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Kveller C, Jakobsen AM, Larsen NH, Lindhardt JL, Baad-Hansen T. First experiences of a hospital-based 3D printing facility - an analytical observational study. BMC Health Serv Res 2024; 24:28. [PMID: 38178068 PMCID: PMC10768152 DOI: 10.1186/s12913-023-10511-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: 10/11/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
PURPOSE To identify the clinical impact and potential benefits of in-house 3D-printed objects through a questionnaire, focusing on three principal areas: patient education; interdisciplinary cooperation; preoperative planning and perioperative execution. MATERIALS AND METHODS Questionnaires were sent from January 2021 to August 2022. Participants were directed to rate on a scale from 1 to 10. RESULTS The response rate was 43%. The results of the rated questions are averages. 84% reported using 3D-printed objects in informing the patient about their condition/procedure. Clinician-reported improvement in patient understanding of their procedure/disease was 8.1. The importance of in-house placement was rated 9.2. 96% reported using the 3D model to confer with colleagues. Delay in treatment due to 3D printing lead-time was 1.8. The degree with which preoperative planning was altered was 6.9. The improvement in clinician perceived preoperative confidence was 8.3. The degree with which the scope of the procedure was affected, in regard to invasiveness, was 5.6, wherein a score of 5 is taken to mean unchanged. Reduction in surgical duration was rated 5.7. CONCLUSION Clinicians report the utilization of 3D printing in surgical specialties improves procedures pre- and intraoperatively, has a potential for increasing patient engagement and insight, and in-house location of a 3D printing center results in improved interdisciplinary cooperation and allows broader access with only minimal delay in treatment due to lead-time.
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Affiliation(s)
- Christian Kveller
- Department of Orthopedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
| | - Anders M Jakobsen
- Department of Plastic and Breast Surgery, 3D Innovation, Aarhus University Hospital, Aarhus, Denmark
| | - Nicoline H Larsen
- Department of Dentistry, Section for Oral and Maxillofacial Surgery, Aarhus University, Aarhus, Denmark
| | - Joakim L Lindhardt
- Department of Plastic and Breast Surgery, 3D Innovation, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Baad-Hansen
- Department of Orthopedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark
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Slavin BV, Ehlen QT, Costello JP, Nayak VV, Bonfante EA, Benalcázar Jalkh EB, Runyan CM, Witek L, Coelho PG. 3D Printing Applications for Craniomaxillofacial Reconstruction: A Sweeping Review. ACS Biomater Sci Eng 2023; 9:6586-6609. [PMID: 37982644 DOI: 10.1021/acsbiomaterials.3c01171] [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] [Indexed: 11/21/2023]
Abstract
The field of craniomaxillofacial (CMF) surgery is rich in pathological diversity and broad in the ages that it treats. Moreover, the CMF skeleton is a complex confluence of sensory organs and hard and soft tissue with load-bearing demands that can change within millimeters. Computer-aided design (CAD) and additive manufacturing (AM) create extraordinary opportunities to repair the infinite array of craniomaxillofacial defects that exist because of the aforementioned circumstances. 3D printed scaffolds have the potential to serve as a comparable if not superior alternative to the "gold standard" autologous graft. In vitro and in vivo studies continue to investigate the optimal 3D printed scaffold design and composition to foster bone regeneration that is suited to the unique biological and mechanical environment of each CMF defect. Furthermore, 3D printed fixation devices serve as a patient-specific alternative to those that are available off-the-shelf with an opportunity to reduce operative time and optimize fit. Similar benefits have been found to apply to 3D printed anatomical models and surgical guides for preoperative or intraoperative use. Creation and implementation of these devices requires extensive preclinical and clinical research, novel manufacturing capabilities, and strict regulatory oversight. Researchers, manufacturers, CMF surgeons, and the United States Food and Drug Administration (FDA) are working in tandem to further the development of such technology within their respective domains, all with a mutual goal to deliver safe, effective, cost-efficient, and patient-specific CMF care. This manuscript reviews FDA regulatory status, 3D printing techniques, biomaterials, and sterilization procedures suitable for 3D printed devices of the craniomaxillofacial skeleton. It also seeks to discuss recent clinical applications, economic feasibility, and future directions of this novel technology. By reviewing the current state of 3D printing in CMF surgery, we hope to gain a better understanding of its impact and in turn identify opportunities to further the development of patient-specific surgical care.
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Affiliation(s)
- Blaire V Slavin
- University of Miami Miller School of Medicine, 1011 NW 15th St., Miami, Florida 33136, United States
| | - Quinn T Ehlen
- University of Miami Miller School of Medicine, 1011 NW 15th St., Miami, Florida 33136, United States
| | - Joseph P Costello
- University of Miami Miller School of Medicine, 1011 NW 15th St., Miami, Florida 33136, United States
| | - Vasudev Vivekanand Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, 1011 NW 15th St., Miami, Florida 33136, United States
| | - Estavam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo, Bauru School of Dentistry, Alameda Dr. Octávio Pinheiro Brisolla, Quadra 9 - Jardim Brasil, Bauru São Paulo 17012-901, Brazil
| | - Ernesto B Benalcázar Jalkh
- Department of Prosthodontics and Periodontology, University of Sao Paulo, Bauru School of Dentistry, Alameda Dr. Octávio Pinheiro Brisolla, Quadra 9 - Jardim Brasil, Bauru São Paulo 17012-901, Brazil
| | - Christopher M Runyan
- Department of Plastic and Reconstructive Surgery, Wake Forest School of Medicine, 475 Vine St, Winston-Salem, North Carolina 27101, United States
| | - Lukasz Witek
- Biomaterials Division, NYU Dentistry, 345 E. 24th St., New York, New York 10010, United States
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York University, 222 E 41st St., New York, New York 10017, United States
- Department of Biomedical Engineering, NYU Tandon School of Engineering, 6 MetroTech Center, Brooklyn, New York 11201, United States
| | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, 1011 NW 15th St., Miami, Florida 33136, United States
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, 1120 NW 14th St., Miami, Florida 33136, United States
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Romero-Araya P, Pino V, Nenen A, Cárdenas V, Pavicic F, Ehrenfeld P, Serandour G, Lisoni JG, Moreno-Villoslada I, Flores ME. Combining Materials Obtained by 3D-Printing and Electrospinning from Commercial Polylactide Filament to Produce Biocompatible Composites. Polymers (Basel) 2021; 13:polym13213806. [PMID: 34771361 PMCID: PMC8588263 DOI: 10.3390/polym13213806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 01/29/2023] Open
Abstract
The design of scaffolds to reach similar three-dimensional structures mimicking the natural and fibrous environment of some cells is a challenge for tissue engineering, and 3D-printing and electrospinning highlights from other techniques in the production of scaffolds. The former is a well-known additive manufacturing technique devoted to the production of custom-made structures with mechanical properties similar to tissues and bones found in the human body, but lacks the resolution to produce small and interconnected structures. The latter is a well-studied technique to produce materials possessing a fibrillar structure, having the advantage of producing materials with tuned composition compared with a 3D-print. Taking the advantage that commercial 3D-printers work with polylactide (PLA) based filaments, a biocompatible and biodegradable polymer, in this work we produce PLA-based composites by blending materials obtained by 3D-printing and electrospinning. Porous PLA fibers have been obtained by the electrospinning of recovered PLA from 3D-printer filaments, tuning the mechanical properties by blending PLA with small amounts of polyethylene glycol and hydroxyapatite. A composite has been obtained by blending two layers of 3D-printed pieces with a central mat of PLA fibers. The composite presented a reduced storage modulus as compared with a single 3D-print piece and possessing similar mechanical properties to bone tissues. Furthermore, the biocompatibility of the composites is assessed by a simulated body fluid assay and by culturing composites with 3T3 fibroblasts. We observed that all these composites induce the growing and attaching of fibroblast over the surface of a 3D-printed layer and in the fibrous layer, showing the potential of commercial 3D-printers and filaments to produce scaffolds to be used in bone tissue engineering.
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Affiliation(s)
- Pablo Romero-Araya
- Laboratorio de Polímeros, Facultad de Ciencias, Instituto de Ciencias Químicas, Universidad Austral de Chile, Valdivia 5090000, Chile; (P.R.-A.); (V.P.); (A.N.); (V.C.); (I.M.-V.)
- Escuela de Odontología, Facultad de Medicina, Universidad Austral de Chile, Valdivia 5090000, Chile
| | - Victor Pino
- Laboratorio de Polímeros, Facultad de Ciencias, Instituto de Ciencias Químicas, Universidad Austral de Chile, Valdivia 5090000, Chile; (P.R.-A.); (V.P.); (A.N.); (V.C.); (I.M.-V.)
- Escuela de Odontología, Facultad de Medicina, Universidad Austral de Chile, Valdivia 5090000, Chile
| | - Ariel Nenen
- Laboratorio de Polímeros, Facultad de Ciencias, Instituto de Ciencias Químicas, Universidad Austral de Chile, Valdivia 5090000, Chile; (P.R.-A.); (V.P.); (A.N.); (V.C.); (I.M.-V.)
| | - Verena Cárdenas
- Laboratorio de Polímeros, Facultad de Ciencias, Instituto de Ciencias Químicas, Universidad Austral de Chile, Valdivia 5090000, Chile; (P.R.-A.); (V.P.); (A.N.); (V.C.); (I.M.-V.)
| | - Francisca Pavicic
- Facultad de Medicina, Instituto de Anatomia, Histologia y Patologia, Universidad Austral de Chile, Valdivia 5090000, Chile; (F.P.); (P.E.)
- Centro de Estudios Interdisciplinarios del Sistema Nervioso (CISNe), Universidad Austral de Chile, Valdivia 5090000, Chile
| | - Pamela Ehrenfeld
- Facultad de Medicina, Instituto de Anatomia, Histologia y Patologia, Universidad Austral de Chile, Valdivia 5090000, Chile; (F.P.); (P.E.)
- Centro de Estudios Interdisciplinarios del Sistema Nervioso (CISNe), Universidad Austral de Chile, Valdivia 5090000, Chile
| | - Guillaume Serandour
- LeufüLAB, Facultad de Ciencias de la Ingeniería, Instituto de Diseño y Métodos Industriales, Universidad Austral de Chile, Valdivia 5090000, Chile;
| | - Judit G. Lisoni
- Facultad de Ciencias, Instituto de Ciencias Físicas y Matemáticas, Universidad Austral de Chile, Valdivia 5090000, Chile;
| | - Ignacio Moreno-Villoslada
- Laboratorio de Polímeros, Facultad de Ciencias, Instituto de Ciencias Químicas, Universidad Austral de Chile, Valdivia 5090000, Chile; (P.R.-A.); (V.P.); (A.N.); (V.C.); (I.M.-V.)
| | - Mario E. Flores
- Laboratorio de Polímeros, Facultad de Ciencias, Instituto de Ciencias Químicas, Universidad Austral de Chile, Valdivia 5090000, Chile; (P.R.-A.); (V.P.); (A.N.); (V.C.); (I.M.-V.)
- Correspondence: ; Tel.: +56-63-2293521
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