Chauhan, Ataide, and Fernandes: Three-dimensional printing in endodontics: A review of literature


Introduction

3D printing is an additive manufacturing process which involves incremental deposition of material. This is an improvement from subtractive manufacturing procedures like CAD/CAM where an object is cut from a block of material. 1, 2

Limited option of materials and orientation requirements of CAD/CAM have led to their limited use in dentistry. 1, 2, 3 3D printing proves to be useful in cases where subtractive manufacturing is inadequate.

In the field of dentistry, one of the following techniques can be used for 3-D printing: stereolithography apparatus (SLA), fused deposition modelling (FDM), MultiJet printing (MJP), PolyJet printing, ColorJet printing (CJP), digital light processing (DLP) and selective laser sintering (SLS), also known as selective laser melting (SLM). 3, 4

SLA is most commonly used in dentistry. 4 Here, the exposure path of a UV laser is directed onto the surface of a vat of photosensitive resin. Subsequently curing starts from the bottom of the object, the layers bind together to form a solid mass. 1, 4 FDM printing has less precision than other methods. It involves deposition of layers of molten material from a filamentous nozzle and solidification within 0.1 second. 1, 3, 4 MultiJet printing and PolyJet printing take place by the spraying the polymer in very thin layers, each layer is cured after depositing onto a tray 1. CJP involves selective dispersion of binder onto layers of powder. 4 In DLP printing, a vat of photosensitive resin is exposed to a two-dimensional image; the object is printed as the base is manipulated. The resin is cured from the bottom as the platform moves up. 1, 4 SLS and SLM printers use a computer directed laser and roller, where powdered material is dispensed in layers which are then melted or sintered. 1, 3, 4, 5, 6

In the 1990s, Computed Tomography (CT) was used to 3D print surgical planning models. 7, 8, 9 When the FDA approved the first CBCT for dental use in 2000, it was found that in contrast to CT voxel, where axial height is determined by slice thickness, the CBCT voxel is cubic, allowing for higher resolution and hence more accurate measurements in multiple planes. 10, 1, 11 CBCT is therefore a more precise source of data for 3D printing, and has the added advantage of reducing radiation exposure, scan time as well as cost. 12, 11

Review of Endodontic Applications

A literature search of PubMed and Scopus was done with the following terms: 3D printing, stereolithography, guided endodontic access, guided endodontic surgery, surgical guide, rapid prototyping, autotransplantation rapid prototyping. Articles were incuded if: (i) article described an application of 3D printing in endodontics, (ii) published in English. Fifty-seven articles met inclusion criteria and were utilized. Documented solutions to endodontic challenges include: guided endodontic access, applications in autotransplantation, pre-surgical planning, and for educational models.

Guided endodontic access

Pulp canal obliteration is insinuated in up to 75% of perforations during attempted location and negotiation of calcified canals.13 In these cases, canals must be located in more apical portions of progressively narrowing roots. 14, 15, 16 The risk of perforation can be reduced by producing a true path of canal access and instrumentation.

In a case series, digital impressions and CBCT scans were recorded, these were merged to form an STL (stereolithography) file showing bony architecture for teeth in cases of pulp canal obliteration in maxillary incisors. Following this, access guides were printed and used to target burs to canal spaces without creating perforations. 17 Also, case reports narrating the use of 3D printed guides to access an obliterated maxillary incisor, 18 a mandibular molar, 19 type V dens evaginatus 20 and obliterated mandibular incisors 21 establish the practicality of this approach. In ex vivo investigations of accuracy, stent guided access preparations were assessed by superimposing a post access CBCT upon a pre-operative designed access. 22, 23, 24 The mean deviation of the access cavities were found to be lower than 0.7 mm. 22 Small deviations from the intended access (0.12- 0.34 mm at the tip of the bur) and a mean angular deviation of less than 2 degrees was reported. 23, 24 These examinations demonstrate that 3D printed access guides provide an coherent and safe method for both chemo-mechanical debridement and conservation of tooth structure.

Autotransplantation

The success of this procedure is dependent on viability of periodontal ligament (PDL) cells and appropriate adaptation of the transplanted tooth to the recipient site. 25, 26 Traditionally, the donor tooth is used as a template for preparation of the recipient site, which leads to multiple adjustments to the alveolar bone and hence an increased extra-oral time and increased risk of damage to the PDL. 25, 26, 27, 28 Therefore, attempts have been made to improve outcomes of autotransplantation. In two studies Computer Aided Rapid Prototyping (CARP) was used to print replicas of teeth and manipulation of the recipient bone sites was completed prior to extraction of the donor teeth. 29, 30 A number of case reports, clinical studies and in vitro studies provide evidence that preoperative CARP of transplant teeth decreases extra-oral time and improves outcomes. 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49 In a case report, the autotransplantation of immature premolars in a maxillary incisor avulsion case using a completely digital workflow has been described. 28 Here CAD was used to select the appropriate donor teeth. Prototype teeth were modified to accommodate the dimensions of Hertwig’s epithelial root sheath and to minimize damage to the apical papilla. Osteotomy guides were created using the CAD software and this led to more accuracy and efficiency in the surgical procedure. In a case report, CAD was used to print surgical instruments customized for the transplanted tooth, achieving an apical deviation of less than 1mm from the planned final tooth position in a human mandible. 45 A systematic review has reported an overall success rate of 80-91% when rapid prototyping was used, leading to a reduction in extra-oral time to less than one minute in some cases. 26

Surgical guides

In clinical scenarios it is difficult to gauge the right orientation, angulation and depth. Due to advancements in magnification, equipment and materials, endodontic microsurgery (EMS) has been accepted as a predictable procedure,50, 51, 52 also targeted osteotomy and root end resection is a pre-requisite for EMS. Osteotomy diameter can be as small as 3 mm, which has been correlated with shorter healing time, decreased postoperative pain, and improved outcomes. 50, 53 Clinicians often find it difficult to carry out procedures in posterior molar area or if important anatomic structures are close to the root end. 3D printed stents can reduce the risk by avoiding invasion of neurovascular structures.

It has been reported that guides designed from CBCT produced more accurate osteotomies than the traditional free-hand technique in an in vitro model. 54 Case reports have described the use of a 3D printed guide for traditional root-end surgery, 55 as well as for designing a stent defining the upper and lower margins of the osteotomy, as well as the root resection site and angulation, resulting in increased clinical efficiency and precision, minimizing risk of sinus perforation. 56 Use of a 3D printed custom tissue retractor to enhance visualization and soft tissue handling during EMS on a maxillary incisor has also been described. 57

Table 1

Endodontic Application

Teeth/ material studied

Author/year

Type of study

3D printer

Guided Endodontic Access

Not stated

Van der Meer WJ et al. 2016 17

Case series

Not stated

Guided Endodontic Access

Maxillary incisor

Krastl G et al. 2016 18

Case report

PolyJet

Guided Endodontic Access

Mandibular molar

Shi X et al. 2017 19

Case report

MJP

Guided Endodontic Access

Type V dens evaginatus

Mena-Alvarez J et al. 2017 20

Case report

SLA

Guided Endodontic Access

Mandibular incisors

Connert T et al. 2018 21

Case report

PolyJet

Guided Endodontic Access

48 extracted Teeth (undisclosed)

Buchgreitz J et al. 2016 22

Ex vivo study

Not stated

Guided Endodontic Access

60 single Rooted human teeth

Zehnder MS et al. 2016 23

Ex vivo study

PolyJet

Guided Endodontic Access

60 mandibular anterior teeth

Connert T et al. 2017 24

Ex vivo study

PolyJet

Tooth autotransplantation

Mandibular third molar

Lee S-J et al. 2001 29

Case series

Not stated

Tooth autotransplantation

Third molars

Lee S-J et al. 2012 30

Case series

Not stated

Tooth autotransplantation

Immature premolar

Keightley A et al. 2010 31

Case report

CJP

Tooth autotransplantation

Right Mandibular Third molar

Honda M et al. 2010 32

Case report

Not stated

Tooth autotransplantation

Maxillary left Second premolar

Pang NS et al. 2010 33

Case report

Not stated

Tooth autotransplantation

Premolar and Third molar

Shahbazian M et al. 2010 34

Pre-clinical

SLA

Tooth autotransplantation

Undisclosed

Shahbazian M et al. 2012 35

Case report

SLA

Tooth autotransplantation

Mandibular Right third molar

Park Y-S et al. 2012 36

Case report

Not stated

Tooth autotransplantation

Mandibular Second premolar

Park Y-S et al. 2013 37

Case Report

Not stated

Tooth autotransplantation

Immature Third molars

Jang J-H et al. 2013 39

Case series

Not stated

Tooth autotransplantation

Mesiodens

Lee Y et al. 2014 40

Case report

Not stated

Tooth autotransplantation

Third molar

Park J-M et al. 2014 41

Case report

PolyJet

Tooth autotransplantation

Maxillary left Central incisor

Vandekar M et al. 2015 42

Case report

DLP

Tooth autotransplantation

Maxillary Right second premolar

Van der Meer WJ et al. 2016 43

Case report

Not stated

Tooth autotransplantation

Mandibular premolars

Khalil W et al. 2016 44

In vitro study

PolyJet

Tooth autotransplantation

Mandibular Left canine

Anssari Moin D et al. 2016 45

Ex vivo

Not stated

Tooth autotransplantation

Mandibular Incisors, canines, premolars

Anssari Moin D et al. 2017 46

Ex vivo

Not stated

Tooth autotransplantation

Maxillary Second premolar

Cousley RRJ et al. 2017 47

Case report

CJP

Tooth autotransplantation

Maxillary Right canine

Kim MS et al. 2017 48

Case report

Not stated

Tooth autotransplantation

Third molar

Verweij JP et al.2017 49

Systematic review

Not stated

Guided EMS

All mandibular teeth

Pinsky HM et al. 2007 54

Pre-clinical

Not stated

Guided apicoectoectomy

Mandibular Right premolar

Liu Y et al. 2014 55

Case report

PolyJet

Surgical guides

Maxillary central incisor

Strbac GD et al. 2016 56

Case report

PolyJet

EMS soft tissue retraction

Maxillary left central incisor

Patel S et al. 2017 57

Case report

Not stated

Simulation exercises

Right Maxillary central incisor

Kfir A et al. 2013 58

Case report

PolyJet

Pre-treatment simulation

Mandibular second molar and paramolar

Kato H et al. 2015 59

Case report

FDM

Research simulation

Mandibular Molar replicas

Marending M et al. 2016 60

Pre-clinical

Not stated

Research simulation

Replicas of teeth extracted for orthodontic, periodontic or prosthetic reasons

Robberecht L et al. 2017 61

Pre-clinical

SLA

Research simulation

Replicas of mandibular molars

Ordinola-Zapata R et al. 2014 62

Pre-clinical

MJP

Research simulation

Mandibular Second premolar

Eken R et al. 2016 63

Pre-clinical

PolyJet

Research simulation

Resin models of maxillary central incisors

Yahata Y et al. 2017 64

Pre-clinical

MJP

Research simulation

Replicas of mandibular molars

Gok T et al. 2017 65

Pre-clinical

DLP

Research simulation

Sheets of Photopolymer material

Mohmmed SA et al. 2017 66

In vitro

SLA

Educational models and clinical simulation

Most dental educational institutes use extracted teeth, human cadavers, or commercially available resin teeth for preclinical exercises.67, 68 Though extracted teeth can provide a clinical simulation close to reality, but it is difficult to find teeth with the required properties and disinfection, storage etc. can change the properties. Commercially available resin teeth are an alternative to the natural dentition but can be expensive.

Tooth prototypes can be used for simulation exercises and have multiple benefits over extracted teeth. 58, 69, 59, 60, 61. Earlier CT slices and starch were used to reconstruct exigent clinical cases such as extracanal invasive resorption70 and a molar with three distal roots.71 In a case report clear tooth replica was used to simulate ideal access, instrumentation and obturation preoperatively in a complex type 3 dens invaginatus scenario, before treating the clinical case.58 In an evaluation of dental student file preferences, commercially available 3D printed molar replicas (RepliDens, Zurich, Switzerland) were used to avoid variance in initial canal configuration 60. A porous, radiopaque hydroxyapatite-based matrix with hardness similar to dentin to print ceramic models for endodontic lab exercises has been developed. 61

3D printing can be used to manufacture a large number of identical prototypes and hence can be utilized in pre-clinical research. Variables like the shaping ability62 and stress values63 of different rotary file systems, centering ability of access preparations64 and different obturation techniques for C-shaped canals65 have been investigated with uniformly controlled canal configurations. Growth of Enterococcus faecalis biofilms on SLA materials comparable to dentin has been demonstrated and subsequently this was applied in vitro model to evaluate irrigation techniques.66

Conclusion

The literature on use of Three-dimensional printing in Endodontics is limited to case reports and pre-clinical studies. Also, acquiring technical expertise within endodontic practices is an obstacle to its widespread use. Hence, consideration should be given to include 3D printing within the curriculum. More studies need to be done at a larger scale with long term follow ups which will help endodontists in making informed decisions regarding the use of this technique in clinical practice.

Conflict of Interest

The author declares no potential conflicts of interest with respect to research, authorship, and/or publication of this article.

Source of Funding

None.

References

1 

R Noort The future of dental devices is digitalDent Mater2012281312

2 

J Abduo K Lyons M Bennamoun Trends in computer-aided manufacturing in prosthodontics: a review of the available streamsInt J Dent201478394810.1155/2014/783948

3 

K Torabi E Farjood S Hamedani Rapid prototyping technologies and their applications in prosthodontics, a review of literatureJ Dent201516119

4 

G B Kim S Lee H Kim Three-dimensional printing: basic principles and applications in medicine and RadiologyKorean J Radiol20161721829710.3348/kjr.2016.17.2.182

5 

T Atta Comparison between Selective Laser Melting (SLM) and Selective Laser Sintering (SLS) 2016http://www.mechanic.com/2016/12/comparison-between-selective-laser.html

6 

G R Buican G Oancea R F Martins Study on SLM manufacturing of teeth used for dental tools testingMATEC Web of Conferences2017941

7 

N J Mankovich A M Cheeseman N G Stoker The display of two contemporary rotary systems in a preclinical student course settingInt End J1990

8 

J S Bill J F Reuther W Dittman N Kubler J L Meier H Pistner Stereolithography in oral and maxillofacial operation planningInt J Oral Maxillofac Surg1995241 Pt 29810310.1016/s0901-5027(05)80869-0

9 

D M Erickson D Chance S Schmitt J Mathis An opinion survey of reported benefits from the use of stereolithographic modelsJ Oral Maxillofac Surg19995791040310.1016/s0278-2391(99)90322-1

10 

R A Danforth Cone beam volume tomography: a new digital imaging option for dentistryJ Calif Dent Assoc200331118145

11 

T P Cotton T M Geisler D T Holden S A Schwartz Schindler Endodontic applications of cone-beam volumetric tomographyJ Endod2007339112132

12 

W C Scarfe A G Farman P Sukovic Clinical applications of cone-beam computed tomography in dental practiceJ Can Dent Assoc20067217580

13 

I Kvinnsland R J Oswald A Halse A G Gronningsaeter A clinical and roentgenological study of 55 cases of root perforationInt Endod J19892227584

14 

H P Delivanis Gjr Sauer Incidence of canal calcification in the orthodontic patientAm J Orthod19828215861

15 

S Sener F K Cobankara F Akgünlü Calcifications of the pulp chamber: prevalence and implicated factorsClin Oral Investig200913220915

16 

P S Mccabe Pmh Dummer Pulp canal obliteration: an endodontic diagnosis and treatment challengeInt Endod J201245217797

17 

W J Van Der Meer A Vissink Y L Ng K Gulabivala 3D Computer aided treatment planning in endodonticsJ Dent201645677210.1016/j.jdent.2015.11.007

18 

G Krastl M S Zehnder T Connert R Weiger Guided endodontics: a novel treatment approach for teeth with pulp canal calcification and apical pathologyDent. Traumatol20163232406

19 

X Shi S Zhao W Wang Q Jiang X Yang Novel navigation technique for the endodontic treatment of a molar with pulp canal calcification and apical pathologyAust Endod J20184416670

20 

J Mena-Alvarez C Rico-Romano A B Lobo-Galindo A Zubizarreta-Macho Endodontic treatment of dens evaginatus by performing a splint guided access cavityJ Esthet Restor Dent2017296396402

21 

T Connert M S Zehnder M Amato R Weiger S Kühl G Krastl Microguided endodontics: a method to achieve minimally invasive access cavity preparation and root canal location in mandibular incisors using a novel computer-guided techniqueInt Endod J201851224755

22 

J Buchgreitz M Buchgreitz D Mortensen L Bjørndal Guided access cavity preparation using cone-beam computed tomography and optical surface scans - an ex vivo studyInt Endod J20164987905

23 

M S Zehnder T Connert R Weiger G Krastl S Kühl Guided endodontics: accuracy of a novel method for guided access cavity preparation and root canal locationInt Endod J2016491096672

24 

T Connert M S Zehnder R Weiger S Kühl G Krastl Microguided endodontics: accuracy of a miniaturized technique for apically extended access cavity preparation in anterior teethJ Endod201743578790

25 

M Tsukiboshi Autotransplantation of teeth: requirements for predictable successDent Traumatol200218415780

26 

J P Verweij F A Jongkees D Anssari Moin D Wismeijer JPR Van Merkesteyn Autotransplantation of teeth using computer-aided rapid prototyping of a three-dimensional replica of the donor tooth: systematic literature reviewInt J Oral Maxillofac Surg20174611146674

27 

E Kim J-Y Jung I-H Cha K-Y Kum S-J Lee Evaluation of the prognosis and causes of failure in 182 cases of autogenous tooth transplantationOral Surg Oral Med Oral Pathol Oral Radiol Endod20051001112910.1016/j.tripleo.2004.09.007

28 

G D Strbac A Schnappauf K Giannis M H Bertl A Moritz C Ulm Guided autotransplantation of teeth: a novel method using virtually planned 3-dimensional templatesJ Endod20164212184450

29 

S-J Lee I-Y Jung C-Y Lee S Y Choi K-Y Kum Clinical application of computer-aided rapid prototyping for tooth transplantationDent Traumatol20011731149

30 

S-J Lee E Kim Minimizing the extra-oral time in autogeneous tooth transplantation: use of computer-aided rapid prototyping (CARP) as a duplicate model tooth Restor Dent Endod201237313641

31 

A Keightley D L Cross R A Mckerlie L Brocklebank Autotransplantation of an immature premolar, with the aid of cone beam CT and computer-aided prototyping: a case reportDent Traumatol20102621959

32 

M Honda H Uehara T Uehara Use of a replica graft tooth for evaluation before autotransplantation of a tooth. A CAD/CAM model produced using dental-cone-beam computed tomographyInt J Oral Maxillofac Surg201039101016910.1016/j.ijom.2010.06.002

33 

N S Pang Y K Choi K D Kim W Park Autotransplantation of an ectopic impacted premolar with sinus lift and allogenic bone graftInt Endod J2011441096775

34 

M Shahbazian R Jacobs J Wyatt Accuracy and surgical feasibility of a CBCT-based stereolithographic surgical guide aiding autotransplantation of teeth: in vitro validationJ Oral Rehabil201037118549

35 

M Shahbazian J Wyatt G Willems R Jacobs Clinical application of a stereolithographic tooth replica and surgical guide in tooth autotransplantation: A case study is presented of the use of a stereolithography-fabricated model donor tooth and several guides to facilitate pre-operative planning as well as surgery in the case of tooth auto transplantation in a 10-year old child. Virtual and Physical Prototyping2012731810.1080/17452759.2012.711681

36 

Y-S Park S-H Baek W-C Lee K-Y Kum W-J Shon Autotransplantation with simultaneous sinus floor elevationJ Endod20123811214

37 

Y-S Park Jung M-H Shon W-J Autotransplantion of a displaced mandibular second premolar to its normal positionAm J Orthod Dentofacial Orthop2013143227480

38 

D Cross A El-Angbawi P Mclaughlin Developments in autotransplantation of teethSurgeon20131114955

39 

J-H Jang S-J Lee E Kim Autotransplantation of immature third molars using a computer-aided rapid prototyping model: A report of 4 casesJ Endod2013391114616

40 

Y Lee S W Chang H Perinpanayagam Autotransplantation of mesiodens for missing maxillary lateral incisor with cone-beam CT-fabricated model and orthodonticsInt Endod J2014479896904

41 

J-M Park Jci Tatad Mea Landayan S-J Heo S-J Kim Optimizing third molar autotransplantation: Applications of reverse-engineered surgical templates and rapid prototyping of three-dimensional teethJ Oral Maxillofac Surg2014729165359

42 

M Vandekar D Fadia N R Vaid V Doshi Rapid protoyping as an adjunct for autotransplantation of impacted teeth in the esthetic zoneJ Clin Orthod201549117115

43 

W J Van Der Meer J Jansma K Delli C Livas Computer-aided planning and surgical guiding system fabrication in premolar autotransplantation: a 12-month follow upDent Traumatol201632433640

44 

W Khalil M Ezeldeen E Van De Casteele Validation of cone beam computed tomography-based tooth printing using different three-dimensional printing technologiesOral Surg Oral Med Oral Pathol Oral Radiol2016121330715

45 

D Anssari Moin W Derksen J P Verweij R Van Merkesteyn D Wismeijer A novel approach for computer-assisted template-guided autotransplantation of teeth with custom 3D designed/printed surgical tooling. An ex vivo proof of conceptJ Oral Maxillofac Surg2016745895902

46 

D Anssari Moin J P Verweij H Waars R Van Merkesteyn D Wismeijer Accuracy of computer assisted template-guided autotransplantation of teeth with custom three-dimensional designed/printed surgical tooling: a cadaveric studyJ Oral Maxillofac Surg2017755925.e17

47 

RRJ Cousley A Gibbons J Nayler A 3D printed surgical analogue to reduce donor tooth trauma during autotransplantationJ Orthod201744428793

48 

M S Kim H-S Lee Nam Ho S C Choi Autotransplantation: a reliable treatment modality for severely malpositioned teethJ Clin Pediatr Dent201741538891

49 

J P Verweij D Anssari Moin Wismeijer D JPR Van Merkesteyn Replacing heavily damaged teeth by third molar autotransplantation with the use of cone-beam computed tomography and rapid prototypingJ Oral Maxillofac Surg2017759180916

50 

S Kim S Kratchman Modern endodontic surgery concepts and practice: a reviewJ Endod200632760123

51 

I Tsesis E Rosen D Schwartz-Arad Z Fuss Retrospective evaluation of surgical endodontic treatment: traditional versus modern techniqueJ Endod20063254126

52 

I Tsesis E Rosen S Taschieri Y Telishevsky Strauss V Ceresoli M Del Fabbro Outcomes of surgical endodontic treatment performed by a modern technique: An updated meta-analysis of the literatureJ Endod20133933329

53 

T Von Arx S Hänni S S Jensen Correlation of bone defect dimensions with healing outcome one year after apical surgeryJ Endod200733910448

54 

H M Pinsky G Champleboux D P Sarment Periapical surgery using CAD/CAM guidance: preclinical resultsJ Endod200733214851

55 

Y Liu W Liao G Jin Q Yang W Peng Additive manufacturing and digital design assisted precise apicoectomy: a case studyRapid Prototyping J2014201334010.1108/RPJ-06-2012-0056

56 

G D Strbac A Schnappauf K Giannis M H Bertl A Moritz C Ulm Guided autotransplantation of teeth: a novel method using virtually planned 3-dimensional templatesJ Endod20164212184450

57 

S Patel A Aldowaisan A Dawood A novel method for soft tissue retraction during periapical surgery using 3D technology: a case reportInt Endod J50881322

58 

A Kfir Y Telishevsky-Strauss A Leitner Z Metzger The diagnosis and conservative treatment of a complex type 3 dens invaginatus using cone beam computed tomography (CBCT) and 3D plastic modelsInt Endod J201346327588

59 

H Kato T Kamio Diagnosis and endodontic management of fused mandibular second molar and paramolar with concrescent supernumerary tooth using cone-beam CT and 3-D printing technology: a case reportBull Tokyo Dent Coll201556317784

60 

M Marending P Biel T Attin M Zehnder Comparison of two contemporary rotary systems in a pre-clinical student course settingInt Endod J20154965918

61 

L Robberecht F Chai M Dehurtevent A novel anatomical ceramic root canal simulator for endodontic trainingEur J Dent Educ2017214e16

62 

R Ordinola-Zapata C M Bramante Mah Duarte B C Cavenago D Jaramillo M A Versiani Shaping ability of Reciproc and TF Adaptive systems in severely curved canals of rapid micro CT based prototyping molar replicasJ Appl Oral Sci201422650915

63 

R Eken O G Sen G Eskitascioglu S Belli Evaluation of the effect of rotary systems on stresses in a new testing model using a 3-Dimensional printed simulated resin root with an oval shaped canal: a finite element analysis studyJ Endod201642812738

64 

Y Yahata Y Masuda T Komabayashi Comparison of apical centering ability between incisal shifted access and traditional lingual access for maxillary anterior teethAust Endod J20174331238

65 

T Gok I D Capar I Akcay A Keles Evaluation of different techniques for filling simulated C-shaped canals of 3-dimensional printed resin teethJ Endod2017439155964

66 

S A Mohmmed M E Vianna S T Hilton D R Boniface Y-L Ng J C Knowles Investigation to test potential stereolithography materials for development of an in vitro root canal modelMicrosc Res Tech20168022021010.1002/jemt.22788

67 

A Spenst H Kahn The use of a plastic block for teaching root canal instrumentation and obturationJ Endod1979592824

68 

MRG Nassri J Carlik CRN Da Silva R E Okagawa S Lin Critical analysis of artificial teeth for endodontic teachingJ Appl Oral Sci2008161439

69 

J K Bahcall Using 3-dimensional printing to create presurgical models for endodontic surgeryCompend Contin Educ Dent20143582930

70 

E Kim K-D Kim B-D Roh Y-S Cho S-J Lee Computed tomography as a diagnostic aid for extracanal invasive resorptionJ Endod20032974635

71 

S-J Lee K-H Jang LSW Spangberg Three-dimensional visualization of a mandibular first molar with three distal roots using computer-aided rapid prototypingOral Surg Oral Med Oral Pathol Oral Radiol Endod200610156687410.1016/j.tripleo.2005.06.013



jats-html.xsl

© This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


  • Article highlights
  • Article tables
  • Article images

Article History

Received : 17-09-2021

Accepted : 23-11-2021

Available online : 28-12-2021


View Article

PDF File   Full Text Article


Copyright permission

Get article permission for commercial use

Downlaod

PDF File   XML File   ePub File


Digital Object Identifier (DOI)

Article DOI

https://doi.org/10.18231/j.ijce.2021.044


Article Metrics






Article Access statistics

Viewed: 98

PDF Downloaded: 38



Open Abstract (Increase article citation) Wiki in hindi