Daniel Alter, MSc, MDT, CDT
We have heard for some time now that extensive efforts have been made to produce living tissues and even organs derived from stem cells and other biological materials with specific genetic markers. This work has been very controversial in many ways, stemming from very polarized opinions that present compelling perspectives and arguments for both sides. Since the beginning, when this work was first theorized, conversations have taken place surrounding whether or not a printed, living, and viable tooth can be made in a laboratory with the patient's DNA and subsequently inserted into the patient's oral cavity. Although this concept was intriguing, it felt very much like science fiction rather than a potential reality for the dental laboratory. Still, while these efforts continued in science, our dental communities concurrently embraced 3D printing for nearly all facets of dentistry, and that market space has proven to grow significantly in innovations, technology, and material offerings. What has been overlooked until now is the ultimate synergy that the two modalities can present and offer the dental communities and their patients, thereby making the potential of realizing the theory of printing living teeth a plausible reality.
A recent article in Biotechnology and Bioengineering delved into this subject and suggested that although we are certainly not there yet, "mimicking such 3D complexity and the multicellular interactions naturally existing in dental structures represents great challenges in dental regeneration. Attempts to construct the complex system of the tooth and tooth-supporting apparatus (i.e., the PDL, alveolar bone, and cementum) have made certain progress owing to 3D printing biotechnology. Recent advances have enabled the 3D printing of biocompatible materials, seed cells, and supporting components into complex 3D functional living tissue. Furthermore, 3D bioprinting is driving major innovations in regenerative medicine, giving the field of regenerative dentistry a boost. The fabrication of scaffolds via 3D printing is already being performed extensively at the laboratory bench and in clinical trials; however, printing living cells and matrix materials together to produce tissue constructs by 3D bioprinting remains limited to the regeneration of dental pulp and the tooth germ."1
3D bioprinting lends itself effectively to the dental laboratory market, in a production form called biofabrication. Although dental biofabrication is not ready for prime time, it will certainly be in the future; therefore, dental laboratory professionals should prepare to establish strategies by which they can participate in some form or another. What will the dental laboratory of the future look like and how will we be fabricating restorations for our clients and their patients in the future? These are all questions that we must ask ourselves often in order to remain nimble and viable, not only now but in the future as well, so that we can sustain and thrive in our dental laboratory businesses.
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1. Ma Y, Xie L, Yang B, Tian W. Three-dimensional printing biotechnology for the regeneration of the tooth and tooth-supporting tissues. Biotechnol Bioeng. 2019 Feb;116(2):452-468. doi: 10.1002/bit.26882. Epub 2018 Dec 14. PMID: 30475386.