Additive Manufacturing Processes in Medical Applications

A Review of Image-Based Simulation Applications in High-Value Manufacturing

Image-Based Simulation (IBSim) is the process by which a digital representation of a real geometry is generated from image data for the purpose of performing a simulation with greater accuracy than with idealised Computer Aided Design (CAD) based simulations. Whilst IBSim originates in the biomedical field, the wider adoption of imaging for non-destructive testing and evaluation (NDT/NDE) within the High-Value Manufacturing (HVM) sector has allowed wider use of IBSim in recent years. IBSim is invaluable in scenarios where there exists a non-negligible variation between the 'as designed' and 'as manufactured' state of parts. It has also been used for characterisation of geometries too complex to accurately draw with CAD. IBSim simulations are unique to the geometry being imaged, therefore it is possible to perform part-specific virtual testing within batches of manufactured parts. This novel review presents the applications of IBSim within HVM, whereby HVM is the value provided by a manufactured part (or conversely the potential cost should the part fail) rather than the actual cost of manufacturing the part itself. Examples include fibre and aggregate composite materials, additive manufacturing, foams, and interface bonding such as welding. This review is divided into the following sections: Material Characterisation; Characterisation of Manufacturing Techniques; Impact of Deviations from Idealised Design Geometry on Product Design and Performance; Customisation and Personalisation of Products; IBSim in Biomimicry. Finally, conclusions are drawn, and observations made on future trends based on the current state of the literature.

Legal issues and underexplored data protection in medical 3D printing: A scoping review

Introduction: 3D printing has quickly found many applications in medicine. However, as with any new technology the regulatory landscape is struggling to stay abreast. Unclear legislation or lack of legislation has been suggested as being one hindrance for wide-scale adoption. Methods: A scoping review was performed in PubMed, Web of Science, SCOPUS and Westlaw International to identify articles dealing with legal issues in medical 3D printing. Results: Thirty-four articles fulfilling inclusion criteria were identified in medical/technical databases and fifteen in the legal database. The majority of articles dealt with the USA, while the EU was also prominently represented. Some common unresolved legal issues were identified, among them terminological confusion between custom-made and patient-matched devices, lack of specific legislation for patient-matched products, and the undefined legal role of CAD files both from a liability and from an intellectual property standpoint. Data protection was mentioned only in two papers and seems an underexplored topic. Conclusion: In this scoping review, several relevant articles and several common unresolved legal issues were identified including a need for terminological uniformity in medical 3D printing. The results of this work are planned to inform our own deeper legal analysis of these issues in the future.

Bioelectronic cell-based device provides a strategy for the treatment of the experimental model of multiple sclerosis

Wireless powered optogenetic cell-based implant provides a strategy to deliver subcutaneously therapeutic proteins. Immortalize Human Mesenchymal Stem Cells (hMSC-TERT) expressing the bacteriophytochrome diguanylate cyclase (DGCL) were validated for optogenetic controlled interferon-β delivery (Optoferon cells) in a bioelectronic cell-based implant. Optoferon cells transcriptomic profiling was used to elaborate an in-silico model of the recombinant interferon-β production. Wireless optoelectronic device integration was developed using additive manufacturing and injection molding. Implant cell-based optoelectronic interface manufacturing was established to integrate industrial flexible compact low-resistance screen-printed Near Field Communication (NFC) coil antenna. Optogenetic cell-based implant biocompatibility, and device performances were evaluated in the Experimental Autoimmune Encephalomyelitis (EAE) mouse model of multiple sclerosis.

Spattering mechanism of laser powder bed fusion additive manufacturing on heterogeneous surfaces

Laser powder additive manufacturing (PBF-LB) is an additive manufacturing method capable of producing high-precision and fully dense parts. However, nondestructively quality assurance of no internal defects remains challenging. Mitigating internal defects requires elucidating their formation mechanism and improving the PBF-LB process conditions. Therefore, we developed an in-situ monitoring system that combines surface morphology measurement by fringe projection and thermal field measurement with a high-speed camera. On heterogeneous surfaces in a practical multi-track PBF-LB process, a roughness index of the built part surface altered cyclically, consistent with the change in the angle between laser scanning and atmospheric gas flow. The high-speed camera monitoring showed that the melt pool was asymmetrical and spindle-shaped and that spatter was emitted mainly from the built part side of the melt pool. Furthermore, it was found that the built-part surface morphology under the powder layer affected the stability of the melt pool. As a result, a graphical representation of the melt pool and spattering for heterogeneous surfaces was proposed. Although it is still difficult to theoretically estimate the process window in which no spattering and no internal defects, in-situ monitoring equipment will provide knowledge to elucidate spattering and internal defects formation.

Functional engineering strategies of 3D printed implants for hard tissue replacement

Three-dimensional printing technology with the rapid development of printing materials are widely recognized as a promising way to fabricate bioartificial bone tissues. In consideration of the disadvantages of bone substitutes, including poor mechanical properties, lack of vascularization and insufficient osteointegration, functional modification strategies can provide multiple functions and desired characteristics of printing materials, enhance their physicochemical and biological properties in bone tissue engineering. Thus, this review focuses on the advances of functional engineering strategies for 3D printed biomaterials in hard tissue replacement. It is structured as introducing 3D printing technologies, properties of printing materials (metals, ceramics and polymers) and typical functional engineering strategies utilized in the application of bone, cartilage and joint regeneration.

Expanding Quality by Design Principles to Support 3D Printed Medical Device Development Following the Renewed Regulatory Framework in Europe

The vast scope of 3D printing has ignited the production of tailored medical device (MD) development and catalyzed a paradigm shift in the health-care industry, particularly following the COVID pandemic. This review aims to provide an update on the current progress and emerging opportunities for additive manufacturing following the introduction of the new medical device regulation (MDR) within the EU. The advent of early-phase implementation of the Quality by Design (QbD) quality management framework in MD development is a focal point. The application of a regulatory supported QbD concept will ensure successful MD development, as well as pointing out the current challenges of 3D bioprinting. Utilizing a QbD scientific and risk-management approach ensures the acceleration of MD development in a more targeted way by building in all stakeholders' expectations, namely those of the patients, the biomedical industry, and regulatory bodies.

An Overview of Various Additive Manufacturing Technologies and Materials for Electrochemical Energy Conversion Applications

Additive manufacturing (AM) technologies have many advantages, such as design flexibility, minimal waste, manufacturing of very complex structures, cheaper production, and rapid prototyping. This technology is widely used in many fields, including health, energy, art, design, aircraft, and automotive sectors. In the manufacturing process of 3D printed products, it is possible to produce different objects with distinctive filament and powder materials using various production technologies. AM covers several 3D printing techniques such as fused deposition modeling (FDM), inkjet printing, selective laser melting (SLM), and stereolithography (SLA). The present review provides an extensive overview of the recent progress in 3D printing methods for electrochemical fields. A detailed review of polymeric and metallic 3D printing materials and their corresponding printing methods for electrodes is also presented. Finally, this paper comprehensively discusses the main benefits and the drawbacks of electrode production from AM methods for energy conversion systems.

3D-Printing for Critical Sized Bone Defects: Current Concepts and Future Directions

The management and definitive treatment of segmental bone defects in the setting of acute trauma, fracture non-union, revision joint arthroplasty, and tumor surgery are challenging clinical problems with no consistently satisfactory solution. Orthopaedic surgeons are developing novel strategies to treat these problems, including three-dimensional (3D) printing combined with growth factors and/or cells. This article reviews the current strategies for management of segmental bone loss in orthopaedic surgery, including graft selection, bone graft substitutes, and operative techniques. Furthermore, we highlight 3D printing as a technology that may serve a major role in the management of segmental defects. The optimization of a 3D-printed scaffold design through printing technique, material selection, and scaffold geometry, as well as biologic additives to enhance bone regeneration and incorporation could change the treatment paradigm for these difficult bone repair problems.

Biomechanical Tests on Long-Bone Elliptical Medullary-Canal Endoprostheses for Limb Salvage in Dogs

Simple Summary

Currently, more owners look for offering a better quality of life to their pets. In fact, the complete limb amputation seems to be the last option considered by pet owners in surgeries to save their pets’ lives. Although this field is under development in veterinary medicine, we believe that 3D-printed implants for this market sector will improve the advancement in its research by reducing production costs. This would allow the pet owners to select this solution without large expenses, allowing at the same time, advances in this field. For this purpose, mechanical tests have been carried out on implants printed in a high-performance plastic that resembles the resistance of metals—that are traditionally used in veterinary surgery—and the properties of dogs’ bones as well. The results obtained have confirmed that the implants could withstand the dog weight in its different gaits, although further comparative studies on the effect of rotation forces applied during the animal’s change of direction (evaluated at different paces) are required to confirm their suitability.

Abstract

Exo-endoprosthesis is a limb salvage procedure poorly described for animals, as only expensive metal devices have been used so far. Currently, additive manufacturing (AM) can make this type of implant affordable by exploring a wide new range of materials. However, safety factors should be considered and could be related to kinetic and kinematic studies of canine natural gaits. The suitability of a novel inner part of an exo-endoprosthesis manufactured by fuse deposition modeling (FDM) was assessed for long canine bones with an elliptical medullary canal. Polyether ether ketone (PEEK) was the material used as an alternative to metal for veterinary traumatology. Poisson’s ratio of 3D-printed PEEK material and ex vivo mechanical tests of the customized endoprosthesis were performed for the evaluation. The customized endoprostheses had promising outcomes for the radii of 20 kg dogs. Quasistatic mechanical tests of bone-inserted endoprostheses—pure compression tests—reached a maximum force of 1045.0 ± 78.0 N. In fatigue tests, the samples reached 500,000 cycles without failure or detriment to their quasistatic results. These outcomes surpass the natural weight-bearing of dogs, even during a galloping pace. Furthermore, torque tests with different adhesives were performed to obtain reference data for future assessments comparing with natural dog movements.

Wire Arc Additive Manufacturing of Zinc as a Degradable Metallic Biomaterial

Wire arc additive manufacturing (WAAM) offers a high rate of material deposition among various additive manufacturing techniques with wire as feedstock material but has not been established for zinc alloys. Zn alloys can be used as degradable biomaterials, in contrast to conventional permanent metallic biomaterials. In this work, commercially pure Zn was processed by WAAM to obtain near-dense parts, and the properties obtained through WAAM-processed Zn were compared with wrought (WR) Zn samples. The microstructure and hardness values of the WAAM (41 ± 1 HV0.3) components were found to be similar to those of the WR (35 ± 2 HV0.3) components. Bulk X-ray diffraction texture measurements suggested that WAAM builds exhibit a heavily textured microstructure compared to the WR counterparts, with peak intensities around <3 3−6 2> or <0 0 0 2> in the directions parallel to the build direction (BD). The corrosion rates in simulated body fluid (SBF) were similar for WAAM (0.45 mmpy) and WR (0.3 mmpy) samples. The weight loss measurements in SBF were found to be marginally higher in the WAAM samples compared to the WR counterparts for a duration of up to 21 days. MC3T3-E1 preosteoblasts were found to be healthy and proliferating in the culture medium containing the degradation products from WAAM-Zn in a manner similar to WR-Zn. This work establishes the feasibility of processing Zn by WAAM for use in bioresorbable metallic implants.

Additively manufactured metallic biomaterials

Metal additive manufacturing (AM) has led to an evolution in the design and fabrication of hard tissue substitutes, enabling personalized implants to address each patient's specific needs. In addition, internal pore architectures integrated within additively manufactured scaffolds, have provided an opportunity to further develop and engineer functional implants for better tissue integration, and long-term durability. In this review, the latest advances in different aspects of the design and manufacturing of additively manufactured metallic biomaterials are highlighted. After introducing metal AM processes, biocompatible metals adapted for integration with AM machines are presented. Then, we elaborate on the tools and approaches undertaken for the design of porous scaffold with engineered internal architecture including, topology optimization techniques, as well as unit cell patterns based on lattice networks, and triply periodic minimal surface. Here, the new possibilities brought by the functionally gradient porous structures to meet the conflicting scaffold design requirements are thoroughly discussed. Subsequently, the design constraints and physical characteristics of the additively manufactured constructs are reviewed in terms of input parameters such as design features and AM processing parameters. We assess the proposed applications of additively manufactured implants for regeneration of different tissue types and the efforts made towards their clinical translation. Finally, we conclude the review with the emerging directions and perspectives for further development of AM in the medical industry.

3D Printing, Intellectual Property Rights and Medical Emergencies: In Search of New Flexibilities

The COVID-19 pandemic has exponentially accelerated the use of 3D printing (3DP) technologies in healthcare. Surprisingly, though, we have seen hardly any public intellectual property right (IPR) disputes concerning the 3D-printed medical equipment produced to cope with this crisis. Yet it can be assumed that a great variety of IPRs could potentially have been enforced against the use of various items of equipment printed out without express consent from IP holders. Many reasons might have motivated IP owners not to enforce their rights during the pandemic, such as the fear of acquiring a bad reputation during a declared situation of national emergency. There is no internationally recognised general exception to IPR enforcement for health emergencies, while several − sometimes ineffective − tools, like compulsory licensing, voluntary licensing arrangements and potential TRIPS waivers, have been considered or used to facilitate access to and the distribution of innovations in critical situations. During the COVID-19 emergency, this has meant that the 3DP community has been operating in a state of relative uncertainty including with regard to the risks of IP infringement. This study contextualises these issues for pandemic-relevant 3DP. Building upon experience gathered during the COVID-19 pandemic, we look to the future to see what novel mechanisms within the IPR system could provide the additional flexibility required for dealing more smoothly, with the help and support of digital technologies, with situations such as global health emergencies.

Porous construction and surface modification of titanium-based materials for osteogenesis: A review

Titanium and titanium alloy implants are essential for bone tissue regeneration engineering. The current trend is toward the manufacture of implants from materials that mimic the structure, composition and elasticity of bones. Titanium and titanium alloy implants, the most common materials for implants, can be used as a bone conduction material but cannot promote osteogenesis. In clinical practice, there is a high demand for implant surfaces that stimulate bone formation and accelerate bone binding, thus shortening the implantation-to-loading time and enhancing implantation success. To avoid stress shielding, the elastic modulus of porous titanium and titanium alloy implants must match that of bone. Micro-arc oxidation technology has been utilized to increase the surface activity and build a somewhat hard coating on porous titanium and titanium alloy implants. More recently, a growing number of researchers have combined micro-arc oxidation with hydrothermal, ultrasonic, and laser treatments, coatings that inhibit bacterial growth, and acid etching with sand blasting methods to improve bonding to bone. This paper summarizes the reaction at the interface between bone and implant material, the porous design principle of scaffold material, MAO technology and the combination of MAO with other technologies in the field of porous titanium and titanium alloys to encourage their application in the development of medical implants.

Molecule-to-Material-to-Bio Nanoarchitectonics with Biomedical Fullerene Nanoparticles

Nanoarchitectonics integrates nanotechnology with various other fields, with the goal of creating functional material systems from nanoscale units such as atoms, molecules, and nanomaterials. The concept bears strong similarities to the processes and functions seen in biological systems. Therefore, it is natural for materials designed through nanoarchitectonics to truly shine in bio-related applications. In this review, we present an overview of recent work exemplifying how nanoarchitectonics relates to biology and how it is being applied in biomedical research. First, we present nanoscale interactions being studied in basic biology and how they parallel nanoarchitectonics concepts. Then, we overview the state-of-the-art in biomedical applications pursuant to the nanoarchitectonics framework. On this basis, we take a deep dive into a particular building-block material frequently seen in nanoarchitectonics approaches: fullerene. We take a closer look at recent research on fullerene nanoparticles, paying special attention to biomedical applications in biosensing, gene delivery, and radical scavenging. With these subjects, we aim to illustrate the power of nanomaterials and biomimetic nanoarchitectonics when applied to bio-related applications, and we offer some considerations for future perspectives.

Scientometric Review for Research Patterns on Additive Manufacturing of Lattice Structures

Over the past 15 years, interest in additive manufacturing (AM) on lattice structures has significantly increased in producing 3D/4D objects. The purpose of this study is to gain a thorough grasp of the research pattern and the condition of the field’s research today as well as identify obstacles towards future research. To accomplish the purpose, this work undertakes a scientometric analysis of the international research conducted on additive manufacturing for lattice structure materials published from 2002 to 2022. A total of 1290 journal articles from the Web of Science (WoS) database and 1766 journal articles from the Scopus database were found using a search system. This paper applied scientometric science, which is based on bibliometric analysis. The data were subjected to a scientometric study, which looked at the number of publications, authorship, regions by countries, keyword co-occurrence, literature coupling, and scientometric mapping. VOSviewer was used to establish research patterns, visualize maps, and identify transcendental issues. Thus, the quantitative determination of the primary research framework, papers, and themes of this research field was possible. In order to shed light on current developments in additive manufacturing for lattice structures, an extensive systematic study is provided. The scientometric analysis revealed a strong bias towards researching AM on lattice structures but little concentration on technologies that emerge from it. It also outlined its unmet research needs, which can benefit both the industry and academia. This review makes a prediction for the future, with contributions by educating researchers, manufacturers, and other experts on the current state of AM for lattice structures.

Additive manufacturing: expanding 3D printing horizon in industry 4.0

Additive Manufacturing (AM) technology enables the production of personalized goods at reduced development costs, shorter lead times, lower energy consumption during manufacturing, and decreased material waste. AM will be consolidated as a leading technology in numerous sectors in the near future due to the maturity of the technology, the wide range of possibilities afforded by 3D printing, and the institutional push. One of the most important aspects of Industry 4.0 is 3D printing. It may be used to fabricate complicated parts and allows companies to cut inventory, develop on-demand items, create smaller localized manufacturing conditions, and even shorten supply chains. AM is expected to increase rapidly in the future because of its above stated remarkable “performance record.“ According to a report published the AM market is predicted to produce US$2 trillion worth of components and end products by year 2030. Hence integration of smart technology and production systems or indirectly one can say that AM is promoting Industry 4.0 and it plays a pivotal role in solving some of the 4th industrial revolution’s most important needs. AM is a future paradigm for futuristic production systems, and Industry 4.0 will leverage its potential to reach essential goals. AM will be found now days in a variety of industrial applications including aerospace and health care to consumer goods. This review article discusses about brief AM technology, history, its industrial applications, challenges, and future prospective. Finally, case studies using AM has been considered.

Investigation of MAO Coatings Characteristics on Titanium Products Obtained by EBM Method Using Additive Manufacturing

Coatings with a thickness from 27 to 62 µm on electron beam melted Ti-6Al-4V have been formed by micro-arc oxidation (MAO) in a silicate-hypophosphite electrolyte. MAO tests in the anode-cathode mode (50 Hz) with an anode-to-cathode current ratio of 1:1 and sum current densities 10 and 20 A/dm² were carried out. The duration of the MAO treatment was 30 and 60 min. The effect of the processing parameters on the structural properties of the MAO treated coatings was studied. The current density and treatment time significantly affect the coating thickness and surface roughness. The values of these characteristics increase as the current density increases. The effect of thermal cycling tests on surface morphology, thickness and roughness, and elemental and phase composition of MAO coatings was analyzed. After 50 cycles of thermal cycling from +200 °C to −50 °C, no cracking or delamination of coatings was observed. Coatings formed in 30 min at a current density of 20 A/dm² turned out to be the best in terms of such indicators as surface morphology, thickness, and roughness.

A Review of Multi-Material 3D Printing of Functional Materials via Vat Photopolymerization

Additive manufacturing or 3D printing of materials is a prominent process technology which involves the fabrication of materials layer-by-layer or point-by-point in a subsequent manner. With recent advancements in additive manufacturing, the technology has excited a great potential for extension of simple designs to complex multi-material geometries. Vat photopolymerization is a subdivision of additive manufacturing which possesses many attractive features, including excellent printing resolution, high dimensional accuracy, low-cost manufacturing, and the ability to spatially control the material properties. However, the technology is currently limited by design strategies, material chemistries, and equipment limitations. This review aims to provide readers with a comprehensive comparison of different additive manufacturing technologies along with detailed knowledge on advances in multi-material vat photopolymerization technologies. Furthermore, we describe popular material chemistries both from the past and more recently, along with future prospects to address the material-related limitations of vat photopolymerization. Examples of the impressive multi-material capabilities inspired by nature which are applicable today in multiple areas of life are briefly presented in the applications section. Finally, we describe our point of view on the future prospects of 3D printed multi-material structures as well as on the way forward towards promising further advancements in vat photopolymerization.

Additive Manufacturing of Bulk Thermoelectric Architectures: A Review

Additive manufacturing offers several opportunities for thermoelectric energy harvesting systems. This new manufacturing approach enables customized leg geometries, minimized thermal boundary resistances, less retooling, reduced thermoelectric material waste, and strong potential to manipulate microstructure for higher values of figure of merit. Although additive manufacturing has been used to fabricate thin thermoelectric films, there has been comparatively limited demonstrations of additive manufacturing for bulk thermoelectric structures. This review provides insights about the current progress of bulk thermoelectric material and device additive manufacturing. Each additive manufacturing technique used to produce bulk thermoelectric structures is discussed in detail along with future directions and challenges.

Compressive and Flexural Strength of 3D-Printed and Conventional Resins Designated for Interim Fixed Dental Prostheses: An In Vitro Comparison

A provisionalization sequence is essential for obtaining a predictable final prosthetic outcome. An assessment of the mechanical behavior of interim prosthetic materials could orient clinicians towards selecting an appropriate material for each clinical case. The aim of this study was to comparatively evaluate the mechanical behavior—with compressive and three-point flexural tests—of certain 3D-printed and conventional resins used to obtain interim fixed dental prostheses. Four interim resin materials were investigated: two 3D-printed resins and two conventional resins (an auto-polymerized resin and a pressure/heat-cured acrylic resin). Cylindrically shaped samples (25 × 25 mm/diameter × height) were obtained for the compression tests and bar-shaped samples (80 × 20 × 5 mm/length × width × thickness) were produced for the flexural tests, observing the producers’ recommendations. The resulting 40 resin samples were subjected to mechanical tests using a universal testing machine. Additionally, a fractographic analysis of failed samples in bending was performed. The results showed that the additive manufactured samples exhibited higher elastic moduli (2.4 ± 0.02 GPa and 2.6 ± 0.18 GPa) than the conventional samples (1.3 ± 0.19 GPa and 1.3 ± 0.38 GPa), as well as a higher average bending strength (141 ± 17 MPa and 143 ± 15 MPa) when compared to the conventional samples (88 ± 10 MPa and 76 ± 7 MPa); the results also suggested that the materials were more homogenous when produced via additive manufacturing.

Translating Imaging Into 3D Printed Cardiovascular Phantoms

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3D printed patient specific phantoms can visualize complex cardiovascular anatomy

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Common imaging modalities for 3D printing are CCT and CMR

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Material jetting/PolyJet and stereolithography are widely used printing techniques

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Standardized validation is warranted to compare different 3D printing technologies

Translation of imaging into 3-dimensional (3D) printed patient-specific phantoms (3DPSPs) can help visualize complex cardiovascular anatomy and enable tailoring of therapy. The aim of this paper is to review the entire process of phantom production, including imaging, materials, 3D printing technologies, and the validation of 3DPSPs. A systematic review of published research was conducted using Embase and MEDLINE, including studies that investigated 3DPSPs in cardiovascular medicine. Among 2,534 screened papers, 212 fulfilled inclusion criteria and described 3DPSPs as a valuable adjunct for planning and guiding interventions (n = 108 [51%]), simulation of physiological or pathological conditions (n = 19 [9%]), teaching of health care professionals (n = 23 [11%]), patient education (n = 3 [1.4%]), outcome prediction (n = 6 [2.8%]), or other purposes (n = 53 [25%]). The most common imaging modalities to enable 3D printing were cardiac computed tomography (n = 131 [61.8%]) and cardiac magnetic resonance (n = 26 [12.3%]). The printing process was conducted mostly by material jetting (n = 54 [25.5%]) or stereolithography (n = 43 [20.3%]). The 10 largest studies that evaluated the geometric accuracy of 3DPSPs described a mean bias <±1 mm; however, the validation process was very heterogeneous among the studies. Three-dimensional printed patient-specific phantoms are highly accurate, used for teaching, and applied to guide cardiovascular therapy. Systematic comparison of imaging and printing modalities following a standardized validation process is warranted to allow conclusions on the optimal production process of 3DPSPs in the field of cardiovascular medicine.

Bioinspired design proposal for a new external bone fixator device

The article presents a new medical device through an authorial and interdisciplinary approach. It consists of a flexible external fixator, whose flexible property may bring advantages over rigid mechanisms. Its design was inspired by the DNA biological mechanism of condensation, while the modeling was based on the pseudo-rigid modeling technique. From the models obtained, this study conducted prototyping and computational tests to obtain a proof-of-concept of the bioinspired theory and dynamic functioning effectiveness. The prototyping relied on hot glue manufacturing and the computational simulations consisted of linear static analysis. The experimental analysis concluded that the prototype with fewer beams and thinner beams delivered better results in all three parameters: flexibility, height variation and rotation arc. In the computational analysis, among the design models with the variation of the number of beams, the model with 8 beams performed better. Concerning thickness variation, the one whose beams measured 8mm in thickness showed better results. Among the models with length variation, the design made with 100 mm long beams better equilibrated the parameters.

Continuous Fiber-Reinforced Aramid/PETG 3D-Printed Composites with High Fiber Loading through Fused Filament Fabrication

Recent development in the field of additive manufacturing, also known as three-dimensional (3D) printing, has allowed for the incorporation of continuous fiber reinforcement into 3D-printed polymer parts. These fiber reinforcements allow for the improvement of the mechanical properties, but compared to traditionally produced composite materials, the fiber volume fraction often remains low. This study aims to evaluate the in-nozzle impregnation of continuous aramid fiber reinforcement with glycol-modified polyethylene terephthalate (PETG) using a modified, low-cost, tabletop 3D printer. We analyze how dimensional printing parameters such as layer height and line width affect the fiber volume fraction and fiber dispersion in printed composites. By varying these parameters, unidirectional specimens are printed that have an inner structure going from an array-like to a continuous layered-like structure with fiber loading between 20 and 45 vol%. The inner structure was analyzed by optical microscopy and Computed Tomography (µCT), achieving new insights into the structural composition of printed composites. The printed composites show good fiber alignment and the tensile modulus in the fiber direction increased from 2.2 GPa (non-reinforced) to 33 GPa (45 vol%), while the flexural modulus in the fiber direction increased from 1.6 GPa (non-reinforced) to 27 GPa (45 vol%). The continuous 3D reinforced specimens have quality and properties in the range of traditional composite materials produced by hand lay-up techniques, far exceeding the performance of typical bulk 3D-printed polymers. Hence, this technique has potential for the low-cost additive manufacturing of small, intricate parts with substantial mechanical performance, or parts of which only a small number is needed.

Modeling, Simulation and Data Processing for Additive Manufacturing

Additive manufacturing or, more commonly, 3D printing is one of the fundamental elements of Industry 4 [...].

Recent Advances in Functional Polymer Materials for Energy, Water, and Biomedical Applications: A Review

Academic research regarding polymeric materials has been of great interest. Likewise, polymer industries are considered as the most familiar petrochemical industries. Despite the valuable and continuous advancements in various polymeric material technologies over the last century, many varieties and advances related to the field of polymer science and engineering still promise a great potential for exciting new applications. Research, development, and industrial support have been the key factors behind the great progress in the field of polymer applications. This work provides insight into the recent energy applications of polymers, including energy storage and production. The study of polymeric materials in the field of enhanced oil recovery and water treatment technologies will be presented and evaluated. In addition, in this review, we wish to emphasize the great importance of various functional polymers as effective adsorbents of organic pollutants from industrial wastewater. Furthermore, recent advances in biomedical applications are reviewed and discussed.

Influence of Print Settings on the Critical Quality Attributes of Extrusion-Based 3D-Printed Caplets: A Quality-by-Design Approach

Extrusion-based 3D-printing is an easy-to-use, cheap manufacturing technique that could be used to produce tailored precision medicines. The technique has an almost unlimited versatility since a multitude of print parameters can easily be adapted. Unfortunately, little is known of the effect of these print parameters on the critical quality attributes of the resulting printlets. In this study, practical guidelines and means to adapt certain parameters in order to achieve the desired outcome (e.g., acceptable visual quality and flexible dosing) are stipulated for medical 3D-printing using a design-of-experiments approach. The current study aims at elucidating the effect of five print parameters (infill, overlap, number of shells, layer height and layer pattern) on the mechanical properties, dimensions, weight, porosity and dissolution characteristics of a fixed-size caplet consisting of Eudragit EPO (69.3%), Polyox WSR N10 (29.7%) and zolpidem hemitartrate (1%). In terms of the mechanical properties, 3D-printed caplets possessed anisotropy where the vertical compression strength and Brinell hardness exceeded the diametral strength. In general, all 3D-printed caplets possessed acceptable mechanical strength except for a small region of the knowledge space. Dimensional analysis revealed small, statistical significant differences between different runs, although the clinical relevance of this variation is likely negligible. The weight or dose of a caplet can be varied mainly using the infill and overlap and, to a lesser extent, via the layer height and number of shells. The impact on porosity was complicated as this was influenced by many factors and their interactions. Infill was the only statistically relevant factor influencing the dissolution rate of the current formulation. This study unravels the importance of the print parameter overlap, which is a regularly neglected parameter. We also discovered that small dose variations while maintaining the same dissolution profile were possible via modifying the overlap or number of shells. However, large dose variations without affecting the dissolution behaviour could only be accomplished by size modifications of the printlet.

Accuracy of commercial 3D printers for the fabrication of surgical guides in dental implantology

OBJECTIVES

To evaluate the accuracy of two different surgical guides (small extent = single implant and large extent = full arch) fabricated by five additive manufacturing technologies (SLA=Stereolithography, DLP= Digital Light Processing, FDM=Fused Deposition Modeling, SLS=Selective Laser Sintering, Inkjet).

METHODS

Overall, 72 guides (6 per type) were obtained with the different machines (SLA=Form2; DLP=Rapid Shape D40 and Cara Print 4.0; FDM=Raise 3D Pro2; SLS=Prodways P1000; Polyjet®=Stratasys J750). The guides were surface-scanned with an optical dental scanner, and the resulting files were compared with the initial design files using a surface matching software. Root Mean Square (RMS) and standard deviation were calculated, representing respectively trueness and precision. Kruskall-Wallis non-parametric test was used to compare trueness and precision between small-extent and large-extent guides and 3D printer by pairs. The threshold for significance was α=0.05, except for the comparison of printers by pairs where a Bonferroni-corrected level of 0.0033 was used.

RESULTS

Significant differences were observed for trueness and precision between small-extent and large-extent guides, regardless the printer except for DLP (trueness and precision) and SLS (precision). SLA, DLP and Polyjet® technologies showed similar results in terms of trueness and precision for both small-extend and large-extend guides (P>0.05).

CONCLUSIONS

The size affected the accuracy of CAD-CAM surgical guides. The different additive manufacturing technologies had a limited impact on the accuracy.

CLINICAL SIGNIFICANCE

This study is of clinical interest as it shows that the 3D printing technology (SLA/DLP) has a limited impact on 3D printed surgical guides accuracy. However, the size of the guide can have a significant impact, as small-extent guides were more accurate than large-extent guides.

Porous Titanium by Additive Manufacturing: A Focus on Surfaces for Bone Integration

Additive manufacturing (AM) is gaining increasing interest for realization of customized porous titanium constructs for biomedical applications and, in particular, for bone substitution. As first, the present review gives a short introduction on the techniques used for additive manufacturing of Ti/Ti-Alloys (Direct Energy Deposition—DED, Selective Laser Melting—SLM and Electron Beam Melting—EBM) and on the main bulk properties of additively manufactured titanium porous structures. Then, it discusses the main advancements in surface modifications of additively manufactured titanium constructs for bone contact applications. Even if specific surface modifications of constructs from AM are currently not widely explored, it is a critical open issue for application in biomedical implants. Some thermal, chemical, electrochemical, and hydrothermal treatments as well as different coatings are here described. The main aim of these treatments is the development of surface micro/nano textures, specific ion release, and addition of bioactivity to induce bone bonding and antibacterial activity. Physicochemical characterizations, in vitro bioactivity tests, protein absorption, in vitro (cellular/bacterial) and in vivo tests reported in the literature for bare and surface modified AM Ti-based constructs are here reviewed. Future perspectives for development of innovative additively manufactured titanium implants are also discussed.

Study on Geometry, Dimensional Accuracy and Structure of Parts Produced by Multi Jet Fusion

Multi Jet Fusion (MJF) is one of the newest additive manufacturing technologies for polymer powders, introduced in recent years. This fully industrial technology is gaining big interest as it allows fast, layer-by-layer, printing process, short production cycle, and very high printing resolution. In this paper, twelve thin-walled, spherical PA12 prints were studied in terms of geometry, dimensional accuracy, and fracture surface characteristics. The various characteristic features for MJF prints were observed here for parts produced according to four various print orientations and having different thicknesses, i.e., 1, 2 or 3 mm. The study showed that MJF technology can print such difficult shapes. However, the set of parameters allowing producing parts with highest geometrical and dimensional accuracy causes at the same time some microstructural issues, like great interlayer porosity or high number of non-processed powder particles embedded in the print structure.

Optimization of a Patient-Specific External Fixation Device for Lower Limb Injuries

The use of external fixation devices is considered a valuable approach for the treatment of bone fractures, providing proper alignment to fractured fragments and maintaining fracture stability during the healing process. The need for external fixation devices has increased due to an aging population and increased trauma incidents. The design and fabrication of external fixations are major challenges since the shape and size of the defect vary, as well as the geometry of the human limb. This requires fully personalized external fixators to improve its fit and functionality. This paper presents a methodology to design personalized lightweight external fixator devices for additive manufacturing. This methodology comprises data acquisition, Computer tomography (CT) imaging analysis and processing, Computer Aided Design (CAD) modelling and two methods (imposed predefined patterns and topology optimization) to reduce the weight of the device. Finite element analysis with full factorial design of experiments were used to determine the optimal combination of designs (topology optimization and predefined patterns), materials (polylactic acid, acrylonitrile butadiene styrene, and polyamide) and thickness (3, 4, 5 and 6 mm) to maximize the strength and stiffness of the fixator, while minimizing its weight. The optimal parameters were found to correspond to an external fixator device optimized by topology optimization, made in polylactic acid with 4 mm thickness.

In vitro resorbability and granular characteristics of 3D-printed hydroxyapatite granules versus allograft, xenograft, and alloplast for alveolar cleft surgery applications

Three-dimensionally printed hydroxyapatite (3DP HA) was investigated in regards to its functional properties supporting bone regeneration and tooth movement in alveolar cleft applications. Commercially available bovine xenograft (BXG), biphasic calcium phosphate alloplast (BCP), and two types of freeze-dried bone allograft granules (FDBA and FDBA-CMC) were employed as control samples. Degradability was studied by submerging the samples in pH 7.4 buffered solution at 37°C for 28 days and determining subsequent weight loss percentage. The wicking property and granular agglomeration were evaluated by putting the granules in contact with deionized water, blood, and phosphate-buffered saline (PBS). Both of FDBA and FDBA-CMC showed the greatest weight loss at 28 days followed by 3DP HA. In contrast, 3DP HA showed significantly greater wicking ability than other samples for all liquid types. FDBA-CMC exhibited the greatest granular agglomeration for all liquid types followed by 3DP HA. 3DP HA was found to be a favorable candidate for bone grafting in alveolar cleft treatment.

A Review on Filament Materials for Fused Filament Fabrication

Fused filament fabrication (FFF) is one of the most popular additive manufacturing (AM) processes that utilize thermoplastic polymers to produce three-dimensional (3D) geometry products. The FFF filament materials have a significant role in determining the properties of the final part produced, such as mechanical properties, thermal conductivity, and electrical conductivity. This article intensively reviews the state-of-the-art materials for FFF filaments. To date, there are many different types of FFF filament materials that have been developed. The filament materials range from pure thermoplastics to composites, bioplastics, and composites of bioplastics. Different types of reinforcements such as particles, fibers, and nanoparticles are incorporated into the composite filaments to improve the FFF build part properties. The performance, limitations, and opportunities of a specific type of FFF filament will be discussed. Additionally, the challenges and requirements for filament production from different materials will be evaluated. In addition, to provide a concise review of fundamental knowledge about the FFF filament, this article will also highlight potential research directions to stimulate future filament development. Finally, the importance and scopes of using bioplastics and their composites for developing eco-friendly filaments will be introduced.

Advances in 3D Printing for Tissue Engineering

Tissue engineering (TE) scaffolds have enormous significance for the possibility of regeneration of complex tissue structures or even whole organs. Three-dimensional (3D) printing techniques allow fabricating TE scaffolds, having an extremely complex structure, in a repeatable and precise manner. Moreover, they enable the easy application of computer-assisted methods to TE scaffold design. The latest additive manufacturing techniques open up opportunities not otherwise available. This study aimed to summarize the state-of-art field of 3D printing techniques in applications for tissue engineering with a focus on the latest advancements. The following topics are discussed: systematics of the available 3D printing techniques applied for TE scaffold fabrication; overview of 3D printable biomaterials and advancements in 3D-printing-assisted tissue engineering.

Experimental, Theoretical and Simulation Studies on the Thermal Behavior of PLA-Based Nanocomposites Reinforced with Different Carbonaceous Fillers

Many research efforts have been directed towards enhancing the thermal properties of polymers, since they are classically regarded as thermal insulators. To this end, the present study focuses on the thermal investigation of poly(lactic acid) (PLA) filled with two types of carbon nanotubes (trade names: TNIMH4 and N7000), two type of graphene nanoplatelets (trade names: TNIGNP and TNGNP), or their appropriate combination. A significant increase in the thermal conductivity by 254% with respect to that of unfilled polymer was achieved in the best case by using 9 wt% TNIGNP, resulting from its favorable arrangement and the lower thermal boundary resistance between the two phases, matrix and filler. To theoretically assist the design of such advanced nanocomposites, Design of Experiments (DoE) and Response Surface Method (RSM) were employed, respectively, to obtain information on the conditioning effect of each filler loading on the thermal conductivity and to find an analytical relationship between them. The numerical results were compared with the experimental data in order to confirm the reliability of the prediction. Finally, a simulation study was carried out with Comsol Multiphysics^® for a comparative study between two heat sinks based on pure PLA, and to determine the best thermally performing nanocomposite with a view towards potential use in heat transfer applications.

Industrial applications of 3D printing to scale-up production of COVID-19-related medical equipment

Additive manufacturing or 3D printing allows the rapid conversion of information from digital 3D models into physical objects. The current COVID-19 crisis underscored the value of 3D-printing technology in addressing critical shortages in the medical product supply chain. This article provides a review of the significant role of additive manufacturing technologies in addressing the COVID-19 situation. This article concludes that 3D printing has an important role in global public health because of its potential to adapt to emerging situations far more easily and quickly as compared with conventional manufacturing methods. There is a need for further research to improve the technology to mass produce better quality products more economically. Currently, the 3D-printing industry is concentrated in the US and Western Europe. Policy efforts are needed to tap all markets across the globe in order to be better prepared for a future pandemic.

Effects of Groove Sealing of the Posterior Occlusal Surface and Offset of the Internal Surface on the Internal Fit and Accuracy of Implant Placements Using 3D-Printed Surgical Guides: An In Vitro Study

This study evaluated the internal fit and the accuracy of the implant placement position in order to determine how the surface shape of the tooth and the offset influence the accuracy of the surgical guide. The acquired digital data were analyzed in three dimensions using 3D inspection software. The obtained results confirmed that the internal fit was better in the groove sealing (GS) group (164.45 ± 28.34 μm) than the original shape (OS) group (204.07 ± 44.60 μm) (p < 0.001), and for an offset of 100 μm (157.50 ± 17.26 μm) than for offsets of 30 μm (206.48 ± 39.12 μm) and 60 μm (188.82 ± 48.77 μm) (p < 0.001). The accuracy of implant placement was better in the GS than OS group in terms of the entry (OS, 0.229 ± 0.092 mm; GS, 0.169 ± 0.061 mm; p < 0.001), apex (OS, 0.324 ± 0.149 mm; GS, 0.230 ± 0.124 mm; p < 0.001), and depth (OS, 0.041 ± 0.027 mm; GS, 0.025 ± 0.022 mm; p < 0.001). In addition, the entries (30 μm, 0.215 ± 0.044 mm; 60 μm, 0.172 ± 0.049 mm; 100 μm, 0.119 ± 0.050 mm; p < 0.001) were only affected by the amount of offset. These findings indicate that the accuracy of a surgical guide can be improved by directly sealing the groove of the tooth before manufacturing the surgical guide or setting the offset during the design process.

Design and Additive Manufacturing of a Biomimetic Customized Cranial Implant Based on Voronoi Diagram

Reconstruction of cranial defects is an arduous task for craniomaxillofacial surgeons. Additive manufacturing (AM) or three-dimensional (3D) printing of titanium patient-specific implants (PSIs) made its way into cranioplasty, improving the clinical outcomes in complex surgical procedures. There has been a significant interest within the medical community in redesigning implants based on natural analogies. This paper proposes a workflow to create a biomimetic patient-specific cranial prosthesis with an interconnected strut macrostructure mimicking bone trabeculae. The method implements an interactive generative design approach based on the Voronoi diagram or tessellations. Furthermore, the quasi-self-supporting fabrication feasibility of the biomimetic, lightweight titanium cranial prosthesis design is assessed using Selective Laser Melting (SLM) technology.

Quality Control in 3D Printing: Accuracy Analysis of 3D-Printed Models of Patient-Specific Anatomy

As comparative data on the precision of 3D-printed anatomical models are sparse, the aim of this study was to evaluate the accuracy of 3D-printed models of vascular anatomy generated by two commonly used printing technologies. Thirty-five 3D models of large (aortic, wall thickness of 2 mm, n = 30) and small (coronary, wall thickness of 1.25 mm, n = 5) vessels printed with fused deposition modeling (FDM) (rigid, n = 20) and PolyJet (flexible, n = 15) technology were subjected to high-resolution CT scans. From the resulting DICOM (Digital Imaging and Communications in Medicine) dataset, an STL file was generated and wall thickness as well as surface congruency were compared with the original STL file using dedicated 3D engineering software. The mean wall thickness for the large-scale aortic models was 2.11 µm (+5%), and 1.26 µm (+0.8%) for the coronary models, resulting in an overall mean wall thickness of +5% for all 35 3D models when compared to the original STL file. The mean surface deviation was found to be +120 µm for all models, with +100 µm for the aortic and +180 µm for the coronary 3D models, respectively. Both printing technologies were found to conform with the currently set standards of accuracy (<1 mm), demonstrating that accurate 3D models of large and small vessel anatomy can be generated by both FDM and PolyJet printing technology using rigid and flexible polymers.