pubs.acs.

org/journal/abseba Review

Recent Advances in Additive Manufacturing, Applications and

Challenges for Dentistry: A Review
Swati Chaudhary, Sarvesh Kumar Avinashi, Jitendra Rao, and Chandkiram Gautam*

Cite This: ACS Biomater. Sci. Eng. 2023, 9, 3987−4019 Read Online

ACCESS Metrics & More Article Recommendations

Downloaded via VELLORE INSTITUTE TECHNOLOGY on September 4, 2023 at 08:39:28 (UTC).
See https://pubs.acs.org/sharingguidelines for options on how to legitimately share published articles.

ABSTRACT: Technological advancement in the field of dentistry has to be proven in new

avenues for professionals as well as laboratory programmers. An advanced type of technology
is emerging based on digitalization, as a computerized three-dimensional (3-D) model,
additive manufacturing also called 3-D printing, allows formation of block pieces by adding
material layer-by-layer. The additive manufacturing (AM) approach has offered extreme
progress in the broad choice of distinct zones, permitting the production of fragments of all
possible varieties of substances such as metal, polymer, ceramic, and composites. The
significant goal of current the article is to recapitulate the recent scenarios including the
imminent perspective of AM techniques and challenges in dentistry. Moreover, this article
reviews the recent developments of 3-D printing advancements along with the advantages and
disadvantages. Herein, various AM technologies comprising vat photopolymerization (VPP),
material jetting, material extrusion, selective laser sintering (SLS), selective laser melting
(SLM), and direct metal laser sintering (DMLS) technologies based powder bed fusion
technologies/direct energy deposition/sheet lamination centered on binder jetting technologies were discussed in detail. This paper
attempts to provide a balanced view by emphasizing the economic, scientific, and technical challenges and presenting an overview of
methods to discuss the similarities based on the authors’ continuing research and development.
KEYWORDS: 3-D printing, additive manufacturing, dental ceramics

1. INTRODUCTION (SLA), usually employed for the fabrication of an aligner, and

According to the ASTM standard, the additive manufacturing
(AM) technology is defined as “A method of linking the
materials to build stuffs from 3-D prototypical statistics,
typically layer by layer, as opposite to subtractive developed
approaches”.1 It became known that techniques which are
based on CAD-CAM usually involve three essential compo-
nents implanted within a digitalized system: (i) data
procurement, (ii) data handling (CAD), and (iii) fabrication
(CAM).2 Moreover, AM creates a 3-D compact piece right
from digital 3-D CAD files which contain significant data
under computer control. Presently the major emphasis is on
invasive development: the indirect fabrication of orthodontic
aligners through production of different molds for specific
items. Numerous fields of production, like industries, defense,
space, therapeutics, and design, are accepting AM for
customization and fast fabrication. Recently, there have been
several claims in the area of odontology for which fabrication
of personalized dentistry prototypes is conceivable. Advanced
techniques effectively harvest drill guides for dentistry.3,4
Therefore, AM technologies accomplish multifaceted chal-
lenges in the broad area of therapeutics and in dentistry. Such
technologies are currently accessible to recover patient results.
Two prominent technologies exposed in the research and
development zone of dental sciences are stereolithography
direct metal laser sintering (DMLS) that is accomplished to
fabricate excellent metallic crown and implant structures in
dentistry.5,6 Most of the implantation surgeries were performed
manually. So during the AM method, dentists firstly have to
examine the patient’s jaw and its scanning and then perforate
the patient’s mouth by using the aid of the scanned feature. In
this process, the extreme of the works based on visualization is
not too accurate.7,8 However, AM development starts with a
simulated image generated via a 3-D scanner/CAD software,
making products by using numerous AM technologies.
Therefore, AM technologies satisfy the multifaceted challenges
in medical research and development. These technologies are
currently accessible to enhance patient outcomes. Recently,
there are two distinct AM techniques for the advancement of
dentistry that are accomplished to fabricate high-performance
metallic dental implants/crowns.9−11 AM is a complex
technique to investigate the best site at which to drill the
Received: December 30, 2022
Accepted: May 17, 2023
Published: June 12, 2023

© 2023 American Chemical Society https://doi.org/10.1021/acsbiomaterials.2c01561

3987 ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
Figure 1. Total projected dental 3D printing application market value, by type, 2021 ($US millions).
object. It enhances the correctness of the surgical procedure
through suitably generating a complete set of dentures which
easily fit in the mouth of a patient. Therefore, the AM
technique is now becoming approachable in dentistry. Further,
AM offers superior health care and generates valuable evidence
for treatment and therapy to the dental surgeon. It has
numerous uses in biomedical sectors during complicated
surgery that are really fruitful to enhance patient out-
comes.12−14 Concerning to the essential variations that our
age has initiated in the earlier century, AM has started a unique
approach to covenant with the consumption of the
biomaterials.15 A standout surrounding the most rapidly
emerging configurations is the significant utilization of 3-D
printing within medicine and dentistry. Moreover, 3-D printing
is a highly anticipated fabricating approach, since it allows
building many designs along with intricate shapes/geometries
and architectures which are not conceivable with conventional
processes. Chuck Hull gave the first idea of AM in 1986,
employing a process called “stereolithography” (SLA).16,17 He
designed and fabricated an initial 3-D printer machine that
employed the approach of SLA and also the leading program
for virtualization as well.18 They achieved extended deliber-
ation in these fields, e.g. manufacturing and engineering, owing
to the stretched perspective in an instant improvement of the
machine fragments, aeronautics in sunlight of the easiness to
fabricate numerous tiny parts employed as the part of rocket
advances, and specialized subassemblies used for aspects of the
broadcast communications. Moreover, their application in
territories that need an order of millimeter (mm) precision has
paved the way of consideration of experts in common
medicine, who initiated performance in the 1990s.19 To
study the recent advancement and claims of AM in dentistry
including requirements, numerous skills, benefits, and future
perspective were highlighted in detail. No doubt, AM
technologies have recently paid the ways to uplift the huge
3988
pubs.acs.org/journal/abseba Review
investment in the market. Therefore, the total projected 3-D
printing application market values are depicted in Figure 1.
2. WHY AM IS REQUIRED?
AM is a progressive and innovative methodology for the
fabrication of numerous materials. It is a set of methods in
which a layer-by-layer process was used to formulate intricate
geometric shapes and their parts. Usually, it is recognized as
prompt prototyping (PP), without construction, with less
potential intake and excellent projection suppleness.20−22 It is a
multipurpose, flexible, malleable, and highly customized
technique that could operate in several medical and industrial
production segments.23 Such individualities were accredited to
be enormously beneficial in medical and locomotive
productions among others like manufacturing, dental, and
space engineering.24,25 Regarding the practical use of AM, its
nonrequirement of molding apparatuses and its reasonably
small time-consumption to build modified fragments are more
useful constraints for a vigorous engineering organization.
Moreover, to fabricate the prototypes, the CAD software is an
essential measure of the AM technique that supports the
production of various modified digital designs and models (3-
D).21 CAD/CAM software makes 3-D replicas/models in the
shape of tiny slices to symbolize the layers of the materials
during polymer printing. So during the AM process, all the
digital data contain information on the used raw material
performances and printing factors which are utilized in
different printing procedures.26
Moreover, the AM technique differs entirely from the
accessible old-style subtractive fabrication based methods.
However, it is centered on the two synthesis methods,
“bottom-up” and “top-down”. At the same time a customized
complex structure was fabricated by employing a layer-by-layer
model and then the casting or injection molding approach. A
widespread range of the materials like metals, ceramics, and
polymers including combinations such as mixtures, amalgams,
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering pubs.acs.org/journal/abseba Review

Figure 2. Additive manufacturing is required in various fields: (a) in dental devices,28 (b) in medical devices and scaffolds for tissue engineering,29
(c) in orthopedics,30 (d) in jaw reconstruction,31 (e) in 3D printed medical implants,32 (f) in the automotive industry,33 (g) in the food industry,34
and (h) in the aerospace industry.35

Figure 3. Eight stages of the additive manufacturing process.332 Reproduced with permission from ref 332. Copyright 2019 MDPI.

and compounds may be used during the AM process. Further
research is needed to explore the provocation related with the
two main aspects of AM, namely material and metrology, to
establish the effectiveness of predictive and generative
methods. This research is crucial to overcome the unique
challenges posed by AM technology.23 Nevertheless, the
3989
curiosity about using an AM technique at industry scale has
significantly increased owing to its competency to harvest a
real, complex shape, and inventive and vigorous products.
Henceforth, the fabrication of complex geometries using
promoted computer formulated software develops an emergent
research domain in 3-D printing technology. The restrictions
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
 Table 1. Parameters of Various Additive Manufacturing Technologies and Accuracy and Their Advantages and Disadvantages with Different Dental Materials
Techniques Accuracy Materials Advantages Disadvantages Energy source Ref
Stereolithography 50−55 μm Acrylate Photopol- It is fast enough to produce working pieces in a day. Manufactured fragments are more fragile. Ultraviolet or 37, 38
(SLA) ymer Used for less fabrication only. visible light
Machine is expensive
Plastic Ceramic Anatomical models, artificial teeth, master designs for
injection molding, and other metal castings are all made
with it.
Selective laser 45−50 μm Thermoplastics No need for any additional materials. A porous surface on printed items is sealed with a coating like cyanoacrylate. High-power 37, 39,
sintering (SLS) Powder Plastic The parts are extremely strong and rigid. laser 40
Metals Ceramic Various finishing options.
Maximum dimensional accuracy.
Excellent chemical resistance.
Fused deposition 35−40 μm Polycarbonate, ABS Manufactured a high-strength component. This frequently results in ribbing, which reveals lines from every single layer. Extrusion 37, 41
modeling (FDM) Polypropylene It is inexpensive and durable. To erase these lines, polishing or sanding might be used.
ACS Biomaterials Science & Engineering

Polyesters PEEK materials can be used for printing. Varying temperatures during fabrication could result in delamination occurring.
Polyjet 3D printing 20−85 μm Photopolymers Manufactured complex shapes. The material’s density and performance were superior to those of injected molds. Ultraviolet light 37,
(PJP) More versatile processes are successfully applied in the 163
healthcare and dental sectors.
Used to create an organ mimic. Not appropriate for mass manufacture.
Fabrication of accurate bridges, crowns, and dental devices.
Inkjet 3D printing 35−40 μm Powder liquid Print any intricate design component. Size of items is restricted. Electric heater 37,
(IJP) binder It created parts rapidly. Machine cost is expensive. 163,
42

3990
Useful in health care like printing organs.
Laminated object 60−70 μm Metal Capability to create larger-scale prototypes. There is a need for describing, which takes a lot of time. Laser 37, 43
manufacturing This is fast and precise.
(LOM)
Plastic Eco-friendly.
Excellent mechanical strength. The stability of paper items is not as good as that of other AM materials.
Color-jet-printing 23−30 μm Gypsum powder Construct excellent color print, extremely quickly and quietly Product is expensive, poor strength. Electron beam, 37, 44,
(CJP) binder, because of its portability. laser or plasma 45
VisiJet PXL It becomes beneficial for small businesses or home offices.
Electron beam melt- 40−50 μm Metal powder Capability to generate a high level of energy in a narrow beam. Requires vacuum, which is expensive and has to be maintained, electron beam Electron 37, 46,
ing (EBM) Titanium Impurities are removed from the environment via vacuuming, technology produces X-rays while in operation 47
lower power consumption.
pubs.acs.org/journal/abseba

Multijet printing 25−35 μm Powder Fabricate smooth and accurate fragments with extremely No ceramic materials accessible commercially yet, inadequate information on Infrared lamps 37, 48,
(MJP) difficult. ceramics AM specifications, high-performance polymers are now being 49
Plastics Rapid fabrication speed. prioritized.
No more finishing treatments are necessary.
Direct metal laser 20−35 μm Ti, Co, Al, Bronze High-strength products are manufactured. Manufactured pieces might be porous or have a rough surface depending on the Laser 50, 51
sintering (DMLS) alloy material used, which causes shrinkage and warping.
Steel
Stainless steel The final product is of high quality with accuracy.
Nickel alloy
Review

https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
in the printing ability and mechanical performances of pure
polymeric materials inspire researchers to increase the
potential characteristics of 3-D printable polymer blends.27
AM technology is not essential in dentistry but also plays a
significant role in the fabrication of many more devices such as
medical tools and scaffolds for tissue engineering, in
orthopedics, 3-D printed medical implants, and the automo-
tive, food, and aerospace industries as shown in Figure 2.28−35
3. THE AM PROCEDURE
AM comprises numerous paces, from the simulated CAD
description to the corporeal consequences. Distinct products
will be involved in AM techniques in different ways along with
assorted degrees. For example, small, comparatively simple
products can only make utilization of the AM approach for the
sake of visualization models, while more oversized, highly
complex products involve superior engineering content during
various stages and reiterations throughout the development
procedure.36 Additionally, primary stages for the product
development can require merely coarse portions, and AM was
used due to the speediness with which they could be designed
and constructed. After certain steps of the procedure, its
various components probably need a cautious dusting along
with post-processing which comprises polishing, surface
grounding, and painting prior to its use with AM being
worthwhile due to the intricacy which may be produced
without considering any tools. Thereafter, to examine the
various stages of the AM procedure, its various steps are
depicted in Figure 3. Herein, the following eight steps were
briefly discussed: (i) During the first step (CAD), all AM
fragments should begin from a specific and suitable software
replica that entirely defines the external shape of the object/
product. This can comprise the utility of nearly any specialized
CAD robust imaging software; however, the output should be
a 3-D solid object or superficial depiction. Moreover, a
converse engineering apparatus such as lasers with optical
scanning may be utilized to make such a type of representation.
(ii) Transformation to an STL file as close to every AM
machine receives the STL data structure that has established a
de facto benchmark. Almost each CAD/CAM technique may
have a data file. Such file format mainly elaborates the meshed
exterior surfaces of the unique and real CAD structure,
formulating the foundation for calculating the parts. (iii)
Transformation to an AM instrument and STL data manage-
ment: Herein, the STL file recognizing the slice should be
transported to the AM instrument. Additionally, there could be
few common manipulations of the data. Thus, it has confirmed
the accurate shape, size, alignment, and location for prosthesis
manufacture. (iv) Machine setup: Besides these steps, the
machine setup must be essential before further processing the
product/materials. Hence, the AM machine should be a
correct set of connections before the fabrication procedure
because such surroundings can correlate with optimizing the
construct parameters like material limitations, energy resour-
ces, thickness of the layers, content of the materials, time, etc.
(v) Build process: Among these steps, constructing the slice is
primarily an automatic procedure in which an instrument may
be able to mainly transfer on without observation. Merely
careful monitoring of an instrument is required to fix at that
time to confirm that there are not any faults comparable to
running out of materials, power- or computer-related software
glitches, etc. (vi) Elimination of the product: Once the AM
machine finishes the build, then the parts from a machine
3991
pubs.acs.org/journal/abseba Review
should be detached wisely. They may interact with the
machine with security interlocks to ascertain whether the
operating temperature is sufficiently low or there are not any
vigorously moving machine parts. (vii) Post-processing: As
soon as the product is detached from the machine, the various
fragments of the machine may need additional cleaning before
being used. Moreover, probably the fragments can be weak at
that time, or they can have supportive structures which should
be detached. This type of technique frequently needs time and
cautious, proficient guide skill. (viii) Applications: In this step,
the final product is ready to be used. Further, this final product
may also need additional treatment before being accepted. For
example, it involves preparation and cleaning to provide a
standard surface quality. Hence, handling can be arduous and
extensive when the necessities of finishing are too challenging.
Moreover, these finished parts must be brought together by
additional mechanical/automated constituents to formulate a
final object. Although various stages involved during the AM
procedure have been deliberated, this is imperative to
understand several AM techniques must be carefully
maintained. Still in several AM machines, a delicate laser
based skill is being used which may be cautiously examined; it
cannot be employed in a dirty or raucous environment.
However, most of the machines were fabricated to function
unattended. Indeed this is really significant to comprise a
systematic check within a prescribed maintenance period;
distinct approaches need diverse maintenance levels. Further, it
is also significant to observe that most of the materials fall
outside process standards during AM processes; elucidating
the current curiosity with the ASTM F42 Technical
Committee on AM techniques is employed to monitor and
deal with this type of complication. Conversely, maximum
machine dealers suggest and offer examination configurations
which may be utilized occasionally to validate that the various
pieces of equipment are functioning in the acceptance limits.
Besides the equipment, all the raw ingredients would need
cautious treatment. However, the raw ingredients utilized in
specific AM procedures have an inadequate service lifespan;
they need to be retained in such circumstances which inhibit
them from annoying chemical changes through various
reactions. Acquaintance to humidity, extra light, and other
pollutants must also be eluded. In the maximum processes, the
application of materials may be reprocessed for several
constructs. Nevertheless, recyclability may deteriorate the
performances if used frequently; consequently, a process for
keeping reliable raw material excellence over reprocessing can
be perceived.
4. TYPES OF THE AM TECHNIQUES
Several technologies have been reported by the researchers and
discussed in brief. The various potential parameters of all AM
technologies are listed in Table 1.
4.1. Stereolithography (SLA). SLA is the first accessible
(commercially) 3-D printing technique. Such a quick synthesis
technique contains photoconvinced polymerization to produce
layered structures by utilizing extremely cross-linked poly-
mers.52 Based on the kind of platform motion and laser
motion, this technique can be sectioned into diverse categories.
In such categories, fabrication succeeds via 3 main stages,
namely exposure of the laser light, motion of the platform, and
resin replenishing. SLA is a typical illustration of an AM
technique, that operates to manufacture a model using a layer-
by-layer concept. 3-D digitized models could be utilized like a
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering pubs.acs.org/journal/abseba Review

Figure 4. Techniques of additive manufacturing: (a) Stereolithography.64 Reproduced with permission from ref 64. Copyright 2012 Hindawi. (b−
e) 3-D printed scaffolds of bioceramic materials such as (b, c) HAp scaffolds62,76 (Reproduced with permission from ref 62. Copyright 2022 Wiley
Online Library. Reproduced with permission from ref 76. Copyright 2008 Springer.), (d) CP77 (Reproduced with permission from ref 77.
Copyright 2013 Elsevier.), and (e) PCL/TCP for bone regeneration applications83 (Reproduced with permission from ref 83. Copyright 2019
Jstage.). (f) Selective laser sintering.126 Reproduced with permission from ref 126. Copyright 2016 Yadda.

prototype for manufacturing development, which dictates a
SLA technique to build a comprehensive printed article.
Herein, all layers of the materials are linked together when
coverage of the resin is to ultraviolet (UV) radiation that
persuades free radical polymerization (FRP) with respect to
monomers of the resin. When a single layer is polymerized, the
resin podium drops through a space which is equivalent to the
thickness of a single layer and constructs the subsequent layer
until the printing of a digitized 3-D article was finalized.53 The
finished way of the processing may be overwhelmed via
combining SLA along with incessant liquid interface
fabrication. Later a whole process of 3-D printing uses
photopolymerization to generate a smooth solid object.54,55
Several variables like the intensity of light source, scanning
speed, and content of resin monomers and photomotivators
could be regulated to obtain preferred modeling kinetics and
performances of an ultimate manufactured object.56 Presently,
SLA is employed in fabrication of momentary and stable
crowns and bridges, momentary implants, medical (invasive)
guides, and prototypes, including dental models.57 Moreover,
SLA accommodates tractability in design, complex geometrical
shapes, and their scaling, resulting in extremely precise
modified devices. Great accuracy dimensions recovered from
patient scanned data allow the fabrication of consistent uses for
an extended period.58 Nevertheless, cell viability of the 3-D
printed appliances can be initiated via the filtering of the
remaining unreacted resin monomers as of a fabricated
product, which can distress the durability of the product.
SLA is a prompt, appropriate, and multifunctional process in
the zone of 3-D dental printing which is demonstrated in
Figure 4(a).
3992
It has been demonstrated to have higher clinical precision
over the rest of the techniques for reliable construction of
dental stone casts; the 3-D printing technique signifies an
adequate substitute for treatment, dealing, along with
construction of dental devices.59 But SLA-fabricated products
for dentistry agonize from feeble mechanical characteristics
produced through an inadequate selection of resin materials
which have to photopolymerize.60 However, inclusion of
nanoparticles within a polymer matrix significantly increases
the mechanical properties.61 Additional coupling mediators
like ceramic fillers prevent the 3-D printed product from
rupture by raising the stress distribution throughout the
structures. Even a few antimicrobial mediators were substituted
into the resin polymers to address the concern about microbial
settlement of different oral devices. Baino et al. and his co-
workers have reported the fabrication of hydroxyapatite (HAp)
based scaffolds analogous to bone-like architecture using the
SLA technique.62 By using this technique they successfully
developed the foam-like HAp scaffolds by employing 3-D
microtomographic restorations of polymer sponges by way of
simulated models for fabricating development (Figure 4(b)).
Moreover, the layer-by-layer building technique comprises a
specific polymerization of PMMA (photocurable) in which
HAp nanoparticles are uniformly distributed. Irradiation was
carried out using a dynamic mask to produce a blue light on
the prepared slurry. To fabricate highly porous HAp scaffolds
having pore size in the range of 100−800 μm, sintering was
performed at 1300 °C for 99 h. In this way, a 3-D open-cell
structure of a fabricated polymeric framework and cancellous
bone was achieved successfully. For the sake of compressive
strength of the scaffolds, mechanical investigations were carried
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
out, and the following distinct values were found: compressive
strength ∼1.60 MPa; elastic modulus ∼513 MPa including
Weibull modulus (m ∼ 2.20). Hence, the SLA technique
displays unlimited potential for the manufacturing of highly
spongy bioceramic scaffolds.62 Putlyaev et al. studied 3-D
ceramic scaffolds of complex form and structure using SLA for
bone tissue restoration applications.63 They proposed that the
heating of printed prototypes makes it promising to develop
bioceramic scaffolds having a lateral resolution of 50 μm
layering. SLA produced many applications in maxillofacial
prosthodontics such as fabrication of auricular, nasal
prosthesis, surgical stents for patients along with large tumors
planned for removal of obturators etc.
4.2. Powder Based Technologies. In powder based
techniques, a single layer of fine particles is usually employed
on a platform, and then a high-energy source (thermal) such as
an electron/laser beam bonds the powder before a second
layer is formed using a roller/blade; such a layering procedure
is repeated. Consequently, herein, four kinds of powder-
founded 3-D printing methods were considered, specifically,
the 3-DP, selective laser sintering (SLS), selective laser melting
(SLM), and direct metal laser sintering (DMLS) techniques.
The previous technique employs print heads, particularly jet
liquid binder (JLB), tiny drops in contact with powders, while
the rest apply the energy of a laser beam to select the sintering
or melting of the powders. Herein, it is necessary to know the
major differences between “3-DP” and “3-D printings”. The “3-
DP” technique is engaged in the distinct 3-D printing method
for historic motives, although “3-D printing” is a very common
term demonstrating the assembly of AM technologies.
Moreover, the 3-DP technique was applied to manufacture
intricate dosage systems of distinct dimensions, shapes, dose
deviations, and dose arrangements including discharge
features, which are not conceivable to produce using traditional
manufacturing techniques.
4.2.1. Three-Dimensional Printing (3-DP). The 3-DP
technique was first established by Sachs and his co-workers
at MIT, USA, in 1993.65 However, the 3-DP technique
probably is deliberated as an unintended ceramic ink jet
printing (IJP) method. Its characteristic feature is the usage of
powder beds; that is why the 3-DP technique is designated as a
powder based method in the present review article. In the 3-
DP process, an organic solution as a binder was used in the
form of droplets which are sprayed via print heads onto the
surface of a powder bed (selected regions). Moreover, solid
layers are made using solidification of an infusing binder, the
liquid that enfolds the powder. Further, a new layer of the fine
powder was also delivered, spreading on an aforementioned
layer, with recurrence of the construction procedure until the
required object is manufactured. Thereafter, loose powder is
eliminated to expose the fabricated object. In order to achieve
a higher green density, the powder can be deposited in both
dry as well as wet states using a liquid vehicle.66,67
Nevertheless, the amount of the liquid should be vaporized
prior to the inkjet process of a binder material. Herein, all
preferred properties, like functional rheological characteristics,
must be fulfilled for the used binder solution, which is
effectively evicted via print heads. To remove the organic
binder from the material, sintering must be required, which
produces the desired mechanical properties. The 3-DP
technique was initially considered for the fast production of
the components by using a greater variety of materials than
that of the other remaining AM techniques like SLA, SLS,
3993
pubs.acs.org/journal/abseba Review
laminated object manufacturing (LOM), etc.65 Various raw
resources of materials like ceramics,68 metals/alloys,69 and
polymers70 in powder form or their combinations71 can be
used. For ceramics fabrication, the 3-DP technique was first
started in the 1990s by using Al2O3 and SiC powders including
a colloidal silica which acts as a binder.68 One of the significant
applications is manufacturing of ceramic mold shells including
cores for casting metals.72 Moreover, this technique was also
used to construct structural parts of the sizes of a few meters as
disclosed by Cesaretti et al.73 Recently, the 3-DP technique
also can be used for other viable applications due to its
significant flexibility along with the material and geometrical
dimensions.74 Besides these applications, numerous promising
investigations were carried out in the area of dentistry such as
fabrication of components for dental restoration, partial
denture frameworks, crowns, coping, and tissue engineering.
3-D fabricated prototypes for the production of “aligners”
gradually reposition the teeth for a time span of months or
years.75
Highly biocompatible ceramic materials such as HAp,76
calcium phosphates (CPs),77 and tricalcium phosphate
(TCP)78 are frequently utilized in 3-DP to build the scaffolds
and bones for implantations. However, their composites with
other biocompatible materials like SrCO3, ZrO2, MgO, La2O3
and TiC play a significant role with enhanced mechanical and
biological performances for various biomedical applica-
tions.79−82
Typical scaffolds of HAp,76 CP,77 and TCP/PLC83 are
printed successfully and shown in Figure 4(c−e), which reveals
the morphology of a rough resolution. 76,77 Recently,
comprehensive studies were carried out on several aspects,
such as powders of the ceramics, including binder perform-
ances, binder to powder bed interface, and processing
parameters. Porosities are the major concern, usually greater
for those parts which are fabricated using a 3-DP process in
comparison to the other AM techniques like SLS and SLM.84
Therefore, the porosities appear beneficial for the scaffold
applications, which are detrimental during the high perform-
ance of the typically fully dense ceramics. Moreover, hitches in
printing highly dense ceramics may restrict the use of the 3-DP
technique. Further, numerous efforts were carried out to
reduce the density restriction by using additional precautions
during post-processing.85
4.2.2. Selective Laser Sintering (SLS) Technique. The SLS
technique was discovered by Deckard and his co-worker
Beaman at University of Texas, USA,86 and further established
by a DTM company that was obtained via 3-D System in 2001.
SLS is a system in which a highly energetic laser beam is
deployed to persuade blending of the fine powdered materials;
a laser beam generates a dense layer out of the powder. For a
laser beam that sinters the subsequent layer of powder, the
platform has to be lowered to create the space. Such
techniques of structure formation do not involve any extra
material aid during printing since support is already delivered
by the surrounding powder itself.87 Numerous scientific
operations like multifunctional training prototypes and
instructions for piercing and cutting, including metallic
structures, would be performed with the help of this technique.
Now major rewards with this technique are the utilization of
autoclavable constituents, the power-driven performance of a
fabricated or printed product, and a decrease in the
manufacturing price plus a rise in manufacturing capacity.
However, limitations of the SLS printing method are
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
represented as the healthiness hazard concomitant along with
breathing of the used raw chemicals in the form of powders,
the preliminary large price in establishment, and the require-
ment for additional deliveries for example pressurized air for
accurate working of this technique.88−90 Herein, the main
purpose of a laser beam is to raise the powder temperature
adjacent to it. However, it does not increase its sintering
temperature. Such sintering methods transform the concrete
potential within the semiliquid state. The base that the initial
layer is placed on reposes it lower by around 0.1 mm, allowing
the laser room to sinter a fresh layer of powder. Here, sintering
and fusing are done in steps that should be continued until the
product is completely printed. Thereafter, the product is kept
to cool down after printing is completed.91
An additional gain of this method is the approximate
consumption inclination of a printed product. Although
conventional printing methods need an additional sanding
stage or further arrangements of finishing before the produced
product is usable, the SLS approach typically does not require
such a step. For the reason that SLS imprinters do not need
any structural aid during printing, the operational interval is
substantially faster as equated with SLA and fused deposition
modeling (FDM).92−94 Three different SLS printing meth-
ods�based on metals, ceramics, and polymers�are presented
here. Fine metal powders were employed in the metal based
SLS technology, whereas fine-grained thermoplastic polymers
were the raw material in the polymer based SLS approach.
Moreover, in the metal based SLS technique, numerous
metallic powders may be used e.g. stainless steel (SS) alloys
such as 316, 304L, 309, and 174, including Ti alloy 6AI-4V.
Recently, metallic materials comprising SS, Co-Cr alloys, Ti,
and Ti alloys are bioactive, are compatible, and can be utilized
for numerous dental applications.95 Further, during the 1920s,
SS alloys were generally used owing to their outstanding
performances for erosion protection, improved mechanical
strength, and low cost.96 SS 316 and SS 316 with less carbon
(LC) amount are extremely used SS alloys in the large area of
maxillofacial restoration.97 Such alloys comprise Cr, Mo, and
Ni resilient corrosion resistance.98 Nevertheless, SS alloys are
not that appropriate with respect to the fabrication of long-
lasting implants owing to their lower mechanical perform-
ances.99 Further, during the 1930s, alloys of Co-Cr, owning to
their superior bioactivity, wear resistance, and greater hardness
as compared to SS 316, were used fruitfully in orthodontics
and prosthodontics100 while Ti and Ti alloys have the benefits
of low density, appreciable precision, high mechanical strength,
and excellent biocompatibility. The porous Ti and Ti alloys
were also effectively exploited in various dental applications
later toward the end of the 1960s.101 Moreover, they are
observed as a perfect 3-D-printing metallic material102 and are
widely being used, particularly for oral and maxillofacial
restoration103 and the fabrication of dental implants.104 So due
to some defects in pure Ti, e.g., the mechanical toughness of
pure Ti is not as high as compared to Ti alloys, the elastic
properties of undoped Ti are greater as compared to the bone
tissues, which could simply lead to irreconcilable mechanical
strength between the Ti implant and bone. Several attempts
were made by researchers to increase the performances of pure
Ti, such as the addition of a coating onto the surface or
oxidation of a pure Ti surface.105−107 There is no stochastic
geometry of Ti with an intermittent recurrence of the lattice
structures displaying enhanced mechanical performances and
improved osseointegration.108 Traini et al. fabricated a gradient
3994
pubs.acs.org/journal/abseba Review
of Ti-6 Al-4 vanadium (Ti6Al-4V) alloys for permeable dental
graft applications, that leads to extra improved physical as well
as biochemical performances. Herein, the tensile strength, unit
contraction, along with elongation are up to AMs4999
(standards on 3-D-fabricated Ti alloys offered by ASTM).109
The elastic modulus of the sintered Ti core is analogous to that
of the machined Ti, whereas the elastic modulus of the porous
layer on the surface of this laser sintered Ti alloy implant is
decreased; therefore, it is analogous to that of a cortical bone.
Hence, it is advantageous for long-term constancy of the
implants.109 Subsequently, heat treatment was performed; the
mechanical strength of Ti-6Al-4V may be improved up to 50%
without losing its Young’s modulus.110 Apart from a standard
Ti-6Al-4V alloy being printed, also the next generation of Ti
alloys, for example Ti-12Mo-6Zr-2Fe, Ti-15Mo5Zr-3Al, To-
13Nb-13Zr, and Ti-15Sn-4Nb-2Ta-0.2Pd, was successfully
fabricated for various printing in biomedical uses.111 These
Ti alloys comprising Nb, Ta, and Zr (β stabilizing elements)
exhibited small moduli of elasticity along with extra toxicity of
the Al or V.112 Therefore, it is possible that the metallic
implants could be manufactured via the AM techniques that
are based on powder bed fusion procedures. Further, several
heat treatment methods were reported. The most recognized
methods are SLS, SLM, and electron beam melting (EBM)
that relied on local fusion of the metallic particles to form a
solid object.113 Moreover, the metal powders utilized in AM
technology were essential to be spherical which exhibit a severe
elemental size distribution to attain a desired packing
density.95 When equated with molding and grinding methods,
the SLS-manufactured Co-Cr-Mo alloys show superior
mechanical performances and small suspension of the metallic
ions.114 Further, the porous architecture of metal alloys that
was fabricated using the AM process supports to balance the
stiffness of the graft with the human bone.115 Consequently,
the stress protection influence could be addressed. Addition-
ally, the porousness also helps to grow the bone cells,
generating solid osseointegration between bone and im-
plant.116 The characteristics of the printed metal materials
change across the printing methods. For instance, Ti-6Al-4V
printed through SLS displays α-martensitic morphology, while
Ti-6Al-4V printed by EBM displays a needle-like α+β Widman
Staten morphology.117 The mechanical performances of SLS-
printed Ti-6Al-4V alloys are anisotropic and entirely discrepant
from the isotropic mechanical characteristics of EBM-printed
alloys of Ti-6Al-4V. Besides, the remaining stresses and
porosity of a SLS-printed Ti-6Al-4V are found to be larger in
comparison to EBM-printed Ti-6Al-4V.117 A unique step
worth revealing is a post-AM heat and surface treatment. Such
AM porous metallic materials acquire developed surface
morphology and mechanical performance.118,119 Moreover,
hot isostatic pressing, associated with high temperature and
high pressure, could be employed to near the resonant
imperfections created during the AM procedure.118,120
Eventually, to obtain the finished product, sand blasting,
including chemical etching, was carried out to eliminate
unmolten powders, hence enhancing the surface characteristics
of AM fabricated porous implants before their use in
vivo.118,120 Unlike the polymer based SLS technique, that
could not comprise a gas injection process, metal based SLS
needs a defensive gas to be flooded into a printing
compartment to evade oxidation of the metallic powders
during sintering at high temperatures.121 Additionally, the SLS
technique was used for the construction of different ceramic
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
Figure 5. (a−b) Schematic diagrams of (a) SLM and (b) Micro SLM systems developed by SIM Tech. (c) Numerous structures manufactured by
micro SLM.131 Reproduced with permission from ref 131. Copyright 2019 Elsevier.
products.122 Subsequently, the ceramic powders required an
applicable contact time for the anticipated density outcome
and hence the temperature of the target material should be
depressed to expedite the densification. Herein, the individual
solution was mixed with other constituents such as organic
(polymers)/inorganic (metal based low-melting materials and
glasses) composites, which act as a binder for the ceramic
powder materials. So, binders melt within the powder bed
surface and generate an adequate bonding glass phase
surrounding the ceramic particles. Further, such binders are
stronger with respect to differences of temperature. To inhibit
the oxidation of binder materials, an inert atmosphere is
compulsory. However, the content of the organic materials can
be evaporated during firing at high temperature, although the
inorganic content remains constant.123 Also an isostatic
pressing associated with this method considerably improves
the mechanical performances of ceramic objects via optimizing
the density.124 Nevertheless, there are numerous hassles to
synthesizing the ceramic objects with the desired optimum
mechanical properties. For example, deposition of the powder,
the interface between the laser and the particles of the raw
materials, the melting mechanism, and its amalgamation,
including thermal as well as residual stresses, are the main
hassles.125−127 The entire set up of this technique is presented
in Figure 4(f).
3995
pubs.acs.org/journal/abseba Review
Copious metals and their alloys exist well. However, some
are safe/nontoxic to implant into the patient. As concerned
with biomedical applications, metal products are essential to
produce adequate mechanical performances, good cell viability,
and corrosion resistance properties.50 Moreover, the bio-
compatibility of the metal substances promises the preferred
function of a material without injurious indigenous or
synergetic effects on the adjacent tissues.
4.2.3. Selective Laser Melting (SLM) Technique. The SLM
technique was invented in Germany in 1996 to promote Laser
Technology (ILT).128 Later, a patent was filed in the USA in
1997.129 This technique works in nearly the same manner as
SLS excluding that it is a time saving, single stage powder bed
fusion through complete melting, that utilizes a source of laser
including plentiful greater energy densities without any need
for low-melting powders as a binder. Therefore, SLM can
generate almost entirely compact and homogeneous products
due to its adequate capability to completely melt the powder to
form a liquid phase, confirming prompt solidification, as an
alternative to heat treating the fine powder to a certain point at
which its particles are partly liquefied and then bonded
together as in the SLS technique. Moreover, this technique was
initially invented to build solid fragments from metallic
powders such as Al, Cu, and SS and is currently extended to
progressively use innovative alloys, mainly for the fabrication of
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering pubs.acs.org/journal/abseba Review

Figure 6. (a) ZrO2 objects produced by the SLM technique. (b−d) Surface morphology of the sintered ZrO2 product showing: (b) clearly
observed cracks, (c) large size open pores134 (Reproduced with permission from ref 134. Copyright 2007 Elsevier.), and (d) the microstructure of
the ZrO2-Y2O3 ceramic sample recorded at 60 W and preheating temperatures at 2000 °C.136 (Reproduced with permission from ref 136.
Copyright 2015 Elsevier.). (f−h) Pure zirconia 3-D substances fabricated by SLS/SLM technology: (e) CAD design, (f) real fabricated part, (g)
ZrO2 cube with 56% density, and (h) top view of open porosity.137 Reproduced with permission from ref 137. Copyright 2007 Elsevier. (i) ZrO2-
Al2O3 frameworks for dental restoration applications.145 Reproduced with permission from ref 145. Copyright 2013 Emerald Group Publishing
Limited.

lightweight products for significant applications in aerospace
engineering.130 Besides that, robust functional and regular
parts can be manufactured by the SLM technique along with
minor porosity and higher stability over the crystalline
structure. A graphic illustration of the SLM technique is
depicted in Figure 5(a). However, Figure 5(b) shows the in-
house micro SLM technique which is decorated by a fine laser
spot including a unique powder recoating arrangement that has
the capability to control the fine powders. Numerous attempts
were carried out to authenticate the system with the help of a
variable laser power source, scanning approach, scanning
speed, and devising density. Figure 5(c) displays several
features which were manufactured by employing the micro
SLM technique131 Additionally, SLM is one of the extremely
fast developing 3-D printing methods, predominantly in the
field of metals forming. This is primarily determinable to its
capability to build robust and strong metallic fragments in a
well-defined single step manner, wherever the ultimate shape
and finishing of the products could be achieved concomitantly.
However, use of the SLM technique with a ceramic powder
3996
comprises complete diffusion/melting of the powder to
construct a dense fragment using a powerful laser beam
layer-by-layer. Consequently, intricate fragments along with
high purity, high density, and adequate strength are anticipated
to be formed instantly. SLM is only a 3-D printing technique
which provides the opportunity of constructing ready-made
ceramic products with comparable density, exceptionally high
mechanical strength, and intricate net shape from the ceramic
powders within a single step. The entire excellence of a SLM
manufactured ceramic product is affected by numerous issues
like feedstock performances, process parameters, production
position including its orientation, the physicochemical
characteristics of the interface during the building procedure,
and the interaction of the source of energy with materials.
Herein, the most significant manufacturing parameter is the
thickness of the product/slice that may affect the time of the
production and the roughness of the surface of the product.
The product thickness depends on the depth of fusion,
analogous to the depth penetration during the SL procedure.
The SLM process of ceramics is very challenging in
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
comparison to metals and other alloy materials; therefore,
more improvement was needed in the application to the
ceramic field. Difficulties such as balling outcome can arise
with an inadequate energy feedback, while extreme content of
the energy may cause spraying of the powders.132 Nevertheless,
direct melting contains enormously high temperature contact
between the laser beam and powder; herein, a shorter
interaction period may lead to high temperature gradients in
the minor dimensions of the material. One more substantial
problem arising during the SLM process is the thermal stress
produced through the enormously short time laser to powder
interaction.133 Owing to such thermal stress, numerous cracks
and distortions are produced within the sintered objects which
obviously have inadequate resistance with respect to thermal
shock. Shishkovsky et al. and Zhang et al.134,135 described the
manufacturing of ZrO2 (Figure 6(a)) and ZrO2-Y2O3 products
by using a SLM process, whereas different imperfections like
flaws/cracks136 and bulk open pores were observed (Figure
6(b−d)).
Further, Bertrand et al.137 revealed the SLM process of pure
powders of ZrO2-Y2O3. Herein, constructed products exhibited
less density of the order of 56% and could not attain any
enhancement through additional heating of the material. The
prepared fragment is shown in Figure 6(f−h), including a SEM
image which shows the high porosity. Moreover, the coarse
surface polish and porosity is obvious. However, Deckers et
al.138 manufactured Al2O3 objects by employing an SLM
technique and achieved density ∼85%. Herein, the high
content of the remaining porosity was recognized as the
inadequate melting of the Al2O3 for the period of the laser
scanning, while all desired limitations were precisely elevated.
Moreover, numerous improved 3-D printing approaches
produced using the SLM process have been revealed to be
skilled in manufacturing ceramic artifacts, for example the
slurry based SLM process139,140 including laser engineered net
shaping (LENS).141,142 To enhance the bed of powder
compactness for the SLM technique, and hence so the
shortcomings of less sintered density and cracks can be
stopped, additional methods of powder filling were established
rather than the deposition of dry powder. Herein, only the
slurry method seems proficient and contains the benefit of an
extra uniform and dense nature. In the LENS technique, the
powder feedstock was settled coaxially with respect to the
selected laser spot zone as the laser beam changed; thus, the
molten pool was shaped instantly.143 Dense Al2O3 cylinders,
cubes, and gears are built effectively by Bella et al. through the
LENS technique, which shows an anisotropy of the achieved
mechanical properties.142 Further, entire heat treatment failure
modifies the mechanical strength as well as anisotropy;
however it enhances the size of the grains from 6 to 200
μm. Several cracks were produced laterally to the columnar
grain boundaries while a tensile load was employed. Niu et al.
have reported fully dense shaped Al2O3-YSZ artifacts along
with fine grained surface morphology using the LENS
process.144 The obtained mechanical properties were similar
to those fabricated using a customary directional solidification
approach. Nevertheless, the quality of the surface and its
dimensional precision are still inadequate. Herein, optimization
of the processing constraints is merely supposed to have a
slight influence on the vindication of such temperature
gradients. To manufacture ceramic fragments along with
extremely fine, well interconnected, and uniform surface
morphology, Wilkes et al.145,146 used a SLM technique to
3997
pubs.acs.org/journal/abseba Review
produce ceramic objects for potential applications in dental
renovations established on the consumption of eutectic
combinations of highly pure ZrO2 plus Al2O3 fine powders.
Herein, induced cracks were eliminated using a CO2 laser to
heat the powder layers at ∼1700 °C, which provides fully
developed dense artifacts having a flexural strength of >500
MPa including a poor surface quality. The prepared ceramic
body (frameworks for dental restorations) is shown in Figure
6(i). Recently, the resolution along with the rough surface of
ceramics fabricated via the SLM technique were significantly
enhanced by the amended process, designated as laser
microsintering (LMS),147,148 which is based on the uses of
submicron ordered powder and a solid-state laser (Q-
switched) operated in a near-infrared region and decorated
with a wavelength of order 1 mm. More recently, Pal et al. have
studied the best fabricating alignment of Co-Cr-W-Si alloy
using the SLM process for dental prosthetic applications.149
They are able to reduce the porosity and enhance the
mechanical strength including the ductility of the fabricated
alloy. The relative density of 100% for cubic samples and yield
strength (YS), ultimate tensile strength (UTS), and elongation
in the tensile mode of the sample of 900 MPa, 1200 MPa, and
15% were achieved in the sample fabricated in the Z-direction
utilizing the laser power source of 60 W with scanning speed @
450 mm/s. Further, Pirinu and his co-workers studied the
mechanical performances of AlSi10Mg lattice based structures
fabricated by employing the SLM process.150 In this study,
they observed the effect of the cell geometry, size of cells, and
diameter of the beam on the deformation and failure nature of
numerous SLM-built alloy AlSi10Mg architectures under
compressive load. SLM is primarily attributed to the formation
of numerous defects like a rough surface, porous morphology,
less control over the dimensions of the product, and
compactness to a nonporous, isotropic ceramic artifact that
is really difficult to produce. Consequently, further accomplish-
ments are essential to increase the material properties and
synthesis methods, including post-processing, to make defect-
free, highly correct, and completely compact ceramic frag-
ments.
4.2.4. Direct Metal Laser Sintering (DMLS) Technique.
DMLS is an advanced and vigorous AM technique for 3-D
printing of metal, and it is the most extensively utilized
technique owing to the precision in the structural geometry, its
cost-effectiveness, and its capability to produce fragments near
to the exact size and shape of the final artifact.151 DMLS has
previously been applied in medical fields such as orthopedics
and dentistry.151−154 In this method, the metal powder,
comprising 20 μm in diameter, free of fluxing agent or binder,
is entirely liquefied (melting) by scanning a high power laser
beam. The subsequent fragment has performances similar to
the real material. DMLS does not involve the polymer as a
binder or burnoff or infiltration stages, and it yields 95%
compact steel products as equated to approximately 70% of the
SLS technique. Another advantage of DMLS in contrast to SLS
is the greater feature resolution owing to the usage of thinner
layers, allowed by the consumption of reduced powder
(diameter ∼20 μm). The most commonly used materials are
alloy steel, stainless steel, tool steel, Al, bronze, Co-Cr, and Ti.
Besides the production of functional models, DMLS is
frequently used in the fabrication of fast tooling, implants for
dentistry, and high-heat applications in the aerospace industry.
A schematic diagram of this technique is demonstrated in
Figure 7(a).155
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
Figure 7. Schematic diagram of additive manufacturing techniques: (a) Direct metal laser sintering.155 Reproduced with permission from ref 155.
Copyright 2019 Elsevier. (b) Fused deposition modeling.64 Reproduced with permission from ref 64. Copyright 2012 Hindawi.
4.3. Fused Deposition Modeling (FDM) Printing
Technique. The FDM technique is also recognized as a
fused filament fabrication (FFF) technique, which is the
trademark designation for the polymers’ and composites/
metallic alloys’ softening procedure which was developed
about 20 years back. Moreover, this second, frequently utilized
3-D printing technique is shown in Figure 7(b).64 Primarily, it
is an inexpensive technique among all the available AM
techniques.156 This technique is based on the instructions of
strands’ extrusion for which the preferred sort of thermoplastic
constituents are molded as strands and brought to the
extruder. During heating, the warm and highly viscid plastic
material was deposited using an extrusion head, producing a
layer-by-layer 3-D structure of a digitized prototypic.157,158 In
contrast to the SLA technique, separate layers inside the
product decrease the bonding, and hence, the final artifact
exhibits superior anisotropy. Various thermoplastic polymers
along with their composites like acrylonitrile-butadiene-styrene
(ABS), polycarbonates, and polysulfones, including metallic
alloys like bronze metal filaments, which melts at low
temperature, were the utmost commonly active FDM
filaments.159,160 Moreover, to fabricate the composite filament
the polymers can be filled with an adequate doping of metal
nanoparticles for the enhancement of various features, like
mechanical and internal resistance characteristics. Mechanical
characteristics in the process FDM could be affected
significantly through various groups of issues such as print
material and structural parameters and synthesis limitations
such as extrusion temperature and rate, layer deposition time,
transverse speed of the nozzle, and temperature of the bed.159
Owing to the feeble mechanical performances of unoccupied
thermoplastics, the FDM technique is utilized merely for the
construction of crowns and bridges (temporary). Similar to the
SLA technique, this process originates by the attainment of
CAD images. The FDM is the technology employed in the
maximum cost-effectiveness household 3-D printers. It permits
the printing of rudimentary structural models without
intricacy. While the final artifact is brittle in nature and
comprises coarse surfaces, the FDM is less expensive than the
other 3-D printing methods. Moreover, this technique is being
frequently utilized in machines with less care/maintenance and
in technical investigations.161 In current years, 3-D polymer
printing (PP) played a crucial role in many areas of research
and therefore in transformations to fabricated products,
particularly in medical arenas.162−165 PP is really advantageous
3998
pubs.acs.org/journal/abseba Review
for various medical fields, and it helps from the multiplicity of
the polymers’ performances and their fabrication meth-
ods.166−169 For instance, the numerous structures of tissue
scaffolds manufactured using a polyjet and stereolithography
printing approaches can attain ordered products and mimic
natural bone, producing a mechanical and biological location
on which to sustain tissue formation.170,171 Furthermore,
selection of the polymer materials has numerous advantages
over metal printing methods, which result in metal transplants
which could not deteriorate inside a human body and proceed
to mechanical concerns like stress protection.172 In concern to
the safety instruments, the PP matrices accomplish effective
energy absorption through a quick manufacturing procedure
which avoids the supply series boundaries of bulk engineer-
ing.173,174 Moreover, PP is quite promising via extrusion, resin,
and powder 3-D printing methods which offer flexibility for the
raw material choice and also backup designs with miscella-
neous architectures, retorts, and outlines.175,176 Thus, polymers
become an elementary developed printing medium measurable
in the domain of 3-D printing. Because of dentistry, there are
numerous polymeric materials, namely polylactic acid (PLA),
polycaprolactone (PCL), and polyetheretherketone (PEEK),
which are comparatively collective 3-D printing materials. So,
3-D printed polymer materials are utilized in the shape of
crowns and bridges for temporary and static dental
implantation. Hence, the prepared crowns and bridges deliver
a lower volume of inner inconsistencies although they also give
a perfect occlusal fit for dentistry.177 Earlier, metal con-
structions have been used as detachable denture modules and
frameworks; however, lately, the PEEK polymer has been
substituted by metals owing to their superior mechanical
resistance including adequate biocompatibility.178 Recently,
Arun et al. have fabricated and effectively fixed a 3-D printed
polymer tooth in a patient.179 The tooth was being tailored to
a patient and delivered the additional benefits of high
eminence and lower price.
Based on 3-D printing, high-density polyethylene (HDPE)
or polypropylene has been implemented successfully for bone
recovery to bone fractured patients.180 Moreover, PLA is an
ecologically approachable material with excellent biodegrad-
ability. It could be fully ruined via microbes in nature
underneath peculiar circumstances and ultimately produce
CO2 and H2O, which could not have been polluted and are
beneficial for the environment. It has transparency and gloss
consistency, making it a perfect candidate for a 3-D printing
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering pubs.acs.org/journal/abseba Review

Figure 8. Figures showing Metals � (a) Stainless steel,182 (b) Titanium implant183 (Reproduced with permission from ref 183. Copyright 2018
IJSRMME.), and (c) Cobalt chromium alloy.184 Ceramic � (d) Zirconia185 and (e) Alumina.186 Polymer � (f) Polylactic acid.187 (Reproduced
with permission from ref 187. Copyright 2021 Jstage.), (g) Polycaprolactone.188

method in the branch of dentistry. Further, a 3-D printing
scaffold employed a blend of PCL along with gelatin which has
greater mechanical flexibility and smoothness that may be
appropriate in lieu of a soft tissue architecture like rhinoplasty.
Human adipose-generated stem cells were also cultured on
that scaffold and exhibited improved cartilage differentiation
and tissue development.181 Some metals, ceramics, and
polymers were commonly used and are depicted in Figure
8.182−188
4.4. Polyjet 3-D Printing (PJP) Technique. A photo-
polymerizable polymer and a dynamic printing head are the
two components of the PJP technology. An inkjet-style
printing top is used here to jet the receptive polymer material
to a construction platform where it is preserved layer-by-layer
on a decreasing platform.189 Also a supportive building was
printed using a delicate backing material for its comfortable
elimination. A vast variety of materials, including resins and
waxes for molding, can now be printed thanks to this
3999
technology. Additionally, silicone-like rubber materials may
be employed as well to print intricate, multifaceted products
with a 16 μm resolution. Hence, the finally printed objects are
probably utilized in dentistry as crown/anatomical training
models. An additional benefit of the PJP printing method is
that implantation drill instructions could be printed promptly
and frugally with superiority. The 3-D jet printers exploit
manifold printing tops to shield the operational platform.190,191
As a result, the printer’s head and its operating platform move
independently in both directions. Thereafter, a source of UV
light was employed to strengthen each and every layer of the
resin/wax which has to be jetted. The main advantages of the
PJP technique were speedy manufacturing, surface sleekness,
and cost effectiveness. However, the major disadvantages
include trouble in eradicating material entirely, owing to strong
assistance, skin annoyance, and incapability to be warm-
sterilized, and costly materials. A schematic diagram of this
technique is depicted in Figure 9(a).192
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering pubs.acs.org/journal/abseba Review

Figure 9. Numerous techniques of additive manufacturing: (a) Polyjet 3-D printing.192 Reproduced with permission from ref 192. Copyright 2017
MATEC Web of Conferences. (b) Inkjet 3-D printing.193 Reproduced with permission from ref 193. Copyright 2019 Springer. (c) Laminated
Object Manufacturing.240 Reproduced with permission from ref 240. Copyright 2019 Springer. (d) Color-Jet-Printing.245 Reproduced with
permission from ref 245. Copyright 2016 Synapse. (e) Electron Beam Melting.246 Reproduced with permission from ref 246. Copyright 2014
American Society of Mechanical Engineers. (f) Multi-Jet printing.249

4.5. Inkjet 3-D Printing (IJP). This is a “non-contact”
printing method which make use of an electromagnetic (EM),
thermal, or piezoelectric (PZ) epoch to accumulate miniscule
drops of the ink including actual ink or diverse materials on the
surface of a substratum in a step using simulated guidelines. In
this technique, drop accumulation was usually achieved by a
procedure of warming or mechanical compression to expel the
ink droplets (Figure 9(b)).193 In thermal inkjet (TIJ) printers,
during heating of a print head, tiny air bubbles are produced
which get collapsed, generating strain pulsates which expel ink
drops from jets (nozzles) between the size range of 10−150
picoliters. Herein, the length of the droplets can differ by
regulating the temperature gradient, the frequency of the pulse,
and the viscosity of the ink. Furthermore, a subordinate profile
structure is placed in a fragile assistance material. This period
suggested the valuation of ∼16 μm and deals with the exact
admittance for fabrication of the complex and acceptable
different products. Particularly, potential applications for TIJ
printers include tissue production and the field of recreating
4000
medicine. This method is currently being approved to readily
print 2-D and 3-D tissues (bioprinting) and organs due to its
computer-generated accuracy, control, flexibility, and sympa-
thetic effect on the cells of mammals. Moreover, this technique
can also exhibit distinct novel usages, which comprise drug
distribution and gene transfection all over tissue fabrication.
Hence, it is advantageous in printing of anatomy or tooth
instructional prototypes. Implant drill instructions could be
rapid and inexpensively created which are greatly less massive.
The 3-D jet printer may additionally utilize a solitary print top,
similar to a computer printer, or multiple heads to shelter the
platform’s breadth. Either way, the print top moves through
the operative platform. Usually, a UV lamp or other light
source was employed to strengthen the resin/wax after each
and every layer was nicely jetted. Since, the liquid-type material
utilized in this technique is fairly analogous to that used in
usual traditional methods like Meyer rod coating, composed of
a very high quality of inkjet printing components with
tremendous various material lithography competencies,
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
 Table 2. Additive Manufacturing of Zirconia (ZrO2), Alumina (Al2O3), and Calcium Phosphate
3-D printing tech-
Materials compositions nologies Characterization of printed products Major outcomes Applications Ref
Suspension (consisting of 3 mol % Y2O3, partly Material extrusion/ Density. Morphology. Weibull Uniform morphology including some micropores. Mechanical strength: 763 MPa. Weibull Dental implants/ 211
stabilized ZrO2 (YSZ) powder, 55% distilled water, jetting constraints. Fracture toughness modulus: 3.5. Fracture toughness of 6.7 ± 1.6 MPa·m1/2. crowns
boehmite sol, and 27 vol % ZrO2 powder) During printing, a single bigger defect was discovered that was likely caused by clogged
nozzles.
Commercial ZrO2 powder dissolved in a polyacrylate Vat polymerization Dimensional precision A volumetrically larger copy is indicated by the 6.67% bigger surface area and the 46.38% of Root analogue im- 212
liquid solution (VP)/SLA the printed RAI that is further away from its original tooth than 0.1 mm. plant (RAI)
Slurry containing industrial YSZ dental composite VP/SLA Precise dimensional control. Den- Dimensional exactness: high (average deviation: 0.089 and −0.129 mm (±0.068)). Dental implants 213
(TZ-3YS-E) plus photocurable resin sity. Biaxial flexural strength. Presence of microcracks and interconnected pores. Surface roughness Ra:
Surface morphology. Surface 1.59 ± 0.41 μm. Flexural strength: 943 MPa.
roughness and crystallographic
phase
Suspension composed of photosensitive PMMA VP/SLA Surface roughness. Morphology. Exhibited several surface roughness values. Flexural strength: 1154 ± 182 MPa. Vickers NA 214
comprising 55 vol % ZrO2 particles of ∼200 nm Flexural strength. Vickers micro- microhardness:13.90 ± 0.62 GPa. Fracture toughness: 6.37 ± 0.25 MPa m1/2. Density:
hardness. Fracture toughness. 99.3%.
Density
ACS Biomaterials Science & Engineering

Suspension composed of commercial ZrO2 powder, Material extrusion/ Droplet formation and fusion Filament-like structures with a smooth surface and a closely uniform cross section (droplet NA 215
TZ3Y-E plus paraffin and beeswax (binder) jetting (Thermo- fusion factor of 44% or higher).
plastic 3-D Print-
ing)
Suspension composed of commercial ZrO2 powder, Material extrusion/ Slurry rheological behavior. Density. Pseudoplastic properties of suspensions. NA 216
TZ-3Y-SE (powder containing 45 vol %), with d50 jetting (Thermo- Surface morphology. Porosity Sintered at 1350 °C. Density: 99%. Porosity: 5.6 ± 1.1%. Mean grain size: 0.46 μm when
= 0.3 μm mixed with paraffin and binder plastic 3-D Print- sintered at 1500 °C. Density: 99%. Porosity: 0.03 ± 0.02%. Mean grain size: 0.96 μm.
ing)
Suspension composed of YSZ powders TZ-3Y-E, Material extrusion/ Rheological behavior of suspensions, Suspensions: shear thinning behavior, Sintered samples: defect-free porosity: 0.11 ± 0.04%, NA 217

4001
pore forming agent (polysaccharide, CERETAN jetting (Thermo- Density, Porosity Outer density: 5.90 ± 0.04 g/cm3, Inner density: 5.93 ± 0.05 g/cm3, To incorporate
MA 7008 or UFC100) paraffin and binder plastic 3-D Print- several features in one component, a brick-like component made of dense (<1% porosity)
ing) and porous (∼5% porosity) ZrO2 sections was created.
Slurry composed of premixture (Acrylamide mono- Material extrusion/ Surface and fracture morphology. Surface Roughness: ↓ on sintering (Ra 8.90 to 8.25 μm). Printed samples showed no NA 218
mer, N,N′-Methylenebis(acrylamide), deionized jetting Surface roughness. Density. deformation on sintering. Vickers hardness: ↓ on sintering. Transverse rupture strength: ↓
(DI) water, ammonium citrate) and ZrO2 (3-D gel-printing) Vickers hardness. Transverse rup- on sintering.
(3YTZP) powder with particle size of 0.5 μm ture strength
Commercial YSZ 50 nm particles with a d50 Material extrusion- Rheological behavior and printabil- Viscosity: 28.6 Pa s (nozzle) and 400 Pa s (platform). No formed agglomerates. NA 219
agglomerate size of 0.6 mm of high purity based ity
(>99.9%) and 2 commercially available UV-resins
(XC11122 (DSM) and UV-A 2137
Suspension composed of 67 vol % alumina with d50 Material extrusion/ Slurry rheological behavior. Density. Pseudoplastic behavior of suspensions. NA 216
= 1−1.7 μm and a purity of 99.8 wt % mixed with jetting (Thermo- Morphology. Porosity Density: 97.3%. Porosity: 0.8 ± 0.4%. Mean grain size: 6.5 μm.
pubs.acs.org/journal/abseba

paraffin and beeswax (binder) plastic 3-D Print-

ing)
Slurries developed using small and large particle size Vat polymerization/ Particle size. Density. Viscosity. Flexural strength: 271.7−273.8 MPa. Weibull modulus: 5 to 15. Overall shrinkage was Crown models 220
Al2O3 powders. d50 = 0.56 and 1.58 μm, SLA Flexural strength. Weibull modu- higher for SLA-fabricated ceramics.
respectively lus. Weibull characteristic
strength. Shrinkage after the sin-
tering
Slurries containing great purity alumina powder. d50 Binder jetting Morphology. Density (green and Density: ↑ utilizing vacuum infiltration process (VIP). Porosity: ↓ utilizing VIP. Strength:↑ NA 221
= 0.32 μm. Poly vinyl alcohol (PVA) was used as a sintered). Pore size distribution. utilizing VIP.
binder Mechanical properties. Surface
roughness
β-TCP colloidal gel composed of ammonium Material extrusion/ Histology osseointegration Monitoring the beginnings of the repair pathway to the defect walls and marrow voids Craniofacial tissue 222
polyacrylate DI water, hydroxypropyl methylcellu- jetting (Robocast- through directional bony growth within the scaffold cavities. New bone development and engineering
lose and polyethylenimine ing) scaffold resorption at bone/scaffold interfaces was detected.
Review

https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
 Table 2. continued
3-D printing tech-
Materials compositions nologies Characterization of printed products Major outcomes Applications Ref
TCP combined at different ratios with lubricants like Material extrusion/ Microstructure. Compressive Compressive stress:6.4−11.6 MPa. Young’s modulus: 104−247 MPa. Osteoinductive Craniofacial im- 223
decane, oleic acid, oleyl alcohol, oleyl ester, jetting (Robocast- strength. Chemical purity. behavior. plant
glycerol, triglycerides and heated paraffin ing) Osteoinductive
TCP combined with gelatin/alginate (additives) Material extrusion/ Viscosity/printability. Morphology. Porosity: 73.42 ± 8.4%. Young’s modulus: 98.31 ± 10.21 MPa. Craniofacial tissue 224
jetting Pore size and porosity. engineering
Compressive strength. Young’s
modulus. Cell proliferation
CaHPO4, (monetite) and CaCO3 (calcite) sintered Binder jetting Osseointegration histology. Dental implants’ healing in bone with synthetic monetite onlays. Higher bone construction Onlay 225
at 1400 °C for 7 h to synthesize α/β-TCP Crystallographic composition found in onlays with improved porosity facing the calvarial surface.
TCP, mixture of 45% α-TCP and 55% β-TCP Binder jetting Dimensional accuracy. Density. Dimensional accuracy. Satisfactory porosity: 28−35%, Thermal conductivity at 37 °C: Craniofacial im- 34
Porosity. Thermal conductivity at 0.294−0.393 W/m K. Bending strength: 3.9−5.2 MPa. plant
37 °C. Bending strength
β-TCP with an average particle size of 550 nm doped Binder jetting Micrograph. Phase analysis. Density. Porosity: 32−51%. Denisty:89−95%. Compressive strength: 2−10 MPa. Addition of SiO2 Scaffold/tissueen- 226
SiO2 and ZnO Mechanical behaviors. In vitro and ZnO dopants. ↑ mechanical strength. ↑ cellular proliferation. gineering
cell−material interactions
ACS Biomaterials Science & Engineering

10% Mg-substituted Wollastonite (Ca90%Mg10% Material extrusion/ Physicochemical characterization. In CSi-Mg10 scaffolds: Major pore dimension but the lowest porosity. Mild in vitro Scaffold/tissue en- 227
SiO3; CSi-Mg10) β-TCP Wollastonite (CaSiO3; jetting (Robocast- vitro degradation. Mechanical biodissolution. Moderate weight loss of ∼7%. Flexural strength: 31 MPa. Higher gineering
CSi) Bredigite ing) behaviors osteogenic capability.
Gypsum paste (CaSO4·1/2H2O + 11/2H2O = Binder jetting Chemical structure, Morphology, Mechanical behaviors: inadequate. Scaffold/tissueen- 228
CaSO4·2H2O) Mechanical testing, Shrinkage, gineering
Density, Cytotoxicity
d90 = 68.83 μm Cytotoxicity: Moderate to Severe.

4002
pubs.acs.org/journal/abseba
Review

https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
hence, IJP is mainly employed for printing various
batteries194−198 including supercapacitors.199−209 Further, to
authenticate the building of the droplets, an inverse Ohnesorge
number Z relationship was used and represented by eq 1.
(1)
where μ is the viscosity, σ is the surface tension, and ρ is the
density and all should be in fixed ranges and fulfill definite rules
for a nozzle having diameter d to allow the inkjet process.210
Various ceramic materials have been used in AM for
biomedical applications and are listed in Table 2. Ceramic
materials play a significant role and are essential for aesthetics,
biocompatibility and poor density, great strength, enough
hardness, high-temperature-bearing capability, erosion resist-
ance, and excellent physicochemical properties. Particularly,
ceramics like zirconia (ZrO2) and alumina (Al2O3) are mainly
used to develop the various artificial dental bridges and circlets.
ZrO2 may also be used in dentistry which shows equivalent
osseointegration with Ti.229 At the time when ZrO2 ceramics
are shaped/fabricated using cutting-edge technology, enor-
mous amounts of the constituents should be subsequently
removed in large quantities and expensive ceramic crowns. So,
such a type of craft procedure can also be the reason for the
creation of inner cracks using cutting forces on dentures, while
the AM process in construction of ZrO2 ceramic dentures may
reach up to 90% material consumption, decrease the price, and
also decrease environmental contamination.230 It is noteworthy
that 3-D printed ZrO2 can successfully bioimitate, e.g.,
hardness via printing superior interior structures.231 The AM
technology for construction of ZrO2 is primarily dependent on
the laser sintering technique; however, some problems exist
like low density and less forming efficacy with surface
cracks.232 However, stereolithography ceramic engineering
has quickly become a research study hotspot due to its
satisfactory surface excellence and controllability of structural
precision.233,234 Currently, there are several difficulties in the
AM process of ZrO2 materials, e.g., enormous inner stress,
cracking defects after sintering, and volume contraction, which
can impair its mechanical performance and clinical fitness.
Most of the ceramics and their fabrication processes still need
advanced examinations.
Besides these materials, hydroxyapatite (HAp) is one of the
best and highly biocompatible ceramic materials, and it is being
used for many applications in dentistry. HAp is chemically
recognized as Ca10(PO4)6·2(OH), whose crystal structure is
hexagonal. It is a chief mineral constituent of the teeth and
bones. Moreover, the bone architecture comprises ∼65 wt %
HAp, a needle-like morphological compound that is liable for
promising stiffness and strength (length 60 nm and width 5−
20 nm).235 Besides, the enamel and layers of the dentine in the
configuration of the tooth are primarily composed of HAp
crystals. Enamel layers comprise 96 wt % of inorganic
ingredients and organic components such as proteins and
lipids and 4 wt % of water (H2O) content. However, the
dentin layer contains 70 wt % of inorganic materials and 20 wt
% of organic materials, including 10 wt % of H2O.102 Based on
the literature, the average crystallites size of HAp in the enamel
was found to be in a specific range of 48−78 nm.235 Further, it
has also been reported that the HAp crystallites presented in
the enamel have a hexagonal crystal structure and inter-
connected and exhibited an ∼4 μm diameter rod-like surface
4003
pubs.acs.org/journal/abseba Review
morphology, while in the case of fully developed dentine,
crystallites exhibited a flattened plates-like morphology
(length: 60−70 nm, thickness: 3−4 nm, and width: 20−30
nm).236 Among the numerous phases, the stoichiometric ratio
of Ca to P is 1.67, and HAp is the only highly stable phase and
is the most insoluble form of a CaP in nature.237 So, owing to
its brilliant biocompatibility and bone-forming capability, HAp
has received extensive research over the last few decades for
numerous biomedical uses, for example, bone grafting and
filling, implant coating, bone scaffold, drug delivery, etc.237−239
4.6. Laminated Object Manufacturing (LOM) Printing
Method. The LOM method is a 3-D printing method in
which layers of different materials like glue, paper, metallic, or
plastic laminates are consecutively pasted/bonded with each
other using a laminating roller. In this technique, premanufac-
tured foil/sheets are cut using a laser beam or sharp edge knife,
rendered to slice a CAD file, and afterward attached on top of
the previous layer (Figure 9(c)).240 Moreover, combining of
neighboring layers is executed by the help of glue, an ultrasonic
method, soldering, or diffusion through welding. For the
fabrication of a product, a heated roller is delivered over the
material sheet on the constructed platform, melting the glue
and persuading it on the platform. A fully controllable beam of
laser via a computer or blade now cuts the product into the
preferred design. Herein, the beam also tends to slice any
surplus substance in a crosshatch design, making it convenient
to eliminate the objective when it is completely printed.
Moreover, a microelectrode was fabricated in a traditional
mold using the LOM procedure.241−243 Further, copper foils of
thickness ∼100 μm were cut using a wire-electrical discharge
machine technique to achieve a cross-sectional area of the 3-D
model of the electrode. Thereafter, 2-D pieces of the slices
were stacked to obtain a 3-D object in the shape of a
microelectrode via vacuum pressure thermal diffusion bonding.
Additionally, owing to the material feedstock as a laminate, the
LOM 3-D printing method could be utilized to manufacture
thin film electrochemical energy storage (EES) given the
suitable material is produced.
In comparison to other techniques, fairly big fragments can
be prepared, because there is not any chemical reaction
required. Unfortunately, major enterprises are concentrating
on the LOM printing have to close their operations in the
recent years. Nevertheless, their machinery is still being used
by engineers, entertainers, and artifact developers to develop
inexpensive prototypes. However, it would not be possible to
utilize other substances except paper. In regard to the old case
of LOM machines, there are few works generating composites
by utilizing such processes.190,191
4.7. Color-Jet-Printing (CJP) Method. CJP is also
recognized as 3-D printing (3-DP) or Z Print, which is the
most commonly used additive method to build fully colored
prototypes. In this process powder was often used as a core
material and a polymeric material such as resin as a binder; the
product is manufactured by dispersion of the powder in layer
form, using the roller process on the fabricated platform.
Afterward, head jet printing/spray binder techniques utilized
on the layers at a specific point are justified through CAD
software; consequently, a vibrant and colorful object is
successfully printed that has numerous applications in the
biomedical area.45,244 This permits the formation of high-
resolution, full of color 3-D fabrications. The CJP technology is
very popularized for the fabrication of numerous products like
architectural prototypes, design models, trade and display
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
models, and prototypes for teaching and science, including 3-D
figures and fictional objects. Moreover, color jet 3-D imprinters
work very similarly to an inkjet printer. Nevertheless, the CJP
printers not only print on paper but also print on tiny sheets of
white powder. Herein, the ink in this method is really acting as
a binder itself, which provides grip to the powder material
together. Five distinct colored binders are mixed directly to
produce the colors for the product while concurrently
generating the shape. Moreover, the third dimension was
produced by printing layer-by-layer and then binding the
printed segments through the layers. Once the single layer is
finished, then the printing platform shifts downward 0.088/0.1
mm; subsequently, fresh plaster is fixed and then another layer
is printed. This process is continued and recurs accordingly.
After efficacious printing, the printed product is quite soft and
brittle. So, the semifinished state of the product is cautiously
cleaned and last permeated using an acrylic material (super
glue). Such permeation delivers strength to the fabricated
product/model. The entire set up of this technique is shown in
Figure 9(d).245
4.8. Electron Beam Melting (EBM) Technique. In this
technique a high-power beam of electrons is employed to
design a model of multiple layers with the help of a metallic
powder and instructions from a CAD prototype having perfect
geometry. In a vacuum environment, all required basic material
is kept and bonded using a beam of electrons.46,47 Herein, this
approach employs a beam of electrons which acts as a source
of power rather than a laser source for metal 3-D printing.
Furthermore, the metal powder can be melted completely
layer-by-layer using a beam of electrons in a closed vacuum
environment (Figure 9(e)246). The mechanical characteristics,
granulate capability, and deterioration of dental grafts shaped
via an electron bar softening were perceived to be comparable
to those of expensive and inexpensive combinations. Moreover,
fatigue resistance was significantly affected through electron
beam alignment and crack proliferation. Hence, this technique
has extensive applications in dentistry such as orthopedics and
oral maxillofacial operation as modified implants as porous
scaffolds.247 It is analogous to the SLM technique that works
layer-by-layer. But, the EBM technique has specific differences
while being comparatively more costly than the SLM
technique. A beam of electrons is fixed for melting and
blending of the particles of the powder rather than a laser
beam. The powder bed was kept at >870 K, and the powder
bed was cooled for overnight after the end of the fabrication of
the product. Moreover, the EBM procedure includes more
processing parameters such as the power of the electron beam,
velocity of the scanning beam, beam focus, diameter of the
beam, spacing of the beamline, plate temperature, preheat
temperature contour approaches, and scan tactic. Herein, the
optimization of these processing parameters is too challenging
in comparison to the SLM technique; therefore, merely limited
constituents are active in EBM, for example Ti (grade 2),
Ti6Al4V, Inconel 718, and CoCrMo.61 The procedure is
slightly slow, and it fabricates the parts very exclusively.
Furthermore, limitations occur in both the parts’ size and the
smallest dimension of the cell in a honeycomb lattice
architecture. However, larger size parts may be prepared
than that of a substrate plate. But, the initial layers of the part
must be less in comparison to the size of a substrate plate. So,
under these conditions, the EBM procedure is established in a
vacuum atmosphere, unlike the inactive atmosphere during the
SLM procedure. Therefore, corrosion of the fabricated parts is
4004
pubs.acs.org/journal/abseba Review
usually prevented. Additionally, in the EBM technique the
adsorbed gases through the surface of the powder particles
could not lead to the building of porosity. Yet, alloys that have
unstable ingredients like Zn, Mg, Pb, Bi, etc. would not be
desirable for the procedure. The EBM technique has enough
ability to process a fragile material (exhibit low thermal
expansion and shrinkage performances) which usually could
not be executed via the SLM process. However, although EBM
may be considerably faster than the SLM process, SLM
fabricates smoother and more highly precise parts.
4.9. Multi-Jet-Printing (MJP) Technique. MJP is one of
the inkjet printing methods which uses the piezo print head
technique to deposit any phototreatable resin material (plastic)
or molding wax ingredients layer-by-layer. It is well applicable
to construct the parts, designs, and casts/molds along with
sharp features for numerous applications. Moreover, in this
technique, usually outlets are being utilized to sprig liquid
binding on a metal/ceramic to generate a solid thin layer. After
fabrication, the product should be sintered in a muffle furnace
to upsurge its toughness.49,248 This printing method originates
with smearing the powder layer (thickness of the layer ∼80
μm) on the top of a build platform by a roller (Figure 9(f)).249
Thereafter, melting and specifying mediators are utilized ,and
then the exposure of entire layer to infrared light is done. The
melting component decides what position within the layer is
welded. The detailing mediator is required to sustain sharp and
flat/smooth boundaries by controlling the powder bonding
adjacent to the surface of the print. The succeeding steps in
this method are involved.
The range of specialized materials devoted to the MJP is
quite inadequate. Currently, it is promising to utilize various
subsequent constituents, namely polyamide 12 (PA12),
polyamide 11 (PA11), polyamide 12 added with glass beads
(PA12GB), polypropylene (PP), thermoplastic polyurethane
(TPU) elastomer, etc. Moreover, the average grain size of the
used powders lies in between the size of 54 to 77 μm. The
important issues in the area of the AM technique are the
testing and the analysis of the structural and dimensional
correctness of the prints. The main cause is the excessively
poor features of a print that are affected by the processing
factors and the alignment of prints inside a working platform.
Understanding the effects of various process factors on the
precision of the final print is crucial for enhancing the quality
of the printed products. Besides, there is huge curiosity in
quick authentication of the 3-D printing made by numerous
AM techniques. Rapid print control is repeatedly expected by
picking the best optimum printing factors and standards or
equating the superiority of specific prints with others.
5. SIGNIFICANT APPLICATIONS OF AM
TECHNOLOGY IN DENTISTRY
In dentistry specifically, a patient’s consequences can be
increased by using an AM application. Further, it is utilized for
preparations before operation, edification, tradition engineer-
ing, and making consistent processes. It produces enduring
dentistry transplants and strategies for the patient.250,251 The
various applications of AM are presented in Figure 10 and
Table 3. The particular uses of materials and methods in
dentistry are also enlisted in Table 4.
5.1. 3-D Printed Dental Implants. At the time of dental
instill surgical procedures, AM contributed to offer an excellent
solution in generating 3-D prototype patterns which are really
useful for the implantation of a missing tooth. It increases the
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering pubs.acs.org/journal/abseba Review

harmonized to the colors of the natural teeth and hence they

Figure 10. Numerous applications of additive manufacturing in
dentistry.
precision of the surgical procedure compared to that of the
customary techniques. It is very efficient and secure, and the
dental model acquires an outstanding surface finish.253,281
5.2. Repair/Replacement of Damaged Tooth. Most
dentists effortlessly have to probe the patient’s mouth and
build a 3-D image of the teeth and gums. Further, CAD
software supports forming a digital design of a tooth and
printing the models via the AM techniques.257,282 There are
numerous ways to overhaul an injured/broken tooth, from
fillings to root canals and inlays/onlays to dental crowns.
Therefore, each kind of repair/treatment has its own benefits
and drawbacks. Herein, surgery/therapy to restore a broken
tooth is vivacious to inhibit further its deterioration. Custom-
arily, dental filling was done using a silver blend that several
persons found to be unattractive.283 Nevertheless, current
fillings may also offer superficial benefits such as they have
blend in flawlessly and are effectively imperceptible to
distinguish. Usually, the fillings were performed in a few
minutes by the dentist. Further, inlays/onlays are dissimilar
from the customary or outdated fillings for the reason that they
were prepared offsite in a dental research laboratory, and then
a dentist has to fix them onto the tooth. Moreover, the major
difference between inlays and onlays is that inlays are utilized
when there is no harm/damage to the cusps, which are the
pointed part of back teeth, while onlays conceal one or more
than one cusps.284 However, during root canal therapy (RCT)
a spoiled/damaged tooth has deteriorated or infection has
extended up to the nerves, which enhances the creation of pulp
and affects the bloodstream inside the tooth. Therefore, a
dentist eliminates the infested pulp from a root canal and
thereafter sterilizes and fills the inside of the tooth. Further,
teeth can be re-established along with a dental crown.
5.3. Surgical Guides. This technique creates surgical
guides along with enormous precision. CAD scanning of a
patient’s teeth results in a printable model. It enhances the
complete reliability of the procedure and gives enhanced
patient results.285,286 Moreover, surgical guide prototypes, in
addition to helping in a patient’s diagnosis and further
treatment arrangements, also enable a dentist to find the
appropriate location and angularity of an implant within the
bone.287 Besides these advantages, implantation employment is
cultivated by the surgical guide prototype, which can reduce
clinical and laboratory hitches.288 Therefore, rising demand for
dental implants has caused growth of novel and advanced
methods for the preparation of such type prototypes.
5.4. Create an Orthodontic Model. Herein, an AM
technique creates a prototype/model which may be used to
deal with anomalies within teeth and jaws. First of all, a dentist
scans some teeth, then designs an orthodontic utilization, and
last prints using an AM technique.289,290
5.5. Printing of Aligner. The printing of orthodontic
cases, that is aligner objects, is utilized for adjusting the
orientation of teeth. This technique manufactures customized
aligners as per the needs of patients,291,292 as depicted in
Figure 11(a−d).293 To manufacture an aligner, numerous steps
were involved: (i) Impersonations of the patient’s teeth were
made (dentition), which in the conformist approach was

Table 3. Dental Material Selection: Application, Materials, Process, and Properties

S.
No. Applications Materials Process Properties Ref
1. Maxillofacial implants Titanium SLS, direct metal deposition Bioinert 252, 253
(DMD)
CaPO4 Photopolymerization, 3-D IJP Bioactive or bioresorbable, tooth-like mechanical 254, 255
stiffness
2. Dentures and crowns Cobalt chrome SLS, FDM, and 3-D IJP Corrosion resistant, simple to manufacture 256−258
Al2O3 Thermoplastic printing (TPP) Bioinert 259, 260
ZrO2 Direct inkjet printing (DIP), TPP Bioinert 261
3. Anatomical and training Metals SLS, DMLS, SLM, DMD Study framework 262
models Veroglaze 3-D PJP Similar as color of tooth 263
Nylon SLA, SLS 262
Plaster 3-D IJP Simple to producte, cost-friendly 264
4. Scaffolds for tissue Polylactide FDM, SLA Simple to produce, bioresorbable 265−269
engineering Polycaprolactone E-jetting, electro-spinning Easiness to produce 267
Ceramics SLS, PJP Similar as color of tooth, excellent mechanical 259−261
behavior
5. Scaffoldless tissue Cells Microextrusion Reduces essential for immunosuppression 270−272
engineering

4005 https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering pubs.acs.org/journal/abseba Review

Table 4. Particular Uses of Methods and Materials in Dentistry

Materials Methods Use in dentistry Ref
Titanium alloy, ZrO2-Al2O3 composite SLM, DLMS Dental implants/Restorations/Replacement 109, 273,
of damaged tooth 274
Resins for Photopolymerization, Ceramic Filled Resins SLA Surgical guides, Create an orthodontic 274
model
Printing of aligner
Cobalt Chrome, Plastic, Zro2 SLS, FDM Fabrication of crowns and dentures 275
3-D IJP
Direct inkjet printing,
Thermoplastic printing
Polyvinyl siloxanes (PVS), Polysulfides, Polyethers Selective pressure technique Traditional dental mold 276−278
Open tray technique
Titanium metal, Stainless steel, Polyamide SLS, SLM, SLA and 3-D CAD Design and upgrading of surgical tools 279
technique
Polymers like- PLA, ABS, PEEK and Nylons etc. FDM 3D printed flexible dentures 280
Low-cost prototyping of simple anatomical 274
artifacts
Alumide, Polyamide, Glass filled polyamide, SLS Copings and bridges 274
Denture model of metal or resin
Cell-loaded gels, Collagen, Photopolymer resins, Agarose, Alginate, Bioprinter Scaffolds containing cells for hard and soft 274
Hyaluronan, and Chitosan, etc. tissue printing

Figure 11. (a) A Smile Direct Club employee performs a quality inspection on an aligner. Photo by Jon Morgan. (b) Soft Smile software platform
for creating aligner treatment plans. (c) Printing dental molds for aligners on the Formlabs Form 3B+. (d) Align Technology is the maker of the
Invisalign clear aligner and 3-D digital scanners.293

comparable to biting down on a tray of dental casting material
or using an intraoral 3-D scanner. Moreover, conventional
impressions were molded in a dental plaster and digitized via a
3-D scanner. Further, the intraoral scans of the dentition were
transferred as STL files to a 3-D printer. (ii) An aligner was
designed to transform a 3-D model of the dentition through a
particular dental software or by CAD software (Autodesk
Meshmixer). This step is very crucial, as it is essential to take
into account clinical/medical facts regarding the tooth
movements, such as the direction of movement/angulation,
surface morphology and size of the roots, adjacent bone
thickness and density, force vectors, occlusion, etc. The result
of this procedure is a series of 3-D models of the dentition,
each performing minor tooth movements nearer to the
preferred final tooth sites. (iii) 3-D printed models: numerous
4006
models have to be printed that are contingent on the size of
the adequate tooth movements. Minor modifications of the
location of 1 or 2 teeth could be accomplished with specific
models, whereas large complex arrangements of a greater
number of teeth probably involve up to 40−50 models,
particularly considering when there is not a sufficient gap for a
tooth to just transfer into the anticipated location. (iv)
Formation of the aligners: When a series of the models are
essential for 3-D printing, they may be applicable for the
fabrication of the actual exciting aligners, each of which has to
be worn by the patient for several weeks. The aligner itself is
not a 3-D printed product, although it is a selection protected
method. Moreover, the aligners were fabricated by using
thermoplastic substances, via thermoforming or vacuum
forming methods.
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering pubs.acs.org/journal/abseba Review

5.6. AM Applications in Research and Development.

They are actively involved in medical and dental research/
investigation and expansion. Herein, by employing a 3-D
scanner and designing software, upgradation in tools is
assumed according to the need of a dentist.294,295 3-D
scanning methods are widely used to transform a physical
model into a digital 3-D CAD file. Such digital output is nicely
utilized for shaping and constructing modified fragments via
AM technologies.296 There are numerous approaches to use 3-
D scanning technologies for instant laser 3-D scanning,
photogrammetry, and contact based 3-D scanning approaches,
including structured light scanning, etc. For this purpose, a
guide is available, which helps to select the best 3-D scanner to
complete the project.
5.7. Fabrication of Crowns and Dentures. It is well
recognized that dentures are a prosthetic device that replaces
teeth and the soft tissues associated with them. Moreover,
dentures are typically detachable and sould be washed on a
regular basis.297,298 Old aged patients or misfortunate sufferers
require whole dentures, if they lose every single tooth.
However, patients losing single or more than single teeth
require partial dentures.
Hence, such a technology may be exploited to formulate Figure 12. Various applications of additive manufacturing in other
crowns promptly. Herein, the patient’s teeth are scanned fields.
unswervingly, and then the crown is printed without any delay
and could also be amended. The method is capable of printing
comprehensive dentures, including gums and teeth. Moreover,
numerous materials are used to print all types (implants) and Moreover, bioink is a biomaterial’s solution or combination of
prototypes. For the printing procedure, it uses explicit numerous biomaterials as a hydrogel, generally condensing
materials.299,300 preferred cell types. Such bioink could be cross-linked or
5.8. Traditional Dental Mold. AM has the potential to alleviated during/instantly when bioprinting to construct a
design and fabricate various modified prototypes. Such final shape, structure, and design of the construct.306 In other
prototypes/models would also be utilized in the form of words, bioink is a special type of a material that may be attuned
molds. In production of customized and multifaceted geometry with a specific human body. Various bioinks will be
implants without delay, various materials can be used.301,302 transformed into the form of a wire. Herein, the printing
5.9. Design and Upgrading of Surgical Tools. 3-D could be extrusion of wire based material. For cell develop-
printing tool guides are also conceivable via this technique ment to take place, the fragment/part after printing will be
allowing the practical designing of clinical apparatuses based reserved in incubation. Bioprinting is capable of construction
on the dentist’s needs.303,304
of functional tissue to exchange damaged or infected tissues,
5.10. Education and Training. Training of scholars in the
making it a comparatively novel method that offers
medical field requires sufficiently clear demonstrations. A
extraordinary replication and accurate control upon entire
model manufactured by using this technology is really
interesting; consequently, it is advantageous in dentistry for parts manufacture.
teaching purposes.305 6.2. Medical Implants. Various medical infixes were used
for replacing injured bones and locomotor systems. Such
6. ADDITIVE MANUFACTURING APPLICATIONS IN fragments are of asymmetrical and extremely complex design.
OTHER FIELDS Therefore, 3-D printing methods like SLS and SLM are being
widely used for the construction of these fragments. The
Besides the applications of AM technology in dentistry, it has
biocompatible and extremely stable materials including a large
numerous applications in other important areas, as is described
time span were utilized successfully in graft printing. Moreover,
in detail as below, and these fields are depicted in Figure 12.
6.1. Tissue Printing. Primarily, bioprinting is defined as neat metallic materials cannot be utilized in mammalian body
the use of the AM approach in medicine. It is well-known that organs due to easy degradation. Hence, metal alloys were
human organs are challenging to produce manually using CAD utilized for the printing of bone implants. A maximum of the
modeling. Thus, we must employ a computerized tomography bones are fabricated using medical grade Ti-6Al-4V alloy. Few
(CT) or magnetic resonance imaging (MRI) scan. In the MRI bioceramics and polymeric materials are generally used
technique, powerful magnetic fields and radio frequency pulses synthetic materials.307 Certain implanted alloys are commonly
(RFP) have been used to generate complete pictures of the prepared via the AM technique using stainless steels (SS), Co/
organs including other interior body configurations. Typically, Cr based alloys, Ti, Ti alloys, etc.308,309 However, various
CT scans use X-rays to generate images of a body. Further, shape memory alloys (SMAs) such as NiTi have also been
these generated images are digitally developed. Moreover, utilized. The shape memory permits NiTi implantations to be
these digitally generated models were then reformed via CAD primarily malformed through freezing and then recurrence to
software as normal slices transferred to a printer. During tissue their predicted shape at body temperature that is a pleasing
printing, material has to be consumed in the form of bioink. peculiarity for the application of stents.310
4007 https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
7. STEPS TO BUILD A 3-D PRINTED DENTAL
PROTOTYPE VIA AN AM TECHNIQUE
There are several steps which are used to construct a 3-D
printed dental prototype through the additive manufacturing
technique:
7.1. Digital 3-D Model of the Patient’s Mouth. First of
all, the digital models are generated via a 3-D scanner as cloud
data with rapid and precise dimensions, which use a 3-D
scanner for accurate scanning of the patient’s mouth and
teeth.311,312
7.2. Modification in Designs. After the scanning process
confirmation, it is essential that the models in dentistry will fit
in a perfect manner by modifying the dimension and position.
Designs can be easily modified via the application of numerous
software and an accompanying AM technique,313,314
7.3. 3-D Printing. A 3-D solid piece can be formulated
directly from a 3-D digital file through the deposition of
materials layer-by-layer. It is well-known that most dental
implants are prepared by employing various AM technologies
concerning the specification of the printing materials.
However, post-processing is applied to enhance the physical
and mechanical performances of the implants. For the
consistency purpose, restoration of the defined teeth and
other tools have been used in dentistry successfully. It is much
more cost-effective than the other fabrication techniques which
could be exploited for training purposes.315−317
7.4. Testing and Implementation. First of all, we have to
ensure that the physical prototype is of standard quality and
strength underneath specific conditions of load, that would be
viable and well consistent. Further testing is needed prior to
genuine implementation. Moreover, the dental model printed
through this method is fully utilized owing to the surgery of a
patient.318,319
8. CHALLENGES
Recently, AM is predicted as a potential technology with great
rewards not merely in the creation of modified healthcare
consequences to increase the healthiness and quality life of
inhabitants but also in its probability of reducing ecological
influence, improving industrial sustainability. Alternately, the
intrinsic challenges of 3-D printing cannot be ignored. Several
aspects like the excellence of the surface, the dimensional
precision, and the mechanical performances require more
development to permit manufacturing of, in effect, fine
products. In concern to surface excellence, it primarily depends
on the used AM technique, the processing parameters, and the
quality of raw materials, which influence the thickness of each
and every printed layer significantly.320−322 Herein, the powder
bed AM has inferior aspects compared to those of the other
AM methods, owing to the existence of immense and fairly
fused particles of the powder within the aspect of the printed
parts. Comparatively about the width of the films/layers, cell
exportation approaches usually accelerate the layer broadness,
≈0.2 mm, owing to the larger diameter size of the nozzle for
deposition of the layers. However, powder bed synthesis with a
vat polymerized source lowers the layer/film thicknesses up to
0.1 mm, owing to the capability to accurately emphasize the
radius of the energy beam. Besides these techniques, material
jetting methods are those which fabricate the optimized
thickness (≈0.02 mm) of the layer due to the tiniest jet
droplets. Another major challenge is the geometrical precision,
which plays a critical role during the fabrication of the dental
4008
pubs.acs.org/journal/abseba Review
fragments, because these must securely fit the requirements of
each patient. A diversity of the further concerns distresses
dimensional correctness. Lee at al. recapitulates the dimen-
sional precision in dissimilar manufacturing procedures.323
Further, they reported that the precision in the Z-direction is
tougher and shoddier to increase than that in the X- and Y-
directions since it is prejudiced via an assortment of processing
parameters which are very challenging to control, various
constraints such as densification of the powder in between the
films or spreading concretion, reduction in the course of
solidification, and evaporation of the material due to laser
heating. The mechanical performances of the materials are
affected owing to the manifestation of defects in which the
surface feature and porosity are the major factors. In this
connection, various solutions were already suggested to
decrease the porosity,324 for instance, selecting ceramic
powders with a suitable granulometric distribution, addition
of numerous dopants/a viscous liquid-forming phase, permeat-
ing a sintered object through vitrified glazed materials, and
retaining warm or cold isostatic pressure to the green object.221
Therefore, shrinkage/reduction is also a major anxiety in AM
techniques; subsequently, it affects considerably an object
dimension which may cause cracking. Moreover, the printing
approaches are essential to be elevated to avoid the impact of
this occurrence. Herein, some promising elucidations to curtail
this concern are the following: (i) Enhancing the content of
ceramic particles within a paste, without disturbing the
rheological activities that may be accomplished by addition
of steric dispersants.219 Addition of the mixture particles which
can enlarge owing to the reaction during the sintering process
or phase transformation.325,326 (ii) Reducing the sintering
temperature, without negotiating the compactness/density of
the body.327,328 (iii) In view of it, this may be used in the CAD
design for the production of numerous parts.322 Mostly, during
the fabrication of a green product, a sacrificial polymeric
material can be used as a binder. For this motive an additional
post-processing step has been involved, named as a firing prior;
the sintering must be essential to remove the binder and
accomplish a dense ceramic body. Now it is effective to
mainstreaming all AM processes with some exemptions like
direct selective laser sintering (DSLS) and SLM methods,
whereas the ceramic powdered material is quickly melted.
Besides these challenges, jet methods and material extrusions
are being used to prepare dental ceramic parts, and they still
exhibit poor mechanical performances as equated to the rest of
the predictable means to generate molded fragments. So
restrictions of this layering method reveal poor bonding
linkage among the various layers and the presence of porosity.
Preparation of the inks/slurries is a tough phase. Hence,
procedures must be as easy as conceivable, prominent to
slurries or inks using a suitable composition, flow reliability,
and their specific viscoelastic characteristics. They must have a
huge solid volume fraction which is not just to condense the
shrinkage through ventilation and thus withstand the elaborate
stresses and then another time also to enhance the density of
the final product. Another significant task is the micro-
biological safety of the eventual products anticipated to be in
neighboring interaction with cells/tissues. Therefore, such
arrangements should be capable of sustaining strict disinfection
protocols without deteriorating their inherent properties.
Further, to recognize such prospective capabilities, scalability
and affordability are the major challenges when advanced
printing approaches are used. Demand for fast printers along
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
with maximum resolution compared to what is presently
accessible are vital limitations which are essential to overcome.
For the construction of a completely functional organ, there is
no need to optimize a single printing procedure, as it would be
more advantageous to incorporate processes that reproduce a
natural body part’s physical diversity, purpose, and structural
tissue hierarchy. Prosthetic miniscule tissues may be employed
to observe the activities of therapeutic/toxic pharmaceuticals
and forecast these activities, possibly reducing the prices of
drugs and permitting more findings to follow by the usage of
bioprinted structures, which is the utmost expected application
of the numerous bioprinted organs to be seem in a while.
Although file setups are being managed and numerous
improvements are proceeding to enhance the therapeutic
imaging which facilitates the transferal of the data of medical
images during CT scans, MRI (magnetic resonance imaging),
and further formulas to a functioning arrangement for
consumption in 3-D printing technologies, the fact remains
exciting that each patient is distinctive and exhibits distinctive
behavior. Normally, medical imaging contains three significant
stages: (i) image acquirement, (ii) image post-processing, and
(iii) 3-D printing process.230 Herein, post-processing converts
the Digital Imaging and Communications in Medicine
(DICOM) pictures into STL documents which are prepared
by thin films within the range from 0.5−2 mm. Consequently,
transferring the document files to a printer to print out their
copy, DICOM images might be useful for a specialist, however
not for a patient. Hence, 3-D printing may overwhelm this type
of limitation. During the construction of a model using a 3-D
printer, DICOM images have several restrictions containing
errors familiarized through the step-by-step growth of a 3-D
model. Such inexactitudes originate from the CAD data to
proceed from a real 3-D model.
Huotilainen et al. revealed the modifications in data
allocation and generated a 3-D model. 329 Moreover,
dimensions of individual models and software were employed
to calculate the faults. Hence, using printers also provided
erroneousness. The polyjet printing method is stated more
correctly than the SLS and 3-D inkjet printing technologies.330
Furthermore, the attainable surface appearance may also
command the type of knowledge that has to be exploited.
For illustration, the SLA system is recommended for obtaining
a surface polish, whereas for the FDM technique this a
problem, thus, a fairly specific model can be utilized.
Multimaterial printing is a novel concern in AM technology
for dentistry. Presently, the various 3-D printing models along
with numerous multimaterials are promising with specific AM
technologies. Thus, the main advantage of multifaceted
printing is that a model may comprise diverse parts such as
organs, soft tissue, and bone giving physicians and surgeons a
superior comprehension of in what way a sufferer body will
sense during the utilization of a 3-model for surgery.
Furthermore, challenges are associated with a material
mechanical and structural strength. Owing to the layer-by-
layer performance of an AM procedure, the finished articles are
well-known to exhibit huge strength in the X- (L) and Y (W)-
planes; however, they exhibit the dreaded nearly nonexistence
strength in the Z-plane (D), where L, D, and W signify the
length, depth, and width, respectively. Although layer-by-layer
processes exhibited adequate mechanical strength for numer-
ous applications, apprehensions continue that 3-D printed
products via AM probably are less architecturally rigorous than
those manufactured via traditional manufacturing.331 Besides,
4009
pubs.acs.org/journal/abseba Review
restrictions of promptness and dimension, absence of ethics,
due to unattainability of sufficient skill, shortage of conscious-
ness around the threats linked with every application, etc.
could be declared as certain of the current tasks for the wide
applications of AM knowledge. Nevertheless, of the afore-
mentioned challenges, AM technology will be critical in the
forthcoming healthcare exercise, and it will modify the
structures of prepared therapeutic models. Among others,
implants prepared via this technology could exchange conven-
tional scaffold construction procedures. Models support the
invasive approaches, and surgeon squads can plan improved
surgeries. They are needed for the creation of miscellaneous
therapeutic devices including various clinical teaching models
only if further research incapacitates the prevailing solicitation
challenges.
The choice to accept a capable, innovative technology in
engineering is promoted via two types of individuals: (i) quick
adopters and modernizers who have a dream for the efficacy of
innovative technology to improve the excellence of life and (ii)
industries who will implement novel technology owing to its
probable monetary benefit in their manufactured goods line.
Herein, it is required to use an economic metric to estimate the
benefit created from changing from customary to AM
technology for a certain set of boundary states. One of the
ultimate modifications between additive/subtractive methods
is the nature of in what way the materials are controlled during
the procedure. With the AM process, the capacity and
dimensions of a product are really too significant, while with
the subtractive process, these parameters of the detached
material are significant. Thus, the perfect metric linking all
methods is the “buy to fly” percentage (α). Moreover, this is a
fraction of the volume of the billet required to fabricate the
portion to the volume of the part. It may be clear for both
(α−) subtractive (e.g., machining) and (α+) AM (e.g., fused
deposition modeling) procedures, as represented by eqs 2 and
3):
(2)
(3)
With AM procedures, α+ is usually near to 1. However, with
subtractive procedures, α− may range from 1 to 40. This
familiarizes an exciting difference between the two methods.
With the AM processes, the minimization of feedstock is
useful. With a smaller amount of material in the fragment, we
assume an inferior worth and a faster development time. With
subtractive processes, near the part to the billet dimension, the
less amount of material is removed, the more significant the
construct size, and the smaller the cost. Herein, we may use
these two expressions and estimate the complete cost of
manufacturing unit artifacts with due deliberation of prices of
energy, employment, design, investment, tooling, material
feedstock, and disappointment to meet the targeted require-
ment.
9. DISCUSSIONS
Research and development occur just before the manufacture
of intricate dental crowns, surgical templates, aligners, bridges,
and orthodontic braces according to the requisites of a specific
patient. 3-D printing has an adequate capability to boost a
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
revolution in dentistry. Various approaches have been used for
a diversity of commitments in the dentistry field. Most of the
AM technologies produce on request fabrication of customized
dental implants and also have enough potential to design and
develop various apparatuses for medical and dental practi-
tioners. AM also can support the formation of different
complex geometric architectures of dental implants and
prototypes with an extensive collection of materials which
makes a surgeon’s profession convenient with the least bad
ramifications owing to a 3-D printed model providing a
superior appreciation of the complicated pathology and
framework of the patients which is also more appropriate for
medical training. Here is an enhancement in the excellence of a
patient’s lifespan and competently explains diverse complica-
tions in dentistry. Hence, surgeons can take 3-D prints of an
implant for training before the surgery. However, a dentist may
execute this idea into an inevitability that will deliver a
complete chance to fabricate various amended dental implants
as per the desire of a patient and a dentist. During the present
observations, a dentist succeeded to scheme a specific orbital
restoration implant (ORI) digitally and generate a corporeal
implant for a medical practice via AM technology. Moreover,
comparable intelligence for the appropriate utilization of 3-D
modeling and AM technology in direct medical implant
procedures is intermittent. This technique facilitates the
rigorous fitting of a dental implant to its adjacent tissues. It
reduces the time period of surgery owing to preoperative
preparation of accurate anatomical and geometrical facts.
Besides these benefits, digital handling also recovers surgical
precision. It can also enhance the performance of various
implants for a specific scenario by changing the macro-
structure. By the implantation, the net volumetric structure
permits the growth of cells and tissues. Thereafter, this
structure could be utilized in another kind of implant since the
sizes and thickness of the existing holes are adaptable.
Furthermore, low mass decreases in the sensitivity concerning
hotness and coldness are also there. Herein, all such aspects
have the potential to decrease the hazards of difficulties and
patient illness.
Nevertheless, previous studies exhibited that 3-D printings
have multitudinous advantages, being the product of obsession
straps during an oral surgery/in orthodontic orthotics molds.
Since the printed items are manufactured to the images of the
patient, the print may be personalized to optimize fit within the
functional environments, and thus, perfection of aligners and
implants could be enhanced. The accessibility of the materials,
medical peculiarities, time-period required, and anticipated
print resolution can be considered when choosing a piece of
printing equipment. The difficulties that need further
investigation are the constraint of the accessible material
variety, particularly poignant away from the recognized
polymers, and the enhancement in the speed of the printing
and further processing. The feed materials should come across
the dental as well as methodological necessities including
standards of the biocompatibility. Hence, there is a great
curiosity to create novel printable materials in dentistry which
meet these necessities. The growth of the material variety also
unlocks new avenues for the sake of clinical uses of 3-D
techniques in the field of dentistry. 3-D printing exhibits great
perspectives for learning, as perceived above in the major
disciplines of dentistry. It provides a superior subjective
perception to a surgeon for the overall bones and teeth in
comparison to the stereotypical acrylic or typodont prototypes.
4010
pubs.acs.org/journal/abseba Review
With the innovations in materials and technology and the
flexibility to modify the physical properties of AM materials,
apprentices have enough prospects to grow superior
functioning and proprioceptive expertise. Overall, 3-D printing
based techniques have a marvelous prospective over scientific
research, treatment procedures, and also educational tributaries
of dentistry enriching oral health care.
10. FUTURE SCOPE
In the future, with the assistance of AM technology, low-cost,
reasonable, functionalized dentures using numerous biocom-
patible materials can be printed. Moreover, it can provide an
utterly printable denture clarification, and therefore, it is
rapidly growing along with novel materials. Prosthodontics and
their physical models, including modified, economical dental
implants, are worthwhile. Furthermore, AM technologies can
empower an excellent collaboration among dentists and
research laboratories which offers a seamless result for the
fabrication of numerous kinds of customized medical and
dental models/implants.
Every day, researchers explore new materials and discover
innovative ways to process them. Recently, AM technology has
played a more crucial role for multiple material printing, where
a grouping of numerous materials can be utilized or inspected
to produce a single part, and it is currently becoming a valid
technology. It is completed by addition of the various
components essential for two or more distinct constituents
within a particular system. For this case, in porcelain fused-to-
metal dental crowns, for a particular stratum, primarily the
metallic section would be prepared, including the building of a
ceramic portion. Moreover, obtaining a multimaterial article
can be recurrent in several layers. In certain circumstances,
wherever specific mechanical performances are essential, it is
possible to adjust the qualities using a combination of
materials. Nowadays, the architecture of tissue engineering is
gratifying in authenticity, and 3-D printing provides this area
biomaterials via AM technology that can work as scaffoldings
to monitor tissue growth. Scaffoldings for numerous tissues
like ligaments, tendons, etc. were developed and verified during
in vitro protocols. Although such type of scaffolds could be
employed for tissue restoration, scaffolds for drug investigation
were also fabricated. Researchers and scientists have reported
various studies for the fabrication of implants via AM
technology. It is recommended that these fabricated implants
are highly efficient as predictably manufactured implants. 3-D
printed implants are found to be worthwhile as support during
healing in periodontics. Also, it is noticed that the 3-D printing
of the tooth has advantages in generating perfect prototypes
comparable to the native tooth. Thus, it could be employed to
exchange a tooth in the location of a lost or damaged tooth.
Owing to current innovations in the technology, it is assumed
that AM technology will certainly play an adequate part for
numerous remarkable applications in the range of dentistry,
mainly in the coming scenario. Additionally, 3-D printing is
similarly used to generate tailored tissue engineering scaffolds
for several usages in oral surgical treatment. Numerous
experimental methods exist, including the use of 3-D printing
for the fabrication of scaffolds which act as a carrier for the
development of bioactive molecules and cells.
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
11. CONCLUSIONS
3-D printing has engaged deeply in promptly prototyping
diverse articles and equipment. During the past decade, the 3-
D printing technique has become digitalized and widely been
extended through various medical fields, including dentistry.
Novel feed materials and printing approaches are being
established to reduce the time during rapid production and
enhance the performance by introducing excellence of the
product traits and various parameters like size, shape, and
dispersal of the feed material (powder) particles, including
solidity and viscosity (flow ability) of the polymeric materials,
by openly modifying the mechanical properties of the final
product. In 3-D printing, the viscosity dependent flow ability of
the polymers and metallic alloys is a major challenge for the
printing. However, clinical dentistry needs construction of
custom dental implants which are distinct from patient to
patient. Dentistry can be an ultimate industry for the growth of
quick prototyping technology to transfer into, as it requires
accurate engineering and precision. Herein, it is important to
point out that there are numerous facets of 3-D printing that
require further development, e.g. enhancement in surface
superiority, mechanical performance, and dimensional exact-
ness. Besides these aspects, printing objects along with
improved surface excellence are directly associated with the
used processing method. The mechanical performances of the
3-D printed object are concomitant with surface and porosity
features. Moreover, the porosity of the product hinges on the
sizes of the particle, processing temperature, and time; material
intrusion is anticipated to overcome such complications.
Reduction of the printing materials owing to manufacturing
could result in substantial deterioration of the mechanical
performances. However, the final products’ dimensional
accuracy varies depending on the printing procedures and
has a significant effect on how well a dental prosthesis fits.
■ AUTHOR INFORMATION
Corresponding Author
Chandkiram Gautam − Advanced Glass and Glass Ceramics
Research Laboratory, Department of Physics, University of
Lucknow, Lucknow 226007, India; orcid.org/0000-0003-
3190-5577; Email: gautam_ceramic@yahoo.com
Authors
Swati Chaudhary − Department of Prosthodontics, Faculty of
Dental Sciences, King George Medical University, Lucknow
226003 Uttar Pradesh, India
Sarvesh Kumar Avinashi − Advanced Glass and Glass
Ceramics Research Laboratory, Department of Physics,
University of Lucknow, Lucknow 226007, India
Jitendra Rao − Department of Prosthodontics, Faculty of
Dental Sciences, King George Medical University, Lucknow
226003 Uttar Pradesh, India
Complete contact information is available at:
https://pubs.acs.org/10.1021/acsbiomaterials.2c01561
Notes
The authors declare no competing financial interest.
■ ACKNOWLEDGMENTS
The authors gratefully recognize all the publishers for granting
permission for the cited contributions to highlight their
previous work for academic motivations. The authors also
4011
pubs.acs.org/journal/abseba Review
recognize the SERB-DST, New Delhi, Government of India,
for financial support under “Empowerment and Equity
Opportunities for Excellence in Science” (File no. EEQ/
2018/000647).
■ REFERENCES
(1) Van Noort, R. The future of dental devices is digital. Dent. Mater.
2012, 28 (1), 3−12.
(2) Singh, V. Rapid prototyping, materials for RP and applications of
RP. Int. J. Eng. Res. Sci. 2013, 4, 473−80.
(3) Javaid, M.; Haleem, A. Additive manufacturing applications in
medical cases: a literature-based review. Alexandria J. Med. 2018, 54
(4), 411−422.
(4) Duta, M.; Caraiane, A. Advances in 3D printing in dentistry. 4th
International Multidisciplinary Scientific Conference on Social Sciences
and Arts SGEM 2017, 49−54.
(5) Xu, X.; Robles-Martinez, P.; Madla, C. M.; Joubert, F.; Goyanes,
A.; Basit, A. W.; Gaisford, S. Stereolithography (SLA) 3D printing of
an antihypertensive polyprintlet: Case study of an unexpected
photopolymer-drug reaction. Addit. Manuf. 2020, 33, 101071.
(6) Venkatesh, K. V.; Nandini, V. V. Direct metal laser sintering: a
digitised metal casting technology. J. Indian Prosthodont. Soc. 2013, 13
(4), 389−392.
(7) Prasad, S.; Kader, N. A.; Sujatha, G.; Raj, T.; Patil, S. 3D printing
in dentistry. 3D Print. Med. 2018, 2 (3), 89−91.
(8) Esposito, M.; Ardebili, Y.; Worthington, H. V. Interventions for
replacing missing teeth: different types of dental implants. Cochrane
Database Syst. Rev. 2014, 7, 1465−1858.
(9) Aboul-Hosn Centenero, S.; Hernandez-Alfaro, F. 3D planning in
orthognathic surgery: CAD/CAM surgical splints and prediction of
the soft and hard tissues results - our experience in 16 cases. J. Cranio-
Maxillofacial Surg. 2012, 40 (2), 162−168.
(10) Logozzo, S.; Zanetti, E. M.; Franceschini, G.; Makynen, A.
Recent advances in dental optics - Part I: 3D intraoral scanners for
restorative dentistry. Optic Laser Eng. 2014, 54, 203−221.
(11) Chang, Y. C.; Shieh, Y. S.; Lee, S. P. Chronic osteomyelitis with
proliferative periostitis in the lower jaw. J. Dent Sci. 2015, 10, 450−
455.
(12) Chawla, K. 3D bioprinting: technology in dentistry. Int. J. Dent
Res. Oral Sci. 2017, 2 (2), 63−64.
(13) Javaid, M.; Haleem, A. Additive manufacturing applications in
orthopaedics: a review. J. Clin Orthop Trauma. 2018, 9 (3), 202−206.
(14) Coachman, C.; Calamita, M. A.; Coachman, F. G.; Coachman,
R. G.; Sesma, N. Facially generated and cephalometric guided 3D
digital design for complete mouth implant rehabilitation: a clinical
report. J. Prosthet Dent. 2017, 117 (5), 577−586.
(15) Fry, R. R.; Gargya, I.; Goyal, S.; Chawla, J. P. S.; Pandher, P. K.;
Dhaliwal, G.; Ghotra, P. S. Additive manufacturing- An enigma: The
future of oral & maxillofacial surgery. IOSR Journal of Dental and
Medical Sciences. 2016, 15 (9), 78−83.
(16) Hull, C. W. Apparatus for production of three-dimensional
objects by stereolithography. US Patent, 4575330, March, 1986.
(17) Prinz, F. B.; Atwood, C. L.; Aubin, R. F.; Beaman, J. J.; Brown,
R. L.; Fussell, P. S.; Lightman, A. J.; Sachs, E.; Weiss, L. E.; Wozny, M.
J. Rapid prototyping in Europe and Japan. Center for Advanced
Technology 1997, 102, 148.
(18) Zaharia, C.; Gabor, A. G.; Gavrilovici, A.; Stan, A. T.; Idorasi,
L.; Sinescu, C.; Negrutiu, M. L. Digital dentistry- 3D printing
applications. J. Interdiscip. Med. 2017, 2 (1), 50−53.
(19) Bensoussan, H.The history of 3D printing: 3D printing
technologies from the 80s to today. Blog post. Sculpteo. Np, 2016, 14.
(20) Daminabo, S. C.; Goel, S.; Grammatikos, S. A.; Nezhad, H. Y.;
Thakur, V. K. Fused deposition modeling-based additive manufactur-
ing (3D printing): techniques for polymer material systems. Mater.
Today Chem. 2020, 16, 100248.
(21) Zhou, Y.; Xia, X.; Liu, X.; Huang, B.; Xiao, L.; Qian, Q.; Chen,
Q. Preparation and rheological and mechanical properties of poly
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
(butylene succinate)/talc composites for material extrusion additive
manufacturing. Macromol. Mater. Eng. 2019, 304 (7), 1900021.
(22) Melenka, G. W.; Cheung, B. K.; Schofield, J. S.; Dawson, M. R.;
Carey, J. P. Evaluation and prediction of the tensile properties of
continuous fiber-reinforced 3D printed structures. Compos. Struct.
2016, 153, 866−875.
(23) Tofail, S. A.; Koumoulos, E. P.; Bandyopadhyay, A.; Bose, S.;
O’Donoghue, L.; Charitidis, C. Additive manufacturing: scientific and
technological challenges, market uptake and opportunities. Mater.
Today 2018, 21 (1), 22−37.
(24) Lille, M.; Nurmela, A.; Nordlund, E.; Metsä-Kortelainen, S.;
Sozer, N. Applicability of protein and fiber-rich food materials in
extrusion-based 3D printing. J. Food Eng. 2018, 220, 20−27.
(25) Liu, J.; Sun, L.; Xu, W.; Wang, Q.; Yu, S.; Sun, J. Current
advances and future perspectives of 3D printing natural-derived
biopolymers. Carbohydr. Polym. 2019, 207, 297−316.
(26) Somireddy, M.; Czekanski, A.; Singh, C. V. Development of
constitutive material model of 3D printed structure via FDM. Mater.
Today Commun. 2018, 15, 143−152.
(27) Anderson, I. Mechanical properties of specimens 3D printed
with virgin and recycled polylactic acid. 3D Print. Addit. Manuf. 2017,
4 (2), 110−115.
(28) Dental 3D Printing To Be Valued at $7.9 Billion. 3Dnatives,
https://www.3dnatives.com/en/dental-3d-printing-7-9-billion-
150320224.
(29) Additive manufacturing in medicine: Applications, restrictions
and future scope. medineer, http://medineer.com/?p=69.
(30) Knee Replacement: Golden Solution for metal implant
allergies. Wockhardt, https://www.wockhardthospitals.com/knee-
replacement-golden-solution-for-metal-implant-allergies.
(31) Adobe Stock mandible images. https://stock.adobe.com/fi/
search?k=mandible.
(32) 3D Printing Medical Devices Market Outlook and Demand |
COVID-19 Analysis, Size, Global Share, Business Opportunity,
Medical Application, Growth, Trends, Segments and Regional
Forecast 2027. medgadget, https://www.medgadget.com/2021/08/
3d-printing-medical-devices-market-outlook-and-demand.
(33) Additive Manufacturing in the Automotive Industry. Future-
Bridge, https://www.futurebridge.com/blog/additive-manufacturing-
in-the-automotive-industry.
(34) 3D printer promises personalised chocolate. FoodNavigator
Europe; https://www.foodnavigator.com/Article/2011/07/05/3D-
printer-promises-personalised-chocolate.
(35) Objectify Envisioning The Growing Trajectory Of 3D Printing
In The Field Of Aerospace & Defense Manufacturing. Objectify,
2022, https://objectify.co.in/objectify-envisioning-the-growing-
trajectory-of-3d-printing-in-the-field-of-aerospace-defense-
manufacturing.
(36) Gibson, I.; Rosen, D.; Stucker, B. Direct digital manufacturing.
Additive manufacturing technologies; Springer: New York, 2015, pp
375−397.
(37) Javaid, M.; Haleem, A. Current status and applications of
additive manufacturing in dentistry: A literature-based review. J. Oral
Biol. Craniofacial Res. 2019, 9 (3), 179−185.
(38) Advantages and limitations of 3D printing by stereolitography.
Prototech Asia, 2017.
(39) Thorat, S. Selective laser sintering−advantages and disadvan-
tages. Manufacturing Technology; LearnMech.Com, 2020.
(40) Msallem, B.; Sharma, N.; Cao, S.; Halbeisen, F. S.; Zeilhofer, H.
F.; Thieringer, F. M. Evaluation of the dimensional accuracy of 3D-
printed anatomical mandibular models using FFF. SLASLS, MJ, and
BJ printing technology. J. Clin. Med. 2020, 9 (3), 817.
(41) Medellin-Castillo, H. I.; Zaragoza-Jorge, Z. S. Design and
manufacturing strategies for fused deposition modeling in additive
manufacturing: A review. Chin. J. Mech. Eng. 2019, 32 (1), 53.
(42) Napadensky, E. Inkjet 3D printing. chemistry of inkjet inks 2009,
255−268.
(43) Dermeik, B.; Travitzky, N. Laminated object manufacturing of
ceramic-based materials. Adv. Eng. Mater. 2020, 22 (9), 2000256.
4012
pubs.acs.org/journal/abseba Review
(44) Chen, M. Y.; Skewes, J.; Woodruff, M. A.; Dasgupta, P.; Rukin,
N. J. Multi-colour extrusion fused deposition modeling: a low-cost 3D
printing method for anatomical prostate cancer models. Sci. Rep.
2020, 10 (1), 10004.
(45) Gardan, J. Method for characterization and enhancement of 3D
printing by binder jetting applied to the textures quality. Assemb
Autom. 2017, 37 (2), 162−169.
(46) Cronskär, M.; Bäckström, M.; Rännar, L. E. Production of
customized hip stem prostheses − a comparison between conven-
tional machining and electron beam melting (EBM). Rapid Prototyp J.
2013, 19 (5), 365−372.
(47) Petrovic, V.; Niñerola, R. Powder recyclability in electron beam
melting for aeronautical use. Aircraft Eng. Aero. Technol: Int. J. 2015,
87 (2), 147−155.
(48) Xu, Z.; Wang, Y.; Wu, D.; Ananth, K. P.; Bai, J. The process and
performance comparison of polyamide 12 manufactured by multi jet
fusion and selective laser sintering. J. Manuf. Process. 2019, 47, 419−
426.
(49) Chen, H.; Zhao, Y. F. Process parameters optimization for
improving surface quality and manufacturing accuracy of binder
jetting additive manufacturing process. Rapid Prototyp J. 2016, 22 (3),
527−538.
(50) Dupláková, D.; Hatala, M.; Duplák, J.; Radchenko, S.; Steranka,
J. Direct metal laser sintering−Possibility of application in production
process. SAR J. 2018, 1 (4), 123−127.
(51) ; Badiru, A. B., Valencia, V. V., Liu, D., Eds. Additive
manufacturing handbook: product development for the defense industry;
CRC Press, 2017.
(52) Manapat, J. Z.; Chen, Q.; Ye, P.; Advincula, R. C. 3D printing
of polymer nanocomposites via stereolithography. Macromol. Mater.
Eng. 2017, 302 (9), 1600553.
(53) Kessler, A.; Hickel, R.; Reymus, M. 3D printing in dentistry-
state of the art. Oper. Dent. 2020, 45, 30−40.
(54) Tumbleston, J. R.; Shirvanyants, D.; Ermoshkin, N.;
Janusziewicz, R.; Johnson, A. R.; Kelly, D.; Chen, K.; Pinschmidt,
R.; Rolland, J. P.; Ermoshkin, A. Continuous liquid interface
production of 3D objects. Science 2015, 347, 1349−1352.
(55) Jain, R.; Supriya, B. S.; Gupta, K. Recent Trends of 3-D
Printing in Dentistry-A review. Ann. Prosthodont. Rest. Dent. 2016, 2,
101−104.
(56) Hazeveld, A.; Huddleston Slater, J. J. R.; Ren, Y. Accuracy and
reproducibility of dental replica models reconstructed by different
rapid prototyping techniques. Am. J. Orthod. Dentofac. Orthop. 2014,
145, 108−115.
(57) Noorani, R. 3D printing: technology, applications, and selection;
CRC Press, 2017.
(58) Aly, P.; Mohsen, C. Comparison of the Accuracy of Three-
Dimensional Printed Casts, Digital, and Conventional Casts: An In
Vitro Study. Eur. J. Dent. 2020, 14, 189.
(59) Sakly, A.; Kenzari, S.; Bonina, D.; Corbel, S.; Fournée, V. A
novel quasicrystal-resin composite for stereolithography. Mater. Des.
2014, 56, 280−285.
(60) Bustillos, J.; Montero-Zambrano, D.; Loganathan, A.; Boesl, B.;
Agarwal, A. Stereolithography-based 3D printed photosensitive
polymer/boron nitride nanoplatelets composites. Polym. Compos.
2019, 40, 379−388.
(61) Makvandi, P.; Esposito Corcione, C. E.; Paladini, F.; Gallo, A.
L.; Montagna, F.; Jamaledin, R.; Pollini, M.; Maffezzoli, A.
Antimicrobial modified hydroxyapatite composite dental bite by
stereolithography. Polym. Adv. Technol. 2018, 29, 364−371.
(62) Baino, F.; Magnaterra, G.; Fiume, E.; Schiavi, A.; Tofan, L.-P.;
Schwentenwein, M.; Verné, E. Digital light processing stereo-
lithography of hydroxyapatite scaffolds with bone-like architecture,
permeability, and mechanical properties. J. Am. Ceram. Soc. 2022, 105,
1648−1657.
(63) Putlyaev, V. I.; Yevdokimov, P. V.; Mamonov, S. A.; Zorin, V.
N.; Klimashina, E. S.; Rodin, I. A.; Safronova, T. V.; Garshev, A. V.
Stereolithographic 3D printing of bioceramic scaffolds of a given
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
shape and architecture for bone tissue regeneration. Inorg. Mater.
Appl. Res. 2019, 10, 1101−1108.
(64) Wong, K. V.; Hernandez, A. A review of additive
manufacturing. International scholarly research notices 2012, 2012,
208760.
(65) Sachs, E. M.; Haggerty, J. S.; Cima, M. J.; Williams, P. A. Three-
dimensional printing techniques. U.S. Patent 5,204,055 A, 1993.
(66) Butscher, A.; Bohner, M.; Doebelin, N.; Galea, L.; Loeffel, O.;
Müller, R. Moisture based three-dimensional printing of calcium
phosphate structures for scaffold engineering. Acta Biomater. 2013, 9
(2), 5369−5378.
(67) Grau, J.; Moon, J.; Uhland, S.; Cima, M.; Sachs, E. High green
density ceramic components fabricated by the slurry-based 3DP
process. Solid Freeform Fabrication Symposium 1997, 371−378.
(68) Sachs, E.; Cima, M.; Williams, P.; Brancazio, D.; Cornie, J.
Three dimensional printing: rapid tooling and prototypes directly
from a CAD model. J. eng. ind. 1992, 114 (4), 481−488.
(69) Sachs, E.; Wylonis, E.; Allen, S.; Cima, M.; Guo, H. Production
of injection molding tooling with conformal cooling channels using
the three dimensional printing process. Polym. Eng. Sci. 2000, 40 (5),
1232−1247.
(70) Wu, B. M.; Borland, S. W.; Giordano, R. A.; Cima, L. G.; Sachs,
E. M.; Cima, M. J. Solid free-form fabrication of drug delivery devices.
J. Controlled Release 1996, 40 (1−2), 77−87.
(71) Singh, R. Three dimensional printing for casting applications: A
state of art review and future perspectives. Adv. Mater. Res. 2009, 83-
86, 342−349.
(72) Sachs, E. CAD-casting: the direct fabrication of ceramic shells
and cores by threedimensional printing. Manuf. Rev. 1992, 5, 118−
126.
(73) Cesaretti, G.; Dini, E.; De Kestelier, X.; Colla, V.; Pambaguian,
L. Building components for an outpost on the Lunar soil by means of
a novel 3D printing technology. Acta Astronaut. 2014, 93, 430−450.
(74) Butscher, A.; Bohner, M.; Hofmann, S.; Gauckler, L.; Müller, R.
Structural and material approaches to bone tissue engineering in
powder-based three-dimensional printing. Acta Biomater. 2011, 7 (3),
907−920.
(75) Tuncay, O. The Invisalign System; Quintessence Publishing Co.
Ltd: New Malden, Surrey, UK, 2006.
(76) Will, J.; Melcher, R.; Treul, C.; Travitzky, N.; Kneser, U.;
Polykandriotis, E.; Horch, R.; Greil, P. Porous ceramic bone scaffolds
for vascularized bone tissue regeneration. J. Mater. Sci. Mater. Med.
2008, 19 (8), 2781−2790.
(77) Butscher, A.; Bohner, M.; Doebelin, N.; Hofmann, S.; Müller,
R. New depowderingfriendly designs for three-dimensional printing of
calcium phosphate bone substitutes. Acta biomater. 2013, 9 (11),
9149−9158.
(78) Ke, D.; Bose, S. Effects of pore distribution and chemistry on
physical, mechanical, and biological properties of tricalcium
phosphate scaffolds by binder-jet 3D printing. Addit. Manuf. 2018,
22, 111−117.
(79) Gautam, C. R.; Tamuk, M.; Manpoong, C. W.; Gautam, S. S.;
Kumar, S.; Singh, A. K. Microwave synthesis of hydroxyapatite
bioceramic and tribological studies of its composites with SrCO3 and
ZrO2. J. Mater. Sci. 2016, 51 (10), 4973−4983.
(80) Gautam, C. R.; Kumar, S.; Biradar, S.; Jose, S.; Mishra, V. K.
Synthesis and enhanced mechanical properties of MgO substituted
hydroxyapatite: a bone substitute material. RSC Adv. 2016, 6, 67565.
(81) Gautam, C. R.; Kumar, S.; Mishra, V. K.; Biradar, S. Synthesis,
structural and 3-D architecture of lanthanum oxide added
hydroxyapatite composites for bone implant applications: enhanced
microstructural and mechanical properties. Ceram. Int. 2017, 43,
14114−14121.
(82) Avinashi, S. K.; Singh, P.; Shweta, S. K.; Hussain, A.; Singh, D.;
Gautam, C. R. Morphological, mechanical, and biological evolution of
pure hydroxyapatite and its composites with titanium carbide for
biomedical applications. Ceram. Int. 2022, 48 (13), 18475−18489.
(83) Choi, S.; Oh, Y. I.; Park, K. H.; Lee, J. S.; Shim, J. H.; Kang, B.
J. New clinical application of three-dimensional-printed polycapro-
4013
pubs.acs.org/journal/abseba Review
lactone/β-tricalcium phosphate scaffold as an alternative to allograft
bone for limb-sparing surgery in a dog with distal radial osteosarcoma.
J. Vet. Med. Sci. 2019, 81 (3), 434−439.
(84) Karapatis, N.; van Griethuysen, J.; Glardon, R. Direct rapid
tooling: a review of current research. Rapid Prototyp. J. 1998, 4 (2),
77−89.
(85) Zocca, A.; Colombo, P.; Gomes, C. M.; Günster, J. Additive
manufacturing of ceramics: issues, potentialities, and opportunities. J.
Am. Ceram. Soc. 2015, 98 (7), 1983−2001.
(86) Deckard, C. R. Method and apparatus for producing parts by
selective sintering. U.S. Patent 4,863,538 A, 1989.
(87) Kruth, J.-P.; Vandenbroucke, B.; Van Vaerenbergh, J.; Naert, I.
Digital manufacturing of biocompatible metal frameworks for complex
dental prostheses by means of SLS/SLM. VRAP. Conf. 2005.
(88) Grossin, D.; Montón, A.; Navarrete-Segado, P.; Ö zmen, E.;
Urruth, G.; Maury, F.; Maury, D.; Frances, C.; Tourbin, M.;
Lenormand, P.; Bertrand, G. A review of additive manufacturing of
ceramics by powder bed selective laser processing (sintering/
melting): Calcium phosphate, silicon carbide, zirconia, alumina, and
their composites. Open Ceramics. 2021, 5, 100073.
(89) Tolochko, N. K.; Savich, V. V.; Laoui, T.; Froyen, L.; Onofrio,
G.; Signorelli, E.; Titov, V. I. Dental root implants produced by the
combined selective laser sintering/melting of titanium powders. Proc.
Inst. Mech. Eng. Part L J. Mater. Des. Appl. 2002, 216, 267−270.
(90) Kruth, J.-P.; Vandenbroucke, B.; Van Vaerenbergh, J.; Naert, I.
Rapid manufacturing of dental prostheses by means of selective laser
sintering/melting. Proc. AFPR S. 2005, 4, 176−186.
(91) Okazaki, Y.; Ishino, A. Microstructures and Mechanical
Properties of Laser-Sintered Commercially Pure Ti and Ti-6Al-4V
Alloy for Dental Applications. Materials (Basel). 2020, 13, 609.
(92) Chen, H.; Li, H.; Zhao, Y.; Zhang, X.; Wang, Y.; Lyu, P.
Adaptation of removable partial denture frameworks fabricated by
selective laser melting. J. of Prosthet. Dent. 2019, 122 (3), 316−324.
(93) Alhnan, M. A.; Okwuosa, T. C.; Sadia, M.; Wan, K.-W.; Ahmed,
W.; Arafat, B. Emergence of 3D printed dosage forms: opportunities
and challenges. Pharm. Res. 2016, 33, 1817−1832.
(94) Alageel, O.; Abdallah, M. N.; Alsheghri, A.; Song, J.; Caron, E.;
Tamimi, F. Removable partial denture alloys processed by laser-
sintering technique. J. Biomed. Mater. Res. - Part B Appl. Biomater.
2018, 106, 1174−1185.
(95) Khorsandi, D.; Fahimipour, A.; Abasian, P. 3D and 4D printing
in dentistry and maxillofacial surgery: printing techniques, materials,
and applications. Acta Biomater. 2021, 122, 26−49.
(96) Bordjih, K. Evaluation of the effect of three surface treatments
on the biocompatibility of 316L stainless steel using human
differentiated cells. Biomaterials 1996, 17 (50), 491−500.
(97) Disegi, J. A.; Eschbach, L. Stainless steel in bone surgery. Injury
2000, 31 (4), D2−D6.
(98) Talha, M.; Behera, C.; Sinha, O. A review on nickel-free
nitrogen containing austenitic stainless steels for biomedical
applications. Mater. Sci. Eng. C-Mater. 2013, 33 (7), 3563−3575.
(99) Asri, R.; Harun, W. S. W.; Samykano, M. Corrosion and surface
modification on biocompatible metals: a review. Mater. Sci. Eng. C-
Mater. 2017, 77, 1261−1274.
(100) Mantripragada, V. P.; Lecka-Czernik, B.; Ebraheim, N. A.;
Jayasuriya, A. C. An overview of recent advances in designing
orthopedic and craniofacial implants. J. Biomed. Mater. Res. A 2012,
101 (11), 3349−3364.
(101) Lueck, R. A. Development of an open pore metallic implant to
permit attachment to bone. Surgery Forum 1969, 20, 456−457.
(102) Hollander, D. A.; von Walter, M.; Wirtz, T. Structural,
mechanical and in vitro characterization of individually structured Ti-
6Al-4V produced by direct laser forming. Biomaterials 2006, 27 (7),
955−963.
(103) Chanchareonsook, N.; Tideman, H.; Lee, S.; Hollister, S. J.;
Flanagan, C.; Jansen, J. A. Mandibular reconstruction with a bioactive-
coated cementless Ti6Al4V modular endoprosthesis in Macaca
fascicularis. Int. J. Oral Maxillofac. Surg. 2014, 43 (6), 758−768.
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
(104) Revathi, A.; Borrás, A. D.; Muñoz, A. I.; Richard, C.;
Manivasagam, G. Degradation mechanisms and future challenges of
titanium and its alloys for dental implant applications in oral
environment. Mater. Sci. Eng. C-Mater. 2017, 76, 1354−1368.
(105) Monjo, M.; Petzold, C.; Ramis, J. M.; Lyngstadaas, S. P.;
Ellingsen, J. E. In vitro osteogenic properties of two dental20 BioMed
Research International implant surfaces. Int. J. Biomater. 2012, 2012,
181024.
(106) Degidi, M.; Nardi, D.; Piattelli, A. 10-year follow-up of
immediately loaded implants with TiUnite porous anodized surface.
Clin. Implant Dent 2012, 14 (6), 828−838.
(107) Cochran, D. L.; Jackson, J. M.; Bernard, J. P. A 5-year
prospective multicenter study of early loaded titanium implants with a
sandblasted and acid-etched surface. Int. J. Oral Maxillofac. Implants.
2011, 26 (6), 1324−1332.
(108) Van Bael, S. The effect of pore geometry on the in vitro
biological behavior of human periosteum-derived cells seeded on
selective laser-melted Ti6Al4V bone scaffolds. Acta Biomater. 2012, 8
(7), 2824−2834.
(109) Traini, T.; Mangano, C.; Sammons, R. L.; Mangano, F.;
Macchi, A.; Piattelli, A. Direct laser metal sintering as a new approach
to fabrication of an isoelastic functionally graded material for
manufacture of porous titanium dental implants. Dent Mater. 2008,
24 (11), 1525−1533.
(110) Velasquez-Garcia, L. F.; Kornbluth, Y. Biomedical applications
of metal 3D printing. Annu. Rev. Biomed. Eng. 2021, 23 (1), 307−338.
(111) Okazaki, Y.; Gotoh, E. Comparison of fatigue strengths of
biocompatible Ti-15Zr-4Nb-4Ta alloy and other titanium materials.
Mater. Sci. Eng. C 2011, 31, 325−333.
(112) Veiga, C.; Davim, J. P.; Loureiro, A. Properties and
applications of titanium alloys: brief review. Rev. Adv. Mater. Sci.
2012, 32, 133−148.
(113) Trevisan, F.; Calignano, F.; Aversa, A. Additive manufacturing
of titanium alloys in the biomedical field: processes. J. Appl. Biomater.
Funct. Mater. 2018, 16 (2), 57−67.
(114) Xin, X. X.; Xiang, N.; Chen, J.; Wei, B. In vitro
biocompatibility of Co−Cr alloy fabricated by selective laser melting
or traditional casting techniques. Mater. Lett. 2012, 88, 101−103.
(115) Zadpoor, A. Additively manufactured porous metallic
biomaterials. J. Mater. Chem. B 2019, 7 (26), 4088−4117.
(116) Zhang, X.; Fang, G.; Leeflang, S.; Zadpoor, A. A.; Zhou, J.
Topological design, permeability and mechanical behavior of
additively manufactured functionally graded porous metallic bio-
materials. Acta Biomater. 2019, 84, 437−452.
(117) Ginestra, P.; Ferraro, R. M.; Zohar-Hauber, K.; Abeni, A.;
Giliani, S.; Ceretti, E. Selective laser melting and electron beam
melting of Ti6Al4V for orthopedic applications: a comparative study
on the applied building direction. Materials 2020, 13 (23), 5584.
(118) Zadpoor, A. Mechanical performance of additively manufac-
tured meta-biomaterials. Acta Biomater 2019, 85, 41−59.
(119) Yu, G.; Li, Z.; Huaetal, Y. The effects of post heat Treatment
on the microstructural and mechanical properties of an additive-
manufactured porous titanium alloy. Materials 2020, 13 (3), 593.
(120) Ahmadi, S.; Kumar, R.; Borisov, E. V. From microstructural
design to surface engineering: a tailored approach for improving
fatigue life of additively manufactured meta-biomaterials. Acta
Biomater 2019, 83, 153−166.
(121) Lakshminarayan, U.; Ogrydiziak, S.; Marcus, H. L. Selective
laser sintering of ceramic materials. Int. Solid Free. Fabr. Symp. 1990,
1990.
(122) Chen, Z.; Li, Z.; Li, J.; Liu, C.; Lao, C.; Fu, Y.; Liu, C.; Li, Y.;
Wang, P.; He, Y. 3D printing of ceramics: A review. J. Eur. Ceram. Soc.
2019, 39, 661−687.
(123) Wohlert, M.; Bourell, D. Rapid prototyping of Mg/SiC
composites by a combined SLS and pressureless infiltration process.
Int. Solid Free. Fabr. Symp. 1996, 1996.
(124) Sing, S. L.; Yeong, W. Y.; Wiria, F. E.; Tay, B. Y.; Zhao, Z.;
Zhao, L.; Tian, Z.; Yang, S. Direct selective laser sintering and melting
of ceramics: a review. Rapid Prototyp. J. 2017, 23, 611−623.
4014
pubs.acs.org/journal/abseba Review
(125) Jain, P.; Kuthe, A. M. Feasibility study of manufacturing using
rapid prototyping: FDM approach. Procedia Eng. 2013, 63, 4−11.
(126) Dudek, P.; Rapacz-Kmita, A. Rapid prototyping: Technolo-
gies, materials and advances. Arch. Metall. Mater. 2016, 61, 891−896.
(127) Deb Roy, T.; Mukherjee, T.; Milewski, J. O. Scientific,
technological and economic issues in metal printing and their
solutions. Nat. Mater. 2019, 18, 1026−1032.
(128) Schleifenbaum, H.; Meiners, W.; Wissenbach, K.; Hinke, C.
Individualized production by means of high power Selective Laser
Melting. CIRP J. Manuf. Sci. Technol. 2010, 2 (3), 161−169.
(129) Meiners, W.; Wissenbach, K.; Gasser, A. Selective laser
sintering at melting temperature. U.S. Patent 6,215,093 B1, 2001.
(130) Simchi, A. Direct laser sintering of metal powders:
Mechanism, kinetics and microstructural features. Mater. Sci. Eng., A
2006, 428 (1−2), 148−158.
(131) Nagarajan, B.; Hu, Z.; Song, X.; Zhai, W.; Wei, J.
Development of micro selective laser melting: The state of the art
and future perspectives. Engineering, 2019, 5 (4), 702−720.
(132) Hao, L.; Dadbakhsh, S.; Seaman, O.; Felstead, M. Selective
laser melting of a stainless steel and hydroxyapatite composite for
load-bearing implant development. J. Mater. Process Technol. 2009,
209 (17), 5793−5801.
(133) Mercelis, P.; Kruth, J. P. Residual stresses in selective laser
sintering and selective laser melting. Rapid prototyp. J. 2006, 12 (5),
254−265.
(134) Shishkovsky, I.; Yadroitsev, I.; Bertrand, P.; Smurov, I.
Alumina−zirconium ceramics synthesis by selective laser sintering/
melting. Appl. Surf. Sci. 2007, 254 (4), 966−970.
(135) Zhang, X.; Wu, X.; Shi, J. Additive Manufacturing of zirconia
ceramics: a state-of-the − art review. J. Mater. Res. Technol. 2020, 9,
9029−9048.
(136) Liu, Q.; Danlos, Y.; Song, B.; Zhang, B. C.; Yin, S.; Liao, H. L.
Effect of high-temperature preheating on the selective laser meltingof
yttria-stabilized zirconia ceramic. J. Mater. Process Technol. 2015, 222,
61−74.
(137) Bertrand, P.; Bayle, F.; Combe, C.; Gœuriot, P.; Smurov, I.
Ceramic components manufacturing by selective laser sintering. Appl.
Surf. Sci. 2007, 254 (4), 989−992.
(138) Deckers, J.; Meyers, S.; Kruth, J.; Vleugels, J. Direct selective
laser sintering/melting of high density alumina powder layers at
elevated temperatures. Phys. Procedia 2014, 56, 117−124.
(139) Mühler, T.; Gomes, C. M.; Heinrich, J.; Günster, J. Slurry-
Based Additive Manufacturing of Ceramics. Int. J. Appl. Ceram.
Technol. 2015, 12 (1), 18−25.
(140) Gahler, A.; Heinrich, J. G.; Guenster, J. Direct Laser Sintering
of Al2O3−SiO2 Dental Ceramic Components by Layer-Wise Slurry
Deposition. J. Am. Ceram. Soc. 2006, 89 (10), 3076−3080.
(141) Li, Y.; Hu, Y.; Cong, W.; Zhi, L.; Guo, Z. Additive
manufacturing of alumina using laser engineered net shaping: effects
of deposition variables. Ceram. Int. 2017, 43 (10), 7768−7775.
(142) Balla, V. K.; Bose, S.; Bandyopadhyay, A. Processing of bulk
alumina ceramics using laser engineered net shaping. Int. J. Appl.
Ceram. Technol. 2008, 5 (3), 234−242.
(143) Griffith, M. L.; Keicher, D. L.; Atwood, C. L. Free form
fabrication of metallic components using laser engineered net shaping
(LENS). Proc. SFF Symp. 1996, 125−131.
(144) Niu, F.; Wu, D.; Ma, G.; Wang, J.; Guo, M.; Zhang, B.
Nanosized microstructure of Al2O3−ZrO2(Y2O3) eutectics fab-
ricated by laser engineered net shaping. Scr. Mater. 2015, 95 (1), 39−
41.
(145) Wilkes, J.; Hagedorn, Y. C.; Meiners, W.; Wissenbach, K.
Additive manufacturing of ZrO2-Al2O3 ceramic components by
selective laser melting. Rapid Prototyp. J. 2013, 19 (1), 51−57.
(146) Hagedorn, Y.; Balachandran, N.; Meiners, W.; Wissenbach,
K.; Poprawe, R. SLM of net-shaped high strength ceramics: new
opportunities for producing dental restorations. Proc. SFF Symp. 2011,
8−10.
(147) Exner, H.; Horn, M.; Streek, A.; Ullmann, F.; Hartwig, L.;
Regenfuß, P.; Ebert, R. Laser micro sintering: A new method to
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
generate metal and ceramic parts of high resolution with sub-
micrometer powder. Virtual Phys. Prototyp. 2008, 3 (1), 3−11.
(148) Exner, H.; Regenfuss, P.; Hartwig, L.; Klötzer, S.; Ebert, R.
Selective laser micro sintering with a novel process. SPIE Int. Soc. Opt.
Photonics 2003, 5063, 145−152.
(149) Pal, S.; Gotlih, J.; Drstvenšek, I. Investigation of the Best
Manufacturing Orientation of Co-Cr-W-Si Dental Prosthetic
Elements in the Selective Laser Melting Process. Acta. Mech. Slovaca
2022, 26 (2), 30−35.
(150) Pirinu, A.; Primo, T.; Del Prete, A.; Panella, F. W.; De
Pascalis, F. Mechanical behaviour of AlSi10Mg lattice structures
manufactured by the Selective Laser Melting (SLM). Int. J. Adv.
Manuf. Technol. 2023, 124 (5−6), 1651−1680.
(151) Keshavarzkermani, A.; Sadowski, M.; Ladani, L. Direct metal
laser melting of Inconel 718: Process impact on grain formation and
orientation. J. Alloys Compd. 2018, 736, 297−305.
(152) Jardini, A. L.; Larosa, M. A.; Filho, R. M.; Zavaglia, C. A. D.
C.; Bernardes, L. F.; Lambert, C. S.; Calderoni, D. R.; Kharmandayan,
P. Cranial reconstruction: 3D biomodel and custom-built implant
created using additive manufacturing. J. Cranio-Maxillofac. Surg. 2014,
42, 1877−1884.
(153) Laverty, D. P.; Thomas, M. B. M.; Clark, P.; Addy, L. D. The
use of 3D metal printing (direct metal laser sintering) in removable
prosthodontics. Dent. Update 2016, 43, 826−835.
(154) Sargioti, N.; Levingstone, T. J.; O’Cearbhaill, E. D.; McCarthy,
H. O.; Dunne, N. J. Metallic Microneedles for Transdermal Drug
Delivery: Applications, Fabrication Techniques and the Effect of
Geometrical Characteristics. Bioengineering 2023, 10 (1), 24.
(155) Marrey, M.; Malekipour, E.; El-Mounayri, H.; Faierson, E. J. A
framework for optimizing process parameters in powder bed fusion
(PBF) process using artificial neural network (ANN). Procedia Manuf.
2019, 34, 505−515.
(156) Heras, E. S.; Haro, F. B.; del Burgo, J. M. d. A.; Marcos, M. E.
I. Plate auto-level system for fused deposition modeling (FDM) 3D
printers. Rapid Prototyp. J. 2017, DOI: 10.1108/RPJ-06-2015-0065
(157) Taylor, A. C.; Beirne, S.; Alici, G.; Wallace, G. G. System and
process development for coaxial extrusion in fused deposition
modeling. Rapid Prototyp. J. 2017, 23, 543
(158) Lu, Z.; Ayeni, O. I.; Yang, X.; Park, H.-Y.; Jung, Y.-G.; Zhang,
J. Microstructure and Phase Analysis of 3D-Printed Components
Using Bronze Metal Filament. J. Mater. Eng. Perform. 2020, 29, 1650.
(159) Lipson, H.; Kurman, M. Fabricated: The new world of 3D
printing. John Wiley Sons, 2013.
(160) Mai, H.-N.; Lee, K.-B.; Lee, D.-H. Fit of interim crowns
fabricated using photopolymerjetting 3D printing. J. Prosthet. Dent.
2017, 118, 208−215.
(161) Cuan-Urquizo, E.; Barocio, E.; Tejada-Ortigoza, V.; Pipes, R.
B.; Rodriguez, C. A.; Roman-Flores, A. Characterization of the
mechanical properties of FFF structures and materials: A review on
the experimental, computational and theoretical approaches. Materials
(Basel). 2019, 12, 895.
(162) Egan, P. F. Integrated Design Approaches for 3D Printed
Tissue Scaffolds: Review and Outlook. Materials 2019, 12, 2355.
(163) Ngo, T. D.; Kashani, A.; Imbalzano, G.; Nguyen, K. T.; Hui,
D. Additive manufacturing (3D printing): A review of materials,
methods, applications and challenges. Compos. Part B Eng. 2018, 143,
172−196.
(164) Ventola, C. L. Medical applications for 3D printing: Current
and projected uses. Pharm. Ther. 2014, 39, 704.
(165) Ligon, S. C.; Liska, R.; Stampfl, J.; Gurr, M.; Mülhaupt, R.
Polymers for 3D printing and customized additive manufacturing.
Chem. Rev. 2017, 117, 10212−10290.
(166) Egan, P. F.; Shea, K. A.; Ferguson, S. J. Simulated tissue
growth for 3D printed scaffolds. Biomech. Model. Mechanobiol. 2018,
17, 1481−1495.
(167) Liaw, C. Y.; Guvendiren, M. Current and emerging
applications of 3D printing in medicine. Biofabrication 2017, 9,
024102.
4015
pubs.acs.org/journal/abseba Review
(168) Goole, J.; Amighi, K. 3D printing in pharmaceutics: A new
tool for designing customized drug delivery systems. Int. J. Pharm.
2016, 499, 376−394.
(169) Rubio-Perez, I.; Diaz Lantada, A. Surgical Planning of Sacral
Nerve Stimulation Procedure in Presence of Sacral Anomalies by
Using Personalized Polymeric Prototypes Obtained with Additive
Manufacturing Techniques. Polymers 2020, 12, 581.
(170) Egan, P. F.; Bauer, I.; Shea, K.; Ferguson, S. J. Mechanics of
Three-Dimensional Printed Lattices for Biomedical Devices. J. Mech.
Des. 2019, 141, 031703.
(171) Kang, H.; Hollister, S. J.; La Marca, F.; Park, P.; Lin, C. Y.
Porous biodegradable lumbar interbody fusion cage design and
fabrication using integrated global-local topology optimization with
laser sintering. J. Biomech. Eng. 2013, 135, 101013.
(172) Seaman, S.; Kerezoudis, P.; Bydon, M.; Torner, J. C.; Hitchon,
P. W. Titanium vs. polyetheretherketone (PEEK) interbody fusion:
Meta-analysis and review of the literature. J. Clin. Neurosci. 2017, 44,
23−29.
(173) Erickson, M. M.; Richardson, E. S.; Hernandez, N. M.;
Bobbert, D. W.; Gall, K.; Fearis, P. Helmet Modification to PPE With
3D Printing During the COVID-19 Pandemic at Duke University
Medical Center: A Novel Technique. J. Arthroplast. 2020, 35, S23−
S27.
(174) Provenzano, D.; Rao, Y. J.; Mitic, K.; Obaid, S. N.; Pierce, D.;
Huckenpahler, J.; Berger, J.; Goyal, S.; Loew, M. H. Rapid
Prototyping of Reusable 3D-Printed N95 Equivalent Respirators at
the George Washington University. Preprints.org 2020, 2020030444.
(175) Egan, P. F.; Ferguson, S. J.; Shea, K. Design of hierarchical
three-dimensional printed scaffolds considering mechanical and
biological factors for bone tissue engineering. J. Mech. Des. 2017,
139, 061401.
(176) Mao, Y.; Yu, K.; Isakov, M. S.; Wu, J.; Dunn, M. L.; Qi, H. J.
Sequential self-folding structures by 3D printed digital shape memory
polymers. Sci. Rep. 2015, 5, 13616.
(177) Jacquet, J. R.; Ossant, F.; Levassort, F.; Grégoire, J. M. 3-D-
Printed phantom fabricated by photopolymer jetting technology for
high-frequency ultrasound imaging. IEEE Trans. Ultrason. Ferroelectr.
Freq. Control 2018, 65 (6), 1048−1055.
(178) Cristache, C. M.; Totu, E. E. 3D Printing-Processed Polymers
for Dental Applications. React. Funct. Polym. Springer: Cham.
Switzerland 2021, 3, 141−164.
(179) Arun, M.; Sathishkumar, N.; Nithesh Kumar, K.; Ajai, S. S.;
Aswin, S. Development of patient specific bio-polymer incisor teeth
by 3D printing process: A case study. Mater. Today Proc. 2021, 39 (4),
1303−1308.
(180) Lin, H.; Shi, L.; Wang, D. A rapid and intelligent designing
technique for patient-specific and 3D-printed orthopedic cast. 3D
Print. Med. 2016, 2 (1), 4.
(181) Chun, S. Y.; Lim, J. O.; Lee, E. H.; Han, M. H.; Ha, Y. S.; Lee,
J. N.; Kim, B. S.; Park, M. J.; Yeo, M.; Jung, B.; Kwon, T. G.
Preparation and characterization of human adipose tissue-derived
extracellular matrix, growth factors, and stem cells: a concise review. J.
Tissue. Eng. Regen. Med. 2019, 16, 385−393.
(182) 3D Printing for Dental Medicine. eos, https://www.eos.info/
en/innovations/all-3d-printing-applications/medical/dental.
(183) Cirak, B. Applications of 3D printing technologies in the
dental implant sector. IJSRMME 2018, 2 (3), 42−47.
(184) coron. straumanngroup, https://www.straumann.com/digital/
nl/en/home/customized-solutions/cad-cam-tooth-prosthetics/coron.
html.
(185) FORMLABS AND BEGO ANNOUNCE PARTNERSHIP
TO ADVANCE TEMPORARY AND PERMANENT DENTAL
RESTORATIONS. 3D Printing Industry, https://3dprintingindustry.
com/news/formlabs-and-bego-announce-partnership-toadvance-
temporary-and-permanent-dental-restorations-168604.
(186) https://www.shaadaesthetics.com/smile-design.
(187) Benli, M.; Eker-Gümüs,̧ B.; Kahraman, Y.; Huck, O.; Ö zcan,
M. Can polylactic acid be a CAD/CAM material for provisional
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
crown restorations in terms of fit and fracture strength? Dent. Mater. J.
2021, 40 (3), 772−780.
(188) Polycaprolactone. Wikipedia, https://en.wikipedia.org/wiki/
Polycaprolactone.
(189) Dawood, A.; Marti, B. M.; Sauret-Jackson, V.; Darwood, A. 3D
printing in dentistry. Br. Dent. J. 2015, 219, 521−529.
(190) Klosterman, D.; Chartoff, R.; Graves, G.; Osborne, N.; Priore,
B. Interfacial characteristics of composites fabricated by laminated
object manufacturing. Compos. Part A Appl. Sci. Manuf. 1998, 29,
1165−1174.
(191) Klosterman, D. A.; Chartoff, R. P.; Osborne, N. R.; Graves, G.
A.; Lightman, A.; Han, G.; Bezeredi, A.; Rodrigues, S. Development of
a curved layer LOM process for monolithic ceramics and ceramic
matrix composites. Rapid Prototyp. J. 1999, 5 (2), 61−71.
(192) Udroiu, R.; Braga, I. C. Polyjet technology applications for
rapid tooling. MATEC Web Conf. 2017, 112, 03011.
(193) Guddati, S.; Kiran, A. S. K.; Leavy, M.; Ramakrishna, S.
Recent advancements in additive manufacturing technologies for
porous material applications. Int. J. Adv. Manuf. Technol. 2019, 105,
193−215.
(194) Delannoy, P. E.; Riou, B.; Brousse, T.; Le Bideau, J.;
Guyomard, D.; Lestriez, B. Ink-jet printed porous composite LiFePO4
electrode from aqueous suspension for microbatteries. J. Power
Sources. 2015, 287, 261−268.
(195) Delannoy, P. E.; Riou, B.; Lestriez, B.; Guyomard, D.; Brousse,
T.; Le Bideau, J. Toward fast and cost-effective ink-jet printing of
solid electrolyte for lithium microbatteries. J. Power Sources. 2015,
274, 1085−1090.
(196) Huang, J.; Yang, J.; Li, W.; Cai, W.; Jiang, Z. Electrochemical
properties of LiCoO2 thin film electrode prepared by ink-jet printing
technique. Thin Solid Films. 2008, 516 (10), 3314−3319.
(197) Milroy, C. A.; Jang, S.; Fujimori, T.; Dodabalapur, A.;
Manthiram, A. Inkjet-printed lithium−sulfur microcathodes for all-
printed, integrated nanomanufacturing. Small. 2017, 13 (11),
1603786.
(198) Zhao, Y.; Zhou, Q.; Liu, L.; Xu, J.; Yan, M.; Jiang, Z. A novel
and facile route of ink-jet printing to thin film SnO2 anode for
rechargeable lithium ion batteries. Electrochim. Acta 2006, 51 (13),
2639−2645.
(199) Choi, K. H.; Yoo, J.; Lee, C. K.; Lee, S. Y. All-inkjet-printed,
solid-state flexible supercapacitors on paper. Energy Environ. Sci. 2016,
9 (9), 2812−2821.
(200) Chen, P.; Chen, H.; Qiu, J.; Zhou, C. Inkjet printing of single-
walled carbon nanotube/RuO2 nanowire supercapacitors on cloth
fabrics and flexible substrates. Nano Research. 2010, 3 (8), 594−603.
(201) Chi, K.; Zhang, Z.; Xi, J.; Huang, Y.; Xiao, F.; Wang, S.; Liu, Y.
Freestanding graphene paper supported three-dimensional porous
graphene−polyaniline nanocomposite synthesized by inkjet printing
and in flexible all-solid-state supercapacitor. ACS Appl. Mater.
Interfaces 2014, 6 (18), 16312−16319.
(202) Conédéra, V.; Mesnilgrente, F.; Brunet, M.; Fabre, N.
Fabrication of activated carbon electrodes by inkjet deposition. The
Fourth International Conference on Systems (ICONS 2009) 2009, 157−
161.
(203) Ervin, M. H.; Le, L. T.; Lee, W. Y. Inkjet-printed flexible
graphene-based supercapacitor. Electrochim. Acta 2014, 147, 610−
616.
(204) Jung, H.; Ve Cheah, C.; Jeong, N.; Lee, J. Direct printing and
reduction of graphite oxide for flexible supercapacitors. Appl. Phys.
Lett. 2014, 105 (5), 053902.
(205) Le, L. T.; Ervin, M. H.; Qiu, H.; Fuchs, B. E.; Lee, W. Y.
Graphene supercapacitor electrodes fabricated by inkjet printing and
thermal reduction of graphene oxide. Electrochem. Commun. 2011, 13
(4), 355−358.
(206) Pang, H.; Zhang, Y.; Lai, W. Y.; Hu, Z.; Huang, W. Lamellar
K2Co3 (P2O7)2· 2H2O nanocrystal whiskers: High-performance
flexible all-solid-state asymmetric micro-supercapacitors via inkjet
printing. Nano Energy. 2015, 15, 303−312.
4016
pubs.acs.org/journal/abseba Review
(207) Pech, D.; Brunet, M.; Taberna, P. L.; Simon, P.; Fabre, N.;
Mesnilgrente, F.; Conédéra, V.; Durou, H. Elaboration of a
microstructured inkjet-printed carbon electrochemical capacitor. J.
Power Sources 2010, 195 (4), 1266−1269.
(208) Wang, S.; Liu, N.; Tao, J.; Yang, C.; Liu, W.; Shi, Y.; Wang, Y.;
Su, J.; Li, L.; Gao, Y. Inkjet printing of conductive patterns and
supercapacitors using a multi-walled carbon nanotube/Ag nano-
particle-based ink. J. Mater. Chem. A 2015, 3 (5), 2407−2413.
(209) Xu, Y.; Hennig, I.; Freyberg, D.; Strudwick, A. J.; Schwab, M.
G.; Weitz, T.; Chih-Pei Cha, K. Inkjet-printed energy storage device
using graphene/polyaniline inks. J. Power Sources 2014, 248, 483−
488.
(210) Derby, B. Inkjet printing of functional and structural materials:
fluid property requirements, feature stability, and resolution. Annu.
Rev. Mater. Res. 2010, 40, 395−414.
(211) Ebert, J.; Ozkol, E.; Zeichner, A.; Uibel, K.; Weiss, O.; Koops,
U.; Telle, R.; Fischer, H. Direct inkjet printing of dental prostheses
made of zirconia. J. Dent. Res. 2009, 88 (7), 673−676.
(212) Anssari Moin, D.; Hassan, B.; Wismeijer, D. A novel approach
for custom three-dimensional printing of a zirconia root analogue
implant by digital light processing. Clin. Oral. Implants Res. 2017, 28
(6), 668−670.
(213) Osman, R. B.; van der Veen, A. J.; Huiberts, D.; Wismeijer, D.;
Alharbi, N. 3D-printing zirconia implants; a dream or a reality? An in-
vitro study evaluating the dimensional accuracy, surface topography
and mechanical properties of printed zirconia implant and discs. J.
Mech. Behav. Biomed. Mater. 2017, 75, 521−528.
(214) Xing, H.; Zou, B.; Li, S.; Fu, X. Study on surface quality,
precision and mechanical properties of 3D printed ZrO2 ceramic
components by laser scanning stereolithography. Ceram. Int. 2017, 43
(18), 16340−16347.
(215) Scheithauer, U.; Johne, R.; Weingarten, S.; Schwarzer, E.;
Richter, H. J.; Moritz, T.; Michaelis, A. Investigation of droplet
deposition for suspensions usable for thermoplastic 3D printing
(T3DP). J. Mater. Eng. Perform. 2018, 27 (1), 44−51.
(216) Scheithauer, U.; Schwarzer, E.; Richter, H. J.; Moritz, T.
Thermoplastic 3D printing-an additive manufacturing method for
producing dense ceramics. Int. J. Appl. Ceram. Technol. 2015, 12 (1),
26−31.
(217) Scheithauer, U.; Weingarten, S.; Johne, R.; Schwarzer, E.;
Abel, J.; Richter, H. J.; Moritz, T.; Michaelis, A. Ceramic-based 4D
components: additive manufacturing (AM) of ceramic-based func-
tionally graded materials (FGM) by thermoplastic 3D printing
(T3DP). Materials 2017, 10 (12), 1368.
(218) Shao, H.; Zhao, D.; Lin, T.; He, J.; Wu, J. 3D gel-printing of
zirconia ceramic parts. Ceram. Int. 2017, 43 (16), 13938−13942.
(219) Faes, M.; Vleugels, J.; Vogeler, F.; Ferraris, E. Extrusion-based
additive manufacturing of ZrO2 using photoinitiated polymerization.
CIRP J. Manuf. Sci. Technol. 2016, 14, 28−34.
(220) Dehurtevent, M.; Robberecht, L.; Hornez, J. C.; Thuault, A.;
Deveaux, E.; Béhin, P. Stereolithography: a new method for
processing dental ceramics by additive computer-aided manufactur-
ing. Dent. Mater. 2017, 33 (5), 477−485.
(221) Maleksaeedi, S.; Eng, H.; Wiria, F. E.; Ha, T. M. H.; He, Z.
Property enhancement of 3D-printed alumina ceramics using vacuum
infiltration. J. Mater. Process Technol. 2014, 214 (7), 1301−1306.
(222) Lopez, C. D.; Diaz-Siso, J. R.; Witek, L.; Bekisz, J. M.;
Cronstein, B. N.; Torroni, A. Three dimensionally printed bioactive
ceramic scaffold osseoconduction across critical-sized mandibular
defects. J. Surg. Res. 2018, 223, 115−122.
(223) Slots, C.; Jensen, M. B.; Ditzel, N.; Hedegaard, M. A. B.; Borg,
S. W.; Albrektsen, O. Simple additive manufacturing of an
osteoconductive ceramic using suspension melt extrusion. Dent.
Mater. 2017, 33 (2), 198−208.
(224) Fahimipour, F.; Rasoulianboroujeni, M.; Dashtimoghadam, E.;
Khoshroo, K.; Tahriri, M.; Bastami, F. 3D printed TCP-based scaffold
incorporating VEGF-loaded PLGA microspheres for craniofacial
tissue engineering. Dent. Mater. 2017, 33 (11), 1205−1216.
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
(225) Tamimi, F.; Torres, J.; Al-Abedalla, K.; Lopez-Cabarcos, E.;
Alkhraisat, M. H.; Bassett, D. C. Osseointegration of dental implants
in 3D-printed synthetic onlay grafts customized according to bone
metabolic activity in recipient site. Biomaterials 2014, 35 (21), 5436−
5445.
(226) Fielding, G. A.; Bandyopadhyay, A.; Bose, S. Effects of silica
and zinc oxide doping on mechanical and biological properties of 3D
printed tricalcium phosphate tissue engineering scaffolds. Dent. Mater.
2012, 28 (2), 113−122.
(227) Shao, H.; Sun, M.; Zhang, F.; Liu, A.; He, Y.; Fu, J. Custom
repair of mandibular bone defects with 3D printed bioceramic
scaffolds. J. Dent. Res. 2018, 97 (1), 68−76.
(228) Asadi-Eydivand, M.; Solati-Hashjin, M.; Shafiei, S. S.;
Mohammadi, S.; Hafezi, M.; Abu Osman, N. A. Structure, properties,
and in vitro behavior of heat-treated calcium sulfate scaffolds
fabricated by 3D printing. PLoS One 2016, 11 (3), No. e0151216.
(229) Depprich, R.; Zipprich, H.; Ommerborn, M. Osseointegration
of zirconia implants compared with titanium: an in vivo study. Head
Face Med. 2008, 4, 30.
(230) Goffard, R.; Sforza, T.; Clarinval, A. Additive manufacturing of
biocompatible ceramics. APEM 2013, 8 (2), 96−106.
(231) Ghazanfari, A.; Li, W.; Leu, M. C.; Watts, J. L.; Hilmas, G. E.
Additive manufacturing and mechanical characterization of high
density fully stabilized zirconia. Ceram. Int. 2017, 43 (8), 6082−6088.
(232) Shahzad, K.; Deckers, J.; Zhang, Z.; Kruth, J. P.; Vleugels, J.
Additive manufacturing of zirconia parts by indirect selective laser
sintering. J. Eur. Ceram. Soc. 2014, 34 (1), 81−89.
(233) Schönherr, J. A.; Baumgartner, S.; Hartmann, M.; Stampfl, J.
Stereolithographic additive manufacturing of high precision glass
ceramic parts. Materials 2020, 13 (7), 1492.
(234) Hoffman, M.; Cho, S. H.; Bansal, N. K. Interproximal distance
analysis of stereolithographic casts made by CAD CAM technology:
an invitro study. J. Prosthet. Dent. 2017, 118 (5), 624−630.
(235) Kúsnieruk, S.; Wojnarowicz, J.; Chodara, A.; Chudoba, T.;
Gierlotka, S.; Lojkowski, W. Influence of hydrothermal synthesis
parameters on the properties of hydroxyapatite nanoparticles.
Beilstein. J. Nanotechnol. 2016, 7, 1586−1601.
(236) De Dios Teruel, J.; Alcolea, A.; Hernández, A.; Ruiz, A. J. O.
Comparison of chemical composition of enamel and dentine in
human, bovine, porcine and ovine teeth. Arch. Oral. Biol. 2015, 60,
768−775.
(237) Antoniac, I.; Miculescu, F.; Cotrut, C.; Ficai, A.; Rau, J. V.;
Grosu, E.; Antoniac, A.; Tecu, C.; Cristescu, I. Controlling the
Degradation Rate of Biodegradable Mg-Zn-Mn Alloys for Orthopedic
Applications by Electrophoretic Deposition of Hydroxyapatite
Coating. Materials 2020, 13, 263.
(238) Szczes, A.; Hołysz, L.; Chibowski, E. Synthesis of
hydroxyapatite for biomedical applications. Adv. Colloid Interface Sci.
2017, 249, 321−330.
(239) Sans, J.; Sanz, V.; Puiggalí, J.; Turon, P.; Alemán, C.
Controlled Anisotropic Growth of Hydroxyapatite by Additive-Free
Hydrothermal Synthesis. Cryst. Growth Des. 2021, 21 (2), 748−756.
(240) Riveiro, A.; del Val, J.; Comesaña, R.; Lusquiños, F.; Quintero,
F.; Boutinguiza, M.; Pou, J. Laser additive manufacturing processes for
near net shape components. NNS manuf. process, Springer 2019, 105−
141.
(241) Feygin, M.; Hsieh, B. Laminated object manufacturing
(LOM): a simpler process. International Solid Freeform Fabrication
Symposium 1991.
(242) Ahn, D.; Kweon, J. H.; Choi, J.; Lee, S. Quantification of
surface roughness of parts processed by laminated object manufactur-
ing. J. Mater. Process. 2012, 212 (2), 339−346.
(243) Mekonnen, B. G.; Bright, G.; Walker, A. A study on state of
the art technology of laminated object manufacturing (LOM). CAD/
CAM, Robotics and Factories of the Future; Springer: New Delhi, 2016;
pp 207−216.
(244) Yuan, J.; Zhu, M.; Xu, B.; Chen, G. Review on processes and
color quality evaluation of color 3D printing. Rapid Prototyp J. 2018,
24 (2), 409−415.
4017
pubs.acs.org/journal/abseba Review
(245) Kim, G. B.; Lee, S.; Kim, H.; Yang, D. H.; Kim, Y. H.; Kyung,
Y. S.; Kim, C. S.; Choi, S. H.; Kim, B. J.; Ha, H.; Kwon, S. U. Three-
dimensional printing: basic principles and applications in medicine
and radiology. Korean J. Radiol. 2016, 17 (2), 182−197.
(246) Sahoo, S.; Chou, K. June. Review on phase-field modeling of
microstructure evolutions: application to electron beam additive
manufacturing. MSEC 2014, 45813, V002T02A020.
(247) Gali, S.; Sirsi, S. Review: 3D printing: The future technology
in prosthodontics. J. Dent. Orofac. Res. 2015, 11, 37−40.
(248) Bass, L.; Meisel, N. A.; Williams, C. B. Exploring variability of
orientation and aging effects in material properties of multi-material
jetting parts. Rapid Prototyp J. 2016, 22 (5), 826−834.
(249) DIFFERENCES BETWEEN MJP AND PJP. THINK3D,
https://www.think3d.in/differences-between-mjp-and-pjp/.
(250) Li, C.; Pisignano, D.; Zhao, Y.; Xue, J. Advances in medical
applications of additive manufacturing. Engineering. 2020, 6 (11),
1222−1231.
(251) Anadioti, E.; Kane, B.; Soulas, E. Current and emerging
applications of 3D printing in restorative dentistry. Curr. Oral Health
Rep. 2018, 5 (2), 133−139.
(252) Jung, J. W.; Lee, H.; Hong, J. M. A new method of fabricating
a blend scaffold using an indirect three-dimensional printing
technique. Biofabrication 2015, 7 (4), 045003.
(253) Tunchel, S.; Blay, A.; Kolerman, R.; Mijiritsky, E.; Shibli, J. A.
3D printing/additive manufacturing single titanium dental implants: a
prospective multicenter study with 3 years of follow-up. Int. J.
Dentistry. 2016, 2016, 1−9.
(254) Kurimoto, M.; Ozaki, H.; Yamashita, Y.; Funabashi, T.; Kato,
T.; Suzuoki, Y. Dielectric properties and 3d printing of uv-cured
acrylic composite with alumina microfiller. IEEE Trans. Dielectr. Electr.
Insul. 2016, 23, 2985−2992.
(255) Trombetta, R.; Inzana, J. A.; Schwarz, E. M.; Kates, S. L.;
Awad, H. A. 3D printing of calcium phosphate ceramics for bone
tissue engineering and drug delivery. Ann. Biomed. Eng. 2017, 45, 23−
44.
(256) Gill, S. S.; Kaplas, M. Comparative study of 3D printing
technologies for rapid casting of aluminium alloy. Mater. Manuf.
Process. 2009, 24, 1405−1411.
(257) Klammert, U.; Gbureck, U.; Vorndran, E.; Rödiger, J.; Meyer-
Marcotty, P.; Kübler, A. C. 3D powder printed calcium phosphate
implants for reconstruction of cranial and maxillofacial defects. J.
Craniomaxillofac. Surg. 2010, 38, 565−570.
(258) Arafa, K. A. O. Comparing the effects of titanium alloy and
chrome cobalt in removable partial denture connectors on tooth
mobility, bone loss and tissue reaction. Saudi J. Dent. Res. 2016, 7,
112−117.
(259) Wu, H.; Cheng, Y.; Liu, W.; He, R.; Zhou, M.; Wu, S.; Song,
X.; Chen, Y. Effect of the particle size and the debinding process on
the density of alumina ceramics fabricated by 3D printing based on
stereolithography. Ceram. Int. 2016, 42, 17290−17294.
(260) Goodall, W. A.; Greer, A. C.; Martin, N. Unilateral removable
partial dentures. Br. Dent. J. 2017, 222, 79−84.
(261) Li, X.; Su, H.; Dong, D.; Zhao, D.; Liu, Y.; Shen, Z.; Jiang, H.;
Guo, Y.; Liu, H.; Fan, G.; Yang, W. Enhanced comprehensive
properties of stereolithography 3D printed alumina ceramic cores with
high porosities by a powder gradation design. J. Mater. Sci. Technol.
2022, 131, 264−275.
(262) Krishnan, S. P.; Dawood, A.; Richards, R.; Henckel, J.; Hart,
A. J. A review of rapid prototyped surgical guides for patient-specific
total knee replacement. J. Bone Joint Surg. Br. 2012, 94-B, 1457−1461.
(263) Harris, B. D.; Nilsson, S.; Poole, C. M. A feasibility study for
using ABS plastic and a low-cost 3D printer for patient-specific
brachytherapy mould design. Australasian Phys. Eng. Sci. Med. 2015,
38, 399−412.
(264) . Superior 3D printing of dental models. Br. Dent. J. 2014, 216,
261.
(265) Zein, I.; Hutmacher, D. W.; Tan, K. C.; Teoh, S. H. Fused
deposition modeling of novel scaffold architectures for tissue
engineering applications. Biomater. 2002, 23 (4), 1169−1185.
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering
(266) Poh, P. S.; Chhaya, M. P.; Wunner, F. M.; De-Juan-Pardo, E.
M.; Schilling, A. F.; Schantz, J. T.; Van Griensven, M.; Hutmacher, D.
W. Polylactides in additive biomanufacturing. Adv. Drug Delivery Rev.
2016, 107, 228−246.
(267) Gutierrez, C. R. R. Improving the engineering properties of
PLA for 3D printing and beyond. University of Texas at El Paso,
2016.
(268) Domingos, M.; Intranuovo, F.; Russo, T.; De Santis, R.;
Gloria, A.; Ambrosio, L.; Bartolo, P. The first systematic analysis of
3D rapid prototyped poly (E-caprolactone) scaffolds manufactured
through BioCell printing: The effect of pore size and geometry on
compressive mechanical behaviour and in vitro hMSC viability.
Biofabrication 2013, 5, 045004.
(269) Kirchmajer, D. M.; Gorkin, R.; in het Panhuis, M. An overview
of the suitability of hydrogel-forming polymers for extrusion-based
3D-printing. J. Mater. Chem. B 2015, 3, 4105−4117.
(270) Kasparova, M.; Grafova, L.; Dvorak, P.; Dostalova, T.;
Prochazka, A.; Eliasova, H.; Prusa, J.; Kakawand, S. Possibility of
reconstruction of dental plaster cast from 3D digital study models.
Biomed. Eng. Online. 2013, 12 (1), 49.
(271) Gong, X.; Lin, C.; Cheng, J.; Su, J.; Zhao, H.; Liu, T.; Wen, X.;
Zhao, P. Generation of multicellular tumor spheroids with microwell-
based agarose scaffolds for drug testing. PloS one. 2015, 10 (6),
No. e0130348.
(272) Zhao, Y.; Li, Y.; Mao, S.; Sun, W.; Yao, R. The influence of
printing parameters on cell survival rate and printability in
microextrusion-based 3D cell printing technology. Biofabrication
2015, 7 (4), 045002.
(273) Zong, W.; Zhang, S.; Zhang, C.; Ren, L.; Wang, Q. Design and
characterization of selective laser-melted Ti6Al4V−5Cu alloy for
dental implants. Mater. Corros. 2020, 71 (10), 1697−1710.
(274) Oberoi, G.; Nitsch, S.; Edelmayer, M.; Janjić, K.; Müller, A. S.;
Agis, H. 3D Printing-encompassing the facets of dentistry. Front.
Bioeng. Biotechnol. 2018, 6, 172.
(275) Guess, P. C.; Att, W.; Strub, J. R. Zirconia in Fixed Implant
Prosthodontics. Clin. Implant Dent. Relat. Res. 2012, 14 (5), 633−645.
(276) Punj, A.; Bompolaki, D.; Garaicoa, J. Dental impression
materials and techniques. Dental Clinics 2017, 61 (4), 779−796.
(277) Rubel, B. S. Impression materials: a comparative review of
impression materials most commonly used in restorative dentistry.
Dent. Clin. North Am. 2007, 51 (3), 629−642.
(278) Wassell, R. W.; Barker, D.; Walls, A. W. G. Crowns and other
extra-coronal restorations: impression materials and technique. Br.
Dent. J. 2002, 192 (12), 679−690.
(279) Takemoto, M.; Fujibayashi, S.; Ota, E.; Otsuki, B.; Kimura,
H.; Sakamoto, T.; Kawai, T.; Futami, T.; Sasaki, K.; Matsushita, T.;
Nakamura, T. Additive-manufactured patient-specific titanium
templates for thoracic pedicle screw placement: novel design with
reduced contact area. Eur. Spine J. 2016, 25, 1698−1705.
(280) Nulty, A. A literature review of 3D printing materials in
dentistry: part four. Clinical Dentistry 2022, 2 (3), 44−49.
(281) Flügge, T. V.; Nelson, K.; Schmelzeisen, R.; Metzger, M. C.
Three-dimensional plotting and printing of an implant drilling guide:
simplifying guided implant surgery. J. Oral Maxillofac. Surg. 2013, 71,
1340−1346.
(282) Chiang, M. T.; Li, T.; Yeh, H. W. Evaluation of missing-tooth
effect on articular eminence inclination of temporomandibular joint. J.
Dent Sci. 2015, 10, 383−387.
(283) Jawahar, A.; Maragathavalli, G. Applications of 3D printing in
dentistry−a review. Int. J. Pharm. Sci. Res. 2019, 11 (5), 1670−1675.
(284) Repairing a chipped or broken tooth, Web MD, https://www.
webmd.com/oral-health/guide/repairing-a-chipped-or-broken-tooth.
(285) When a dental inlay is your best option. Colgate, https://
www.colgate.com/en-us/oral-health/fillings/when-a-dental-inlay-is-
your-best-option.
(286) Anssari Moin, D.; Derksen, W.; Verweij, J.P.; van Merkesteyn,
R.; Wismeijer, D. A novel approach for computer-assisted template-
guided auto transplantation of teeth with custom 3D designed/
4018
pubs.acs.org/journal/abseba Review
printed surgical tooling. An ex vivo proof of concept. J. Oral
Maxillofac. Surg. 2016, 74 (5), 895−902.
(287) Yamamoto, S.; Kanazawa, M.; Iwaki, M.; Jokanovic, A.;
Minakuchi, S. Effects of offset values for artificial teeth positions in
CAD/CAM complete denture. Comput. Biol. Med. 2014, 52, 1−7.
(288) Park, C.; Raigrodski, A. J.; Rosen, J.; Spiekerman, C.; London,
R. M. Accuracy of implant placement using precision surgical guides
with varying occlusogingival heights: an in vitro study. J. Prosthet.
Dent. 2009, 101, 372−381.
(289) Garber, D. A.; Belser, U. C. Restoration-driven implant
placement with restoration-generated site development. Compend.
Contin. Educ. Dent. 1995, 16 (8), 796−798.
(290) Van Assche, N.; van Steenberghe, D.; Guerrero, M. E.
Accuracy of implant placement based on pre-surgical planning of
three-dimensional cone-beam images: a pilot study. J. Clin.
Periodontol. 2007, 34, 816−821.
(291) Xia, J.; Ip, H. H.; Samman, N. Computer assisted three-
dimensional surgical planning and simulation: 3D virtual osteotomy.
Int. J. Oral Maxillofac. Surg. 2000, 29 (1), 11−17.
(292) Li, H.; Song, L.; Sun, J.; Ma, J.; Shen, Z. Dental ceramic
prostheses by stereolithography-based additive manufacturing:
potentials and challenges. Adv. Appl. Ceram. 2019, 118 (1−2), 30−36.
(293) Cutting Edge 3D Printing Clear Dental Aligners. All3DP,
https://all3dp.com/1/3d-printing-clear-dental-aligners.
(294) Bhargav, A.; Sanjairaj, V.; Rosa, V.; Feng, L. W.; Fuh, J. Y. H.
Applications of additive manufacturing in dentistry: A review. J.
Biomed. Mater. Res. B Appl. Biomater. 2018, 106 (5), 2058−2064.
(295) Liu, Q.; Leu, M.; Schmitt, S. Rapid prototyping in dentistry:
technology and application. Int. J. Adv. Manuf. Technol. 2006, 29,
317−335.
(296) Evans, J. W.; Desai, P. S. Applications for three-dimensional
printing in dentistry. J. Multidiscip. Care 2016.
(297) Javaid, M.; Haleem, A.; Kumar, L. Current status and
applications of 3D scanning in dentistry. Clin. Epidemiology Glob.
Health 2019, 7, 228−233.
(298) Carrel, J.; Wiskott, A.; Moussa, M.; Rieder, P.; Scherrer, S.;
Durual, S. A 3D printed TCP/HA structure as a new osteoconductive
scaffold for vertical bone augmentation. Clin. Oral Implants Res. 2016,
27, 55−62.
(299) Tian, Y.; Chen, C.; Xu, X.; Wang, J.; Hou, X.; Li, K.; Lu, X.;
Shi, H. Y.; Lee, E. S.; Jiang, H. B. A review of 3D printing in dentistry:
Technologies, affecting factors, and applications. Scanning 2021, 2021,
9950131.
(300) Soares, P. V.; de Almeida Milito, G.; Pereira, F. A.; Reis, B. R.;
Soares, C. J.; de Sousa Menezes, M.; de Freitas Santos-Filho, P. C.
Rapid prototyping and 3D-Virtual models for operative dentistry
education in Brazil. J. Dent. Educ. 2013, 77 (3), 358−363.
(301) Chan, D. C. N.; Frazier, K. B.; Tse, L.; Rosen, D. Application
of rapid prototyping to operative dentistry curriculum. J. Dent. Educ.
2004, 68 (1), 64−70.
(302) Kurenov, S. N.; Ionita, C.; Sammons, D.; Demmy, T. L.
Three-dimensional printing to facilitate anatomic study, device
development, simulation, and planning in thoracic surgery. J. Thorac.
Cardiovasc. Surg. 2015, 149, 973−979.
(303) Haleem, A.; Javaid, M. Role of CT and MRI in the design and
development of orthopaedic model using additive manufacturing. J.
Clin. Orthop. Trauma. 2018, 9 (3), 213−217.
(304) Singh, R. P.; Kataria, R.; Singhal, S. Performance evaluation of
macor dental ceramic: an investigation with rotary ultrasonic
machining. Adv. Dent. Oral Health. 2018, 8 (2), 555733.
(305) Miyazaki, T.; Hotta, Y. CAD/CAM systems available for the
fabrication of crown and bridge restorations. Aust. Dent. J. 2011, 56,
97−106.
(306) Kobryn, P. A.; Ontko, N. R.; Perkins, L. P.; Tiley, J. S.
Additive Manufacturing of Aerospace Alloys for Aircraft Structures.
Defense Technical Information Center, 2006.
(307) Gungor-Ozkerim, P. S.; Inci, I.; Zhang, Y. S.; Khademhosseini,
A.; Dokmeci, M. R. Bioinks for 3D bioprinting: an overview. Biomater.
Sci. 2018, 6 (5), 915−946.
https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019
ACS Biomaterials Science & Engineering pubs.acs.org/journal/abseba Review

(308) Atala, A.; Yoo, J. J. Essentials of 3D biofabrication and (329) Huotilainen, E.; Jaanimets, R.; Valasek, J.; Marcian, P.; Mika,
translation; Academic Press, 2015. S. Inaccuracies in additive manufactured medical skull models caused
(309) Laheurte, P.; Prima, F.; Eberhardt, A.; Gloriant, T.; Wary, M.; by the DICOM to STL conversion process. J. Cranio-maxillofac. Surg.
Patoor, E. Mechanical properties of low modulus beta titanium alloys 2014, 42 (5), 259−265.
designed from the electronic approach. J. Mech. Behav. Biomed. Mater. (330) Salmi, M.; Paloheimo, K. S.; Tuomi, J.; Wolff, J.; Makitie, A.
2010, 3 (8), 565−573. Accuracy of medical models made by additive manufacturing (rapid
(310) Kong, D.; Ni, X.; Dong, C.; Lei, X.; Zhang, L.; Man, C.; Yao, manufacturing). J. Cranio-maxillofac. Surg. 2013, 41 (7), 603−609.
J.; Cheng, X.; Li, X. Bio-functional and anti-corrosive 3D printing (331) Snyder, G. H.; Cotteleer, M.; Kotek, B. 3D opportunity in
316L stainless steel fabricated by selective laser melting. Mater. Des. medical technology: Additive manufacturing comes to life; Deloitte
2018, 152, 88−101. University Press, 2014.
(311) Haleem, A.; Javaid, M. 3D scanning applications in medical (332) González-Henríquez, C. M.; Sarabia-Vallejos, M. A.;
field: a literature-based review. Clin. Epidemiol. Glob. Health. 2019, 7 Rodríguez Hernandez, J. Antimicrobial polymers for additive
(2), 199−210. manufacturing. Int. J. Mol. Sci. 2019, 20 (5), 1210.
(312) Kumar, L.; Shuaib, M.; Tanveer, Q.; Kumar, V.; Javaid, M.;
Haleem, A. 3 D scanner integration with product development. Int. J.
Eng. Technol. 2018, 7 (2), 220−225.
(313) Azari, A.; Nikzad, S. The evolution of rapid prototyping in
dentistry: a review. Rapid Prototyp J. 2009, 15, 216−222.
(314) Tahmaseb, A.; Wismeijer, D.; Coucke, W.; Derksen, W.
Computer technology applications in surgical implant dentistry: a
systematic review. Int. J. Oral Maxillofac. Implant. 2014, 29, 25−42.
(315) Kumar, L.; Tanveer, Q.; Kumar, V.; Javaid, M.; Haleem, A.
Developing low cost 3 D printer. Int. J. Appl. Sci. Eng. Res. 2016, 5,
433−447.
(316) Chang, S.; Lo, C.; Jiang, C.; Juan, D. The fit consideration of
the denture manufactured by 3D printing and sintering. Int. Pharm. J.
Med. Biol. Sci. 2015, 4, 184−187.
(317) Javaid, M.; Haleem, A. Current status and challenges of
Additive manufacturing in orthopaedics: an overview. J. Clin. Orthop.
Trauma. 2019, 10 (2), 380−386.
(318) Chen, J.; Zhang, Z.; Chen, X.; Zhang, C.; Zhang, G.; Xu, Z.
Design and manufacture of customized dental implants by using
reverse engineering and selective laser melting technology. J. Prosthet.
Dent. 2014, 112, 1088−1095.
(319) Vale, F.; Scherzberg, J.; Cavaleiro, J.; Sanz, D.; Caramelo, F.;
Malo, L.; Marcelino, J. P. 3D virtual planning in orthognathic surgery
and CAD/CAM surgical splints generation in one patient with
Recommended by ACS
craniofacial microsomia: a case report. Dent. Press J. Orthod. 2016, 21
(1), 89−100. Activated Metals to Generate Heat for Biomedical
(320) Chartier, T.; Dupas, C.; Lasgorceix, M.; Brie, J.; Champion, Applications
E.; Delhote, N. Additive manufacturing to produce complex 3D Eva Remlova, Giovanni Traverso, et al.
ceramic parts. J. Ceram. Sci. Technol. 2015, 6 (2), 95−104. AUGUST 16, 2023
(321) Gao, W.; Zhang, Y.; Ramanujan, D.; Ramani, K.; Chen, Y.; ACS MATERIALS LETTERS READ
Williams, C. B. The status, challenges, and future of additive
manufacturing in engineering. Comput. Aided Des. 2015, 69, 65−89. Leaflet Tissue Generation from Microfibrous Heart Valve
(322) Gonzalez-Gutierrez, J.; Cano, S.; Schuschnigg, S.; Kukla, C.; Leaflet Scaffolds with Native Characteristics
Sapkota, J.; Holzer, C. Additive manufacturing of metallic and ceramic
Soumen Jana, Amir Lerman, et al.
components by the material extrusion of highly-filled polymers: A
NOVEMBER 03, 2021
review and future perspectives. Materials 2018, 11 (5), 840. ACS APPLIED BIO MATERIALS READ
(323) Lee, P. H.; Chung, H.; Lee, S. W.; Yoo, J.; Ko, J. Review:
dimensional accuracy in additive manufacturing processes. Am. Soc.
Aggregate Materials beyond AIEgens
Mech. Eng. 2014, 45806, V001T004A045.
(324) Yang, L.; Miyanaji, H. Ceramic additive manufacturing: a Zheng Zhao, Ben Zhong Tang, et al.
review of current status and challenges. Int. SFF Symp. University of NOVEMBER 05, 2021
ACCOUNTS OF MATERIALS RESEARCH READ
Texas at Austin 2017, 652−679.
(325) Wang, Z.; Shemilt, J.; Xiao, P. Fabrication of ceramic
composite coatings using electrophoretic deposition, reaction bonding The twists and turns of Oreo cookie cream, and flavorful fun
and low temperature sintering. J. Eur. Ceram. Soc. 2002, 22 (2), 183− with tasty toy bubbles
189. Mitch Jacoby.
(326) Geschke, R. Ceramic gap-fills for ceramic restoration. Conserv. JUNE 06, 2022
2004, 28 (1), 74−83. C&EN GLOBAL ENTERPRISE READ
(327) An, D.; Li, H.; Xie, Z.; Zhu, T.; Luo, X.; Shen, Z.; Ma, J.
Additive manufacturing and characterization of complex Al2O3 parts
based on a novel stereolithography method. Int. J. Appl. Ceram.
Technol. 2017, 14 (5), 836−844.
(328) Wang, Y.; Zhao, Y. F. Investigation of sintering shrinkage in
Get More Suggestions >
binder jetting additive manufacturing process. Procedia Manuf. 2017,
10, 779−790.

4019 https://doi.org/10.1021/acsbiomaterials.2c01561
ACS Biomater. Sci. Eng. 2023, 9, 3987−4019