Interview with Dr. Sherif Kandil

What is 4D Printing?

So we all heard about 3D what does the extra D in 4D stand for?

Yes that is true that we have been hearing lately only about 3D, nowadays the extra D represents the dimension of time. 4D refers to additive manufacturing or printing of special materials that have certain memory characterization built in a specific layering system on a 3D printer, yet was designed or CADed on a software that dictates the material reshaping and response to stimuli by time.

Tell us Dr. Kandil about your activities lately in concern to 4D tech?

After I patented the idea of 4D printing in orthodontics I moved on applying this technology in our R&D labs in K Line Europe in Düsseldorf. The 4D printing technology has been shifting engineers’ focus and even many in the medical field on the possibilities and chances that have been unleashed after the introduction recently of this technology. I have been focusing on applying this science to clear aligners and also on orthodontic wires using advanced 3D printers and re-engineered Meta-materials.

Since I would consider myself as an experimenter I am currently applying the 4D printing concept of therapy on my own teeth to manufacture clear aligners, I am strictly recording all details as would publish results in a scientific study after treatment completion.

So how does 4D change medicine in general and orthodontics in particular?

I believe in next two years 4D printing will be changing many approaches we currently do to treat our patients. If you search online for 4D you will get so many results and would even discover how medicine in particular would have the first and biggest impact with this technology in the next two years in particular as Bioengineers for example are trying to apply 4D printing tech in replacing some tissue parts or even manufacturing implants and splints that are placed in our body, this could save many people’s lives pertaining to the fact that the 4D printed objects could change their shape inside our body to conform to what needs exactly to be replaced without the need for multiple surgeries.

In orthodontics is most interesting in my opinion as we will be able to provide patients a much more precise treatment that meets exactly their needs through customizing the clear aligners or the orthodontic wire to change its shape when placed in the oral cavity to the requested final result. So it is crafting the final result with way much higher precision and with least amount of clear aligners or wires to an extent of only 1-2 aligners or 1-2 orthodontic wires for the whole treatment.

What are the challenges faced in the current clear aligners and fixed braces in the market?

Currently I believe there are three main challenges we face in orthodontics when it comes to clear aligners or fixed orthodontics, first is the manufacturing process as there are many steps in manufacturing of clear aligners thus rendering the final result less accuracy, more cost, more time and more control required. Second which is the complexity of applying the exact designed forces on the software for manufacturing the clear aligners, you might need accessories more attachments on teeth and etc.. to overcome the limitations of clear aligners. Third challenge is the comfort of the patients as with clear aligners or braces patients need numerous amounts of aligners or wires to be changed throughout the treatment.

And how will 4D technology tackle these problems?

4D tech promises to solve the above mentioned points and more. To give first a short explanation of how this works simply as follows. Teeth are normally 3D scanned, then through a 3D CADing software aligners or orthodontic wire is made as a negative replica of the model stage representing the corresponding movement that shows where and how teeth need to be moved. The software allows you to put in the object to be 3D printed joints and layers that allow contraction at one side and expansion on the other and thus on the 3D software we could stage all the aligner or wire shapes that will be self-morphed by the material. The object ( i.e aligner or wire ) is 3D printed using special Meta material that are smartly responsive to the built in software joint and layer changes. When object placed in mouth there are fortunately the absolute most effective two stimuli for the material to change its shape which is salivation ( i.e. fluids ) and 37 degrees body temperature ( i.e. heat )

So simply patient wears an aligner or wire on brackets that keeps changing its shape gradually to reach the final form through applying light continuous forces on teeth. Each aligner or orthodontic wire could be worn for over 5 months depending on the movements that were programmed on the software from the initial planning stage.

How would you describe the advantages that would be implemented in orthodontics upon the 4D concept?

Advantages are quite clear as the patients will enjoy a more friendly treatment where they don’t have to visit their orthodontist on short intervals as before this coincides with the recent approaches of distant treatments applied in orthodontics nowadays. Also many treatments won’t need the refinements as before was negatively experienced with clear aligner treatments. Most of all the precision of force application and distribution is way more precise as in the software exact force amount and time will be controlled furthermore the aligner thickness could be altered upon need and controlled throughout the whole treatment so as to keep force and anchorage distribution absolutely stable and avoid the variability that was experienced with previous clear aligners systems.

When do you think this technology will be available in the market?

We hope we could bring this technology into light very soon, yet a rational expectation would be to expect it in 2019 to enter the market and change many applied current treatment concepts in orthodontics.

Technology is shifting really quick these days how do you see it evolving in the next few years in orthodontics?

I see 4D printing and augmented reality to be one of the game changers in medicine in the upcoming period.

How could we get more info and even follow up this upcoming high Tech?

Currently the internet is full with many approaches in 4D tech yet for orthodontic application you could follow up more on the following webpage

Thanks Dr. Kandil for the valuable input and we hope to hear soon even more about new inventions.

Thanks for this opportunity and I hope that this advancement could bring more welfare to our patients.