Trueness and precision of milled and 3D printed root-analogue implants: A comparative in vitro study

Mostafa Aldesoki; Ludger Keilig; Istabrak Dörsam; Bernd Evers-Dietze; Tarek M Elshazly; Christoph Bourauel

doi:10.1016/j.jdent.2023.104425

Trueness and precision of milled and 3D printed root-analogue implants: A comparative in vitro study

J Dent. 2023 Mar:130:104425. doi: 10.1016/j.jdent.2023.104425. Epub 2023 Jan 13.

Authors

Mostafa Aldesoki¹, Ludger Keilig², Istabrak Dörsam², Bernd Evers-Dietze³, Tarek M Elshazly⁴, Christoph Bourauel⁴

Affiliations

¹ Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany. Electronic address: aldesoki@uni-bonn.de.
² Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany; Department of Prosthodontics, Dental School, University Hospital Bonn, Bonn, Germany.
³ Department of Electrical Engineering, Mechanical Engineering and Technical Journalism (EMT), Bonn-Rhein-Sieg University of Applied Sciences, Sankt Augustin, Germany.
⁴ Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany.

PMID: 36646269
DOI: 10.1016/j.jdent.2023.104425

Abstract

Objectives: The present study aimed to evaluate the accuracy (trueness and precision) of titanium and zirconia multi-rooted root analogue implants (RAIs) manufactured by milling and 3D-printing.

Methods: A multi-rooted RAI was designed based on a mandibular second molar segmented from cone-beam computed tomography (CBCT). The manufactured RAIs were divided into four groups: 3D-printed titanium (PT) and 3D-printed zirconia (PZ) (n=10 each), as well as milled titanium (MT) and milled zirconia (MZ) (n=5 each). The specimens were scanned with a high-precision scanner, and the scanned data were imported into 3D-measurement software to evaluate the precision and trueness of each group. Root mean square (RMS) deviations were measured and statistically analysed (One-way ANOVA, Tukey's, p≤0.05).

Results: PZ showed the highest precision with RMS value of 21±6 µm. Nevertheless, there was no statistically significant difference in precision among the other groups. Regarding trueness, MZ showed the highest trueness with RMS value of 66±3 µm, whereas MT showed the lowest trueness result. Inspection sections showed that MT had significantly high RMS deviation in the furcation area (612±64 µm), whereas PZ showed significantly high RMS deviation at the apical area (197±17 µm).

Conclusions: The manufacturing process significantly influenced the RAI accuracy. PZ exhibited the highest precision, whereas MZ exhibited the highest trueness, followed by PT. Finally, our results suggest that 3D-printing can reproduce concave surfaces and less accessible areas better than milling.

Clinical significance: Milled and 3D-printed RAIs showed promising results in terms of precision and trueness. However, further clinical research is needed to advocate their use as immediate implants. Additionally, the inherent volumetric changes of the various materials during manufacturing should be considered.

Keywords: 3D printing; Accuracy; Milling; Precision; Root analogue implant (RAI); Trueness.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Computer-Aided Design*
Printing, Three-Dimensional
Titanium*
Zirconium

Substances

zirconium oxide
Titanium
Zirconium