# 3D-Printed Accessories and Auxiliaries in Orthodontic Treatment
## 4 Discussion
### Artificial Intelligence and 3D Printing and Future Possibilities  
Artificial intelligence (AI) is already used to support the 3D design of appliances. Right from the start, at the imaging phase, AI can help with the segmentation and optimization of 3D data. AI already helps in clinical practice by identifying anatomical structures [2]. In the design phase, it can automatically recognize teeth from raw scan data, segment them, and make measurements of them with minimal help from the doctor. It can already be used to adapt existing appliance designs to a new situation without the need for a completely new design. AI can assist 3D design by adapting a structure automatically to the tooth surface, finding and matching the same or similar objects in different 3D structures [82]. Artificial intelligence is already used to overcome the previous limitation of printing only on flat surfaces; it offers flexibility by performing on irregular surfaces as well. On top of this, AI can help optimize the trajectory of printing nozzles to ensure high quality and accuracy. Predictive modeling can help compensate for expected material shrinkage and distortions [2]. Given that AI is already used in other areas of orthodontics or 3D printing as a powerful problem-solving tool [2; 83]. AI can be effectively applied to detect and predict errors in 3D printing processes, enhancing the quality and reliability of 3 Dprinted devices. This approach allows for greater precision and optimization, addressing common issues such as surface quality and structural integrity [84]. We can expect further uses empowering the specialist orthodontists [1]. However, there are concerns over over-reliance on AI tools for 3D appliance design and evaluation, emphasizing that AI remains an assistive technology and cannot replace clinical expertise or manual validation for now  
Future research could focus on the artificial intelligence (AI)-supported design of appliances to reduce the workload and skills required in the dental practice. In the future, the research could explore the AI-supported adaptation of one design to another similar clinical situation without the need for a completely new design process. AI could also support the work, by the automatic fabrication of study models from raw scan data [82]. In orthodontics, 3D applications are expected to overtake 2D applications in the future [85], and this technological advancement must be supported by adequate evidence provided by up-to-date research. Future development should aim to harness AI to help the specialist during everyday orthodontic practice and assist in the specialist's job. Another area for future research is the question of long-term biocompatibility. Patient safety and occupational safety are critical with all medical devices. Monomers, incomplete polymerization, and microplastics all pose possible health challenges that need to be investigated [86; 87; 85]. Even after rigorous polymerization and cleaning, leads to some unpolymerized monomers are left over and these molecules can escape from the plastic [86]. Three-dimensional printing raises the important aspect of occupational safety. During the manufacturing of 3D-printed plastics, nanoparticles and volatile organic compounds (VOC) can be released, which have direct and indirect toxic effects on humans. Exposure to some of these materials can lead to asthma, allergies, neurological damage, and even DNA damage [88]. Microplastics have been shown to accumulate in the human body. As of now, there is more evidence accumulating about the potential toxic and adverse effects [89], not just through their physical presence but also through the chemical effects of substances leaching out, through altering the microbiome, and even through the possibility of microplastics bringing other toxic substances with them on their surface. Ingesting microplastics were shown to cause harm to marine organisms and similar results came from other animal studies [90].