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Accuracy assessment of 3D-printed tooth replicas
EAO Online Library. Sokolowski A. Oct 9, 2018; 232634; P-BR-82
Armin Sokolowski
Armin Sokolowski
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There have been several studies published proposing different methods for fabricating tooth replicas to use them as a template during tooth auto-transplantations, further increasing the success rates. First successful case reports about the use of dental root analogue implants show promising clinical results+ however, this technology-sensitive method requires a particularly high degree of precision in the production process of the root-analogue implants.The purpose of this study was to establish and evaluate a method for fabricating a individual 3D-printed tooth replicas and evaluate the precision for a possible use as dental root-analogue implants or as tooth-templates in tooth auto-transplantations.For this study 10 patients requiring extraction of a wisdom tooth were included. Inclusion criteria were a planned tooth extraction and a preoperatively required cone beam computed tomography (CBCT) for medical indications+ exclusion criteria were intraoperative fragmentation or fracture of the tooth. As source data for rapid prototyping, DICOM data from the patients CBCTs was used. 3Dslicer 4.6.2 (revision 25516 built 2016-11-08) was used for tooth segmentation and model generation from the DICOM data. The tooth replicas were manufactured by means of a selective laser melting process (Lasercusing, Concept Laser). For an objective examination of the similarity, the extracted teeth and the corresponding 3D-printed replicas were scanned with an optical scanning system (Cerec Omnicam, Dentsply Sirona) and tested for surface congruence in CloudCompare 2.8.1 by calculating the mean differences in the distance between the surface meshes of the natural teeth and the 3D replicas. The subjective assessment of shape and dimension of the 3D-printed teeth compared to the corresponding extracted teeth showed a very high degree of similarity and appeared practically identical with the naked eye. The mean differences between the surface meshes of the 3D-printed replicas and their original segmentation from the CBCT data ranged from -0.05 mm to +0.01 mm with a standard deviation of 0.03 mm to 0.08 mm. This suggests a valid and highly accurate 3D-printing process based on the segmentation from CBCT data. The mean differences between the surface meshes of the 3D-printed replicas and the corresponding extracted teeth ranged from -0.10 mm to +0.03 mm with a standard deviation of 0.17 mm to 0.32 mm. This suggests a valid and highly accurate segmentation and 3D-printing process based on CBCT data.According to the protocol as described above, it could be demonstrated that a high coverage of the surfaces of the extracted teeth and the 3D printed replicates can be achieved proving that the described method for manufacturing tooth replicas is reliable for producing clinically accurate copies for the use in tooth auto-transplantations or for fabricating root-analogue implants.
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