JID: ACTBIO

ARTICLE IN PRESS [m5G;January 4, 2021;11:7]

Acta Biomaterialia xxx (xxxx) xxx

Contents lists available at ScienceDirect

Acta Biomaterialia
journal homepage: www.elsevier.com/locate/actbio

Review article

3D and 4D printing in dentistry and maxillofacial surgery: Printing

techniques, materials, and applications
Danial Khorsandi a,b,c, Amir Fahimipour d, Payam Abasian e, Sepehr Sadeghpour Saber f,
Mahla Seyedi g, Sonya Ghanavati h, Amir Ahmad f, Andrea Amoretti De Stephanis f,
Fatemeh Taghavinezhaddilami f, Anna Leonova i, Reza Mohammadinejad j, Majid Shabani k,l,
Barbara Mazzolai k, Virgilio Mattoli k, Franklin R. Tay m,∗, Pooyan Makvandi k,∗
a
Department of Biotechnology-Biomedicine, University of Barcelona, Barcelona 08028, Spain
b
Department of Mechanical engineering, McMaster University, Hamilton, ON L8S 4L8, Canada
c
Department of Medical and Scientific Affair, Procare Health Iberia, Barcelona 08860, Spain
d
Discipline of Oral Surgery, Medicine and Diagnostics, School of Dentistry, Faculty of Medicine and Health, Westmead Centre for Oral Health, The University
of Sydney, NSW 2145, Australia
e
Department of Chemical Engineering, Isfahan University of Technology, Isfahan, Iran
f
International University of Catalunya, Faculty of Dentistry, Sant Cugat, Barcelona 08195, Spain
g
Department of Engineering, Corrosion and Metallurgy Study Center “A. Dacco”, University of Ferrara, Ferrara 44121, Italy
h
Department of Medicine and Health Technology, Tampere University of technology, Tampere 33720, Finland
i
Department of Medical Sciences, McMaster University, Hamilton L8S 4L8, ON, Canada
j
Research Center for Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman 7618866749, Iran
k
Istituto Italiano di Tecnologia, Centre for Micro-BioRobotics, viale Rinaldo Piaggio 34, 56025 Pontedera, Pisa, Italy
l
The BioRobotics Institute, Scuola Superiore Sant’Anna, viale Rinaldo Piaggio 34, 56025 Pontedera, Pisa, Italy
m
The Graduate School, Augusta University, Augusta, Georgia 30912, United States

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

Article history: 3D and 4D printing are cutting-edge technologies for precise and expedited manufacturing of objects
Received 23 October 2020 ranging from plastic to metal. Recent advances in 3D and 4D printing technologies in dentistry and max-
Revised 16 December 2020
illofacial surgery enable dentists to custom design and print surgical drill guides, temporary and perma-
Accepted 17 December 2020
nent crowns and bridges, orthodontic appliances and orthotics, implants, mouthguards for drug delivery.
Available online xxx
In the present review, different 3D printing technologies available for use in dentistry are highlighted
Keywords: together with a critique on the materials available for printing. Recent reports of the application of these
3D printing printed platformed are highlighted to enable readers appreciate the progress in 3D/4D printing in den-
4D printing tistry.
dental applications Published by Elsevier Ltd on behalf of Acta Materialia Inc.
dental devices
dentistry
maxillofacial surgery

Statement of Significance
Abbreviations: AIBN, 2,2-́azo-bis-isobutyrylnitrile; ABS, Acrylonitrile buty-
rostyrene; AM, Additive manufacturing; ATZ, Alumina toughened zirconia; ATH,
Alumina trihydrate; Al2 O3 , Aluminium; 12Ce-TZP, Ceria-stabilized zirconia; Cr2 O3 ,
Chromium oxide; CoCrMo, Cobalt chromium molybdenum; CP-Ti, Commercially
pure titanium; CBCT, Cone beam computed tomography; CRP, Controlled radical
polymerization; DLP, Digital light projection; MDM, Digital micromirror device;
EDX, Energy dispersive X-Ray; FDM, Fused deposition modeling; FFF, Fused filament
fabrication; FRP, Free radical polymerization; HCP, Hexagonal close-packed; MgO,
Magnesium oxide; n-BuLi, n-butyllithium; PLA, Polylactic acid; PMMA, Poly(methyl
methacrylate); PCL, Polycaprolactone; PC, Polycarbonate; PEEK, Polyetheretherke-
tone; PS, Polystyrene; PVS, Polyvinylsiloxane; RP, Rapid prototyping; SEM, Scanning
electron microscopy; SLS, Selective laser sintering; SL, Stereolithography; SLA, Stere-
olithography apparatus; TMJ, Temporomandibular joint; TiO2 , Titanium dioxide; UV,
Ultraviolet; ZTA, Zirconia-toughened alumina; ZrO2 , Zirconium oxide.
∗
Corresponding authors.
E-mail addresses: ftay@augusta.edu (F.R. Tay), Pooyan.makvandi@iit.it (P. Mak-
vandi).
3D and 4D printing are cutting-edge technologies that en-
ables precise and expedited manufacturing of objects rang-
ing from polymers to metals. Despite great progress in this
rapidy advancing field over the last 5 years, there has not
been a thorough review that covers the materials, methods
and applications of 3D/4D printing in dentistry and maxillo-
facial surgery. Apart from the discussion on 3D materials and
technologies, to the best of our knowledge, recent experi-
mental 4D platforms such as potential responsive materials
will also be discussed to provide a backdrop for future re-
search and advances in using these platforms in dentistry.
There is no review article to cover 3D and more importantly
4D printing in dentistry and maxillofacial surgery.

https://doi.org/10.1016/j.actbio.2020.12.044
1742-7061/Published by Elsevier Ltd on behalf of Acta Materialia Inc.

Please cite this article as: D. Khorsandi, A. Fahimipour, P. Abasian et al., 3D and 4D printing in dentistry and maxillofacial surgery:
Printing techniques, materials, and applications, Acta Biomaterialia, https://doi.org/10.1016/j.actbio.2020.12.044
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
1. Introduction
Three dimensional (3D) printing is an industrial technology
that has rapidly evolved over its forty-year history [1]. This ad-
ditive manufacturing (AM) approach differs from classical subtrac-
tive manufacturing principles and is currently utilized in a plethora
of disciplines ranging from aerospace industries to personalized
medicine and dentistry. This manufacturing scheme enables rapid
creation of custom-based complex parts, made it an applicable
solution in developing self-growing robots [2]. Additive manufac-
turing is represented by technologies such as stereolithography,
fused deposition modeling, selective laser sintering, inkjet print-
ing, photopolymer jetting and powder binder printing [3–8]. Dif-
ferent materials, e.g., polymers, composites, ceramics, and metal
alloys, are employed for additive manufacturing [9,10]. Integration
of 3D printing into different facets of contemporary dentistry has
enabled the production of complex prosthodontic, orthodontic and
surgical devices that demand flexibility and abrasion resistance
from the molding materials.
Recent progress in 3D-printable smart materials has brought
into fruition a newer generation of “dimensional printing” that is
coined 4D printing. Four-dimensional printing is the combination
of 3D printing with time as the 4th dimension [11]. Such a printing
platform produces pre-programable bio-objects that change their
shape in response to the surrounding media [12].
Fig. 1. Current 3D and/or 4D printing techniques used in dentistry.
2
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
Companies are taking advantage of recent expiration of the ini-
tial patents to introduce and expand their technologies (Fig. 1). In
light of 3D and 4D printing rapidly becoming a manufacturing and
prototyping alternative in dentistry, the objective of the present re-
view is to explore, explain and compare the different 3D printing
technologies that have been utilized for the fabrication of dental
biomaterials. Applications of these 3D printed platforms will also
be described to enable readers appreciate the progress achieved in
this rapidly developing field.
2. 3D printing techniques
2.1. Stereolithography
Stereolithography (SLA) is the first commercially available 3D
printing technology. This rapid manufacturing method involves
photoinduced polymerization to create layered structures using
highly cross-linked polymers [38]. This technology may be subdi-
vided into different categories based on the type of platform mo-
tion and laser movement. Irrespective of these categories, print-
ing proceeds through three major steps: light/laser exposure, plat-
form movement, and resin refilling. Stereolithography is the typical
representative of AM, which utilizes layer-by-layer modeling. A 3D
digitized model, which is used as the template for the fabrication
process, guides the SLA machinery to complete the printed object.
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
Fig. 2. Stereolithography printing. (A) Layer by layer printing process. (B) An example of a crown printed with stereolithography prior to removal of supports and polishing.
The layers are bound together bottom-up upon exposure of the
resin to ultraviolet light, which induces free radical polymerization
(FRP) of the resin monomers. As one layer is polymerized, the resin
platform lowers by a distance equal to the thickness of one layer
and builds the next layer until the printing of the digitized 3D ob-
ject is completed (Fig. 2A and B) [39]. The discontinued manner
of processing can be overcome by combining SLA with continu-
ous liquid interface production. The latter a proprietary method of
3D printing that uses photopolymerization to create smooth-sided
solid objects [25,40] Variables such as light source intensity, scan-
ning speed as well as the amount of resin monomers and pho-
toinitiators may be controlled to achieve the required modeling ki-
netics and properties of the final product [31]. Currently, SLA is
applied in the manufacturing of temporary and permanent crowns
and bridges, temporary restorations, surgical guides, templates, and
dental model replicas (Fig. 2B) [26]. Table 1 represents the pros
and cons of 3D/4D printing methods in dentistry and maxillofacial
surgery.
Stereolithography accommodates flexibility in design, geomet-
ric shape and scaling, resulting in highly accurate personalized de-
vices. High precision measurements retrieved from the patient’s
scanning data enable production of reliable appliances for long-
term use [41]. However, cytotoxicity of the printed appliances may
be caused by the leaching of residual unreacted resin monomers
from the printed appliances. The may affect the longevity of the
appliances.
Stereolithography demonstrated greater clinical accuracy than
other digital/analog methods in the production of dental stone
casts; the 3D printing technique represents an acceptable alter-
native for diagnosis, treatment, and production of prosthetic de-
vices [42]. Nevertheless, SLA-printed dental devices suffer from
poor mechanical properties caused by the limited choice of resins
that can be photopolymerized [39]. Nanoparticle incorporation into
the polymeric matrix improves mechanical properties [43]. Other
coupling agents such as ceramic fillers protect the printed struc-
ture from fracture by improving stress distribution. Antimicrobial
agents have also been incorporated into the resins to address the
issue of microbial colonization of oral devices [14,44]. Overall, SLA
is a rapid, convenient and multifunctional technique in 3D dental
printing (Fig. 2).
2.2. Digital light projection
DLP is a photocuring technology which is similar to SLA pro-
cess. The materials are liquid photosensitive resins which undergo
photocuring and subsequently form the 3D printed part layer by
layer. The first layer is formed on the build platform. Based on the
position of the UV source, the build platform may be ascending or
descending as shown in Fig. 3B [45]. Next layers will be formed
on their previous layers. DLP 3D printer utilizes a digital projec-
tor screen to flash the current layer’s image, through a transparent
bottom/top of the resin tank, across the build platform or previous
3
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
layer. After curing each layer, the build platform goes up/down as
the thickness of a layer until completing the entire part [46,47]. A
digital micromirror device (MDM) is used to reflect the light. DMD
consists of a matrix of microscopic-size mirrors. These mirrors con-
duct the light from the laser projector to the projection lens. They
make different configurations, adjustable for each layer, such that
they create the 2D sketch of the layer by light on the curing sur-
face [48].
Although SLA and DPL are very similar, they also have some dif-
ferences. The main difference is the light source. SLA benefits from
UV laser beam while DLP uses UV light from the projection source.
Consequently, in SLA laser beam moves from point to point and
cures the resin from point to point while in DLP the light source is
stationary and cures each layer of the resin at a time. These differ-
ent curing processes result in more accurate and better quality in
SLA compared to DLP, while on the other hand improves the print-
ing speed in DLP method. The intensity of the light source in the
DLP 3D printer is adjustable while it is not adjustable in the SLA
printer. This means that the operator can control the effect of light
on the resin. In summary, DLP is advantageous in the fast print-
ing of bigger parts with fewer details while SLA is advantageous in
printing accurate parts with intricate details [49–53].
2.3. Fused deposition modeling
Fused deposition modeling (FDM), also known as fused fila-
ment fabrication (FFF), is the trade name for a polymer, com-
posites, or metal alloys softening process that was invented over
20 years ago. It is the second most commonly used 3D print-
ing technique, after SLA [55]. This method is remarkably cheaper
than the other AM techniques [56]. The basis of this technique
is the principle of strand extrusion: the desired type of thermo-
plastic materials, shaped as strands, is delivered to the extruder.
Upon softening, the heated viscous plastic is deposited by an ex-
trusion head that results in layer-by-layer fabrication of the digi-
tized model (Fig. 4A) [57,58]. Unlike SLA, individual layers within
the object have reduced bonding and thus, the final product has
greater anisotropy [25]. Thermoplastic polymers and their com-
posites (e.g., acrylonitrile-butadiene-styrene (ABS), polycarbonates
and polysulfones) along with low melting temperature metal alloys
(e.g., bronze metal filament) are the most common employed FDM
filaments [9,56]. Polymers may be filled with metal (nano)particle
reinforcement to prepare (nano)composite filament to improve dif-
ferent features, e.g., thermal resistance and mechanical properties.
Mechanical properties in the FDM method can be affected by three
main groups of parameters: print material, structural parameters
(i.e. rasters angle, infill density, print orientation, and stacking se-
quence), and manufacturing parameters (i.e. extrusion temperature
and rate, layer time, nozzle transverse speed, and bed tempera-
ture) [56]. Because of the weak mechanical properties of these un-
filled thermoplastics, FDM is used only for the printing of tempo-
rary crowns and bridges in dentistry. Similarly to SLA, processing
JID: ACTBIO
ARTICLE IN PRESS [m5G;January 4, 2021;11:7]

D. Khorsandi, A. Fahimipour, P. Abasian et al. Acta Biomaterialia xxx (xxxx) xxx

Table 1
Advantages and disadvantages of 3D/4D printing methods in dentistry.

3D/ 4D printing Material

system characteristics Materials Advantages Disadvantages Ref.

Stereolithography Light curable resin Epoxy and - Product resolution - Over-curing [13–16]
(SLA) methacrylate - Efficiency - Lack of surface smoothness
monomers - Short working time - Limited mechanical strength
- Irritant
Selective laser Powder - Polymers - Structures are fully self-supporting - Sample surfaces appear porous and [17–20]
sintering (SLS) - Ceramics - Protective gas in not needed rough
- Metals - Vast variety of materials can be - Harmful gases release during
selected fabrication
- Little to no thermal stresses are - Materials waste is relatively high
accumulated on the component - Raw powders are expensive to an
- Components exhibit excellent extent
mechanical properties - Post-processing is often expensive
- Relatively fast method and tedious
Fused deposition Thermoplastic - Paste - Filaments are cheap and arrive in - The seam between layers is visible [9,21–25]
modeling (FDM) polymer and - Wire various colors - Discontinuous extrusion results in
composites, low - Easy to change materials formation of defects
melting - Cost-effective maintenance - Support structure is required in
temperature metal - Capable of fast production of shelled some cases
alloys structures - Delamination between layers may
- Fundamental for thinner layers up to occur due to low extrusion
0.1 mm thick temperature
- Released fumes are not toxic - Printed component may curl off the
build platform because of induced
thermal stresses

Photopolymer Light curable resin - Biocompatible - High resolution due to thin layer - Irritant [26–32]
jetting (MED610) printing (∼16 microns per layer) - High cost
- VeroDentPlus - Short working time
(MED690) and - Excellent surface features
VeroDent - No need for post-modification
(MED670)(all are - Supporting wide range of materials
natural looking
medically -approved
photopolymers)
Powder binders Materials which - Metal - Safe material - Low resolution [33,34]
are available in - Ceramic - Short working time - Low strength
powder - Plastics - Suitable mechanical performance - Cannot be soaked/heat sterilized
- Low cost
Digital light Light curable resin - Resin - High complexity and excellent - Limited material selection [35]
projection surface finish - Photocurable resin can cause skin
- Short timeframe sensitization, and maybe irritant by
- Good accuracy contact
- Smooth surfaces
Computed axial Light curable resin - Resin containing - It can be used in specific conditions - Limited material selection [36,37]
lithography dissolved oxygen where existing methods fall short,
such as:
• Printing soft materials that cannot
maintain the forces applied during
layerwise printing,
• Creating lenses with smooth curved
surfaces,
• Encapsulating other objects in three
dimensions

commences with the acquisition of computer-aided design (CAD)
images, as depicted in Fig. 4B. Based on these digitized images,
FDM is capable of rapid printing of the destined product (Fig. 4C).
Fused deposition modeling is the technology utilized in most
low-cost ‘home’ 3D printers. It enables the printing of crude
anatomical models without too much complexity. Although the fi-
nal product is brittle and contains rough surfaces, FDM is cheaper
than other 3D printing techniques. This technique is used in ma-
chines with low maintenance and in scientific research [55].
2.4. Selective laser sintering
Selective laser sintering (SLS) is a system wherein a high energy
beam laser is used to induce fusion of the powdered raw material.
The laser creates a solid layer out of the powder, The platform will
be lowered to make space for the laser to sinter the next layer
of powder. This method of structure creation does not require ad-
ditional material support during printing because support is pro-
vided by the powder surrounding it [60].
Multi-purpose study models, guides for drilling and cutting as
well as metal frameworks can be created using SLS (Fig. 5). The
advantages of SLS include the use of autoclavable materials, me-
chanical functionality of the printed object, reduction in produc-
tion cost with increase in production volume. The disadvantages
of this printing technique are the health risk associated with in-
halation of the powdered raw material, the initial high cost in set-
ting up and the need for supplementary supplies such as com-
pressed air for proper functioning of SLS [17,19,20]. The function
of the laser is to increase the temperature of the powder to close
to, but not its sintering point. This sintering process converts the
solid power into a semi-liquid state. The platform on which the
first layer rests lowers by ∼0.1 mm, giving the laser space for a

4
JID: ACTBIO
ARTICLE IN PRESS [m5G;January 4, 2021;11:7]

D. Khorsandi, A. Fahimipour, P. Abasian et al. Acta Biomaterialia xxx (xxxx) xxx

Fig. 3. Digital light projection (DLP). (A) Schematic of the printer components and printing procedure. Reprinnted with permission from [49]. (B) Demonstration of two kinds
of platform movements in DLP method [54].

Fig. 4. Fused deposition modeling (FDM). (A) FDM printer. (B) dental crown CAD file. (C) dental crown FDM. Reprinted with permission from [59].

new layer of powder to be sintered. This stepwise sintering and
fusion continue until the object is fully printed. The object is left
to cool down after printing is complete [19].
Another benefit of SLS is the almost utilization readiness of the
printed object. Whereas other printer methods necessitate an extra
sanding step or other forms of finishing before the printed prod-
ucts are usable, this step is usually not mandatory for the SLS
technique. Because SLS printers do not require structural support
during printing, the processing time is considerably faster com-
pared with SLA and FDM [61–63]. Three types of SLS printing are
available: metal-based, ceramic-based, and polymer-based SLS. The
metal-based SLS technique utilizes fine metal powders, whereas
the polymer-based SLS technique utilizes fine-grained thermoplas-
tic polymers as raw materials. For metal-based SLS, different metal
powders may be employed, such as stainless steel alloys (316,
304L, 309, 174), and titanium alloy (6AI-4V). Unlike polymer-based
SLS which does not require gas injection, metal-based SLS requires
protective gas to be flooded into the printing chamber to avoid ox-
idation of the metal powder when the latter is heated to a high
sintering temperature.

5
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
Fig. 5. Selective laser sintering (SLS). (A) illustrations of the design and fabrication of a removable partial denture (RPD) framework by SLS. (B) CAD design of RPD framework,
(C) the final RPD framework, (D) laser-sintered metal frame, (E) partial denture fabricated using the sintered framework. Reprinted with permission from [64].
In addition, SLS technique has been employed for fabricating
ceramic parts [65]. Since ceramic powders need appropriate ex-
posure time to result in the desired density, the target temper-
ature should be lowered to facilitate the densification. One so-
lution is mixing other materials such as organic (e.g., polymers)
or inorganic (e.g., metal-based low-melting materials and glass)
compounds, as binders in the ceramic powder. Therefore, binders
melt in the heated powder bed surface and creat a bonding glassy
phase around the ceramic particles. Besides, these binders are
more sturdy to temperature variations. To prevent the oxidation
of the binder contents, insert atmospheres is mandatory. Organic
contents can be removed in the high-temperature firing in furnace,
while the inorganic parts remain [66]. Infiltration/isostatic pressing
along with SLS enhances the mechanical performance of the ce-
ramic parts by maximizing the final density [67]. However, there
are several challenges in the fabrication of ceramic parts with op-
timal mechanical performances. Powder deposition, the interaction
between laser and powder, mechanism of melting and consolida-
tion, as well as thermal and residual stress analysis are some of
these challenges [68].
2.5. Photopolymer jetting
This technology involves the combination of two techniques, us-
ing a dynamic printing head and photopolymerizable polymer. The
light-sensitive polymer is jetted to a building platform from an
inkjet-type printing head and cured layer by layer on the descend-
ing platform (Fig. 6) [69]. A supporting structure is also printed us-
ing fragile support material for easy removal. This technology en-
ables printing of an extensive range of resins and waxes for cast-
ing. Silicone-like rubber materials may also be used for printing
complex and highly-detailed products with a resolution of ∼16 mi-
crons. The printed products may be used as crowns or anatomi-
cal study models. Another advantage of the printing technique is
that implant drill guides may be printed rapidly and economically
with better quality. 3D jet printers utilize multiple printing heads
to cover the working platform width [27,30].
The printing head and working platform move bidirectionally
but independently. An ultraviolet light source is used to harden
each layer of resin or wax that has been jetted. The advantages of
this technology are rapid manufacturing, surface smoothness and
cost efficacy. The drawbacks include difficulty in removing the ma-
terial completely due to rigid support, skin irritation, inability to
be heat-sterilized and the high cost of the material [25,26].
6
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
2.6. Powder binder printer
This AM process uses liquid adhesive droplets within a modi-
fied inkjet head. The inkjet head releases these droplets for infil-
trating a layer of powder located underneath. This step is repeated
by replenishing a new layer of powder until the final product is
manufactured. The main application of powder binder printing in
dentistry is in the printing of study casts or prototypes. However,
the printed objects are fragile and lacked accuracy. Because this is
low-cost technology, the technique finds use in applications that
do not require sterilization, such as printing of study casts. How-
ever, the manufacturing process is messy because of the use of
powder (Fig. 7) [70,71].
2.7. Computed axial lithography
There is intense interest in the adaptation of novel technolo-
gies for 3D/4D printing in dentistry. Volumetric AM is an example
of these newly developed systems. Computed axial lithography is
a form of volumetric AM printing technique. It has some similarity
to DLP method as both systesm employ projector as light source to
photopolymerize the resin. The difference between computed axial
lithography and other conventional printing technqiues is that light
polymerization is applied at several angles to the material, where
as other AM printing methods utilize layer-by-layer polymeriza-
tion. In other words, computed axial lithography can produce the
entire object at once (not layer by layer). The idea of computed
axial lithography is inspired by computed tomography scanners.
In computed tomography, X-ray scanning is performed from many
different angles. This concept was utilized in the development of
computed axial lithography [35]. The object is fabricated by pro-
jecting a light (with specific wavelength) containing many 2D pic-
tures (from different angles of the object) to a rotating container of
photocurable resin (Fig. 8). Photopolymerization of the resin mate-
rial permits manufacturing of products with higher complexity and
better surface finish in shorter timeframe, compared with other
AM methods. Centimeter-scaled products may be printed within a
minute with the use of computed axial lithography. The products
printed with this technique can be easily designed with CAD and
saved in stereolithography file format. To date, high viscosity resins
or solid materials are used predominantly for this technique. The
application of materials with low viscosity may permit prining of
tissues in the future. However, more in vivo studies are required
to investigate the mechanical and chemical properties, tolerability
JID: ACTBIO
ARTICLE IN PRESS [m5G;January 4, 2021;11:7]

D. Khorsandi, A. Fahimipour, P. Abasian et al. Acta Biomaterialia xxx (xxxx) xxx

Fig. 6. (A) Photopolymer jetting. (B) Temporary crowns fabricated with the photopolymer jetting method. Micrographs of the cross-sections of the temporary crown (C)
Margin. (D) Axial. (C) Cusp. (D) Fossa. (Magnification × 50). Reprinted with permission from [27].

Fig. 7. (A) Powder binder printing. (B) A 3D printed denture model. (C) Scanning electron micrograph of the powder used for printing. (D) Distribution in particle size of
the powder employed for printing. Reprinted with permission from [71].

7
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
Fig. 8. Schematic of scanning (I) and then printing (II) using computed axial lithography as volumetric additive manufacturing. A 3D model is initially prepared using
scanners (I). The 3D model is converted into many 2D images. Each image is projected in one angle to the rotating container. DLP: digital light processing.
Fig. 9. (A) General chemistry involved in the synthesis of vinyl polymers. (B) Pho-
topolymerization of the monomers.
and biocompatibility of the photopolymerized resin products prior
to their recommendation for clinical applications [35,72].
3. Materials employed for 3D/4D printing in dentistry
3.1. Polymers
3.1.1. Vinyl polymers
Vinyl polymers are the most commonly used polymers in den-
tistry because of their tunable properties. They are produced from
vinyl monomers using FRP (Fig. 9A). Although vinyl polymers are
biocompatible, the majority of them are not biodegradable mak-
8
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
ing them unfavoured material for many medical applications, but
not dentistry, since degradation is not desirable for a long-term
use, such as dental implants. For this reason, new synthesis meth-
ods such as controlled radical polymerization (CRP) have been im-
plemented to tune material properties and control the molecular
weight of the resulting polymer, as well as their end and chain
functional groups. Vinyl polymers are extensively used for dental
3D printing that involves sintering (e.g., SLS) or photopolymeriza-
tion (e.g., SLA) (Fig. 9B) [70,73–76].
Poly(methyl methacrylate) (PMMA) is the most commonly used
vinyl polymer in dental 3D printing. It is polymerized from methyl
methacrylate monomer via FRP or anionic polymerization using
2,2-́azo-bis-isobutyronitrile or n-butyllithium as initiators, respec-
tively. PMMA is the most favorable material for printing den-
ture base materials owing to the ease of its processing, low cost,
lightweight, stability in the oral environment, and esthetic prop-
erties. However, PMMA has poor surface properties and weak me-
chanical properties; the latter may be circumvented by using ad-
ditives such as polyetheretherketone, SiO2 , and Al2 O3 [3,77,78].
Furthermore, the addition of titanium dioxide yields antimicrobial
property.
3.1.2. Styrene polymers
There are two styrene polymers commonly utilized in dental
3D printing: polystyrene (PS) and acrylonitrile-butadiene-styrene
(ABS). PS is an aromatic hydrocarbon polymerized from styrene
monomers via FRP, using benzoyl peroxide as initator (Fig. 10). It
is structurally amorphous with high transparency and a smooth
surface. Mechanical properties and ease of fabrictaion make it a
good candidate for dental applications [79,80]. High impact PS was
used to prepare 3D printed objects using fused filament fabrica-
tion, with improvement of the properties of the resulting product
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
Fig. 10. Free radical polymerization of polystyrene from styrene monomer and ben-
zoyl peroxide as initiator.
[81]. Photopolymerization strategies are similar to those discussed
in the previous session.
Another material used in 3D printing is ABS, a thermoplastic
polymer that inherits its superior properties from its monomers:
acrylonitrile, butadiene and styrene [82,83]. Each of the monomers
contributes to the quality of ABS. Therefore, ABS owes its heat
tolerance, high impact strength, and rigidity to acrylonitrile, bu-
tadiene, and styrene respectively. Different initiators have been
used for the synthesis of ABS via FRP: t-butyl or cumene
hydroperoxide/sodium formaldehyde sulfoxylate dihydrate/EDTA-
chelated Fe2+ redox, ammonium persulfate, ammonium persul-
fate/sodium bisulfite redox initiator and oil-soluble 2.2 -azobis(2,4-
dimethylvaleronitrile). FDM and SLS are usually employed for 3D
printing of ABS [84–86].
3.1.3. Polyesters
Polyester refers to a group of thermoplastic polymers that con-
tain ester functional groups in the main chain. They are poly-
merized via polycondensation by the removal of water molecules
(Fig. 11). The three most popular polyesters are polycarbonate (PC),
polycaprolactone (PCL) and polylactic acid (PLA) [87,88].
PCs are polymerized via polycondensation reaction between
bisphenol A and carbonyl chloride/diphenyl carbonate from the
main chain. They are mechanically robust, amorphous and trans-
parent polymers. PCs are used extensively in dentistry to produce
orthodontic brackets, denture bases and prefabricated provisional
crowns. They have been used experimentally as a based composite
printed by FDM [89]. Despite the advantageous properties of PC,
there is a probability of bisphenol A release making it a potentially
harmful substance [90].
PCL is synthesized via ring-opening polymerization of ɛ-
caprolactone monomers in the presence of a catalyst such as
stannous octanoate. PCL is a biodegradable and biocompatible
polyester with high in vivo stability because of its hydrophobicity.
In the field of 3D printing, PCL is of interest because of its low
9
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
Fig. 11. Synthesis of polyesters by polycondensation.
melting point (∼63°C), making is useful for printing techniques
such as FDM. Furthermore, 3D-printed PCL is used in bone tissue
regeneration such as alveolar bone augmentation [91].
PLA is one of the most extensively used polymers in human
body-related applications [92,93]. It is synthesized from lactic acid
via polycondensation, and in some cases via ring-opening polymer-
ization. The latter results in lower molecular weight and more brit-
tle PLA. PLA is highly biocompatible and possesses tunable physic-
ochemical properties. The excellent processability of PLA enables it
to be used in different 3D printing methods and for various appli-
cations as FDM printing of drill guides for surgical insertion of den-
tal implants, [94] and provisional restorations for protecting teeth
after crown preparations [95].
3.2. Metal-based materials
Metals are vastly employed in fabricating biocompatible de-
vices, especially when resistance to corrosion, and wear is required
[96,97]. Mechanical properties and biocompatibility are also impor-
tant factors for choosing metal for biomedical applications. Bio-
compatibility of a metallic material enables the material to per-
form its desired function without eliciting undesirable local or sys-
temic effects on the surrounding tissues. Despite many types of
metallic materials available, only a few of them are biologically
compatible with the human body and can be used for long-term
applications [98].
3.2.1. Stainless steel alloys
The earliest metal implant, introduced in the early 1990s, was
made of vanadium steel [99]. However, it was associated with pre-
mature loss of implant function, patient dissatisfaction and a need
for revision surgery because of mechanical and corrosion failure.
As a consequence, stainless steel alloys with more advanced char-
acteristics were introduced [100,101]. 302 stainless steel alloy was
initially developed as an alternative to vanadium steel [102]. It was
subsequently replaced by two other stainless steel alloys, 316 and
316 low carbon content (L). These alloys contain molybdenum and
at least 11% chromium yielding corrosion resistance [103]. Forma-
tion of a protective Cr-based oxide film on the alloy surface occurs
spontaneously in the body environment. This passive surface layer
improves corrosion resistance and wear resistance of the fabricated
implant [99]. Moreover, a maximum amount of 17-20% nickel helps
to stabilize the austenitic phase at room temperature and increases
corrosion resistance [103]. Nevertheless, the presence of a large
amount of Cr and Ni in these stainless steel alloys can provoke
an allergic reaction in patients, which require revision surgery for
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
their retrieval [104]. These stainless steel alloys are also not suit-
able for manufacturing permanent implants [105]. Their low me-
chanical properties render them susceptible to stress, corrosion,
cracking and pitting corrosion, with formation of deep pits on the
metal surface. Implant failure initiates from these weakened spots
along with the passive surface layer, which propagates through the
bulk material [106].
3.2.2. Titanium and its alloys
The use of stainless steel as implants was eventually replaced
by titanium and its alloys due to their improved corrosion resis-
tance, biocompatibility, strength, and lightweight [107,108]. Com-
mercially pure titanium (CP-Ti) and Ti-6Al-4V are the most bio-
compatible titanium alloys. They are the preferred materials for
manufacturing orthopedic implants [109,110]. In addition, the for-
mation of a thin, stable oxide film on the surface of titanium and
its alloys contribute to their excellent corrosion resistance [111].
Bulk titanium alloy has a much higher Young’s modulus than a
natural bone (110 vs. 10-30 GPa, respectively) [112]. making it in-
applicable for orthopedic use, since materials with Young’s mod-
uli exceeding that of a natural bone cause stress-shielding and
subsequently bone resorption, which results in loosening of the
implant. Despite the advanced properties of Ti-6Al-4V it cannot
be used without surface treatment and coating due to its poor
wear resistance. There are also potential concerns with toxicity of
the vanadium or aluminum present in the alloy [113]. The sec-
ond generation of titanium alloys have since been introduced that
have lower moduli of elasticity (e.g., Ti-12Mo-6Zr-2Fe, Ti-15Mo-
5Zr-3Al, Ti-15Sn-4Nb-2Ta-0.2Pd and To-13Nb-13Zr.( [114] However,
these alloys are more embrittlement-susceptible due to the oxy-
gen dissolution caused by the oxygen diffusion into titanium which
is introduced during fabrication/heat treatment. In addition, their
higher cost have led to their substitution with cobalt-based alloys
[115].
3.2.3. Cobalt-based alloys
Cobalt-based alloys have attracted considerable interest as med-
ical implant materials because of their superior corrosion and wear
resistance, excellent mechanical properties, biocompatibility and
low rigidity [116]. The first cobalt chromium (CoCr)-based implant
was fabricated in 1930. More than half a century of research has
led to refinement in the manufacturing of this alloy for biomedical
use [117].
Four types of CoCr-based alloys are available for biomedical
applications, including cast CoCrMo alloy (F75), wrought CoCr-
WNi alloy (F90), wrought CoNiCrMo alloy (F562) and wrought
CoNiCrMoWFe alloy (F563) [118]. Among the CoCr alloys, cobalt
chromium molybdenum (CoCrMo) alloys are of major interest due
to their advanced corrosion and wear resistance, high tensile and
yield strength, and biocompatibility [104]. In addition, integration
of oxide-forming elements such as Cr, Mo and Co makes them
thermodynamically favorable for the formation of a thin protective
passive oxide film after exposure to body fluids. This protective ox-
ide layer is mostly composed of Cr2 O3 with minor amounts of Co-
and Mo-oxides [119].
Cobalt is the major alloying element of CoCrMo alloys. Cobalt
imparts an unstable face centered cubic (FCC) crystal structure
with very low stacking fault energy to the alloy. At a tempera-
ture of 690 K, Co-based alloys experience a change in their crys-
tal structure, from unstable FCC to a hexagonal close-packed (HCP)
crystal structure. This transformation occurs at relatively slow cool-
ing rates. Since the transition from FCC to HCP is kinetically ar-
rested at room temperature, the main crystalline structure of Co-
based alloys is unstable FCC structure [120]. Transformation from
FCC to HCP crystalline structure only occurs at high temperature
after long-term exposure and/or application of mechanical stress.
10
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
Both methods provide atoms with enough time to rearrange them-
selves from an unstable to a metastable structure, which leads
to significant improvements in yield strength and reduced fatigue
damage under cyclic stresses [121,122]. These properties account
for the wear resistance and corrosion resistance of cobalt-based al-
loys [122].
Chromium has a significant effect on the alloy’s properties
[123]. Presence of ∼28% chromium is the main reason for their
corrosion resistance, which is characterized by the formation of a
protective oxide film on the surface of the alloy segregating the
surface from aggressive agents. Chromium is also the predominant
carbide former. The embedded carbide in the alloys matrix serves
as structural hardening sites that imparts additional strength to the
matrix. Chromium-rich carbide, especially M23 C6 , is the most com-
mon carbide in CoCrMo alloys [124].
Molybdenum is another important constituent of CoCrMo al-
loys. It typically comprises 5-7 wt% of the alloys [125]. Molybde-
num enables solid solution strengthening of the alloy due to its
large atomic size. It serves as structural blocking sites for disloca-
tion flow when present as solute atoms. In addition, formation of
an Mo-oxide layer on the alloy surface imparts corrosion resistance
to the alloy. If Mo is higher than 5 wt%, M6 C carbide may also pre-
cipitate during alloy fabrication, which adds strength to the matrix
[126].
Carbon is also an important constituent in the chemical com-
position of the alloy. Carbon is a FCC stabilizer which strengthens
the alloy by forming carbide within the matrix. Based on the car-
bon content in the alloy, CoCrMo alloys are categorized into ‘low
carbon alloy’ (0.06 wt%) and ‘high carbon alloy’ (0.15-0.25 wt%).
Increase in carbon content results in improvement in corrosion,
wear and tribocorrosion resistance of the CoCrMo alloy [127]. De-
spite having exceptional corrosion and wear resistance and excel-
lent biocompatibility, CoCrMo alloys have poor frictional proper-
ties and may cause an allergic reaction due to their nickel content
[128].
Metal-based AM techniques such as SLS and SLM are used ex-
tensively for fabricating 3D structures from a starting mixture of
metal alloy powders characteristics of which are critical for repro-
ducibility of the printed metallic parts. Metal powders used in 3D
printing need to be spherical and have a stringent particle size dis-
tribution to achieve good packing behavior. This enables fabrication
of dense and complex metallic parts with predictable mechanical
properties. With the use of metal-based AM techniques, it is pos-
sible to fabricate fully-functional components using laser sintering
in a layer-by-layer process.
The properties of AM alloys used for dental application have
been investigated in different studies. For example, microstructure
and hardness of CoCrMo dental alloys manufactured by casting,
milling and SLS have been evaluated [129–131]. The highest hard-
ness value was achieved by SLS (371 ± 10 HV), followed by cast-
ing (320 ± 12 HV) and milling (297 ± 5 HV). In another study,
SLS-fabricated CoCrMo alloys had better mechanical properties and
less dissolution of metal ions than cast alloys [132]. The total Co
ions released into solution was lower in alloys produced by SLS
[132]. Both groups of authors suggested SLS as a better fabrication
method for dental devices than the conventional casting technique.
3.3. Ceramics
The use of ceramics has become very common in dental clin-
ical practice as well as in research. Ceramics are highly biocom-
patible and possess strong mechanical properties, excellent wear
resistance and superior esthetics compared with titanium or CoCr
alloys [133]. These advantages have been harnessed in the devel-
opment of 3D printed ceramic systems [10,134]. The following sec-
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
Fig. 12. The use of ceramic (zirconia) for 3D printing of dental bridges. (A) An illustration of the ceramic stereolithography process. (B) Additive manufacturing of zirconia
dental bridges after (I) printing, (II) debinding and (III) sintering. (IV) The corresponding change in size of zirconia-based dental implants after each step. Reprinted with
permission from [133].
tion discusses zirconia and alumina as ceramic materials for dental
application.
3.3.1. Zirconia
The use of zirconia for fabricating metal-free ceramic dental
implants began with the introduction of the Z-System in 2004
[135]. These implants osseointegrate well with hard tissues and are
highly biocompatible with soft oral tissues. Different methods of
treating the implant surface were employed to enhance osteoblast
adhesion, differentiation and to improve bone-implant osseointe-
gration [136]. Three major surface treatment methods have been
employed: surface roughening, surface coating with active com-
positions to convert a bio-inert surface into a bioactive surface,
and reducing surface contaminant to enhance surface hydrophilic-
ity [137]. These methods include surface treatment with oxygen
plasma,[138] acid-etching,[139] ultraviolet irradiation or hydrogen
peroxide treatmet [140]. A previous study indicated that zirconia
implants osseointegrate at least as well as titanium implants [141].
The strength of zirconia implants lies in their ability to accommo-
date peri-impant soft tissues well. In vitro data reported that zirco-
nia decreases inflammatory response, plaque accumulation, reduce
bacterial population and modify fibroblast adhesion and prolifer-
ation [142,143]. As an example, yttria-stabilized zirconia (3Y-TZP)
powder has been blended with acrylates and methacrylates, pho-
toinitiator and dispersing agent to create a homogenous hybrid sol.
This “ink” can be photopolymerized by a 3D printer with light-
curing capability. SL was used for printing dental bridges (Fig. 12)
[133].
3.3.2. Alumina
Aluminum oxide or alumina (Al2 O3 ) is a ceramic material pro-
duced from alumina trihydrate. It is available in different forms
(e.g., α , χ , η, δ , κ , θ , γ and ρ ). All these forms exist during
heat treatment of aluminum hydroxide [144]. The most thermody-
namically stable form is α -aluminum oxide. This material is used
for such dentistry applications as ceramic abutments, endodontic
posts, orthodontic brackets, dental implants, and crowns [134]. The
high purity of alumina (∼99.99% pure) makes it a suitable candi-
date for replacing metal alloys in some dental applications [33].
11
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
Alumina is wear-resistant and biocompatible but is less compact
and has lower flexural strength compared with zirconia [145]. To
improve the mechanical properties of alumina, it is possible to in-
filtrate zirconia into the alumina matrix to produce a mineral com-
posite [146]. The toughness and fracture resistance of alumina may
be altered by controlling the grain size and porosity, the number of
sinter cycles, sintering temperature and time, heating/cooling rates,
and the addition of stabilizer such as zirconium oxide, magnesium
oxide or chromium oxide [147,148]. An alumina ceramic with sub-
micron grain-size has been prepared for dental applications, with
improvements in mechanical properties and optical quality. Stud-
ies on polycrystalline alumina ceramics indicate that alumina with
grain size less than 1 μm and a porosity level of less than 0.7
percent has the same degree of translucency as commercial high-
translucency porcelain [149].
3.4. Responsive materials for 4D printing
Four-dimensional printing adds the time dimension to 3D print-
ing by producing pieces made of smart materials. 4D printing in-
deed combines 3D printing with the use of responsive materials
that change their properties or shape in response to mechanical,
chemical, thermal or electrical stimuli. Smart materials may be
divided into shape-memory materials and shape-changing mate-
rials [11]. Shape memory materials may be derived from alloys,
polymers or ceramics. Each material has advantages and disadvan-
tages depending on the applications of the material. Shape mem-
ory polymers have applications in dentistry including orthodontics,
endodontics, prosthodontics, oral surgery and implantology [150–
152]. Through molecular view, shape memory polymers are elas-
tic matrixes enjoying some reversible functional covalent cross-
linking. This kind of polymers consists of functional groups that
undergo some changes toward a temporary shape under a stim-
ulus. They can subsequently reverse that change to the previous
permanent shape once the stimulus is canceled; or they undergo
cleaving the covalent bond induced by the stimuli between the
functional groups throughout the matrix [153]. To prepare a 3D
printed object that responds to external or internal stimuli, sensi-
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
Fig. 13. (A) Schematic of the deformation of a 4D-printed object in response to a stimulus. (B) Types of responses that may occur in 4D-printed dynamic materials. (C)
Internal or external stimulus that may be utilized for triggering a 4D response.
tive materials should be employed in these systems (Fig. 13). Some
examples are presented n the following paragraphs.
Magnetically-sensitive materials are generally constructed by
embedding magnetic nanocompounds (e.g., Fe, Co, Ni, Fe2 O3 ,
Fe3 O4 , CuFe2 O4 , ZnFe2 O4 , NiFe2 O4 ) into the raw material.
These nanomaterials are utilized in-situ (embedded) or deco-
rated/mixed with the pre-defined materials for printing [154,155].
Electrically-responsive materials are manufactured by incorporat-
ing inherently-conductive polymers (e.g., polyacetylene, polypyr-
role, polyaniline, polythiophene) as well as their derivatives or
copolymers into the material. Conductive carbon-based nanostruc-
tures and metal nanoparticles may also be used for this purpose
[156,157].
Light-responsive materials are fabricated from light-conducting
materials or materials comprising azobenzene, stilbene, spiropyran,
fulgide or diarylethene, as well as photosensitive-metal nanostruc-
tures (e.g., TiO2 , Pt and Au) [158,159]. Ultrasound-sensitive mate-
rials comprise polymers the bonds of which are cleaved in the
presence of high ultrasound intensity. These polymers are classi-
fied into biodegradable (e.g., polyglycolides and polylactides) and
non-biodegradable polymers (e.g., poly(ethylene-co-vinyl acetate)
and poly(lactide-co-glycolide)) [160,161].
Thermo-responsive materials (e.g., poly(N-isopropyl acry-
lamide), poly(N-vinylcaprolactam), gelatin, collagen, soybean oil
epoxidized acrylate, pluronic and poly(ether urethane) are fre-
quently employed materials in 4D printing platforms [162–164].
pH-sensitive materials swell or collapse depending on the sur-
rounding pH due to the presence of functional groups such as
hydroxyl (−OH), carboxylic (−COOH), sulfonic acid (−SO3 H) and
amine (−NH2 ) groups in the polymer chain [165,166]. Moisture-
sensitive materials (e.g., hydrogels) are similar and have similar
hydrophilic functional group as the pH-responsive systems. Their
hydrophilicity causes the systems to swell to a volume greater
than the original volume [166,167].
12
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
There is another class of materials that responds to a biological
stimulus (e.g., glucose, enzymes). For example, the level of blood
glucose may be controlled by using smart materials that release
insulin in response to the blood sugar level [11].
The characteristics of smart materials include self-sensing, self-
responsiveness, shape memory, self-repair, self-adaptability and
multi-functionality. Smart materials fall into two major categories,
shape-memory materials which recover their original shape fol-
lowing a stimulus and shape-changing materials which maintain
their original shape and undergo morphology change in response
to a stimulus [164,168].
Experimental dental 4D printing began in 2012. Although the
technology is not yet commercially available, it represents a quan-
tum leap in AM capability. For example, 4D printed dental implants
possess the capability to alter their shape in response to changes
in oral temperature and humidity. The properties that these im-
plants possess are comparable to those exhibited by natural teeth
[150,169].
3.5. Materials safety
Ceramic materials used in dentistry are reported to be rela-
tively safe and free of toxicity for dental pulp or periodontal tissue
surrounding the material [170–172]. Corrosion is the main com-
plication followed by metal devices in the oral cavity. Nickel and
chrome are the most substances found in the oral cavity, due to
placement of orthodontic appliances, metal crowns, metal bridge
or prosthesis devices. Several other consequences might be fol-
lowed with application of metal such as hypersensitivity, cyto-
toxicity, or genotoxicity. Exposure of oral mucosa to metal leads
to inflammation, pain, redness or at a deeper level causes cellu-
lar metabolism disturbance. Depending on the degree of corrosion
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
that metal undergoes, its carcinogenesis ability varies. The symp-
toms can appear at distance from metal alloy [173–175].
Polymer materials have various applications in dentistry, how-
ever, their main form of application in 3D printers are light curable
resins. The uncured resins including monomers, macromonomers,
and initiators are not biocompatible materials. After photocur-
ing, the degree of conversion is relatively high which means the
amount of unreacted monomers is decreased; however, the resid-
ual monomers may lead to irritation of mucosa, inflammation, ul-
ceration and edema. The side effects of residual monomers are not
only limited in local tissue and affect systemic circulation in case
of blood stream entry [176]. This situation may be better for the
3D printers (e.g., FDM method) that do not employ resin. At least,
for the filaments used for FDM approach, there are no cytotoxic
monomers but the type of polymer/composite employed for fila-
ment should be taken into consideration. However, for a specific
3D printer, most providers sell a different range of resins from bio-
compatible (for medical applications) to non-biocompatible com-
pounds (for other applications). Accordingly, based on the targeted
applications, the desired materials can be selected.
4. Applications
Over the last decade, 3D printing technology is increasingly
being utilized in dental education and patient treatment. Exam-
ples include the manufacture of drill guides for prosthodontics, or-
thodontics, endodontics and oral maxillofacial surgery. New tech-
nologies have been developed for the production of dentures and
implants, and the fabrication of bridges, crowns, aligners and or-
thodontic brackets [34,177]. The recent advances in the applica-
tions of 3D printing in dentistry will be highlighted below. Table 2
represents the applications of 3D printing in dentistry.
4.1. Dentures
Tooth loss occurs due to trauma, fracture, periodontal disease
and caries [194,195]. Different methods have been used to replace
missing teeth, such as complete or partial removable prosthe-
ses, teeth-supported bridges and implant-supported crowns. In the
past, construction of a prosthetic device commences with the tak-
ing of an alginate or polyvinylsiloxane impression. A model is sub-
sequently constructed for complex laboratory work performed by
a skilled dental technician. The advent CAD/compute-aided manu-
facturing (CAD/CAM) systems has completely revolutionalized how
dental prostheses are constructed. There are three phases in the
construction scheme. The first phase involves acquisition of vir-
tual impressions using intraoral and extraoral scanners and regis-
tering the patient’s occlusion. The second phase consists of pros-
thesis design using computer softwares. These procedures may be
performed in the the laboratory or a dental clinic. This enables
the practitioner to have better visualization of the final product.
The third phase involves prosthesis construction, which may be
performed using additive or subtractive manufacturing techniques
[196–198].
Denture design and manufacturing now involves the use of
3D printing technology in combination with digital modeling and
computational optimization. Both denture bases and denture teeth
are now printed by 3D printing technology using methacrylate-
based photopolymerizable resins [199,200]. Denture based and ar-
tificial teeth are printed separately and are subsequently attached
together using a photo-curable bonding agent. Unlike conventional
denture processing technique which involves compression molding
and hot water processing, 3D printed dentures enables more effi-
cacious clinical modification, which reduces patient discomfort as
well as long-term residual bone resorption (Fig. 14) [34,177,199–
201].
13
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
4.2. Crowns and bridges
3D printing of dental crowns and bridges is one of the most at-
tractive applications of 3D printing technology in dentistry. Crowns
may be placed on teeth for protecting the underlying tooth struc-
ture, or on dental implants to make them functional and tooth-like.
One of the most important uses of crowns is to serve as an an-
chor (i.e. tooth abutment) for replacing a missing tooth. Recently,
3D printing technology has been utilized to fabricate crowns and
bridges. In addition, low-cost 3D printers have been used for fabri-
cating more precise provisional crown and bridge restorations us-
ing SLA printing techqniue [203]. SLA offers great efficiency and
high level of accuracy [204]. By using SLA, an object can be pro-
duced at a resolution down to 0.05 mm, making this method a
superior technique in accuracy, even compared to some new tech-
niques such as digital light projection (DLP) [205]. However, the
process of photopolymeter curing in DLP printer is fairly faster
than SLA, since SLA uses laser light photopolymer sources that pro-
cess layer by layer [206].
4.3. Orthodontic appliances and orthotics
3D printing provides exciting opportunities for fabricating
tooth-fitting orthodontic devices such as Invisalign® aligners [207].
Aligners are popular alternatives to braces for treatment of mild
malocclusion because they are transparent and can be removed for
eating, drinking and tooth brushing. In 3D printing of clear align-
ers, the orthodontist takes a virtual impression of the patient’s
upper or lower arch using an intraoral scanner. Stereolithography
or FDM is then used to print the model for thermoforming the
aligner. 3D printing reduces production time without altering the
quality of the aligners. This acceleration is attributed to the reduc-
tion in manufacturing steps (Fig. 15).
Orthotics are used for treatment of malocclusion and relief
of temporomanidular joint symptoms. These appliances can also
be fabricated by the use of intraoral scanners and 3D printers.
Nanofillers used for reinforcing these appliances, such as silica and
hydroxyapatite, do not bind to the resin during SLA. In light of this,
the surface of HAp was decorated with methacrylate functional-
ity to enhance adhesion of the nanofillers to the polymer matrix
(Fig. 16) [14]. Quaternary ammonium salts have also been func-
tionalized on the nanofillers to impart antibacterial and antifungal
activities. The resulting orthotics exhibited enhanced mechanical
properties and possessed antimicrobial activity [14].
4.4. Oral and maxillofacial surgery
The advent of cone beam computerized tomography (CBCT) has
expedited the development of 3D printing in dentistry. This has re-
sulted in more accurate diagnosis and treatment planning, as well
as guidance during surgery, thereby reducing post-operative com-
plications. The types of surgery that benefit from the use of 3D
printed devices include maxillofacial surgeries, implant placement
in difficult or ethetics-sensitive areas, sinus lift and orthognathic
surgeries.
Maxillofacial defects caused by trauma or cancer require exten-
sive removal of the defect as well as the surrounding tissues. De-
pending on the size of the defect, the severity of the trauma and
the patient’s economical condition, oral, nasal and orbital maxillo-
facial prostheses are often required for post-surgical rehabilitation.
The recent use of scanners for scanning the area of involvement
is a much more comfortable and precise means for fabricating
the prostheses. Maxillofacial prosthesis printed using AM methods
have been shown to have higher accuracy and better fit of the de-
fect area [208,209].
JID: ACTBIO
ARTICLE IN PRESS [m5G;January 4, 2021;11:7]

D. Khorsandi, A. Fahimipour, P. Abasian et al. Acta Biomaterialia xxx (xxxx) xxx

Table 2
Recent applications of 3D printing in dentistry.

Method Schematic illustration Applications References

Stereolithography Temporary and permanent crowns

Temporary bridges [3,27]
Temporary restorations [178–180]
Surgical guides and templates [181,182]
Dental replica models [22,26,183]

Fused deposition Denture flasks [133]

modeling Bites [14]
Mouth guards
Oral drug delivery device [184]

Selective laser Custom-made dental implants Partial [185–187]

sintering dentures

Photopolymer Temporary crowns Dental replica models [27,188–

Jetting 190]

Powder Binder [18,191]

Printer

Digital Light Temporary and permanent crowns [192]

Processing Removable dental prosthesis [193]

14
JID: ACTBIO
ARTICLE IN PRESS [m5G;January 4, 2021;11:7]

D. Khorsandi, A. Fahimipour, P. Abasian et al. Acta Biomaterialia xxx (xxxx) xxx

Fig. 14. (A) Intraoral scanning for taking virtual impression of a patient’s pre-existing teeth. (B) 3D illustration of denture file from a design software. (C) A real tooth
size configuration used for reconstruction of the denture. (D) Digital sculpting of denture teeth secured to a denture flask. Pink denture base acrylic resin is to be injected
through the injection port. (E) Separate illustration of the denture and flask from the analyzing software. (F) 3D–printed flask. (G) Placement of the teeth into the flask. The
teeth were fabricated also by 3D printing. (H) Combination of upper and lower denture flasks produced by 3D printing. (I) Separate printed upper and lower flasks showing
packing of acryic resin. (J) Detachment of the flask and denture parts. (K) Polished, completed 3D printed denture. Reprinted with permission from [184,202].

Fig. 15. Designin an aligner. (A) Steps involved in conventional processing (B) Workflow in 3D printing.

Orthognathic surgeries are performed for patients with maxil-
lary or mandibular deformity, severe malocclusion and those re-
quiring facial esthetic modifications. Development of 3D printed
models have improved patient communication as well as surgical
outcome. Many of the traditional operations are now replaced with
the help of digital techniques, such as printing of occlusal splints
tht are more accurate and provide more accessible jaw positions
during surgery (Fig. 17). The use of 3D printed osteotomy or ge-
nioplasty surgical guides reduces operation time and minimizes in-
juries to nerves such as the inferior alveolar nerve [210].
The use of 3D printed surgical guides for implant placement in
the edentulous area improves hard and soft tissue healing around
the implant. Surgical guides are used in challenging locations to
improve implant placement accuracy. The surgical guide must have
adequate hard or sift tissue support to increase stability and bal-
ance during implant placement. Support is gained by methods
such as tooth-supported guides, mucosa-supported guides, bone-
supported guides and pin -supported guides. These guides are se-
lected based on the number of remaining teeth, the availability of
hard and soft tissue support and the location of the implant site
[211].
4.5. 3D printing of metals in dentistry
Accuracy and mechanical properties are the most important
factors to be considered in dentistry. Compared to conventional

15
JID: ACTBIO
ARTICLE IN PRESS [m5G;January 4, 2021;11:7]

D. Khorsandi, A. Fahimipour, P. Abasian et al. Acta Biomaterialia xxx (xxxx) xxx

Fig. 16. (A) Surface functionalization of hydroxyapatite. (B) 3D CAD drawing of an orthodontic aligner (left panel) and the photograph of the corresponding aligner fabricated
by SLA (right panel). (C) Scanning electron microscopy image of the material used for construction of a nanofillers-reinforced orthotic (left panel). Energy dispersive X-Ray
(EDX) mappings of P (red) and Ca (green). (D) Antibacterial and antifungal properties of the samples containing different ratios of the nanofiller. mHAP: modified HAP.
Reprinted with permission from [14].

casting and forging techniques, additive manufacturing of metal
parts reduces manufacturing time and cost. More importantly, AM
almost eliminates all human errors as well as possible defects in
the resulting product. According to the definition of the American
Society for Testing and Materials (ASTM), ASTM F2792, AM is “a
process of joining materials to make objects from 3D model data,
usually layer upon layer, as opposed to subtractive manufacturing
methodologies” [212]. Selective laser sintering, selective laser melt-
ing (SLM) and electron-beam additive manufacturing (EBM) are the
three most commonly used techniques for 3D printing of metal
parts [213].
Dental metal alloys that utilize 3D printing technology include
CoCr, Ti and tantalum powders (Fig. 18) [214]. For example, den-
tal prostheses have been fabricated with CoCr alloy powder us-
ing the SLM technique [215]. The potential of 3D printed metal
parts in dentistry is enormous. Metallic structures that can be 3D-
printed include removable partial denture, overdenture and fixed
prosthetic frameworks, endodontic hand and rotary files and metal
implants. Metal frameworks were prepared by SLM technique to
evaluate the accuracy of removable partial denture frameworks.
The authors showed that the frameworks manufactured by SLM fit
better than those fabricated by the lost-wax technique and metal
casting [216]. In another work, porous implants made of Ti and Ta
were fabricated via SLM and tested for their fitting accuracy. The
authors reported that 3-D printed Ta implants were better-fitting
comparied to conventional Ti implants manufactured by milling. By
using 3D printing, the authors were able to optimize manufactur-
ing cost and maximize reproducibility [217].
4.6. Hard and soft tissue engineering
Bone augmentation is an important procedure in patients with
hard tissue defects who are in need of implant placement. Insuf-
ficient bone results in lack of support and implant failure. Hence,
bone augmentation is necessary in selected cases prior to implant
placement. The ideal bone graft to be placed is an autograft de-
rived from the patient’s own bone, which has both osteoinductive
and osteocondictive properties. Other alternative bone graft ma-

16
JID: ACTBIO
ARTICLE IN PRESS [m5G;January 4, 2021;11:7]

D. Khorsandi, A. Fahimipour, P. Abasian et al. Acta Biomaterialia xxx (xxxx) xxx

Fig. 17. (A) 3D printing of a patient’s jaw model after simulation for orthognathic surgery. (B) Positioning and fixing the printed guides and occlusal splint. (C) A 3D printed
model of the final position of segment. (D) An illustration of the application of 3D printing in maxillofacial surgery. Reprinted with permission from [210].

terials include allografts, xenografts and alloplastics. A graft used 4.7. Mouthguards for drug delivery
for bone augmentation needs to have specific properties, including
biocompatibility, same shape and design as the defect, does not Treating oral diseases by local release of a drug is common
induce an immune response, as well as porosities for tissues to ac- practice in oral medicine. 3D printing permits the design of unique
cess nutrients and communicate with immune cells (Fig. 19) [218]. drug delivery systems with exceptional precision, comprehensive
Many biomaterials are available as hard tissue engineering scaf- three dimensional composition and manageable release patterns
folds, such as polymers, bioceramics and composites. To enhance [83]. Chlorhexidine-coated mouthguards have been tested for sup-
the regeneration ability of the biomaterials, they should be able pression of oral bacteria in human subjects [221]. A 3D printed
to be loaded with stem cells; growth factors released by the stem wearable oral delivery device in the form of a mouthguard has
cells are critical for angiogenesis and osteogenesis. Scaffolds fabri- been fabricated via FDM to deliver a preloaded drug to the oral
cated by 3D printers can be tuned by using inks containing stem cavity (Fig. 20) [184]. 3D printed oral drug delivery mouthguards
cells. This method of printing enables the stem cells to be placed have immense potential for drug delivery in personalized dental
at precise locations. Moreover, precision 3D printing of complex therapeutics.
scaffold surfaces enables more intimate contact with bone surfaces,
expedites healing and yields better esthetic results compared with
4.8. 3D printing in endodontics
conventional scaffolds [220].
The periodontal ligament (PDL) absorbs masticatory stresses
Three dimensional printing has been used to support nonsurgi-
and provides the tooth with micro-movement during mastication.
cal and surgical root canal treatment. As an example, 3D printing
The PDL contains blood vessels and nerve fibers. Destruction of the
may be used experimentally for regeneration of new teeth by stem
PDL reduces tooth support, increases tooth movement and expe-
cell delivery[219], or regeneration of the dental pulp by develop-
dites microbial infection. Periodontal bone defects may be covered
ment of calcium phosphate cements [222]. In addition, 3D printing
with a 3D printed scaffold in which mesenchymal stem cells are
has been used for printing tooth models to simulate surgical proce-
incorporated within the scaffold to enhance regeneration of the
dures. For example, a tooth model was printed for root canal treat-
PDL.
ment of a 12 year-old boy with tooth anomalies. The authors de-
Soft tissue regeneration surgery has been used to improve root
signed and printed a custom-made guide for access into the canal
coverage of a tooth with gingival recession or damaged soft tis-
spaces (Fig. 21) [223]. The advantages of the 3D printing in en-
sue. Although the ideal graft is an autograft excised from the palate
dodontics include improving the accuracy of access, enhancing the
or tuberosity, this generates post-operation discomfort for the pa-
skills of non-specialists and improved success with pulpal regener-
tient. Recently, 3D printed soft tissue grafts have been introduced
ation [224] In addition, 3D printed resin teeth are useful in educat-
for augmentation of keratinized tissue surrounding teeth with pe-
ing students and general practitioners in all steps of the root canal
riodontal defects. These soft tissue grafts can be printed to cover
therapy. The trainee can observe endodontic working length, root
large defects. Moreover, 3D printed soft tissue grafts permit more
canal morphology and anatomy of the apical delta, using trans-
complicated designs and accuracy to cover the defect. They are also
parent resin teeth constructed usingh CBCT data derived from ex-
better received by patient because of reduced post-operation dis-
tracted natural teeth. During canal shaping, errors associated with
comfort and expedited healing [219].
the use of endodontic instruments, such as gauging of preparation

17
JID: ACTBIO
ARTICLE IN PRESS [m5G;January 4, 2021;11:7]

D. Khorsandi, A. Fahimipour, P. Abasian et al. Acta Biomaterialia xxx (xxxx) xxx

Fig. 18. 3D printing of metal in dentistry. (A) SEM image of tantalum powder used for 3D printing of dental implants. (B) A 3D printed porous metal-based implant. (C,
D) A 3D printed CoCr-based denture implant framework. (E) Designing a removable partial denture framework prior to 3D printing. (F) A 3D printed CoCr powder-based
removable partial denture framework with accompanying support structures that have to be removed after printing. Reprinted with permission from [213,214,216].

walls and canal transportation may be readily observed. More im-

portantly, 3D printed guides based on CBCT data are indispensable
for finding highly calcified canals in nonsurgical root canal treat-
ment and for apicoetomy of posterior teeth in surgical endodon-
tics. The use of these guides has enabled more teeth to be saved
by root canal treatment.

4.9. 3D printing application in dental education

Three dimensional printing in dentistry has extended beyond

Fig. 19. Tissue augmentation workflow. (A) The soft tissue defect. (B) Scanned soft
tissue defect. (C) Designed soft tissue graft ready to be 3D printed. (D) 3D printed
soft tissue graft. (E) Simulated surgical procedure. Reprinted and modified with per-
mission from [219].
clinical application and has been integrated into dental educa-
tion [225]. 3D printed teeth serve as models for teaching den-
tal anatomy and for the practice of a wide range of dental pro-
cedures such as caries excavation, pulp capping, core build-up,
crown preparation as well as veneer preparation and dental bond-
ing [226]. These models are used for training predoctoral students
and have replaced the use of extracted teeth which are prone to
contamination [227]. Apart from the anatomical accuracy of the
printed replicas, fabrication of these resin replica teeth can be done
by any institution that has access to CBCT and a 3D printer [228].
Three dimensionally-printed models are extensively used for
pre-operative surgical simulations. The ease of fabricating these
surgical models provides a readily available resource for oral and
maxillofacial surgery [229]. It is beyond doubt that this versatile
technology will keep on improving over the course of its applica-
tion. The elastic properties of currently available materials and the

18
JID: ACTBIO
ARTICLE IN PRESS [m5G;January 4, 2021;11:7]

D. Khorsandi, A. Fahimipour, P. Abasian et al. Acta Biomaterialia xxx (xxxx) xxx

Fig. 20. Application of 3D printing in manufacturing of oral drug delivery mouthguards. Reprinted with permission from [184].

Fig. 21. A 3D printed, custom-made jig for complicated root canal treatment. (A) Panoramic radiograph of the patient’s teeth. (B) Buccal view. (C) Coronal view. (D) Digital
image view. I STL file. (F) 3D printed jig with a hole that guides the insertion path and depth of a bur into the complicated root canal space. (G) Canal filing simulation. (H)
Location of glide path into the root canal space using the printed jig; (I) Intraoral radiograph 3 months after canal filling. Reprinted with permission from [223].

geometric complexity of the printed models still require improve-
ments for perfect mimicking of human tissues [230].
5. 4D printing in dentistry and maxillofacial surgery:
Challenges and future perspectives
In a nutshell, 4D printing technology can give active and re-
sponsive functions to their counterpart 3D printed objects. It can
be triggered by a response to different stimuli, for example, light,
to change their structure. Fortunately, through using simulations
and analytical calculations to theoretically model the structural
changes are well predictable. In other words, we know what will
happen for the material which at the mercy of any external stim-
ulus. In dentistry, it is of the most interest to have such materials
[231].
One of the most common materials used in orthodontics is
nickel-titanium archwires, with many advantages and disadvan-
tages. Some of the drawbacks of these shape memory archwires
may be overcome with the application of shape memory polymers
[151]. Superior esthetics improved elastic modulus, enhanced me-
chanical and chemical stability and ability of the archwire to self-
adjust during the treatment make the application of this mate-
rial more suitable for the patient and the practitioner. Endodon-
tics is another field that may benefit from 4D printing. One of the
most common complications during root canal therapy is instru-
ment separation. The ability of shape memory metals to adapt to

19
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
root canal curvatures is an important asset that makes them com-
petitive as a replacement of traditional nickel titanium rotary in-
struments in the future [12,232].
In prosthodontics, permanent seating of bridge pontics while
the surrounding hard and soft tissues are undergoing changes may
result in suboptimal fitting of the pontics. Application of shape
memory polymers in these cases may be beneficial because of the
self-adjustment capability of the material, which helps to minimize
future complications. Full or partial removable dentures are often
problematic for the patient because of bone resorption that accom-
panies tooth removal, as well as forces applied over the bony ridge
by the denture. As a result, denture relining is a common proce-
dure. The use of shape memory polymers for 4D printing of den-
tures may improve the ability of these dentures to adapt to the al-
tering hard and soft tissue profiles. In implantology, titanium alloys
are the most common materials used for fabricating oral implants.
Although there are many benefits associated with titanium alloys,
hypersensitivity and surface degradation have been reported. Re-
placement of titanium alloys with biocompatible shape memory
polymers does not enhance implant strength but it may improve
some properties. For instance, SMPs possess more tunable prop-
erties, remarkable elastic deformation ability, cost and time effec-
tiveness, low density (resulting in lower weights), ease of produc-
tion, more flexibility in programming, and exhibiting better bio-
compatibility and biodegradability. Therefore, in some applications,
ranging from tissue scaffolds to long-lasting implants, they may
be designed and fabricated more readily with a higher feasibil-
ity and certainty rate [164]. Shape-memory polymers are advan-
tageous by well filling the root canals, leading to prevent reinfec-
tions, biofilm formation, and periradicular diseases. They exhibit
the natural tooth like expansion and contraction to fill the gap at
the interface, decreasing the microleakage as well. Shape-memory
polymers also produce biocompatible degradation products—they
are biocompatible—as well as not produce metal ions which trig-
gering chronic diseases, in comparison with metals. By the features
far outweighing other types of materials, the shape-memory poly-
mers show great stability and much more effectiveness, at least
here in dentistry [233].
6. Conclusion and outlook
Three-dimensional printing has been employed for rapid pro-
totyping of different objects and equipments. Over the last decade,
3D printing technology has expanded rapidly across different med-
ical sectors, including dentistry. New feed materials and printing
methods are being developed to reduce design time, expedite fab-
rication and improve performance. Quality traits such as particle
size, shape, distribution of the feed material powder as well as
density, flowability and viscosity of the polymer directly affect the
mechanical performance of the final product [234–237]. Viscosity-
dependent flowability of polymers and metal allays is a challenge
in 3D printing. Clinical dentistry requires fabrication of custom
dental devices that differs from one patient to another. Dentistry
may be the final industry for rapid prototyping technology to move
into because it demands precise manufacturing and accuracy.
The advantages of 3D printing in dentistry have already been
mentioned. It is important to point out that there are several as-
pects of 3D printing that require enhancement, such as improve-
ment in surface quality, mechanical properties and dimensional
accuracy. Printing products with better surface quality is directly
related to the processing technique, the thickness of each layer
and the depth of polymerization. The mechanical properties of
the printed product are associated with porosity and surface qual-
ity. The porosity of a material depends on the particle size and
processing temperature; material infiltration has been proposed
to overcome this obstacle. Shrinkage of printing materials during
20
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
manufacturing may result in significant reduction of mechanical
properties. Dimensional accuracy of the products printed by 3D
printers varies with the use of printing techniques and has a sig-
nificant impact on the passive fit of dental prostheses.
Declaration of Competing Interest
The authors declare no conflict of interest.
Acknowledgment
P. M. and V. M. acknowledge funding from the European Hori-
zon 2020 Research and Innovation Programme under Grant Agree-
ment No 899349 (5D NanoPrinting).
References
[1] M. Carlotti, V. Mattoli, Functional Materials for Two-Photon Polymerization in
Microfabrication, Small 15 (2019) 1902687.
[2] A. Sadeghi, E. Del Dottore, A. Mondini, B. Mazzolai, Passive Morphological
Adaptation for Obstacle Avoidance in a Self-Growing Robot Produced by Ad-
ditive Manufacturing, Soft Robot. 7 (2020) 85–94, doi:10.1089/soro.2019.0025.
[3] X. Li, B. Xie, J. Jin, Y. Chai, Y. Chen, 3D Printing Temporary Crown and Bridge
by Temperature Controlled Mask Image Projection Stereolithography, Procedia
Manuf 26 (2018) 1023–1033.
[4] D.H. Ballard, A.P. Trace, S. Ali, T. Hodgdon, M.E. Zygmont, C.M. DeBenedectis,
S.E. Smith, M.L. Richardson, M.J. Patel, S.J. Decker, Clinical applications of 3D
printing: primer for radiologists, Acad. Radiol. 25 (2018) 52–65.
[5] W. Yang, W.S. Choi, Y.Y. Leung, J.P. Curtin, R. Du, C. Zhang, X. Chen, Y. Su,
Three-dimensional printing of patient-specific surgical plates in head and
neck reconstruction: a prospective pilot study, Oral Oncol 78 (2018) 31–36.
[6] D. Chytas, M. Piagkou, E.O. Johnson, Can three-dimensional visualization tech-
nologies be more effective than cadavers for dental anatomy education? Anat.
Sci. Educ. 13 (2020) 664–665.
[7] J.C. Ruiz-Morales, A. Tarancón, J. Canales-Vázquez, J. Méndez-Ramos,
L. Hernández-Afonso, P. Acosta-Mora, J.R.M. Rueda, R. Fernández-González,
Three dimensional printing of components and functional devices for energy
and environmental applications, Energy Environ. Sci. 10 (2017) 846–859.
[8] T.-S. Jang, H.-D. Jung, M.H. Pan, W.T. Han, S. Chen, J. Song, 3D printing of
hydrogel composite systems: recent advances in technology for tissue engi-
neering, Int. J. Bioprint 4 (2018) 126–131.
[9] Z. Lu, O.I. Ayeni, X. Yang, H.-Y. Park, Y.-G. Jung, J. Zhang, Microstructure and
phase analysis of 3D-printed components using bronze metal filament, J.
Mater. Eng. Perform. (2020) 1–7.
[10] T.D. Ngo, A. Kashani, G. Imbalzano, K.T.Q. Nguyen, D. Hui, Additive manufac-
turing (3D printing): a review of materials, methods, applications and chal-
lenges, Compos. Part B Eng. (2018) 172–196, doi:10.1016/j.compositesb.2018.
02.012.
[11] W. Zhou, Z. Qiao, E.N. Zare, J. Huang, X. Zheng, X. Sun, M. Shao, H. Wang,
X. Wang, D. Chen, J. Zheng, S. Fang, Y.M. Li, X. Zhang, L. Yang, P. Makvandi,
A. Wu, 4D-printed dynamic materials in biomedical applications: chemistry,
challenges, and their future perspectives in the clinical sector, J. Med. Chem.
(2020) In presshttps://doi.org/acs.jmedchem.9b02115.
[12] A.Y. Lee, J. An, C.K. Chua, Two-way 4D printing: a review on the reversibil-
ity of 3D-printed shape memory materials, Engineering 3 (2017) 663–674,
doi:10.1016/J.ENG.2017.05.014.
[13] M. Dehurtevent, L. Robberecht, J.-C. Hornez, A. Thuault, E. Deveaux, P. Béhin,
Stereolithography: a new method for processing dental ceramics by additive
computer-aided manufacturing, Dent. Mater. 33 (2017) 477–485.
[14] P. Makvandi, C. Esposito Corcione, F. Paladini, A.L. Gallo, F. Montagna, R. Ja-
maledin, M. Pollini, A. Maffezzoli, Antimicrobial modified hydroxyapatite
composite dental bite by stereolithography, Polym. Adv. Technol. 29 (2018)
364–371.
[15] A.E. Ersoy, I. Turkyilmaz, O. Ozan, E.A. McGlumphy, Reliability of implant
placement with stereolithographic surgical guides generated from com-
puted tomography: clinical data from 94 implants, J. Periodontol. 79 (2008)
1339–1345.
[16] Y. Sun, H. Luebbers, J.O. Agbaje, S. Schepers, C. Politis, S. Van Slycke,
L. Vrielinck, Accuracy of dental implant placement using CBCT-derived mu-
cosa-supported stereolithographic template, Clin. Implant Dent. Relat. Res. 17
(2015) 862–870.
[17] J.-P. Kruth, B. Vandenbroucke, J. Van Vaerenbergh, I. Naert, Digital manufac-
turing of biocompatible metal frameworks for complex dental prostheses by
means of SLS/SLM, Proc. VRAP, Leir. (2005) 139–146.
[18] J. Liu, B. Zhang, C. Yan, Y. Shi, The effect of processing parameters on charac-
teristics of selective laser sintering dental glass-ceramic powder, Rapid Proto-
typ. J. (2010) 138–145, doi:10.1108/13552541011025861.
[19] J.-P. Kruth, B. Vandenbroucke, J. Van Vaerenbergh, I. Naert, Rapid manufactur-
ing of dental prostheses by means of selective laser sintering/melting, Proc.
AFPR S. 4 (2005) 176–186.
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
[20] N.K. Tolochko, V.V Savich, T. Laoui, L. Froyen, G. Onofrio, E. Signorelli,
V.I. Titov, Dental root implants produced by the combined selective laser sin-
tering/melting of titanium powders, Proc. Inst. Mech. Eng. Part L J. Mater. Des.
Appl. 216 (2002) 267–270.
[21] P.M. Gronet, G.A. Waskewicz, C. Richardson, Preformed acrylic cranial im-
plants using fused deposition modeling: a clinical report, J. Prosthet. Dent.
90 (2003) 429–433.
[22] R.E. Rebong, K.T. Stewart, A. Utreja, A.A. Ghoneima, Accuracy of three-di-
mensional dental resin models created by fused deposition modeling, stere-
olithography, and Polyjet prototype technologies: a comparative study, Angle
Orthod 88 (2018) 363–369.
[23] J. Brandt, H.-C. Lauer, T. Peter, S. Brandt, Digital process for an implant-sup-
ported fixed dental prosthesis: a clinical report, J. Prosthet. Dent. 114 (2015)
469–473.
[24] V.N.V.M.R. Daule, Rapid prototyping and its application in dentistry, J. Dent.
Allied Sci. 2 (2013) 57–61.
[25] A. Kessler, R. Hickel, M. Reymus, 3D printing in dentistry—state of the art,
Oper. Dent. 45 (2020) 30–40.
[26] A. Hazeveld, J.J.R. Huddleston Slater, Y. Ren, Accuracy and reproducibility
of dental replica models reconstructed by different rapid prototyping tech-
niques, Am. J. Orthod. Dentofac. Orthop. 145 (2014) 108–115, doi:10.1016/j.
ajodo.2013.05.011.
[27] H.-N. Mai, K.-B. Lee, D.-H. Lee, Fit of interim crowns fabricated using pho-
topolymer-jetting 3D printing, J. Prosthet. Dent. 118 (2017) 208–215.
[28] S. Prasad, N.A. Kader, G. Sujatha, T. Raj, S. Patil, 3D printing in dentistry,
(2018).
[29] P.W. Poeschl, N. Schmidt, G. Guevara-Rojas, R. Seemann, R. Ewers, H.T. Zipko,
K. Schicho, Comparison of cone-beam and conventional multislice computed
tomography for image-guided dental implant planning, Clin. Oral Investig. 17
(2013) 317–324.
[30] A. Dawood, B.M. Marti, V. Sauret-Jackson, A. Darwood, 3D printing in den-
tistry, Br. Dent. J. 219 (2015) 521–529.
[31] R. Jain, B.S. Supriya, K. Gupta, Recent trends of 3-D printing in dentistry-a
review, Ann. Prosthodont. Rest. Dent. 2 (2016) 101–104.
[32] R. Pandey, Photopolymers in 3D printing applications, Photopolymers 3D
Print. Appl. (2014).
[33] L. Ferrage, G. Bertrand, P. Lenormand, D. Grossin, B. Ben-Nissan, A re-
view of the additive manufacturing (3DP) of bioceramics: alumina, zirconia
(PSZ) and hydroxyapatite, J. Aust. Ceram. Soc. 53 (2017) 11–20, doi:10.1007/
s41779- 016- 0 0 03-9.
[34] A. Dawood, B.M. Marti, V. Sauret-Jackson, A. Darwood, 3D printing in den-
tistry, Br. Dent. J. 219 (2015) 521–529, doi:10.1038/sj.bdj.2015.914.
[35] B.E. Kelly, I. Bhattacharya, H. Heidari, M. Shusteff, C.M. Spadaccini, H.K. Taylor,
Volumetric additive manufacturing via tomographic reconstruction, Science
(80-.) 363 (2019) 1075–1079, doi:10.1126/science.aau7114.
[36] A.J. Hart, A. Rao, How to print a 3D object all at once, Science (80-.) 363
(2019) 1042–1043, doi:10.1126/science.aaw7062.
[37] P. Fiedor, J. Ortyl, A new approach to micromachining: High-precision and
innovative additive manufacturing solutions based on photopolymerization
technology, Materials (Basel) 13 (2020) 1–25, doi:10.3390/ma13132951.
[38] D. Fan, Y. Li, X. Wang, T. Zhu, Q. Wang, H. Cai, W. Li, Y. Tian, Z. Liu, Progres-
sive 3D printing technology and its application in medical materials, Front.
Pharmacol. 11 (2020).
[39] A. Sakly, S. Kenzari, D. Bonina, S. Corbel, V. Fournée, A novel quasicrys-
tal-resin composite for stereolithography, Mater. Des. 56 (2014) 280–285.
[40] J.R. Tumbleston, D. Shirvanyants, N. Ermoshkin, R. Janusziewicz, A.R. Johnson,
D. Kelly, K. Chen, R. Pinschmidt, J.P. Rolland, A. Ermoshkin, Continuous liquid
interface production of 3D objects, Science (80-.) 347 (2015) 1349–1352.
[41] R. Noorani, 3D printing: technology, applications, and selection, CRC Press,
2017.
[42] P. Aly, C. Mohsen, Comparison of the accuracy of three-dimensional printed
casts, digital, and conventional casts: an in vitro study, Eur. J. Dent. 14 (2020)
189.
[43] J. Bustillos, D. Montero-Zambrano, A. Loganathan, B. Boesl, A. Agarwal,
Stereolithography-based 3D printed photosensitive polymer/boron nitride
nanoplatelets composites, Polym. Compos. 40 (2019) 379–388.
[44] R. França, J. Winkler, H.H. Hsu, M. Rahimnejad, Z. Abdali, 3D printing—addi-
tive manufacturing of dental biomaterials, Dent. Biomater. 2 (2018) 421.
[45] Y. Pan, C. Zhou, Y. Chen, A fast mask projection stereolithography process for
fabricating digital models in minutes, J. Manuf. Sci. Eng. 134 (2012) 051011,
doi:10.1115/1.4007465.
[46] C. Sun, N. Fang, D.M. Wu, X. Zhang, Projection micro-stereolithography us-
ing digital micro-mirror dynamic mask, Sensors Actuators A Phys. 121 (2005)
113–120, doi:10.1016/j.sna.2004.12.011.
[47] L. Ge, L. Dong, D. Wang, Q. Ge, G. Gu, A digital light processing 3D printer
for fast and high-precision fabrication of soft pneumatic actuators, Sensors
Actuators A Phys. 273 (2018) 285–292, doi:10.1016/j.sna.2018.02.041.
[48] Y. Lu, G. Mapili, G. Suhali, S. Chen, K. Roy, A digital micro-mirror device-
based system for the microfabrication of complex, spatially patterned tis-
sue engineering scaffolds, J. Biomed. Mater. Res. Part A. 77A (2006) 396–405,
doi:10.1002/jbm.a.30601.
[49] Y. He, Y. Wu, J. Fu, Q. Gao, J. Qiu, Developments of 3D Printing Microflu-
idics and Applications in Chemistry and Biology: a Review, Electroanalysis 28
(2016) 1658–1678, doi:10.10 02/elan.20160 0 043.
[50] Z. Zhang, P. Li, F. Chu, G. Shen, Influence of the three-dimensional print-
ing technique and printing layer thickness on model accuracy, J. Orofac. Or-
21
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
thop. / Fortschritte Der Kieferorthopädie. 80 (2019) 194–204, doi:10.1007/
s0 0 056- 019- 00180- y.
[51] A. Bagheri Saed, A.H. Behravesh, S. Hasannia, S.A. Alavinasab Ardebili,
B. Akhoundi, M. Pourghayoumi, Functionalized poly l-lactic acid synthesis and
optimization of process parameters for 3D printing of porous scaffolds via
digital light processing (DLP) method, J. Manuf. Process. 56 (2020) 550–561,
doi:10.1016/j.jmapro.2020.04.076.
[52] H. Quan, T. Zhang, H. Xu, S. Luo, J. Nie, X. Zhu, Photo-curing 3D printing
technique and its challenges, Bioact. Mater. 5 (2020) 110–115, doi:10.1016/j.
bioactmat.2019.12.003.
[53] J.W. Koo, J.S. Ho, J. An, Y. Zhang, C.K. Chua, T.H. Chong, A review on spacers
and membranes: conventional or hybrid additive manufacturing? Water Res.
188 (2021) 116497, doi:10.1016/j.watres.2020.116497.
[54] Digital Light Processing, DLP, https://www.manufacturingguide.com/en/ (ac-
cessed December 7, 2020).
[55] P. Jain, A.M. Kuthe, Feasibility study of manufacturing using rapid prototyp-
ing: FDM approach, Procedia Eng. 63 (2013) 4–11.
[56] E. Cuan-Urquizo, E. Barocio, V. Tejada-Ortigoza, R.B. Pipes, C.A. Rodriguez,
A. Roman-Flores, Characterization of the mechanical properties of FFF struc-
tures and materials: A review on the experimental, computational and theo-
retical approaches, Materials (Basel) 12 (2019) 895.
[57] E.S. Heras, F.B. Haro, J.M. de A. del Burgo, M.E.I. Marcos, Plate auto-level
system for fused deposition modelling (FDM) 3D printers, Rapid Prototyp. J.
(2017).
[58] A.C. Taylor, S. Beirne, G. Alici, G.G. Wallace, System and process development
for coaxial extrusion in fused deposition modelling, Rapid Prototyp. J. (2017).
[59] A. Arnesano, S. Kunjalukkal Padmanabhan, A. Notarangelo, F. Montagna,
A. Licciulli, Fused deposition modeling shaping of glass infiltrated alumina for
dental restoration, Ceram. Int. 46 (2020) 2206–2212, doi:10.1016/j.ceramint.
2019.09.205.
[60] E.O. Olakanmi, R.F. Cochrane, K.W. Dalgarno, A review on selective laser
sintering/melting (SLS/SLM) of aluminium alloy powders: processing, mi-
crostructure, and properties, Prog. Mater. Sci. 74 (2015) 401–477.
[61] Y. Okazaki, A. Ishino, Microstructures and mechanical properties of laser-sin-
tered commercially pure Ti and Ti-6Al-4V alloy for dental applications, Mate-
rials (Basel) 13 (2020) 609.
[62] O. Alageel, M. Abdallah, A. Alsheghri, J. Song, E. Caron, F. Tamimi, Remov-
able partial denture alloys processed by laser-sintering technique, J. Biomed.
Mater. Res. Part B Appl. Biomater. 106 (2018) 1174–1185.
[63] M.A. Alhnan, T.C. Okwuosa, M. Sadia, K.-W. Wan, W. Ahmed, B. Arafat, Emer-
gence of 3D printed dosage forms: opportunities and challenges, Pharm. Res.
33 (2016) 1817–1832.
[64] O. Alageel, M.N. Abdallah, A. Alsheghri, J. Song, E. Caron, F. Tamimi, Remov-
able partial denture alloys processed by laser-sintering technique, J. Biomed.
Mater. Res. - Part B Appl. Biomater. 106 (2018) 1174–1185, doi:10.1002/jbm.b.
33929.
[65] U. Lakshminarayan, S. Ogrydiziak, H.L. Marcus, Selective laser sintering of ce-
ramic materials, 1990 Int. Solid Free. Fabr. Symp., 1990.
[66] Z. Chen, Z. Li, J. Li, C. Liu, C. Lao, Y. Fu, C. Liu, Y. Li, P. Wang, Y. He, 3D printing
of ceramics: A review, J. Eur. Ceram. Soc. 39 (2019) 661–687, doi:10.1016/j.
jeurceramsoc.2018.11.013.
[67] M. Wohlert, D. Bourell, Rapid prototyping of Mg/SiC composites by a com-
bined SLS and pressureless infiltration process, 1996 Int. Solid Free. Fabr.
Symp., 1996.
[68] S.S. Leong, Y.W. Yee, W.F. Edith, T.B. Yen, Z. Ziqiang, Z. Lin, T. Zhiling,
Y. Shoufeng, Direct selective laser sintering and melting of ceramics: a re-
view, Rapid Prototyp. J. 23 (2017) 611–623, doi:10.1108/RPJ- 11- 2015- 0178.
[69] H. Lipson, M. Kurman, Fabricated: The new world of 3D printing, John Wiley
& Sons, 2013.
[70] J.W. Stansbury, M.J. Idacavage, 3D printing with polymers: challenges among
expanding options and opportunities, Dent. Mater. 32 (2016) 54–64, doi:10.
1016/j.dental.2015.09.018.
[71] A. Mostafaei, E.L. Stevens, J.J. Ference, D.E. Schmidt, M. Chmielus, Binder jet
printing of partial denture metal, Mater. Sci. Technol. 2017 (2017) 289–291,
doi:10.7449/2017/MST.
[72] C. Yu, J. Schimelman, P. Wang, K.L. Miller, X. Ma, S. You, J. Guan, B. Sun,
W. Zhu, S. Chen, Photopolymerizable biomaterials and light-based 3D print-
ing strategies for biomedical applications, Chem. Rev. (2020).
[73] F.G. Mangano, P.A. Zecca, R. van Noort, S. Apresyan, G. Iezzi, A. Pi-
attelli, A. Macchi, C. Mangano, Custom-made computer-aided-de-
sign/computer-aided-manufacturing biphasic calcium-phosphate scaffold
for augmentation of an atrophic mandibular anterior ridge, Case Rep. Dent.
2015 (2015).
[74] S.F.S. Shirazi, S. Gharehkhani, M. Mehrali, H. Yarmand, H.S.C. Metselaar,
N.A. Kadri, N.A.A. Osman, A review on powder-based additive manufacturing
for tissue engineering: selective laser sintering and inkjet 3D printing, Sci.
Technol. Adv. Mater. 16 (2015) 33502.
[75] A. Dawood, B.M. Marti, V Sauret-Jackson, A. Darwood, 3D Printing in Den-
tistry Brit, Br Dent J. 219 (2015) 521–529.
[76] K.V Wong, A. Hernandez, A review of additive manufacturing, ISRN Mech, Eng
1 (2012) 1–10.
[77] S. Nayar, S. Bhuminathan, W.M. Bhat, Rapid prototyping and stereolithogra-
phy in dentistry, J. Pharm. Bioallied Sci. 7 (2015) S216.
[78] S.S. Bammani, P.R. Birajdar, S.S. Metan, Dental crown manufacturing using
stereolithography method, in: Proc. Int. Conf. Adv. Ind. Prod. Eng., Citeseer,
2012.
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
[79] G.S. Jacob, Three-dimensional printing of dentures using fused deposition
modeling, Insid. Dent. Technol. 4 (2013).
[80] J. Jockusch, M. Özcan, Additive manufacturing of dental polymers : an
overview on processes, materials and applications, Dent. Mater. J. (2020),
doi:10.4012/dmj.2019-123.
[81] N. Sathishkumar, A.S.M. Udayakumar, B. Vincent, V.A. Kumar, Study and anal-
ysis of 3D printed FDM components by non-destructive testing techniques,
Int. J. Res. Rev. 7 (2020).
[82] M. Harris, J. Potgieter, R. Archer, K.M. Arif, Effect of material and process spe-
cific factors on the strength of printed parts in fused filament fabrication: a
review of recent developments, Materials (Basel) 12 (2019) 1664.
[83] A.K. Miri, E. Mostafavi, D. Khorsandi, S.-K. Hu, M. Malpica, A. Khademhosseini,
Bioprinters for organs-on-chips, Biofabrication 11 (2019) 42002.
[84] H.B. Yamak, Emulsion polymerization: effects of polymerization variables on
the properties of vinyl acetate based emulsion polymers, Polym. Sci., Inte-
chOpen, 2013.
[85] A. Echte, Rubber-toughened styrene polymers: A review, ACS Publications,
1989.
[86] C.A. Ponyik, D.T. Wu, S.K.R. Williams, Separation and composition distribu-
tion determination of triblock copolymers by thermal field-flow fractionation,
Anal. Bioanal. Chem. 405 (2013) 9033–9040.
[87] Z.A.A. Halim, M.A.M. Yajid, M.H. Idris, H. Hamdan, Dispersion of polymeric–
coated-silica aerogel particles in unsaturated polyester composites: effects on
thermal-mechanical properties, J. Dispers. Sci. Technol. 39 (2018) 1093–1101.
[88] S.D. Jensen, Thermoplastic/thermoset dental restorative prosthetics, U.S.
Patent Application No 12/396,438, (2009).
[89] S.L. Messimer, T.Rocha Pereira, A.E. Patterson, M. Lubna, F.O. Drozda, Full-den-
sity fused deposition modeling dimensional error as a function of raster an-
gle and build orientation: Large dataset for eleven materials, J. Manuf. Mater.
Process. 3 (2019) 6.
[90] M. Šimková, A. Tichý, M. Dušková, P. Bradna, Dental composites - a low-
dose source of bisphenol A? Physiol. Res. 69 (2020) S295–S304, doi:10.33549/
physiolres.934518.
[91] S.A. Park, H.-J. Lee, K.-S. Kim, S.J. Lee, J.-T. Lee, S.-Y. Kim, N.-H. Chang,
S.-Y. Park, In vivo evaluation of 3D-printed polycaprolactone scaffold implan-
tation combined with β -TCP powder for alveolar bone augmentation in a
beagle defect model, Materials (Basel) 11 (2018) 238.
[92] E.A.M. Hassan, S.E. Elarabi, Y. Wei, M. Yu, Biodegradable poly (lactic acid)/poly
(butylene succinate) fibers with high elongation for health care products,
Text. Res. J. 88 (2018) 1735–1744.
[93] S. Khan, S. Ali, A. Bermak, Recent developments in printing flexible and wear-
able sensing electronics for healthcare applications, Sensors 19 (2019) 1230.
[94] O.T. David, C. Szuhanek, R.A. Tuce, A.P. David, M. Leretter, Polylactic acid 3D
printed drill guide for dental implants using CBCT, Rev. Chim.-Bucharest. 68
(2017) 341–342.
[95] P. Molinero-Mourelle, S. Canals, M. Gómez-Polo, M. Fernanda Solá-Ruiz, J. del
Río Highsmith, A. Celemín Viñuela, M.F. Solá-Ruiz, A.C. Viñuela, Polylactic
acid as a material for three-dimensional printing of provisional restorations,
Int. J. Prosthodont. 31 (2018).
[96] E. Neiva, S. Badia, A.F. Martín, M. Chiumenti, A scalable parallel finite element
framework for growing geometries. application to metal additive manufactur-
ing, Int. J. Numer. Methods Eng. 119 (2019) 1098–1125.
[97] T. Debroy, T. Mukherjee, J.O. Milewski, J.W. Elmer, B. Ribic, J.J. Blecher,
W. Zhang, Scientific, technological and economic issues in metal printing and
their solutions, Nat. Mater. (2019) 1.
[98] L. Kunčická, R. Kocich, T.C. Lowe, Advances in metals and alloys for joint re-
placement, Prog. Mater. Sci. 88 (2017) 232–280.
[99] C.-W. Kang, F.-Z. Fang, State of the art of bioimplants manufacturing: part I,
Adv. Manuf. 6 (2018) 20–40.
[100] G. Struzikiewicz, W. Zebala
˛ , A. Matras, M. Machno, Ł. Ślusarczyk, S. Hichert,
F. Laufer, Turning research of additive laser molten stainless steel 316L ob-
tained by 3D printing, Materials (Basel) 12 (2019) 182.
[101] M.Z. Ibrahim, A.A.D. Sarhan, T.Y. Kuo, F. Yusof, M. Hamdi, Characterization and
hardness enhancement of amorphous Fe-based metallic glass laser cladded
on nickel-free stainless steel for biomedical implant application, Mater. Chem.
Phys. 235 (2019) 121745.
[102] G. Singh, A. Saini, Developments in Metallic Biomaterials and Surface Coat-
ings for Various Biomedical Applications, in: Adv. Mater. Process., Springer,
2020, pp. 197–206.
[103] M. Talha, C.K. Behera, O.P. Sinha, A review on nickel-free nitrogen containing
austenitic stainless steels for biomedical applications, Mater. Sci. Eng. C. 33
(2013) 3563–3575.
[104] Q. Chen, G.A. Thouas, Metallic implant biomaterials, Mater. Sci. Eng. R Re-
ports. 87 (2015) 1–57.
[105] N.S. Manam, W.S.W. Harun, D.N.A. Shri, S.A.C. Ghani, T. Kurniawan, M.H. Is-
mail, M.H.I. Ibrahim, Study of corrosion in biocompatible metals for implants:
a review, J. Alloys Compd. 701 (2017) 698–715.
[106] M. Liu, C. Li, L. Liu, Y. Ye, D. Dastan, H. Garmestani, Inhibition of stress corro-
sion cracking in 304 stainless steel through titanium ion implantation, Mater.
Sci. Technol. 36 (2020) 284–292.
[107] L. Zhao, X. Pei, L. Jiang, C. Hu, J. Sun, F. Xing, C. Zhou, Y. Fan, X. Zhang, Bionic
design and 3D printing of porous titanium alloy scaffolds for bone tissue re-
pair, Compos. Part B Eng. 162 (2019) 154–161.
[108] S.C. Kim, W.L. Jo, Y.S. Kim, S.Y. Kwon, Y.S. Cho, Y.W. Lim, Titanium pow-
der coating using metal 3D printing: a novel coating technology for
cobalt–chromium alloy implants, Tissue Eng. Regen. Med. 16 (2019) 11–18.
22
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
[109] X. Chen, K. Shah, S. Dong, L. Peterson, E.C. La Plante, G. Sant, Elucidating
the corrosion-related degradation mechanisms of a Ti-6Al-4V dental implant,
Dent. Mater. 36 (2020) 431–441.
[110] J.W Nicholson, Titanium alloys for dental implants: a review, Prosthesis 2
(2020) 100–116.
[111] H.M. Hamza, K.M. Deen, W. Haider, Microstructural examination and cor-
rosion behavior of selective laser melted and conventionally manufactured
Ti6Al4V for dental applications, Mater. Sci. Eng. C. (2020) 110980.
[112] O.P. Gbenebor, Potentials of polylactide-chitin composites as femoral scaffold
in orthopaedics, (2017).
[113] C. Veiga, J.P. Davim, A.J.R. Loureiro, Properties and applications of titanium
alloys: a brief review, Rev. Adv. Mater. Sci. 32 (2012) 133–148.
[114] Y. Okazaki, E. Gotoh, Comparison of fatigue strengths of biocompatible
Ti-15Zr-4Nb-4Ta alloy and other titanium materials, Mater. Sci. Eng. C. 31
(2011) 325–333.
[115] L. Hitzler, J. von Kobylinski, R. Lawitzki, C. Krempaszky, E. Werner, Mi-
crostructural development and mechanical properties of selective laser
melted Co–Cr–W dental alloy, in: TMS 2020 149th Annu. Meet. Exhib. Suppl.
Proc., Springer, 2020, pp. 195–202.
[116] M. Lowther, S. Louth, A. Davey, A. Hussain, P. Ginestra, L. Carter, N. Eisenstein,
L. Grover, S. Cox, Clinical, industrial, and research perspectives on powder
bed fusion additively manufactured metal implants, Addit. Manuf. 28 (2019)
565–584.
[117] X. Li, X. Liu, S. Wu, K.W.K. Yeung, Y. Zheng, P.K. Chu, Design of magnesium
alloys with controllable degradation for biomedical implants: from bulk to
surface, Acta Biomater. 45 (2016) 2–30.
[118] J. Zuchuat, A. Cura, A. Manzano, O. Decco, CoCrMo alloy as biomaterial for
bone reconstruction in oral and maxillofacial surgery: a scoping review, J.
Oral Res. 9 (2020) 336–349.
[119] H. Li, H. Yang, Y. Zheng, F. Zhou, K. Qiu, X. Wang, Design and characterizations
of novel biodegradable ternary Zn-based alloys with IIA nutrient alloying el-
ements Mg, Ca and Sr, Mater. Des. 83 (2015) 95–102.
[120] A. Ziebowicz,
˛ K. Matus, W. Pakieła, G. Matula, M. Pawlyta, Comparison of the
crystal structure and wear resistance of Co-based alloys with low carbon con-
tent manufactured by selective laser sintering and powder injection molding,
Crystals (2020) 197, doi:10.3390/cryst10030197.
[121] Y.S. Al Jabbari, Physico-mechanical properties and prosthodontic applications
of Co-Cr dental alloys: a review of the literature, J. Adv. Prosthodont. 6 (2014)
138–145.
[122] H.R. Kim, S.-H. Jang, Y.K. Kim, J.S. Son, B.K. Min, K.-H. Kim, T.-Y. Kwon, Mi-
crostructures and mechanical properties of Co-Cr dental alloys fabricated by
three CAD/CAM-based processing techniques, Materials (Basel) 9 (2016) 596.
[123] N.H. Mat-Baharin, M. Razali, S. Mohd-Said, J. Syarif, A. Muchtar, Influence of
alloying elements on cellular response and in-vitro corrosion behavior of ti-
tanium-molybdenum-chromium alloys for implant materials, J. Prosthodont.
Res. (2020).
[124] P. Hu, Improvement in metal-on-metal bearing of hip implants with advanced
stellite alloys, (2013).
[125] N.R. Reddy, A.P. Abraham, K. Murugesan, V. Matsa, An invitro analysis of ele-
mental release and cytotoxicity of recast nickel–chromium dental casting al-
loys, J. Indian Prosthodont. Soc. 11 (2011) 106–112.
[126] B. Konieczny, A. Szczesio-Wlodarczyk, J. Sokolowski, K. Bociong, Challenges of
Co–Cr alloy additive manufacturing methods in dentistry—the current state of
knowledge (systematic review), Materials (Basel) 13 (2020) 3524.
[127] B. Henriques, D. Soares, F.S. Silva, Microstructure, hardness, corrosion resis-
tance and porcelain shear bond strength comparison between cast and hot
pressed CoCrMo alloy for metal–ceramic dental restorations, J. Mech. Behav.
Biomed. Mater. (182).Ris. 12 (2012) 83–92.
[128] G. Manivasagam, D. Dhinasekaran, A. Rajamanickam, Biomedical implants:
corrosion and its prevention-a review, Recent Patents Corros. Sci. (2010) 40–
54, doi:10.2174/1877610801002010040.
[129] Y.S. Al Jabbari, T. Koutsoukis, X. Barmpagadaki, S. Zinelis, Metallurgical and
interfacial characterization of PFM Co–Cr dental alloys fabricated via casting,
milling or selective laser melting, Dent. Mater. 30 (2014) e79–e88.
[130] T. Koutsoukis, S. Zinelis, G. Eliades, K. Al-Wazzan, M. Al Rifaiy, Y.S. Al Jabbari,
Selective laser melting technique of Co-Cr dental alloys: a review of structure
and properties and comparative analysis with other available techniques, J.
Prosthodont. 24 (2015) 303–312.
[131] B. Qian, K. Saeidi, L. Kvetková, F. Lofaj, C. Xiao, Z. Shen, Defects-tolerant
Co-Cr-Mo dental alloys prepared by selective laser melting, Dent. Mater. 31
(2015) 1435–1444.
[132] X.Z. Xin, N. Xiang, J. Chen, B. Wei, In vitro biocompatibility of Co–Cr alloy
fabricated by selective laser melting or traditional casting techniques, Mater.
Lett. 88 (2012) 101–103.
[133] H. Li, L. Song, J. Sun, J. Ma, Z. Shen, Dental ceramic prostheses by
stereolithography-based additive manufacturing: potentials and challenges,
Adv. Appl. Ceram. 118 (2019) 30–36, doi:10.1080/17436753.2018.1447834.
[134] R. Galante, C.G. Figueiredo-Pina, A.P. Serro, Additive manufacturing of ce-
ramics for dental applications: a review, Dent. Mater. 35 (2019) 825–846,
doi:10.1016/j.dental.2019.02.026.
[135] J. Han, J. Zhao, Z Shen, Zirconia ceramics in metal-free implant dentistry, Adv.
Appl. Ceram. 116 (3) (2017) 138–150, doi:10.1080/17436753.2016.1264537.
[136] C.-H. Li, C.-H. Wu, C.-L. Lin, Design of a patient-specific mandible reconstruc-
tion implant with dental prosthesis for metal 3D printing using integrated
weighted topology optimization and finite element analysis, J. Mech. Behav.
Biomed. Mater. 105 (2020) 103700.
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
[137] M. Bollman, R. Malbrue, C. Li, H. Yao, S. Guo, S. Yao, Improvement of osseoin-
tegration by recruiting stem cells to titanium implants fabricated with 3D
printing, Ann. N. Y. Acad. Sci. 1463 (2020) 37–44.
[138] C.-S. Chen, J.-H. Chang, V. Srimaneepong, J.-Y. Wen, O.-H. Tung, C.-H. Yang,
H.-C. Lin, T.-H. Lee, Y. Han, H.-H. Huang, Improving the in vitro cell differenti-
ation and in vivo osseointegration of titanium dental implant through oxygen
plasma immersion ion implantation treatment, Surf. Coatings Technol. (2020)
126125.
[139] Y. Doe, H. Ida, M. Seiryu, T. Deguchi, N. Takeshita, S. Sasaki, S. Sasaki, D. Irie,
K. Tsuru, K. Ishikawa, Titanium surface treatment by calcium modification
with acid-etching promotes osteogenic activity and stability of dental im-
plants, Materialia (2020) 100801.
[140] A. Noro, M. Kaneko, I. Murata, M. Yoshinari, Influence of surface topography
and surface physicochemistry on wettability of zirconia (tetragonal zirconia
polycrystal), J. Biomed. Mater. Res. - Part B Appl. Biomater. 101 B (2013) 355–
363, doi:10.1002/jbm.b.32846.
[141] S. Schultze-MosgauH.S.-O. Surgery, undefined Oral, undefined, Osseointegra-
tion of endodontic endosseous conesZirconium oxide vs titanium, Elsevier,
20 0 0 (n.d.).
[142] M. Hisbergues, S. Vendeville, P. Vendeville, Review zirconia : established facts
and perspectives for a biomaterial in dental implantology, (2008) 519–529.
10.1002/jbm.b.31147.
[143] A.E. Rodriguez, M. Monzavi, C.L. Yokoyama, H. Nowzari, Zirconia dental im-
plants: a clinical and radiographic evaluation, J. Esthet. Restor. Dent. 30 (2018)
538–544.
[144] G.P. Jayaswal, S.P. Dange, A.N. Khalikar, Bioceramic in dental implants:
A review, J. Indian Prosthodont. Soc. 10 (2010) 8–12, doi:10.1007/
s13191- 010- 0 0 02-4.
[145] R. Barkallah, R. Taktak, N. Guermazi, K. Elleuch, Mechanical properties and
wear behaviour of alumina / tricalcium phosphate / titania ceramics as coat-
ing for orthopedic implant, Eng. Fract. Mech. (2020) 107399, doi:10.1016/j.
engfracmech.2020.107399.
[146] A. De Aza, J. Chevalier, G. Fantozzi, Crack growth resistance of alumina, zirco-
nia and zirconia toughened alumina ceramics for joint prostheses, Biomateri-
als 23 (3) (2002) 937–945, doi:10.1016/s0142-9612(01)00206-x.
[147] A. Shenoy, N. Shenoy, Dental ceramics: an update, Journal of conservative
dentistry: JCD 13 (4) (2010) 195.
[148] T.A. Khabas, L.V Maletina, K.S. Kamyshnaya, Influence of nanopowders and
pore-forming additives on sintering of alumma-zircorna ceramics, IOP Confer-
ence Series: Materials Science and Engineering, IOP Publishing, 2014, doi:10.
1088/1757-899X/66/1/012050.
[149] Y. Zhang, Y. Yang, W. Li, Y. Ren, Effect of Al2O3 addition on the flexural
strength and light-transmission properties of bone china, Int. J. Appl. Ceram.
Technol. 12 (2015) 875–884, doi:10.1111/ijac.12296.
[150] A. Bruni, F.G. Serra, A. Deregibus, T. Castroflorio, Shape-memory polymers in
dentistry: systematic review and patent landscape report, Materials (Basel)
12 (2019) 1–22, doi:10.3390/ma12142216.
[151] Y.Y.C. Choong, S. Maleksaeedi, H. Eng, J. Wei, P.-C. Su, 4D printing of high
performance shape memory polymer using stereolithography, Mater. Des. 126
(2017) 219–225.
[152] W. Sun, B. Starly, A.C. Daly, J.A. Burdick, J. Groll, G. Skeldon, W. Shu, Y. Sakai,
M. Shinohara, M. Nishikawa, The bioprinting roadmap, Biofabrication 12
(2020) 22002.
[153] M. Behl, A. Lendlein, Shape-memory polymers, Mater. Today. 10 (2007) 20–
28, doi:10.1016/S1369-7021(07)70047-0.
[154] E.N. Zare, R. Jamaledin, P. Naserzadeh, E. Afjeh-Dana, B. Ashtari, M. Hossein-
zadeh, R. Vecchione, A. Wu, F.R. Tay, A. Borzacchiello, P. Makvandi, Metal-
based nanostructures/PLGA nanocomposites: antimicrobial activity, cytotoxic-
ity, and their biomedical applications, ACS Appl. Mater. Interfaces. 12 (2020)
3279–3300, doi:10.1021/acsami.9b19435.
[155] E.N. Zare, M.M. Lakouraj, A. Ramezani, Effective adsorption of
heavy metal cations by superparamagnetic poly(aniline-co-m-
phenylenediamine)@Fe<inf>3</inf>O<inf>4</inf>
nanocomposite, Adv. Polym. Technol. 34 (2015), doi:10.1002/adv.21501.
[156] E. Nazarzadeh Zare, M.M. Lakouraj, M. Baghayeri, Electro-magnetic polyfu-
ran/Fe3O4 nanocomposite: synthesis, characterization, antioxidant activity,
and its application as a biosensor, Int. J. Polym. Mater. Polym. Biomater. 64
(2015) 175–183, doi:10.1080/00914037.2014.936588.
[157] R. Zare, Ehsan Nazarzadeh Lakouraj, Moslem Mansour Moghadam, Peyman
Najafi Azimi, Novel polyfuran/functionalized multiwalled carbon nanotubes
composites with improved conductivity: chemical synthesis, characterization,
and antioxidant activity, Polym. Compos. 34 (2013) 732–739.
[158] H. Hingorani, Y.-F. Zhang, B. Zhang, A. Serjouei, Q. Ge, Modified commercial
UV curable elastomers for passive 4D printing, Int. J. Smart Nano Mater. 10
(2019) 225–236.
[159] H. Cui, S. Miao, T. Esworthy, S. Lee, X. Zhou, S.Y. Hann, T.J. Webster, B.T. Har-
ris, L.G. Zhang, A novel near-infrared light responsive 4D printed nanoarchi-
tecture with dynamically and remotely controllable transformation, Nano Res
12 (2019) 1381–1388.
[160] T. Manouras, M. Vamvakaki, Field responsive materials: photo-, electro-, mag-
netic-and ultrasound-sensitive polymers, Polym. Chem. 8 (2017) 74–96.
[161] A.-Z. Zardad, Y.E. Choonara, L.C. Du Toit, P. Kumar, M. Mabrouk, P.P.D. Kon-
diah, V. Pillay, A review of thermo-and ultrasound-responsive polymeric sys-
tems for delivery of chemotherapeutic agents, Polymers (Basel) 8 (2016) 359.
[162] P. Makvandi, G.W. Ali, F.Della Sala, W.I. Abdel-Fattah, A. Borzacchiello,
Hyaluronic acid/corn silk extract based injectable nanocomposite: a
23
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
biomimetic antibacterial scaffold for bone tissue regeneration, Mater. Sci. Eng.
C. 107 (2019) 10195, doi:10.1016/j.msec.2019.110195.
[163] P. Makvandi, G.W. Ali, F.Della Sala, W.I. Abdel-Fattah, A. Borzacchiello, Biosyn-
thesis and characterization of antibacterial thermosensitive hydrogels based
on corn silk extract, hyaluronic acid and nanosilver for potential wound heal-
ing, Carbohydr. Polym. 223 (2019) 115023.
[164] a) S. Miao, N. Castro, M. Nowicki, L. Xia, H. Cui, X. Zhou, W. Zhu, S. jun Lee,
K. Sarkar, G. Vozzi, Y. Tabata, J. Fisher, L.G. Zhang, 4D printing of polymeric
materials for tissue and organ regeneration, Mater. Today. 20 (2017) 577–591,
doi:10.1016/j.mattod.2017.06.005; b) R. Xiao, W.M. Huang, Heating/solvent re-
sponsive shape-memory polymers for implant biomedical devices in mini-
mally invasive surgery: current status and challenge, Macromol. Biosci. 20
(2020) 20 0 0108, doi:10.1016/j.mattod.2017.06.005.
[165] F. Reyes-Ortega, 3 - pH-responsive polymers: properties, synthesis and ap-
plications, in: M.R. Aguilar, J.B.T.-S.P.and their A.San Román (Eds.), Smart
Polym. Their Appl., Woodhead Publishing, 2014, pp. 45–92, doi:10.1533/
9780857097026.1.45.
[166] A. Muzaffar, M.B. Ahamed, K. Deshmukh, T. Kovářík, T. Křenek, S.K.K. Pasha,
3D and 4D printing of pH-responsive and functional polymers and their
composites, in: 3D 4D Print. Polym. Nanocomposite Mater., Elsevier, 2020,
pp. 85–117.
[167] E.N. Zare, P. Makvandi, F.R. Tay, Recent progress in the industrial and biomed-
ical applications of tragacanth gum, Carbohydr. Polym. 212 (2019) 450–467,
doi:10.1016/J.CARBPOL.2019.02.076.
[168] E. Pei, G.H. Loh, Technological considerations for 4D printing: an overview,
Prog. Addit. Manuf. 3 (2018) 95–107, doi:10.1007/s40964- 018- 0047- 1.
[169] M. Javaid, A. Haleem, 4D printing applications in medical field: a brief review,
Clin. Epidemiol. Glob. Heal. 7 (2019) 317–321, doi:10.1016/j.cegh.2018.09.007.
[170] L. Zhang, E.-M. Haddouti, K. Welle, C. Burger, K. Kabir, F.A. Schildberg, Lo-
cal cellular responses to metallic and ceramic nanoparticles from orthopedic
joint arthroplasty implants, Int. J. Nanomed. 15 (2020) 6705.
[171] Y. Liu, B. Rath, M. Tingart, J. Eschweiler, Role of implants surface modification
in osseointegration: a systematic review, J. Biomed. Mater. Res. Part A. 108
(2020) 470–484.
[172] A. Dreanca, C. Sarosi, A.E. Parvu, M. Blidaru, G. Enacrachi, R. Purdoiu, A. Nagy,
B. Sevastre, N.A. Oros, I. Marcus, Systemic and local biocompatibility assess-
ment of graphene composite dental materials in experimental mandibular
bone defect, Materials (Basel) 13 (2020) 2511.
[173] S. Zafar, A. Siddiqi, Biological responses to pediatric stainless steel crowns, J.
Oral Sci. (2020) 20–83.
[174] A.V Tibau, B.D. Grube, B.J. Velez, V.M. Vega, J. Mutter, Titanium exposure and
human health, Oral Sci. Int. 16 (2019) 15–24.
[175] S.T. Kumar, S.P. Devi, C. Krithika, R.N. Raghavan, Review of metallic biomate-
rials in dental applications, J. Pharm. Bioallied Sci. 12 (2020) S14.
[176] M. Moldovan, R. Balazsi, A. Soanca, A. Roman, C. Sarosi, D. Prodan, M. Vlassa,
I. Cojocaru, V. Saceleanu, I. Cristescu, Evaluation of the degree of conversion,
residual monomers and mechanical properties of some light-cured dental
resin composites, Materials (Basel) 12 (2019) 2109, doi:10.3390/ma12132109.
[177] J. Chen, R. Ahmad, H. Suenaga, W. Li, K. Sasaki, M. Swain, Q. Li, Shape op-
timization for additive manufacturing of removable partial dentures-a new
paradigm for prosthetic CAD/CAM, PLoS One 10 (2015) e0132552, doi:10.
1371/journal.pone.0132552.
[178] M. Cassetta, S. Di Carlo, N. Pranno, V. Sorrentino, G. Di Giorgio, G. Pompa,
The use of stereolithographic surgical templates in oral implantology, Ann.
Ital Chir. 84 (2013) 589–593.
[179] T. Dikova, Production of high-quality temporary crowns and bridges by stere-
olithography, Scr. Sci. Med. Dent. 5 (2019) 33–38.
[180] M. Cassetta, Immediate loading of implants inserted in edentulous arches
using multiple mucosa-supported stereolithographic surgical templates: a
10-year prospective cohort study, Int. J. Oral Maxillofac. Surg. 45 (2016)
526–534.
[181] O. Ozan, I. Turkyilmaz, A.E. Ersoy, E.A. McGlumphy, S.F. Rosenstiel, Clinical
accuracy of 3 different types of computed tomography-derived stereolitho-
graphic surgical guides in implant placement, J. Oral Maxillofac. Surg. 67
(2009) 394–401.
[182] J. D’haese, T. Van De Velde, A. Komiyama, M. Hultin, H. De Bruyn, Accu-
racy and complications using computer-designed stereolithographic surgical
guides for oral rehabilitation by means of dental implants: a review of the
literature, Clin. Implant Dent. Relat. Res. 14 (2012) 321–335.
[183] M. Shahbazian, R. Jacobs, J. Wyatt, G. Willems, V. Pattijn, E. Dhoore, C. Van
Lierde, F. Vinckier, Accuracy and surgical feasibility of a CBCT-based stere-
olithographic surgical guide aiding autotransplantation of teeth: in vitro vali-
dation, J. Oral Rehabil. 37 (2010) 854–859.
[184] K. Liang, S. Carmone, D. Brambilla, J.C. Leroux, 3D printing of a wearable per-
sonalized oral delivery device: a first-in-human study, Sci. Adv. 4 (2018) 1–12,
doi:10.1126/sciadv.aat2544.
[185] J. Chen, Z. Zhang, X. Chen, C. Zhang, G. Zhang, Z. Xu, Design and manufac-
ture of customized dental implants by using reverse engineering and selec-
tive laser melting technology, J. Prosthet. Dent. 112 (2014) 1088–1095.
[186] F. Mangano, M. Bazzoli, L. Tettamanti, D. Farronato, M. Maineri, A. Macchi,
C. Mangano, Custom-made, selective laser sintering (SLS) blade implants as a
non-conventional solution for the prosthetic rehabilitation of extremely atro-
phied posterior mandible, Lasers Med. Sci. 28 (2013) 1241–1247.
[187] M. Figliuzzi, F. Mangano, C. Mangano, A novel root analogue dental implant
using CT scan and CAD/CAM: selective laser melting technology, Int. J. Oral
Maxillofac. Surg. 41 (2012) 858–862.
JID: ACTBIO
ARTICLE IN PRESS
D. Khorsandi, A. Fahimipour, P. Abasian et al.
[188] A. Jawahar, G. Maragathavalli, Applications of 3D printing in dentistry–a re-
view, J. Pharm. Sci. Res. 11 (2019) 1670–1675.
[189] F. Alifui-Segbaya, S. Varma, G.J. Lieschke, R. George, Biocompatibility of pho-
topolymers in 3D printing, 3D Print, Addit. Manuf. 4 (2017) 185–191.
[190] E. Anadioti, B. Kane, E. Soulas, Current and emerging applications of 3D print-
ing in restorative dentistry, Curr. Oral Heal. Reports. 5 (2018) 133–139.
[191] A.C. Hayes, G.L. Whiting, Powder-binder jetting large-scale, metal direct-drive
generators: selecting the powder, binder, and process parameters, ASME 2019
Power Conf., American Society of Mechanical Engineers Digital Collection,
2019.
[192] R.B. Osman, N. Alharbi, D. Wismeijer, Build angle: does it influence the accu-
racy of 3D-printed dental restorations using digital light-processing technol-
ogy? Int. J. Prosthodont. 30 (2017) 182–188, doi:10.11607/ijp.5117.
[193] W.-S. Lin, B.T. Harris, J. Pellerito, D. Morton, Fabrication of an interim com-
plete removable dental prosthesis with an in-office digital light processing
three-dimensional printer: a proof-of-concept technique, J. Prosthet. Dent.
120 (2018) 331–334.
[194] P. Gaind, Injuries to the Teeth: Long-Term Effects and Their Management, in:
Atlas Oper. Maxillofac. Trauma Surg., Springer, 2020, pp. 801–813.
[195] P. Makvandi, J.T. Gu, E.N. Zare, B. Ashtari, A. Moeini, F.R. Tay, L. Niu, Polymeric
and inorganic nanoscopical antimicrobial fillers in dentistry, Acta Biomater
101 (2020) 69–101, doi:10.1016/j.actbio.2019.09.025.
[196] M. Zimmermann, A. Ender, T. Attin, A. Mehl, Fracture load of three-unit ful-
l-contour fixed dental prostheses fabricated with subtractive and additive
CAD/CAM technology, Clin. Oral Investig. 24 (2020) 1035–1042.
[197] H. Nishiyama, A. Taniguchi, S. Tanaka, K. Baba, Novel fully digital workflow for
removable partial denture fabrication, J. Prosthodont. Res. 64 (2020) 98–103.
[198] G.-S. Unsal, I. Turkyilmaz, S. Lakhia, Advantages and limitations of implant
surgery with CAD/CAM surgical guides: a literature review, J. Clin. Exp. Dent.
12 (2020) e409.
[199] M.T. Kattadiyil, C. Goodacre, N.Z. Baba, CAD/CAM complete dentures: a re-
view of two commercial fabrication systems, J. Calif. Dent. Assoc. 41 (2013)
407–416.
[200] M.O. Hussein, L.A. Hussein, Novel 3D modeling technique of removable partial
denture framework manufactured by 3D printing technology, Int. J. Adv. Res.
2 (2014) 686–694.
[201] N.M. inaya Pereyra, J. Marano, G. Subramanian, S. Quek, D. Leff, Comparison
of patient satisfaction in the fabrication of conventional dentures vs. DENTCA
(CAD/CAM) dentures: a case report, J. N. J. Dent. Assoc. 86 (2015) 26–33.
[202] H. Kim, D. Lee, S.Young Lee, H. Yang, S.W. Park, H.P. Lim, K.D. Yun, C. Park,
Denture flask fabrication using fused deposition modeling three-dimensional
printing, J. Prosthodont. Res. 64 (2020) 231–234, doi:10.1016/j.jpor.2019.07.
001.
[203] A. Tahayeri, M. Morgan, A.P. Fugolin, D. Bompolaki, A. Athirasala, C.S. Pfeifer,
J.L. Ferracane, L.E. Bertassoni, 3D printed versus conventionally cured provi-
sional crown and bridge dental materials, Dent. Mater. 34 (2018) 192–200.
[204] Y. Etemad-Shahidi, O.B. Qallandar, J. Evenden, F. Alifui-Segbaya, K.E. Ahmed,
Accuracy of 3-dimensionally printed full-arch dental models: a systematic re-
view, J. Clin. Med. 9 (2020) 3357, doi:10.3390/jcm9103357.
[205] T. Hada, M. Kanazawa, M. Iwaki, T. Arakida, Y. Soeda, A. Katheng, R. Otake,
S. Minakuchi, Effect of printing direction on the accuracy of 3D-printed den-
tures using stereolithography technology, Materials (Basel) 13 (2020) 1–12,
doi:10.3390/ma13153405.
[206] D. Seprianto, R. Sugiantoro, Yahya Siproni, M. Erwin, The effect of rectangular
parallel key manufacturing process parameters made with stereolithography
DLP 3D printer technology against impact strength, J. Phys. Conf. Ser. 1500
(2020), doi:10.1088/1742-6596/1500/1/012028.
[207] M. Gao, X. Yan, R. Zhao, Y. Shan, Y. Chen, F. Jian, Comparison of pain percep-
tion, anxiety, and impacts on oral health-related quality of life between pa-
tients receiving clear aligners and fixed appliances during the initial stage of
orthodontic treatment, European Journal of Orthodontics (2020) 1–7, doi:10.
1093/ejo/cjaa037.
[208] A. Barazanchi, K.C. Li, B. Al-Amleh, K. Lyons, J.N. Waddell, Additive technol-
ogy: update on current materials and applications in dentistry, J. Prosthodont.
26 (2017) 156–163, doi:10.1111/jopr.12510.
[209] G. Oberoi, S. Nitsch, M. Edelmayer, K. Janjic, A.S. Müller, H. Agis, 3D printing-
Encompassing the facets of dentistry, Front. Bioeng. Biotechnol. 6 (2018) 1–
13, doi:10.3389/fbioe.2018.00172.
[210] H.H. Lin, D. Lonic, L.J. Lo, 3D printing in orthognathic surgery − a literature
review, J. Formos. Med. Assoc. 117 (2018) 547–558, doi:10.1016/j.jfma.2018.01.
008.
[211] J. D’haese, J. Ackhurst, D. Wismeijer, H. De Bruyn, A. Tahmaseb, Current state
of the art of computer-guided implant surgery, Periodontol. 20 0 0 73 (2017)
121–133, doi:10.1111/prd.12175.
24
[m5G;January 4, 2021;11:7]
Acta Biomaterialia xxx (xxxx) xxx
[212] Y. Zhai, D.A. Lados, J.L. LaGoy, Additive manufacturing: making imagination
the major limitation, Jom 66 (2014) 808–816.
[213] M. Revilla-León, M. Özcan, Additive manufacturing technologies used for 3d
metal printing in dentistry, Curr. Oral Heal. Reports. 4 (2017) 201–208, doi:10.
1007/s40496- 017- 0152- 0.
[214] R. Wauthle, J. Van Der Stok, S.A. Yavari, J. Van Humbeeck, J.P. Kruth, A.A. Zad-
poor, H. Weinans, M. Mulier, J. Schrooten, Additively manufactured porous
tantalum implants, Acta Biomater. 14 (2015) 217–225, doi:10.1016/j.actbio.
2014.12.003.
[215] A.M. Baciu, C. Bejinariu, A. Corăbieru, E. Mihalache, M. Lupu–Poliac, C. Baciu,
E.R. Baciu, Influence of process parameters for Selective Laser Melting on the
roughness of 3D printed surfaces in Co-Cr dental alloy powder, in: IOP Conf.
Ser. Mater. Sci. Eng., IOP Publishing, 2019, p. 12054.
[216] S.O. Bajunaid, B. Altwaim, M. Alhassan, R. Alammari, The fit accuracy of
removable partial denture metal frameworks using conventional and 3D
printed techniques: An in vitro study, J. Contemp. Dent. Pract. 20 (2019) 476–
481, doi:10.5005/jp- journals- 10024- 2542.
[217] H. Wang, K. Su, L. Su, P. Liang, P. Ji, C. Wang, Comparison of 3D-printed
porous tantalum and titanium scaffolds on osteointegration and osteogene-
sis, Mater. Sci. Eng. C. 104 (2019), doi:10.1016/j.msec.2019.109908.
[218] P. Rider, Ž.P. Kačarević, S. Alkildani, S. Retnasingh, R. Schnettler, M. Barbeck,
Additive manufacturing for guided bone regeneration: a perspective for alve-
olar ridge augmentation, 2018. 10.3390/ijms19113308.
[219] D. Nesic, B.M. Schaefer, Y. Sun, N. Saulacic, 3D printing approach in dentistry :
the future for personalized oral soft tissue regeneration, J. Clin. Med. (2020).
[220] M. Salah, L. Tayebi, K. Moharamzadeh, F.B. Naini, Three-dimensional bio-
printing and bone tissue engineering: technical innovations and potential ap-
plications in maxillofacial reconstructive surgery, Maxillofac. Plast. Reconstr.
Surg. 42 (2020), doi:10.1186/s40902- 020- 00263- 6.
[221] S. D’Ercole, M. Tieri, D. Fulco, D. Martinelli, D. Tripodi, The use of chlorhexi-
dine in mouthguards, J. Biol. Regul. Homeost. Agents. 31 (2017) 487–493.
[222] H.H.K. Xu, P. Wang, L. Wang, C. Bao, Q. Chen, M.D. Weir, L.C. Chow, L. Zhao,
X. Zhou, M.A. Reynolds, Calcium phosphate cements for bone engineering and
their biological properties, Bone Res. 5 (2017) 1–19.
[223] C. Byun, C. Kim, S. Cho, S.H. Baek, G. Kim, S.G. Kim, S.-Y. Kim, Endodontic
treatment of an anomalous anterior tooth with the aid of a 3-dimensional
printed physical tooth model, J. Endod. 41 (2015) 961–965.
[224] P. Shah, B.S. Chong, 3D imaging, 3D printing and 3D virtual planning in en-
dodontics, Clin. Oral Investig. 22 (2018) 641–654.
[225] J. Anderson, J. Wealleans, J. Ray, Endodontic applications of 3D printing, Int.
Endod. J. 51 (2018) 1005–1018, doi:10.1111/iej.12917.
[226] E. Kröger, M. Dekiff, D. Dirksen, 3D printed simulation models based on
real patient situations for hands-on practice, Eur. J. Dent. Educ. 21 (2017)
e119–e125.
[227] C. Höhne, M. Schmitter, 3D printed teeth for the preclinical education of den-
tal students, J. Dent. Educ. 83 (2019) 1100–1106, doi:10.21815/jde.019.103.
[228] M. Reymus, C. Fotiadou, A. Kessler, K. Heck, R. Hickel, C. Diegritz, 3D printed
replicas for endodontic education, Int. Endod. J. 52 (2019) 123–130, doi:10.
1111/iej.12964.
[229] S.M. Werz, S.J. Zeichner, B. Berg, H. Zeilhofer, F. Thieringer, 3D printed sur-
gical simulation models as educational tool by maxillofacial surgeons, Eur. J.
Dent. Educ. 22 (2018) e500–e505.
[230] J. Garcia, Z. Yang, R. Mongrain, R.L. Leask, K. Lachapelle, 3D printing materi-
als and their use in medical education: a review of current technology and
trends for the future, BMJ Simul. Technol. Enhanc. Learn. 4 (2018) 27–40.
[231] H.Y. Jeong, B.H. Woo, N. Kim, Y.C. Jun, Multicolor 4D printing of shape-
memory polymers for light-induced selective heating and remote actuation,
Sci. Rep. 10 (2020) 1–11, doi:10.1038/s41598- 020- 63020- 9.
[232] A. Haleem, M. Javaid, Four-dimensional printing applications in dentistry,
Curr. Med. Res. Pract. 9 (2019) 41–42.
[233] R.O. do Nascimento, N. Chirani, Shape-memory polymers for dental applica-
tions, Elsevier Ltd., 2015, doi:10.1016/B978- 0- 85709- 698- 2.0 0 013-1.
[234] L.C. Hwa, S. Rajoo, A.M. Noor, N. Ahmad, M.B. Uday, Recent advances in 3D
printing of porous ceramics: a review, Curr. Opin. Solid State Mater. Sci. 21
(2017) 323–347.
[235] S.C. Ligon, R. Liska, J. Stampfl, M. Gurr, R. Mülhaupt, Polymers for 3D printing
and customized additive manufacturing, Chem. Rev. 117 (2017) 10212–10290.
[236] L. Lin, Y. Fang, Y. Liao, G. Chen, C. Gao, P. Zhu, 3D printing and digital process-
ing techniques in dentistry: a review of literature, Adv. Eng. Mater. 21 (2019)
1801013.
[237] J.K. Fink, Materials, Chemicals and Methods for Dental Applications, John Wi-
ley & Sons, 2018.