The current state of 3D printing in orthodontics: a review

Clinical use information of 3D printing in orthodontics isn’t the same across all applications. This review aims to reflect on the current strengths and weaknesses to develop 3D printing as a sustainable and effective tool in orthodontics

Peer-Reviewed Publication

SciOpen

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3D printing allows for a wide variety of uses in orthodontics, with the ability to be customized on a per-patient basis

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Credit: Fulan Wei, Shandong University

3D printing has enjoyed success across fields, from creative endeavors to medical applications. In orthodontics, 3D printing is emerging as a means to customize care and deliver flexibility in manufacturing along with streamlining the process itself. As with any newly applied technology, there is still a process to be worked out to employ 3D printing as a viable option in orthodontics. Researcher Fulan Wei from Shandong University reviews the uses, practicality, challenges and future direction of 3D printing in a clinical setting for orthodontics.

 

Dr. Fulan Wei published their review in Oral Science and Homeostatic Medicine on September 15, 2026.

 

The most established trials on 3D printed orthodontics appear to be for applications such as printed orthodontic models and indirect bonding trays. Indirect bonding trays start with a mold taken of a patient’s teeth, in which the orthodontist individually places each bracket. Then, the custom-fit tray with the brackets already attached is placed all at once on the patient’s teeth. This approach can reduce chairside time and improve the consistency of bracket placement. The customizability, ease of use and benefit to the patient for this process makes 3D printing an attractive path for patients and doctors.

 

However, emerging applications such as customized brackets and direct-printed aligners remain less extensively studied, despite their potential advantages in appliance customization and manufacturing efficiency. Direct printed aligners remove the need for the intermediate step of model printing and heat-forming, thereby reducing steps in the manufacturing workflow and materials used and potentially wasted.

 

While the use of direct printed aligners applies more to mild cases of misalignment, there is not currently any evidence that they are better than current thermoformed aligners. Over time and in use, directly-printed aligners appear to lose their force exerted on the teeth, rendering them as potentially less effective with time and use, not to mention the questions regarding safety under oral conditions.

A major limitation is the lack of long-term clinical studies evaluating the performance of these appliances under real intraoral conditions. Biocompatibility, surface degradation and other safety complications that may arise due to the nature of the orthodontics are also important to study for the long-term.

“The long-term success of 3D-printed orthodontic applications will depend on more robust prospective clinical studies, better standardization of printing and post-processing protocols, and deeper understanding of biological safety, intraoral aging behavior, and material sustainability,” said Dr. Fulan Wei of Shandong University, corresponding author of the review.

The future of 3D printed orthodontics isn’t limited to three-dimensions; 4D printing, which essentially uses all the tech of 3D but with the added dimensionality of change-over-time, is a promising albeit abstract future path. In orthodontics, such materials could potentially enable adaptive aligners that change their shape or mechanical properties in response to external stimuli, allowing more dynamic control of orthodontic forces. However, these applications remain largely experimental.

Feng Qiu, Jingyi Yu, Mengfei Xu, Zhimeng Lei and Fulan Wei of the Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine at Shandong University, Shandong Key Laboratory of Oral Tissue Regeneration, Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration, and Shandong Provincial Clinical Research Center for Oral Diseases, and Menglong Hu of the Shandong Huge Dental Medical Group contributed to this research.

 

This research was supported by the Shandong Natural Science Foundation.

 

DOI Link:

https://doi.org/10.26599/OSHM.2026.9610071

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Journal

Oral Science and Homeostatic Medicine

DOI

10.26599/OSHM.2026.9610071 

Mandibular Third Molar Surgery

New Book Provides a Practical and Evidence-Based Guide to Impacted Mandibular Third Molar Surgery

Book Announcement

Bentham Science Publishers

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Comprehensive Mandibular Third Molar Surgery

New Book Provides a Practical and Evidence-Based Guide to Impacted Mandibular Third Molar Surgery

Bentham Books announces the release of Comprehensive Mandibular Third Molar Surgery, a clinically focused guide providing a systematic and evidence-based approach to the diagnosis, treatment planning, surgical management and complication management of impacted mandibular third molars.

About the Book

Impacted mandibular third molars are among the most frequently encountered surgical conditions in oral and maxillofacial practice. Effective management requires a thorough understanding of surgical anatomy, impaction patterns, radiological assessment, treatment planning and operative techniques.

Comprehensive Mandibular Third Molar Surgery begins with fundamental concepts, including applied surgical anatomy, theories of impaction and indications and contraindications for removal. It then covers the classification of impacted mandibular third molars and preoperative assessment, including clinical examination, radiological evaluation and the role of cone beam computed tomography (CBCT).

The surgical section provides practical guidance on anesthesia, surgical instruments, incision and flap design, bone removal, tooth sectioning, wound debridement and closure techniques. The book also addresses postoperative care, pharmacological management, prophylactic removal, complications, recent surgical advances and medico-legal considerations.

Designed as a practical clinical reference, the book provides a structured approach to achieving safe, efficient and predictable outcomes in third molar surgery.

Key Highlights

• Applied surgical anatomy and classification of impacted mandibular third molars

• Evidence-based treatment planning and radiological assessment

• Role of CBCT in preoperative evaluation

• Step-by-step surgical techniques for third molar removal

• Guidance on anesthesia, flap design, bone removal and tooth sectioning

• Postoperative care and pharmacological management

• Prevention and management of surgical complications

• Recent advances and medico-legal considerations in third molar surgery

Readership

Oral and maxillofacial surgeons, oral surgeons, dental practitioners, postgraduate students, dental educators and healthcare professionals involved in the surgical management of impacted third molars.

About the Authors

Dr. Nilesh Mishra is a specialist in Oral and Maxillofacial Surgery and heads the Department of Oral and Maxillofacial Surgery at Krishna Vishwa Vidyapeeth, Karad, India. He is a Fellow of the Royal College of Surgeons of Glasgow and has published more than 100 research papers and delivered numerous keynote lectures.

Dr. Ravina Dharamsi is an Oral and Maxillofacial Surgeon and Assistant Professor at Dr. D. Y. Patil Dental College and Hospital, Pimpri, Pune. She is a gold-medal-winning postgraduate with interests in clinical practice, teaching and oral and maxillofacial surgery.

Book Link: https://bit.ly/4BpWsNF

DOI: 10.2174/97988988144721260101
https://doi.org/10.2174/97988988144721260101
 

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DOI

10.2174/97988988144721260101

 

AI-powered mobile oral health screening for older adults

 

A smartphone-based oral health screening platform that uses artificial intelligence and user-captured photographs to identify common dental conditions and help older adults, caregivers, and dental providers monitor oral health

Business Announcement

Research Foundation for the State University of New York

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Read more about the new world-class SUNY discoveries that are available for licensing at SUNY TechConnect. The Research Foundation offers numerous pathways to translate SUNY innovation into economic development opportunities.

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Credit: State University of New York

A smartphone-based oral health screening platform that uses artificial intelligence and user-captured photographs to identify common dental conditions and help older adults, caregivers, and dental providers monitor oral health outside of the traditional dental office.

BACKGROUND:

Older adults experience a substantial burden of dental caries, periodontal disease, tooth loss, and other oral conditions, yet many face significant barriers to routine dental care. Mobility limitations, transportation difficulties, fixed incomes, and limited dental coverage can make regular in-person examinations difficult, particularly for elderly patients who require caregiver assistance. These barriers are especially important because poor oral health is associated with broader systemic conditions and can contribute to worsening overall health.

TECHNOLOGY OVERVIEW:

The University at Buffalo technology, OralScan, is a smartphone application that combines guided image capture, on-device image-quality assessment, cloud-based artificial intelligence, and visual presentation of screening results. Users capture images of the front, upper, and lower teeth. Before an image is accepted, the application performs blur detection and verifies that the appropriate teeth are visible. The platform combines results from multiple oral views into unified dental-arch visualizations and supports longitudinal tracking of oral health findings. The current prototype targets seven conditions: calculus/plaque buildup, dental caries, oral lesions, gingivitis, hypodontia, tooth discoloration, and leukoplakia.

ADVANTAGES:

• Provides preliminary oral health screening using a standard smartphone rather than requiring an initial in-person dental examination.
• Targets seven common oral conditions within a single screening platform.
• Uses automated blur and tooth-presence checks to improve the quality and consistency of user-captured images.

APPLICATIONS:

• At-home oral health screening for older adults
• Remote oral health monitoring for mobility-limited patients
• Caregiver-assisted dental screening
• Teledentistry and remote dental triage

Use of omega-3 and ASA has a similar effect to antibiotics against severe periodontitis

Study shows that combining the two compounds with conventional treatment may be a promising alternative, reducing the need for antibiotics

A combination of omega-3 and low-dose acetylsalicylic acid (aspirin) produced results comparable to antibiotics in treating severe periodontitis. This conclusion is based on a study conducted by researchers affiliated with Albert Einstein Israelite Hospital, Guarulhos University (UNG), the University of Taubaté (UNITAU), and the Ribeirão Preto School of Dentistry at USP (FORP-USP) in Brazil, as well as Harvard University in the United States. The findings were published in May in the Journal of Periodontology and suggest a promising therapeutic alternative for some patients by reducing the need for antibiotics. These findings are particularly relevant in the context of growing global concern about bacterial resistance.
 
Supported by FAPESP (projects 20/05874-2 and 20/05875-9), the study followed 109 patients with advanced periodontitis over the course of one year. Advanced periodontitis is a chronic inflammatory disease caused by the accumulation of bacteria beneath the gums, affecting the tissues that support the teeth. If left untreated, it can lead to tooth mobility, bone loss, and even tooth loss. 
 
“Patients with severe disease have very deep pockets, which act as reservoirs for bacteria associated with the disease. It’s a very challenging condition to treat,” says dental surgeon Nídia Cristina Castro dos Santos, the first author of the study and a professor and researcher at Einstein. 
 
For the study, participants were randomly assigned to one of four groups. All underwent subgingival instrumentation – popularly known as scaling – which is considered the standard treatment for periodontitis. However, they received different complementary therapies.
 
The control group received placebos of the antibiotics, omega-3, and ASA in capsules identical to those used for the active treatments. A second group received a combination of the antibiotics metronidazole and amoxicillin, considered the therapy with the strongest scientific evidence for severe cases of the disease, administered three times a day for 14 days. The third group took three grams per day of omega-3, in addition to a daily dose of aspirin for six months. The fourth group received a combination of the two strategies simultaneously: antibiotics for two weeks and the omega-3 and ASA protocol for six months. Participants were reevaluated after three, six, and twelve months.
 
By the end of the follow-up period, about 58% of patients who were treated with antibiotics had met the researchers’ established clinical goal of having no more than four remaining deep periodontal pockets. Among those who received omega-3 and ASA, the percentage was virtually the same: 57.7%. In contrast, in the group that received only scaling and a placebo, the rate was 23.1%. Combining the two strategies, antibiotics and supplementation, didn’t provide any additional benefits.
 
“The use of antibiotics isn’t considered the gold standard of treatment. Although metronidazole and amoxicillin yield good results in the most severe cases, their use should be evaluated on a case-by-case basis due to risks related to bacterial resistance and possible adverse effects,” says Castro dos Santos. 
 
These results reinforce a line of research that has been underway for some time. In a previous study also supported by FAPESP and published in the journal Scientific Reports, the researchers observed that omega-3 supplementation reduced inflammation and bone loss caused by periodontal disease in rats, especially when combined with physical exercise. Although the study was conducted in an animal model, it already indicated the nutrient’s potential in inflammatory processes related to oral health (read more at agencia.fapesp.br/54990). 
 
According to Castro, omega-3 differs from traditional anti-inflammatory drugs in that it contributes to the production of molecules involved in the natural resolution of inflammation and tissue repair, rather than blocking certain inflammatory pathways. Low-dose ASA, on the other hand, was used because it enhances the formation of these mediators. The researchers hypothesized that this strategy would help the body better control the chronic inflammatory process characteristic of periodontitis.
 
“We imagined that the combination of antibiotics and omega-3 would be most effective in controlling periodontitis in these patients. We also believed that the results for the group that used omega-3 with ASA would be slightly lower than those for the antibiotic group. The result was surprising because the two therapies performed very similarly, paving the way for it to become a treatment option for these patients,” says Castro.
 
Another finding that caught the researchers’ attention was the persistence of the observed benefits. Even six months after supplementation ended, patients continued to show results similar to those recorded at the end of treatment. According to Castro, this suggests that modulating the inflammatory response may produce lasting effects, although the mechanisms involved are still being investigated.
 
For dental surgeon Magda Feres, the lead author of the study and a full professor at the Harvard School of Dental Medicine and the Graduate Program in Dentistry at UNG, the results suggest that modulating the inflammatory response may represent a viable alternative for selected patients. “The combination of omega-3 and low-dose aspirin achieved clinical benefits comparable to those of the metronidazole and amoxicillin protocol, opening up a real alternative for those who can’t take antibiotics, especially patients with allergies or intolerance to these medications,” she says.
 
The researcher adds that the results are especially significant in light of growing concerns about antibiotic resistance, which is considered one of the main threats to global public health. “Demonstrating that it’s possible to treat severe periodontitis by modulating the body’s own response is new and relevant information that helps preserve antibiotics for when they are truly indispensable,” says Feres.
 
However, the authors emphasize that the results do not imply an immediate change in clinical practice. The study was conducted on patients without significant systemic or oral diseases. Further research is needed to confirm the findings in different populations and to identify which groups can truly benefit from each approach.
 
According to Feres, some of the answers may come from microbiological analyses currently underway. These analyses are investigating how these therapies influence the composition of bacteria in periodontal pockets. Preliminary data suggest a reduction in disease-associated species and an increase in microorganisms related to gum health. “It’s an important step forward, but not the end of the story. Therefore, the message is one of cautious optimism: we have a promising, scientifically plausible alternative to antibiotics in select cases. Routine replacement will require more evidence,” she concludes.

About São Paulo Research Foundation (FAPESP)
The São Paulo Research Foundation (FAPESP) is a public institution with the mission of supporting scientific research in all fields of knowledge by awarding scholarships, fellowships and grants to investigators linked with higher education and research institutions in the State of São Paulo, Brazil. FAPESP is aware that the very best research can only be done by working with the best researchers internationally. Therefore, it has established partnerships with funding agencies, higher education, private companies, and research organizations in other countries known for the quality of their research and has been encouraging scientists funded by its grants to further develop their international collaboration. You can learn more about FAPESP at www.fapesp.br/en and visit FAPESP news agency at www.agencia.fapesp.br/en to keep updated with the latest scientific breakthroughs FAPESP helps achieve through its many programs, awards and research centers. You may also subscribe to FAPESP news agency at http://agencia.fapesp.br/subscribe

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Journal

Journal of Periodontology

DOI

10.1002/jper.70081  

A dental chair can be a danger zone for haemophilia patients

 

  Unless Dentists Know What They Are Doing

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The research was led by corresponding author Dr. Amit Kumar of the Department of Public Health Dentistry, Santosh Dental College, Santosh Deemed to be University, Ghaziabad, Uttar Pradesh, India. Many dentists have never managed a haemophilia patient and lack the training to do so safely, leading to treatment delays, inconsistent practices, and — in the worst cases — uncontrolled bleeding after procedures that could easily have been managed with proper preparation. A new mini-review published in The Open Medicine Journal, authored by Dr. Sanjeev Kumar Singh and Dr. Abhilasha Smith (Department of Dentistry, SMMH Government Medical College, Saharanpur), Dr. Ajit Vishwakarma (Department of Dentistry, Government Medical College, Azamgarh), and Dr. Meena Jain (Department of Public Health Dentistry, Santosh Dental College, Ghaziabad), pulls together the current evidence and clinical guidance on this topic with the aim of equipping dental professionals with what they need to manage these patients confidently and safely.

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Why a Routine Extraction Is Anything But Routine for Patients Who Cannot Clot Properly

For most people, a tooth extraction or a deep cleaning is a minor inconvenience. For a patient with haemophilia — a hereditary condition in which the blood is missing one of the proteins it needs to form a clot — the same procedure can trigger prolonged, life-threatening bleeding. Haemophilia A, the more common form, affects approximately 1 in every 5,000 males worldwide and involves a deficiency of clotting factor VIII; haemophilia B is rarer and involves factor IX. Both types place patients at serious risk during any dental procedure that breaks the gum or bone tissue, and the oral cavity is a uniquely high-risk site because it is constantly exposed to saliva, chewing forces, and minor trauma.

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From Clotting Factor Injections to Gene Therapy: What Dentists Need to Know Is Changing Fast

The review covers the full landscape of haemophilia management in dental practice, from the initial assessment all the way through to postoperative care, and makes clear that the field is no longer static. Before any invasive dental procedure — including extractions, deep scaling, or nerve blocks near vascular tissue — patients must be carefully assessed for their specific type of haemophilia, its severity (classified as mild, moderate, or severe based on residual clotting factor levels), and whether they have developed inhibitor antibodies that block the standard replacement therapy. The cornerstone of safe dental management remains clotting factor replacement before and after procedures, guided by a haematologist, and supported by local measures such as absorbable sutures, collagen-based or gelatin-based haemostatic sponges, fibrin sealants, and antifibrinolytic mouthwashes containing tranexamic acid. Crucially, the review also addresses a new generation of treatments — extended half-life clotting factor concentrates, bispecific antibody therapies such as emicizumab that mimic factor VIII activity, and early-stage gene therapies that may one day correct the underlying defect permanently — all of which alter how these patients respond to surgical bleeding and therefore change what the dental team needs to plan for. Dental lasers are also highlighted as a practical tool for minimizing soft tissue bleeding during procedures. The review includes a practical quick-reference clinical decision table covering pre-treatment assessment steps, procedure-specific management decisions, local haemostatic measures, drug prescribing rules, and postoperative instructions, designed to support dentists who do not regularly see these patients.

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The Gap Between What Dentists Know and What Haemophilia Patients Need Must Close

The overarching message of this review is one of prevention over intervention — and communication over guesswork. Poor oral hygiene, driven largely by fear of bleeding during brushing and flossing, leaves haemophilia patients disproportionately vulnerable to tooth decay and gum disease, conditions that ultimately demand the very invasive procedures they are most at risk from. Breaking this cycle requires dentists who understand the condition well enough to perform regular, low-risk preventive care — check-ups, fluoride applications, fissure sealants — without defaulting to avoidance or unnecessary referral. For more invasive treatment, close collaboration between the dental team and the patient's haematologist is not optional; it is the foundation of safe care. Paracetamol, not aspirin or other anti-inflammatory drugs, must be the default analgesic choice, since the latter interfere with platelet function and increase bleeding risk. The authors acknowledge that this is a narrative review rather than a systematic one, which limits the strength of its conclusions, and call for more standardisoured clinical protocols and ongoing training for dental professionals.

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Read the published article here: https://bit.ly/4p81hFu

Why some oral inflammatory diseases progress much more rapidly than others

 A team of researchers from VCU Massey Comprehensive Cancer Center, the VCU School of Dentistry and the University of Pennsylvania recently published a study in Nature Communications examining why some oral inflammatory diseases progress much more rapidly than others.

The study was co-led by Kang I. Ko, D.D.S., Ph.D., of the University of Pennsylvania, Jinze Liu, Ph.D., of VCU, and Kevin Matthew Byrd, D.D.S., Ph.D., of VCU, with co-first authors Quinn T. Easter, Ph.D., and Khoa L.A. Huynh, Ph.D. The findings identified previously unrecognized changes in blood vessels that may help researchers better understand tissue destruction in oral disease and provide insights relevant to other inflammatory conditions, including cancer.

To conduct this study, the research team used and expanded a tool they created, the Human Periodontal Atlas—the leading periodontal atlas in the world—as part of the wider Human Cell Atlas, a single cell atlas built from existing publicly available data sets, to examine RNA patterns across different cell types.

“It’s a lot like building really complicated LEGO structures,” said Byrd, a member of the Cancer Biology research program at Massey and assistant professor of oral and craniofacial molecular biology at the VCU School of Dentistry. “Each dataset gives us another set of pieces. By putting them together, we can see which disease patterns are unique to one condition and which ones show up across related inflammatory diseases.”

The study compared three oral inflammatory conditions:

• Peri-implantitis, inflammation and tissue breakdown around dental implants
• Chronic periodontitis, a more common form of gum disease around teeth
• Rapidly advancing periodontitis, a more aggressive form of gum disease marked by faster tissue destruction

The research findings

One of their major findings was that differences in bacterial burden alone did not explain why peri-implantitis and rapidly advancing periodontitis cause more severe tissue destruction. This suggested that changes in the body's own tissue response may play an important role in disease progression.

The key similarity they found was that CD38, a protein associated with inflammation, aging and cellular metabolism, was enriched in blood vessel cells in cases of rapidly progressing periodontitis and peri-implantitis.

By using spatial biology to compare these related diseases directly in human tissue, the team was able to identify a shared blood vessel pattern that may represent a drug-targetable mechanism of rapid tissue destruction.

“This hasn’t been described before in peri-implantitis,” said Easter, research scientist at the VCU School of Dentistry. “This is a new mechanism that could potentially change the way that this disease is thought about or even treated.”

What’s next?

Moving forward, the team plans to continue building single-cell and spatial atlases across more than 20 human diseases, including oral inflammatory diseases and cancer. By integrating these datasets, researchers aim to identify shared disease patterns, uncover potential therapeutic targets and support more precise approaches to treatment.

Collaborators

Using ultrasound to attack oral cancer cells

 

Peer-Reviewed Publication

Indian Institute of Science (IISc)

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Ultrasound mechanostimulation-mediated killing of oral cancer cells and compromised integrity of the capsule-like barrier

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Credit: Rashmita Luha

Oral cancer is a major health challenge in India, where tobacco and areca nut use contribute substantially to the disease burden. Despite advances in surgery, chemotherapy, and radiotherapy, treatment remains difficult because current approaches can damage healthy tissues along with cancer cells, often affecting patients’ quality of life.

In a new study, researchers at the Indian Institute of Science (IISc), in collaboration with clinicians at MS Ramaiah Medical College and Hospitals, explored whether low-frequency ultrasound mechanical stimulation could selectively kill oral cancer cells. The team worked with patient-derived oral tumour samples that better reflect variations among Indian patients.

The team found that oral cancer cells are surprisingly vulnerable to the moderate mechanical stimulations produced by ultrasound. This vulnerability appears to arise from reduced levels of Tropomyosin 2.1, a mechanosensory protein that helps body cells sense and withstand physiologically relevant mechanical stimulation. When exposed to ultrasound-driven mechanical stimulation, oral cancer cells underwent selective cell death, while healthy oral epithelial cells remained unharmed.

“The novelty of this study lies in showing how ultrasound mechanostimulation can selectively target oral cancer cells by exploiting their mechanical weakness,” says Ajay Tijore, Assistant Professor at the Department of Bioengineering, IISc, and corresponding author. “Instead of using heat or drugs, this approach uses moderate mechanical forces to damage cancer cells beyond their ability to recover.”

The team also found that ultrasound drastically reduces the cancer cells’ ability to migrate and invade surrounding tissue. Intriguingly, using a 3D co-culture platform that mimics the oral tumour microenvironment, the team found that ultrasound disrupted the dense capsule-like barrier formed by cancer-associated cells around the tumour core. Such barriers prevent drugs and immune cells from reaching the tumour core, resulting in treatment failure.

“What surprised us most was the consistency of the response across cancer cells derived from multiple patients from different cancer stages. They were highly vulnerable to ultrasound, while normal cells were much less affected,” says Rashmita Luha, PhD student in the Department of Bioengineering and first author.

Since ultrasound is non-invasive and already approved for various medical uses, these findings suggest that ultrasound mechanostimulation could exploit the mechanical weakness of oral cancer cells. With further validation in advanced preclinical models, this approach may help develop safer, more targeted treatment strategies for oral cancer and potentially other easily accessible cancers such as breast and skin cancers.

“The clinical collaboration was very important because it allowed us to work with patient-derived oral tumour samples rather than relying only on standard cell lines developed in Western countries,” says Tijore. “In the future, we want to test this approach in more physiologically relevant models and explore whether ultrasound can be combined with existing treatments to improve drug penetration and therapeutic outcomes.”

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Journal

Materials Today Bio

DOI

10.1016/j.mtbio.2026.103375