d W o r k fl o w V a l s i b l e E n d R e s u l P o s s t i l t O v e r B e s C H E C K O U T Y O U R D 5 0 + rapidshape.de

“To maintain good oral care, the focus should be on preventing oral diseases and reducing the need for comprehensive dental treatment.” properly fits in the patient’s hand in order to improve the quality of brushing. Dr Colvenkar told DTI that the research team was waiting for expressions of interest from manufacturers and researchers so that the 3D-printed handle can be made available and benefit the population. In their report, the authors emphasised: “To maintain good oral care, the focus should be on preventing oral diseases and reducing the need for compre- hensive dental treatment. The final objective should focus on maintenance and self-care to improve quality of life.” news | Researchers in India have developed a customised and interchangeable 3D-printed handle for tooth cleaning products for patients with limited manual dexterity. (Image: © Dr Shreya Colvenkar et al./Cureus) Editorial note: The report, titled “Individually modeled 3D printed toothbrush and interproximal brush handle with name for patients with limited manual dexterity”, was published online on 21 July 2022 in the Cureus Journal of Medical Sciences. AD Messe Frankfurt Group 15 – 18 NOVEMBER 2022 FRANKFURT / GERMANY We know that Additive Manufacturing offers undrea med-of potential. In addition to the printer, however you also need the upstream and downstream processes plus the experts, who have mastered the formnext.com Content partner Honorary sponsor PARTNER COUNTRY FRANCE 3D printing 2 2022 11

interview | Rebecca Hall, a fi nal-year mechanical engineering student at the University of Central Florida in Orlando in the US. “A big part of working with 3D printing is troubleshooting, and that’s not something taught in college.” by taking a basic CAD course or one on an industry- specific program to learn how parts are designed. But you don’t have to know CAD to be successful at 3D printing; you can always grab existing files avail- able online to start out and just print. Buying a cheap, basic printer is a great way to practise and to learn how to troubleshoot before investing in anything specific for your business. You will waste less money later by practising before you graduate to a more expensive, task-specific printer. Google, YouTube and hobbyist groups are going to be the best resource as you learn. A lot of off-the-shelf 3D printers are very beginner- friendly, as is the software itself. They’ve eliminated a lot of steps we needed to use in the past. Often, I find them easier to use than a regular, 2D, printer! 3D printing 13 2 2022 13

a new denture can be easily refabricated using the digital files and only a seating appointment is required. Comparing milling and 3D printing Milling has been used in the dental profession for longer than 3D printing. The most significant difference between the two technologies is how they are conducted. Milling, or sub- tractive manufacturing, begins with a solid block of material (such as PMMA or zirconia) and uses cutting tools to remove material until the final shape is achieved. In contrast, 3D printing, or additive manufacturing, uses various processes to build up the raw material into its final shape, one layer at a time. Dental 3D printers typically use a viscous liquid resin that reacts with light to become solid, using a laser or other light source to se- lectively expose the material to light and polymerise it in place. Given the difference in the nature of the manufacturing pro- cesses, the design parameters to bear in mind are different. In milling, we acknowledge limitations such as milling radius compensation during the design and preparation of our restoration or splint for its specific output. In 3D printing, there are fewer design limitations, but file preparation for manufacturing requires more attention, such as the orien- tation of the part relative to the printer (Fig. 2) and the use of supporting structures to hold the part securely during the printing process (Fig. 3). The costs of operation and maintenance of each manufac- turing option are relevant when analysing investment. In milling, it is important to acknowledge the total waste generated in production, as well as the long-term maintenance costs. In printing, the waste is reduced owing to the nature of the manufacturing process, but some equipment requires nearly as much maintenance as milling machines, and consum- ables like resin tanks can be expensive. Lastly, the materials available and developed for each manu- facturing system and clinical indication are important to analyse and understand, as well as the clinical scenarios for which dental professionals will opt for one technology or the other. Comparing 3D-printing technologies As mentioned, most dental 3D printers use a liquid resin in a technology called vat photopolymerisation, but several other technologies exist, including powder bed fusion (such as selective laser sintering), material extrusion (such as fused deposition modelling) and material jetting. Within the category of vat photopolymerisation are the techniques of low-force stereolithography, stereolithography, digital light processing and liquid crystal display (Fig. 4). When choosing a 3D-printing technology, it is important to consider several aspects, the most important of which are accuracy, production time and material availability. Accuracy can be measured in multiple ways. Trueness and precision refer to how closely the produced part matches the digital file. This can be achieved through a combination 4 Fig. 4: Different 3D-printing categories. SLA = stereolithography; DLP = digital light processing; LFS = low-force stereolithography. of equipment specifications, such as resolution in the x- and y-axes, layer height (resolution in the z-axis) and laser spot size. Post-processing methods, such as post-polymerising the printed part, can also impact accuracy. With the fast pace of clinical dentistry, timing is critical. How- ever, printing time is only one step of the process. File prepa- ration, post-processing and final clean-up of parts may be more time-consuming, and crucially, these are the steps that take up valuable technician or assistant time. Be sure to eval- uate the entire production time, not just the printing speed, when looking at production speed. Lastly, material availability varies. Consider whether it is more important to you to have highly versatile equipment or to have equipment that is specialised for a certain use case. Research your intended use case and look for material availability, often categorised by whether it is biocompatible or not—if biocompatible, whether it is Class I or Class IIa— and the intended application. It is also important to look into certifications or product approvals (U.S. Food and Drug Ad- ministration, EU medical device regulations, and others) and the implied suitability for the intended application (Figs. 5 & 6). Carefully read and follow protocols In the absence of in vivo results, following the right protocols according to the manufacturer’s instructions is key (Fig. 7). Manufacturers conduct testing according to International Organization for Standardization (ISO) standards to guarantee that the mechanical and biocompatible properties of parts made with their materials are suitable for their intended ap- plication, and they publish these protocols in their instruc- tions for use documents. Following these protocols precisely is mandatory to ensure biocompatibility and optimal perfor- mance of the printed part. Fig. 5: Complete denture printed in Denture Base Resin and Denture Teeth Resin (both Formlabs) in 50 μm. Fig. 6: Restorative model printed in Model Resin (V3, Formlabs) in 50 μm. 5 6

case report | 5 6 7 8 Figs. 5–8: Digital scanning and design. digital dentistry lies. This technology allows dental pro- fessionals to obtain optimal results with fewer digital tools, less investment in equipment and reduced costs per part, among other advantages. The question now is what the best material is for the different dental applications, specifically for restorative dentistry. I have tested all dental materials available for use with 3D printing, but lately I have been focusing on the new restorative ones, such as Temporary CB Resin and Permanent Crown Resin (Formlabs). Today, my overall perception is that these materials are a via- ble solution and guarantee a promising future for up- coming restorative printable materials. These resins have been proved to be able to produce good clinical outcomes, having the right mechanical and aesthetic properties to last for a long time. We always look to use dental materials that simulate the natural tooth and possess properties that mimic those of the natural structures. 9 Fig. 9: Oriented and supported restorations in PreForm. 3D printing 2 2022 19

case report | 18 19 Fig. 18: Isolation of the operating field. Fig. 19: Try-in of restorations. Can 3D-printed restorations be considered a good aesthetic solution? It is important to understand that these printable ma- terials are monolithic and therefore are aesthetically different to ceramics, for example lithium disilicate. This is important because colour modulation and aesthetic perception will differ from those of traditional layered restorative materials when placing these in the patient’s mouth. Though for posterior restorations the aesthetic demands are lower, this have raised questions about how aesthetic these monolithic restorative materials appear in the anterior region. Should we limit their use to specific sections of the mouth? With this clinical case, I want to showcase that high-quality aesthetic outcomes can be achieved with this material, but that it does not depend on the printing phase alone. It is critical that an optimal design is done in the CAD phase, allowing the creation of natural textures that will be then replicated via 3D printing and will play a vital role in light modulation and overall perception. Moreover, it is critical that dental professionals learn and follow the manufacturer’s instructions and protocols regarding post-processing, including specific washing times, polymerisation cycles with times and tempera- tures, characterisation and glazing, and finally, adhesive cementation in order to guarantee the short- and long- term success of the printed restorations. Following the instructions guarantees biocompatibility of the parts and that their mechanical properties will be optimal. Case presentation Diagnosis A 30-year-old male patient consulted us for a clinical evaluation, as he was unhappy with the current evo- lution and timing of the orthodontic treatment he was undergoing in another clinical practice (Fig. 1). A CBCT scan was indicated in order to perform an interdisciplin- ary evaluation of bone and periodontal structures with the orthodontist. After the clinical and paraclinical eval- 20 21 22 Fig. 20: Sandblasting. Fig. 21: Silanisation. Fig. 22: Cementation via the preheated resin adhesive technique. 3D printing 2 2022 21

case report | 28 29 30 Fig. 28: Washing and drying. Fig. 29: Application of primer and bonding. Fig. 30: Placement of restorations. Manufacturing stage The STL file was imported into PreForm print preparation software (Formlabs), where the restorations were given the correct print orientation and supporting structures (Fig. 9). The restorations were sent to the Form 3B printer (Formlabs) to be fabricated with Permanent Crown Resin in Shade B1 within our clinic (Fig. 10). After printing, the restorations were removed from the build platform and washed in 99% isopropyl alcohol for 3 minutes in the Form Wash (Formlabs). The parts were dried using compressed air. The first polymerisation cycle was done in the Form Cure (Formlabs) for 20 minutes at 60 °C. The surfaces were sandblasted carefully to remove the powder surface coating (ceramic fillers contained in the resin) using the AquaCare (Velopex) at 150 kPa maximum pressure (Fig. 11). We then removed the supporting structures using a di- amond disc (Fig. 13). The second polymerisation cycle was done in the Form Cure for 20 minutes at 60 °C. The next steps were critical for guaranteeing success. All external surfaces of the restorations were polished in two stages, first using DiaShine Super Fine Soft with a soft brush at 8,000 rpm (Fig. 13) and then using DiaShine Coarse with a medium brush at 8,000 rpm (Fig. 14). The restorations were then characterised and glazed (OPTIGLAZE Color, GC) for further customisation (Figs. 15 & 16). After completing this step, a final characterisation step with the restorations seated in the patient’s mouth was done. This was a critical step to ensure the perfect aes- thetic integration of the restorations. After placing the printed restorations in the patient’s mouth, an evaluation on the impact of the tooth substrate colour on the res- torations was done. In a moisture-controlled operating field, the restorations were finally characterised in differ- ent areas (cervical, incisal edges and borders). Glaze was applied to finalise the restorations (Fig. 17). Delivery and cementation protocol As this case was for same-day delivery, no temporary restorations were necessary. The operating field was set up using a dental dam. This allowed us to completely isolate the site from the moisture of the oral cavity and improve visibility. The restorations were tried in to validate their insertion and fit (Figs. 18 & 19). As for cementation, the following steps were performed simultaneously on the tooth structures and the internal surface of the restorations with the help of the dental assistant. 31 32 Fig. 31: Light polymerisation. Fig. 32: Cemented restorations. 3D printing 2 2022 23

would be achieved with a mock-up for advanced aes- thetic dentistry permitting controlled preparation, that is, preparation that is calibrated on the different thick- nesses of the mock-up. This basis would be used to create semi-indirect veneers for space closure (Type IIB veneers according to Magne and Belser).1 Treatment During the first appointment, photographs (Figs. 1–3) and alginate impressions of the dental arches were taken. After photographic study of the case, the nec- essary aesthetic and functional corrections were per- formed by means of an analogue diagnostic wax-up phase. The wax-up was transferred to the patient’s mouth in the form of a mock-up that he tested in his mouth for a few days prior to the operative session. At the following appointment, this was used as a work- ing mock-up for calibrated preparation, that is, a mock- up-guided approach for extremely minimally invasive, controlled tooth reduction. To simulate the final result as already seen with the an- alogue wax-up as accurately as possible, the waxed-up model was scanned.2 For moulding the mock-up from the wax-up (Figs. 4a & b), a silicone index was created on the wax-up (Fig. 4c). Composite (Structur 3, VOCO) was injected into this silicone key to create the mock-up. The diagnostic mock-up was temporarily cemented (Provicol QM Aesthetic, VOCO) in the patient’s mouth for a few days until the operative session. At the next appointment, the mock-up took on the role of a working guide for controlled preparation. Controlled- thickness reduction grooves were made in the mock-up for orientation, as they were used to determine the depth of the preparation and thus the desired material thickness of the veneers (Fig. 5). For providing clear ori- entation, the guiding grooves were marked with a pencil (Fig. 6). Where the residual mock-up remained, the tooth was intact (extremely minimally invasive preparation). Only in the areas where the mock-up had been com- pletely ground down was there an effective preparation of the tooth structure (Fig. 7). Compared with conventional veneer preparation, for which the dentist grinds the tooth structure directly from the beginning, this procedure allowed for much more conservative tooth reduction. It was decided not to intervene in the lateral and protru- sive movement. The first step was to perform window or Walls, Steele and Wassell Type A preparations,3 meaning that the preparations were only carried out on the vestibu- lar aspect, without finishing margins and without any reduction of the incisal edge. However, an incisal butt joint margin was carried out to cover the incisal edge without any vertical reduction in the palatal area. It has case report | 4a 4b 4c Fig. 4a: Analogue wax-up on the gypsum model, palatal view. Fig. 4b: Analogue wax-up on the gypsum model, vestibular view. Fig. 4c: Silicone index for moulding the mock-up in composite for the provisional restoration. been shown that such a covering of the incisal edge achieves a higher survival rate than preparations with a palatal chamfer.4, 5 5 6 7 Fig. 5: Operative phase in which the mock-up acted as a guide for highly conservative, controlled preparations. Fig. 6: Guide grooves marked with pencil for calibrated preparation primarily on the composite. Fig. 7: Mock-up removed with pencil marks where the preparation would continue directly on the tooth (sacrificing the mock-up spared healthy hard tissue). 3D printing 2 2022 27

® HIGHCLASS 3D RESINS N E W 3D CATALOGUE MDR CERTIFIED 2020

Things you should not shake! V-PRINT PRINTING MATERIALS: ALWAYS OPTIMALLY HOMOGENEOUS No need to be shaken – you define the timing of your workflow Efficient – save time and costs for homogenisation devices, print savely – even overnight! Reproducible – product properties are reliably achieved, again and again TRUSTED PARTNER All print partner can be found here www.voco.dental/3dprintingpartners Please visit us in Cologne 14. − 18.03.2023 Hall 10.2: Stand N10/O19 + N20/O29 Hall 5.2: Stand C40 VOCO GmbH · Anton-Flettner-Straße 1-3 · 27472 Cuxhaven · Germany · Freecall 00 800 44 444 555 · www.voco.dental

Europe's Nº1 orthodontic chain The Impress invisible orthodontic treatment has been named the best orthodontic treatment of the year 2022 130 clinics across 9 different countries 500 medical professionals specialized in orthodontics Impress Latest innovation in clear orthodontics More than 50,000 happy patients Scan this QR code to discover Impress

opinion | place the implants and then as quickly as possible pro- duce a temporary restoration that would be immediately loaded. Pre-extraction scans of the mandibular dentition and of the maxillary denture in occlusion were first taken. Selected teeth were then extracted from the mandible, and the anterior implants, multi-unit abutments and su- tures were placed. Tektonics with wings were placed upon the anterior multi-unit abutments and bonded within the wing guttering systems. The bonded Tektonics and the remaining teeth were scanned (although we only kept two teeth for superimposition, it still worked very well). This allowed the laboratory team to align the anterior im- plant positions with the bite in the pre-extraction scan. After scanning, the Tektonics were removed and the rest of the teeth were extracted. The posterior implants, multi- unit abutments and sutures were placed and the anterior Tektonics re-affixed. As a result of the Tektonic wing-to- wing bonding system, the Tektonic scanning bridge will not be affected by vertical shrinkage and will thus not incur any meaningful dimensional change in the cross-arch scan. The posterior Tektonics were placed, the full complement of the cross-arch Tektonic scanning bridge was scanned and the Tektonics were removed. Depending on the type of scanner being used, the Tektonic scan file can be locked and copied so that a digital verification and full soft-tissue scan can be created. This is done by cropping the Tektonics from the scan and then rescan- ning over the multi-unit abutments and any soft tissue that may have been missed in the full-arch Tektonic scan. The files were then sent to the laboratory for the tem- porary fixed restoration. The present and the future For the dentist, Tektonic’s innovation will mean significant time saved and less stress, along with more confidence in the accuracy of the restoration fitting, all while using a fully digital workflow. The patient will also be far less inconvenienced, thanks to shorter appointment times, and feel more comfortable with dental procedures, as traditional intra-oral impressions and record taking are no longer required. The emergence of intra-oral scanners and 3D-printing technology has revolutionised the prac- tice of implant dentistry and enabled the development of the Tektonic system. I look forward to seeing how the Tektonic system continues to evolve with ongoing devel- opment of innovative digital workflows. when recording implant positions is that anatomy does not care about dental innovation. The anatomy presents in unique and often very complex patterns. When you add multiple implants to that environment (which are often at divergent angulations) and then try to accurately record these positions digitally, it can be very difficult to scan, particularly in the edentulous mandible. That is why Tektonic is not a horizontal scanning system. It is a vertical one with fixation points to allow a myriad of geometric wing piece options which overcome the incon- gruent nature of the oral anatomy. The 3D-printed wing pieces are selected according to the best shape for the implant position and anatomy. They are then locked on to the titanium core piece. This core piece is then screwed to the implant multi-unit abutment so that the practitioner can bond the wings together in the Tektonic guttering systems using dental composite. This results in a rigid scanning bridge upon which to follow and record implant position and soft tissue—a verification jig (both virtual and physical). The bonding together of the wings allows a truly unique scanning path that is very easy to traverse. Tektonic workflow To demonstrate the use of Tektonic, this example will cover the steps of a workflow for an immediate loading protocol in the case of a patient with a complete maxillary denture opposing failing mandibular natural dentition. The treatment goal was to extract the mandibular teeth, Leif Svensson is the co-founder and creative director of Tektonic Scankraft company in Australia which offers innovative solutions for full-arch implantology. More information can be found at www.tektonicscan.com. about 3D printing 2 2022 35 © Tektonic

user report | 3 Fig. 3: The SprintRay Cloud Design service supports users who are looking to print directly from the scan without performing CAD themselves. With fast turnaround times, specialised design teams individually prepare printable STL files according to users’ requirements. to greater inaccuracies, however. It is therefore import- ant to know the correct layer thickness for each work- piece. There are also a few basics to keep in mind for achieving good printing results. For example, the printer should not be placed in direct light, the room tempera- ture should be kept stable and the air should be as dust-free as possible. We have been using various intra-oral scanners in our dental office since 2012. Our dentures and splints are also fabricated digitally. A milling machine is also avail- able to us to enhance chairside workflow. The launch of 3D printing using the SprintRay Pro printer closed the yawning gap in our internal digital fabrication pro- cesses. It has always been important to us that all processes are quick and easy alongside the daily office routine and do not have to be transferred to dental technicians who have to be specially employed for the task. This process also clearly defines the range of indica- tions for workpieces produced in the office. Fabricating models for creating retainers, splints, thermoformed aligners, custom trays and even simple night guards is now easy to accomplish in the dental office. Temporary restorations, eggshell temporary restorations and dig- ital mock-ups can also be produced in this way. The appropriate CAD software must be available for these applications. As the added value remains in the of- fice, the acquisition costs can be paid off very quickly. SprintRay has also introduced a cloud design service recently, which we have not tried yet, but which would take the CAD software completely out of the equation. The printing software (RayWare) that is used with a SprintRay printer is very simple and can also be used by practice staff after induction training. RayWare sup- ports the user in positioning the object, mounting any necessary supporting structures, and selecting the right resin and the required layer thickness. Plenty of materials are available for the SprintRay printer, from the manufacturer and from third parties. Special car- tridges are not required. The appropriate resin tank is then placed in the printer, and the printing process is started. With the new RayWare Cloud solution, all these steps are automatic. Post-processing of the printed workpiece is important in achieving a good printing result. Pro Wash/Dry is a very high-quality device from SprintRay for washing objects in isopropanol. This is an automated process. After washing the object, the object is then light- polymerised in ProCure 2, heating and light intensity varying depending on the material. The software sets the pressure and polymerisation parameters automat- ically according to the material specifications. 3D printers are now an indispensable tool in the digi- tal dental office for fabricating a wide variety of work- pieces. 3D printing 2 2022 37

industry news | Research and development in the field of resins is ongo- ing. Regulatory requirements have become stringent owing to the new EU Medical Device Regulation and the latest U.S. Food and Drug Administration regulatory framework for the 3D printing of medical devices. Thus, validated manufacturing processes are indispensable prerequisites which include the—often underestimated—post-processing steps: washing and postcuring. Compliance to wave- length, intensity, time, and atmospheric conditions such as vacuum are essential. Seamless end-to-end process- ing equipment allows users to execute and protocol the validated process parameters at the touch of a button, all linked to the specific patient case. Bioresorbable 3D-printing resins— helping people heal in the future So where will the resins of the future take us? Consider as a future application the ideal polymer for use in regen- erative medicine. Such resins must not only be biocom- patible but also exhibit non-toxic biodegradation with mechanical properties matched to specific applications, whether they be soft tissue, connective tissue or bone. The UK-based company 4D Biomaterials is intensively engaged in the development of 3D-printable, biocom- patible and bioresorbable material and is supported in its work by the 3D printer manufacturer Rapid Shape. The 4D Biomaterials photocurable resin brand 4Degra is based on polycarbonate urethane chemistry and is available in several grades. Early tests show that 4Degra materials promote cell growth significantly better than in- cumbent bioresorbable polymers such as polylactic acid and polylactic-co-glycolic acid. The resin inks are already available for use in research and development projects. without requiring manual removal of the print job. The excess material remaining on parts and the platform can thus be recovered during the automatic separation process. This allows up to 25% resin recovery. As such, the 3D printer comes with a designated device for clean material recovery. Sustainability in 3D printing— material savings and material recovery 3D printing of the future is automated Sustainability and environmental compatibility are the words of the day in many industries and are hot topics for manufacturing companies. For this reason, every company must make sustainability its goal, acting in the interest of future generations. Material use, material savings and material recovery are all- important in 3D printing in order to make the print- ing process not just sustainable but also effective and economical. 3D-printing technology is in its prime. In terms of pro- jection technology, meaning digital light processing, manufacturers are moving at the highest technical level. This is because this technology makes it possible to print high-resolution parts repeatedly over a long period of time. Handling is manageable, and the system ends up remaining cost-effective. In addition, the processes are becoming increasingly digitalised and automated, pro- viding process reliability and saving time. Manufacturers of modern 3D printers have established the technical prerequisites for material savings. An auto matic part separation module reduces idle time between two print jobs significantly and enables op- erations to produce multiple print jobs seamlessly one after the other in a self-determined sequence without having to remove the build platform from the printer and As for the materials in 3D printing, we foresee continual, strong development on the horizon as research continues. Close collaboration between material manufacturers and 3D printer manufacturers will continue to lead to innova- tive solutions. The everyday use of 3D-printing systems has already proved useful in many new areas and is sure to become standard across production. 3D printing 2 2022 39

were dental graduates. Denture manufacturing was time- consuming and labour-intensive, relying entirely on the skills and experience of dental technicians. As the process was often prone to quality defects, the entire manufacturing process was affected. In 2008, JC Dental Technology introduced several pieces of imported digital dental equipment, improving manufac- turing efficiency to a certain extent. However, owing to im- mature technology and after-sales services, the company faced many problems. In 2016, JC Dental Technology officially cooperated with UnionTech to widely apply UnionTech’s professional dental 3D-printing technology to denture manufacturing, providing digital turnkey solutions for dental practices. 3D-printing technology not only simplifies the traditional 20 or more production processes to just three to five processes, greatly saving on time and labour costs, but also changes the traditional process of manufacturing silicone aligner tray seaters, enabling precise customisation and improving patients’ comfort. Digital dental application scenarios Image data is transmitted via the cloud to accurately deter- mine design plans. After an order is placed on the JC Dental Technology FC Implant supply chain platform, a dental mock-up is designed on the FC Implant software using the patient’s CBCT data to precisely restore the patient’s intra-oral condition. Data can be quickly saved to the platform after transfer, greatly shortening the impression taking process. Based on the data, dentists can design and make the most accurate implant plan and confirm the best position to install the virtual implant into the patient's alveolar bone, providing predictive guidance for the actual procedure. With the help of 3D-printing technology, the dental treatment quality is improved. The digital dental application system developed by UnionTech has transformed the manufacturing of JC Dental Technology. 3D-printing technology enables JC Dental Technology to precisely and efficiently manufac- ture dental surgical guides, mock-ups, temporary crowns, dentures, custom temporary abutments and other dental appliances. The high-quality products provide double insurance for dentists and patients The surgical guides printed by UnionTech’s dental 3D printers and the dedicated surgical kits provided by JC Dental Technology FC enable precise implant placement. Accord- ing to previous findings, the actual position of an implant in the alveolar bone deviates from the position planned in the preoperative design by no more than 1.2 mm. With 4 6 8 5 7 9 Figs. 4 & 5: Surgical guide and model manufactured using 3D-printing technology. Figs. 6 & 7: Custom temporary abutment on a 3D-printed model. Figs. 8 & 9: Temporary crown on 3D-printed model. a high-precision surgical guide, a temporary abutment and a temporary prosthesis can be placed in the same session as the implant placement. According to Qian Yuan, general manager of JC Dental Technology, UnionTech’s 3D-printing technology completely digitises the JC Dental Technology FC Implant platform into a one-stop implant solution for dentists and patients. This solution offers unprecedented convenience for both dentists and patients: dentists can design surgical guides and accessories and complete plan communication and confirmation in the supply chain, and the patient benefits from immediate restoration. 10 Fig. 10: UnionTech’s dental 3D printers. 3D printing 2 2022 41

industry news | produce highly accurate and reliable appliances that pre- viously had been possible only with traditional fabrication methods. Glidewell has been steadily advancing its 3D-printing capability from top to bottom. The laboratory’s workflow improves case success rates by using proprietary soft- ware to streamline the 3D-printing process. This software enhances every aspect of the process, including impres- sion taking, design and fabrication. It has been tweaked and optimised, eventually reaching the point of self- automation, which has contributed to more accurate, consistent results. Glidewell is committed to increasing production using 3D-printing technology, aiming for the optimal combina- tion of speed and affordability. As part of its initiative to expand on the assortment of 3D-printable resins, products such as the Comfort3D Bite Splint especially stand out. The splint offers a more precise fit than splints produced with traditional techniques, and because it is 3D-printed, there is no excess material left on the appliance, resulting in a more comfortable fit for patients. Additionally, Glidewell has invested in printers that can print using different materials. Selective laser sintering (SLS), for example, has a promising future. By utilising the cutting-edge SLS technology to print high-quality metal frameworks for partial dentures, Glidewell show- cases its capability of exploring new options and extending the scope of 3D-printed products. The most exciting part of Glidewell’s ambitious 3D trans- formation is that it allows clinicians to benefit from tech- nological advances without the need to invest their own time or money. Jason Song, director of laboratory operations, discussed the company’s goal: “We disrupt ourselves for the betterment of the customer. We never want to get comfortable and miss out on utilising the newest technology just because what we’ve done has worked out so far. We always have a progressive mindset, advancing dentistry and making it more consistent as well as more accessible.” The goal for Glidewell is not to deter clinicians from util- ising in-office 3D printers. Rather, Glidewell is seeking to improve materials, design software and workflows so that when in-office printers become more prominent and realistic for practices Glidewell can offer clinicians better solutions at an affordable price, in line with its goal of democratising dental technology. “We trust the technology,” said Song, “and we believe that it can improve dentistry as a whole. Our ultimate goal is to broaden the imagination of what can be achieved with 3D printing. And we are excited to be at the fore- front.” 3D printing 2 2022 43

industry news | 5 6 Fig. 5: Design in 3D Sprint software. Fig. 6: NextDent C&B MFH material for crowns and bridges. Designing customised appliances At NEOLab, the team works together closely with many dentists who submit their cases digitally. Utilising digital workflows allows the appliances to more quickly reach the technicians, saving valuable time. This creates extra floor time, allowing the team to make even higher quality appliances. Breeze explained: “I have a team of three 3D-printing technicians. They all use 3D Systems’ 3D Sprint nesting software. The software is so user-friendly and consistent that I am unable to determine who did the nesting.” 3D-printed pontics NEOLab is one of the few laboratories that utilises 3D-printed pontics. 3D Systems’ NextDent 5100 has proved to be a reliable printer for NEOLab, accurately printing teeth with the necessary cleanliness and dura- bility. Christian Saurman said that he has seen increasing numbers of 3D-printed teeth, and he expects the market to expand further. According to the 3D pontic designer at NEOLab, Kim Jordan, 3D-printed pontic teeth allow her to mirror or copy other teeth in a way that looks more natural than other methods can achieve. During the process, she also designs a ridge at the patient’s gingival margin that allows the pontic to click con- sistently into the correct position and eliminates the need for adjustments to create a perfect fit by the next department. Bringing it all together At NEOLab, the team pushes the limits of digital tech- nology. Speaking from experience, Breeze said, “We’re glad to have a printer that quickly and reliably produces our appliances and are proud to send them out to our dentists and their patients. We put our passion and ded- ication into our work and when they receive our printed products, it makes them both smile.” Jordan summed it up beautifully: “When I design teeth, I am shaping someone’s confidence, and the end result is going to be a smile—a perfect smile!” www.neolab.com 7 8 9 Fig. 7: Printed pontics. Fig. 8: Kim Jordan, 3D pontic designer at NEOLab. Fig. 9: 3D-printed pontic teeth on the model. 3D printing 2 2022 45

industry news | in major cities throughout Europe (including in the UK, Spain, France and Italy). Although some competitors can provide the same services, none do so from their own clinics, leaving patients under the care of third- party dental services and therefore open to unneces- sary risk. Impress prides itself on its unique value proposition, being the only invisible aligner provider to offer in-depth medical examinations and treatment monitoring led by in-house orthodontists. Because direct-to-consumer models continue to lose credibility, Impress employs a hybrid model, having its own technology-enabled ortho- dontic clinics since the very beginning. This has led to industry-leading sales conversion rates, an exceptional customer experience and best-in-class clinical out- comes, all driven by a combination of technologies that is becoming more difficult to replicate. The company also has its own digital treatment planning and mass aligner production facility, elevating the business to true full-service status. Technology is one of the main pillars of Impress. It has strategic partnerships with 3D-printing technology company Carbon and with HP, taking advantage of the capabilities of the latter’s Multi Jet Fusion technology. The digital orthodontic brand’s growing network of hybrid clinics is supported by practice management “At Impress, all vital services are carried out by expert teams in the company’s own clinics, which are now in major cities throughout Europe.” software and a best-in-class treatment monitoring app that make use of artificial intelligence. Impress takes the top spot In just three years, Impress has become the No. 1 brand and category leader in Europe. With more than 130 clin- ics in nine countries, Impress has a global team of over 1,000 employees, of which 500 are medical professionals specialised in orthodontics. For more information, visit www.smile2impress.com or contact impress@fullvolumepr.co.uk. 3D printing 2 2022 47

REGISTER FOR FREE DT Study Club – e-learning community THE GLOBAL DENTAL CE COMMUNITY THE GLOBAL DENTAL CE COMMUNIT Y THE GLOBAL DENTAL CE COMMUNIT Y THE GLOBAL DENTAL CE COMMUNIT Y THE GLOBAL DENTAL CE COMMUNIT Y webinars / live operations / online CE events / CE credits www.dtstudyclub.com @DTStudyClub Tribune Group is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.This continuing education activity has been planned and implemented in accordance with the standards of the ADA Continuing Education Recognition Program (ADA CERP) through joint efforts between Tribune Group and Dental Tribune Int. GmbH.

NextDent Surgical Guide FREEPRINT CAST 2.0 FREEPRINT CROWN FREEPRINT DENTURE 3D Systems (Vertex-Dental B.V.) DETAX DETAX DETAX  US FDA  USA FDA 510(k)  USP Class VI  MDR  KFDA  Other  US FDA  USA FDA 510(k)  USP Class VI  MDR  KFDA  Other: ....................................... Non-medical device  US FDA  USA FDA 510(k)  USP Class VI  MDR in progress  KFDA  Other: ................................... Worldwide in progress  US FDA  USA FDA 510(k)  USP Class VI  MDR  KFDA  Other: ..................................................... Worldwide  Europe: .......................................................... Class I Non-medical device  Europe: ....................................................... Class IIa  US: ................................................... Class II (510k)  Europe: ....................................................... Class IIa  US: .................................................... Class II (510k)  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other: ............................................. Casting material  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Dental shades  Gingival shades  Other .......................................... Translucent orange  Dental shades  Gingival shades  Other ................................................................ Red  Dental shades: .......................................... 8 shades  Gingival shades  Other  Dental shades  Gingival shades: ........................................ 2 shades  Other Viscosity: ................................................. 1,000 mPa · s Flexural strength/modulus: ............... 85 MPa/2,118 MPa Water solubility/sorption: ........................................ n.a. Density: ................................................................. n.a. Hardness: .............................................................. n.a. Viscosity: .................................................... 125 mPa · s Flexural strength/modulus: .............. 70 MPa/1,700 MPa Water solubility/sorption: ........................................ n.a. Density: ......................................................... 1.1 g/cm³ Hardness: .................................................... Shore D 80 Viscosity: ................................................. 1,750 mPa · s Flexural strength/modulus: ............ 115 MPa/3,500 MPa Water solubility/sorption: ... < 40 µg/mm3/< 7.5 µg/mm3 Density: ......................................................... 1.3 g/cm³ Hardness: ..................................................... Barcol 50 Viscosity: ................................................. 1,300 mPa · s Flexural strength/modulus: ............ 110 MPa/2,700 MPa Water solubility/sorption: ... < 32 µg/mm3/< 1.6 µg/mm3 Density: ......................................................... 1.1 g/cm³ Hardness: .................................................. Shore D 83  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No n.a. n.a. n.a. n.a. Follow supplied instructions for use by manufacturer for necessary steps (cleaning, processing, post-curing and fi nishing).  All printers  Specifi c printers:  NextDent 5100 DLP 3D Printer Washing with isopropyl alcohol and post curing. Washing with isopropyl alcohol and post curing. Washing with isopropyl alcohol and post curing.  All printers  Specifi c printers:  All printers  Specifi c printers:  All printers  Specifi c printers: Please check the latest list on www.DETAX.com Please check the latest list on www.DETAX.com Please check the latest list on www.DETAX.com  € ............. /mg  € ............. /ml  For prices please contact your local authorized  € ............. /mg  € ............. /ml  For price range please contact  € ............. /mg  € ............. /ml  For price range please contact  € ............. /mg  € ............. /ml  For price range please contact NextDent dealer or NextDent directly. your local authorized DETAX dealer. your local authorized DETAX dealer. your local authorized DETAX dealer. The market overview does not claim to be complete. Status: October 2022. 3D printing 2 2022 51

FREEPRINT SPLINT 2.0 FREEPRINT SPLINTMASTER FREEPRINT TEMP FREEPRINT TRAY 2.0 DETAX DETAX DETAX DETAX  US FDA  USA FDA 510(k)  USP Class VI  MDR  KFDA  Other: ..................................................... Worldwide  US FDA  USA FDA 510(k) in progress  USP Class VI  MDR in progress  KFDA  Other: .................................... Worldwide in progress  US FDA  USA FDA 510(k)  USP Class VI  MDR  KFDA  Other: ..................................................... Worldwide  US FDA  USA FDA 510(k)  USP Class VI  MDR  KFDA  Other: ..................................................... Worldwide  Europe: ....................................................... Class IIa  US: ................................................................ Class I  Europe: ....................................................... Class IIa  US: .................................................... Class II (510k)  Europe: ....................................................... Class IIa  US: .................................................... Class II (510k)  Europe: ......................................................... Class I  US: ................................................................ Class I  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Dental shades  Gingival shades  Other: ............................................................. Clear  Dental shades  Gingival shades  Other: ............................................................. Clear  Dental shades: .......................................... 3 shades  Gingival shades  Other  Dental shades  Gingival shades  Other Viscosity: .................................................... 800 mPa · s Flexural strength/modulus: .............. 80 MPa/2,000 MPa Water solubility/sorption: ...... < 32 µg/mm3/< 5 µg/mm3 Density: ......................................................... 1.1 g/cm³ Hardness: .................................................... Shore D 83 Viscosity: .............................................................. n.a. Flexural strength/modulus: ................................... n.a. Water solubility/sorption: ...... < 32 µg/mm3/< 5 µg/mm3 Density: 1.1 g/cm³; Tensile strain: 20%; Tensile strength: 40 MPa Hardness: .................................................... Shore D 75 Viscosity: ................................................. 1,300 mPa · s Flexural strength/modulus: ............ 100 MPa/2,300 MPa Water solubility/sorption: ... < 40 µg/mm3/< 7,5 µg/mm3 Density: ......................................................... 1.1 g/cm³ Hardness: .................................................... Barcol 44 Viscosity: .................................................... 750 mPa · s Flexural strength/modulus: ............. 95 MPa/2,300 MPa Water solubility/sorption: ........................................ n.a. Density: ......................................................... 1.1 g/cm³ Hardness: .................................................... Shore D 83  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No n.a. n.a. n.a. n.a. Washing with isopropyl alcohol and post curing. Washing with isopropyl alcohol and post curing. Washing with isopropyl alcohol and post curing. Washing with isopropyl alcohol and post curing.  All printers  Specifi c printers:  All printers  Specifi c printers:  All printers  Specifi c printers:  All printers  Specifi c printers: Please check the latest list on www.DETAX.com Please check the latest list on www.DETAX.com Please check the latest list on www.DETAX.com Please check the latest list on www.DETAX.com  € ............. /mg  € ............. /ml  For price range please contact  € ............. /mg  € ............. /ml  For price range please contact  € ............. /mg  € ............. /ml  For price range please contact  € ............. /mg  € ............. /ml  For price range please contact your local authorized DETAX dealer. your local authorized DETAX dealer. your local authorized DETAX dealer. your local authorized DETAX dealer. The market overview does not claim to be complete. Status: October 2022. 3D printing 2 2022 53

buyer’s guide | Model Resin (V3) Formlabs Dental Permanent Crown Resin Surgical Guide Resin Temporary CB Resin Formlabs Dental Formlabs Dental Formlabs Dental  US FDA  USA FDA 510(k)  USP Class VI  MDR  KFDA  Other: ....................................... Non-medical device  US FDA  USA FDA 510(k)  USP Class VI  MDR in progress  KFDA  Other  US FDA  USA FDA 510(k)  USP Class VI  MDR  KFDA  Other  US FDA  USA FDA 510(k)  USP Class VI  MDR  KFDA  Other Non-medical device  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Europe: ....................................................... Class IIa  US: ............................................................... Class II  Europe: ......................................................... Class I  US: ............................................................... Class I  Europe: ......................................................... Class I  US: ................................................................ Class I  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Dental shades  Gingival shades  Other: ................................................... Light yellow  Dental shades: ............... 4 shades (A2, A3, B1, C2)  Gingival shades  Other  Dental shades  Gingival shades  Other  Dental shades: ............... 4 shades (A2, A3, B1, C2)  Gingival shades  Other Viscosity: .............................................................. n.a. Flexural strength/modulus: ................. 85 MPa/2.2 GPa Water solubility/sorption: ...................................... n.a. Density: ................................................................. n.a. Hardness: .............................................................. n.a. Viscosity: .................................... 2,500–6,000 mPa · s Flexural strength/modulus: ............ 116 MPa/4,090 MPa Water solubility/sorption: ....... 0.23 µg/mm3/3.6 µg/mm3 Density: ................................................. 1.4–1.5 g/cm³ Hardness: .............................................................. n.a. Viscosity: .............................................................. n.a. Flexural strength/modulus: ...... > 102 MPa/>2,400 MPa Water solubility/sorption: ...................................... n.a. Density: ................................................................. n.a. Hardness: .................................................... Shore D 76 Viscosity: .................................... 2,500–6,000 mPa · s Flexural strength/modulus: ....................... ⭓ 100 MPa Water solubility/sorption: ........................................ n.a. Density: .................................................. 1.4–1.5 g/cm³ Hardness: .............................................................. n.a.  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other: Disinfection with isopropyl alcohol or ethanol is possible.  No  Yes: Steam sterilisation (autoclaving): ....... Autoclave at 134°C for 20 minutes or at 121°C for 30 minutes.  Gamma irradiation: ... 29.4–31.2 kGy gamma radiation.  Electron beam irradiation: ... 35 kGy E-beam radiation.  Ethylene oxide sterilisation: 100% ethylene oxide at 55°C for 180 minutes.  Other: Chemical disinfection 70% isopropyl alcohol for 5 mins.  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other: Disinfection with isopropyl alcohol or ethanol is possible.  No n.a. Yes n.a. Yes Once resin product is completed: Wash in Form Wash. Cure in Form Cure. This material requires the use of Formlabs' Stainless Steel Build Platform. Once resin product is completed: Wash in Form Wash. First curing cycle in Form Cure. Support removal and sandblasting. Second curing cycle in Form Cure. Polishing & characterization. Once resin product is completed: Wash in Form Wash. Dry parts completely. Cure in Form Cure. This material requires the use of Formlabs' Stainless Steel Build Platform. Once resin product is completed: Wash in Form Wash. First curing cycle in Form Cure. Support removal and sandblasting. Second curing cycle in Form Cure. Polishing & characterization.  All printers  Specifi c printers:  All printers  Specifi c printers:  All printers  Specifi c printers:  All printers  Specifi c printers:  Form 2, Form 3B, Form 3B+, Form 3BL  Form 3B, Form 3B+  Form 2, Form 3B, Form 3B+, Form 3BL  Form 2, Form 3B, Form 3B+  € ............. /mg  € 0.135/ml  € ............. /mg  € 1.92/ml  € ............. /mg  € 0.249/ml  € ............. /mg  € 0.712/ml The market overview does not claim to be complete. Status: October 2022. 3D printing 2 2022 55

buyer’s guide | UltraPrint-Dental Model TF UV 2.0 UltraPrint-Dental Temp C&B UV 2.0 V-Print cast HeyGears HeyGears VOCO V-Print dentbase VOCO  US FDA  USA FDA 510(k)  USP Class VI  MDR  KFDA  Other: ..................................................... CE NMPA  US FDA  USA FDA 510(k)  USP Class VI  MDR (in progress)  KFDA  Other: .................................... MFDS ANVISA NMPA  US FDA  USA FDA 510(k)  USP Class VI  MDR  KFDA  Other: ..................... Technical resin – not necessary  US FDA  USA FDA 510(k)  USP Class VI  MDR  KFDA  Other: .......................................... CE notifi ed body  Europe: ..................................... Non-medical device  US: ........................................... Non-medical device  Brazil: .......................................................... Class II  South Korea: ................................................ Class II  US: .............................................................. Class II  Europe: ............................................ Technical resin  Middle East: ..................................... Technical resin  North America: ................................. Technical resin  Europe: ................................................ MD Class IIa  Middle East: ................................................. Class B  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other: ..................................... Clear aligner models  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other: ............................................. Crowns, bridges  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other: .............. For casting and pressing processes  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other: ................................................ Denture base  Dental shades  Gingival shades  Other  Dental shades: 8 shades (A1, A2, A3, A3.5, B1, B2, B3, BL)  Gingival  Other  Dental shades  Gingival shades  Other: ............................................................. Blue  Dental shades  Gingival shades  Other: .............................................................. Pink Viscosity: .............................................................. n.a. Flexural strength/modulus: 104.2–119.16 MPa/2,020–2,214 MPa Water solubility/sorption: ......................... 0.35–0.48% Density: .................................................................. n.a. Hardness: .................................................... Shore D 85 Viscosity: .............................................................. n.a. Flexural strength/modulus: 93.6–104.5 MPa/1,846–2,021 MPa Water solubility/sorption: ........................ ⭐ 40 µg/mm3 Density: .................................................................. n.a. Hardness: .................................................... Shore D 84 Viscosity: ................................................. 1,550 mPa · s Flexural strength/modulus: ............. 78 MPa/2,470 MPa Water solubility/sorption: ....................................... n.a. Density: ................................................................. n.a. Hardness: .............................................................. n.a. Viscosity: ................................................. 1,700 mPa · s Flexural strength/modulus: ............. 90 MPa/2,450 MPa Water solubility/sorption: ................... > 0.1/24 µg/mm3 Density: .................................................................. n.a. Hardness: .............................................................. n.a.  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other: .................. Ethyl alcohol, hydrogen peroxide, ................... glutaraldehyde, quaternary ammonium salt  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other: ............... Not necessary for prostheses bases  No n.a. n.a. n.a. n.a. Post-processing: isopropyl alcohol. Post-processing: isopropyl alcohol. Post-printing: washing and curing in accordance with the manufacturer’s recommendations. Post-printing: washing and curing in accordance with the manufacturer’s recommendations.  All printers  Specifi c printers:  All printers  Specifi c printers:  All printers  Specifi c printers:  All printers  Specifi c printers:  HeyGears UltraCraft A2D, A2D Ortho, A2D 4K,  HeyGears UltraCraft A2D, A2D 4K, A3D, A3D, ChairSide, ChairSide Pro ChairSide (US), ChairSide Pro (US) An up-to-date list of printer partners is available at www.voco.dental/3dprintingpartners An up-to-date list of printer partners is available at www.voco.dental/3dprintingpartners  € ............. /mg  € ............. /ml  For price range please contact the manufacturer.  € ............. /mg  € ............. /ml  For price range please contact the manufacturer.  € ............. /mg  € ............. /ml  For price range please contact the manufacturer.  € ............. /mg  € ............. /ml  For price range please contact the manufacturer. The market overview does not claim to be complete. Status: October 2022. 3D printing 2 2022 57

buyer’s guide | V-Print splint VOCO V-Print splint comfort VOCO V-Print tray VOCO V-Print Try-In VOCO  US FDA  USA FDA 510(k)  USP Class VI  MDR (in progress)  KFDA  Other: ........................................... CE notifi ed body  US FDA  USA FDA 510(k)  USP Class VI  MDR (in progress)  KFDA  Other: ........................................... CE notifi ed body  US FDA  USA FDA 510(k)  USP Class VI  MDR (in progress)  KFDA  Other: ................................................................ CE  US FDA  USA FDA 510(k)  USP Class VI  MDR (in progress)  KFDA  Other: ................................................................ CE  Europe: ................................................ MD Class IIa  Middle East: ................................................ Class B  North America: ........................................... Class II  Europe: ................................................ MD Class IIa  Middle East: ................................................ Class B  North America: ........................................... Class II  Europe: ................................................... MD Class I  Middle East: ................................................ Class A  North America: .............................................. Class I  Europe: ................................................... MD Class I  Middle East: ................................................ Class A  North America: .............................................. Class I  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other  Africa  Asia Pacifi c  Europe  Latin America  Middle East  North America  Temporary restorations  Defi nitive restorations  Models  Surgical guides  Occlusal splints  Complete dentures  Custom trays  Indirect bonding trays  Other .............................................................. Try-In  Dental shades  Gingival  Other: ............................................................ Clear  Dental shades  Gingival  Other: ............................................................. Clear  Dental shades  Gingival  Other: ............................................................ Blue  Dental shades  Gingival  Other: ............................................................ Beige Viscosity: ................................................. 1,000 mPa · s Flexural strength/modulus: .............. 75 MPa/2,100 MPa Water solubility/sorption: ..... < 0.1 µg/mm3/27.7 µg/mm3 Density: ................................................................. n.a. Hardness: .............................................................. n.a. Viscosity: ................................................. 1,250 mPa · s Flexural strength/modulus: ............................. 115 MPa Water solubility/sorption: ......... 2.5 µg/mm3/15 µg/mm3 Density: ................................................................. n.a. Hardness: .............................................................. n.a. Viscosity: ................................................. 1,500 mPa · s Flexural strength/modulus: .............................. 100 MPa Water solubility/sorption: ............ 3 µg/mm3/30 µg/mm3 Density: ................................................................. n.a. Hardness: .............................................................. n.a. Viscosity: .................................................... 850 mPa · s Flexural strength/modulus: .............. 85 MPa/2,500 MPa Water solubility/sorption: ...... 0.1 µg/mm3/17.5 µg/mm3 Density: ................................................................. n.a. Hardness: .............................................................. n.a.  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No  Yes:  Steam sterilisation (autoclaving)  Gamma irradiation  Electron beam irradiation  Ethylene oxide sterilisation  Other  No n.a. n.a. n.a. n.a. Post-printing: washing and curing in accordance with the manufacturer’s recommendations. Post-printing: washing and curing in accordance with the manufacturer’s recommendations. Post-printing: washing and curing in accordance with the manufacturer’s recommendations. Post-printing: washing and curing in accordance with the manufacturer’s recommendations.  All printers  Specifi c printers:  All printers  Specifi c printers:  All printers  Specifi c printers:  All printers  Specifi c printers: An up-to-date list of printer partners is available at www.voco.dental/3dprintingpartners An up-to-date list of printer partners is available at www.voco.dental/3dprintingpartners An up-to-date list of printer partners is available at www.voco.dental/3dprintingpartners An up-to-date list of printer partners is available at www.voco.dental/3dprintingpartners  € ............. /mg  € ............. /ml  For price range please contact the manufacturer.  € ............. /mg  € ............. /ml  For price range please contact the manufacturer.  € ............. /mg  € ............. /ml  For price range please contact the manufacturer.  € ............. /mg  € ............. /ml  For price range please contact the manufacturer. The market overview does not claim to be complete. Status: October 2022. 3D printing 2 2022 59

manufacturer news | Accessible and easy to use SprintRay Cloud Design service now available in Europe! You scan, we plan. A frictionless design workfl ow. The best design software is the one you do not have to learn how to use. SprintRay Cloud Design was created to fuel the next 100 years of digital dentistry by removing the friction of dental CAD from your workfl ow. The SprintRay Europe Cloud Design service is completely in- tegrated into the 3D-printing solution from SprintRay and can be accessed by any new or existing user. It is compatible with any intra-oral scanner and delivers custom printable fi les pro- duced by expert design teams. Dental 3D printing has never been easier. Additional applications will be added continuously to the platform. Find out more about the available design services on Sprint Ray website: https://sprintray.com/en-uk/sprintray-cloud-design- dental- applications-design-service. Occlusal guards Nearly every patient can benefi t from an occlusal guard. Drastically reduce the delivery time of this useful appliance by fabricating it in your dental practice or laboratory with minimal labour and lead time. Leverage the innovative SprintRay EU Splint material to deliver high-quality, comfortable guards of high strength and durability. With SprintRay Cloud Design, you can receive a design straight to your printer. Crowns SprintRay Cloud Design makes in-house production of aesthetic, custom temporary or defi nitive crowns truly frictionless. With a variety of shades in our SprintRay EU Temporary Crown & Teeth or SprintRay Crown materials to choose from, your patient will leave with a confi dent smile. Models for clear aligners Give patients the treatment they want at a price they can afford with SprintRay Cloud Design. Upload patient data and let our team of experts design ready-to-print aligner models that you can fabricate in your dental practice or laboratory. If you are interested in learning more about the SprintRay 3D-printing system and the SprintRay Europe Cloud Design service, visit our website, or contact us directly. www.sprintray.com 3D printing 2 2022 61

manufacturer news | For laboratories looking to boost their production capabilities HeyGears launches new UltraCraft A3D 3D printer for fully automated intelligent mass production HeyGears has recently launched its latest A-series 3D printer for dental laboratories, the UltraCraft A3D. As dental laboratories have an ever-growing need for efficient, automated and easily scalable production solutions, HeyGears has developed the A3D for labora- tories looking to boost their production capabilities. and regular business intelligence reports and insights, labora- tories can optimise their production strategically. Over-the-air updates ensure that the A3D is running the latest system and features. Greater build volume for larger batch production Featuring a build volume of 159 × 144 × 110 mm—double the size of that of the UltraCraft A2D—while maintaining printing pre- cision, the A3D enables dental technicians to print more dental applications in a single batch. Fully integrated automation options The A3D 3D printer has a variety of automation options for the specific requirements of each dental laboratory. For example, integrated automatic printed part removal, along with an internal storage bin capable of holding nearly 250* full-arch models, enables 3D printing of batches overnight, ready for collection the next day. The printer’s 1 l or 3 l automatic resin refill options can refill the printing tray in 2.5 minutes. This means that the printer can operate continuously and efficiently for up to 8 hours un- attended. Dental technicians can print nearly 500* clear aligner models with the A3D every 24 hours. The A3D includes useful and smart features such as a thermo- static printing chamber to ensure high-quality printing results, a passive infrared sensor to automatically detect whether a user is nearby and near field communication recognition for key parts to track the remaining usage lifespan. Scale up with ease For dental laboratories with larger production needs, the A3D can connect with the Resin Station to enable full-scale automated mass production. The Resin Station can connect with and automatically refill up to four A3D printers with its ultra-large 24 l resin storage capacity, distributed across four 6 l resin bottles. Each bottle can contain a different resin type. With the resin station connected, four A3Ds together are able to 3D-print nearly 2,000* clear aligner models over 24 hours. With these capabilities, HeyGears’ UltraCraft A3D can meet the needs of a wide variety of dental laboratories looking to bring automated flexibility and scalability to their digital dental production. Powerful software and smart features To make this intelligent automation possible, HeyGears Cloud simplifies production process management, from dental appli- cation design to 3D printing. With complete process monitoring * depending on printed model thickness and size www.heygears.com 3D printing 2 2022 63

manufacturer news | Higher productivity and model accuracy Nexa3D announces professional series upgrade for its ultra-fast dental 3D printer Nexa3D, the maker of ultra-fast polymer 3D printers for industrial and dental applications, has an- nounced the immediate availability of its new professional series upgrade for its NXD 200 dental 3D printer. Based on Nexa3D’s ultra-fast Lubricant Sublayer Photo-curing (LSPc) technology, the pro series delivers higher productivity and model accuracy with greater print success. The pro series accommodates a broader range of dental mate- rials, including Keystone Industries’ KeyOrtho IBT and KeySplint Hard. Nexa3D showcased its new NXD 200Pro at LMT LAB DAY East in October. “We are thrilled to release this signifi cant upgrade to our NXD 200 dental 3D printer,” said Nina Swienton, chief marketing offi cer at Nexa3D. “We recognise the pressing need for higher productivity and lower operating costs that dental laboratories are faced with, and that is exactly why we enhanced the NXD 200 printer in order to deliver even better throughput with greater reliability, accuracy and repeat- ability. Additionally, the new pro series opens the materials portfolio of the NXD platform to accommodate new dental materials that are tailored for ultra-fast printing of dental parts.” The NXD 200Pro is an industry-leading production platform for same-day production of orthodontic models, surgical guides, splints, impression trays and night guards. The printer is powered by the company’s proprietary LSPc technology and patented structured light matrix that delivers up to 20× productivity gains over other stereolithographic and digital light processing 3D printers. It is the ideal solution for high-throughput dental laboratory applications given its large 8.5 l build volume measuring 275 × 155 × 200 mm. Designed specifi cally for dental laboratories, the NXD 200Pro offers world-class dental model manufacturing capabilities at ultra-fast speeds with validated Keystone performance dental resins. The NXD 200Pro offers high throughput to keep dental operations productive, being capable of producing up to 20 fl at 3D-printed dental models in less than 30 minutes. “At Key Dental Technologies, precision and high quality defi ne our aligners, MyClearALIGN!, and Nexa3D’s dental 3D-printing solutions enable us to deliver our product with incredible speed, high defi nition and affordability,” said Christina Montiel, lab- oratory technician at Key Dental Technologies. Nexa3D’s growing dental customer base includes large and small dental laboratories as well as dental practices looking to increase their 3D-printing throughput with ease and affordability. Tyler Dowdle, director of operations at Excel Orthodontics, said: “At Excel Orthodontics, our priority is providing exceptional orthodontic laboratory services, and Nexa3D’s LSPc tech- nology with the NXD 200Pro enables us to deliver those services with accuracy, afforda- bility and twice the throughput of our previous 3D-printing solution.” NXD 200Pro series features – High throughput: the pro series prints up to 8.5 l of volume in a single build, delivering up to 20× productivity gains over comparable dental 3D printers. – Advanced printability: the pro series is powered by an armoured light engine that improves print repeatability, consistency and reliability. – Greater print success: the pro series printing leverages Nexa3D’s latest light engine and Everlast membrane interface technology and enhanced auto-homing capability to reduce fi rst-layer gap and substantially increase fi rst-print success. – Higher consistency: the pro series reduces the variation in parts across a single build, delivering reliability, consistency and higher production yields. – Cost-effectiveness: the pro series build plates are designed to maximise part-nesting capa- bilities while enabling effi cient resin drainage and easier cleaning between print jobs, increasing part output while reducing waste and lowering operating time and costs. – Compatibility: the pro series is fully compatible with Nexa3D’s post-processing solutions, including xWash, xCure and xCLEAN, which together reduce the time to produce ready-to-use models from hours to just minutes. – Upgradability: delivering on the company’s long-standing promise of upgradeability, the pro upgrade kit is available for sale to all current NXD 200 users. Coupled with the pro series upgrade are enhancements to the NexaX software, including features like auto-stacking, improved automatic part nesting and cupping avoidance. Additionally, the new settings profi le manager supports the entire workfl ow by combining validation, customisation, reusability and shareability to create a powerful and adaptive tool for any application, Nexa3D printer model or resin type. The NXD 200Pro printer is available for order now. Customers wishing to upgrade their current model can do so by ordering an upgrade kit from Nexa3D or from its growing reseller network. For pricing or reseller information, please visit Nexa3D website. www.nexa3d.com 3D printing 2 2022 65

meetings | will be participating in Formnext. In France, the strong aerospace and automotive industries offer promising ap- plications for AM, as does construction and architecture, viticulture, medicine and many more. Among the French companies that will be showcasing a diverse portfolio of products and services along the entire process chain are internationally established AM giants such as AddUp, numerous highly innovative young companies such as Lynxter and Pollen AM, and renowned industrial companies such as Arkema, BINC Industries, Constellium and Granges, for which AM is playing an increasingly important role. The second day of Formnext 2022 will be dedicated to France, involving partner presentations by Cimes and France Additive and a visit by a French delegation, among other events. A diverse programme of supporting events The programme of supporting events will continue some established events and expand upon them. For example, the start-up challenge, which recognises innovative and viable business ideas from young companies, will take place for the eighth time. The up-and-coming companies exhibiting in the start-up area will pitch their products and services on the AM4U stage. There will also be interesting contributions on the topic of investment and funding. The ideas competition known as the purmundus challenge will celebrate its tenth anniversary with a reception and special showcase of the highlights of the last ten years. Alongside the established Discover3Dprinting seminars (in German and English), attendees can visit the AM4U area to learn about the wide range of career opportuni- ties within the AM industry. The high-quality conference programme organised by Formnext’s content partner, TCT, will address current trends and developments in AM in 2022. The VDMA will present a showcase on valuable AM applications from the world of mechanical engineer- ing and provide further insights through presentations on the AM4U stage. The BE-AM showcase will demonstrate advanced devel- opments in relation to the increasingly important topic of 3D printing in the construction industry, and the BE-AM symposium will present significant background and information on future developments in this field. The topic of standards, important for the entire AM industry and all users, will once again be discussed by experts and decision-makers from around the world at the renowned Standards Forum, organised by ASTM, U.S. Commercial Service and ISO—International Organiza- tion for Standardization, on 14 November, the day before the trade fair commences. On the same day the Wohlers Report Team, will host an evening event giving attendees an overview of the most interesting findings and trends in additive manufacturing. On top of that, you have the unique opportunity to speak to the Wohlers Report team in person and learn more about the future of AM. Further information is available at www.formnext.com. 3D printing 2 2022 69

How to send us your work submission guidelines | m o c . k c o t s r e t t u h S / s l i e x p 2 3 © Please note that all the textual compo- nents of your submission must be com- bined into one MS Word document. Please do not submit multiple files for each of these items: · the complete article; · all the image (tables, charts, photo- · · graphs, etc.) captions; the complete list of sources consulted and the author or contact information (bi- ographical sketch, mailing address, e-mail address, etc.). In addition, images must not be embed- ded into the MS Word document. All im- ages must be submitted separately, and details about such submission follow be- low under image requirements. Text length Article lengths can vary greatly—from 1,500 to 5,500 words—depending on the subject matter. Our approach is that if you need more or fewer words to do the topic justice, then please make the article as long or as short as necessary. We can run an unusually long article in multiple parts, but this usually entails a topic for which each part can stand alone because it contains so much in- formation. In short, we do not want to limit you in terms of article length, so please use the word count above as a general guideline and if you have specific questions, please do not hesitate to contact us. Text formatting We also ask that you forego any special formatting beyond the use of italics and boldface. If you would like to emphasise certain words within the text, please only use italics (do not use underlining or a larger font size). Boldface is reserved for article headers. Please do not use un- derlining. Please use single spacing and make sure that the text is left justified. Please do not centre text on the page. Do not indent paragraphs, rather place a blank line be- tween paragraphs. Please do not add tab stops. Should you require a special layout, please let the word processing pro- gramme you are using help you do this formatting automatically. Similarly, should you need to make a list, or add footnotes or endnotes, please let the word process- ing programme do it for you automatically. There are menus in every programme that will enable you to do so. The fact is that no matter how carefully done, errors can creep in when you try to number footnotes yourself. Any formatting contrary to stated above will require us to remove such formatting before layout, which is very time-consum- ing. Please consider this when formatting your document. Larger image files are always better, and those approximately the size of 1 MB are best. Thus, do not size large image files down to meet our requirements but send us the largest files available. (The larger the starting image is in terms of bytes, the more leeway the designer has for resizing the image in order to fill up more space should there be room available.) Also, please remember that images must not be embedded into the body of the article submitted. Images must be submitted separately to the textual sub- mission. You may submit images via e-mail or share the files in our cloud storage (please contact us for the link). Please also send us a head shot of your- self that is in accordance with the re- quirements stated above so that it can be printed with your article. Image requirements Abstracts Please number images consecutively throughout the article by using a new number for each image. If it is imperative that certain images are grouped together, then use lowercase letters to designate these in a group (for example, 2a, 2b, 2c). Please place image references in your article wherever they are appropriate, whether in the middle or at the end of a sentence. If you do not directly refer to the image, place the reference at the end of the sentence to which it relates enclosed within brackets and before the period. In addition, please note: An abstract of your article is not re- quired. Author or contact information The author’s contact information and a head shot of the author are included at the end of every article. Please note the exact information you would like to ap- pear in this section and format it accord- ing to the requirements stated above. A short biographical sketch may precede the contact information if you provide us with the necessary information (60 words or less). · We require images in TIF or JPEG for- mat. · These images must be no smaller than Questions? 6 x 6 cm in size at 300 DPI. · These image files must be no smaller than 80 KB in size (or they will print the size of a postage stamp!). Magda Wojtkiewicz (Managing Editor) m.wojtkiewicz@dental-tribune.com 3D printing 2 2022 73

Reliable, Easy-to-integrate 3D Printing Solutions for Dental Professionals Work Smarter, Not Harder To request a free sample part scan here scan here North American Sales Inquiries dental@formlabs.com +1 (617) 702 8476 dental.formlabs.com Europe Sales Inquiries dental@formlabs.com +49 30 8878 9870 International Sales Inquiries Find a reseller in your region: dental.formlabs.com/eu formlabs.com/find-a-reseller