Additive manufacturing in medical sciences: past, present and the future

Additive Manufacturing (AM) is a process of making a Three-Dimensional (3D) solid object of virtually any shape from a digital model that is used for both prototyping and distributed manufacturing with applications in many fields, such as dental and medical industries and biotech (human tissue replacement). AM refers to technologies that create objects through a sequential layering process. AM processes have several primary areas of complexity that may not be measured precisely, due to uncertain situations. Therefore, this chapter reports an analytical model for evaluating process complexity that takes into account uncertain situations and additive manufacturing process technologies. The model is able to rank AM processes based on their relative complexities. An illustrative example for several processes is demonstrated in order to present the application of the model.

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Complexity Analysis in Additive Manufacturing for the Production of Tissue Engineering Constructs

Additive Manufacturing ◽

10.4018/978-1-5225-9624-0.ch016 ◽

2020 ◽

pp. 370-393

Author(s):

Kouroush Jenab ◽

Philip D. Weinsier

Keyword(s):

Tissue Engineering ◽

Additive Manufacturing ◽

Human Tissue ◽

Complexity Analysis ◽

Three Dimensional ◽

Solid Object ◽

Tissue Replacement ◽

3D Solid ◽

Process Complexity ◽

Am Processes

Additive Manufacturing (AM) is a process of making a Three-Dimensional (3D) solid object of virtually any shape from a digital model that is used for both prototyping and distributed manufacturing with applications in many fields, such as dental and medical industries and biotech (human tissue replacement). AM refers to technologies that create objects through a sequential layering process. AM processes have several primary areas of complexity that may not be measured precisely, due to uncertain situations. Therefore, this chapter reports an analytical model for evaluating process complexity that takes into account uncertain situations and additive manufacturing process technologies. The model is able to rank AM processes based on their relative complexities. An illustrative example for several processes is demonstrated in order to present the application of the model.

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Imaging, Virtual Planning, Design, and Production of Patient-Specific Implants and Clinical Validation in Craniomaxillofacial Surgery

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0032-1313357 ◽

2012 ◽

Vol 5 (3) ◽

pp. 137-143 ◽

Cited By ~ 58

Author(s):

Per Dérand ◽

Lars-Erik Rännar ◽

Jan-M Hirsch

Keyword(s):

Additive Manufacturing ◽

Treatment Plan ◽

Maxillofacial Surgery ◽

Bone Substitutes ◽

Patient Specific ◽

Virtual Design ◽

Patient Specific Implants ◽

Cutting Guide ◽

Ablative Surgery ◽

Cutting Guides

The purpose of this article was to describe the workflow from imaging, via virtual design, to manufacturing of patient-specific titanium reconstruction plates, cutting guide and mesh, and its utility in connection with surgical treatment of acquired bone defects in the mandible using additive manufacturing by electron beam melting (EBM). Based on computed tomography scans, polygon skulls were created. Following that virtual treatment plans entailing free microvascular transfer of fibula flaps using patient-specific reconstruction plates, mesh, and cutting guides were designed. The design was based on the specification of a Compact UniLOCK 2.4 Large (Synthes®, Switzerland). The obtained polygon plates were bent virtually round the reconstructed mandibles. Next, the resections of the mandibles were planned virtually. A cutting guide was outlined to facilitate resection, as well as plates and titanium mesh for insertion of bone or bone substitutes. Polygon plates and meshes were converted to stereolithography format and used in the software Magics for preparation of input files for the successive step, additive manufacturing. EBM was used to manufacture the customized implants in a biocompatible titanium grade, Ti6Al4V ELI. The implants and the cutting guide were cleaned and sterilized, then transferred to the operating theater, and applied during surgery. Commercially available software programs are sufficient in order to virtually plan for production of patient-specific implants. Furthermore, EBM-produced implants are fully usable under clinical conditions in reconstruction of acquired defects in the mandible. A good compliance between the treatment plan and the fit was demonstrated during operation. Within the constraints of this article, the authors describe a workflow for production of patient-specific implants, using EBM manufacturing. Titanium cutting guides, reconstruction plates for fixation of microvascular transfer of osteomyocutaneous bone grafts, and mesh to replace resected bone that can function as a carrier for bone or bone substitutes were designed and tested during reconstructive maxillofacial surgery. A clinically fit, well within the requirements for what is needed and obtained using traditional free hand bending of commercially available devices, or even higher precision, was demonstrated in ablative surgery in four patients.

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Applications of 3D Planning, Plastic Materials and Additive Manufacturing in Functional Rehabilitations in the Head and Neck Surgery

Materiale Plastice ◽

10.37358/mp.18.3.5044 ◽

2018 ◽

Vol 55 (3) ◽

pp. 431-433

Author(s):

Gheorghe Muhlfay ◽

Zoltan Fabian ◽

Radu Neagoe ◽

Karin Ursula Horvath

Keyword(s):

Additive Manufacturing ◽

Surgical Planning ◽

Standard Of Care ◽

Neck Surgery ◽

Patient Specific ◽

Patient Specific Implants ◽

Planning Software ◽

Plastic Materials ◽

Potential Benefits ◽

Manufacturing Technologies

The developments in the biocompatible materials and additive manufacturing technologies gave birth to new possibilities in reconstructive surgery. In addition to revolutionizing the diagnostic possibilities, the modern medical imaging has led to the development of surgical planning software. Using these state-of-the-art technologies, a new standard of care is rising with the spread of patient specific implants. Our view in studying and using these materials and technologies goes beyond their biocompatibility, focusing on the functional and esthetic impact of these restorations. Our aim is to show their potential benefits and pitfalls presenting a couple of posttraumatic and oncological application possibilities, focusing on the new presurgical planning, choice of materials and manufacturing technologies.

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Direct Freeform Fabrication Technique for Bio-Manufacturing of Pre-Seeded, Spatially Heterogeneous, Anatomically-Shaped Alginate Hydrogel Implants

Manufacturing Engineering and Materials Handling, Parts A and B ◽

10.1115/imece2005-81067 ◽

2005 ◽

Cited By ~ 1

Author(s):

Daniel L. Cohen ◽

Evan Malone ◽

Hod Lipson ◽

Lawrence J. Bonassar

Keyword(s):

Tissue Engineering ◽

Solid Freeform Fabrication ◽

Crosslinking Agent ◽

Three Dimensional ◽

Patient Specific ◽

Efficient Production ◽

Alginate Hydrogel ◽

Freeform Fabrication ◽

Patient Specific Implants ◽

Multiple Material

A major challenge in orthopaedic tissue engineering is the generation of cell-seeded implants with structures that mimic native tissue, both in terms of anatomic geometries and intratissue cell distributions. By combining the strengths of injection molding tissue engineering with those of Solid Freeform Fabrication (SFF), three-dimensional pre-seeded implants were fabricated without custom-tooling, enabling efficient production of patient-specific implants. The incorporation of SFF technology also enables the fabrication of geometrically complex, multiple-material implants with spatially heterogeneous cell distributions that could not otherwise be produced. Using a custom-built robotic SFF platform and gel deposition tools, alginate hydrogel was used with calcium sulfate as a crosslinking agent to produce pre-seeded living implants of arbitrary geometries. The process was determined to be sterile and viable at 94±5%. The GAG production was found to be about half that of a similarly molded samples. The compressive elastic modulus was determined to be 1.462±0.113 kPa.

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Splintless orthognathic surgery: A novel technique using patient-specific implants (PSI)

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/j.jcms.2014.12.003 ◽

2015 ◽

Vol 43 (3) ◽

pp. 319-322 ◽

Cited By ~ 54

Author(s):

Thomas Gander ◽

Marius Bredell ◽

Theodore Eliades ◽

Martin Rücker ◽

Harald Essig

Keyword(s):

Orthognathic Surgery ◽

Patient Specific ◽

Novel Technique ◽

Patient Specific Implants

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Patient specific implants: scope for the future

Current Reviews in Musculoskeletal Medicine ◽

10.1007/s12178-014-9214-2 ◽

2014 ◽

Vol 7 (2) ◽

pp. 125-130 ◽

Cited By ~ 11

Author(s):

Rajesh N. Maniar ◽

Tushar Singhi

Keyword(s):

Patient Specific ◽

Patient Specific Implants ◽

The Future

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Application of 3D Printing Technology in Orthopedic Medical Implant -Spinal surgery as an example

International Journal of Bioprinting ◽

10.18063/ijb.v5i2.168 ◽

2019 ◽

Vol 5 (2) ◽

pp. 3

Author(s):

Rong Feng Zhang ◽

Peng Yun Wang ◽

Ming Yang ◽

Xuebo Dong ◽

Xue Liu ◽

...

Keyword(s):

Additive Manufacturing ◽

Spinal Surgery ◽

Surgical Planning ◽

Operating Time ◽

Manufacturing Technology ◽

Patient Specific ◽

Additive Manufacturing Technology ◽

Patient Specific Implants ◽

Surgical Guides ◽

Communication Aid

Additive manufacturing has been used in complex spinal surgical planning since the 1990s and is now increasingly utilized to produce surgical guides, templates, and more recently customized implants. Surgeons report beneficial impacts using additively manufactured biomodels as pre-operative planning aids as it generally provides a better representation of the patient’s anatomy than on-screen viewing of computed tomography (CT) or magnetic resonance imaging (MRI). Furthermore, it has proven to be very beneficial in surgical training and in explaining complex deformity and surgical plans to patients/ parents. This paper reviews the historical perspective, current use, and future directions in using additive manufacturing in complex spinal surgery cases. This review reflects the authors’ opinion of where the field is moving in light of the current literature. Despite the reported benefits of additive manufacturing for surgical planning in recent years, it remains a high niche market. This review raises the question as to why the use of this technology has not progressed more rapidly despite the reported advantages – decreased operating time, decreased radiation exposure to patients intraoperatively, improved overall surgical outcomes, pre-operative implant selection, as well as being an excellent communication aid for all medical and surgical team members. Increasingly, the greatest benefits of additive manufacturing technology in spinal surgery are customdesigned drill guides, templates for pedicle screw placement, and customized patient-specific implants. In view of these applications, additive manufacturing technology could potentially revolutionize health care in the near future.

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