Design and manufacture of customized dental implants by using reverse engineering and selective laser melting technology.

STATEMENT OF PROBLEM Recently a new therapeutic concept of patient-specific implant dentistry has been advanced based on computer-aided design/computer-aided manufacturing technology. However, a comprehensive study of the design and 3-dimensional (3D) printing of the customized implants, their mechanical properties, and their biomechanical behavior is lacking. PURPOSE The purpose of this study was to evaluate the mechanical and biomechanical performance of a novel custom-made dental implant fabricated by the selective laser melting technique with simulation and in vitro experimental studies. MATERIAL AND METHODS Two types of customized implants were designed by using reverse engineering: a root-analog implant and a root-analog threaded implant. The titanium implants were printed layer by layer with the selective laser melting technique. The relative density, surface roughness, tensile properties, bend strength, and dimensional accuracy of the specimens were evaluated. Nonlinear and linear finite element analysis and experimental studies were used to investigate the stress distribution, micromotion, and primary stability of the implants. RESULTS Selective laser melting 3D printing technology was able to reproduce the customized implant designs and produce high density and strength and adequate dimensional accuracy. Better stress distribution and lower maximum micromotions were observed for the root-analog threaded implant model than for the root-analog implant model. In the experimental tests, the implant stability quotient and pull-out strength of the 2 types of implants indicated that better primary stability can be obtained with a root-analog threaded implant design. CONCLUSIONS Selective laser melting proved to be an efficient means of printing fully dense customized implants with high strength and sufficient dimensional accuracy. Adding the threaded characteristic to the customized root-analog threaded implant design maintained the approximate geometry of the natural root and exhibited better stress distribution and primary stability.

[1]  P. J. García Nieto,et al.  Non-linear numerical analysis of a double-threaded titanium alloy dental implant by FEM , 2008, Appl. Math. Comput..

[2]  Leila Jahangiri,et al.  Patient satisfaction survey of mandibular two-implant-retained overdentures in a predoctoral program. , 2013, The Journal of prosthetic dentistry.

[3]  Ruxu Du,et al.  Design and fabrication of custom-made dental implants , 2012 .

[4]  Chun-Pin Lin,et al.  Effects of thread depth, taper shape, and taper length on the mechanical properties of mini-implants. , 2012, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[5]  E. D. Rekow,et al.  Additive CAD/CAM process for dental prostheses. , 2011, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[6]  H. Yatani,et al.  Influences of implant neck design and implant-abutment joint type on peri-implant bone stress and abutment micromovement: three-dimensional finite element analysis. , 2012, Dental materials : official publication of the Academy of Dental Materials.

[7]  Jen-Kuang Huang,et al.  Designing Natural-Tooth-Shaped Dental Implants based on Soft-Kill Option Optimization , 2013 .

[8]  Francesco Guido Mangano,et al.  Custom-made, root-analogue direct laser metal forming implant: a case report , 2012, Lasers in Medical Science.

[9]  A. Kocher,et al.  Immediate, non-submerged, root-analogue zirconia implant in single tooth replacement. , 2008, International journal of oral and maxillofacial surgery.

[10]  B. Liu,et al.  Eigenvalue problems of rotor system with uncertain parameters , 2012 .

[11]  Wael Aly Ghuneim In situ tooth replica custom implant: a 3-dimensional finite element stress and strain analysis. , 2013, The Journal of oral implantology.

[12]  Hsueh-Chuan Hsu,et al.  Structure and mechanical properties of as-cast Ti–5Nb–xCr alloys , 2013 .

[13]  Mariana Calin,et al.  Manufacture by selective laser melting and mechanical behavior of commercially pure titanium , 2014 .

[14]  A. Kocher,et al.  Immediate, single stage, truly anatomic zirconia implant in lower molar replacement: a case report with 2.5 years follow-up. , 2011, International journal of oral and maxillofacial surgery.

[15]  Richard van Noort,et al.  The future of dental devices is digital. , 2012 .

[16]  Jui-Ting Hsu,et al.  Bone stress and interfacial sliding analysis of implant designs on an immediately loaded maxillary implant: a non-linear finite element study. , 2008, Journal of dentistry.

[17]  A Piattelli,et al.  Direct laser metal sintering as a new approach to fabrication of an isoelastic functionally graded material for manufacture of porous titanium dental implants. , 2008, Dental materials : official publication of the Academy of Dental Materials.

[18]  Wael Aly Ghuneim In situ tooth replica custom implant: rationale, material, and technique. , 2010, The Journal of oral implantology.

[19]  S. Razzouk Bone remodeling and individual-based implant therapy. , 2010, The New York state dental journal.

[20]  E. Collings,et al.  Materials Properties Handbook: Titanium Alloys , 1994 .

[21]  A. Kocher,et al.  Root analog zirconia implants: true anatomical design for molar replacement--a case report. , 2011, The International journal of periodontics & restorative dentistry.

[22]  Wenhe Liao,et al.  Design of a custom angled abutment for dental implants using computer-aided design and nonlinear finite element analysis. , 2010, Journal of biomechanics.

[23]  J B Brunski,et al.  Biomaterials and biomechanics of oral and maxillofacial implants: current status and future developments. , 2000, The International journal of oral & maxillofacial implants.

[24]  Fawad Javed,et al.  The role of primary stability for successful immediate loading of dental implants. A literature review. , 2010, Journal of dentistry.

[25]  M Honl,et al.  Artificial composite bone as a model of human trabecular bone: the implant-bone interface. , 2007, Journal of biomechanics.

[26]  M. Figliuzzi,et al.  A novel root analogue dental implant using CT scan and CAD/CAM: selective laser melting technology. , 2012, International journal of oral and maxillofacial surgery.

[27]  A. Kocher,et al.  Immediate, non-submerged, root-analogue zirconia implants placed into single-rooted extraction sockets: 2-year follow-up of a clinical study. , 2009, International journal of oral and maxillofacial surgery.

[28]  Reinhart Poprawe,et al.  Densification behavior, microstructure evolution, and wear performance of selective laser melting processed commercially pure titanium , 2012 .

[29]  J Lindström,et al.  Intra-osseous anchorage of dental prostheses. I. Experimental studies. , 1969, Scandinavian journal of plastic and reconstructive surgery.

[30]  Hom-Lay Wang,et al.  Dental Implant Design and Its Relationship to Long-Term Implant Success , 2003, Implant dentistry.