Cytotoxicity of Printed Aligners: A Systematic Review

<b>Background/Objectives:</b> The capability of printing aligners directly, eliminating the need for a dental model or thermoforming, represents a significant advancement in aligner therapy. This review aimed to assess the cytotoxicity of 3D-printed aligners to clarify their safety profi...

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Main Authors: Mauro Lorusso, Fariba Esperouz, Gabriele Di Carlo, Michele Tepedino, Rosa Esposito, Giovanni Pappalettera, Caterina Casavola, Lucio Lo Russo, Domenico Ciavarella
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Dentistry Journal
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Online Access:https://www.mdpi.com/2304-6767/13/7/275
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author Mauro Lorusso
Fariba Esperouz
Gabriele Di Carlo
Michele Tepedino
Rosa Esposito
Giovanni Pappalettera
Caterina Casavola
Lucio Lo Russo
Domenico Ciavarella
author_facet Mauro Lorusso
Fariba Esperouz
Gabriele Di Carlo
Michele Tepedino
Rosa Esposito
Giovanni Pappalettera
Caterina Casavola
Lucio Lo Russo
Domenico Ciavarella
author_sort Mauro Lorusso
collection DOAJ
description <b>Background/Objectives:</b> The capability of printing aligners directly, eliminating the need for a dental model or thermoforming, represents a significant advancement in aligner therapy. This review aimed to assess the cytotoxicity of 3D-printed aligners to clarify their safety profile, given their growing clinical use. <b>Methods:</b> An electronic literature search was independently conducted by two reviewers up to February 2025 across PubMed, Scopus, and Web of Science. After a thorough selection process, five in vitro studies were included. The quality and risk of bias were evaluated using the QUIN tool. <b>Results:</b> Five studies were included in the systematic review, four of which used TC-85 resin and one TA-28. Two reported no cytotoxic effects. Mild cytotoxicity was observed in one study using UV and heat post-curing, while another reported increased cytotoxicity with extended UV/nitrogen curing. However, notable heterogeneity was present among the studies in terms of the experimental protocols, the cell lines used, and the outcome measures. <b>Conclusions:</b> The cytotoxicity of printed aligners appears to be influenced by post-curing duration and system type, highlighting the importance of strict adherence to manufacturers’ protocols. Nevertheless, due to the limited number of studies and methodological variability, definitive conclusions cannot yet be drawn. Further clinical and standardised in vitro studies are needed to better assess the biocompatibility of 3D-printed aligners.
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institution Kabale University
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publishDate 2025-06-01
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series Dentistry Journal
spelling doaj-art-ba5ee67f10ff41e7a27d6e955c917ab42025-08-20T03:58:27ZengMDPI AGDentistry Journal2304-67672025-06-0113727510.3390/dj13070275Cytotoxicity of Printed Aligners: A Systematic ReviewMauro Lorusso0Fariba Esperouz1Gabriele Di Carlo2Michele Tepedino3Rosa Esposito4Giovanni Pappalettera5Caterina Casavola6Lucio Lo Russo7Domenico Ciavarella8Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, 71122 Foggia, ItalyDepartment of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, 71122 Foggia, ItalyDepartment of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Viale Regina Elena 287a, 00161 Rome, ItalyDepartment of Biotechnological and Applied Clinical Sciences, Dental School of L’Aquila, University of L’Aquila, 67100 L’Aquila, ItalyDepartment of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, 71122 Foggia, ItalyDepartment of Mechanics, Mathematics, and Management, Polytechnic University of Bari, 70126 Bari, ItalyDepartment of Mechanics, Mathematics, and Management, Polytechnic University of Bari, 70126 Bari, ItalyDepartment of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, 71122 Foggia, ItalyDepartment of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, 71122 Foggia, Italy<b>Background/Objectives:</b> The capability of printing aligners directly, eliminating the need for a dental model or thermoforming, represents a significant advancement in aligner therapy. This review aimed to assess the cytotoxicity of 3D-printed aligners to clarify their safety profile, given their growing clinical use. <b>Methods:</b> An electronic literature search was independently conducted by two reviewers up to February 2025 across PubMed, Scopus, and Web of Science. After a thorough selection process, five in vitro studies were included. The quality and risk of bias were evaluated using the QUIN tool. <b>Results:</b> Five studies were included in the systematic review, four of which used TC-85 resin and one TA-28. Two reported no cytotoxic effects. Mild cytotoxicity was observed in one study using UV and heat post-curing, while another reported increased cytotoxicity with extended UV/nitrogen curing. However, notable heterogeneity was present among the studies in terms of the experimental protocols, the cell lines used, and the outcome measures. <b>Conclusions:</b> The cytotoxicity of printed aligners appears to be influenced by post-curing duration and system type, highlighting the importance of strict adherence to manufacturers’ protocols. Nevertheless, due to the limited number of studies and methodological variability, definitive conclusions cannot yet be drawn. Further clinical and standardised in vitro studies are needed to better assess the biocompatibility of 3D-printed aligners.https://www.mdpi.com/2304-6767/13/7/275cytotoxicityprinted alignersbiocompatibilitycritical review
spellingShingle Mauro Lorusso
Fariba Esperouz
Gabriele Di Carlo
Michele Tepedino
Rosa Esposito
Giovanni Pappalettera
Caterina Casavola
Lucio Lo Russo
Domenico Ciavarella
Cytotoxicity of Printed Aligners: A Systematic Review
Dentistry Journal
cytotoxicity
printed aligners
biocompatibility
critical review
title Cytotoxicity of Printed Aligners: A Systematic Review
title_full Cytotoxicity of Printed Aligners: A Systematic Review
title_fullStr Cytotoxicity of Printed Aligners: A Systematic Review
title_full_unstemmed Cytotoxicity of Printed Aligners: A Systematic Review
title_short Cytotoxicity of Printed Aligners: A Systematic Review
title_sort cytotoxicity of printed aligners a systematic review
topic cytotoxicity
printed aligners
biocompatibility
critical review
url https://www.mdpi.com/2304-6767/13/7/275
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AT rosaesposito cytotoxicityofprintedalignersasystematicreview
AT giovannipappalettera cytotoxicityofprintedalignersasystematicreview
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