Relevance of PEG in PLA-based blends for tissue engineering 3D-printed scaffolds

Achieving high quality 3D-printed structures requires establishing the right printing conditions. Finding processing conditions that satisfy both the fabrication process and the final required scaffold properties is crucial. This work stresses the importance of studying the outcome of the plasticizing effect of PEG on PLA-based blends used for the fabrication of 3D-direct-printed scaffolds for tissue engineering applications. For this, PLA/PEG blends with 5, 10 and 20% (w/w) of PEG and PLA/PEG/bioactive CaP glass composites were processed in the form of 3D rapid prototyping scaffolds. Surface analysis and differential scanning calorimetry revealed a rearrangement of polymer chains and a topography, wettability and elastic modulus increase of the studied surfaces as PEG was incorporated. Moreover, addition of 10 and 20% PEG led to non-uniform 3D structures with lower mechanical properties. In vitro degradation studies showed that the inclusion of PEG significantly accelerated the degradation rate of the material. Results indicated that the presence of PEG not only improves PLA processing but also leads to relevant surface, geometrical and structural changes including modulation of the degradation rate of PLA-based 3D printed scaffolds.

A Method to Represent Heterogeneous Materials for Rapid Prototyping: The Matryoshka Approach

PURPOSE

The purpose of this paper is to present a new method for representing heterogeneous materials using nested STL shells, based, in particular, on the density distributions of human bones.

DESIGN/METHODOLOGY/APPROACH

Nested STL shells, called Matryoshka models, are described, based on their namesake Russian nesting dolls. In this approach, polygonal models, such as STL shells, are "stacked" inside one another to represent different material regions. The Matryoshka model addresses the challenge of representing different densities and different types of bone when reverse engineering from medical images. The Matryoshka model is generated via an iterative process of thresholding the Hounsfield Unit (HU) data using computed tomography (CT), thereby delineating regions of progressively increasing bone density. These nested shells can represent regions starting with the medullary (bone marrow) canal, up through and including the outer surface of the bone.

FINDINGS

The Matryoshka approach introduced can be used to generate accurate models of heterogeneous materials in an automated fashion, avoiding the challenge of hand-creating an assembly model for input to multi-material additive or subtractive manufacturing.

ORIGINALITY/VALUE

This paper presents a new method for describing heterogeneous materials: in this case, the density distribution in a human bone. The authors show how the Matryoshka model can be used to plan harvesting locations for creating custom rapid allograft bone implants from donor bone. An implementation of a proposed harvesting method is demonstrated, followed by a case study using subtractive rapid prototyping to harvest a bone implant from a human tibia surrogate.

Rapid prototyping to design a customized locking plate for pancarpal arthrodesis in a giant breed dog

This report describes the treatment of traumatic carpal hyperextension in a giant breed dog by pancarpal arthrodesis using a custom-made Fixin locking plate, created with the aid of a three-dimensional plastic model of the bones of the antebrachium produced by rapid prototyping technology. A three-year-old 104 kg male Mastiff dog was admitted for treatment of carpal hyperextension injury. After diagnosis of carpal instability, surgery was recommended. Computed tomography images were used to create a life-size three-dimensional plastic model of the forelimb. The model was used as the basis for constructing a customized 12-hole Fixin locking plate. The plate was used to attain successful pancarpal arthrodesis in the animal. Radiographic examination after 74 and 140 days revealed signs of osseous union of the arthrodesis. Further clinical and radiographic follow-up examination three years later did not reveal any changes in implant position or complications.

Development of three-dimensional hollow elastic model for cerebral aneurysm clipping simulation enabling rapid and low cost prototyping

OBJECTIVE

We developed a method for fabricating a three-dimensional hollow and elastic aneurysm model useful for surgical simulation and surgical training. In this article, we explain the hollow elastic model prototyping method and report on the effects of applying it to presurgical simulation and surgical training.

METHODS

A three-dimensional printer using acrylonitrile-butadiene-styrene as a modeling material was used to produce a vessel model. The prototype was then coated with liquid silicone. After the silicone had hardened, the acrylonitrile-butadiene-styrene was melted with xylene and removed, leaving an outer layer as a hollow elastic model.

RESULTS

Simulations using the hollow elastic model were performed in 12 patients. In all patients, the clipping proceeded as scheduled. The surgeon's postoperative assessment was favorable in all cases. This method enables easy fabrication at low cost.

CONCLUSION

Simulation using the hollow elastic model is thought to be useful for understanding of three-dimensional aneurysm structure.

Clinical and radiographic evaluation of a computer-generated guiding device in bilateral sagittal split osteotomies

The bilateral sagittal split osteotomy (BSSO) is one of the main orthognathic surgery procedures used for managing skeletal mandibular excess, deficiency or asymmetry. It is known to be a technique-sensitive procedure with high reported incidences of inferior alveolar nerve injury, bad splits and post-surgical relapse. With the increasing use of computer-assisted techniques in orthognathic surgery, the accurate transfer of the virtual plan to the operating room is currently a subject of research. This study evaluated the efficacy of computer-generated device at maintaining the planned condylar position and minimizing inferior alveolar nerve injury during BSSO. The device was used in 6 patients who required isolated mandibular surgery for correction of their skeletal deformities. Clinical evaluation showed good recovery of the maximal incisal opening and a reproducible occlusion in 5 of the 6 patients. Radiographic evaluation showed better control of the condyle position in both the vertical and anteroposterior directions than in the mediolateral direction. The degree of accuracy between the planned and achieved screw positions were judged as good to excellent in all cases. Within the limitations of this study and the small sample size, the proposed device design allowed for good transfer of the virtual surgical plan to the operating room.

Design of anthropomorphic flow phantoms based on rapid prototyping of compliant vessel geometries

Anatomically realistic flow phantoms are essential experimental tools for vascular ultrasound. Here we describe how these flow phantoms can be efficiently developed via a rapid prototyping (RP) framework that involves direct fabrication of compliant vessel geometries. In this framework, anthropomorphic vessel models were drafted in computer-aided design software, and they were fabricated using stereolithography (one type of RP). To produce elastic vessels, a compliant photopolymer was used for stereolithography. We fabricated a series of compliant, diseased carotid bifurcation models with eccentric stenosis (50%) and plaque ulceration (types I and III), and they were used to form thin-walled flow phantoms by coupling the vessels to an agar-based tissue-mimicking material. These phantoms were found to yield Doppler spectrograms with significant spectral broadening and color flow images with mosaic patterns, as typical of disturbed flow under stenosed and ulcerated disease conditions. Also, their wall distension behavior was found to be similar to that observed in vivo, and this corresponded with the vessel wall's average elastic modulus (391 kPa), which was within the nominal range for human arteries. The vessel material's acoustic properties were found to be sub-optimal: the estimated average acoustic speed was 1801 m/s, and the attenuation coefficient was 1.58 dB/(mm·MHz(n)) with a power-law coefficient of 0.97. Such an acoustic mismatch nevertheless did not notably affect our Doppler spectrograms and color flow image results. These findings suggest that phantoms produced from our design framework have the potential to serve as ultrasound-compatible test beds that can simulate complex flow dynamics similar to those observed in real vasculature.

3-D printouts of the tracheobronchial tree generated from CT images as an aid to management in a case of tracheobronchial chondromalacia caused by relapsing polychondritis

This report concerns a 67 year old male patient with known advanced relapsing polychondritis complicated by tracheobronchial chondromalacia who is increasingly symptomatic and therapeutic options such as tracheostomy and stenting procedures are being considered. The DICOM files from the patient's dynamic chest CT in its inspiratory and expiratory phases were used to generate stereolithography (STL) files and hence print out 3-D models of the patient's trachea and central airways. The 4 full-sized models allowed better understanding of the extent and location of any stenosis or malacic change and should aid any planned future stenting procedures. The future possibility of using the models as scaffolding to generate a new cartilaginous upper airway using regenerative medical techniques is also discussed.

Microstructure and mechanical behavior of porous Ti-6Al-4V parts obtained by selective laser melting

Rapid prototyping allows titanium porous parts with mechanical properties close to that of bone tissue to be obtained. In this article, porous parts of the Ti-6Al-4V alloy with three levels of porosity were obtained by selective laser melting with two different energy inputs. Thermal treatments were performed to determine the influence of the microstructure on the mechanical properties. The porous parts were characterized by both optical and scanning electron microscopy. The effective modulus, yield and ultimate compressive strength were determined by compressive tests. The martensitic α' microstructure was observed in all of the as-processed parts. The struts resulting from the processing conditions investigated were thinner than those defined by CAD models, and consequently, larger pores and a higher experimental porosity were achieved. The use of the high-energy input parameters produced parts with higher oxygen and nitrogen content, their struts that were even thinner and contained a homogeneous porosity distribution. Greater mechanical properties for a given relative density were obtained using the high-energy input parameters. The as-quenched martensitic parts showed yield and ultimate compressive strengths similar to the as-processed parts, and these were greater than those observed for the fully annealed samples that had the lamellar microstructure of the equilibrium α+β phases. The effective modulus was not significantly influenced by the thermal treatments. A comparison between these results and those of porous parts with similar geometry obtained by selective electron beam melting shows that the use of a laser allows parts with higher mechanical properties for a given relative density to be obtained.

Accuracy of medical models made by additive manufacturing (rapid manufacturing)

BACKGROUND

Additive manufacturing (AM) is being increasingly used for producing medical models. The accuracy of these models varies between different materials, AM technologies and machine runs.

PURPOSE

To determine the accuracy of selective laser sintering (SLS), three-dimensional printing (3DP) and PolyJet technologies in the production of medical models.

MATERIAL

3D skull models: "original", "moderate" and "worse". SLS, 3DP and PolyJet models, and a coordinate measuring machine (CMM).

METHODS

Measuring balls designed for measurements were attached to each 3D model. Skull models were manufactured using SLS, 3DP and PolyJet. The midpoints of the balls were determined using CMM. The distances between these points were calculated and compared with the 3D model.

RESULTS

The dimensional error for the PolyJet was 0.18 ± 0.12% (first measurement) and 0.18 ± 0.13% (second measurement), for SLS 0.79 ± 0.26% (first model) and 0.80 ± 0.32% (second model), and for 3DP 0.67 ± 0.43% (original model, first measurement) and 0.69 ± 0.44% (original model, second measurement), 0.38 ± 0.22% (moderate model) and 0.55 ± 0.37% (worse model). Repeatability of the measurement method was 0.12% for the PolyJet and 0.08% for the 3DP.

CONCLUSION

A novel measuring technique was developed and its repeatability was found to be good. The accuracy of the PolyJet was higher when compared with SLS or 3DP.

Manufacturing implant supported auricular prostheses by rapid prototyping techniques

Maxillofacial prostheses are usually fabricated on the models obtained following the impression procedures. Disadvantages of conventional impression techniques used in production of facial prosthesis are deformation of soft tissues caused by impression material and disturbance of the patient due to. Additionally production of prosthesis by conventional methods takes longer time. Recently, rapid prototyping techniques have been developed for extraoral prosthesis in order to reduce these disadvantages of conventional methods. Rapid prototyping technique has the potential to simplify the procedure and decrease the laboratory work required. It eliminates the need for measurement impression procedures and preparation of wax model to be performed by prosthodontists themselves In the near future this technology will become a standard for fabricating maxillofacial prostheses.

Comparative evaluation of dimension and surface detail accuracy of models produced by three different rapid prototype techniques

Rapid prototyping (RP) is a technology that produces physical models by selectively solidifying ultra violet (UV) sensitive liquid resin using a laser beam. These models can be formed using various techniques. A study was undertaken to compare the dimensional accuracy and surface details of three prototype models with a 3D STL (standard template library) image. In this study the STL file was used to produce three different rapid prototype models namely; model 1-fused deposition model (FDM) using ABS (acrylonitrile butadiene styrene), model 2-Polyjet using a clear resin and model 3-a 3 dimensional printing using a composite material. Measurements were made at various anatomical points. For surface detail reproductions the models were subjected to scanning electron microscopy analysis. The dimensions of the model created by Polyjet were closest to the 3D STL virtual image followed by the 3DP model and FDM. SEM analysis showed uniform smooth surface on Polyjet model with adequate surface details.

Finite Element Analysis of Meniscal Anatomical 3D Scaffolds: Implications for Tissue Engineering

Solid Free-Form Fabrication (SFF) technologies allow the fabrication of anatomical 3D scaffolds from computer tomography (CT) or magnetic resonance imaging (MRI) patients’ dataset. These structures can be designed and fabricated with a variable, interconnected and accessible porous network, resulting in modulable mechanical properties, permeability, and architecture that can be tailored to mimic a specific tissue to replace or regenerate. In this study, we evaluated whether anatomical meniscal 3D scaffolds with matching mechanical properties and architecture are beneficial for meniscus replacement as compared to meniscectomy. After acquiring CT and MRI of porcine menisci, 3D fiber-deposited (3DF) scaffolds were fabricated with different architectures by varying the deposition pattern of the fibers comprising the final structure. The mechanical behaviour of 3DF scaffolds with different architectures and of porcine menisci was measured by static and dynamic mechanical analysis and the effect of these tissue engineering templates on articular cartilage was assessed by finite element analysis (FEA) and compared to healthy conditions or to meniscectomy. Results show that 3DF anatomical menisci scaffolds can be fabricated with pore different architectures and with mechanical properties matching those of natural menisci. FEA predicted a beneficial effect of meniscus replacement with 3D scaffolds in different mechanical loading conditions as compared to meniscectomy. No influence of the internal scaffold architecture was found on articular cartilage damage. Although FEA predictions should be further confirmed by in vitro and in vivo experiments, this study highlights meniscus replacement by SFF anatomical scaffolds as a potential alternative to meniscectomy.

An experimental method for stereolithic mandible fabrication and image preparation

Reproduction of anatomical structures by rapid prototyping has proven to be a valid adjunct for craniofacial surgery, providing alternative methods to produce prostheses and development of surgical guides. The aim of this study was to introduce a methodology to fabricate asymmetric human mandibles by rapid prototyping to be used in future studies for evaluating mandibular symmetries. Stereolithic models of human mandibles were produced with varying amounts of asymmetry in the condylar neck, ramus and body of the mandible by means of rapid prototyping. A method for production of the synthetic mandibles was defined. Model preparation, landmark description and development of the experimental model were described. A series of synthetic mandibles ranging in asymmetry were accurately produced from a scanned human mandible. A method for creating the asymmetries, fabricating, coating and landmarking the synthetic mandibles was formulated. A description for designing a reproducible experimental model for image acquisition was also outlined. Production of synthetic mandibles by stereolithic modeling is a viable method for creating skeletal experimental models with known amounts of asymmetry.