Pouya Sabanik, T P Liu, Mahmoudreza Tabatabaeian, Mateus Garcia Rocha, Neeraj Surathu, Nathaniel C. Lawson
OBJECTIVES: To summarize and synthesize evidence-based conclusions on optimal three-dimensional (3D) printing technologies, materials, and clinical protocols for splints, crowns, and dentures. OVERVIEW: In resin vat printing, stereolithography (SLA) offers superior surface finish, while liquid crystal display (LCD) and digital light processing (DLP) excel in speed for larger prints, with LCD providing a cost advantage. Ceramic vat printing yields clinically acceptable strength but is equipment- and time-intensive. Optimal angulation varies by application: splints (0°), crowns (150°-210°), dentures (45°-90°). A 50 μm layer height is preferred for most restorations, with dentures tolerating 100 μm. Commonly used resins employ low-viscosity monomers (e.g., ethoxylated bisphenol A dimethacrylate [Bis-EMA]) that limit stiffness and fast photoinitiators (e.g., ethyl (2,4,6-trimethylbenzoyl) phenylphosphinate [TPO]), requiring 385-405 nm curing. CONCLUSIONS: Flexible splints excel in fracture toughness and impact strength; firm splints match milled wear performance. Printed crowns, while weaker than milled options, offer toughness; wear rates remain a concern. Printed denture bases vary in strength but can match or exceed conventional options; printed teeth show favorable wear resistance. Postprocessing, polishing, and bonding protocols critically influence outcomes. CLINICAL SIGNIFICANCE: Employing validated printing parameters, selecting the appropriate resin, and following evidence-based protocols allows clinicians to maximize restoration accuracy and mechanical performance while leveraging 3D printing's efficiency and cost benefits.