Dental Implants with AM Lattices and Graded Porosities Analysis

This project proposal investigates the use of additive manufacturing (AM) lattices and graded porosities in dental implants. The study aims to determine the impact of lattice structures and graded porosities on implant design, osseointegration, and patient outcomes. The research encompasses a liter...Read More

Running head: DENTAL IMPLANTS WITH AM LATTICES AND GRADED
POROSITIES
Dental implants with AM lattices and graded porosities
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1DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
Abstract
Orthopaedic implantation is a vital area of the medical science that intended to replace the
damage bones by providing usual flexibility to the patients. Dental implantation is a part of
orthopaedic implantation, which comes with greater risk and responsibility. This paper aims
to discuss the process how the designing of additive manufacturing lattice with the graded
porosity material will enhance the dental implant process in the biological point of view. The
characteristic of this particular design provides flexibility in the jawbone along with muscle
relaxation in the gum. This design process will provide the patient immense stress relaxation
as the vital concern of it is to let the patient experience the feelings of their natural tooth root.
In case of the wholly exhausted tooth root, the design advantages of this process will be
beneficial in reconstructing the natural tooth root functionality.

2DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
Table of Contents
1. Introduction.........................................................................................................................3
2. Background of the study.....................................................................................................3
3. Research aims and Objectives............................................................................................7
4. Research Methodology.......................................................................................................8
5. Expected outcome.............................................................................................................10
6. Program of work...............................................................................................................10
7. References.........................................................................................................................11

3DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
1. Introduction
Additive manufacture technology is effectively advantageous in printing the
customized products, making the technology well suited for orthopaedic implant industries.
Apart from that, the design freedom provided by this particular technology, enhance the
process of orthopaedic implantation. On the other hand, graded porosities materials are the
heterogeneous composite materials, gaining immense attention in the biomedical field
especially in the orthopaedic implants such as dental implantation. Discussing about the
process of dental implant, the particular is a responsible activity, which requires strong
support of effective Osseointegration on the bone surroundings for achieving effective
functionality. In contrast to the bulk structures, the benefits of the graded interconnected
porous comprises with providing larger surface area and lower stiffness providing more bone
implant flexibility. This proposal intended to evaluate the benefits from the designing of
additive manufactured lattice with graded porosities in dental implantation.
2. Background of the study
Previously the researches have conducted regarding the use of lattices and the graded
materials in the orthopaedic implantation. As opined by Wally et al. (2019), the lattice
improve the bone integration and enhance stability of the dental implantation. Moreover, due
to the reflection of tremendous biological and mechanical properties, pure titanium and the
associated alloys are mainly used in the dental implantation (Wally et al. 2015). However,
according to the findings of Özçakır Tomruk, Özkurt-Kayahan and Şençift (2014), the
resentments and the cost of the process can become major hindrance to the adoption of this
particular process. Hence, the particular matter is a little debatable; nevertheless, in case of
dental implantation, the design of additive manufactured lattice with graded porosities can be
advantageous.

4DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
Literature review
a. Additive manufacturing lattice structure in dental implant
The current progress of additive manufacturing is reflecting in developing the novel
application of numerous industries; not only automotive, tooling and aerospace industry, but
also in medical industry, especially the orthopaedic department is gaining advantages of it. In
contrast to the traditional methods, the additive manufacturing provide the advantages of
tailoring the implantation in accordance to patient’s autonomy, which makes the particular
technology a favourable one. Furthermore, the lattice structure is best known for featuring the
space filling unit cell property, which can be used for effortless tessellating in any axis,
eliminating the cell gaps (Helou and Kara 2018). Moreover, the lattice structure is classified
in accordance to the unit cell design for providing better bone scaffolding. The particular
design can be broadly classified into four categories, such as image based, CAD based,
topology optimised cell and implicate surface (Mahmoud and Elbestawi 2017). All this
classification exist in order to accelerate the implantation process in a better way. Apart from
that, the use of lattice structure in the orthopaedic implantation, can add more values such as,
matched modules and stiffness in the surrounding bone and tissue by enhancing the particular
process. In numerous maxillofacial along with the different dental procedure require
obtaining early Osseointegration, which is the process of bonding of the titanium embedded
with the bone. The use of additive manufacturing and design can be effectively harnessed in
order to integrate the complex design of the lattice structure for enhancing the dental
implantation and gaining improved clinical outcomes. As opined by Nakano and Ishimoto
(2015), the lattice structure in the orthopaedic implantation is beneficial in reducing stiffness
as well as result in increasing the muscle strength. Regardless of the type of treatment, every
medical treatment requires flexibility in accordance to the pathological condition of the

5DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
patients and the tremendous features of the effective additive manufacturing technique make
the functionality of any medical device comparatively tuneable (Campanelli et al.,2014).
b. Impact of graded porosities in dental implantation process
The functionally graded porosity materials in dental implantation is becoming
beneficial. These are the innovative materials, which provides flexibility in its structure and
composition, becoming beneficial to the orthopaedic implantation (Gaviria et al. 2014).
Furthermore, these materials have evidenced advantageous to the dental implantation, as
functional gradient provides the advantages of reproducing the properties of the original
initial bone that helps to limit the associated stress-shielding factor as well as helps in
reducing shear stress in the surrounding bone tissue (Rabiei, Cuomo and Thomas 2013). The
advantages of this particular implantation is noticeable when the root of the tooth is wholly
lost or extracted. The implant is set to locate at the jawbone efficiently in order to perform
successful penetration from inside to outside of the bone. The process of implantation varies
in the inside and outside of the jawbone along with the jaw boundary (Mehrali et al. 2013).
Enlightening the implantation process in a brief, the inside jawbone requires to have proper
bone implant contact, osteo-conductivity and stress relaxation. On the other hand, the outside
jawbone needs the implantation process to have immense mechanical strength in order to
carry the occlusal force. Furthermore, the tissues and organs will named as functionally
graded when every single layer of the organ or tissue poses multiple functionality in order to
achieve the local functional requirements. Hence, to regain or regenerate the original
functionality of the tissues, it is necessary for a successful dental implantation process to
include the concept of graded porosities. Moreover, the concept of porous graded materials
include a simplified fabrication technique of partial densification during the process sintering

6DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
of the metal powder (Lin et al. 2013). This particular process enhances the implantation
process in a comparatively better way. The benefits of the additive manufacturing lattice
structure with the functionally graded porosity material is noticeable in the process of dental
implantation as the particular design poses the followings;
 Improvement in the biocom-patibility (Zhou et al. 2015).
 Diminution of efficient stress shielding process in the bone surrounding, which
occurs regularly in case of the fully metallic implantation.
Enhancing the biomechanical controllability as well as the requirements for the graded
bio reaction in each single bone region.
c. Critical evaluation of the suggested process
The medical science has improved, covering a vast area of treatment including a series
of technologies, which have successfully evidenced in simplifying the complicated treatment
procedure. Orthopaedic implantation is a sensitive area of the medical industry that needs to
be handed carefully. Dental implantation is the process of replacing the tooth roots in order
achieve a strong foundation to match the natural teeth. Dental implantation using the additive
manufacturing lattice structure with the graded porosity material will surely enhance the
implantation process by giving the feelings of the natural teeth to the patient. However, this
particular process might poses some limitation due to the cost factor associated with it. This
particular process might not be cost efficient for every patient. Apart from that, risk of
infection, injury and gum and teeth pain might be impeding factors to the particular process
(Nagarajan et al. 2014). Yet, the benefits of the above discussed process will surely supress
the limitations associated with the process of dental implantation. Designing of the additive
lattice structure with the graded material will improve the oral health of the patients by
providing them comfort in conversation as well as eating process. In contrast to the

7DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
traditional uniform design structure, this particular method provide the flexibility in the
design method in order to meet the requirements of the dental implantation criteria having
different properties such as, elastic modulus osteo-conductivity, corrosion resistance, strength
and bio compatibility. Formation of the gradable structure in case of the discussed graded
material design provides flexibility in the composition of the tissue and relaxation in the
jawbone (Soydan et al. 2013). Hence, choosing this particular method over the traditional
dental implantation can be beneficial to the patients.
d. Literature Gap
Previously a numerous researches have carried out on the process of dental
implantation or any orthopaedic implantation using different methods. Nevertheless, the
process of using additive lattice structure with the graded porosity material is new to the
medical science. Dental implant requires restoring the jawbone and providing a natural tooth
root feelings to the patients. Therefore, it brings the literature gap to examine and explore the
advantages of additive lattice structure with the graded material in dental implantation;
though the particular process is in its infancy, yet in contrast to the traditional implantation
technique, it can be way advantageous to the patients giving them muscle relaxation and
jawbone flexibility (Zhou et al. 2015).
3. Research aims and Objectives
This research aims to examine the followings;
 To determine the impact of lattice structure in the additive manufacturing of the
dental implantation
 To analyse the role of graded porosities in the dental implant process
 To critically evaluate the process of using the lattice structure with graded porosities
in the dental implantation.

8DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
 To recommend some strategies for effective dental implantation using the additive
manufacturing lattice with graded porosities.
Research questions
 What is the role of lattice structure in the process of additive manufacturing of the
dental implantation?
 What is the role of graded porosity materials in the dental implantation?
 What are the potential advantages of using additive manufactured lattice structure
with graded porosities in the biomedical application such as the dental implantation?
 What recommendations can be given in order to enhance the process of dental
implantation using lattice structure and graded materials?
4. Research Methodology
Data collection method
This research will combine both the methods of data collection, which is primary data
sources and secondary data sources. The primary resources will comprise with the data
collected from conducting numerous survey as well as interview the samples (Alshenqeeti
2014). Moreover, the online available data and information along with some printed forms
will help in collecting the secondary data. Both type of data are essential for conducting the
research in a more efficient way.
Data analysis method
This particular method of analysing the data will gather the qualitative and quantitative
data necessary for conducting the research. The process of analysing the quantitative data

9DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
comprises with the method of providing a percentage or numeric format to all the data, which
are collected from the particular survey (Johnston 2017). This method will add a comparative
comprehension to those gathered data. After that, the same will transformed into some charts
or graphs in order to give a justified pictorial representation to the collected data. On the
other hand, qualitative data is the mathematical data, which will gather all the information
from the census, service records, Clint histories or any government publication related to the
proposed topic (Sutton and Austin 2015).
Sample Size
In this research, both type of samplings that is the probability as well as the non-
probability sampling methods will be taken into consideration. Moreover, in order to create
comparatively better understanding and giving strong support to the purposed topic, several
random samplings can be considered. The research will conducted by considering an average
number of 70 samples, who will show a voluntary participation.
Ethical issues
Apart from focusing on the topic, this project research will be conducted by obeying all
the rule regulations associated with it. While collecting the primary data through interview
and survey, it will be ensured that the samples will participate voluntarily without any
pressure or force applied on them. Furthermore, if require, the anonymity as well as
confidentiality of the samples will surely be maintained. The research will avoid any kind of
violence and follow all the ethics and norms.
Research Limitation
Regardless of immense effort and effective plans, their might exist some limitations in
the research. Considering an instance, the given time might be a limitation to it; else, resource

10DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
inaccessibility and lack of resource availability might be a hindrance for conducting the
research.
5. Expected outcome
Therefore, after outlining the discussed project proposal, it can be noticed that the dental
implantation can be enhance by using the additive manufacture lattice with the graded
porosities designing process. However, orthopaedic implantations such as dental implant can
be risker in some cases; yet, the particular process can be beneficial by this particular
designing as, it provides design flexibility to regain the muscle strength and strongly avoids
the risk of infection and swelling in the gum as well as in the jawbone.
6. Program of work
0-1 2-5 6-8 9-10 14th
Research
Activities
Weeks Weeks Weeks Weeks Week
Selecting the topic
Literature Review
Data collection
process
Data analysis
process
Final submission

11DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
7. References
Alshenqeeti, H., 2014. Interviewing as a data collection method: A critical review. English
Linguistics Research, 3(1), pp.39-45.
Bohidar, S.K., Sharma, R. and Mishra, P.R., 2014. Functionally graded materials: A critical
review. International Journal of Research, 1(4), pp.289-301.
Campanelli, S., Contuzzi, N., Ludovico, A., Caiazzo, F., Cardaropoli, F. and Sergi, V., 2014.
Manufacturing and characterization of Ti6Al4V lattice components manufactured by
selective laser melting. Materials, 7(6), pp.4803-4822.
Gaviria, L., Salcido, J.P., Guda, T. and Ong, J.L., 2014. Current trends in dental
implants. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 40(2),
pp.50-60.
Helou, M. and Kara, S., 2018. Design, analysis and manufacturing of lattice structures: an
overview. International Journal of Computer Integrated Manufacturing, 31(3), pp.243-261.
Johnston, M.P., 2017. Secondary data analysis: A method of which the time has
come. Qualitative and quantitative methods in libraries, 3(3), pp.619-626.
Lin, W.S., Starr, T.L., Harris, B.T., Zandinejad, A. and Morton, D., 2013. Additive
manufacturing technology (direct metal laser sintering) as a novel approach to fabricate
functionally graded titanium implants: preliminary investigation of fabrication
parameters. The International journal of oral & maxillofacial implants, 28(6), pp.1490-1495.
Mahmoud, D. and Elbestawi, M., 2017. Lattice structures and functionally graded materials
applications in additive manufacturing of orthopedic implants: A review. Journal of
Manufacturing and Materials Processing, 1(2), p.13.

12DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
Mehrali, M., Shirazi, F.S., Mehrali, M., Metselaar, H.S.C., Kadri, N.A.B. and Osman,
N.A.A., 2013. Dental implants from functionally graded materials. Journal of Biomedical
Materials Research Part A: An Official Journal of The Society for Biomaterials, The
Japanese Society for Biomaterials, and The Australian Society for Biomaterials and the
Korean Society for Biomaterials, 101(10), pp.3046-3057.
Nagarajan, A., Perumalsamy, R., Thyagarajan, R. and Namasivayam, A., 2014. Diagnostic
imaging for dental implant therapy. Journal of clinical imaging science, 4(Suppl 2).
Nakano, T. and Ishimoto, T., 2015. Powder-based additive manufacturing for development of
tailor-made implants for orthopedic applications. KONA Powder and Particle Journal, 32,
pp.75-84.
Özçakır Tomruk, C., Özkurt-Kayahan, Z. and Şençift, K., 2014. Patients' knowledge and
awareness of dental implants in a Turkish subpopulation. The journal of advanced
prosthodontics, 6(2), pp.133-137.
Rabiei, A., Cuomo, J.J. and Thomas, B.C., North Carolina State University,
2013. Functionally graded biocompatible coating and coated implant. U.S. Patent 8,491,936.
Soydan, S.S., Cubuk, S., Oguz, Y. and Uckan, S., 2013. Are success and survival rates of
early implant placement higher than immediate implant placement?. International journal of
oral and maxillofacial surgery, 42(4), pp.511-515.
Sutton, J. and Austin, Z., 2015. Qualitative research: data collection, analysis, and
management. The Canadian journal of hospital pharmacy, 68(3), p.226.
Wally, Z., van Grunsven, W., Claeyssens, F., Goodall, R. and Reilly, G., 2015. Porous
titanium for dental implant applications. Metals, 5(4), pp.1902-1920.

13DENTAL IMPLANTS WITH AM LATTICES AND GRADED POROSITIES
Wally, Z.J., Haque, A.M., Feteira, A., Claeyssens, F., Goodall, R. and Reilly, G.C., 2019.
Selective laser melting processed Ti6Al4V lattices with graded porosities for dental
applications. Journal of the mechanical behavior of biomedical materials, 90, pp.20-29.
Zhou, C., Deng, C., Chen, X., Zhao, X., Chen, Y., Fan, Y. and Zhang, X., 2015. Mechanical
and biological properties of the micro-/nano-grain functionally graded hydroxyapatite
bioceramics for bone tissue engineering. journal of the mechanical behavior of biomedical
materials, 48, pp.1-11.