3D printing of teeth from micro-CT scans for the purpose of research and training

Lead Research Organisation: Queen Mary University of London
Department Name: Dental Institute

Abstract

Within dental education, there is a distinct need for hands-on pre-clinical training before a patient's treatment is carried out for the first time. Throughout the years, numerous techniques have been developed to teach students the anatomy and to perform various dental treatments. Artificial teeth are used and have widely been replicated with transparent resins in which the pulp chamber and root canals are distinguishable with different colours. However, extracted human teeth remain one of the most popular techniques used during pre-clinical endodontic training. Both techniques have advantages and disadvantages, with the standard practice being a combination of artificial models and extracted human teeth during pre-clinical training. Extracted teeth, for many years, were exclusively used in dental education. However, the use of extracted teeth has its disadvantages; such as the possibility of cross-infection, being potentially infectious to students; the unavailability of these teeth and anatomical variability of extracted teeth, meaning valid assessment for students is not uniform. Currently, artificial teeth models have been made using opaque and transparent resin to reproduce features of natural teeth for teaching purposes. The benefits of artificial teeth are that they do not have the risk of infection, are available in large quantities, allow for validated assessment through their uniformity, can be different to offer anatomical challenges, and can be three-dimensionally (3D) printed into training models for simulation-based medical education. However, based on previous studies, students perceived artificial teeth as unsatisfactory because of the physical characteristics of these teeth, making them more difficult to treat compared to natural teeth. Despite the reported difficulties, students recognised the advantages and suggested improvements, such as the hardness of resin teeth, to reflect the hardness of natural tissues.

Endodontic procedures performed by undergraduates' have a high frequency of failure, confirming the need for hands-on pre-clinical training before treatments on patients. The lack of uniformity in assessment, questions the validity of assessments. If students were provided with uniform teeth, a valid assessment could be carried out, and an artificial tooth with similar properties to extracted human teeth would prepare students for real-life environments.

The main aim of the study is to create an artificial tooth using data collected from X-ray microtomography (XMT) and is manufactured by 3D printing techniques, for pre-clinical training. The artificial teeth must have similar mechanical and physical properties as extracted teeth to overcome the drawbacks of traditional artificial teeth and to offer dental students a realistic simulation of clinical treatments.

1. Collect high definition datasets using XMT from extracted human teeth, with the premise of 3D printing this data into 3D models.
2. Develop a method of converting extracted human teeth datasets into a workable 3D model file, suitable for 3D printing.
3. Measure and record the mechanical properties of extracted teeth and to compare to artificial teeth.
4. Develop a material/s that mimic the mechanical properties of an extracted human tooth that can be used in 3D printing.
5. Create an artificial tooth that mimics the physical properties of extracted human teeth to be used in dental training that can be used to standardise current assessment methods.

Publications

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Cresswell-Boyes AJ (2018) Approaches to 3D printing teeth from X-ray microtomography. in Journal of microscopy

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Cresswell-Boyes AJ (2022) Composite 3D printing of biomimetic human teeth. in Scientific reports

Studentship Projects

Project Reference Relationship Related To Start End Student Name
EP/P510610/1 30/09/2016 29/09/2021
1797308 Studentship EP/P510610/1 30/09/2016 29/09/2020 Alexander Cresswell-Boyes
 
Title Mandibular Left First Molar - VR Model 
Description Virtual reality model of a mandibular first molar for teaching anatomy purposes. 
Type Of Art Artwork 
Year Produced 2019 
Impact The artwork was used as a teaching tool as part of the research carried out during the project. 
URL https://sketchfab.com/3d-models/mandibular-left-first-molar-d8f3f2d2411445fea96d2b1073966b5c
 
Title Stereolithography Model - Artificial Molar 
Description STL file of an artificial molar, imaged by X-ray microtomography. 
Type Of Art Image 
Year Produced 2018 
Impact Generated over 1000 views and multiple downloads. 
URL https://www.thingiverse.com/thing:2770647
 
Title Stereolithography Model - Extracted Molar 
Description STL file of an extracted molar, imaged by X-ray microtomography. 
Type Of Art Image 
Year Produced 2018 
Impact Generated over 1000 views and multiple downloads. 
URL https://www.thingiverse.com/thing:2770645
 
Description Developed a method to measure the amount of force required to cut real and artificial teeth using a dental drill. The results showed that more force was required to cut a fake plastic tooth and real teeth, meaning difficulty in practising of fake teeth. Highlighting the issues trainee dentists have when performing practise procedures on simulated teeth.
Exploitation Route These results are key for material testing especially in trying to design an alternative to the artificial teeth being used. The technique can be used to look at the machinability of other dental materials.
Sectors Education

Healthcare

Manufacturing

including Industrial Biotechology

Pharmaceuticals and Medical Biotechnology

 
Description Festival of Communities - Public Engagement Fund
Amount £500 (GBP)
Organisation Queen Mary University of London 
Sector Academic/University
Country United Kingdom
Start 03/2018 
 
Description GSK Studentship Case Award 
Organisation GlaxoSmithKline (GSK)
Country Global 
Sector Private 
PI Contribution The award research carried out by Alexander Jon Cresswell-Boyes.
Collaborator Contribution GSK provide financial stipend, and award fees for the research carried out. Also provided is a 3 month placement to carry out any research at a GSK research facility.
Impact Publications.
Start Year 2016
 
Description Institute of Dentistry Open Day 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Undergraduate students
Results and Impact Over 150 undergraduate students took part in a virtual reality "tooth tour", in which participants were taken on a guided tour of an enlarged virtual tooth. Participants were then asked to fill out a questionnaire afterwards on what they thought of the experience.
Year(s) Of Engagement Activity 2019
URL https://sketchfab.com/3d-models/upper-left-second-molar-cd766135210449ad87110dbeefa93af0
 
Description Public Engagement - Festival of Communities 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Festival of Communities was an public engagement event carried out on behalf of Queen Mary University of London, showcasing the research being conducted at the institute. A stall demonstrating the effect of 3D printing of healthcare was set-up including 3D printed models and a live demonstration of 3D printing, a rolling presentation was also shown.
Year(s) Of Engagement Activity 2018