Mechanical properties of direct-printed orthodontic aligners compared to thermoformed aligners
DOI:
https://doi.org/10.33448/rsd-v14i1.48031Keywords:
Aesthetic aligners, Thermoforming, 3D printing.Abstract
Orthodontics has evolved over the years, seeking faster, more effective and aesthetic treatments, with clear aligners gaining popularity due to their discretion and comfort. The manufacturing process for aligners can be done by direct 3D printing or thermoforming, with both methods having advantages and disadvantages. Thermoforming involves heating a thermoplastic material over a model to create the aligner. This process can modify the mechanical properties of the material, such as thickness and strength, influencing the effectiveness of orthodontic treatment. Direct 3D printing uses digital data to create the aligners layer by layer, without the need for molds, which results in greater dimensional accuracy and stability of mechanical properties, such as strength and rigidity. This review aims to compare the mechanical properties of printed orthodontic aligners with thermoformed aligners. Studies show that 3D printed aligners have better fit accuracy and greater resistance to deformation when compared to thermoformed ones, in addition to not undergoing significant changes due to heat. However, more studies are still needed to fully evaluate the effectiveness and biocompatibility of this technology. In conclusion, direct 3D printing stands out as an evolution in the manufacture of orthodontic aligners, providing more precise and effective results, although more research is needed to consolidate its clinical use.
Downloads
References
Bichu, Y. M., Alwafi, A., Liu, X., Andrews, J., Ludwig, B., Bichu, A. Y., & Zou, B. (2022). Advances in orthodontic clear aligner materials. Bioactive Materials, 22, 384–403. https://doi.org/10.1016/j.bioactmat.2022.10.006
Bosio, J. A., & Liu, D. (2010). Movimentação dentária mais rápida, melhor e indolor: será possível? Dental Press Journal of Orthodontics, 15(6), 14–17.
Brockmeyer, P., Kramer, K., Böhrnsen, F., Gruber, R. M., Batschkus, S., Rödig, T., & Hahn, W. (2017). Removable thermoplastic appliances modified by incisal cuts show altered biomechanical properties during tipping of a maxillary central incisor. Progress in Orthodontics, 18(1), 1–7. https://doi.org/10.1186/S40510-017-0183-Z
Bucci, R., Rongo, R., Levaté, C., Michelotti, A., Barone, S., Razionale, A. V., & D’Antô, T. (2019). Thickness of orthodontic clear aligners after thermoforming and after 10 days of intraoral exposure: A prospective clinical study. Progress in Orthodontics, 20, 36.
Can, E., Panayi, N., Polychronis, G., Papageorgiou, S. N., Zinelis, S., Eliades, G., & Eliades, T. (2022). Alinhadores impressos em 3D internamente: Efeito do envelhecimento in vivo em propriedades mecânicas. European Journal of Orthodontics, 44, 51–55.
Casarin, S. T. et al. (2020). Tipos de revisão de literatura: considerações das editoras do Journal of Nursing and Health. Journal of Nursing and Health. 10 (5). https://periodicos.ufpel.edu.br/index.php/enfermagem/article/view/19924. 10)
Christensen, L. R. (2017). Digital workflows in contemporary orthodontics. APOS Trends in Orthodontics, 7(1), 12–18.
Cianci, C., Pappalettera, G., Renna, G., Casavola, C., Laurenziello, M., Pappalettere, C., & Ciavarella, D. (2020). Comportamento de fadiga por compressão cíclica de alinhadores dentários PET-G. In Anais do Simpósio Internacional IEEE de 2020 sobre Medidas e Aplicações Médicas (MeMeA), Bari, Itália, 1 de junho a 1 de julho de 2020 (pp. 1–6).
Couto, B. L. B., & Abreu, L. G. (2020). Comparação entre alinhadores ortodônticos e aparelhos ortodônticos fixos convencionais: Uma revisão sistemática e meta-análise. Arquivos em Odontologia, 56. https://doi.org/10.7308/aodontol/2020.56.e30
Dogramaci, E., Chubb, D., & Rossi, F. G. (2018). Orthodontic thermoformed retainers: A two-arm laboratory study into post-fabrication outcomes. Australian Dental Journal, 63(3), 347–355.
Elkhoy, F., Schmidt, F., Jager, R., & Lapatki, B. G. (2016). Forces and moments delivered by novel, thinner PET-G aligners during labio-palatal bodily movement of a maxillary central incisor: An in vitro study. Angle Orthodontist, 86(6), 883–890. https://doi.org/10.2319/011316-37R.1
Feu, D., Catharino, F., Duplat, C. B., & Capelli, J. J. (2012). Esthetic perception and economic value of orthodontic appliances by lay Brazilian adults. Dental Press Journal of Orthodontics, 17(5), 102–114.
Goracci, C., Juloski, J., D'Amico, C., Balestra, D., Volpe, A., Juloski, J., & Vichi, A. (2023). Propriedades clinicamente relevantes de materiais imprimíveis em 3D para uso intraoral em ortodontia: Uma revisão crítica da literatura. Materials, 16, 2166. https://doi.org/10.3390/ma16062166
Gracco, A., Mazzoli, A., Favoni, O., Conti, C., Ferraris, P., Tosi, G., et al. (2009). Short-term chemical and physical changes in Invisalign appliances. Australian Orthodontic Journal, 25(1), 34–40.
Hahn, W., Fialka-Fricke, J., Dathe, H., Fricke-Zech, S., Zapf, A., Gruber, R., Kubein-Meesenburg, D., & Sadat-Khonsari, R. (2009). Initial forces generated by three types of thermoplastic appliances on an upper central incisor during tipping. European Journal of Orthodontics, 31(6), 625–631. https://doi.org/10.1093/EJO/CJP047
Hazeveld, A., Slater, J. J. R. H., & Ren, Y. (2014). Accuracy and reproducibility of dental replica models reconstructed by different rapid prototyping techniques. American Journal of Orthodontics and Dentofacial Orthopedics, 145(1), 62–72. https://doi.org/10.1016/j.ajodo.2013.05.011
Jindal, P., Juneja, M., Siena, F., Bajaj, D., & Breedon, P. (2019). Mechanical and geometric properties of thermoformed and 3D printed clear dental aligners. American Journal of Orthodontics and Dentofacial Orthopedics, 156(5), 639–647. https://doi.org/10.1016/j.ajodo.2019.05.012
Kandhan, G. (2022). Clear aligners in orthodontic tooth movement: A conceptual review. Journal of Advanced Medical and Dental Sciences Research, 10(4), 40–43.
Lee, S. Y., Kim, H., Kim, H.-J., Chung, C. J., Choi, Y. J., Kim, S.-J., & Cha, J.-Y. (2022). Thermo-mechanical properties of 3D printed photocurable shape memory resin for clear aligners. Scientific Reports, 12(1), 6246. https://doi.org/10.1038/s41598-022-09831-4
Maspero, C., & Tartaglia, G. M. (2020). Impressão 3D de alinhadores ortodônticos transparentes: Onde estamos e para onde vamos. Materials, 13(22), 5204. https://doi.org/10.3390/ma13225204
McCarty, M. C., Chen, S. J., Inglês, J. D., & Kasper, F. (2020). Efeito da orientação da impressão e duração da cura ultravioleta na precisão dimensional de um design de alinhador transparente ortodôntico impresso tridimensionalmente. American Journal of Orthodontics and Dentofacial Orthopedics, 158, 889–897. https://doi.org/10.1016/j.ajodo.2020.05.015
Melkos, A. B. (2005). Advances in digital technology and orthodontics: A reference to the Invisalign method. Medical Science Monitor, 11(5), PI39–PI42.
Milovanović, A., Sedmak, A., Golubović, Z., Zelić-Mihajlović, K., Zurkić, A., Trajković, I., & Milošević, M. (2021). O efeito do tempo nas propriedades mecânicas de resinas fotopoliméricas biocompatíveis usadas para fabricação de alinhadores dentais transparentes. Journal of the Mechanical Behavior of Biomedical Materials, 119, 104494. https://doi.org/10.1016/j.jmbbm.2021.104494
Nakano, H., Kato, R., Kakami, C., Okamoto, H., Mamada, K., & Maki, K. (2019). Desenvolvimento de resinas biocompatíveis para impressão 3D de alinhadores diretos. Journal of Photopolymer Science and Technology, 32(2), 209–216. https://doi.org/10.2494/jpst.32.209
Panayi, N., Cha, J. Y., & Kim, K. B. (2023). 3D Printed aligners: Material science, workflow, and clinical applications. Seminars in Orthodontics, 29(1), 25–33. https://doi.org/10.1053/j.sodo.2023.03.001
Papadimitriou, A., Mousoulea, S., Gkantidis, N., & Kloukos, D. (2018). Clinical effectiveness of Invisalign® orthodontic treatment: A systematic review. Progress in Orthodontics, 19(1), 37. https://doi.org/10.1186/s40510-018-0231-z
Pereira, T. V. S. (2023). Evolução dos alinhadores “IN-OFFICE”: Versatilidade no tratamento ortodôntico e perspectivas futuras. Escola Bahiana de Medicina e Saúde Pública, Salvador.
Pereira, A. S. Shitsuka, D. M. Parreira, F. J. & Shitsuka, R. (2018). Metodologia da pesquisa científica. [free ebook]. Santa Maria: Ed. UFSM.
Perucchi, M. M. (2023). Previsibilidade dos movimentos dentários com alinhadores termoformados: Revisão de literatura. Monografia apresentada ao Curso de Especialização Lato Sensu, Programa de Pós-Graduação em Ortodontia da Faculdade Sete Lagoas – FACSETE, Sociedade Paulista de Ortodontia, São Paulo.
Prasad, S., Kader, N. A., Sujath, G., & Raj, T. (2018). Impressão 3D em odontologia. Journal of 3D Printing in Medicine, 2, 89–91. https://doi.org/10.1515/j3dpm-2018-0008
Quivoron, L. E. (2024). Alinhadores: Quais as limitações – Uma revisão narrativa. Instituto Universitário Egas Moniz, obtenção do grau de Mestre em Medicina Dentária, Julho de 2024.
Rajasekaran, A., & Chaudhari, P. K. (2023). Integrated manufacturing of direct 3D-printed clear aligners. Frontiers in Dental Medicine, 3, 1–6. https://doi.org/10.3389/fdent.2023.1068879
Rother, E. T. (2007). Revisão sistemática x revisão narrativa. Acta Paul. Enferm. 20 (2). https://doi.org/10.1590/S0103-21002007000200001. Mattos, P. C. (2015). Tipos de revisão de literatura. Unesp, 1-9. https://www.fca.unesp.br/Home/Biblioteca/tipos-de-evisao-de-literatura.pdf.
Ryu, J. H., Kwon, J. S., Jiang, H. B., Cha, J. Y., & Kim, K. M. (2018). Effects of thermoforming on the physical and mechanical properties of thermoplastic materials for transparent orthodontic aligners. Korean Journal of Orthodontics, 48(5), 316–325. https://doi.org/10.4041/kjod.2018.48.5.316
Shah, M. J., Kubavat, A. K., Patel, K. V., & Prajapati, N. H. (2022). Fabrication of in-house aligner - A review. Journal of Contemporary Orthodontics, 6(3), 120–124. https://doi.org/10.5005/jco-2022-0034
Silva, G. H. C., Beatrici, A., Takamori, E. R., & Granjeiro, J. M. (2024). Análise de forças de movimentação e características físico-químicas em alinhadores ortodônticos: Avanços tecnológicos e considerações críticas. International Journal of Science Dentistry, 3, 143–156. https://periodicos.uff.br/ijosd/article/view/60280
Souki, B. Q., Maia, R. M., Azevedo, G. M., Tavares, L. D. F., & Bosoni, C. (2023). Guia prático de fabricação de alinhadores in house - Parte 3: Impressão de modelos, pós-processamento, termoplastificação, acabamento e gestão clínica. Orthodontic Science and Practice, 16(63), 115–133. https://doi.org/10.24077/2023;1663-063013258
Sousa, H. A. F., Nascimento, J. J. P. N. F., Sousa, M. A. F., Genari, B., Souza, A. O., & Degrazia, F. W. (2021). Aparelhos ortodônticos invisíveis: Uma revisão. Research, Society and Development, 10(1), e5510111259. https://doi.org/10.33448/rsd-v10i1.11259
Tartaglia, G. M., Mapelli, A., Maspero, C., Santaniello, T., Serafin, M., Farronato, M., et al. (2021). Direct 3D printing of clear orthodontic aligners: Current state and future possibilities. Materials, 14(7), 1799. https://doi.org/10.3390/ma14071799
Thakkar, D., Benattia, A., Bichu, Y. M., Zou, B., Aristizabal, J. F., Fadia, D., et al. (2023). Seamless workflows for in-house aligner fabrication. Seminars in Orthodontics, 29(1), 17–24. https://doi.org/10.1053/j.sodo.2023.03.002
Zinelis, S., Panayi, N., Polychronis, G., Papageorgiou, S. N., & Eliades, T. (2022). Análise comparativa das propriedades mecânicas de alinhadores ortodônticos produzidos por diferentes impressoras 3D contemporâneas. Craniofacial Orthodontics Research, 25, 336–341. https://doi.org/10.1111/ocr.12537
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Laís Melyna da Silva Mendonça; Karly Victoria de Oliveira Capozzi Queiroga; Emilly Alves da Silva; Nilton Costa; Alexandre Rodrigues da Ponte; Andressa Nascimento Lira da Ponte; Wanderson Roberto Azevedo dos Santos
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
