Consumer vs. High-End 3D Printers for Guided Implant Surgery-An In Vitro Accuracy Assessment Study of Different 3D Printing Technologies

Abstract

This study evaluates the accuracy of drill guides fabricated in medical-grade, biocompatible materials for static, computer-aided implant surgery (sCAIS). The virtually planned drill guides of ten completed patient cases were printed (n = 40) using professional (Material Jetting (MJ)) and consumer-level three-dimensional (3D) printing technologies, namely, Stereolithography (SLA), Fused Filament Fabrication (FFF), and Digital Light Processing (DLP). After printing and post-processing, the drill guides were digitized using an optical scanner. Subsequently, the drill guide's original (reference) data and the surface scans of the digitized 3D-printed drill guide were superimposed to evaluate their incongruencies. The accuracy of the 3D-printed drill guides was calculated by determining the root mean square (RMS) values. Additionally, cast models of the planned cases were used to check that the drill guides fitted manually. The RMS (mean ± SD) values for the accuracy of 3D-printed drill guides were-MJ (0.09 ± 0.01 mm), SLA (0.12 ± 0.02 mm), FFF (0.18 ± 0.04 mm), and DLP (0.25 ± 0.05 mm). Upon a subjective assessment, all drill guides could be mounted on the cast models without hindrance. The results revealed statistically significant differences (p < 0.01) in all except the MJ- and SLA-printed drill guides. Although the measured differences in accuracy were statistically significant, the deviations were negligible from a clinical point of view. Within the limits of this study, we conclude that consumer-level 3D printers can produce surgical guides with a similar accuracy to a high-end, professional 3D printer with reduced costs.

Keywords: biocompatible materials; computer-aided design; guided implant surgery; patient-specific; printing; surgical; three-dimensional.

Figure 1

(a) STL planning file and (b) print preparation (here for the Form 3 using PreForm).

Figure 2

Printed drill guides after removal of support structures: (a) Objet30 Prime, (b) Form 3, (c) Ultimaker 3 Extended, (d) Duplicator 7 Plus.

Figure 3

Color-coded deviation maps within each 3D printing technology: (a) MJ (b) SLA (c) FFF (d) DLP technology, scale in cm.

Figure 4

Box plot of the accuracy (trueness) of the root mean square (RMS) values (in mm) for each 3D printer.