Position Accuracy of Implant Analogs on 3D Printed Polymer versus Conventional Dental Stone Casts Measured Using a Coordinate Measuring Machine

Abstract

Purpose: To compare the accuracy of implant analog positions on complete edentulous maxillary casts made of either dental stone or additive manufactured polymers using a coordinate measuring machine (CMM).

Material and methods: A completely edentulous maxillary model of a patient with 7 implant analogs was obtained. From this model, two types of casts were duplicated, namely conventional dental stone (CDS) using a custom tray impression technique after splinting (N = 5) and polymer cast using additive manufacturing based on the STL file generated. Polymer casts (N = 20; n = 5 per group) were fabricated using 4 different additive manufacturing technologies (multijet printing-MJP1, direct light processing-DLP, stereolithography-SLA, multijet printing-MJP2). CMM was used to measure the correct position of each implant, and distortion was calculated for each system at x-, y-, and z-axes. Measurements were repeated 3 times per specimen in each axis yielding a total of 546 measurements. Data were analyzed using ANOVA, Sheffé tests, and Bonferroni correction (α = 0.05).

Results: Compared to CMM, the mean distortion (μm) ranged from 22.7 to 74.9, 23.4 to 49.1, and 11.0 to 85.8 in the x-, y-, and z-axes, respectively. CDS method (x-axis: 37.1; z-axis: 27.62) showed a significant difference compared to DLP on the x-axis (22.7) (p = 0.037) and to MJP1 on the z-axis (11.0) (p = 0.003). Regardless of the cast system, x-axes showed more distortion (42.6) compared to y- (34.6) and z-axes (35.97). Among additive manufacturing technologies, MJP2 presented the highest (64.3 ± 83.6), and MJP1 (21.57 ± 16.3) and DLP (27.07 ± 20.23) the lowest distortion, which was not significantly different from CDS (32.3 ± 22.73) (p > 0.05).

Conclusion: For the fabrication of the definitive casts for implant prostheses, one of the multijet printing systems and direct light processing additive manufacturing technologies showed similar results to conventional dental stone.

Clinical significance: Conventional dental stone casts could be accurately duplicated using some of the additive manufacturing technologies tested.

Keywords: 3D printing; additive manufacturing technologies; definitive implant cast; direct light processing technology; implant prostheses; inject technology; multijet printing; stereolitography technology.