The Shape of Things to Come: Emerging Applications of 3D Printing in Healthcare

Sustained release of 3D printed bupropion hydrochloride tablets bearing Braille imprints for the visually impaired

3D printing has been introduced as a novel approach for the design of personalized dosage forms and support patient groups with special needs that require additional assistance for enhanced medication adherence. In this study liquid crystal display (LCD) is introduced for the development of sustained release bupropion.HCl printed tablets. The optimization of printing hydrogel inks was combined with the display of Braille patterns on the tablet surface for blind or visually impaired patients. Due to the high printing accuracy, the Braille patterns could be verified by blind patients and provide the required information. Further characterization revealed the presence of BUP in amorphous state within the photopolymerized resins. The selection of poly(ethylene glycol) (PEG)-diacrylate (PEGDA) of different molecular weights and the presence of surfactants or solubilizers disrupted the resin photopolymerization, thus controlling the BUP dissolution rates. A small batch scale-up study demonstrated the capacity of LCD to print rapidly a notable number of tablets within 24 min.

User-Centered Design of Limb Prostheses: A New University Course Designed to Spark Interest in Orthotics & Prosthetics for Bioengineering Students

There is a current need to increase recruitment in orthotics and prosthetics, and a promising approach is to increase awareness, interest and cross-disciplinary engagement in O&P among students of allied disciplines such as bioengineering. We describe a new interdisciplinary course we jointly developed at the University of Pittsburgh and deployed for the first time in the spring of 2023. The course was built on core foci of human-centered design, design thinking, experiential learning, 3D printing, creative problem-solving and prototyping. We leveraged a real-world project-based learning approach that included early and ongoing involvement of student teams with clients who used prosthetics. We explored creating a learning environment in which bioengineering students were motivated to learn about the O&P field by partnering with clients to investigate their unmet prosthetic needs and invent new solutions, with computer-aided design and 3D printing as key enabling technologies. Each student team produced an individually designed and fitted device for a specific application for a person with limb difference. Student feedback was positive throughout with several recipients expressing enthusiasm about the field of O&P and about the opportunity to work with actual patients. Several students stated their new-found interest in pursuing a career in the field. We believe that this sort of class offering could be implemented in many institutions that host O&P graduate programs, to raise awareness of the profession and attract more and better prepared applicants.

Research landscape on 3D printing applications in healthcare within Southeast Asian countries: a systematic scoping review protocol

INTRODUCTION

Three-dimensional (3D) printing plays a significant role as a promising technological advancement in modern healthcare settings. 3D printing has been incorporated by many sectors worldwide including in Southeast Asian countries. However, there is a paucity of research, especially in the healthcare pertaining to 3D printing activity in the Southeast Asian region. Thus, a scoping review is conducted to gain insight into 3D printing healthcare research landscape in the Southeast Asian region.

METHODS AND ANALYSIS

The methodology draws on Arksey and O'Malley's seminal framework for the scoping review. The literature search will be conducted by using keywords to find suitable published literature. The existing literature will be searched using selected electronic databases such as PubMed/MEDLINE, CINAHL, Scopus, ProQuest and Web of Science from the years 2011 and 2021. The selected publications will focus on 10 Southeast Asian countries: Malaysia, Indonesia, Singapore, Thailand, Brunei, Philippines, Laos, Vietnam, Cambodia and Myanmar. Two reviewers will be performing title and abstract screening for the criteria of each publication, in which they will be working independently of each other. The included publication will undergo a full-text review and references cited will be examined for relevance using the same inclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram will guide throughout the process. Data will be extracted, analysed and charted within each category from the selected publications for each Southeast Asian country.

ETHICS AND DISSEMINATION

The results of this scoping review will illustrate an overview of the 3D printing healthcare research in the Southeast Asian context, which can be a guide for the advancement of 3D printing that can be accentuated in future research. The results will undergo dissemination which will be submitted for publication in a scientific journal.

The Application and Challenge of Binder Jet 3D Printing Technology in Pharmaceutical Manufacturing

Three-dimensional (3D) printing is an additive manufacturing technique that creates objects under computer control. Owing to the rapid advancement of science and technology, 3D printing technology has been widely utilized in processing and manufacturing but rarely used in the pharmaceutical field. The first commercial form of Spritam® immediate-release tablet was approved by FDA in 2015, which promoted the advancement of 3D printing technology in pharmaceutical development. Three-dimensional printing technology is able to meet individual treatment demands with customized size, shape, and release rate, which overcomes the difficulties of traditional pharmaceutical technology. This paper intends to discuss the critical process parameters of binder jet 3D printing technology, list its application in pharmaceutical manufacturing in recent years, summarize the still-open questions, and demonstrate its great potential in the pharmaceutical industry.

Immediate release 3D printed oral dosage forms: How different polymers have been explored to reach suitable drug release behaviour

Three-dimensional (3D) printing has been gaining attention as a new technological approach to obtain immediate release (IR) dosage forms. The versatility conferred by 3D printing techniques arises from the suitability of using different polymeric materials in the production of solids with different porosities, geometries, sizes, and infill patterns. The appropriate choice of polymer can facilitate in reaching IR specifications and afford other specific properties to 3D printed solid dosage forms. This review aims to provide an overview of the polymers that have been employed in the development of IR 3D printed dosage forms, mainly considering their in vitro drug release behaviour. The physicochemical and mechanical properties of the IR 3D printed dosage forms will also be discussed, together with the manufacturing process strategies. Up to now, methacrylic polymers, cellulosic polymers, vinyl derivatives, glycols and different polymeric blends have been explored to produce IR 3D printed dosage forms. Their effects on drug release profiles are critically discussed here, giving a complete overview to drive formulators towards a rational choice of polymeric material and thus contributing to future studies in 3D printing of pharmaceuticals.

Organizational and Supply Chain Impacts of 3D Printers Implementation in the Medical Sector

3D printing application extends to various sectors, such as aerospace, construction, art, domestic, up to healthcare. It is in this domain that its adoption could offer technological solutions aimed at improving the individual life and guaranteeing organizational effectiveness. The aim of this study is to understand the way in which the adoption of medical 3D printers has introduced economic-business changes at the supply chain, organizational and environmental level within business processes considering the point of view of 3D printer manufacturers. A multiple case study has been developed, through the administration of a semi-structured interview to 7 Italian companies that design, manufacture and sell 3D printers offering additive technological solutions to the medical sector. The results show how companies believe that the organizational impact related to the adoption of this technology is quite significant, highlighting how it leads to the definition of a new organizational culture. Secondly, it emerges that the adoption of 3D printers within the medical sector also leads to a change in procedures and production activities. Finally, it also emerges that the impact at the supply chain level particularly affects the reduction in the number of players in the supply chain and product time to market.

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.

Development of a 3D-Printed Dosing Platform to Aid in Zolpidem Withdrawal Therapy

The long-term use of benzodiazepine receptor agonists (BZRAs) is associated with multiple side effects, such as increased sedation, hangover or an elevated risk of dependency and abuse. Unfortunately, the long-term use of BZRAs is reaching worrying intake rates, and therefore, the need for action is high. It was demonstrated already that the overall willingness of patients for deprescription increased when a slow dose reduction scheme with the possibility for dose increase, if needed, is employed. The current study aims to develop a flexible dosing platform of zolpidem hemitartrate (ZHT) to facilitate such withdrawal therapy. As this is the first report on the extrusion and 3D printing of ZHT, its thermal behaviour and sensitivity towards photolytic degradation was characterised. It was shown that ZHT possesses multiple polymorphs and was especially prone to oxidative photolysis. Next, a variety of immediate release polymers (Eudragit EPO, Kollidon VA64, Kollidon 12PF and Soluplus) were blended and extruded with Polyox WSR N10 to investigate their feedability and printability by mechanical and rheological analysis. The addition of PEO was shown to enable printing of these brittle pharmaceutical polymers, although the processing temperature was deemed critical to avoid surface defects on the resulting filaments. An EPO(70)PEO(30) system was selected based on its suitable mechanical properties and low hygroscopicity favoring ZHT stability. The matrix was blended with 1% or 10% API. The effect of certain printing parameters (caplet size, nozzle diameter, % overlap) on dissolution behaviour and caplet weight/dimensions/quality was assessed. A flexible dosing platform capable of delivering <1 mg and up to 10 mg of ZHT was created. Either caplet modification (incorporation of channels) or disintegrant addition (Primojel, Explotab, Ac-Di-Sol, Primellose and Polyplasdone-XL) failed to achieve an immediate release profile. This study provides the first report of a 3D-printed flexible dosing platform containing ZHT to aid in withdrawal therapy.

3D printing technology in healthcare: applications, regulatory understanding, IP repository and clinical trial status

Mass consumerization of three-dimensional (3D) printing innovation has revolutionised admittance of 3D-printing in an expansive scope of ventures. When utilised predominantly for industrial manufacturing, 3D-printing strategies have rapidly attained acquaintance in different parts of health care industry. 3D-printing is a moderately new technology that has discovered promising applications in the medication conveyance and clinical areas. This review intends to explore different parts of 3D- printing innovation concerning pharmaceutical and clinical applications. Review on pharmaceutical products like tablets, caplets, films, polypills, microdots, biodegradable patches, medical devices (uterine and subcutaneous), patient specific implants, cardiovascular stents, etc. and prosthetics/anatomical structures, surgical models, organs and tissues created utilising 3D-printing is being presented. In addition, the regulatory understanding and current IP and clinical trial status pertaining to 3D fabricated products/medical applications have also been funnelled, garnering information from different web portals of regulatory agencies and databases. It is additionally certain that for such new innovations, there would be difficulties and questions before these are acknowledged as protected and viable. The circumstance demands purposeful and wary endeavours to acquire regulations which would at last prompt the accomplishment of this progressive innovation, thus various regulatory challenges faced have been conscientiously discussed.

Extrusion-based 3D printing of oral solid dosage forms: Material requirements and equipment dependencies

Extrusion-based 3D printing is steadily gaining importance as a manufacturing technique due to its flexibility and wide range of possible end-products. In the medical field, the technique is being exploited for a variety of applications and one of these is the production of personalised medicines. However, despite many proof-of-concept studies, more thorough insights in the production technique itself and the required material properties are needed before 3D printing can be fully exploited in a hospital or pharmacy setting. This research aims at clarifying the complex interplay between material properties, process parameters and printer-dependent variables. A variety of different polymers and polymer-drug blends were extruded (diameter 1.75±0.05 mm) and characterised in terms of mechanical, thermal and rheological properties. These properties, together with the processing temperature, printing speeds and different nozzle diameters of the 3D printer were linked to the quality of the end-product. Different failure mechanisms (mechanical, thermal) were assessed. Decisive material parameters (e.g. cross-over point) for optimal printing behaviour and the importance of printer construction (nozzle diameter) were clarified. In general, this study offers insight into the 3D printing process and will help to speed up future pharmaceutical formulation development for printlets.