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Emiliani N, Porcaro R, Pisaneschi G, Bortolani B, Ferretti F, Fontana F, Campana G, Fiorini M, Marcelli E, Cercenelli L. Post-printing processing and aging effects on Polyjet materials intended for the fabrication of advanced surgical simulators. J Mech Behav Biomed Mater 2024; 156:106598. [PMID: 38815435 DOI: 10.1016/j.jmbbm.2024.106598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/06/2024] [Accepted: 05/23/2024] [Indexed: 06/01/2024]
Abstract
Material Jetting (MJ) 3D printing technology is promising for the fabrication of highly realistic surgical simulators, however, the changes in the mechanical properties of MJ materials after post-printing treatments and over time remain quite unknown. In this study, we investigate the effect of different post-printing processes and aging on the mechanical properties of a white opaque and rigid MJ photopolymer, a white flexible MJ photopolymer and on a combination of them. Tensile and Shore hardness tests were conducted on homogeneous 3D-printed specimens: two different post-printing procedures for support removal (dry and water) and further surface treatment (with glycerol solution) were compared. The specimens were tested within 48 h from printing and after aging (30-180 days) in a controlled environment. All groups of specimens treated with different post-printing processes (dry, water, glycerol) exhibited a statistically significant difference in mechanical properties (i.e. elongation at break, elastic modulus, ultimate tensile strength). Particularly, the treatment with glycerol makes the flexible photopolymer more rigid, but then with aging the initial elongation of the material tends to be restored. For the rigid photopolymer, an increase in deformability was observed as a major effect of aging. The hardness tests on the printed specimens highlighted a significant overestimation of the Shore values declared by the manufacturer. The study findings are useful for guiding the material selection and post-printing processing techniques to manufacture realistic and durable models for surgical training.
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Affiliation(s)
- Nicolas Emiliani
- eDIMES Lab - Laboratory of Bioengineering, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138, Bologna, Italy
| | - Rita Porcaro
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), University of Bologna, Via Terracini 28, 40131, Bologna, Italy
| | - Gregorio Pisaneschi
- Department of Industrial Engineering (DIN), University of Bologna, Viale del Risorgimento, 40136, Bologna, Italy
| | - Barbara Bortolani
- eDIMES Lab - Laboratory of Bioengineering, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138, Bologna, Italy
| | - Fabrizio Ferretti
- eDIMES Lab - Laboratory of Bioengineering, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138, Bologna, Italy
| | - Francesco Fontana
- Department of Industrial Engineering (DIN), University of Bologna, Viale del Risorgimento, 40136, Bologna, Italy
| | - Giampaolo Campana
- Department of Industrial Engineering (DIN), University of Bologna, Viale del Risorgimento, 40136, Bologna, Italy
| | - Maurizio Fiorini
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), University of Bologna, Via Terracini 28, 40131, Bologna, Italy
| | - Emanuela Marcelli
- eDIMES Lab - Laboratory of Bioengineering, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138, Bologna, Italy
| | - Laura Cercenelli
- eDIMES Lab - Laboratory of Bioengineering, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138, Bologna, Italy.
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Ban S, Lee H, Chen J, Kim HS, Hu Y, Cho SJ, Yeo WH. Recent advances in implantable sensors and electronics using printable materials for advanced healthcare. Biosens Bioelectron 2024; 257:116302. [PMID: 38648705 DOI: 10.1016/j.bios.2024.116302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/20/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
This review article focuses on the recent printing technological progress in healthcare, underscoring the significant potential of implantable devices across diverse applications. Printing technologies have widespread use in developing health monitoring devices, diagnostic systems, and surgical devices. Recent years have witnessed remarkable progress in fabricating low-profile implantable devices, driven by advancements in printing technologies and nanomaterials. The importance of implantable biosensors and bioelectronics is highlighted, specifically exploring printing tools using bio-printable inks for practical applications, including a detailed examination of fabrication processes and essential parameters. This review also justifies the need for mechanical and electrical compatibility between bioelectronics and biological tissues. In addition to technological aspects, this article delves into the importance of appropriate packaging methods to enhance implantable devices' performance, compatibility, and longevity, which are made possible by integrating cutting-edge printing technology. Collectively, we aim to shed light on the holistic landscape of implantable biosensors and bioelectronics, showcasing their evolving role in advancing healthcare through innovative printing technologies.
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Affiliation(s)
- Seunghyeb Ban
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30024, USA; IEN Center for Wearable Intelligent Systems and Healthcare at the Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Haran Lee
- Department of Mechanical Engineering, Chungnam National University, 99 Daehak-Ro, Yuseong-Gu, Daejeon, 34134, Republic of Korea
| | - Jiehao Chen
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30024, USA
| | - Hee-Seok Kim
- School of Engineering and Technology, University of Washington Tacoma, Tacoma, WA, 98195, USA
| | - Yuhang Hu
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30024, USA; School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Seong J Cho
- Department of Mechanical Engineering, Chungnam National University, 99 Daehak-Ro, Yuseong-Gu, Daejeon, 34134, Republic of Korea.
| | - Woon-Hong Yeo
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30024, USA; IEN Center for Wearable Intelligent Systems and Healthcare at the Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, 30332, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Tech and Emory University School of Medicine, Atlanta, GA, 30332, USA; Parker H. Petit Institute for Bioengineering and Biosciences, Institute for Materials, Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
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Głowacki M, Skórczewska K, Lewandowski K, Mazurkiewicz A, Szewczykowski P. Evaluation of the Effect of Mineral Oil Exposure on Changes in the Structure and Mechanical Properties of Polymer Parts Produced by Additive Manufacturing Techniques. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3680. [PMID: 39124350 PMCID: PMC11313062 DOI: 10.3390/ma17153680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/21/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024]
Abstract
The paper describes the type of changes in the structure and mechanical properties of 3D printed shapes under the influence of mineral oil. The effects of a room (23 °C) and elevated temperature (70 °C) on 3D prints manufactured by the FDM method and stored in oil for 15, 30, and 60 days on the change of properties and structure were investigated. The samples were produced from ABS (poly(acrylonitrile-co-butadiene-co-styrene)), ASA (poly(acrylonitrile-co-styrene-co-acrylate), PLA (poly(lactic acid)), and HIPS (high-impact polystyrene). Tests related to the strength of the materials, such as the static tensile test and Charpy impact test, were carried out. The structure was evaluated using a scanning electron microscope, and changes in chemical structure were determined by conducting FTIR (Fourier transform infrared spectroscopy) and TGA (thermogravimetric analysis) tests. The analysis of the results provided important information about the impact of mineral oil on specific materials. This is critical for designing and manufacturing components that can withstand mineral oil exposure in real-world environments. The materials underwent varying changes. Strength increased for PLA by about 28%, remained unchanged for ABS and HIPS during exposure for 30 days, and decreased for ASA with extended exposure up to 14%.
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Affiliation(s)
- Marcin Głowacki
- Faculty of Mechanical Engineering, Bydgoszcz University of Science and Technology, Kaliskiego 7 Street, 85-796 Bydgoszcz, Poland; (A.M.); (P.S.)
| | - Katarzyna Skórczewska
- Faculty of Chemical Technology and Engineering, Bydgoszcz University of Science and Technology, Seminaryjna 3 Street, 85-326 Bydgoszcz, Poland;
| | - Krzysztof Lewandowski
- Faculty of Chemical Technology and Engineering, Bydgoszcz University of Science and Technology, Seminaryjna 3 Street, 85-326 Bydgoszcz, Poland;
| | - Adam Mazurkiewicz
- Faculty of Mechanical Engineering, Bydgoszcz University of Science and Technology, Kaliskiego 7 Street, 85-796 Bydgoszcz, Poland; (A.M.); (P.S.)
| | - Piotr Szewczykowski
- Faculty of Mechanical Engineering, Bydgoszcz University of Science and Technology, Kaliskiego 7 Street, 85-796 Bydgoszcz, Poland; (A.M.); (P.S.)
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Chanabodeechalermrung B, Chaiwarit T, Udomsom S, Rachtanapun P, Piboon P, Jantrawut P. Determination of vat-photopolymerization parameters for microneedles fabrication and characterization of HPMC/PVP K90 dissolving microneedles utilizing 3D-printed mold. Sci Rep 2024; 14:16174. [PMID: 39003398 PMCID: PMC11246459 DOI: 10.1038/s41598-024-67243-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 07/09/2024] [Indexed: 07/15/2024] Open
Abstract
Three-dimensional (3D) printing serves as an alternative method for fabricating microneedle (MN) patches with a high object resolution. In this investigation, four distinct needle shapes: pyramid mounted over a long cube (shape A), cone mounted over a cylinder (shape B), pyramidal shape (shape C), and conical shape (shape D) were designed using computer-aided design (CAD) software with compensated bases of 350, 450 and 550 µm. Polylactic acid (PLA) biophotopolymer resin from eSun and stereolithography (SLA) 3D printer from Anycubic technology were used to print MN patches. The 3D-printed MN patches were employed to construct MN molds, and those molds were used to produce hydroxypropyl methylcellulose (HPMC) and polyvinyl pyrrolidone (PVP) K90 dissolving microneedles (DMNs). Various printing parameters, such as curing time, printing angle, and anti-aliasing (AA), were varied to evaluate suitable printing conditions for each shape. Furthermore, physical appearance, mechanical property, and skin insertion ability of HPMC/PVP K90 DMNs were examined. The results showed that for shape A and C, the suitable curing time and printing angle were 1.5 s and 30° while for shapes B and D, they were 2.0 s and 45°, respectively. All four shapes required AA to eliminate their stair-stepped edges. Additionally, it was demonstrated that all twelve designs of 3D-printed MN patches could be employed for fabricating MN molds. HPMC/PVP K90 DMNs with the needles of shape A and B exhibited better physicochemical properties compared to those of shape C and D. Particularly, both sample 9 and 10 displayed sharp needle without bent tips, coupled with minimal height reduction (< 10%) and a high percentage of blue dots (approximately 100%). As a result, 3D printing can be utilized to custom construct 3D-printed MN patches for producing MN molds, and HPMC/PVP K90 DMNs manufactured by those molds showed excellent physicochemical properties.
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Affiliation(s)
| | - Tanpong Chaiwarit
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Suruk Udomsom
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Chiang Mai, 50200, Thailand
- Office of Research Administration, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Pornchai Rachtanapun
- Division of Packaging Technology, School of Agro-Industry, Faculty of Agro-Industry, Chiang Mai University, Chiang Mai, 50100, Thailand
- Center of Excellence in Materials Science and Technology, Chiang Mai University, Chiang Mai, 50200, Thailand
- Center of Excellence in Agro Bio-Circular-Green Industry (Agro BCG), Agro-Industry, Chiang Mai University, Chiang Mai, 50100, Thailand
| | - Promporn Piboon
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, 50100, Thailand
| | - Pensak Jantrawut
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand.
- Center of Excellence in Materials Science and Technology, Chiang Mai University, Chiang Mai, 50200, Thailand.
- Center of Excellence in Agro Bio-Circular-Green Industry (Agro BCG), Agro-Industry, Chiang Mai University, Chiang Mai, 50100, Thailand.
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Suri C, Pande B, Sahu T, Sahithi LS, Verma HK. Revolutionizing Gastrointestinal Disorder Management: Cutting-Edge Advances and Future Prospects. J Clin Med 2024; 13:3977. [PMID: 38999541 PMCID: PMC11242723 DOI: 10.3390/jcm13133977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/22/2024] [Accepted: 06/29/2024] [Indexed: 07/14/2024] Open
Abstract
In recent years, remarkable strides have been made in the management of gastrointestinal disorders, transforming the landscape of patient care and outcomes. This article explores the latest breakthroughs in the field, encompassing innovative diagnostic techniques, personalized treatment approaches, and novel therapeutic interventions. Additionally, this article emphasizes the use of precision medicine tailored to individual genetic and microbiome profiles, and the application of artificial intelligence in disease prediction and monitoring. This review highlights the dynamic progress in managing conditions such as inflammatory bowel disease, gastroesophageal reflux disease, irritable bowel syndrome, and gastrointestinal cancers. By delving into these advancements, we offer a glimpse into the promising future of gastroenterology, where multidisciplinary collaborations and cutting-edge technologies converge to provide more effective, patient-centric solutions for individuals grappling with gastrointestinal disorders.
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Affiliation(s)
- Chahat Suri
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB T6G 1Z2, Canada
- Lung Health and Immunity, Helmholtz Zentrum Munich, IngolstädterLandstraße 1, 85764 Oberschleißheim, 85764 Munich, Germany
| | - Babita Pande
- Department of Physiology, All India Institute of Medical Science, Raipur 492099, India
| | - Tarun Sahu
- Department of Physiology, All India Institute of Medical Science, Raipur 492099, India
| | | | - Henu Kumar Verma
- Lung Health and Immunity, Helmholtz Zentrum Munich, IngolstädterLandstraße 1, 85764 Oberschleißheim, 85764 Munich, Germany
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Oley MH, Oley MC, Sukarno V, Faruk M. Advances in Three-Dimensional Printing for Craniomaxillofacial Trauma Reconstruction: A Systematic Review. J Craniofac Surg 2024:00001665-990000000-01748. [PMID: 38958985 DOI: 10.1097/scs.0000000000010451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/01/2024] [Indexed: 07/04/2024] Open
Abstract
Craniomaxillofacial (CMF) fractures present significant challenges for plastic surgeons due to their intricate nature. Conventional methods such as autologous bone grafts have limitations, necessitating advancements in reconstructive surgery techniques. This study reviewed the use of three-dimensional printing for CMF trauma reconstruction using human studies. A systematic search of PubMed, EMBASE, and Google Scholar was conducted in February 2024 for case reports, case series, and clinical trials related to CMF trauma reconstruction using three-dimensional printing technology. The authors' systematic review included 20 studies and a total of 170 participants with CMF bone defects. In general, the authors observed low bias risk in analyzed case reports and series, serious bias risk in nonrandomized controlled trials, and moderate bias risk in randomized controlled trials. The printed objects included CMF structure model prototypes, patient-specific implants, and other custom surgical devices. Studies reveal successful outcomes, including restored facial symmetry and function, restored orbital occlusion, resolved enophthalmos and diplopia, achieved cosmetically symmetrical lower face reconstruction, and precise fitting of surgical devices, enhancing patient and surgeon comfort. However, complications such as local infection, implant exposure, and persistent diplopia were reported. Three-dimensional printed devices reduced surgery time but increased preparation time and production costs. In-house production options could mitigate these time and cost expenditures. Three-dimensional printing holds potential in CMF trauma reconstruction, addressing both functional and esthetic restoration. Nevertheless, challenges persist in implementing this advanced technology in resource-limited environments.
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Affiliation(s)
- Mendy Hatibie Oley
- Division of Plastic Reconstructive and Esthetic Surgery, Department of Surgery, Faculty of Medicine, Sam Ratulangi University
- Division of Plastic Reconstructive and Esthetic Surgery, Department of Surgery, Kandou Hospital
- Hyperbaric Centre Siloam Hospital
| | - Maximillian Christian Oley
- Hyperbaric Centre Siloam Hospital
- Division of Neurosurgery, Faculty of Medicine, Department of Surgery, Sam Ratulangi University
- Division of Neurosurgery, Department of Surgery, Kandou Hospital, Manado
| | | | - Muhammad Faruk
- Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
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Solyom A, Moldovan F, Moldovan L, Strnad G, Fodor P. Clinical Workflow Algorithm for Preoperative Planning, Reduction and Stabilization of Complex Acetabular Fractures with the Support of Three-Dimensional Technologies. J Clin Med 2024; 13:3891. [PMID: 38999455 PMCID: PMC11242480 DOI: 10.3390/jcm13133891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 06/28/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Treatment of pelvic injuries poses serious problems for surgeons due to the difficulties of the associated injuries. The objective of this research is to create a clinical workflow that integrates three-dimensional technologies in preoperative planning and performing surgery for the reduction and stabilization of associated acetabular fractures. Methods: The research methodology consisted of integrating the stages of virtual preoperative planning, physical preoperative planning, and performing the surgical intervention in a newly developed clinical workflow. The proposed model was validated in practice in a pilot surgical intervention. Results: On a complex pelvic injury case of a patient with an associated both-column acetabular fracture (AO/OTA-62C1g), we presented the results obtained in the six stages of the clinical workflow: acquisition of three-dimensional (3D) images, creation of the virtual model of the pelvis, creation of the physical model of the pelvis, preoperative physical simulation, orthopedic surgery, and imaging validation of the intervention. The life-size 3D model was fabricated based on computed tomography imagistics. To create the virtual model, the images were imported into Invesalius (version 3.1.1, CTI, Brazil), after which they were processed with MeshLab (version 2023.12, ISTI-CNR, Italy) and FreeCAD (version 0.21.2, LGPL, FSF, Boston, MA, USA). The physical model was printed in 21 h and 37 min using Ultimaker Cura software (version 5.7.2), on an Ultimaker 2+ printing machine through a Fused Deposition Modeling process. Using the physical model, osteosynthesis plate dimensions and fixation screw trajectories were tested to reduce the risk of neurovascular injury, after which they were adjusted and resterilized, which enhanced preoperative decision-making. Conclusions: The life-size physical model improved anatomical appreciation and preoperative planning, enabling accurate surgical simulation. The tools created demonstrated remarkable accuracy and cost-effectiveness that support the advancement and efficiency of clinical practice.
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Affiliation(s)
- Arpad Solyom
- Orthopedics—Traumatology Department, Faculty of Medicine, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania; (A.S.); (P.F.)
| | - Flaviu Moldovan
- Orthopedics—Traumatology Department, Faculty of Medicine, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania; (A.S.); (P.F.)
| | - Liviu Moldovan
- Faculty of Engineering and Information Technology, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania; (L.M.); (G.S.)
| | - Gabriela Strnad
- Faculty of Engineering and Information Technology, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania; (L.M.); (G.S.)
| | - Pal Fodor
- Orthopedics—Traumatology Department, Faculty of Medicine, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania; (A.S.); (P.F.)
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Rienas W, Hubbell R, Toivonen J, Geritano M, Hall A, Prabhu S, Robson C, Weinstock P, Poe DS. 3D printed temporal bones for preoperative simulation and planning. Am J Otolaryngol 2024; 45:104340. [PMID: 38723379 DOI: 10.1016/j.amjoto.2024.104340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE Demonstrate the utility of 3D printed temporal bone models in individual patient preoperative planning and simulation. METHODS 3D models of the temporal bone were made from 5 pediatric and adult patients at a tertiary academic hospital with challenging surgical anatomy planned for cochlear implantation or exteriorization of cholesteatoma with complex labyrinthine fistula. The 3D models were created from CT scan used for preoperative planning, simulation and intraoperative reference. The utility of models was assessed for ease of segmentation and production and impact on surgery in regard to reducing intraoperative time and costs, improving safety and efficacy. RESULTS Three patients received cochlear implants, two exteriorization of advanced cholesteatoma with fistulas (1 internal auditory canal/cochlea, 1 all three semicircular canals). Surgical planning and intraoperative referencing to the simulations by the attending surgeon and trainees significantly altered original surgical plans. In a case of X-linked hereditary deafness, optimal angles and rotation maneuvers for cochlear implant insertion reduced operating time by 93 min compared to the previous contralateral side surgery. Two cochlear implant cases planned for subtotal petrosectomy approach due to aberrant anatomy were successfully approached through routine mastoidectomy. The cholesteatoma cases were successfully exteriorized without necessitating partial labyrinthectomy or labyrinthine injury. There were no complications. CONCLUSION 3D printed models for simulation training, surgical planning and use intraoperatively in temporal bone surgery demonstrated significant benefits in designing approaches, development of patient-specific techniques, avoidance of potential or actual complications encountered in previous or current surgery, and reduced surgical time and costs.
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Affiliation(s)
- William Rienas
- George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20052, United States of America; Department of Otorhinolaryngology, Boston Children's Hospital, Harvard Medical School, 333 Longwood Ave, Boston, MA 02115, United States of America
| | - Richard Hubbell
- Department of Otolaryngology - Head and Neck Surgery, Loyola University Medical Center, 2160S. First Ave, Maywood, IL 60153, United States of America.
| | - Joonas Toivonen
- Department of Otorhinolaryngology, Boston Children's Hospital, Harvard Medical School, 333 Longwood Ave, Boston, MA 02115, United States of America; Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, University of Turku, FI-20014 Turun Yliopisto, Finland.
| | - Mariah Geritano
- Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States of America.
| | - Andrew Hall
- University Hospital for Wales, Heath Park Way, Cardiff CF14 4XW, United Kingdom
| | - Sanjay Prabhu
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States of America.
| | - Caroline Robson
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States of America.
| | - Peter Weinstock
- Immersive Design Systems, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States of America; Department of Anesthesia, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States of America.
| | - Dennis S Poe
- Department of Otorhinolaryngology, Boston Children's Hospital, Harvard Medical School, 333 Longwood Ave, Boston, MA 02115, United States of America.
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Mihaylova A, Shopova D, Parahuleva N, Yaneva A, Bakova D. (3D) Bioprinting-Next Dimension of the Pharmaceutical Sector. Pharmaceuticals (Basel) 2024; 17:797. [PMID: 38931464 PMCID: PMC11206453 DOI: 10.3390/ph17060797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 05/26/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
To create a review of the published scientific literature on the benefits and potential perspectives of the use of 3D bio-nitrification in the field of pharmaceutics. This work was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting meta-analyses and systematic reviews. The scientific databases PubMed, Scopus, Google Scholar, and ScienceDirect were used to search and extract data using the following keywords: 3D bioprinting, drug research and development, personalized medicine, pharmaceutical companies, clinical trials, drug testing. The data points to several aspects of the application of bioprinting in pharmaceutics were reviewed. The main applications of bioprinting are in the development of new drug molecules as well as in the preparation of personalized drugs, but the greatest benefits are in terms of drug screening and testing. Growth in the field of 3D printing has facilitated pharmaceutical applications, enabling the development of personalized drug screening and drug delivery systems for individual patients. Bioprinting presents the opportunity to print drugs on demand according to the individual needs of the patient, making the shape, structure, and dosage suitable for each of the patient's physical conditions, i.e., print specific drugs for controlled release rates; print porous tablets to reduce swallowing difficulties; make transdermal microneedle patches to reduce patient pain; and so on. On the other hand, bioprinting can precisely control the distribution of cells and biomaterials to build organoids, or an Organ-on-a-Chip, for the testing of drugs on printed organs mimicking specified disease characteristics instead of animal testing and clinical trials. The development of bioprinting has the potential to offer customized drug screening platforms and drug delivery systems meeting a range of individualized needs, as well as prospects at different stages of drug development and patient therapy. The role of bioprinting in preclinical and clinical testing of drugs is also of significant importance in terms of shortening the time to launch a medicinal product on the market.
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Affiliation(s)
- Anna Mihaylova
- Department of Healthcare Management, Faculty of Public Health, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria;
| | - Dobromira Shopova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria;
| | - Nikoleta Parahuleva
- Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria;
| | - Antoniya Yaneva
- Department of Medical Informatics, Biostatistics and eLearning, Faculty of Public Health, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria;
| | - Desislava Bakova
- Department of Healthcare Management, Faculty of Public Health, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria;
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Zavaleta-Monestel E, Barrantes-López M, García-Montero J, Arguedas-Chacón S, Campos-Hernández J. Unveiling the Drug Formulation Code: A Journey to Three-Dimensional Precision. Cureus 2024; 16:e62614. [PMID: 39027795 PMCID: PMC11257164 DOI: 10.7759/cureus.62614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
Magistral formulations emerged years ago and were of great help in the personalization of treatments for patients. Over time, innovation began in this area with new technologies such as three-dimensional (3D) printing, which has brought greater benefits, ease of preparation, new scopes, and even cost reduction. Three-dimensional printing of medicines opened the way to create personalized multi-dose, controlled-release, multi-drug tablets, among others. In addition, this technology manages to be more specific in adjusting pharmacokinetics, doses, and even organoleptic qualities, which is precisely what is sought since the medication is being personalized for a patient due to a particular case or condition. Throughout the research, some studies can be observed that function as a base that provides safety and effectiveness for the subsequent use of other pharmaceuticals in the 3D printing of medicines.
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Affiliation(s)
- Esteban Zavaleta-Monestel
- Pharmacy, Hospital Clínica Bíblica, San José, CRI
- Pharmacy, Universidad de Iberoámerica, San José, CRI
| | | | - Jonathan García-Montero
- Pharmacy and Clinical Research, Hospital Clínica Bíblica, San José, CRI
- Pharmacy, Universidad de Iberoámerica, San José, CRI
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11
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Galliotto F, Veronese P, Cerutti A, Zemin F, Bertelli F, Di Salvo G, Guariento A, Vida VL. Enhancing parental understanding of congenital heart disease through personalized prenatal counseling with 3D printed hearts. Prenat Diagn 2024; 44:725-732. [PMID: 38777748 DOI: 10.1002/pd.6583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/25/2024] [Accepted: 04/21/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES In addition to a correct prenatal diagnosis of congenital heart disease (CHD), comprehensive parental counseling is crucial to ensure that parents are well-informed about the condition of the fetus. This study aims to investigate whether there is a significant difference in the information acquired by parents through traditional counseling, utilizing 2-dimensional (2D) illustrations and images, compared to an advanced approach utilizing personalized three-dimensional (3D) printed models of the fetal heart developed from 3D ultrasound imaging. METHODS This study, designed as a pilot randomized control trial, enrolled pregnant women with gestational ages greater than 18 weeks, whose fetuses were diagnosed with CHD and referred to our center between November, 2020 and June, 2021. Two groups of patients were included in the study. The first group received standard medical counseling with 2D images and illustrations, while the second group underwent advanced counseling with 3D-printed patient-specific heart models. Both groups were then required to complete the same survey in which the knowledge of the CHD was investigated. The 3D models were created from 3D ultrasound imaging and printed using resin materials in both 1:1 and 5:1 scale. RESULTS A comparison of the scores obtained from the two groups revealed that 3D visualization of the fetus's heart has the potential to increase parental knowledge about CHD and the required surgical procedures. Furthermore, all couples expressed interest in receiving a 1:1 scale model of their baby's heart. CONCLUSION Personalized prenatal counseling with 3D-ultrasound-based heart models positively impacts parents' understanding of CHD. The use of 3D models provides a more comprehensive and accessible representation of the condition, contributing to an increased knowledge gain, and potentially helping to support informed decisions regarding their child's care.
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Affiliation(s)
- Francesco Galliotto
- Pediatric Cardiac Surgery Division, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Paola Veronese
- Maternal Fetal Medicine Division, Department of Woman and Child Health, University of Padua, Padua, Italy
| | - Alessia Cerutti
- Pediatric Cardiology Division, Department of Woman and Child Health, University of Padua, Padua, Italy
| | - Filippo Zemin
- Maternal Fetal Medicine Division, Department of Woman and Child Health, University of Padua, Padua, Italy
| | - Francesco Bertelli
- Pediatric Cardiac Surgery Division, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Giovanni Di Salvo
- Pediatric Cardiology Division, Department of Woman and Child Health, University of Padua, Padua, Italy
| | - Alvise Guariento
- Pediatric Cardiac Surgery Division, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Vladimiro L Vida
- Pediatric Cardiac Surgery Division, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
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Zahid MJ, Mavani P, Awuah WA, Alabdulrahman M, Punukollu R, Kundu A, Mago A, Maher K, Adebusoye FT, Khan TN. Sculpting the future: A narrative review of 3D printing in plastic surgery and prosthetic devices. Health Sci Rep 2024; 7:e2205. [PMID: 38915353 PMCID: PMC11194296 DOI: 10.1002/hsr2.2205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 06/02/2024] [Accepted: 06/08/2024] [Indexed: 06/26/2024] Open
Abstract
Background and Aims The advent of 3D printing has revolutionized plastic surgery and prosthetic devices, providing personalized solutions for patients with traumatic injuries, deformities, and appearance-related conditions. This review offers a comprehensive overview of 3D printing's applications, advantages, limitations, and future prospects in these fields. Methods A literature search was conducted in PubMed, Google Scholar, and Scopus for studies on 3D printing in plastic surgery. Results 3D printing has significantly contributed to personalized medical interventions, with benefits like enhanced design flexibility, reduced production time, and improved patient outcomes. Using computer-aided design (CAD) software, precise models tailored to a patient's anatomy can be created, ensuring better fit, functionality, and comfort. 3D printing allows for intricate geometries, leading to improved aesthetic outcomes and patient-specific prosthetic limbs and orthoses. The historical development of 3D printing, key milestones, and breakthroughs are highlighted. Recent progress in bioprinting and tissue engineering shows promising applications in regenerative medicine and transplantation. The integration of AI and automation with 3D printing enhances surgical planning and outcomes. Emerging trends in patient-specific treatment planning and precision medicine are potential game-changers. However, challenges like technical considerations, economic implications, and ethical issues exist. Addressing these challenges and advancing research in materials, design processes, and long-term outcomes are crucial for widespread adoption. Conclusion The review underscores the increasing adoption of 3D printing in healthcare and its impact on plastic surgery and prosthetic devices. It emphasizes the importance of evaluating the current state and addressing knowledge gaps through future research to foster further advancements.
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Affiliation(s)
| | - Parit Mavani
- B. J. Medical CollegeAhmedabadIndia
- Department of SurgeryEmory University School of MedicineAtlantaGeorgiaUSA
| | | | | | | | - Arnab Kundu
- R.G. Kar Medical College and HospitalKolkataIndia
| | - Arpit Mago
- Jawaharlal Nehru medical CollegeBelgaumIndia
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Vakilian S, Al-Hashmi S, Al-Kindi J, Al-Fahdi F, Al-Wahaibi N, Shalaby A, Al-Riyami H, Al-Harrasi A, Jamshidi-Adegani F. Avastin-Loaded 3D-Printed Alginate Scaffold as an Effective Antiadhesive Barrier to Prevent Postsurgical Adhesion Bands Formation. Macromol Biosci 2024; 24:e2300530. [PMID: 38319279 DOI: 10.1002/mabi.202300530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/18/2024] [Indexed: 02/07/2024]
Abstract
Postoperative adhesion can cause complications, such as pain and organ blockage, in the abdominal regions. To address this issue, surgical techniques and antiadhesive treatments are applied. Given the significant role of vascularization in adhesion band formation, Avastin (Ava) that targets vascular endothelial growth factor (VEGF) can be applied to prevent peritoneal adhesion bands. Moreover, Alginate (Alg), a natural polysaccharide, is a promising physical barrier to prevent adhesion bands. Incorporating Ava into Alg hydrogel in a form of 3D-printed scaffold (Alg/Ava) has potential to suppress inflammation and angiogenesis, leading to reduce peritoneal adhesion bands. Following physical, morphological, and biocompatibility evaluations, the efficacy of Alg and Ava alone and their combination in Alg/Ava on the formation of postsurgical adhesions is evaluated. Upon confirming physical stability and sustained release of Ava, the Alg/Ava scaffold effectively diminishes both the extent and strength of adhesion bands. Histopathological examination shows that the reduction in fibrosis and inflammation is responsible for preventing adhesion bands by the Alg/Ava scaffold. Additionally, the cytokine assessment reveals that this is due to the inhibition in the secretion of VEGF and Interleukin 6 suppressing vascularization and inflammatory pathways. This study suggests that a 3D-printed Alg/Ava scaffold has great potential to prevent the postsurgical adhesion bands.
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Affiliation(s)
- Saeid Vakilian
- Laboratory for Stem Cell & Regenerative Medicine, Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, PC 616, Oman
| | - Sulaiman Al-Hashmi
- Laboratory for Stem Cell & Regenerative Medicine, Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, PC 616, Oman
| | - Juhaina Al-Kindi
- Laboratory for Stem Cell & Regenerative Medicine, Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, PC 616, Oman
| | - Fahad Al-Fahdi
- Laboratory for Stem Cell & Regenerative Medicine, Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, PC 616, Oman
| | - Nasar Al-Wahaibi
- Department of Biomedical Science, College of Medicine & Health Sciences, Sultan Qaboos University, Alkoudh, 123, Oman
- Department of Pathology, College of Medicine & Health Sciences, Sultan Qaboos University, P. O. Box: 35, Alkoudh, 123, Oman
| | - Asem Shalaby
- Department of Pathology, College of Medicine & Health Sciences, Sultan Qaboos University, P. O. Box: 35, Alkoudh, 123, Oman
- Pathology Department, College of Medicine, Mansoura University, Mansoura, Dakahlia, 35516, Egypt
| | - Hamad Al-Riyami
- Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Alkoudh, PC 123, Oman
| | - Ahmed Al-Harrasi
- Laboratory for Stem Cell & Regenerative Medicine, Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, PC 616, Oman
| | - Fatemeh Jamshidi-Adegani
- Laboratory for Stem Cell & Regenerative Medicine, Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, PC 616, Oman
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Ratajski J, Bałasz B, Mydłowska K, Pancielejko M, Szparaga Ł. The Effect of Ageing on Phase Transformations and Mechanical Behaviour in Ni-Rich NiTi Alloys. MATERIALS (BASEL, SWITZERLAND) 2024; 17:2420. [PMID: 38793486 PMCID: PMC11123298 DOI: 10.3390/ma17102420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024]
Abstract
In this article, the results of research on a NiTi alloy with a high nickel content (51.7 at.%), produced using the additive technology SLM method and subjected to isothermal ageing after solution annealing, are presented. The study involved the determination of the sequence of phase transformations occurring using differential scanning calorimetry (DSC) and the determination of the temperature range of these transformations. In parallel, the phase composition was determined using the XRD method; the hardness and the Young's modulus were also determined. The analysis of the DSC results obtained indicates the following characteristic features of the NiTi alloy, which change with ageing time: (1) During cooling (from +150 °C to -50 °C), the type of transformation changes from a one-step transformation after solution annealing to a two-step transformation after the ageing process over 1, 20, and 100 h at 500 °C; (2) during heating (from -50 °C to +150 °C) for all the samples, regardless of the ageing time, only a one-step transformation from martensite M(B19') to austenite A(B2) is observed; (3) the temperature at which the transformation starts increases with the ageing time; (4) the width of the total temperature range of the transformation M(B19') → A(B2) during heating changes from large (ΔT = 49.7 °C), after solution annealing, to narrow (ΔT = 19.3 °C and ΔT = 17.9 °C after 20 h and 100 h of ageing); and, most importantly, (5) a comparison with the literature data shows that, irrespective of the composition of the NiTi alloy and the manufacturing technology of the alloy samples (regardless of whether this was traditional or additive technology), a sufficiently long ageing process period leads to the occurrence of the martensite → austenite transformation in the same temperature range.
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Affiliation(s)
- Jerzy Ratajski
- Department of Biomedical Engineering, Faculty of Mechanical and Power Engineering, Koszalin University of Technology (KUT), ul. Śniadeckich 2, 75-453 Koszalin, Poland
| | - Błażej Bałasz
- Rapid Prototyping Center, Faculty of Mechanical and Power Engineering, Koszalin University of Technology (KUT), ul. Śniadeckich 2, 75-453 Koszalin, Poland
| | - Katarzyna Mydłowska
- Department of Biomedical Engineering, Faculty of Mechanical and Power Engineering, Koszalin University of Technology (KUT), ul. Śniadeckich 2, 75-453 Koszalin, Poland
| | - Mieczysław Pancielejko
- Department of Technical Physics and Nanotechnology, Faculty of Mechanical and Power Engineering, Koszalin University of Technology (KUT), ul. Śniadeckich 2, 75-453 Koszalin, Poland
| | - Łukasz Szparaga
- Department of Biomedical Engineering, Faculty of Mechanical and Power Engineering, Koszalin University of Technology (KUT), ul. Śniadeckich 2, 75-453 Koszalin, Poland
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Ramadan S, Altwarah Q, Abu-Shams M, Alkurdi D. Optimizing tensile strength and energy consumption for FDM through Mixed-Integer Nonlinear Multi-objective optimization and design of experiments. Heliyon 2024; 10:e30164. [PMID: 38707300 PMCID: PMC11068625 DOI: 10.1016/j.heliyon.2024.e30164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/20/2024] [Accepted: 04/21/2024] [Indexed: 05/07/2024] Open
Abstract
This study presents a methodology for optimizing key parameters of a fused deposition modeling (FDM) printer to minimize energy consumption (EC) while exceeding a specified tensile strength (TS) threshold. Employing Design of Experiments (DoE) with Taguchi and Response Surface analysis, we identify influential parameters affecting TS and EC. A Mixed-Integer Nonlinear Multi-Objective Optimization model is then utilized to balance TS and EC, resulting in optimal parameter values. Validation using fabricated specimens demonstrates less than 5 % error in Tensile Strength and less than 2 % error in Energy Consumption, confirming the efficacy of the proposed methodology.
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Affiliation(s)
- Saleem Ramadan
- Industrial Engineering Department, School of Engineering Technology, Al Hussein Technical University, Amman, 11831, Jordan
| | - Qutaiba Altwarah
- School of Engineering and Technology, Central Michigan University, Mt. Pleasant, MI, 48859, USA
| | - Mohammad Abu-Shams
- Industrial Engineering Department, School of Applied Technical Sciences, German Jordanian University, Amman, 11180, Jordan
| | - Duha Alkurdi
- Industrial and Manufacturing Systems Engineering, University of Michigan at Dearborn, Dearborn, MI, 48128, USA
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16
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Burkhardt F, Schirmeister CG, Wesemann C, Baur L, Vach K, Nutini M, Licht EH, Metzger MC, Mülhaupt R, Spies BC. Dimensional accuracy and simulation-based optimization of polyolefins and biocopolyesters for extrusion-based additive manufacturing and steam sterilization. J Mech Behav Biomed Mater 2024; 153:106507. [PMID: 38503082 DOI: 10.1016/j.jmbbm.2024.106507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/21/2024]
Abstract
Polyolefins exhibit robust mechanical and chemical properties and can be applied in the medical field, e.g. for the manufacturing of dentures. Despite their wide range of applications, they are rarely used in extrusion-based printing due to their warpage tendency. The aim of this study was to investigate and reduce the warpage of polyolefins compared to commonly used filaments after additive manufacturing (AM) and sterilization using finite element simulation. Three types of filaments were investigated: a medical-grade polypropylene (PP), a glass-fiber reinforced polypropylene (PP-GF), and a biocopolyester (BE) filament, and they were compared to an acrylic resin (AR) for material jetting. Square specimens, standardized samples prone to warpage, and denture bases (n = 10 of each group), as clinically relevant and anatomically shaped reference, were digitized after AM and steam sterilization (134 °C). To determine warpage, the volume underneath the square specimens was calculated, while the deviations of the denture bases from the printing file were measured using root mean square (RMS) values. To reduce the warpage of the PP denture base, a simulation of the printing file based on thermomechanical calculations was performed. Statistical analysis was conducted using the Kruskal-Wallis test, followed by Dunn's test for multiple comparisons. The results showed that PP exhibited the greatest warpage of the square specimens after AM, while PP-GF, BE, and AR showed minimal warpage before sterilization. However, warpage increased for PP-GF, BE and AR during sterilization, whereas PP remained more stable. After AM, denture bases made of PP showed the highest warpage. Through simulation-based optimization, warpage of the PP denture base was successfully reduced by 25%. In contrast to the reference materials, PP demonstrated greater dimensional stability during sterilization, making it a potential alternative for medical applications. Nevertheless, reducing warpage during the cooling process after AM remains necessary, and simulation-based optimization holds promise in addressing this issue.
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Affiliation(s)
- Felix Burkhardt
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Carl G Schirmeister
- Freiburg Materials Research Center FMF and Institute for Macromolecular Chemistry, Albert-Ludwigs-University Freiburg, Stefan-Meier-Str. 21, 79104, Freiburg, Germany; Basell Sales & Marketing B.V., LyondellBasell Industries, Industriepark Höchst, 65926, Frankfurt a.M, Germany
| | - Christian Wesemann
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Lukas Baur
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Kirstin Vach
- Medical Center - University of Freiburg, Institute for Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg, Germany
| | - Massimo Nutini
- Basell Poliolefine Italia Srl, LyondellBasell Industries, P. le Privato G. Donegani 12, 44122, Ferrara, Italy
| | - Erik H Licht
- Basell Sales & Marketing B.V., LyondellBasell Industries, Industriepark Höchst, 65926, Frankfurt a.M, Germany
| | - Marc C Metzger
- Medical Center - University of Freiburg, Center of Dental Medicine, Department of Oral and Maxillofacial Surgery, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Rolf Mülhaupt
- Freiburg Materials Research Center FMF and Institute for Macromolecular Chemistry, Albert-Ludwigs-University Freiburg, Stefan-Meier-Str. 21, 79104, Freiburg, Germany; Sustainability Center Freiburg, Ecker-Str. 4, 79104, Freiburg, Germany
| | - Benedikt C Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
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Calderon C, Golzar A, Marcott S, Gifford K, Napel S, Fleischmann D, Baik FM, Osborne TF, Finegersh A, Sirjani D. 3D Printing for the Development of Palatal Defect Prosthetics. Fed Pract 2024; 41:S3-S7. [PMID: 38813248 PMCID: PMC11132111 DOI: 10.12788/fp.0464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Background Three-dimensional (3D) printing has emerged as a promising new technology for the development of surgical prosthetics. Research in orthopedic surgery has demonstrated that using 3D printed customized prosthetics results in more precise implant placements and better patient outcomes. However, there has been little research on implementing customized 3D printed prosthetics in otolaryngology. The program sought to determine whether computed tomography (CT) serves as feasible templates to construct 3D printed palatal obturator prosthetics for defects in patients who have been treated for head and neck cancers. Observations A retrospective review of patients with palatal defects was conducted and identified 1 patient with high quality CTs compatible with 3D modeling. CTs of the patient's craniofacial anatomy were used to develop a 3D model and a Formlabs 3B+ printer printed the palatal prosthetic. We successfully developed and produced an individualized prosthetic using CTs from a veteran with head and neck deformities caused by cancer treatment who was previously treated at the Veterans Affairs Palo Alto Health Care System. This project was successful in printing patient-specific implants using CT reproductions of the patient's craniofacial anatomy, particularly of the palate. The program was a proof of concept and the implant we created was not used on the patient. Conclusions Customized 3D printed implants may allow otolaryngologists to enhance the performance and efficiency of surgeries and better rehabilitate and reconstruct craniofacial deformities to restore appearance and function to patients. Additional research will strive to enhance the therapeutic potential of these prosthetics to serve as low-cost, patient-specific implants.
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Affiliation(s)
- Christian Calderon
- Stanford University School of Medicine, California
- Veterans Affairs Palo Alto Health Care System, California
| | - Autreen Golzar
- Stanford University School of Medicine, California
- Veterans Affairs Palo Alto Health Care System, California
| | - Stephen Marcott
- Stanford University School of Medicine, California
- Veterans Affairs Palo Alto Health Care System, California
| | - Kyle Gifford
- 3D and Quantitative Imaging Laboratory, Stanford, California
| | - Sandy Napel
- 3D and Quantitative Imaging Laboratory, Stanford, California
| | | | - Fred M. Baik
- Stanford University School of Medicine, California
- Veterans Affairs Palo Alto Health Care System, California
| | - Thomas F. Osborne
- Stanford University School of Medicine, California
- Veterans Affairs Palo Alto Health Care System, California
| | - Andrey Finegersh
- Stanford University School of Medicine, California
- Veterans Affairs Palo Alto Health Care System, California
| | - Davud Sirjani
- Stanford University School of Medicine, California
- Veterans Affairs Palo Alto Health Care System, California
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18
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Reisman Y, van Renterghem K, Meijer B, Ricapito A, Fode M, Bettocchi C. Development and validation of 3-dimensional simulators for penile prosthesis surgery. J Sex Med 2024; 21:494-499. [PMID: 38477106 DOI: 10.1093/jsxmed/qdae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/02/2024] [Accepted: 01/21/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND The acquisition of skills in penile prosthesis surgery has many limitations mainly due to the absence of simulators and models for training. Three-dimensional (3D) printed models can be utilized for surgical simulations, as they provide an opportunity to practice before entering the operating room and provide better understanding of the surgical approach. AIM This study aimed to evaluate and validate a 3D model of human male genitalia for penile prosthesis surgery. METHODS This study included 3 evaluation and validation stages. The first stage involved verification of the 3D prototype model for anatomic landmarks compared with a cadaveric pelvis. The second stage involved validation of the improved model for anatomic accuracy and teaching purposes with the Rochester evaluation score. The third stage comprised validation of the suitability of the 3D prototype model as a surgical simulator and for skill acquisition. The third stage was performed at 3 centers using a modified version of a pre-existing, validated questionnaire and correlated with the Rochester evaluation score. OUTCOME We sought to determine the suitability of 3D model for training in penile prosthesis surgery in comparison with the available cadaveric model. RESULTS The evaluation revealed a high Pearson correlation coefficient (0.86) between questions of the Rochester evaluation score and modified validated questionnaire. The 3D model scored 4.33 ± 0.57 (on a Likert scale from 1 to 5) regarding replication of the relevant human anatomy for the penile prosthesis surgery procedure. The 3D model scored 4.33 ± 0.57 (on a Likert scale from 1 to 5) regarding its ability to improve technical skills, teach and practice the procedure, and assess a surgeon's ability. Furthermore, the experts stated that compared with the cadaver, the 3D model presented greater ethical suitability, reduced costs, and easier accessibility. CLINICAL IMPLICATIONS A validated 3D model is a suitable alternative for penile prosthesis surgery training. STRENGTHS AND LIMITATIONS This is the first validated 3D hydrogel model for penile prosthesis surgery teaching and training that experts consider suitable for skill acquisition. Because specific validated guidelines and questionnaires for the validation and verifications of 3D simulators for penile surgery are not available, a modified questionnaire was used. CONCLUSION The current 3D model for penile prosthesis surgery shows promising results regarding anatomic properties and suitability to train surgeons to perform penile implant surgery. The possibility of having an ethical, easy-to-use model with lower costs and limited consequences for the environment is encouraging for further development of the models.
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Affiliation(s)
- Yacov Reisman
- Flare-Health, Amsterdam, the Netherlands
- Reuth Rehabilitation Hospital, Tel-Aviv 67062, Israel
| | | | - Boaz Meijer
- Department of Urology, Acibadem Medical Center, 1043, HP Amsterdam, the Netherlands
| | - Anna Ricapito
- Andrology and Male Genitalia Reconstructive Surgery Unit, University of Foggia, 71122, Foggia FG, Italy
| | - Mikkel Fode
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, 13DK-2730, Herlev, Denmark
| | - Carlo Bettocchi
- Andrology and Male Genitalia Reconstructive Surgery Unit, University of Foggia, 71122, Foggia FG, Italy
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Ho CL, Lee IY, Hsu HY, Kuo LC, Fang JJ. Metacarpophalangeal joint reconstruction using a costal osteochondral graft: A case report. Medicine (Baltimore) 2024; 103:e37868. [PMID: 38640291 PMCID: PMC11029923 DOI: 10.1097/md.0000000000037868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/05/2024] [Accepted: 03/21/2024] [Indexed: 04/21/2024] Open
Abstract
RATIONALE The conventional treatment of giant cell tumors is intralesional curettage with local adjuvant therapy. Because hand tumors have a high local recurrence, the primary goal for treating tumors of the hand is to eradicate the lesion. PATIENT CONCERNS To preserve the metacarpophalangeal (MCP) joint function as well as avoid further recurrence after surgery. DIAGNOSES The giant cell tumor invades the patient's MCP joint in an index proximal phalanx. INTERVENTIONS Using computer-aided design and three-dimensional printing techniques, we reformed the original shapes of the MCP joint and its peripheral bone to replica models. The surgeon then performed an en bloc resection and proximal phalanx with MCP joint reconstruction by fabricating the patient's costal osteochondral graft during the operation. OUTCOMES After 6 months of rehabilitation, the patient's finger functions could pinch and grasp objects naturally. At the 1-year follow-up, the range of motion of the MCP, proximal interphalangeal, and distal interphalangeal joints improved from flexion of 35° to 60°, 75° to 85°, and 60° to 80°, respectively. The hand function achieved the mean performance of non-preferred hands for young females at the postoperative 3-year follow-up. LESSONS The customized prototyping technique has the potential to replica the original patient's bony graft to reach the goal of minimizing the defects at the donor site and maximizing the function of the reconstructed MCP joint.
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Affiliation(s)
- Chien-Liang Ho
- Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University, Tainan, Taiwan
| | - I-Ying Lee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University, Tainan, Taiwan
| | - Hsiu-Yun Hsu
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Chieh Kuo
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
| | - Jing-Jing Fang
- Department of Mechanical Engineering, National Cheng Kung University, Tainan, Taiwan
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20
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Bell C, Feizi A, Roytman GR, Ramji AF, Tommasini SM, Wiznia DH. Fabricating patient-specific 3D printed drill guides to treat femoral head avascular necrosis. 3D Print Med 2024; 10:10. [PMID: 38564090 PMCID: PMC10986134 DOI: 10.1186/s41205-024-00208-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Femoral head avascular necrosis (AVN), or death of femoral head tissue due to a lack of blood supply, is a leading cause of total hip replacement for non-geriatric patients. Core decompression (CD) is an effective treatment to re-establish blood flow for patients with AVN. Techniques aimed at improving its efficacy are an area of active research. We propose the use of 3D printed drill guides to accurately guide therapeutic devices for CD. METHODS Using femur sawbones, image processing software, and 3D modeling software, we created a custom-built device with pre-determined drill trajectories and tested the feasibility of the 3D printed drill guides for CD. A fellowship trained orthopedic surgeon used the drill guide to position an 8 ga, 230 mm long decompression device in the three synthetic femurs. CT scans were taken of the sawbones with the drill guide and decompression device. CT scans were processed in the 3D modeling software. Descriptive statistics measuring the angular and needle-tip deviation were compared to the original virtually planned model. RESULTS Compared to the original 3D model, the trials had a mean displacement of 1.440 ± 1.03 mm and a mean angle deviation of 1.093 ± 0.749º. CONCLUSIONS The drill guides were demonstrated to accurately guide the decompression device along its predetermined drill trajectory. Accuracy was assessed by comparing values to literature-reported values and considered AVN lesion size. This study demonstrates the potential use of 3D printing technology to improve the efficacy of CD techniques.
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Affiliation(s)
- Cameron Bell
- Department of Orthopaedics and Rehabilitation, Yale University, Room 526B Farnham Memorial Building 330 Cedar St, New Haven, CT, 06510, USA.
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06510, USA.
| | - Alborz Feizi
- Department of Orthopaedics and Rehabilitation, Yale University, Room 526B Farnham Memorial Building 330 Cedar St, New Haven, CT, 06510, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06510, USA
| | - Gregory R Roytman
- Department of Orthopaedics and Rehabilitation, Yale University, Room 526B Farnham Memorial Building 330 Cedar St, New Haven, CT, 06510, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06510, USA
| | - Alim F Ramji
- Department of Orthopaedics and Rehabilitation, Yale University, Room 526B Farnham Memorial Building 330 Cedar St, New Haven, CT, 06510, USA
| | - Steven M Tommasini
- Department of Orthopaedics and Rehabilitation, Yale University, Room 526B Farnham Memorial Building 330 Cedar St, New Haven, CT, 06510, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06510, USA
| | - Daniel H Wiznia
- Department of Orthopaedics and Rehabilitation, Yale University, Room 526B Farnham Memorial Building 330 Cedar St, New Haven, CT, 06510, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06510, USA
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21
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Burkhardt F, Handermann L, Rothlauf S, Gintaute A, Vach K, Spies BC, Lüchtenborg J. Accuracy of additively manufactured and steam sterilized surgical guides by means of continuous liquid interface production, stereolithography, digital light processing, and fused filament fabrication. J Mech Behav Biomed Mater 2024; 152:106418. [PMID: 38295512 DOI: 10.1016/j.jmbbm.2024.106418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
Different printing technologies can be used for prosthetically oriented implant placement, however the influence of different printing orientations and steam sterilization remains unclear. In particular, no data is available for the novel technology Continuous Liquid Interface Production. The objective was to evaluate the dimensional accuracy of surgical guides manufactured with different printing techniques in vertical and horizontal printing orientation before and after steam sterilization. A total of 80 surgical guides were manufactured by means of continuous liquid interface production (CLIP; material: Keyguide, Keyprint), digital light processing (DLP; material: Luxaprint Ortho, DMG), stereolithography (SLA; Surgical guide, Formlabs), and fused filament fabrication (FFF; material: Clear Base Support, Arfona) in vertical and horizontal printing orientation (n = 10 per subgroup). Spheres were included in the design to determine the coordinates of 17 reference points. Each specimen was digitized with a laboratory scanner after additive manufacturing (AM) and after steam sterilization (134 °C). To determine the accuracy, root mean square values (RMS) were calculated and coordinates of the reference points were recorded. Based on the measured coordinates, deviations of the reference points and relevant distances were calculated. Paired t-tests and one-way ANOVA were applied for statistical analysis (significance p < 0.05). After AM, all printing technologies showed comparable high accuracy, with an increased deviation in z-axis when printed horizontally. After sterilization, FFF printed surgical guides showed distinct warpage. The other subgroups showed no significant differences regarding the RMS of the corpus after steam sterilization (p > 0.05). Regarding reference points and distances, CLIP showed larger deviations compared to SLA in both printing orientations after steam sterilization, while DLP manufactured guides were the most dimensionally stable. In conclusion, the different printing technologies and orientations had little effect on the manufacturing accuracy of the surgical guides before sterilization. However, after sterilization, FFF surgical guides exhibited significant deformation making their clinical use impossible. CLIP showed larger deformations due to steam sterilization than the other photopolymerizing techniques, however, discrepancies may be considered within the range of clinical acceptance. The influence on the implant position remains to be evaluated.
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Affiliation(s)
- Felix Burkhardt
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Leon Handermann
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Severin Rothlauf
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Aiste Gintaute
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Kirstin Vach
- Medical Center - University of Freiburg, Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg, Germany
| | - Benedikt C Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Jörg Lüchtenborg
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
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Amin R, Hossaeini Marashi SM, Reza Noori SM, Alavi Z, Dehghani E, Maleki R, Safdarian M, Rocky A, Berizi E, Amin Alemohammad SM, Zamanpour S, Ali Noori SM. Medical, pharmaceutical, and nutritional applications of 3D-printing technology in diabetes. Diabetes Metab Syndr 2024; 18:103002. [PMID: 38615569 DOI: 10.1016/j.dsx.2024.103002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/16/2024]
Abstract
AIMS Despite numerous studies covering the various features of three-dimensional printing (3D printing) technology, and its applications in food science and disease treatment, no study has yet been conducted to investigate applying 3D printing in diabetes. Therefore, the present study centers on the utilization and impact of 3D printing technology in relation to the nutritional, pharmaceutical, and medicinal facets of diabetes management. It highlights the latest advancements, and challenges in this field. METHODS In this review, the articles focusing on the application and effect of 3D printing technology on medical, pharmaceutical, and nutritional aspects of diabetes management were collected from different databases. RESULT High precision of 3D printing in the placement of cells led to accurate anatomic control, and the possibility of bio-printing pancreas and β-cells. Transdermal drug delivery via 3D-printed microneedle (MN) patches was beneficial for the management of diabetes disease. 3D printing supported personalized medicine for Diabetes Mellitus (DM). For instance, it made it possible for pharmaceutical companies to manufacture unique doses of medications for every diabetic patient. Moreover, 3D printing allowed the food industry to produce high-fiber and sugar-free products for the individuals with DM. CONCLUSIONS In summary, applying 3D printing technology for diabetes management is in its early stages, and needs to be matured and developed to be safely used for humans. However, its rapid progress in recent years showed a bright future for the treatment of diabetes.
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Affiliation(s)
- Reza Amin
- Department of Mechanical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Sayed Mahdi Hossaeini Marashi
- College of Engineering, Design and Physical Sciences Michael Sterling Building (MCST 055), Brunel University London, Uxbridge, UB8 3PH, United Kingdom; School of Physics, Engineering and Computer Science, Centre for Engineering Research, University of Hertfordshire, Mosquito Way, Hatfield AL10 9EU, United Kingdom
| | - Seyyed Mohammad Reza Noori
- Department of Medical Imaging and Radiation Sciences, School of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zeinab Alavi
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elaheh Dehghani
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reyhaneh Maleki
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Safdarian
- Nanotechnology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arash Rocky
- Department of Electrical and Computer Engineering, University of Windsor, Canada
| | - Enayat Berizi
- Nutrition Research Center, Department of Food Hygiene and Quality Control, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Setayesh Zamanpour
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Deputy of Food and Drug, Semnan University of Medical Sciences, Semnan, Iran
| | - Seyyed Mohammad Ali Noori
- Toxicology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Sourvanos D, Sun H, Zhu TC, Dimofte A, Byrd B, Busch TM, Cengel KA, Neiva R, Fiorellini JP. Three-dimensional printing of the human lung pleural cavity model for PDT malignant mesothelioma. Photodiagnosis Photodyn Ther 2024; 46:104014. [PMID: 38346466 DOI: 10.1016/j.pdpdt.2024.104014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE The primary aim was to investigate emerging 3D printing and optical acquisition technologies to refine and enhance photodynamic therapy (PDT) dosimetry in the management of malignant pleural mesothelioma (MPM). MATERIALS AND METHODS A rigorous digital reconstruction of the pleural lung cavity was conducted utilizing 3D printing and optical scanning methodologies. These reconstructions were systematically assessed against CT-derived data to ascertain their accuracy in representing critical anatomic features and post-resection topographical variations. RESULTS The resulting reconstructions excelled in their anatomical precision, proving instrumental translation for precise dosimetry calculations for PDT. Validation against CT data confirmed the utility of these models not only for enhancing therapeutic planning but also as critical tools for educational and calibration purposes. CONCLUSION The research outlined a successful protocol for the precise calculation of light distribution within the complex environment of the pleural cavity, marking a substantive advance in the application of PDT for MPM. This work holds significant promise for individualizing patient care, minimizing collateral radiation exposure, and improving the overall efficiency of MPM treatments.
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Affiliation(s)
- Dennis Sourvanos
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA; Center for Innovation and Precision Dentistry (CiPD), School of Dental Medicine, School of Engineering, University of Pennsylvania, PA, USA.
| | - Hongjing Sun
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Timothy C Zhu
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Andreea Dimofte
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Brook Byrd
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Theresa M Busch
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Keith A Cengel
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Rodrigo Neiva
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Joseph P Fiorellini
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA
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24
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Serantoni V, Rouby C, Heller U, Boisson J. Approximation of extracted features enabling 3D design tuning for reproducing the mechanical behaviour of biological soft tissues. SOFT MATTER 2024; 20:2730-2738. [PMID: 38426860 DOI: 10.1039/d3sm01159c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
This article describes a new method, inspired by machine learning, to mimic the mechanical behaviour of target biological soft tissues with 3D printed materials. The principle is to optimise the structure of a 3D printed composite consisting of a geometrically tunable fibre embedded in a soft matrix. Physiological features are extracted from experimental stress-strain curves of several biological soft tissues. Then, using a cubic Bézier curve as the composite inner fibre, we optimised its geometric parameters, amplitude and height, to generate a specimen that exhibits a stress-strain curve in accordance with the extracted features of tensile tests. From this first phase, we created a database of specimen geometries that can be used to reproduce a wide variety of biological soft tissues. We applied this process to two soft tissues with very different behaviours: the mandibular periosteum and the calvarial periosteum. The results show that our method can successfully reproduce the mechanical behaviour of these tissues. This highlights the versatility of this approach and demonstrates that it can be extended to mimic various biological soft tissues.
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Affiliation(s)
- Vincent Serantoni
- UME, LMI, ENSTA-Paris, Institut Polytechnique de Paris, 828 boulevard des Maréchaux, Palaiseau, 91120, France.
| | - Corinne Rouby
- UME, LMI, ENSTA-Paris, Institut Polytechnique de Paris, 828 boulevard des Maréchaux, Palaiseau, 91120, France.
| | - Ugo Heller
- APHP, Necker Enfant Malades, Unit of Maxillofacial Surgery and Plastic Surgery, Paris, France
- University Paris Cité, Paris, France
| | - Jean Boisson
- UME, LMI, ENSTA-Paris, Institut Polytechnique de Paris, 828 boulevard des Maréchaux, Palaiseau, 91120, France.
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25
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Ke Re Mu ALM, Liang ZL, Chen L, Tu Xun AKBE, A Bu Li Ke Mu MMTAL, Wu YQ. 3D printed PLGA scaffold with nano-hydroxyapatite carrying linezolid for treatment of infected bone defects. Biomed Pharmacother 2024; 172:116228. [PMID: 38320333 DOI: 10.1016/j.biopha.2024.116228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Linezolid has been reported to protect against chronic bone and joint infection. In this study, linezolid was loaded into the 3D printed poly (lactic-co-glycolic acid) (PLGA) scaffold with nano-hydroxyapatite (HA) to explore the effect of this composite scaffold on infected bone defect (IBD). METHODS PLGA scaffolds were produced using the 3D printing method. Drug release of linezolid was analyzed by elution and high-performance liquid chromatography assay. PLGA, PLGA-HA, and linezolid-loaded PLGA-HA scaffolds, were implanted into the defect site of a rabbit radius defect model. Micro-CT, H&E, and Masson staining, and immunohistochemistry were performed to analyze bone infection and bone healing. Evaluation of viable bacteria was performed. The cytocompatibility of 3D-printed composite scaffolds in vitro was detected using human bone marrow mesenchymal stem cells (BMSCs). Long-term safety of the scaffolds in rabbits was evaluated. RESULTS The linezolid-loaded PLGA-HA scaffolds exhibited a sustained release of linezolid and showed significant antibacterial effects. In the IBD rabbit models implanted with the scaffolds, the linezolid-loaded PLGA-HA scaffolds promoted bone healing and attenuated bone infection. The PLGA-HA scaffolds carrying linezolid upregulated the expression of osteogenic genes including collagen I, runt-related transcription factor 2, and osteocalcin. The linezolid-loaded PLGA-HA scaffolds promoted the proliferation and osteogenesis of BMSCs in vitro via the PI3K/AKT pathway. Moreover, the rabbits implanted with the linezolid-loaded scaffolds showed normal biochemical profiles and normal histology, which suggested the safety of the linezolid-loaded scaffolds. CONCLUSION Overall, the linezolid-loaded PLGA-HA scaffolds fabricated by 3D printing exerts significant bone repair and anti-infection effects.
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Affiliation(s)
- A Li Mu Ke Re Mu
- Orthopedics Center, First People's Hospital of Kashgar, Kashgar 844000, Xinjiang, China
| | - Zhi Lin Liang
- Orthopedics Center, First People's Hospital of Kashgar, Kashgar 844000, Xinjiang, China
| | - Linlin Chen
- Nanjing Genebios Biotechnology Co., Ltd., Nanjing 21100, China
| | - Ai Ke Bai Er Tu Xun
- Orthopedics Center, First People's Hospital of Kashgar, Kashgar 844000, Xinjiang, China
| | | | - Yuan Quan Wu
- Orthopedics Center, First People's Hospital of Kashgar, Kashgar 844000, Xinjiang, China.
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26
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Gow KW, Lautz TB, Malek MM, Cost NG, Newman EA, Dasgupta R, Christison-Lagay ER, Tiao GM, Davidoff AM. Children's Oncology Group's 2023 blueprint for research: Surgery. Pediatr Blood Cancer 2024; 71:e30766. [PMID: 37950538 PMCID: PMC10872730 DOI: 10.1002/pbc.30766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
Surgery plays a crucial role in the treatment of children with solid malignancies. A well-conducted operation is often essential for cure. Collaboration with the primary care team is important for determining if and when surgery should be performed, and if performed, an operation must be done in accordance with well-established standards. The long-term consequences of surgery also need to be considered. Indications and objectives for a procedure vary. Providing education and developing and analyzing new research protocols that include aims relevant to surgery are key objectives of the Surgery Discipline of the Children's Oncology Group. The critical evaluation of emerging technologies to ensure safe, effective procedures is another key objective. Through research, education, and advancing technologies, the role of the pediatric surgeon in the multidisciplinary care of children with solid malignancies will continue to evolve.
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Affiliation(s)
- Kenneth W. Gow
- Division of General & Thoracic Surgery, Seattle Children’s Hospital, Seattle, Washington, USA
| | - Timothy B. Lautz
- Department of Pediatric Surgery, Lurie Children’s Hospital of Chicago, Northwestern University School of Medicine, Chicago, Illinois, USA
| | - Marcus M. Malek
- Division of Pediatric General and Thoracic Surgery, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nicholas G. Cost
- Department of Surgery, Division of Urology and the Surgical Oncology Program, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Erika A. Newman
- Department of Surgery, Mott Children’s Hospital, University of Michigan, Ann Arbor, Michigan, USA
| | - Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Emily R. Christison-Lagay
- Division of Pediatric Surgery, Yale School of Medicine, Yale-New Haven Children’s Hospital, New Haven, Connecticut, USA
| | - Gregory M. Tiao
- Division of Pediatric General and Thoracic Surgery, Cincinnati Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Andrew M. Davidoff
- Department of Surgery, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
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27
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Krishnan PD, Durai RD, Veluri S, B Narayanan VH. Semisolid extrusion 3D printing of Dolutegravir-Chitosan nanoparticles laden polymeric buccal films: personalized solution for pediatric treatment. Biomed Mater 2024; 19:025046. [PMID: 38364288 DOI: 10.1088/1748-605x/ad2a3a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 02/16/2024] [Indexed: 02/18/2024]
Abstract
In this work, the semi solid extrusion 3D printing process was utilized to incorporate anti-HIV drug Dolutegravir and its nanoparticles into the buccal film (BF) that was fabricated using the developed polymer ink. The composite made of polyvinyl alcohol (PVA) and sodium alginate was processed into a 3D printing polymer ink with optimum viscosity (9587 ± 219 cP) needed for the seamless extrusion through the nozzle of the 3D printer. The formulated BFs were assessed for its physical properties like weight (0.414 ± 0.3 g), thickness (1.54 ± 0.02 mm), swelling index (18.5 ± 0.91%), and mucoadhesiveness strength (0.165 ± 0.09 N) etc, The structural integrity and the surface morphology of the developed BFs were investigated by scanning electron microscopy analysis. The chemical stability and the solid-state nature of the drug in the BFs were assessed by Fourier transform infrared and x-ray diffraction analysis respectively. Further the BFs were assessed for drug dissolutionin-vitroandex-vivo, to study the effect of polymer composition and printing condition on the dissolution profile of the drug in the simulated salivary fluid. The results demonstrated that the developed PVA based polymer ink for 3D printing utilizing pressure is a versatile approach in the context of manufacturing mucoadhesive BFs customized in terms of shape and the amount of drug loaded.
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Affiliation(s)
- Priya Dharshini Krishnan
- Pharmaceutical Technology Laboratory, ASK-II, Lab No: 214, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India
| | - Ramya Devi Durai
- Pharmaceutical Technology Laboratory, ASK-II, Lab No: 214, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India
| | - Sivanjineyulu Veluri
- Centre of Molecular and Macromolecular Studies, Polish Academy of Sciences, Sienkiewicza 112, 90-363 Lodz, Poland
| | - Vedha Hari B Narayanan
- Pharmaceutical Technology Laboratory, ASK-II, Lab No: 214, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India
- Centre of Molecular and Macromolecular Studies, Polish Academy of Sciences, Sienkiewicza 112, 90-363 Lodz, Poland
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28
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Townsend A, Guevar J, Oxley B, Hetzel S, Bleedorn J. Comparison of three-dimensional printed patient-specific guides versus freehand approach for radial osteotomies in normal dogs: Ex vivo model. Vet Surg 2024; 53:234-242. [PMID: 37309843 DOI: 10.1111/vsu.13968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/10/2023] [Accepted: 04/19/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare the accuracy of three-dimensional (3D) printed patient-specific guide (PSG) with a freehand (FH) approach for radial osteotomies in ex vivo normal dogs. STUDY DESIGN Experimental study. ANIMALS Twenty four ex vivo thoracic limb pairs from normal beagle dogs. METHODS Computed tomography (CT) images were collected preoperatively and postoperatively. Three osteotomies tested (n = 8/group) were: (1) uniplanar 30° frontal plane wedge ostectomy, (2) oblique plane (30° frontal, 15° sagittal) wedge ostectomy, and (3) single oblique plane osteotomy (SOO, 30° frontal, 15° sagittal, and 30° external). Limb pairs were randomized to a 3D PSG or FH approach. The resultant osteotomies were compared with virtual target osteotomies by surface shape-matching postoperative to the preoperative radii. RESULTS The mean ± standard deviation osteotomy angle deviation for all 3D PSG osteotomies (2.8 ± 2.8°, range 0.11-14.1°) was less than for the FH osteotomies (6.4 ± 6.0°, range 0.03-29.7°). No differences were found for osteotomy location in any group. In total, 84% of 3D PSG osteotomies were within 5° deviance from the target compared to 50% of freehand osteotomies. CONCLUSION Three-dimensional PSG improved FH accuracy of osteotomy angle in select planes and the most complex osteotomy orientation in a normal ex vivo radial model. CLINICAL SIGNIFICANCE Three-dimensional PSGs provided more consistent accuracy, which was most notable in complex radial osteotomies. Future work is needed to investigate guided osteotomies in dogs with antebrachial bone deformities.
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Affiliation(s)
- Adam Townsend
- Department of Surgical Sciences and Comparative Orthopedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Julien Guevar
- Division of Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | | | - Scott Hetzel
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jason Bleedorn
- Department of Surgical Sciences and Comparative Orthopedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Veterinary Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Kyser AJ, Fotouh B, Mahmoud MY, Frieboes HB. Rising role of 3D-printing in delivery of therapeutics for infectious disease. J Control Release 2024; 366:349-365. [PMID: 38182058 PMCID: PMC10923108 DOI: 10.1016/j.jconrel.2023.12.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/18/2023] [Accepted: 12/28/2023] [Indexed: 01/07/2024]
Abstract
Modern drug delivery to tackle infectious disease has drawn close to personalizing medicine for specific patient populations. Challenges include antibiotic-resistant infections, healthcare associated infections, and customizing treatments for local patient populations. Recently, 3D-printing has become a facilitator for the development of personalized pharmaceutic drug delivery systems. With a variety of manufacturing techniques, 3D-printing offers advantages in drug delivery development for controlled, fine-tuned release and platforms for different routes of administration. This review summarizes 3D-printing techniques in pharmaceutics and drug delivery focusing on treating infectious diseases, and discusses the influence of 3D-printing design considerations on drug delivery platforms targeting these diseases. Additionally, applications of 3D-printing in infectious diseases are summarized, with the goal to provide insight into how future delivery innovations may benefit from 3D-printing to address the global challenges in infectious disease.
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Affiliation(s)
- Anthony J Kyser
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA.
| | - Bassam Fotouh
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA.
| | - Mohamed Y Mahmoud
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Department of Toxicology and Forensic Medicine, Faculty of Veterinary Medicine, Cairo University, Egypt.
| | - Hermann B Frieboes
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA; Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA; UofL Health - Brown Cancer Center, University of Louisville, KY 40202, USA.
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30
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Oyem PC, Burke ZD, Mesko NW, Nystrom LM. Custom three-dimensional printed implants for reconstruction of oncologic pelvic defects. J Surg Oncol 2024; 129:424-435. [PMID: 37754672 DOI: 10.1002/jso.27465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023]
Abstract
The use of three-dimensional printed implants in the field of orthopedic surgery has become increasingly popular and has potentiated hip reconstruction in the setting of oncologic resections of the pelvis and acetabulum. In this review, we examine and discuss the indications and technical considerations for custom implant reconstruction of pelvic defects.
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Affiliation(s)
- Precious C Oyem
- Cleveland Clinic, Lerner College of Medicine of Case Western University, Cleveland, Ohio, USA
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Zachary D Burke
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Nathan W Mesko
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Lukas M Nystrom
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA
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Clegg DJ, Deek AJ, Blackburn C, Scott CA, Daggett JR. The Use and Outcomes of 3D Printing in Pediatric Craniofacial Surgery: A Systematic Review. J Craniofac Surg 2024:00001665-990000000-01313. [PMID: 38299853 DOI: 10.1097/scs.0000000000009981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
Three-dimensional (3D) printing has demonstrated efficacy in multiple surgical specialties. As accessibility improves, its use in specific fields deserves further attention. We conducted a systematic review of the implementation and outcomes of 3D printing in pediatric craniofacial surgery, as none has been performed. A systematic review was conducted according to Cochrane and PRISMA guidelines. PubMed, Embase, Cochrane library, and Clinicaltrials.gov were queried with combinations of the terms: "3D printing," "craniofacial," "surgery," and "pediatric." Original human studies containing patients <18 years old implementing 3D printing to aid in craniofacial surgery were included. Study selection, grading, and data extraction were performed independently by multiple authors. After screening 120 articles, 7 (3 case series and 4 case reports) were included, published from 2017 to 2022. All studies addressed patients with different disease processes including craniosynostosis, cleft lip/palate, and mandibular hypoplasia. 3D printing was used to create mock surgical models in 2 studies, intraoperative cutting guides/molds (CGs) in 6 studies, and cranioplasty implants in 2 studies. Two case series determined the accuracy of the CGs was acceptable within historical comparison, while 4 articles included subjective statements on improved accuracy. Five studies noted reduced operating time, 2 noted reduced intraoperative blood loss, and 1 felt the use of 3D printed materials was responsible for shorter hospitalization duration. No adverse events were reported. Despite the limitations of the current literature, all studies concluded that the use of 3D printing in pediatric craniofacial surgery was beneficial. Definitive conclusions cannot be made until further controlled research is performed.
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Affiliation(s)
- Devin J Clegg
- Department of Surgery, The University of Tennessee Graduate School of Medicine, Knoxville, TN
| | - Andrew J Deek
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA
| | - Caleb Blackburn
- Department of Oral and Maxillofacial Surgery, The University of Tennessee Graduate School of Medicine, Knoxville, TN
| | - Christopher A Scott
- Department of Oral and Maxillofacial Surgery, The University of Tennessee Graduate School of Medicine, Knoxville, TN
| | - Justin R Daggett
- Department of Pediatric Plastic and Reconstructive Surgery, East Tennessee Children's Hospital, Knoxville, TN
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Filho CWLS, Pontes MDDS, Ramos CH, Cunha LAMD. Methodology for Preoperative Planning of Bone Deformities Using Three-dimensional Modeling Software. Rev Bras Ortop 2024; 59:e130-e135. [PMID: 38524711 PMCID: PMC10957277 DOI: 10.1055/s-0044-1779700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/25/2023] [Indexed: 03/26/2024] Open
Abstract
Rapid prototyping technology, known as three-dimensional (3D) printing, and its use in the medical field are advancing. Studies on severe bone deformity treatment with 3D printing showed benefits in postoperative outcomes thanks to this technology. Even so, preoperative planning guidance for surgeons is lacking. This technical note describes a practical step-by-step guide to help surgeons use this technology to optimize the therapeutic plan with free license software and an intuitive interface. This study aims to organize the 3D modeling process using a preoperative computed tomography (CT) scan. This technology allows a deeper understanding of the case and its particularities, such as the direction, planes, and dimensions of the deformity. Planning considering these topics may reduce the surgical time and result in better functional outcomes by understanding the deformity and how to correct it. Associating planning via software with 3D printing can further enhance this therapeutic method.
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Affiliation(s)
| | | | - Carlos Henrique Ramos
- Serviço de Ortopedia e Traumatologia, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, PR, Brasil
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Gauci SC, Vranic A, Blasco E, Bräse S, Wegener M, Barner-Kowollik C. Photochemically Activated 3D Printing Inks: Current Status, Challenges, and Opportunities. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2306468. [PMID: 37681744 DOI: 10.1002/adma.202306468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/23/2023] [Indexed: 09/09/2023]
Abstract
3D printing with light is enabled by the photochemistry underpinning it. Without fine control over the ability to photochemically gate covalent bond formation by the light at a certain wavelength and intensity, advanced photoresists with functions spanning from on-demand degradability, adaptability, rapid printing speeds, and tailored functionality are impossible to design. Herein, recent advances in photoresist design for light-driven 3D printing applications are critically assessed, and an outlook of the outstanding challenges and opportunities is provided. This is achieved by classing the discussed photoresists in chemistries that function photoinitiator-free and those that require a photoinitiator to proceed. Such a taxonomy is based on the efficiency with which photons are able to generate covalent bonds, with each concept featuring distinct advantages and drawbacks.
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Affiliation(s)
- Steven C Gauci
- School of Chemistry and Physics, Centre for Materials Science, Queensland University of Technology (QUT), 2 George Street, Brisbane, Queensland, 4000, Australia
| | - Aleksandra Vranic
- Institute of Organic Chemistry (IOC), Karlsruhe institute of Technology (KIT), Fritz-Haber-Weg 6, 76133, Karlsruhe, Germany
| | - Eva Blasco
- Institute for Molecular Systems Engineering and Advanced Materials (IMSEAM), Heidelberg University, 69120, Heidelberg, Germany
- Institute of Nanotechnology (INT), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - Stefan Bräse
- Institute of Organic Chemistry (IOC), Karlsruhe institute of Technology (KIT), Fritz-Haber-Weg 6, 76133, Karlsruhe, Germany
- Institute of Biological and Chemical Systems-Functional Molecular Systems (IBCS-FMS), Karlsruhe Institute of Technology (KIT), 76133, Karlsruhe, Germany
| | - Martin Wegener
- Institute of Nanotechnology (INT), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
- Institute of Applied Physics (APH), Karlsruhe Institute of Technology (KIT), 76128, Karlsruhe, Germany
| | - Christopher Barner-Kowollik
- School of Chemistry and Physics, Centre for Materials Science, Queensland University of Technology (QUT), 2 George Street, Brisbane, Queensland, 4000, Australia
- Institute of Nanotechnology (INT), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
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Lu A, Williams RO, Maniruzzaman M. 3D printing of biologics-what has been accomplished to date? Drug Discov Today 2024; 29:103823. [PMID: 37949427 DOI: 10.1016/j.drudis.2023.103823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/27/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023]
Abstract
Three-dimensional (3D) printing is a promising approach for the stabilization and delivery of non-living biologics. This versatile tool builds complex structures and customized resolutions, and has significant potential in various industries, especially pharmaceutics and biopharmaceutics. Biologics have become increasingly prevalent in the field of medicine due to their diverse applications and benefits. Stability is the main attribute that must be achieved during the development of biologic formulations. 3D printing could help to stabilize biologics by entrapment, support binding, or crosslinking. Furthermore, gene fragments could be transited into cells during co-printing, when the pores on the membrane are enlarged. This review provides: (i) an introduction to 3D printing technologies and biologics, covering genetic elements, therapeutic proteins, antibodies, and bacteriophages; (ii) an overview of the applications of 3D printing of biologics, including regenerative medicine, gene therapy, and personalized treatments; (iii) information on how 3D printing could help to stabilize and deliver biologics; and (iv) discussion on regulations, challenges, and future directions, including microneedle vaccines, novel 3D printing technologies and artificial-intelligence-facilitated research and product development. Overall, the 3D printing of biologics holds great promise for enhancing human health by providing extended longevity and enhanced quality of life, making it an exciting area in the rapidly evolving field of biomedicine.
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Affiliation(s)
- Anqi Lu
- Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy, The University of Texas at Austin, Austin, TX 78712, USA
| | - Robert O Williams
- Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy, The University of Texas at Austin, Austin, TX 78712, USA
| | - Mohammed Maniruzzaman
- Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy, The University of Texas at Austin, Austin, TX 78712, USA; Pharmaceutical Engineering and 3D Printing (PharmE3D) Lab, Department of Pharmaceutics and Drug Delivery, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
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35
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Ullah M, Bibi A, Wahab A, Hamayun S, Rehman MU, Khan SU, Awan UA, Riaz NUA, Naeem M, Saeed S, Hussain T. Shaping the Future of Cardiovascular Disease by 3D Printing Applications in Stent Technology and its Clinical Outcomes. Curr Probl Cardiol 2024; 49:102039. [PMID: 37598773 DOI: 10.1016/j.cpcardiol.2023.102039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 08/22/2023]
Abstract
Cardiovascular disease (CVD) is a leading cause of death worldwide. In recent years, 3D printing technology has ushered in a new era of innovation in cardiovascular medicine. 3D printing in CVD management encompasses various aspects, from patient-specific models and preoperative planning to customized medical devices and novel therapeutic approaches. In-stent technology, 3D printing has revolutionized the design and fabrication of intravascular stents, offering tailored solutions for complex anatomies and individualized patient needs. The advantages of 3D-printed stents, such as improved biocompatibility, enhanced mechanical properties, and reduced risk of in-stent restenosis. Moreover, the clinical trials and case studies that shed light on the potential of 3D printing technology to improve patient outcomes and revolutionize the field has been comprehensively discussed. Furthermore, regulatory considerations, and challenges in implementing 3D-printed stents in clinical practice are also addressed, underscoring the need for standardization and quality assurance to ensure patient safety and device reliability. This review highlights a comprehensive resource for clinicians, researchers, and policymakers seeking to harness the full potential of 3D printing technology in the fight against CVD.
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Affiliation(s)
- Muneeb Ullah
- Department of Pharmacy, Kohat University of Science, and technology (KUST), Kohat, Khyber Pakhtunkhwa, Pakistan
| | - Ayisha Bibi
- Department of Pharmacy, Kohat University of Science, and technology (KUST), Kohat, Khyber Pakhtunkhwa, Pakistan
| | - Abdul Wahab
- Department of Pharmacy, Kohat University of Science, and technology (KUST), Kohat, Khyber Pakhtunkhwa, Pakistan
| | - Shah Hamayun
- Department of Cardiology, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan
| | - Mahboob Ur Rehman
- Department of Cardiology, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan
| | - Shahid Ullah Khan
- Department of Biochemistry, Women Medical and Dental College, Khyber Medical University, Abbottabad, Khyber Pakhtunkhwa, Pakistan.
| | - Uzma Azeem Awan
- Department of Biological Sciences, National University of Medical Sciences (NUMS) Rawalpindi, Rawalpindi, Punjab, Pakistan
| | - Noor-Ul-Ain Riaz
- Department of Pharmacy, Kohat University of Science, and technology (KUST), Kohat, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Naeem
- Department of Biological Sciences, National University of Medical Sciences (NUMS) Rawalpindi, Rawalpindi, Punjab, Pakistan.
| | - Sumbul Saeed
- School of Environment and Science, Griffith University, Nathan, Queensland, Australia
| | - Talib Hussain
- Women Dental College Abbottabad, Abbottabad, Khyber Pakhtunkhwa, Pakistan
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Aggarwal K, Nagpal K. Three-Dimensional Printing as a Progressive Innovative Tool for Customized and Precise Drug Delivery. Crit Rev Ther Drug Carrier Syst 2024; 41:95-130. [PMID: 38037821 DOI: 10.1615/critrevtherdrugcarriersyst.2023046832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
While using three-dimensional printing, materials are deposited layer by layer in accordance with the digital model created by computer-aided design software. Numerous research teams have shown interest in this technology throughout the last few decades to produce various dosage forms in the pharmaceutical industry. The number of publications has increased since the first printed medicine was approved in 2015 by Food and Drug Administration. Considering this, the idea of creating complex, custom-made structures that are loaded with pharmaceuticals for tissue engineering and dose optimization is particularly intriguing. New approaches and techniques for creating unique medication delivery systems are made possible by the development of additive manufacturing keeping in mind the comparative advantages it has over conventional methods of manufacturing medicaments. This review focuses on three-dimensional printed formulations grouped in orally disintegrated tablets, buccal films, implants, suppositories, and microneedles. The various types of techniques that are involved in it are summarized. Additionally, challenges and applications related to three-dimensional printing of pharmaceuticals are also being discussed.
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Affiliation(s)
- Kirti Aggarwal
- Amity Institute of Pharmacy, Amity University, Uttar Pradesh, Noida, AUUP
| | - Kalpana Nagpal
- Amity Institute of Pharmacy, Amity University Uttar Pradesh, Noida, UP-201303, India
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37
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Wang Z, Wang L, Tang F, Shen C. PLA-Based Composite Panels Prepared via Multi-Material Fused Filament Fabrication and Associated Investigation of Process Parameters on Flexural Properties of the Fabricated Composite. Polymers (Basel) 2023; 16:109. [PMID: 38201774 PMCID: PMC10780428 DOI: 10.3390/polym16010109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/17/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
This study prepares composite panels with three Polylactic acid (PLA)-based materials via the multi-material fused filament fabrication method. The influences of four processing parameters on the mechanical properties of 3D-printed samples are investigated employing the Taguchi method. These parameters include the relative volume ratio, material printing order, filling pattern, and filling density. A "larger is better" signal-to-noise analysis is performed to identify the optimal combination of printing parameters that yield maximum bending strength and bending modulus of elasticity. The results reveal that the optimal combination of printing parameters that maximizes the bending strength involves a volume ratio of 1:1:2, a material sequence of PLA/foam-agent-modified eco-friendly PLA (ePLA-LW)/glass fiber-reinforced eco-friendly PLA (ePLA-GF), a Gyroid filling pattern, and a filling density of 80%, and the optimal combination of printing parameters for maximum bending modulus involves a volume ratio of 1:2:1 with a material sequence of PLA/ePLA-LW/ePLA-GF, a Grid filling pattern, and 80% filling density. The Taguchi prediction method is utilized to determine an optimal combination of processing parameters for achieving optimal flexural performances, and predicted outcomes are validated through related experiments. The experimental values of strength and modulus are 43.91 MPa and 1.23 GPa, respectively, both very close to the predicted values of 46.87 MPa and 1.2 GPa for strength and modulus. The Taguchi experiments indicate that the material sequence is the most crucial factor influencing the flexural strength of the composite panels. The experiment result demonstrates that the flexural strength and modulus of the first material sequence are 67.72 MPa and 1.53 GPa, while the flexural strength and modulus of the third material sequence are reduced to 27.09 MPa and 0.72 GPa, respectively, only 42% and 47% of the first material sequence. The above findings provide an important reference for improving the performance of multi-material 3D-printed products.
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Affiliation(s)
- Zhaogui Wang
- Department of Mechanical Engineering, Naval Architecture and Ocean Engineering College, Dalian Maritime University, Dalian 116026, China
| | - Lihan Wang
- Department of Mechanical Engineering, Naval Architecture and Ocean Engineering College, Dalian Maritime University, Dalian 116026, China
| | - Feng Tang
- Houston International Institute, Dalian Maritime University, Dalian 116026, China
| | - Chengyang Shen
- Houston International Institute, Dalian Maritime University, Dalian 116026, China
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38
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Awuah WA, Tenkorang PO, Adebusoye FT, Ng JC, Wellington J, Abdul-Rahman T, Nazir A, Mustapha MJ, Bulut H, Papadakis M. 3D printing in surgery: revolutionizing trauma and fracture care in low and middle-income countries. Postgrad Med J 2023; 100:1-3. [PMID: 37857514 DOI: 10.1093/postmj/qgad100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/27/2023] [Accepted: 09/25/2023] [Indexed: 10/21/2023]
Affiliation(s)
| | | | | | - Jyi Cheng Ng
- Faculty of Medicine and Health Sciences, 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Jack Wellington
- Cardiff University School of Medicine, Cardiff University, Cardiff CF14 4XN, Wales, United Kingdom
| | | | - Abubakar Nazir
- Faculty of Medicine, King Edward Medical University, Nelagumbad, Anarkali, Lahore 54000, Pakistan
| | | | - Halil Bulut
- Cerrahpasa School of Medicine, Istanbul University Cerrahpasa, Istanbul 34320, Turkey
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, University of Witten-Herdecke, Wuppertal 42283, Germany
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Bell CE, Feizi A, Roytman GR, Ramji AF, Tommasini SM, Wiznia DH. Fabricating Patient-Specific 3D Printed Drill Guides to Treat Femoral Head Avascular Necrosis. RESEARCH SQUARE 2023:rs.3.rs-3650115. [PMID: 38106183 PMCID: PMC10723539 DOI: 10.21203/rs.3.rs-3650115/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Background Femoral head avascular necrosis (AVN), or death of femoral head tissue due to a lack of blood supply, is a leading cause of total hip replacement for non-geriatric patients. Core decompression (CD) is an effective treatment to re-establish blood flow for patients with AVN. Techniques aimed at improving its efficacy are an area of active research. We propose the use of 3D printed drill guides to accurately guide therapeutic devices for CD. Methods Using femur sawbones, image processing software, and 3D modeling software, we created a custom-built device with pre-determined drill trajectories and tested the feasibility of the 3D printed drill guides for CD. A fellowship trained orthopedic surgeon used the drill guide to position an 8 ga, 230 mm long decompression device in the three synthetic femurs. CT scans were taken of the sawbones with the drill guide and decompression device. CT scans were processed in the 3D modeling software. Descriptive statistics measuring the angular and needle-tip deviation were compared to the original virtually planned model. Results Compared to the original 3D model, the trials had a mean displacement of 1.440±1.03 mm and a mean angle deviation of 1.093±0.749°. Conclusions The drill guides were demonstrated to accurately guide the decompression device along its predetermined drill trajectory. Accuracy was assessed by comparing values to literature-reported values and considered AVN lesion size. This study demonstrates the potential use of 3D printing technology to improve the efficacy of CD techniques.
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40
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Yasli M, Dabbagh SR, Tasoglu S, Aydin S. Additive manufacturing and three-dimensional printing in obstetrics and gynecology: a comprehensive review. Arch Gynecol Obstet 2023; 308:1679-1690. [PMID: 36635490 DOI: 10.1007/s00404-023-06912-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/03/2023] [Indexed: 01/14/2023]
Abstract
Three-dimensional (3D) printing, also known as additive manufacturing, is a technology used to create complex 3D structures out of a digital model that can be almost any shape. Additive manufacturing allows the creation of customized, finely detailed constructs. Improvements in 3D printing, increased 3D printer availability, decreasing costs, development of biomaterials, and improved cell culture techniques have enabled complex, novel, and customized medical applications to develop. There have been rapid development and utilization of 3D printing technologies in orthopedics, dentistry, urology, reconstructive surgery, and other health care areas. Obstetrics and Gynecology (OBGYN) is an emerging application field for 3D printing. This technology can be utilized in OBGYN for preventive medicine, early diagnosis, and timely treatment of women-and-fetus-specific health issues. Moreover, 3D printed simulations of surgical procedures enable the training of physicians according to the needs of any given procedure. Herein, we summarize the technology and materials behind additive manufacturing and review the most recent advancements in the application of 3D printing in OBGYN studies, such as diagnosis, surgical planning, training, simulation, and customized prosthesis. Furthermore, we aim to give a future perspective on the integration of 3D printing and OBGYN applications and to provide insight into the potential applications.
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Affiliation(s)
- Mert Yasli
- Koç University School of Medicine, Koç University, Sariyer, 34450, Istanbul, Turkey
| | - Sajjad Rahmani Dabbagh
- Department of Mechanical Engineering, Koç University, Sariyer, 34450, Istanbul, Turkey
- Arçelik Research Center for Creative Industries (KUAR), Koç University, Koç University, Sariyer, 3445, Istanbul, Turkey
- Koc University Is Bank Artificial Intelligence Lab (KUIS AILab), Koç University, Sariyer, 34450, Istanbul, Turkey
| | - Savas Tasoglu
- Department of Mechanical Engineering, Koç University, Sariyer, 34450, Istanbul, Turkey
- Arçelik Research Center for Creative Industries (KUAR), Koç University, Koç University, Sariyer, 3445, Istanbul, Turkey
- Koc University Is Bank Artificial Intelligence Lab (KUIS AILab), Koç University, Sariyer, 34450, Istanbul, Turkey
- Physical Intelligence Department, Max Planck Institute for Intelligent Systems, 70569, Stuttgart, Germany
| | - Serdar Aydin
- Department of Obstetrics and Gynecology, Koç University Hospital, Davutpaşa Cad. No:4, Zeytinburnu, 34010, Istanbul, Turkey.
- Koç University School of Medicine, Koç University, Sariyer, 34450, Istanbul, Turkey.
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41
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Gawande V, Badge A. Clinical Effectiveness of Arthroscopy-Assisted Fixation in the Treatment of Avulsed Posterior Cruciate Ligament Injuries. Cureus 2023; 15:e50152. [PMID: 38186527 PMCID: PMC10771625 DOI: 10.7759/cureus.50152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Avulsed posterior cruciate ligament (PCL) injuries are complex orthopedic challenges that require careful consideration and optimal management. Arthroscopy offers advantages, including smaller incisions, reduced soft tissue disruption, reduced postoperative pain, and improved visualization of intraarticular anatomy. Arthroscopy-assisted fixation results in superior clinical outcomes. Patient-specific factors, graft choice, and timing of surgery significantly impact outcomes. Rehabilitation is vital and requires a tailored approach to restore knee function. Biomechanically, arthroscopy-assisted fixation enhances joint stability and range of motion, reducing the risk of secondary injuries. Advancements in technology and surgical techniques further improve outcomes. Concomitant injuries and incorporation are essential considerations. Arthroscopy-assisted fixation is a recommended approach, but personalized care is crucial for successful recovery. Its precision in reattaching the PCL enhances joint stability and clinical results, aligning with outcomes seen in conventional procedures. Using biocompatible materials in fixation devices has significantly reduced the risk of allergic reactions or complications. This has allowed a faster and smoother recovery process for patients undergoing arthroscopy-assisted fixation. The incorporation of physical therapy and rehabilitation programs after surgery plays a vital role in restoring joint function and preventing muscle atrophy. The combination of advanced technology, surgical techniques, and personalized care has greatly improved the success rate of arthroscopy-assisted fixation procedures. Advancements in technology further improve patient outcomes, but each case should be individually assessed to determine the most appropriate treatment approach.
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Affiliation(s)
- Vasant Gawande
- Orthopedics, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Ankit Badge
- Medicine, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
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42
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Urkande NK, Mankar N, Nikhade PP, Chandak M. Understanding the Complexities of Cast Post Retention: A Comprehensive Review of Influential Factors. Cureus 2023; 15:e51258. [PMID: 38288201 PMCID: PMC10823198 DOI: 10.7759/cureus.51258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 12/27/2023] [Indexed: 01/31/2024] Open
Abstract
This comprehensive review delves into the intricate landscape of cast post retention in restorative dentistry, encompassing historical perspectives, contemporary techniques, and future directions. Examining factors ranging from tooth-related considerations to prosthesis-related dynamics, the review provides a detailed analysis of clinical techniques, including step-by-step procedures, common challenges, and innovative advancements. Technological breakthroughs, such as digital impressions, computer-aided design and computer-aided manufacturing (CAD/CAM) technology, three-dimensional (3D) printing, and finite element analysis, are explored for their transformative impact on precision and customization. The discussion extends to the promising future of cast post retention, emphasising emerging materials, the integration of artificial intelligence in treatment planning, and patient-specific approaches. Implications for clinical practice underscore the importance of individualised treatment planning and the adoption of advanced technologies. Recommendations for future research advocate for comprehensive long-term clinical studies, investigations into AI-driven treatment planning, and a focus on patient outcomes and satisfaction. This review consolidates existing knowledge and anticipates a future marked by enhanced precision, individualised care, and improved long-term success in cast post-retained restorations.
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Affiliation(s)
- Neha K Urkande
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Nikhil Mankar
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pradnya P Nikhade
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Manoj Chandak
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Reddy K, Gharde P, Tayade H, Patil M, Reddy LS, Surya D. Advancements in Robotic Surgery: A Comprehensive Overview of Current Utilizations and Upcoming Frontiers. Cureus 2023; 15:e50415. [PMID: 38222213 PMCID: PMC10784205 DOI: 10.7759/cureus.50415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 12/12/2023] [Indexed: 01/16/2024] Open
Abstract
Robotic surgery, a groundbreaking advancement in medical technology, has redefined the landscape of surgical procedures. This comprehensive overview explores the multifaceted world of robotic surgery, encompassing its definition, historical development, current applications, clinical outcomes, benefits, emerging frontiers, challenges, and future implications. We delve into the fundamentals of robotic surgical systems, examining their components and advantages. From general and gynecological surgery to urology, cardiac surgery, orthopedics, and beyond, we highlight the diverse specialties where robotic surgery is making a significant impact. The many benefits discussed include improved patient outcomes, reduced complications, faster recovery times, cost-effectiveness, and enhanced surgeon experiences. The outlook reveals a healthcare landscape where robotic surgery is increasingly vital, enabling personalized medicine, bridging healthcare disparities, and advancing surgical precision. However, challenges such as cost, surgeon training, technical issues, ethical considerations, and patient acceptance remain relevant. In conclusion, robotic surgery is poised to continue shaping the future of health care, offering transformative possibilities while emphasizing the importance of collaboration, innovation, and ethical governance.
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Affiliation(s)
- Kavyanjali Reddy
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pankaj Gharde
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Harshal Tayade
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mihir Patil
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Lucky Srivani Reddy
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Dheeraj Surya
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Neumann M, di Marco G, Iudin D, Viola M, van Nostrum CF, van Ravensteijn BGP, Vermonden T. Stimuli-Responsive Hydrogels: The Dynamic Smart Biomaterials of Tomorrow. Macromolecules 2023; 56:8377-8392. [PMID: 38024154 PMCID: PMC10653276 DOI: 10.1021/acs.macromol.3c00967] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/21/2023] [Indexed: 12/01/2023]
Abstract
In the past decade, stimuli-responsive hydrogels are increasingly studied as biomaterials for tissue engineering and regenerative medicine purposes. Smart hydrogels can not only replicate the physicochemical properties of the extracellular matrix but also mimic dynamic processes that are crucial for the regulation of cell behavior. Dynamic changes can be influenced by the hydrogel itself (isotropic vs anisotropic) or guided by applying localized triggers. The resulting swelling-shrinking, shape-morphing, as well as patterns have been shown to influence cell function in a spatiotemporally controlled manner. Furthermore, the use of stimuli-responsive hydrogels as bioinks in 4D bioprinting is very promising as they allow the biofabrication of complex microstructures. This perspective discusses recent cutting-edge advances as well as current challenges in the field of smart biomaterials for tissue engineering. Additionally, emerging trends and potential future directions are addressed.
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Affiliation(s)
- Myriam Neumann
- Department of Pharmaceutics,
Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht 3508 TB, The Netherlands
| | - Greta di Marco
- Department of Pharmaceutics,
Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht 3508 TB, The Netherlands
| | - Dmitrii Iudin
- Department of Pharmaceutics,
Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht 3508 TB, The Netherlands
| | - Martina Viola
- Department of Pharmaceutics,
Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht 3508 TB, The Netherlands
| | - Cornelus F. van Nostrum
- Department of Pharmaceutics,
Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht 3508 TB, The Netherlands
| | - Bas G. P. van Ravensteijn
- Department of Pharmaceutics,
Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht 3508 TB, The Netherlands
| | - Tina Vermonden
- Department of Pharmaceutics,
Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht 3508 TB, The Netherlands
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Alzoubi L, Aljabali AAA, Tambuwala MM. Empowering Precision Medicine: The Impact of 3D Printing on Personalized Therapeutic. AAPS PharmSciTech 2023; 24:228. [PMID: 37964180 DOI: 10.1208/s12249-023-02682-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/16/2023] [Indexed: 11/16/2023] Open
Abstract
This review explores recent advancements and applications of 3D printing in healthcare, with a focus on personalized medicine, tissue engineering, and medical device production. It also assesses economic, environmental, and ethical considerations. In our review of the literature, we employed a comprehensive search strategy, utilizing well-known databases like PubMed and Google Scholar. Our chosen keywords encompassed essential topics, including 3D printing, personalized medicine, nanotechnology, and related areas. We first screened article titles and abstracts and then conducted a detailed examination of selected articles without imposing any date limitations. The articles selected for inclusion, comprising research studies, clinical investigations, and expert opinions, underwent a meticulous quality assessment. This methodology ensured the incorporation of high-quality sources, contributing to a robust exploration of the role of 3D printing in the realm of healthcare. The review highlights 3D printing's potential in healthcare, including customized drug delivery systems, patient-specific implants, prosthetics, and biofabrication of organs. These innovations have significantly improved patient outcomes. Integration of nanotechnology has enhanced drug delivery precision and biocompatibility. 3D printing also demonstrates cost-effectiveness and sustainability through optimized material usage and recycling. The healthcare sector has witnessed remarkable progress through 3D printing, promoting a patient-centric approach. From personalized implants to radiation shielding and drug delivery systems, 3D printing offers tailored solutions. Its transformative applications, coupled with economic viability and sustainability, have the potential to revolutionize healthcare. Addressing material biocompatibility, standardization, and ethical concerns is essential for responsible adoption.
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Affiliation(s)
- Lorca Alzoubi
- Department of Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy, Yarmouk University, P.O. Box 566, Irbid, 21163, Jordan
| | - Alaa A A Aljabali
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Yarmouk University, P.O. Box 566, Irbid, 21163, Jordan.
| | - Murtaza M Tambuwala
- Lincoln Medical School, Brayford Pool Campus, University of Lincoln, Lincoln, LN6 7TS, UK.
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Soni P, Shrivastava P, Rai SK. Development of reduced volume endosseous cuspid tooth implant using topology optimization by SIMP technique for improved osseointegration. Comput Methods Biomech Biomed Engin 2023:1-15. [PMID: 37950447 DOI: 10.1080/10255842.2023.2279939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/01/2023] [Indexed: 11/12/2023]
Abstract
The article aims to design and develop a topology-optimized endosseous cuspid tooth implant of the maxilla region. The manuscript presents a numerical analysis of the resulting von Mises stresses and effective strain resulting in the topology-optimized implant with occlusal loading of 110 N. Solid Isotropic Material with Penalization (SIMP) method is employed for topology optimization and four different models, namely model-1, model-2, model-3, and model-4, are developed based on volume reduction rates of 8%, 16%, 24%, and 32%, respectively. FEA results highlight that the maximum stress and strain in the screw increases with volume reduction rates. The comparative analyses of the resulting stresses in the compact and cancellous bone along with the strain in the screw led to the conclusion that model-1, model-2, and model-3 resulted in moderate stresses on compact and cancellous bone compared to the original model of the implant. However, the screw and bones are subjected to maximum stress and strain in the model-4. The study concludes that model-2, with 16% reduced volume and 14.2% reduced mass as compared to the original implant, may be considered as the optimized design of the model. The resulting model offers a significant reduction in the weight and volume with a minor increase in effective stress and strain without negatively impacting the functionality and bio-mechanical performance of the implant. The optimized dental implant prototype is also fabricated as a proof of concept by the Fused Deposition Modelling process.
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Affiliation(s)
- Priyanshu Soni
- School of Biomedical Engineering, Indian Institute of Technology BHU, Varanasi, India
| | - Parnika Shrivastava
- Department of Mechanical Engineering, National Institute of Technology, Jalandhar, India
| | - Sanjay Kumar Rai
- School of Biomedical Engineering, Indian Institute of Technology BHU, Varanasi, India
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Wang C, Cheng Y, Song Y, Lei J, Li Y, Li X, Shi H. Dosimetric parameters and safety analysis of 3D-printing non-coplanar template-assisted interstitial brachytherapy for non-centrally recurrent cervical cancer. Front Oncol 2023; 13:1174470. [PMID: 37954084 PMCID: PMC10637940 DOI: 10.3389/fonc.2023.1174470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 10/10/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction The prognosis of patients with non-central recurrent cervical cancer (NRCC) remains poor, and treatment options are limited. We aimed to explore the accuracy and safety of the 3D-printed non-coplanar template (3D-PNCT)-assisted 192Ir interstitial brachytherapy (ISBT) in the treatment of NRCC. Material and methods A total of 36 patients with NRCC who received 3D-PNCT-guided 192Ir ISBT in the First Affiliated Hospital of Zhengzhou University from January 2021 to July 2022 were included in this study. There were 36 3D-PNCTs that were designed and printed. The prescribed dose was 30-36 Gy, divided into five to six times, once a week. To evaluate whether the actual parameters were consistent with the preoperative design, the dosimetric parameters of pre- and postoperative treatment plans were compared, including dose of 90% high-risk clinical target volume (HR-CTV D90), volume percentage of 100% and 150% prescribed dose V100% and V150%, homogeneity index (HI), conformal index (CI), external index (EI), and dose received by 2 cm3 (D2cm3) of the rectum, colon, bladder, and ileum. The safety parameters including occurrence of bleeding, infection, pain, radiation enteritis, and radiation cystitis within 3 months after operation were recorded. Results All patients successfully completed the treatment and achieved the goals of the preoperative plan. There was no significant difference in the accuracy (HRCTVD90, V100%, EI, CI, and HI) and safety (D2cm3 of rectum, colon, bladder, and ileum) parameters of the postoperative plan compared with the preoperative plan (all p>0.05). Major side effects included bleeding at the puncture site (13.9%), postoperative pain (8.3%), acute radiation cystitis (13.9%), and radiation enteritis (19.4%). There were no serious perioperative complications and no grade 3-4 acute radiotherapy side effects. Conclusion 3D-PNCT-assisted 192Ir ISBT can be accurately and safely applied in the treatment of patients with NRCC.
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Affiliation(s)
- Cong Wang
- Department of Gynecological Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Cheng
- Department of Gynecological Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yadong Song
- Department of Gynecological Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jia Lei
- Department of Gynecological Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yiqian Li
- Department of Gynecological Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xia Li
- Department of Gynecological Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huirong Shi
- Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Choi J, Lee EJ, Jang WB, Kwon SM. Development of Biocompatible 3D-Printed Artificial Blood Vessels through Multidimensional Approaches. J Funct Biomater 2023; 14:497. [PMID: 37888162 PMCID: PMC10607080 DOI: 10.3390/jfb14100497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/28/2023] Open
Abstract
Within the human body, the intricate network of blood vessels plays a pivotal role in transporting nutrients and oxygen and maintaining homeostasis. Bioprinting is an innovative technology with the potential to revolutionize this field by constructing complex multicellular structures. This technique offers the advantage of depositing individual cells, growth factors, and biochemical signals, thereby facilitating the growth of functional blood vessels. Despite the challenges in fabricating vascularized constructs, bioprinting has emerged as an advance in organ engineering. The continuous evolution of bioprinting technology and biomaterial knowledge provides an avenue to overcome the hurdles associated with vascularized tissue fabrication. This article provides an overview of the biofabrication process used to create vascular and vascularized constructs. It delves into the various techniques used in vascular engineering, including extrusion-, droplet-, and laser-based bioprinting methods. Integrating these techniques offers the prospect of crafting artificial blood vessels with remarkable precision and functionality. Therefore, the potential impact of bioprinting in vascular engineering is significant. With technological advances, it holds promise in revolutionizing organ transplantation, tissue engineering, and regenerative medicine. By mimicking the natural complexity of blood vessels, bioprinting brings us one step closer to engineering organs with functional vasculature, ushering in a new era of medical advancement.
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Affiliation(s)
- Jaewoo Choi
- Laboratory for Vascular Medicine and Stem Cell Biology, Department of Physiology, Medical Research Institute, School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea; (J.C.); (E.J.L.)
- Convergence Stem Cell Research Center, Pusan National University, Yangsan 50612, Republic of Korea
| | - Eun Ji Lee
- Laboratory for Vascular Medicine and Stem Cell Biology, Department of Physiology, Medical Research Institute, School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea; (J.C.); (E.J.L.)
- Convergence Stem Cell Research Center, Pusan National University, Yangsan 50612, Republic of Korea
| | - Woong Bi Jang
- Laboratory for Vascular Medicine and Stem Cell Biology, Department of Physiology, Medical Research Institute, School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea; (J.C.); (E.J.L.)
- Convergence Stem Cell Research Center, Pusan National University, Yangsan 50612, Republic of Korea
| | - Sang-Mo Kwon
- Laboratory for Vascular Medicine and Stem Cell Biology, Department of Physiology, Medical Research Institute, School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea; (J.C.); (E.J.L.)
- Convergence Stem Cell Research Center, Pusan National University, Yangsan 50612, Republic of Korea
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López Seguí F, Cos Codina J, Ricou Ríos L, Martínez Segura MI, Miró Mezquita L, Escrich Navarro R, Davins Riu M, Estrada Cuxart O, Anashkin Kachalin G, Moreno-Martínez D. Readiness for Change in the Implementation of a 3D Printing Initiative in a Catalan Tertiary Hospital Using the Normalization Process Theory: Survey Study. JMIR Hum Factors 2023; 10:e47390. [PMID: 37801353 PMCID: PMC10589830 DOI: 10.2196/47390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/13/2023] [Accepted: 08/12/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The high failure rate of innovation projects motivates us to understand the perceptions about resistances and barriers of the main stakeholders to improving success rates. OBJECTIVE This study aims to analyze the readiness for change in the implementation of a 3D printing project in a Catalan tertiary hospital prior to its implementation. METHODS We used a web-based, voluntary, and anonymous survey using the Normalization Measurement Development questionnaire (NoMAD) to gather views and perceptions from a selected group of health care professionals at Germans Trias i Pujol University Hospital. RESULTS In this study, 58 professionals, including heads of service (n=30, 51%), doctors (n=18, 31%), nurses (n=7, 12%), and support staff (n=3, 5%), responded to the questionnaire. All groups saw the value of the project and were willing to enroll and support it. Respondents reported the highest scores (out of 5) in cognitive participation (mean 4.45, SD 0.04), coherence (mean 3.72, SD 0.13), and reflective monitoring (mean 3.80, SD 0.25). The weakest score was in collective action (mean 3.52, SD 0.12). There were no statistically significant differences in scores among professions in the survey. CONCLUSIONS The 3D printing project implementation should pay attention to preparing, defining, sharing, and supporting the operational work involved in its use and implementation. It should also understand, assess, and communicate the ways in which the new set of practices can affect the users and others around them. We suggest that health officers and politicians consider this experience as a solid ground toward the development of a more efficient health innovation system and as a catalyst for transformation.
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Affiliation(s)
- Francesc López Seguí
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
- Chair in ICT and Health, Centre for Health and Social Care Research, University of Vic - Central University of Catalonia, Vic, Spain
| | - Joan Cos Codina
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Laura Ricou Ríos
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
| | - María Isabel Martínez Segura
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
| | - Laura Miró Mezquita
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
| | - Raquel Escrich Navarro
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
| | - Meritxell Davins Riu
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
| | - Oriol Estrada Cuxart
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
| | - German Anashkin Kachalin
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
| | - Daniel Moreno-Martínez
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
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Cho RY, Byun SH, Park SY, On SW, Kim JC, Yang BE. Patient-specific plates for facial fracture surgery: A retrospective case series. J Dent 2023; 137:104650. [PMID: 37544353 DOI: 10.1016/j.jdent.2023.104650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 07/24/2023] [Accepted: 08/02/2023] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVES Surgeons often encounter challenges when treating maxillofacial fractures using conventional methods that involve trimming or bending ready-made titanium plates for open reduction and internal fixation (ORIF) since it can be time-consuming, imprecise, and inconvenient. This retrospective case series aimed to introduce a novel bone reduction method that utilizes virtual planning, patient-specific surgical guides, and titanium plates. METHODS Seven patients with mandibular symphysis or subcondylar fractures resulting from facial trauma underwent cone-beam computed tomography (CBCT) or facial CT scans, and their medical histories were documented. Virtual surgery was conducted based on three-dimensional (3D) stereolithography images derived from CT scans using the FaceGide software (MegaGen, Daegu, Korea). ORIF was performed using patient-specific surgical guides and plates that were designed, printed, and milled. Radiographic, clinical, and occlusal evaluations were conducted at two weeks and six weeks postoperatively. Subsequently, 3D images from virtual surgery and postoperative CT scans were compared. RESULTS The comparison of 3D virtual surgery and postoperative images revealed minimal surface differences of less than 1 mm. T-scan evaluations indicated that there were no statistically significant differences between the two- and six-week postoperative assessments. Favorable clinical outcomes were observed. CONCLUSION This novel method demonstrated stable outcomes in terms of occlusion and healing, with no notable complications. Consequently, this approach may serve as a viable alternative to conventional methods. CLINICAL SIGNIFICANCE Facial fracture surgery that utilizes patient-specific surgical guides and plates within a digital workflow can facilitate meticulous surgical planning, reducing the risk of complications and minimizing operation time.
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Affiliation(s)
- Ran-Yeong Cho
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea; Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
| | - Soo-Hwan Byun
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea; Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
| | - Sang-Yoon Park
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea; Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
| | - Sung-Woon On
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Republic of Korea
| | - Jong-Cheol Kim
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea; Mir Dental Hospital, Daegu 41940, Republic of Korea
| | - Byoung-Eun Yang
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea; Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea.
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