METHODS: Two 3D printed models were designed and fabricated using actual patient imaging data with reference marker points embedded artificially within these models that were then registered to a surgical navigation system using 3 different methods. The first method uses a conventional manual registration, using the actual patient's imaging data. The second method is done by directly scanning the created model using intraoperative computed tomography followed by registering the model to a new imaging dataset manually. The third is similar to the second method of scanning the model but eventually uses an automatic registration technique. The errors for each experiment were then calculated based on the distance of the surgical navigation probe from the respective positions of the embedded marker points.
RESULTS: Errors were found in the preparation and printing techniques, largely depending on the orientation of the printed segment and postprocessing, but these were relatively small. Larger errors were noted based on a couple of variables: if the models were registered using the original patient imaging data as opposed to using the imaging data from directly scanning the model (1.28 mm vs. 1.082 mm), and the accuracy was best using the automated registration techniques (0.74 mm).
CONCLUSION: Spatial accuracy errors occur consistently in every 3D fabricated model. These errors are derived from the fabrication process, the image registration process, and the surgical process of registration.
MATERIALS AND METHODS: Thirty-six patients debonded from fixed appliances at a teaching institution were allocated by block randomization stratified for gender to three groups [VFRs fabricated on conventional, fused deposition modeling (FDM) or stereolithography apparatus (SLA) working models]. Participants wore the VFRs for three months full-time followed by three months part-time. VFRs were collected after each follow-up for Streptococcus and yeast counts. Surface roughness was measured indirectly on the working models using a 3D optical surface texture analyzer. Blinding was not feasible due to appliance appearance. The trial was registered [NCT03844425 ( ClinicalTrials.gov )] and funded by the Universiti Malaya Dental Postgraduate Research Grant (DPRG/14/19).
RESULTS: Thirty participants (eleven conventional, ten FDM, and nine SLA) were analyzed after six dropped out. No harms were reported. Microbial counts between the groups were not significantly different. There were more microbes in the lower VFRs than upper VFRs (total count: p<0.05; effect size, 0.5 during full-time wear and 0.4 during part-time wear). SLA had significantly (p<0.05) smoother surface than FDM (effect size, 0.3) and conventional models (effect size, 0.5). Microbial adherence was not associated with working model surface roughness.
CONCLUSION: Microbial adherence on VFRs was not influenced by degree of surface roughness imprints from working models.
CLINICAL RELEVANCE: 3D printed models can be used to make VFRs. Lower VFRs tended to accumulate oral microbes, potentially increasing the oral health risk in the lower arch.
STUDY DESIGN: The research was designed as a crossover, randomized control trial.
MATERIALS AND METHODS: Subjects comprised patients receiving fixed appliances at a teaching institution and indicated for VFRs. Post-treatment stone models were scanned with a structured-light scanner. A fused deposition modelling machine was used to construct acrylonitrile-butadiene-styrene (ABS)-based replicas from the 3D scanned images. VFRs were fabricated on the original stone and printed models. Analysis comprised independent t-tests and repeated measures analysis of variance.
RANDOMIZATION: Subjects were allocated to two groups using Latin squares methods and simple randomization. A week after debond, subjects received either VFR-CV first (group A) or VFR-3D first (group B) for 3 months, then the interventions were crossed over for another 3 months.
BLINDING: In this single-blinded study, subjects were assigned a blinding code for data entry; data were analysed by a third party.
OUTCOME MEASURES: The primary outcome measured was oral health-related quality of life (OHRQoL) based on Oral Health Impact Profile-14 (OHIP-14). Secondary outcome was post-treatment stability measured using Little's Irregularity Index (LII).
RESULTS: A total of 30 subjects (15 in each group) were recruited but 3 dropped out. Analysis included 13 subjects from group A and 14 subjects from group B. Group A showed an increase in LII (P < 0.05) after wearing VFR-CV and VFR-3D, whereas group B had no significant increase in LII after wearing both VFRs. Both groups reported significant improvement in OHRQoL after the first intervention but no significant differences after the second intervention. LII changes and OHIP-14 scores at T2 and T3 between groups, and overall between the retainers were not significantly different. No harm was reported during the study.
CONCLUSION: VFRs made on ABS-based 3D printed models showed no differences in terms of patients' OHRQoL and stability compared with conventionally made retainers.
REGISTRATION: NCT02866617 (ClinicalTrials.gov).
METHODS AND ANALYSIS: The methodology draws on Arksey and O'Malley's seminal framework for the scoping review. The literature search will be conducted by using keywords to find suitable published literature. The existing literature will be searched using selected electronic databases such as PubMed/MEDLINE, CINAHL, Scopus, ProQuest and Web of Science from the years 2011 and 2021. The selected publications will focus on 10 Southeast Asian countries: Malaysia, Indonesia, Singapore, Thailand, Brunei, Philippines, Laos, Vietnam, Cambodia and Myanmar. Two reviewers will be performing title and abstract screening for the criteria of each publication, in which they will be working independently of each other. The included publication will undergo a full-text review and references cited will be examined for relevance using the same inclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram will guide throughout the process. Data will be extracted, analysed and charted within each category from the selected publications for each Southeast Asian country.
ETHICS AND DISSEMINATION: The results of this scoping review will illustrate an overview of the 3D printing healthcare research in the Southeast Asian context, which can be a guide for the advancement of 3D printing that can be accentuated in future research. The results will undergo dissemination which will be submitted for publication in a scientific journal.
MATERIALS AND METHODS: An electronic search was performed in PubMed, SCOPUS, and Web of Science using a combination of relevant keywords: digital workflow, digital designing, computer-assisted design-computer aided manufacturing, 3D printing, maxillectomy, and mandibulectomy. The Joanna Briggs Institute Critical Appraisal Tool was used to assess the quality of evidence in the studies reviewed.
RESULTS: From a total of 542 references, 33 articles were selected, including 25 on maxillary prostheses and 8 on mandibular prostheses. The use of digital workflows was limited to one or two steps of the fabrication of the prostheses, and only four studies described a complete digital workflow. The most preferred method for data acquisition was intraoral scanning with or without a cone beam computed tomography combination.
CONCLUSION: Currently, the fabrication process of maxillofacial prostheses requires combining digital and conventional methods. Simplifying the data acquisition methods and providing user-friendly and affordable software may encourage clinicians to use the digital workflow more frequently for patients requiring maxillofacial prostheses.
MATERIALS AND METHODS: Tristar Trubalance aligner sheets were used to fabricate the CAs. Thirty-four resin models were 3D printed and 17 each, were bonded with ellipsoidal or rectangular attachments on maxillary right central incisors. Fuji Prescale pressure film was used to measure the force generated by the attachment of CA. The images of colour density produced on the films were processed using a calibrated pressure mapping system utilising image processing techniques and topographical force mapping to quantify the force. The force measurement process was repeated after the flash was removed from the attachment using tungsten-carbide bur on a slow-speed handpiece.
RESULTS: The intraclass correlation coefficient showed excellent reliability (ICC = 0.96, 95% CI = 0.92-0.98). The average mean force exerted by ellipsoidal attachments with flash was 8.05 ± 0.16 N, while 8.11 ± 0.18 N was without flash. As for rectangular attachments, the average mean force with flash was 8.48 ± 0.27 N, while 8.53 ± 0.13 N was without flash. Paired t-test revealed no statistically significant difference in the mean force exerted by CA in the presence or absence of flash for both ellipsoidal (p = 0.07) and rectangular attachments (p = 0.41). Rectangular attachments generated statistically significantly (p 0.05).