ISQUA18-0034Optimization of Personalized Precise Treatment of Patients Suffered with Severe Bone Defects through 3D Printing Technology

: Clinically, the treatment of bone defects remains a significant challenge, as it requires autogenous bone grafts or bone graft substitutes. However, the existing biomaterials often fail to meet the clinical requirements in terms of structural support, bone induction and controllable biodegradability. In the treatment of bone defects, 3D porous scaffolds have at-tracted much attention in the orthopedic field. In terms of appearance and microstructure, complex bone scaffolds created by 3D printing technology are similar to human bone. On this basis, the combination of active substances including cells and growth factors is more conducive to bone tissue reconstruction, which is of great significance for the personalized treatment of bone defects. With the continuous development of 3D printing technology, it has been widely used in bone defect repair as well as diagnosis and rehabilitation, creating an emerging industry with excellent market potential. Meanwhile, the di-verse combination of 3D printing technology with multi-disciplinary fields such as tissue engineering, digital medicine, and materials science has made 3D printing products with good biocompatibility, excellent osteo-inductive capacity and stable mechanical properties. In the clinical application of the repair of bone defects, various biological materials and 3D printing methods have emerged to make patient-specific bioactive scaffolds. The microstructure of 3D printed scaffolds can meet the complex needs of bone defect repair and support the personalized treatment of patients. Some of the new materials and technologies that emerged from the 3D printing industry's advent in the past decade successfully translated into clinical practice. In this article, we first introduced the development and application of different types of materials that were used in 3D bioprinting, including metal, ceramic materials, polymer materials, composite materials, and cell tissue. The combined application of 3D bioprinting and other manufacturing method used for bone tissue engineering are also discussed in this ar-ticle. Finally, we discussed the bottleneck of 3D bioprinting technique and forecasted its research orientation and prospect.

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Novel exploration of 3D printed wrist arthroplasty to solve the severe and complicated bone defect of wrist

Rapid Prototyping Journal ◽

10.1108/rpj-01-2016-0005 ◽

2017 ◽

Vol 23 (3) ◽

pp. 465-473 ◽

Cited By ~ 9

Author(s):

Qing Han ◽

Yanguo Qin ◽

Yun Zou ◽

Chenyu Wang ◽

Haotian Bai ◽

...

Keyword(s):

3D Printing ◽

Three Dimensional ◽

Surgical Techniques ◽

Bone Defects ◽

Printing Technology ◽

Content Type ◽

3D Printing Technology ◽

3D Printed ◽

And Function ◽

Wrist Arthroplasty

Purpose Although proximal row carpectomy, wrist arthrodesis and even total wrist arthroplasty were developed to treat wrist disease using bone and cartilage of the wrist, severe and complicated bone defects caused by ferocious trauma and bone tumors remain a stubborn problem for surgeons. Development and application of the three-dimensional (3D) printing technology may provide possible solutions. Design/methodology/approach Computed tomography (CT) data of three cases with severe bone defects caused by either trauma or bone tumor were collected and converted into three-dimensional models. Prostheses were designed individually according to the residual anatomical structure of the wrist based on the models. Both the models and prostheses were produced using 3D printing technology. A preoperative design was prepared according to the models and prostheses. Then arthroplasty was performed after preoperative simulation with printed models and prostheses. Findings The diameter of the stem and radial medullary cavity, the direction and location of the prosthesis, and other components were checked during the preoperative design and simulation process phases. The three cases with 3D printed wrist all regained reconstruction of normal anatomy and part of the function after surgery. The average increasing Cooney score rate of Cases 2 and 3 was 133.34 ± 23.57 per cent, and that of Case 1 reached 85 per cent. The average declining rate of the Gartland and Werley Score in Cases 2 and 3 was 65.21 ± 18.89 per cent, and that of Case 1 dropped to 5 per cent in the last follow-up. The scores indicated that patients experienced pain relief and function regain. In addition, the degree of patient satisfaction improved. Originality/value 3D printed wrist arthroplasty may provide an effective method for severe and complicated cases without sacrificing other bones. Personal customization can offer better anatomy and function than arthrodesis or other traditional surgical techniques.

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Individualized 3D printing-assisted repair and reconstruction of neoplastic bone defects at irregular bone sites: exploration and practice in the treatment of scapular aneurysmal bone cysts

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04859-5 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Guochen Luo ◽

Yao Zhang ◽

Xiahua Wang ◽

Shuaishuai Chen ◽

Dongyi Li ◽

...

Keyword(s):

3D Printing ◽

Surgical Approach ◽

Bone Structure ◽

Operation Time ◽

Bone Defects ◽

Anatomical Structure ◽

Printing Technology ◽

3D Printing Technology ◽

Medical Software

Abstract Background The irregular anatomical shape and complex structures of irregular bones make it more difficult to repair and reconstruct bone defects in irregular bones than in the long bones of the extremities. Three-dimensional (3D) printing technology can help to overcome the technical limitations of irregular bone repair by generating simulations that enable structural integration of the lesion area and bone structure of the donor site in all directions and at multiple angles. Thus, personalized and accurate treatment plans for restoring anatomical structure, muscle attachment points, and maximal function can be made. The present study aimed to investigate the ability of 3D printing technology to assist in the repair and reconstruction of scapular aneurysmal ABC defects. Methods The study included seven patients with ABCs of the scapula. Based on computed tomography (CT) data for the patient, the scapula (including the defect) and pelvis were reconstructed using Mimics Medical software. The reconstructed scapula model was printed using a 3D printer. Before the operation, the model was used to design the surgical approach and simulate the operation process, to determine the length and radius of the plate and the number and direction of screws, and to determine the bone mass of the ilium and develop reasonable strategies for segmentation and distribution. The operation time, amount of bleeding, length and radius of the plate, and direction and number of screws were recorded. Results The average duration of follow-up was 25.6 months, and none of the seven patients experienced recurrence during the follow-up period. The surgical approach, the length and radius of internal fixation, and the number and direction of screws were consistent with the designed operation plan. Patients gradually recovered the anatomical structure of the scapula and function of the shoulder joint. Conclusions In the treatment of bone defects caused by irregular bone tumors, 3D printing technology combined with surgery has the advantages of less trauma, short operation time, less bleeding and reducing the difficulty of operation, which can reduce the waste of bone graft, and more complete reconstruction of the anatomical structure of the defective bone.

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3D Printing of a Mandibular Bone Deffect

Materiale Plastice ◽

10.37358/mp.17.1.4778 ◽

2017 ◽

Vol 54 (1) ◽

pp. 29-31

Author(s):

Alin Gabor ◽

Tiberiu Hosszu ◽

Cristian Zaharia ◽

Alexandru Kozma ◽

Andreea Codruta Cojocariu ◽

...

Keyword(s):

3D Printing ◽

Bone Defect ◽

Maxillofacial Surgery ◽

Bone Defects ◽

Scanning System ◽

Printing Technology ◽

Mandibular Bone ◽

Optical Scanning ◽

3D Printing Technology ◽

Polymeric Scaffold

The aim of this study was to achieve a polymeric scaffold, ex-vivo, using 3D printing technology and then subjecting it to various tests to check its optimal property. Initially there was selected a lower jaw with a bone defect that would have prevented any treatment based prosthetic implant. The mandible was first scanned using an optical scanner (MAESTRO DENTAL SCANNER MDS400). The scanning parameters using optical scanning system are: 10 micron accuracy, resolution 0.07 mm, 2 rooms with High-Resolution LED structured light, two axes. The scan time of the mandible was 4-5 min. Later the same mandible was scanned using CBCT�s CRANEX 3DX. The images obtained using CBCT�s were correlated with those obtained by optical scanning. Further on, there was achieved the digital design of the future scaffold with the conventional technique of wax addition directly on the mandibular bone defect. After that, this was again scanned using scanning system MAESTRO DENTAL SCANNER MDS400, and using CBCT�s CRANEX 3DX. The images obtained were correlated with all the scanned images of original mandible bone defects. There were made two polymeric scaffolds using 3D printing system an (D20 Digital Wax System 3D Printer). After printing, scaffold sites were introduced for 30 minutes in an oven curing. Later the pieces obtained were processed to remove small excesses of work. There were obtained 3 blocks of polymers that have a good adaptation to the bone profile. Often, in oral implantology and maxillofacial surgery appear bone defects. They prevent an optimal treatment of bio-functional and aesthetic restoration. Using 3D printing technology one can achieve scaffold sites of different biocompatible materials that have optimal properties to replace bone defect and restore the defective area. These scaffold sites have an intimate adaptation to the defect. 3D printing techniques used to restore bone defects can quickly and efficiently give the possibility to have a successful implantology prosthetics treatment.

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