d e n t a l m a t e r i a l s 3 2 ( 2 0 1 6 ) 54–64

Available online at www.sciencedirect.com

ScienceDirect

journal homepage: www.intl.elsevierhealth.com/journals/dema

3D printing with polymers: Challenges among

expanding options and opportunities

Jeffrey W. Stansbury a,b,∗ , Mike J. Idacavage c

a Department of Craniofacial Biology, School of Dental Medicine, University of Colorado Anschutz Medical Campus,
12800 East 19th Avenue, MS 8310, Aurora, CO 80045, USA
b Department of Chemical and Biological Engineering, University of Colorado at Boulder, 3415 Colorado Avenue ,

Boulder, CO 80303, USA

c Colorado Photopolymer Solutions, 1880 South Flatirons Ct, Suite F, Boulder, CO 80301, USA

a r t i c l e i n f o a b s t r a c t

Keywords: Objectives. Additive manufacturing, which is more colloquially referred to as 3D printing,

3D printing is quickly approaching mainstream adoption as a highly flexible processing technique that
Additive manufacturing can be applied to plastic, metal, ceramic, concrete and other building materials. However,
Dental materials taking advantage of the tremendous versatility associated with in situ photopolymerization
Layered materials as well as the ability to select from a variety of preformed processible polymers, 3D prin-
Photopolymer ting predominantly targets the production of polymeric parts and models. The goal of this
Prepolymer review is to connect the various additive manufacturing techniques with the monomeric and
Rapid prototyping polymeric materials they use while highlighting emerging material-based developments.
Thermoplastic Methods. Modern additive manufacturing technology was introduced approximately three
decades ago but this review compiles recent peer-reviewed literature reports to demon-
strate the evolution underway with respect to the various building techniques that differ
significantly in approach as well as the new variations in polymer-based materials being
employed.
Results. Recent growth of 3D printing has been dramatic and the ability of the various plat-
form technologies to expand from rapid production prototypic models to the greater volume
of readily customizable production of working parts is critical for continued high growth
rates. This transition to working part production is highly dependent on adapting materials
that deliver not only the requisite design accuracy but also the physical and mechanical
properties necessary for the application.
Significance. With the weighty distinction of being called the next industrial revolution, 3D
printing technologies is already altering many industrial and academic operations including
changing models for future healthcare delivery in medicine and dentistry.
© 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

∗
Corresponding author at: Department of Craniofacial Biology, School of Dental Medicine, University of Colorado Anschutz Medical
Campus, 12800 East 19th Avenue, MS 8310, Aurora, CO 80045, USA. Tel.: +1 303 724 1044; fax: +1 303 424 1945.
E-mail addresses: jeffrey.stansbury@ucdenver.edu (J.W. Stansbury), mike.idacavage@cpspolymers.com (M.J. Idacavage).
http://dx.doi.org/10.1016/j.dental.2015.09.018
0109-5641/© 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
 d e n t a l m a t e r i a l s 3 2 ( 2 0 1 6 ) 54–64
1. Introduction
The accessibility of 3D printers for both industrial and gen-
eral public use has grown dramatically in the past decade.
Global sales that include the devices, materials and services
for industrial-scale to consumer-based printers have grown
by an annual average of more than 33% over the last three
years to a total of $4.1billion in 2014 [1]. A significant driver
of this growth is the fact that the early patents related to the
additive manufacturing devices and processes have expired.
This has opened the door for many start-up companies to
develop new 3D printer devices that have pushed innovative
design approaches while driving down the cost, in some cases
well below $1000 for an entry-level printer. There are now
more than 300 companies selling relatively inexpensive desk-
top devices, which currently is a category defined as units
costing less than $5000 [2]. This rapid evolution of the mar-
ket has placed 3D printers not just in tremendously varied
industrial settings but also in K-12 schools, public libraries,
university classrooms and laboratories not to mention more
and more commonly now, in homes. Some envision a future
where virtual stores maintain only vast digital inventories that
will allow customers to rapidly produce simple or complex
products at a predictable, inexpensive price. Biomedical appli-
cations for 3D printing are one of the current growth leaders
within a technology that overall is growing remarkably fast.
We are already beginning to experience the integration of 3D
printing in dental offices and laboratories. Although currently
a fairly small component of dentistry, there are projections
that the dental market for additive manufacturing processes
is prime for explosive future growth. This paper provides
an overview of the field of 3D printing involving polymeric
materials with a focus on how developments in both device
technology as well as the materials, whether in resin, filament
or powder form, are combining to continue the impressive
advance this rapidly moving technology.
The majority of 3D printing devices sold in 2014 for all med-
ical uses were systems based on various material jetting and
photopolymerization techniques [makepartsfast.com] with
polymer-based printing accounting for the vast majority of
the materials currently used in additive manufacturing mar-
ket as a whole. These machines and the various polymeric
materials that they accommodate or produce are suitable
for creating a wide array of surgical guides and other tools
as well as for the production of medical model implants,
abutments, crowns, bridges and CT-imaged tissue replicas.
New continuous rather than layered printing approaches
allow structures of significant size to be printed in min-
utes and certain biocompatible-grade polymeric materials are
approved for in-mouth placement. However, there remains a
great amount of work to be done before 3D printed polymer-
based materials are more widely implemented in dental
practice. 3D printed ceramic and metallic constructs already
are being used for implant, crown and bridge and direct other
applications in dentistry. The opportunities for use of polymer-
based 3D-printed materials across all aspects of dentistry are
widespread but will depend on further improvements in the
processing technologies as well as innovation in the materials
being applied.
55
Table 1 – Polymer-based additive manufacturing (AM)
acronyms.
SLA Stereolithography apparatus
DLP Digital light projection
CLIP Continuous liquid interface production
SLS Selective laser sintering
SHS Selective heat sintering
BAAM Big area additive manufacturing
FFF/FDM Fused filament fabrication/fused deposition modeling
LOM Laminated object manufacturing
2. Additive manufacturing processes and
materials
If taken loosely, the world of 3D printing encompasses a wide
range of technologies. At its highest level, production of 3D
parts can be sorted into three major categories – forming,
subtractive or additive manufacturing. Forming involves the
reshaping of a work piece without reducing or adding material
with an example being vacuum forming molding. Subtractive
manufacturing usually involves using cutting tools to remove
unwanted material, as exemplified by the CNC milling of a
precision part. As the name implies, additive manufacturing
involves adding material rather than removing it to form the
finished item. A clear advantage exists for additive processes
when complex structures are required. The term 3D printing
was originally associated with a specific additive processing
technique but it is now commonly interchanged with the
broader general designation of additive manufacturing. Rapid
prototyping enabled by computer-aided design was conceived
as a technique to allow engineers to efficiently and reliably
convert virtual concepts to physical models and prototypic
parts. The rapid production of physical models remains a key
driver for the 3D printing market while the improvements in
processing and the advancements in materials are now lead-
ing a transition toward 3D printing being used to produce
readily customizable end-use parts that is expected to spur
substantially greater growth. A significant component of the
current market for printed structures involves the nimble cre-
ation of forms used to make molds that in turn are used to
mass fabricate actual production parts. The additive manufac-
turing process is an effective means to produce limited-run,
customized products with complex structure. In dentistry, the
ability to satisfy the demand for patient-personalized models,
tools and devices makes 3D printing a potentially very good fit
with the profession (Table 1).
While preformed polymeric materials in powder, filament
and sheet form are used in 3D printing (Fig. 1), several
additive manufacturing also utilize the active polymeriza-
tion of photo-sensitive resins. Since dentistry was an early
adopter of photo-curing and remains heavily reliant on pho-
topolymerization, it is natural that UV or visible light-based
approaches to 3D printing will be utilized as dentistry takes
advantage of this quickly developing technology. In fact, the
photocuring as a methodology for 3D printing is particularly
attractive for several reasons: high levels of build resolution,
smooth part surfaces that do not typically require finishing
processes, good z axis strength due to chemical bonding
between layers, fast builds possible, and the ability to print
56 d e n t a l m a t e r i a l s 3 2 ( 2 0 1 6 ) 54–64
Fig. 1 – Overview of monomer/polymer materials used with
specific layered building methods in additive processing.
clear objects. The initial layered material building approach
was indeed photopolymerization based. The technology got
its commercial start in 1986 [3] when 3D Systems introduced
the stereolithography apparatus (SLA) where specific surface
regions of photosensitive liquid resin undergo localized poly-
merization by exposure to a rastered UV laser [4–6]. A platform
is first constructed to anchor the piece and support any over-
hanging structures. The x/y axis exposure of each distinct
layer can be modified as the z axis incrementally evolves in
the build process. Between each layer, the platform is lowered
by 50 ␮m or less in higher resolution applications and 200 ␮m
or more for parts with standard or lower resolution demands.
When the part is complete, the excess resin is drained and
can be reused. The formed parts are washed to remove excess
resin and the support structures are physically removed.
Depending on the resin material, a UV flood post-curing step
may be included to raise conversion of the photopolymer. The
finished parts generally have little surface roughness with
appearances similar to that of molded parts. Final surface
finishing can involve treatments with sealants, primers,
paints or metallic coatings. A schematic representation of
a stereolithography device is shown in Fig. 2. 3D Systems
also developed the requisite .STL or Standard Tessellation
Language file format that permits three-dimensional orien-
tation between slices that serves as the basis of all additive
manufacturing processes although several other subsequent
file formats have been developed [7].
In the SLA approach, the depth of cure, which ultimately
determines the z axis resolution, is controlled by the pho-
toinitiator and the irradiant exposure conditions (wavelength,
power and exposure time/velocity) as well as any dyes, pig-
ments or other added UV absorbers, since these processes
typically involve UV sources in the form of UV lasers or
UV LEDs. The use of UV absorbers allows the formation of
transparent parts. The photo-induced layer thickness typi-
cally can range from approximately 50–200 ␮m. Step size is
selected based on a balance between decreased build times
and enhanced resolution. With micro-stereolithography and
a UV-laser curing source, resolution of about 5 ␮m in the x/y
Fig. 2 – Schematic of a photopolymerization-based,
top-down stereolithographic apparatus (SLA) part
production process. There are also devices that photocure
with a bottom-up approach where the bath has a UV
transmissive, nonadhesive base and the inverted support
platform is incrementally raised throughout the process,
which minimizes need for sacrificial support structures.
plane and 10 ␮m in the z axis can be achieved [8]. The use
of a near-IR pulsed laser source in conjunction with a two-
photon initiation strategy can create layers as fine as 100 nm,
which is well below the light diffraction limit [9,10]. Two-
photon activation provides the ability to write lines or complex
structures in three dimensions below a resin surface due to
the focal patterning combined with the two-photon initiation
mechanism [11]. The two-photon approach typically requires
alternative, large cross-section photoinitiators [12] along with
focused, high intensity irradiance at wavelengths approxi-
mately twice the absorbance maximum of the initiator to
achieve reasonable efficiency; however, the approach remains
practically limited to micro-machining scale applications [13]
in terms of part production, such as lab-on-chip devices,
microfluidic devices, photonic crystals, optical waveguides,
nerve scaffolds and many others. Surface-patterned expo-
sure from digital light projection (DLP) sources and using high
power LED sources essentially allows any selected portion of
the entire x/y workspace to be exposed simultaneously as
opposed to dynamic writing with a condensed laser beam.
Even though high laser scanning velocities are employed in the
SLA approach, the ability to simultaneously photocure all por-
tions of a given slice with DLP significantly speeds cycle times
between layers. The SLA or DLP techniques can be used with a
wide variety of monomers and resin systems. An example of
the versatility in SLA monomer selection is demonstrated with
the complex UV-curable hybrid resin prepared with both radi-
cal activated acrylates and cationic initiated epoxy monomers
as a route to fast photocuring multi-phase polymers with low
polymerization shrinkage [14]. The polymerization-induced
shrinkage as the photopolymer is formed when coupled
with the thermal expansion/contraction leads to stress
 d e n t a l m a t e r i a l s 3 2 ( 2 0 1 6 ) 54–64
development that can produce warped parts. Strategies based
on both the material selection and the exposure protocol can
be developed to largely mitigate the development of residual
stresses and heated resin baths are also possible to reduce
resin viscosity while increasing polymerization speed and
degree of conversion in the photopolymer.
Ideally, the monomers (typically comonomers and reactive
oligomers) used in photopolymerization-based part printing
should be of relatively low to modest overall viscosity (viscosi-
ties either too low or too high introduce problems), capable
of rapid polymerization and yield crosslinked polymers with
properties suited to the demands imposed by the target appli-
cation. Just as in the UV-curable coatings industry, this means
that acrylates and epoxy monomers are most commonly
encountered as photo-based printing materials although vinyl
ether-functionalized monomers and other monomer types
are used as well. Also related to the UV coatings indus-
try, relatively high photoinitiator concentrations (often up to
3–5 wt%) are used to achieve fast polymerization and limited
depth of cure. With the fast curing monomers and short irra-
diation exposures, significant amounts of residual initiator
remain and this permits parts to be post-cured in a UV oven
to promote completion of the curing process. Some work
with relatively viscous resin systems has demonstrated that
the sacrificial support structure for overhanging elements or
freely moving aspects of the part design can be eliminated but
this also increases the cycle times between layers. An alternate
materials-based approach to creating support structures util-
izes a thermally reversible Diels–Alder network swollen with
a photo-crosslinkable acrylate monomer. This strategy allows
a permanent photo-patterned structure to be developed and
then released from the supporting matrix by raising the tem-
perature to cause reverse gelation in the unexposed regions
[15].
The mechanical strength of the parts produced by the SLA
approach is somewhat limited by the viscosity restrictions
generally imposed on the resins as well as the preference
for faster curing acrylate monomers rather than analogous
methacrylates, which offer higher strength polymers and bet-
ter biocompatibility compared with acrylates. However, since
the photopolymerization of each new layer is intimately con-
nected with the prior layer, this leads to good strength and
minimal anisotropy in the structure and properties of SLA
printed parts. Initiators should be matched well to the irradi-
ation source and have high molar absorptivity to achieve high
photocuring efficiency as well as a shallow depth of cure.
A recent development in UV-based 3D printing involves
continuous liquid interface production (CLIP) that utilizes
a bottom-up building approach that is facilitated through
a well-controlled oxygen inhibited dead-zone that avoids
attachment of the 3D part to an oxygen-permeable curing
window [16]. The window (Fig. 3) is a thin, amorphous Teflon
film with high chemical resistance and gas transport poten-
tial, very low refractive index and excellent optical clarity
that extends into the UV range. As with SLA, the choice
of photo-active resins is fairly broad; however, the viscos-
ity and reactivity of the monomers are critical here since
even small variations affect the physical and kinetic aspects
of oxygen diffusion within the resin that dictate the dimen-
sion of the dead-zone, which is approximately 20–30 ␮m as
57
Fig. 3 – Schematic of a CLIP ‘bottom-up’ DLP device that
utilizes a continuous rather than step-wise building
process to increase part production speed significantly.
Continuous elevation of the build platform reduces
processing time and eliminates micro-step features on part
surfaces.
a practical minimum. Within this region, the diffused oxygen
completely consumes the initiating radicals to avoid adhesion
of the part. The rate of resin replenishment in this dead-zone,
the initiation efficiency and the resin reactivity all combine
to determine the rate at which the part can be formed in
continuous rather than layer-by-layer fashion. The platform
elevation rate can vary according to the area of exposure at
any stage of the build process. The resulting part resolution
is inversely related to the print speed but parts with feature
size down to 10’s of ␮m can be formed with z axis print speeds
of 25–1000 mm/min, which considerably outpaces the produc-
tion efficiencies associated with step-wise layered building
techniques that typically take several hours with conventional
SLA techniques.
MultiJet (or PolyJet) printing utilizes another UV-cured prin-
ting format that can produce smooth parts in highly complex
geometries that do not require surface finishing since layer
dimensions below 20 ␮m are possible. The UV-curable poly-
meric materials are applied only where desired for the design
and since multiple print heads can be used, a wax or other gel-
like supporting material can be co-deposited for subsequent
removal by heating or water washout [17]. Since multiple prin-
ting heads are simultaneously available (Fig. 4), free variations
in blended color or even different building materials with dif-
ferent properties can be spatially designated including the for-
mation or structures with spatially graded properties [18]. For
jetted inks, a shear-thinning, non-Newtonian fluid is a desir-
able component that provides some restriction in the material
choice. Ink viscosity can vary and be compensated for with
either reactive diluent additives or heated print heads. Rather
than using wax as a support material, objects can be formed
entirely from jetted wax and then used directly for investment
58 d e n t a l m a t e r i a l s 3 2 ( 2 0 1 6 ) 54–64
Object and support
materials
Curing light
Inkjet heads
Leveling blade
Part
Support
Fig. 4 – MultiJet printer heads dispense droplets of liquid
building and support materials in a layer-by-layer manner
interspersed with photo-curing to covalently interconnect
the designed shape within a given layer as well as to
provide adhesion to the previous layer.
casting applications, which is often encountered in dentistry
and in jewelry design applications. Much work has already
developed a range of UV-curable inkjet inks for 2D printing
applications. These formulations are typically composed of
monomers, oligomers, colorants (pigments or dyes dispersed
or dissolved in the reactive carrier), photoinitiator(s) and
other additives. A UV-curable ink applied as an oil-in-water
emulsion has been used to create intentional well-controlled
porosity in parts upon curing followed by evaporation of the
aqueous phase. With a co-continuous phase structure in the
ink, interconnected pores can be obtained in printed parts that
permit infiltration to achieve, for example, conductive mate-
rials [19]. Inks can contain nano-fillers such as silica, clay of
suitable dimension to be accommodated within a jetted ink
droplet to provide both viscosity control during deposition as
well as reinforced mechanical properties in the final part [20].
A leveling blade can be used between layers to assure uni-
form build layers prior to exposure to the UV curing lamp
and z axis stage translation in preparation for the next layer.
The parts produced are dimensionally accurate and can be
robust in their mechanical properties; however, the build ori-
entation can significantly affect elastic modulus and fracture
stress but tensile strength is relatively insensitive to print
direction [21]. However, as with all 3D printing approaches,
the degree of isotropic mechanical property character can vary
greatly based on the material used with any given building
process.
Selective laser sintering (SLS) was introduced soon after
the SLA technique but it employs primarily semi-crystalline,
particulate thermoplastic prepolymer as the building mate-
rial. The technique relies on two energy sources accomplish
part production. First a bed of polymeric particles is preheated
close to the melting transition and above the temperature
necessary for recrystallization during the cooling cycle. The
preheated powder bed limits the energy input necessary
from the laser to cause sintering, which avoids large thermal
differentials that would otherwise result in part distortion.
Localized thermal sintering of the particles is achieved by the
Fig. 5 – The SLS approach uses a scanned laser to locally
fuse prepolymer particles on the surface of a preheated
build chamber that is incrementally lowered as the process
progresses.
controlled additional energy input by a high-power CO2 laser,
which traces the 2D layer design that fuses exposed particles
together within the layer as well as connects it to the previ-
ously scanned underlying layer (Fig. 5). The laser power (up to
20–50 W), beam size (typically about 0.5 mm), beam speed and
spacing between scans (both physical, known as hatch spac-
ing, and temporal) needs to be carefully controlled to balance
effective sintering while avoiding polymer property degrada-
tion that comes with overheating [22]. The sintering steps are
interspersed with application of an incremental layer of pre-
polymer powder of approximately 100 ␮m applied by a roller or
blade. Since the polymer powders are approximately 30–90 ␮m
in dimension, this means only about 2–4 particles represent a
layer thickness. This minimizes the extent of indirect heating
based on thermal conductivity to provide effective sintering.
The particles must be free flowing since layers receive no
further compaction. Therefore, particle size, shape and free
packing density are critical factors in the material design along
with the thermal behavior. Spherical particles flow more eas-
ily and pack more densely than irregular shapes so ground
polymer processing is problematic since it creates irregular
particle shape and a broad distribution of particle size. Par-
ticles that are too small create processing difficulties due
to either excessive cohesion or electrostatic repulsive forces.
After the part is completed, the entire building chamber is
cooled slowly to maximize polymer crystallization to provide
added strength as well as to reduce stress development and
improve dimensional accuracy, which can be improved fur-
ther by incorporation of shrinkage modeling into the initial
part design [23,24]. The unsintered powder serves as the phys-
ical support for the part throughout the process. The free
powder is removed at the end of the build cycle and it can
generally be reused albeit with concerns of material alter-
ation related to oxidation (which can be mainly avoided by an
inert gas purging), thermal degradation and even increases in
polymer molecular weight (with changes in many properties
including reduced polymer crystallinity) during the extended
heating process. This means that recycled polymer typically
 d e n t a l m a t e r i a l s 3 2 ( 2 0 1 6 ) 54–64
is mixed with virgin powder for subsequent use [25]. Rather
than the aging effects associated passive heating, a separate
study investigated PA12 material alterations resulting from
the higher temperatures as a result of direct laser exposure at
varied power levels. The results were that higher laser power
resulted in PA12 chain scission as evidenced by lower viscosity
and lower values for elongation at break [26].
The scanned laser produces a melt zone within the polymer
powder bed that has a comparable radius in both the horizon-
tal and vertical dimensions. Within this zone, depending on
particle size and laser power, adjacent particles may be com-
pletely melted or just liquefied at the particle surface with
gravity and capillary forces serving to produce consolidation
[27]. In addition to the more dense core within the scanned
beam path, the sintered zone extends to a more loosely
bound and less dense boundary layer that was exposed to
less power and lower temperatures based on thermal conduc-
tivity [28]. When the processing conditions are well matched
to the polymeric material [29], including the hatch spacing
between adjacent scans in the x/y plane, reasonable mechani-
cal strength and good toughness can be achieved with certain
materials. One approach to reaching increased part den-
sity, minimizing defects and improving mechanical properties
involves the application of pressure in the build chamber [30].
Polyamide (PA12 or nylon 12) represents the vast majority
of the current commercial SLS materials market. Alterna-
tive materials include other polyamides (PA6, PA10, PA11),
poly(acrylonitrile/butadiene/styrene) (ABS), polystyrene (PS),
polycarbonate (PC) and work continues to develop polypropyl-
ene, high-density polyethylene, polyether ether ketone (PEEK)
among others for use in polymer powder form. Significantly
higher powder bed heating temperatures are necessary to
allow use of high performance polymers such as PEEK. These
high powder processing temperatures (∼350 ◦ C) limit poten-
tial recycling of the non-fused PEEK powder, which greatly
increases the production expense, while also excluding its use
with most commercial SLS devices [27].
Semi-crystalline polymers are primarily used with the
intrinsic selection criteria ideally including a broad process
temperature window between polymer melting upon heating
and recrystallization upon cooling, a narrow melt transition,
and a high melting enthalpy to minimize unwanted sinter-
ing associated with thermal conductivity [31]. The surface
tension of the particle must also be sufficient to avoid inter-
particle fusion even though the powder is maintained far
above its glass transition temperature for extended inter-
vals. The polymers can be selected to yield parts that are
glassy or elastomeric. The preheating and laser sintering con-
ditions can be empirically modified to account for differences
in melting temperatures of materials as well as also being
able to work with amorphous polymers that display elevated
glass transition temperatures. Amorphous polymers such as
polycarbonate or polystyrene tend to yield weaker, more
porous structures than the semi-crystalline polymer pow-
ders [32], although relatively brittle polystyrene parts can be
strengthened and toughened by substitution of poly(styrene-
acrylonitrile) or ABS [33]. However, amorphous polymers do
not undergo the significant dimensional contraction associ-
ated with polymer crystallization as the process temperature
is reduced [34]. In some situations, a more porous structure
59
may be desired so that a secondary infiltration with an epoxy
resin or wax can be used to provide parts with much enhanced
mechanical properties or varied surface finish [14]. While
poly(methyl methacrylate) is used widely in dentistry and
many other amorphous commodity polymer applications,
PMMA has only recently been adapted for use in 3D prin-
ting [35]. As with all the polymer powders, very rigorously
controlled, high-grade material stocks are required. So while
the palate of polymers for use in SLS is growing, it is orders
of magnitude smaller than the choices of polymers available
for injection and extrusion molding applications. A range of
fillers, such as silica, aluminum, carbon fiber and glass can
also be incorporated into the powdered polymer to further
modify the appearance and properties of the printed parts.
One study has demonstrated that the SLS processing intro-
duces an orientation bias of micro-scale carbon fiber filler in PA
parts [36]. Silica can be added separately to polymer powders
to improve flow properties. Achieving uniform distribution of
filler in a mixed powder system where differences in particle
size and density are involved makes this nontrivial. The fac-
tors that govern a successful material are quite complex in
terms of both the polymer powder production and its inter-
action with the SLS process [37]. The current state-of-the-art
in SLS is that a given material will have significantly different
mechanical properties based on how it is oriented [38], and
processed within a given device and that because of the sen-
sitivity of the materials to the process conditions, the same
material used on different devices can produce quite varied
results [27]. Certain materials, PA12 being a good example, are
more forgiving in that regard but the transition from printed
structures used mainly as models toward 3D printed func-
tional parts remains a challenge; however it is a target toward
which definite progress is being made. A technology known
as Selective Heat Sintering (SHS) utilizes a thermal printhead
rather than a laser to fuse the surface of a powdered thermo-
plastic into patterned, layered structures analogous to the SLS
approach.
Another AM technique that relates to both SLS and MultiJet
printing is the binder jetting process. This method originally
gave rise to the term “3D printing” that subsequently has
been broadened to include all the additive manufacturing
approaches described here. A liquid binder is delivered with
high spatial resolution to a powder bed surface from a print
head. The binder connects just the exposed particles together
either through solvent welding or chemical reaction with no
thermal processing necessary, which improves building effi-
ciency since no cooling cycle is involved and the unexposed
powder stock can be freely reused. The powder can be poly-
mer or many other materials and a range of binders can be
employed based on the powder used. With some materials, a
dilute polymer solution is used as the binder. The layers need
to remain small to allow effective binding between incremen-
tal layers while also achieving reasonable x/y resolution. The
choice of polymeric powder materials can be much broader
than that associated with SLS since the constraints involved
with thermal processing windows are largely avoided; how-
ever, for solvent welded parts or in applications with solvent-
carried adhesives, there are obvious solvent resistance con-
siderations. The ability to use multi-print heads dispensing
binder of different colors provides a means to produce blended
60 d e n t a l m a t e r i a l s 3 2 ( 2 0 1 6 ) 54–64
Fig. 6 – The FFF technique relies on one or more heated
nozzles that spatially distribute extruded polymer as a fine
filament in the layer-by-layer building approach using a
spatially translatable platform.
multicolored articles; however, the final parts have substantial
porosity, which may necessitate infusion of a reactive resin or
wax to provide suitable surface finish and strength [18].
Fused filament fabrication (FFF) (or fused deposition mod-
eling – FDM) was developed in the early 1990s as another 3D
printing approach that like SLS uses preformed polymer as
the building material. However, in this case, the processing
energy input is involved at the pre-deposition stage to obtain
a polymer melt material that can be applied through a fine
print head or nozzle (Fig. 6). As such, this method is analogous
to conventional extrusion or injection molding except that
molds are unnecessary. Heated build chambers can be used to
minimize the thermal distortion associated with non-uniform
cooling. The FFF technique produces somewhat greater
anisotropy in terms of properties compared with the SLA and
SLS printing processes. One approach to address this direc-
tional disparity in strength and toughness that results from
interlayer bonding being less than intra-layer strength relies
on a post-print processing with exposure to gamma radiation
to induce crosslink formation within and between FFF printed
layers [39]. Since polymer melt extrusion in the FFF method
requires processible prepolymers, the ionizing radiation
provides a route to convert a thermoplastic polymer to a ther-
moset final printed part that along with more homogeneous
mechanical properties also displays greater solvent resistance
that may be important in biomedical and other applications.
A materials-based approach that circumvents the processing
barrier associated with thermoset polymeric materials in the
FFF technique relies on the thermally reversible Diels–Alder
reaction to allow heated flow of the polymer followed by
covalent bond formation upon cooling as a means to provide
reinforcement between applied layers in 3D builds [40].
Multiple print heads can be accommodated with FFF
devices to permit co-printing of temporary support material
for complex overhanging structure as well as use of multi-
color or different build materials to be used within a single
part; however, unlike the MultiJet process, intimately blended
colors or materials cannot be accommodated in the design.
Most of the commercial FFF devices are used with ABS or
PLA thermoplastic materials delivered as fibers from spools.
Other material options include polycarbonate, polyamide,
high-impact polystyrene, polyetherimide, polyoxymethylene,
polyphenylsulfone and others. Recent work has further
expanded the materials palette to include other polymer
blends as well as ultra-high molecular weight polyethylene
[41]. Due to the greater materials tolerance of the FFF approach
as compared with SLS processes, even recycled commodity
polymer stocks can be considered for use [42]. As with the
jetted printing inks, nano-fillers can be included to induce
the shear thinning character but the continuous filament
approach uniquely allows high aspect ratio microscopic fillers
to be used to provide greatly enhanced polymeric mechanical
strength based on alignment within the filament. Silicon car-
bide and carbon fiber with dimensions of 0.65 ␮m × 12 ␮m and
10 ␮m × 220 ␮m, respectively, have been used with an epoxy-
based resin, which relies on a post-print thermal treatment
to achieve final cure, to produce printed parts with strength
and modulus results that significantly surpass the mechanical
properties of conventionally molded samples of the unfilled
base resin [43]. The thermal treatment when combined with
well-design printing layout is probably also responsible for the
printed parts showing little anisotropic character. Modeling
considerations of factors such as the pressure drop and bead
cooling as the polymer melt leaves the nozzle and condenses
with adjacent previously deposited material has received con-
siderable attention [44]. Despite these technical details, the
relatively straightforward FFF ‘melt-apply-solidify’ approach
has lead to this being by far the most common version of 3D
printing and it represents the vast majority of consumer-based
low cost devices. An alternate approach related in principle to
FFF uses a resin with sufficient viscosity based on the resin
itself or due to added filler that yield an extrudable filament
that can be rapidly solidified in place based on gelation reac-
tion, drying or photopolymerization. An example of this is
the free-form building of continuous microstructures based
on resin extrusion coupled with UV curing [45].
As an example of what the future of fused deposition 3D
printing may include, the US Department of Energy, which
is interested in efficiency and energy aspects related to
manufacturing, printed a full-size, working replica of a Shelby
Cobra as an electric car that was displayed at the 2015 North
American International Auto Show in Detroit [46]. The frame,
body and other parts (500 lbs in total) were printed from
ABS thermoplastic containing 20% carbon fiber using the big
area additive manufacturing (BAAM) facility at Oak Ridge
National Laboratory where the build space is 20 × 8 × 6 ft
and the material deposition cross section is well above the
conventional filament scale. A calculation of the energy used
 d e n t a l m a t e r i a l s 3 2 ( 2 0 1 6 ) 54–64
to print the car was significantly less than that associated
with typical auto manufacturing practices.
A recent marriage between filament deposition 3D printing
and electrospinning has further expanded the possibilities
for the preparation of reinforced tissue engineering scaffold
structures among other applications. By moving the collec-
tor plate in the same fashion as FFF techniques, the random
coiling nature of the electrospinning process can be cir-
cumvented to form very well defined continuous patterned
structures [47–49]. Laminated object manufacturing (LOM) is
yet another layered manufacturing technique that uses a
variety of materials including polymer-based foils in layer-
by-layer application process interspersed with cutting with a
blade or laser to achieve spatial patterning within each of the
laminated film layers [50]. Thus, this approach represents a
compromise between additive and subtractive manufacturing
strategies in the building of three dimensional structures.
The areas of 3D printing in bioengineering including bio-
printing, which involves printing structures that include cells,
DNA and other bioactive components as integral parts of the
building process, are growing at a remarkable rate [51,52]. Labs
everywhere are printing prototypic organs including heart
valves, ears, artificial bone, joints, menisci, vascular tubes
and skin grafts. The structural and compositional complexity
associated with many types of tissue mimics greatly compli-
cates both the programming and the printing [53]. Even the
tremendous challenge of achieving viable vascularized tissue
constructs is potentially enabled by the additive processing
approach [54,55]. In tissue engineering, the ability to repro-
ducibly print the physical aspects of a tissue scaffold or other
constructs for use in complex cell-based studies means that
this physical parameter can be removed as a variable while
the chemical, mechanical or other properties of a scaffold are
systematically probed. Alternatively, physical features such as
pore structure in a given scaffold material can be manipulated
at will [56]. Poly(latic acid) is commercially available for SLS
and FFF printing applications and because of the widespread
use of PLA in other forms in human, animal and cell-based
studies, it is a popular choice for biomedical related poly-
mer printing [57]. Polycaprolactone is also being evaluated as
a biodegradable printed scaffolding material [58]. Due to the
specific material requirements associated with scaffolds for
bioengineering, microfluidic devices, drug delivery vehicles
and many other biological applications, the medical field has
actually significantly expanded the number of new polymers
that have been examined for use in 3D printing applications
[59].
Additive manufacturing of polymeric biomedical materi-
als are also being applied to dentistry with patient-specific
constructs used in clinical applications beginning to emerge
[60]. This type of hard and soft tissue repair will certainly
expand and there are predictions of printed replacement
teeth but as with the other organ printing considerations,
implementation of these prospects remains an aspiration on
the horizon. Current mainstream polymer-based 3D printing
applied to clinical dental practice include dental wax-ups,
orthodontic patterns, crown and bridge molds, which can offer
quicker turnarounds along with local control of the model
processing. Presently, 3D printing is being used in dental labo-
ratories around the world. Restorative labs are using it to make
61
patterns for fixed prosthodontics, surgical guides, and com-
plete removable dentures. Based on individual patient data,
implant drill guides [61] as well as thermo-formable orthodon-
tic patterns [62] and aligners are also in use in dental offices
with additive manufacturing devices designed exclusively for
dental and medical applications being very actively promoted
to the dental profession. Models of mandibles and other com-
plex tissue structure can be realized relatively rapidly based on
the 3D data obtained by digital scanning techniques including
laser scanning, computerized tomography (CT) and magnetic
resonance imaging (MRI) [63–65]. Materials have been specifi-
cally designed to produce life-like colors and textures for teeth
and gingiva in models. Recent advances in 3D printing speed
while retaining the potential for high spatial accuracy and res-
olution will only further expand these opportunities. One such
opportunity is demonstrated by the option to make printed
structures that include bioactive components. As an exam-
ple, a drug (nitrofurantoin) as well as hydroxy apatite were
blended into PLA to obtain an extruded filament with up to a
30% mass fraction of drug that could be processed by FFF to
create a device that prevented surface-associated and plank-
tonic growth of Staphylococcus aureus [66]. The development
of 3D printed drug delivery devices with spatial variations in
drug loading and material properties is an area of growing
interest that will likely find application in dentistry [67]. The
accuracy of 3D printed dental models relative to plaster casts
has been documented [68]. However, a recent study focused on
the dimensional fidelity of printed die spacers relative to the
input computer-aided design parameters for crown fabrica-
tion demonstrated some inaccuracies and inconsistencies in
print-producing these sub-100 ␮m details [69]. As the materi-
als, the 3D build design software and the hardware associated
with the building processes continue to improve, obviously
more mainstream as well as specialized applications of 3D
polymer-based printing in dentistry will continue to develop
with further expansion into both dental labs and dental
practices.
It should also be noted that there are well-designed studies
to compare the dimensional accuracy, mechanical proper-
ties, surface roughness, build speed and materials cost across
multiple 3D printing platforms [70]. This demonstrates that
there are advantages and disadvantages associated with each
approach. As the penetration of additive manufacturing con-
tinues to grow and evolve in the industrial world as well as in
the varied arenas of dental/biomedical materials and tissue
engineering, quality standards associated with the wide array
of 3D printing processes and materials becomes of greater con-
cern. To address this issue, ASTM International Committee
F42 on additive manufacturing technologies has been engaged
and there is an ASTM standard (F2792-12a) on the standard ter-
minology for additive manufacturing technologies [71]. The
National Institute for Standards and Technology has pro-
posed a standard AM test artifact [72]. This artifact would
permit independent, objective assessment of build quality
based on standardized measurements. The proposed arti-
fact would be large enough to provide features near edges of
build platforms as well as central locations and contain prac-
tical features such as flat surfaces, ramps, arcs, thin walls,
holes and protruding features over a broad range of length
scales.
62 d e n t a l m a t e r i a l s 3 2 ( 2 0 1 6 ) 54–64
3. Conclusions
As expansion of the 3D printing field continues, practical
factors such as processing costs, which include material
costs, production speed and volume, energy costs, are now
being carefully evaluated alongside that involved with more
traditional manufacturing processes [73,74]. The properties,
performance, lifetimes and recycling potential of printed parts
must also be considered. In dentistry, the mass customiza-
tion and digital inventory aspects, which are areas where
additive manufacturing excels, will almost certainly drive sig-
nificant further growth. The ability to locally create accurate,
working models for individual patients along with predictable
low cost and rapid turnaround times are appealing factors
that will likely drive mainstream acceptance of this technol-
ogy in some form within dental practices. The potential to
readily produce devices and scaffolds with complex structures
with spatially designated compositions or properties, includ-
ing unique access to structures with micro-scale gradients,
will likely provide critical enablement of dental disciplines
that involve tissue engineering. It will certainly be of inter-
est to see whether the 3D printing platform lives up to
the expectations of empowering a third industrial revolu-
tion and whether polymer-based materials, undoubtedly with
continued advances, remain the cornerstone of this pivotal
technology.
references
[1] Wohlers T. Wohlers report. Wohlers Associates; 2015.
[2] Chuang T. 3-D printer counts kids as customers. The Denver
Post; 2015.
[3] Hull CW inventor, UVP, Inc., assignee. Apparatus for
production of three-dimensional objects by
stereolithography. US Patent 4575330; 1986.
[4] Carts YA. Software enables laser stereolithography. Laser
Focus World 1990;26:57.
[5] Kaplan H. Stereolithography – a marriage of technologies.
Photon Spectra 1990;24:74–6.
[6] Neckers DC. Stereolithography – an introduction. Chemtech
1990;20:615–9.
[7] Wong KV, Hernandez A. A review of additive manufacturing.
ISRN Mech Eng 2012;2012:208760.
[8] Liska R, Schuster M, Infuhr R, Tureeek C, Fritscher C, Seidl B,
et al. Photopolymers for rapid prototyping. J Coatings
Technol Res 2007;4:505–10.
[9] Infuehr R, Pucher N, Heller C, Lichtenegger H, Liska R,
Schmidt V, et al. Functional polymers by two-photon 3D
lithography. Appl Surface Sci 2007;254:836–40.
[10] Sugioka K, Cheng Y. Femtosecond laser three-dimensional
micro- and nanofabrication. Appl Phys Rev 2014;1(4):
041303.
[11] Belfield KD, Schafer KJ, Liu YU, Liu J, Ren XB, Van Stryland
EW. Multiphoton-absorbing organic materials for
microfabrication, emerging optical applications and
non-destructive three-dimensional imaging. J Phys Org
Chem 2000;13:837–49.
[12] Schafer KJ, Hales JM, Balu M, Belfield KD, Van Stryland EW,
Hagan DJ. Two-photon absorption cross-sections of common
photoinitiators. J Photochem Photobiol A Chem
2004;162:497–502.
[13] Ostendorf A, Chichkov BN. Two-photon polymerization: a
new approach to micromachining. Photon Spectra
2006;40:72–8.
[14] Yan CZ, Shi YS, Yang JS, Liu JH. Multiphase polymeric
materials for rapid prototyping and tooling technologies and
their applications. Compos Interface 2010;17:257–71.
[15] Berg GJ, Gong T, Fenoli CR, Bowman CN. A dual-cure,
solid-state photoresist combining a thermoreversible
Diels–Alder network and a chain growth acrylate network.
Macromolecules 2014;47:3473–82.
[16] Tumbleston JR, Shirvanyants D, Ermoshkin N, Janusziewicz
R, Johnson AR, Kelly D, et al. Continuous liquid interface
production of 3D objects. Science 2015;347:
1349–52.
[17] Fahad M, Dickens P, Gilbert M. Novel polymeric support
materials for jetting based additive manufacturing
processes. Rapid Prototyping J 2013;19:230–9.
[18] Hofmann M. 3D printing gets a boost and opportunities with
polymer materials. ACS Macro Lett 2014;3:382–6.
[19] Cooperstein I, Layani M, Magdassi S. 3D printing of porous
structures by UV-curable O/W emulsion for fabrication of
conductive objects. J Mater Chem C 2015;3:2040–4.
[20] Sugavaneswaran M, Arumaikkannu G. Analytical and
experimental investigation on elastic modulus of reinforced
additive manufactured structure. Mater Design
2015;66:29–36.
[21] Cazon A, Morer P, Matey L. PolyJet technology for product
prototyping: tensile strength and surface roughness
properties. P I Mech Eng B J Eng 2014;228:1664–75.
[22] Jain PK, Pandey PM, Rao PVM. Effect of delay time on part
strength in selective laser sintering. Int J Adv Manuf Technol
2009;43:117–26.
[23] Raghunath N, Pandey PM. Improving accuracy through
shrinkage modelling by using Taguchi method in selective
laser sintering. Int J Mach Tool Manu 2007;47:985–95.
[24] Soe SP, Eyers DR, Setchi R. Assessment of non-uniform
shrinkage in the laser sintering of polymer materials. Int J
Adv Manuf Technol 2013;68:111–25.
[25] Dotchev K, Yusoff W. Recycling of polyamide 12 based
powders in the laser sintering process. Rapid Prototyping J
2009;15:192–203.
[26] Drummer D, Wudy K, Drexler M. Influence of energy input
on degradation behavior of plastic components
manufactured by selective laser melting. Phys Procedia
2014;56:176–83.
[27] Goodridge RD, Tuck CJ, Hague RJM. Laser sintering of
polyamides and other polymers. Prog Mater Sci
2012;57:229–67.
[28] Riedlbauer D, Drexler M, Drummer D, Steinmann P,
Mergheim J. Modelling, simulation and experimental
validation of heat transfer in selective laser melting of the
polymeric material PA12. Comp Mater Sci 2014;93:239–48.
[29] Majewski C, Zarringhalam H, Hopkinson N. Effect of the
degree of particle melt on mechanical properties in selective
laser sintered Nylon-12 parts. P I Mech Eng B J Eng
2008;222:1055–64.
[30] Jones JB, Wimpenny DI, Gibbons GJ. Additive manufacturing
under pressure. Rapid Prototyping J 2015;21:89–97.
[31] Dupin S, Lame O, Barres C, Charmeau J-Y. Microstructural
origin of physical and mechanical properties of polyamide
12 processed by laser sintering. Eur Polym J 2012;48:
1611–21.
[32] Kruth JP, Levy G, Klocke F, Childs THC. Consolidation
phenomena in laser and powder-bed based layered
manufacturing. CIRP Ann Manuf Technnol 2007;56:730–59.
[33] Yan C, Shi Y, Yang J, Liu J. Investigation into the selective
laser sintering of styrene-acrylonitrile copolymer and
postprocessing. Int J Adv Manuf Technol 2010;51:973–82.
 d e n t a l m a t e r i a l s 3 2 ( 2 0 1 6 ) 54–64
[34] Yan C, Shi Y, Hao L. Investigation into the differences in the
selective laser sintering between amorphous and
semi-crystalline polymers. Int Polym Proc 2011;26:416–23.
[35] Polzin C, Spath S, Seitz H. Characterization and evaluation of
a PMMA-based 3D printing process. Rapid Prototyping J
2013;19:37–43.
[36] Floersheim RB, Hou G, Firestone K. CFPC material
characteristics and SLS prototyping process. Rapid
Prototyping J 2009;15:339–45.
[37] Schmid M, Amado A, Wegener K. Materials perspective of
polymers for additive manufacturing with selective laser
sintering. J Mater Res 2014;29:1824–32.
[38] Ajoku U, Saleh N, Hopkinson N, Hague R, Erasenthiran P.
Investigating mechanical anisotropy and end-of-vector
effect in laser-sintered nylon parts. P I Mech Eng B J Eng
2006;220:1077–86.
[39] Shaffer S, Yang K, Vargas J, Di Prima MA, Voit W. On reducing
anisotropy in 3D printed polymers via ionizing radiation.
Polymer 2014;55:5969–79.
[40] Yang KJ, Appuhamillage G, Shaffer S, Lund B, Smaldone R,
Voit W. Novel polymers for 3D printing with improved
interlayer adhesion by reversible Diels–Alder reactions.
Abstr Pap Am Chem S 2014:248. Abstr 784-POLY.
[41] Rocha CR, Perez ART, Roberson DA, Shemelya CM,
MacDonald E, Wicker RB. Novel ABS-based binary and
ternary polymer blends for material extrusion 3D printing. J
Mater Res 2014;29:1859–66.
[42] Hunt EJ, Zhang CL, Anzalone N, Pearce JM. Polymer recycling
codes for distributed manufacturing with 3-D printers.
Resour Conserv Recy 2015;97:24–30.
[43] Compton BG, Lewis JA. 3D-printing of lightweight cellular
composites. Adv Mater 2014;26:5930–5.
[44] Turner BN, Strong R, Gold SA. A review of melt extrusion
additive manufacturing processes: I. Process design and
modeling. Rapid Prototyping J 2014;20:192–204.
[45] Farahani RD, Lebel LL, Therriault D. Processing parameters
investigation for the fabrication of self-supported and
freeform polymeric microstructures using
ultraviolet-assisted three-dimensional printing. J
Micromech Microeng 2014;24:055020.
[46] Office of Energy Efficiency and Renewable Energy at
http://energy.gov/eere/amo/3d-printed-shelby-cobra
[accessed June 2015].
[47] Visser J, Melchels FPW, Jeon JE, van Bussel EM, Kimpton LS,
Byrne HM, et al. Reinforcement of hydrogels using
three-dimensionally printed microfibres. Nat Commun
2015;6:6933.
[48] Zheng G, Yu Z, Zhuang M, Wei W, Zhao Y, Zheng J, et al.
Electrohydrodynamic direct-writing of three-dimensional
multi-loop nanofibrous coils. Appl Phys A 2014;116:171–7.
[49] Brown TD, Edin F, Detta N, Skelton AD, Hutmacher DW,
Dalton PD. Melt electrospinning of poly(␧-caprolactone)
scaffolds: phenomenological observations associated with
collection and direct writing. Mater Sci Eng C
2014;45:698–708.
[50] Klosterman D, Chartoff R, Graves G, Osborne N, Priore B.
Interfacial characteristics of composites fabricated by
laminated object manufacturing. Composites Part A Appl S
1998;29:1165–74.
[51] Murphy SV, Atala A. 3D bioprinting of tissues and organs.
Nat Biotechnol 2014;32:773–85.
[52] Seliktar D, Dikovsky D, Napadensky E. Bioprinting and tissue
engineering: recent advances and future perspectives. Isr J
Chem 2013;53:795–804.
[53] Xu T, Zhao WX, Zhu JM, Albanna MZ, Yoo JJ, Atala A.
Complex heterogeneous tissue constructs containing
multiple cell types prepared by inkjet printing technology.
Biomaterials 2013;34:130–9.
63
[54] Lee VK, Lanzi AM, Ngo H, Yoo SS, Vincent PA, Dai GH.
Generation of multi-scale vascular network system within
3D hydrogel using 3D bio-printing technology. Cell Mol
Bioeng 2014;7:460–72.
[55] Paulsen SJ, Miller JS. Tissue vascularization through 3D
printing: will technology bring us flow? Dev Dynam
2015;244:29–640.
[56] Bohner M, Loosli Y, Baroud G, Lacroix D, Commentary:.
Deciphering the link between architecture and biological
response of a bone graft substitute. Acta Biomater
2011;7:478–84.
[57] Serra T, Mateos-Timoneda MA, Planell JA, Navarro M. 3D
printed PLA-based scaffolds: a versatile tool in regenerative
medicine. Organogenesis 2013;9:239–44.
[58] Elomaa L, Teixeira S, Hakala R, Korhonen H, Grijpma DW,
Seppala JV. Preparation of poly(epsilon-caprolactone)-based
tissue engineering scaffolds by stereolithography. Acta
Biomater 2011;7:3850–6.
[59] Gross BC, Erkal JL, Lockwood SY, Chen CP, Spence DM.
Evaluation of 3D printing and its potential impact on
biotechnology and the chemical sciences. Anal Chem
2014;86:3240–53.
[60] Rasperini G, Pilipchuk SP, Flanagan CL, Park CH, Pagni G,
Hollister SJ, et al. 3D-printed bioresorbable scaffold for
periodontal repair. J Dent Res 2015:94,
http://dx.doi.org/10.1177/0022034515588303.
[61] Flugge TV, Nelson K, Schmelzeisen R, Metzger MC.
Three-dimensional plotting and printing of an implant
drilling guide: simplifying guided implant surgery. J Oral
Maxil Surg 2013;71:1340–6.
[62] Martorelli M, Gerbino S, Giudice M, Ausiello P. A comparison
between customized clear and removable orthodontic
appliances manufactured using RP and CNC techniques.
Dent Mater 2013;29:E1–10.
[63] Anderson PJ, Yong R, Surman TL, Rajion ZA, Ranjitkar S.
Application of three-dimensional computed tomography in
craniofacial clinical practice and research. Aust Dent J
2014;59:174–85.
[64] Cohen A, Laviv A, Berman P, Nashef R, Abu-Tair J.
Mandibular reconstruction using stereolithographic
3-dimensional printing modeling technology. Oral Surg Oral
Med Oral Pathol Oral Radiol Endod 2009;108:661–6.
[65] Kfir A, Telishevsky-Strauss Y, Leitner A, Metzger Z. The
diagnosis and conservative treatment of a complex type 3
dens invaginatus using cone beam computed tomography
(CBCT) and 3D plastic models. Int Endod J 2013;46:
275–88.
[66] Water JJ, Bohr A, Boetker J, Aho J, Sandler N, Nielsen HM,
et al. Three-dimensional printing of drug-eluting implants:
preparation of an antimicrobial polylactide feedstock
material. J Pharm Sci 2015;104:1099–107.
[67] Katakam P, Dey B, Assaleh FH, Hwisa NT, Adiki SK, Chandu
BR, et al. Top-down and bottom-up approaches in 3D
printing technologies for drug delivery challenges. Crit Rev
Ther Drug 2015;32:61–87.
[68] Kasparova M, Grafova L, Dvorak P, Dostalova T, Prochazka A,
Eliasova H, et al. Possibility of reconstruction of dental
plaster cast from 3D digital study models. Biomed Eng
Online 2013;12:49.
[69] Hoang LN, Thompson GA, Cho SH, Berzins DW, Ahn KW. Die
spacer thickness reproduction for central incisor crown
fabrication with combined computer-aided design and 3D
printing technology: an in vitro study. J Prosthet Dent
2015;113:398–404.
[70] Kim GD, Oh YT. A benchmark study on rapid prototyping
processes and machines: quantitative comparisons of
mechanical properties, accuracy, roughness, speed, and
material cost. P I Mech Eng B J Eng 2008;222:201–15.
64 d e n t a l m a t e r i a l s 3 2 ( 2 0 1 6 ) 54–64

[71] F2792/12a A. Standard terminology for additive
manufacturing technologies. West Conshohocken, PA: ASTM
International; 2012.
[72] Moylan S, Slotwinski J, Cooke A, Jurrens K, Donmez MA. An
additive manufacturing test artifact. J Res Natl Inst Stan
2014;119:429–59.
[73] Gebler M, Uiterkamp A, Visser C. A global sustainability
perspective on 3D printing technologies. Energy Policy
2014;74:158–67.
[74] Weller C, Kleer R, Piller FT. Economic implications of 3D
printing: market structure models in light of additive
manufacturing revisited. Int J Prod Econ 2015;164:43–56.