Selective laser sintering in biomedical engineering

Auxetic Biomedical Metamaterials for Orthopedic Surgery Applications: A Comprehensive Review

Poisson's ratio in auxetic materials shifts from typically positive to negative, causing lateral expansion during axial tension. This scale-independent characteristic, originating from tailored architectures, exhibits specific physical properties, including energy adsorption, shear resistance, and fracture resistance. These metamaterials demonstrate exotic mechanical properties with potential applications in several engineering fields, but biomedical applications seem to be one of the most relevant, with an increasing number of articles published in recent years, which present opportunities ranging from cellular repair to organ reconstruction with outstanding mechanical performance, mechanical conduction, and biological activity compared with traditional biomedical metamaterials. Therefore, focusing on understanding the potential of these structures and promoting theoretical and experimental investigations into the benefits of their unique mechanical properties is necessary for achieving high-performance biomedical applications. Considering the demand for advanced biomaterial implants in surgical technology and the profound advancement of additive manufacturing technology that are particularly relevant to fabricating complex and customizable auxetic mechanical metamaterials, this review focuses on the fundamental geometric configuration and unique physical properties of negative Poisson's ratio materials, then categorizes and summarizes auxetic material applications across some surgical departments, revealing efficacy in joint surgery, spinal surgery, trauma surgery, and sports medicine contexts. Additionally, it emphasizes the substantial potential of auxetic materials as innovative biomedical solutions in orthopedics and demonstrates the significant potential for comprehensive surgical application in the future.

Adaptation of removable partial denture rest seats in prostheses made with selective laser sintering or casting techniques: A randomized clinical trial

STATEMENT OF PROBLEM

New fabrication techniques have been developed for removable partial denture (RPD) frameworks although studies validating the clinical application of these techniques are scarce.

PURPOSE

The purpose of this clinical study was to compare the adaptation of RPD framework rests made with conventional casting or computer-aided design and computer-aided manufacturing (CAD-CAM) with selective laser sintering (SLS) at the clinical evaluation and 1 year after the delivery of the prostheses.

MATERIAL AND METHODS

This triple-blinded pilot study included 18 participants presenting with maxillary and/or mandibular partial edentulism, of which only 7 returned for the second measurement 1 year after prosthesis delivery. Participants were randomly assigned to 1 of 2 groups depending on whether the RPD framework was made with SLS or conventional lost-wax casting. The adaptation of the RPD at the rest seat area was evaluated by injecting a silicone material on the abutment tooth before seating. The silicone specimens were then sectioned transversely and measured with a scanning electron microscope. The statistical analysis was performed with a linear mixed-effect model with the intention to treat and with a 3-factor repeated measures ANOVA (α=.05).

RESULTS

At the metal framework evaluation (T0), the prostheses made with SLS showed a mean ±standard deviation adaptation of 398 ±45 μm, while those made with conventional casting presented a mean ±standard deviation adaptation of 176 ±41 μm (P=.009). One year after the delivery of the prostheses (T1), the adaptation of the frameworks made with conventional casting was still significantly better (88 ±6 μm versus 197 ±94 μm, P=.03).

CONCLUSIONS

Frameworks made with SLS showed worse clinical accuracy at the rest than frameworks produced with conventional casting.

Polymers in 3D printing of external maxillofacial prostheses and in their retention systems

Maxillofacial defects, arising from trauma, oncological disease or congenital abnormalities, detrimentally affect daily life. Prosthetic repair offers the aesthetic and functional reconstruction with the help of materials mimicking natural tissues. 3D polymer printing enables the design of patient-specific prostheses with high structural complexity, as well as rapid and low-cost fabrication on-demand. However, 3D printing for prosthetics is still in the early stage of development and faces various challenges for widespread use. This is because the most suitable polymers for maxillofacial restoration are soft materials that do not have the required printability, mechanical strength of the printed parts, as well as functionality. This review focuses on the challenges and opportunities of 3D printing techniques for production of polymer maxillofacial prostheses using computer-aided design and modeling software. Review discusses the widely used polymers, as well as their blends and composites, which meet the most important assessment criteria, such as the physicochemical, biological, aesthetic properties and processability in 3D printing. In addition, strategies for improving the polymer properties, such as their printability, mechanical strength, and their ability to print multimaterial and architectural structures are highlighted. The current state of the prosthetic retention system is presented with a focus on actively used polymer adhesives and the recently implemented prosthesis-supporting osseointegrated implants, with an emphasis on their creation from 3D-printed polymers. The successful prosthetics is discussed in terms of the specificity of polymer materials at the restoration site. The approaches and technological prospects are also explored through the examples of the nasal, auricle and ocular prostheses, ranging from prototypes to end-use products.

Prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections

Osteomyelitis is a devastating disease caused by microbial infection in deep bone tissue. Its high recurrence rate and impaired restoration of bone deficiencies are major challenges in treatment. Microbes have evolved numerous mechanisms to effectively evade host intrinsic and adaptive immune attacks to persistently localize in the host, such as drug-resistant bacteria, biofilms, persister cells, intracellular bacteria, and small colony variants (SCVs). Moreover, microbial-mediated dysregulation of the bone immune microenvironment impedes the bone regeneration process, leading to impaired bone defect repair. Despite advances in surgical strategies and drug applications for the treatment of bone infections within the last decade, challenges remain in clinical management. The development and application of tissue engineering materials have provided new strategies for the treatment of bone infections, but a comprehensive review of their research progress is lacking. This review discusses the critical pathogenic mechanisms of microbes in the skeletal system and their immunomodulatory effects on bone regeneration, and highlights the prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections. It will inform the development and translation of antimicrobial and bone repair tissue engineering materials for the management of bone infections.

Development and Characterization of Heparin-Containing Hydrogel/3D-Printed Scaffold Composites for Craniofacial Reconstruction

Regeneration of cartilage and bone tissues remains challenging in tissue engineering due to their complex structures, and the need for both mechanical support and delivery of biological repair stimuli. Therefore, the goal of this study was to develop a composite scaffold platform for anatomic chondral and osteochondral repair using heparin-based hydrogels to deliver small molecules within 3D-printed porous scaffolds that provide structure, stiffness, and controlled biologic delivery. We designed a mold-injection system to combine hydrolytically degradable hydrogels and 3D-printed scaffolds that could be employed rapidly (< 30 min) in operating room settings (~23 °C). Micro-CT analysis demonstrated the effectiveness of our injection system through homogeneously distributed hydrogel within the pores of the scaffolds. Hydrogels and composite scaffolds exhibited efficient loading (~94%) of a small positively charged heparin-binding molecule (crystal violet) with sustained release over 14 days and showed high viability of encapsulated porcine chondrocytes over 7 days. Compression testing demonstrated nonlinear viscoelastic behavior where tangent stiffness decreased with scaffold porosity (porous scaffold tangent stiffness: 70%: 4.9 MPa, 80%: 1.5 MPa, and 90%: 0.20 MPa) but relaxation was not affected. Lower-porosity scaffolds (70%) showed stiffness similar to lower ranges of trabecular bone (4-8 MPa) while higher-porosity scaffolds (80% and 90%) showed stiffness similar to auricular cartilage (0.16-2 MPa). Ultimately, this rapid composite scaffold fabrication method may be employed in the operating room and utilized to control biologic delivery within load-bearing scaffolds.

3D bioprinting approaches for spinal cord injury repair

Regenerative healing of spinal cord injury (SCI) poses an ongoing medical challenge by causing persistent neurological impairment and a significant socioeconomic burden. The complexity of spinal cord tissue presents hurdles to successful regeneration following injury, due to the difficulty of forming a biomimetic structure that faithfully replicates native tissue using conventional tissue engineering scaffolds. 3D bioprinting is a rapidly evolving technology with unmatched potential to create 3D biological tissues with complicated and hierarchical structure and composition. With the addition of biological additives such as cells and biomolecules, 3D bioprinting can fabricate preclinical implants, tissue or organ-like constructs, andin vitromodels through precise control over the deposition of biomaterials and other building blocks. This review highlights the characteristics and advantages of 3D bioprinting for scaffold fabrication to enable SCI repair, including bottom-up manufacturing, mechanical customization, and spatial heterogeneity. This review also critically discusses the impact of various fabrication parameters on the efficacy of spinal cord repair using 3D bioprinted scaffolds, including the choice of printing method, scaffold shape, biomaterials, and biological supplements such as cells and growth factors. High-quality preclinical studies are required to accelerate the translation of 3D bioprinting into clinical practice for spinal cord repair. Meanwhile, other technological advances will continue to improve the regenerative capability of bioprinted scaffolds, such as the incorporation of nanoscale biological particles and the development of 4D printing.

Effect of lamination layer thickness and abutment preparation on the fit of Co-Cr multi-unit prostheses fabricated by additive manufacturing: An in vitro study

STATEMENT OF PROBLEM

Selective laser melting has been increasingly used in the fabrication of metal-ceramic prostheses. The lamination layer thickness may influence the fit of the restoration. However, data regarding its impact remain scarce.

PURPOSE

The purpose of this in vitro study was to evaluate the marginal and internal fit of cobalt-chromium (Co-Cr) 3-unit frameworks fabricated by additive manufacturing with different melting layer thicknesses on different abutments.

MATERIAL AND METHODS

The first right maxillary premolar and molar from a typodont were prepared with a circumferential 1.2-mm chamfer, 2-mm occlusal reduction, and total taper of 8 degrees to receive 3-unit fixed partial dentures. After framework design, the data were sent to a laser machine, and 30 specimens were fabricated from Co-Cr metal powder (Mediloy S-Co) by selective laser melting. Specimens were assigned to 3 groups (n=10) with different lamination layer thicknesses of 25 (L25), 50 (L50), and 100 (L100) μm. Marginal fit and internal fit were evaluated. Results were compared among layer thickness groups and abutments. Data were compared by using the Levene test, t test, and ANOVA (α=.05).

RESULTS

A statistical difference was found between different layer thickness groups (P=.016), but not between abutments (P=.429). On the abutment level, significant difference was found in the gap values for the molars (P=.049) between layer thickness groups, but not for the premolars (P=.126). Group L25 reported the smallest mean discrepancy values, and group L100 reported the highest, with statistical difference found between group L100 and groups L25 (P<.001) and L50 (P<.025), but not between groups L25 and L50 (P=.094).

CONCLUSIONS

The lamination layer thickness affected the adaptation of the metal frameworks. Framework fit did not significantly differ between abutments.

Process Study of Selective Laser Sintering of PS/GF/HGM Composites

To address the issues of insufficient strength and poor precision in polystyrene forming parts during the selective laser sintering process, a ternary composite of polystyrene/glass fiber/hollow glass microbeads was prepared through co-modification by incorporating glass fiber and hollow glass microbeads into polystyrene using a mechanical mixing method. The bending strength and dimensional accuracy of the sintered composites were investigated by conducting an orthogonal test and analysis of variance to study the effects of laser power, scanning speed, scanning spacing, and delamination thickness. The process parameters were optimized and selected to determine the optimal combination. The results demonstrated that when considering bending strength and Z-dimensional accuracy as evaluation criteria for terpolymer sintered parts, the optimum process parameters are as follows: laser power of 24 W, scanning speed of 1600 mm/s, scanning spacing of 0.24 mm, and delamination thickness of 0.22 mm. Under these optimal process parameters, the bending strength of sintered parts reaches 6.12 MPa with a relative error in the Z-dimension of only 0.87%. The bending strength of pure polystyrene sintered parts is enhanced by 15.69% under the same conditions, while the relative error in the Z-dimension is reduced by 63.45%. It improves the forming strength and precision of polystyrene in the selective laser sintering process and achieves the effect of enhancement and modification, which provides a reference and a new direction for exploring polystyrene-based high-performance composites and expands the application scope of selective laser sintering technology.

Visible light-based 3D bioprinted composite scaffolds of κ-carrageenan for bone tissue engineering applications

Three-dimensional (3D) printing of bone scaffolds using digital light processing (DLP) bioprinting technology empowers the treatment of patients suffering from bone disorders and defects through the fabrication of cell-laden patient-specific scaffolds. Here, we demonstrate the visible-light-induced photo-crosslinking of methacrylate-κ-carrageenan (MA-κ-CA) mixed with bioactive silica nanoparticles (BSNPs) to fabricate 3D composite hydrogels using digital light processing (DLP) printing. The 3D printing of complex bone structures, such as the gyroid, was demonstrated with high precision and resolution. DLP-printed 3D composite hydrogels of MA-κ-CA-BSNP were prepared and systematically assessed for their macroporous structure, swelling, and degradation characteristics. The viscosity, rheological, and mechanical properties were also investigated for the influence of nanoparticle incorporation in the MA-κ-CA hydrogels. The in vitro study performed with MC3T3-E1 pre-osteoblast-laden scaffolds of MA-κ-CA-BSNP revealed high cell viability, no cytotoxicity, and proliferation over 21 days with markedly enhanced osteogenic differentiation compared to neat polymeric scaffolds. Furthermore, no inflammation was observed in the 21-day study involving the in vivo examination of DLP-printed 3D composite scaffolds in a Wistar rat model. Overall, the observed results for the DLP-printed 3D composite scaffolds of MA-κ-CA and BSNP demonstrate their biocompatibility and suitability for bone tissue engineering.

Inverted laser sintering of metal powders

We demonstrate the ability of the inverted laser sintering process to manufacture parts composed of metal powder. We fabricate a 10-layer part by depositing a layer of copper powder onto a sapphire plate, then pressing the plate against the part being built and sintering the powder onto the part by shining a 14W 445 nm laser through the glass. The process was then repeated multiple times, each time adding a new layer to the component being printed until completion. We discuss the potential applications and impacts of this process, including the ability to directly fabricate multi-material metallic parts without the use of a powder bed.

Preceramic Polymers for Additive Manufacturing of Silicate Ceramics

The utilization of preceramic polymers (PCPs) to produce both oxide and non-oxide ceramics has caught significant interest, owing to their exceptional characteristics. Diverse types of polymer-derived ceramics (PDCs) synthesized by using various PCPs have demonstrated remarkable characteristics such as exceptional thermal stability, resistance to corrosion and oxidation at elevated temperatures, biocompatibility, and notable dielectric properties, among others. The application of additive manufacturing techniques to produce PDCs opens up new opportunities for manufacturing complex and unconventional ceramic structures with complex designs that might be challenging or impossible to achieve using traditional manufacturing methods. This is particularly advantageous in industries like aerospace, automotive, and electronics. In this review, various categories of preceramic polymers employed in the synthesis of polymer-derived ceramics are discussed, with a particular focus on the utilization of polysiloxane and polysilsesquioxanes to generate silicate ceramics. Further, diverse additive manufacturing techniques adopted for the fabrication of polymer-derived silicate ceramics are described.

Use of 3D Printing Techniques to Fabricate Implantable Microelectrodes for Electrochemical Detection of Biomarkers in the Early Diagnosis of Cardiovascular and Neurodegenerative Diseases

This Review provides a comprehensive overview of 3D printing techniques to fabricate implantable microelectrodes for the electrochemical detection of biomarkers in the early diagnosis of cardiovascular and neurodegenerative diseases. Early diagnosis of these diseases is crucial to improving patient outcomes and reducing healthcare systems' burden. Biomarkers serve as measurable indicators of these diseases, and implantable microelectrodes offer a promising tool for their electrochemical detection. Here, we discuss various 3D printing techniques, including stereolithography (SLA), digital light processing (DLP), fused deposition modeling (FDM), selective laser sintering (SLS), and two-photon polymerization (2PP), highlighting their advantages and limitations in microelectrode fabrication. We also explore the materials used in constructing implantable microelectrodes, emphasizing their biocompatibility and biodegradation properties. The principles of electrochemical detection and the types of sensors utilized are examined, with a focus on their applications in detecting biomarkers for cardiovascular and neurodegenerative diseases. Finally, we address the current challenges and future perspectives in the field of 3D-printed implantable microelectrodes, emphasizing their potential for improving early diagnosis and personalized treatment strategies.

Selective Laser Melting and Spark Plasma Sintering: A Perspective on Functional Biomaterials

Achieving lightweight, high-strength, and biocompatible composites is a crucial objective in the field of tissue engineering. Intricate porous metallic structures, such as lattices, scaffolds, or triply periodic minimal surfaces (TPMSs), created via the selective laser melting (SLM) technique, are utilized as load-bearing matrices for filled ceramics. The primary metal alloys in this category are titanium-based Ti6Al4V and iron-based 316L, which can have either a uniform cell or a gradient structure. Well-known ceramics used in biomaterial applications include titanium dioxide (TiO2), zirconium dioxide (ZrO2), aluminum oxide (Al2O3), hydroxyapatite (HA), wollastonite (W), and tricalcium phosphate (TCP). To fill the structures fabricated by SLM, an appropriate ceramic is employed through the spark plasma sintering (SPS) method, making them suitable for in vitro or in vivo applications following minor post-processing. The combined SLM-SPS approach offers advantages, such as rapid design and prototyping, as well as assured densification and consolidation, although challenges persist in terms of large-scale structure and molding design. The individual or combined application of SLM and SPS processes can be implemented based on the specific requirements for fabricated sample size, shape complexity, densification, and mass productivity. This flexibility is a notable advantage offered by the combined processes of SLM and SPS. The present article provides an overview of metal-ceramic composites produced through SLM-SPS techniques. Mg-W-HA demonstrates promise for load-bearing biomedical applications, while Cu-TiO2-Ag exhibits potential for virucidal activities. Moreover, a functionally graded lattice (FGL) structure, either in radial or longitudinal directions, offers enhanced advantages by allowing adjustability and control over porosity, roughness, strength, and material proportions within the composite.

Development of Biocompatible 3D-Printed Artificial Blood Vessels through Multidimensional Approaches

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.

From materials to clinical use: advances in 3D-printed scaffolds for cartilage tissue engineering

Osteoarthritis caused by articular cartilage defects is a particularly common orthopedic disease that can involve the entire joint, causing great pain to its sufferers. A global patient population of approximately 250 million people has an increasing demand for new therapies with excellent results, and tissue engineering scaffolds have been proposed as a potential strategy for the repair and reconstruction of cartilage defects. The precise control and high flexibility of 3D printing provide a platform for subversive innovation. In this perspective, cartilage tissue engineering (CTE) scaffolds manufactured using different biomaterials are summarized from the perspective of 3D printing strategies, the bionic structure strategies and special functional designs are classified and discussed, and the advantages and limitations of these CTE scaffold preparation strategies are analyzed in detail. Finally, the application prospect and challenges of 3D printed CTE scaffolds are discussed, providing enlightening insights for their current research.

3D printing metal implants in orthopedic surgery: Methods, applications and future prospects

Background

Currently, metal implants are widely used in orthopedic surgeries, including fracture fixation, spinal fusion, joint replacement, and bone tumor defect repair. However, conventional implants are difficult to be customized according to the recipient's skeletal anatomy and defect characteristics, leading to difficulties in meeting the individual needs of patients. Additive manufacturing (AM) or three-dimensional (3D) printing technology, an advanced digital fabrication technique capable of producing components with complex and precise structures, offers opportunities for personalization.

Methods

We systematically reviewed the literature on 3D printing orthopedic metal implants over the past 10 years. Relevant animal, cellular, and clinical studies were searched in PubMed and Web of Science. In this paper, we introduce the 3D printing method and the characteristics of biometals and summarize the properties of 3D printing metal implants and their clinical applications in orthopedic surgery. On this basis, we discuss potential possibilities for further generalization and improvement.

Results

3D printing technology has facilitated the use of metal implants in different orthopedic procedures. By combining medical images from techniques such as CT and MRI, 3D printing technology allows the precise fabrication of complex metal implants based on the anatomy of the injured tissue. Such patient-specific implants not only reduce excessive mechanical strength and eliminate stress-shielding effects, but also improve biocompatibility and functionality, increase cell and nutrient permeability, and promote angiogenesis and bone growth. In addition, 3D printing technology has the advantages of low cost, fast manufacturing cycles, and high reproducibility, which can shorten patients' surgery and hospitalization time. Many clinical trials have been conducted using customized implants. However, the use of modeling software, the operation of printing equipment, the high demand for metal implant materials, and the lack of guidance from relevant laws and regulations have limited its further application.

Conclusions

There are advantages of 3D printing metal implants in orthopedic applications such as personalization, promotion of osseointegration, short production cycle, and high material utilization. With the continuous learning of modeling software by surgeons, the improvement of 3D printing technology, the development of metal materials that better meet clinical needs, and the improvement of laws and regulations, 3D printing metal implants can be applied to more orthopedic surgeries.

The translational potential of this paper

Precision, intelligence, and personalization are the future direction of orthopedics. It is reasonable to believe that 3D printing technology will be more deeply integrated with artificial intelligence, 4D printing, and big data to play a greater role in orthopedic metal implants and eventually become an important part of the digital economy. We aim to summarize the latest developments in 3D printing metal implants for engineers and surgeons to design implants that more closely mimic the morphology and function of native bone.

Advances in additive manufacturing of polycaprolactone based scaffolds for bone regeneration

Critical sized bone defects are difficult to manage and currently available clinical/surgical strategies for treatment are not completely successful. Polycaprolactone (PCL) which is a biodegradable and biocompatible thermoplastic can be 3D printed using medical images into patient specific bone implants. The excellent mechanical properties and low immunogenicity of PCL makes it an ideal biomaterial candidate for 3D printing of bone implants. Though PCL suffers from the limitation of being bio-inert. Here we describe the use of PCL as a biomaterial for 3D printing for bone regeneration, and advances made in the field. The specific focus is on the different 3D printing techniques used for this purpose and various modification that can enhance bone regeneration following the development pathways. We further describe the effect of various scaffold characteristics on bone regeneration both in vitro and the translational assessment of these 3D printed PCL scaffolds in animal studies. The generated knowledge will help understand cell-material interactions of 3D printed PCL scaffolds, to further improve scaffold chemistry and design that can replicate bone developmental processes and can be translated clinically.

Regeneration of Critical-Sized Mandibular Defects Using 3D-Printed Composite Scaffolds: A Quantitative Evaluation of New Bone Formation in In Vivo Studies

Mandibular tissue engineering aims to develop synthetic substitutes for the regeneration of critical size defects (CSD) caused by a variety of events, including tumor surgery and post-traumatic resections. Currently, the gold standard clinical treatment of mandibular resections (i.e., autologous fibular flap) has many drawbacks, driving research efforts toward scaffold design and fabrication by additive manufacturing (AM) techniques. Once implanted, the scaffold acts as a support for native tissue and facilitates processes that contribute to its regeneration, such as cells infiltration, matrix deposition and angiogenesis. However, to fulfil these functions, scaffolds must provide bioactivity by mimicking natural properties of the mandible in terms of structure, composition and mechanical behavior. This review aims to present the state of the art of scaffolds made with AM techniques that are specifically employed in mandibular tissue engineering applications. Biomaterials chemical composition and scaffold structural properties are deeply discussed, along with strategies to promote osteogenesis (i.e., delivery of biomolecules, incorporation of stem cells, and approaches to induce vascularization in the constructs). Finally, a comparison of in vivo studies is made by taking into consideration the amount of new bone formation (NB), the CSD dimensions, and the animal model.

3D Printing-Enabled Design and Manufacturing Strategies for Batteries: A Review

Lithium-ion batteries (LIBs) have significantly impacted the daily lives, finding broad applications in various industries such as consumer electronics, electric vehicles, medical devices, aerospace, and power tools. However, they still face issues (i.e., safety due to dendrite propagation, manufacturing cost, random porosities, and basic & planar geometries) that hinder their widespread applications as the demand for LIBs rapidly increases in all sectors due to their high energy and power density values compared to other batteries. Additive manufacturing (AM) is a promising technique for creating precise and programmable structures in energy storage devices. This review first summarizes light, filament, powder, and jetting-based 3D printing methods with the status on current trends and limitations for each AM technology. The paper also delves into 3D printing-enabled electrodes (both anodes and cathodes) and solid-state electrolytes for LIBs, emphasizing the current state-of-the-art materials, manufacturing methods, and properties/performance. Additionally, the current challenges in the AM for electrochemical energy storage (EES) applications, including limited materials, low processing precision, codesign/comanufacturing concepts for complete battery printing, machine learning (ML)/artificial intelligence (AI) for processing optimization and data analysis, environmental risks, and the potential of 4D printing in advanced battery applications, are also presented.

3D-printed metals: Process parameters effects on mechanical properties of 17-4 P H stainless steel

Additive Manufacturing (AM) has spread significantly in recent years, with relevant applications in many fields of research and engineering. Thanks to its distinctive production methods, AM enables the creation of parts with complex shapes that cannot be fabricated easily by employing traditional subtractive processes. 3D printing, which involves overlapping material layer by layer until the designed part is completed, shows several advantages in terms of limiting material waste, reducing production phases and postprocessing/heat treatments needs, leading to an additional benefit in terms of environmental sustainability. However, there are still limited available data on the influence of the 3D printing process on the mechanical properties of the materials that are commonly used and additional investigations are strongly demanded. So, the purpose of the present paper is to provide a useful contribution in the field of metal additive manufacturing, reporting the results of an experimental campaign carried out on 17-4 P H stainless steel, produced using selective laser melting technology. The effects of different printing orientations and scanning times on the tensile behaviour, impact strength and microhardness features of the 3D-printed products are investigated. Furthermore, the influence of an annealing heat treatment on the material mechanical performance is evaluated.

Three Dimensional Printing and Its Applications Focusing on Microneedles for Drug Delivery

Microneedles (MNs) are considered to be a novel smart injection system that causes significantly low skin invasion upon puncturing, due to the micron-sized dimensions that pierce into the skin painlessly. This allows transdermal delivery of numerous therapeutic molecules, such as insulin and vaccines. The fabrication of MNs is carried out through conventional old methods such as molding, as well as through newer and more sophisticated technologies, such as three-dimensional (3D) printing, which is considered to be a superior, more accurate, and more time- and production-efficient method than conventional methods. Three-dimensional printing is becoming an innovative method that is used in education through building intricate models, as well as being employed in the synthesis of fabrics, medical devices, medical implants, and orthoses/prostheses. Moreover, it has revolutionary applications in the pharmaceutical, cosmeceutical, and medical fields. Having the capacity to design patient-tailored devices according to their dimensions, along with specified dosage forms, has allowed 3D printing to stand out in the medical field. The different techniques of 3D printing allow for the production of many types of needles with different materials, such as hollow MNs and solid MNs. This review covers the benefits and drawbacks of 3D printing, methods used in 3D printing, types of 3D-printed MNs, characterization of 3D-printed MNs, general applications of 3D printing, and transdermal delivery using 3D-printed MNs.

Current Status and Future Outlook of Additive Manufacturing Technologies for the Reconstruction of the Trachea

Tracheal stenosis and defects occur congenitally and in patients who have undergone tracheal intubation and tracheostomy due to long-term intensive care. Such issues may also be observed during tracheal removal during malignant head and neck tumor resection. However, to date, no treatment method has been identified that can simultaneously restore the appearance of the tracheal skeleton while maintaining respiratory function in patients with tracheal defects. Therefore, there is an urgent need to develop a method that can maintain tracheal function while simultaneously reconstructing the skeletal structure of the trachea. Under such circumstances, the advent of additive manufacturing technology that can create customized structures using patient medical image data provides new possibilities for tracheal reconstruction surgery. In this study, the three-dimensional (3D) printing and bioprinting technologies used in tracheal reconstruction are summarized, and various research results related to the reconstruction of mucous membranes, cartilage, blood vessels, and muscle tissue, which are tissues required for tracheal reconstruction, are classified. The prospects for 3D-printed tracheas in clinical studies are also described. This review serves as a guide for the development of artificial tracheas and clinical trials using 3D printing and bioprinting.

A Virtual Multi-Ocular 3D Reconstruction System Using a Galvanometer Scanner and a Camera

A novel visual 3D reconstruction system, composed of a two-axis galvanometer scanner, a camera with a lens, and a set of control units, is introduced in this paper. By changing the mirror angles of the galvanometer scanner fixed in front of the camera, the boresight of the camera can be quickly adjusted. With the variable boresight, the camera can serve as a virtual multi-ocular system (VMOS), which captures the object at different perspectives. The working mechanism with a definite physical meaning is presented. A simple and efficient method for calibrating the intrinsic and extrinsic parameters of the VMOS is presented. The applicability of the proposed system for 3D reconstruction is investigated. Owing to the multiple virtual poses of the camera, the VMOS can provide stronger constraints in the object pose estimation than an ordinary perspective camera does. The experimental results demonstrate that the proposed VMOS is able to achieve 3D reconstruction performance competitive with that of a conventional stereovision system with a much more concise hardware configuration.

Titanium Lattice Structures Produced via Additive Manufacturing for a Bone Scaffold: A Review

The progress in additive manufacturing has remarkably increased the application of lattice materials in the biomedical field for the fabrication of scaffolds used as bone substitutes. Ti6Al4V alloy is widely adopted for bone implant application as it combines both biological and mechanical properties. Recent breakthroughs in biomaterials and tissue engineering have allowed the regeneration of massive bone defects, which require external intervention to be bridged. However, the repair of such critical bone defects remains a challenge. The present review collected the most significant findings in the literature of the last ten years on Ti6Al4V porous scaffolds to provide a comprehensive summary of the mechanical and morphological requirements for the osteointegration process. Particular attention was given on the effects of pore size, surface roughness and the elastic modulus on bone scaffold performances. The application of the Gibson–Ashby model allowed for a comparison of the mechanical performance of the lattice materials with that of human bone. This allows for an evaluation of the suitability of different lattice materials for biomedical applications.

Scaffold Guided Bone Regeneration for the Treatment of Large Segmental Defects in Long Bones

Bone generally displays a high intrinsic capacity to regenerate. Nonetheless, large osseous defects sometimes fail to heal. The treatment of such large segmental defects still represents a considerable clinical challenge. The regeneration of large bone defects often proves difficult, since it relies on the formation of large amounts of bone within an environment impedimental to osteogenesis, characterized by soft tissue damage and hampered vascularization. Consequently, research efforts have concentrated on tissue engineering and regenerative medical strategies to resolve this multifaceted challenge. In this review, we summarize, critically evaluate, and discuss present approaches in light of their clinical relevance; we also present future advanced techniques for bone tissue engineering, outlining the steps to realize for their translation from bench to bedside. The discussion includes the physiology of bone healing, requirements and properties of natural and synthetic biomaterials for bone reconstruction, their use in conjunction with cellular components and suitable growth factors, and strategies to improve vascularization and the translation of these regenerative concepts to in vivo applications. We conclude that the ideal all-purpose material for scaffold-guided bone regeneration is currently not available. It seems that a variety of different solutions will be employed, according to the clinical treatment necessary.

Recent advances in biomimetic soft robotics: fabrication approaches, driven strategies and applications

Compared to traditional rigid-bodied robots, soft robots are constructed using physically flexible/elastic bodies and electronics to mimic nature and enable novel applications in industry, healthcare, aviation, military, etc. Recently, the fabrication of robots on soft matter with great flexibility and compliance has enabled smooth and sophisticated 'multi-degree-of-freedom' 3D actuation to seamlessly interact with humans, other organisms and non-idealized environments in a highly complex and controllable manner. Herein, we summarize the fabrication approaches, driving strategies, novel applications, and future trends of soft robots. Firstly, we introduce the different fabrication approaches to prepare soft robots and compare and systematically discuss their advantages and disadvantages. Then, we present the actuator-based and material-based driving strategies of soft robotics and their characteristics. The representative applications of soft robotics in artificial intelligence, medicine, sensors, and engineering are summarized. Also, some remaining challenges and future perspectives in soft robotics are provided. This work highlights the recent advances of soft robotics in terms of functional material selection, structure design, control strategies and biomimicry, providing useful insights into the development of next-generation functional soft robotics.

3D printing in aortic endovascular therapies

Endovascular treatment of aortic disease, including aneurysm or dissection, is expanding at a rapid pace. Often, the specific patient anatomy in these cases is complex. Additive manufacturing, also known as three-dimensional (3D) printing, is especially useful in the treatment of aortic disease, due to its ability to manufacture physical models of complex patient anatomy. Compared to other surgical procedures, endovascular aortic repair can readily exploit the advantages of 3D printing with regard to operative planning and preoperative training. To date, there have been numerous uses of 3D printing in the treatment of aortic pathology as an adjunct in presurgical planning and as a basis for training modules for fellows and residents. In this review, we summarize the current uses of 3D printing in the endovascular management of aortic disease. We also review the process of producing these models, the limitations of their applications, and future directions of 3D printing in this field.

3D printing of inorganic-biopolymer composites for bone regeneration

In most cases, bone injuries heal without complications, however, there is an increasing number of instances where bone healing needs major clinical intervention. Available treatment options have severe drawbacks, such as donor site morbidity and limited availability for autografting. Bone graft substitutes containing growth factors would be a viable alternative, however they have been associated with dose-related safety concerns and lack control over spatial architecture to anatomically match bone defect sites. 3D printing offers a solution to produce patient specific bone graft substitutes that are customized to the patient bone defect with temporal control over the incorporated therapeutics to maximize their efficacy. Inspired by the natural constitution of bone tissue, composites made of inorganic phases, such as nanosilicate particles, calcium phosphate, and bioactive glasses, combined with biopolymer matrices have been investigated as building blocks for the biofabrication of bone constructs. Besides capturing elements of the bone physiological structure, these inorganic/organic composites can be designed for specific cohesivity, rheological and mechanical properties, while both inorganic and organic constituents contribute to the composite bioactivity. This review provides an overview of 3D printed composite biomaterial-inks for bone tissue engineering. Furthermore, key aspects in biomaterial-ink design, 3D printing techniques, and the building blocks for composite biomaterial-inks are summarized.

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.

Review: Auxetic Polymer-Based Mechanical Metamaterials for Biomedical Applications

Over the last three decades but more particularly during the last 5 years, auxetic mechanical metamaterials constructed from precisely architected polymer-based materials have attracted considerable attention due to their fascinating mechanical properties. These materials present a negative Poisson's ratio and therefore unusual mechanical behavior, which has resulted in enhanced static modulus, energy adsorption, and shear resistance, as compared with the bulk properties of polymers. Novel advanced polymer processing and fabrication techniques, and in particular additive manufacturing, allow one to design complex and customizable polymer architectures that are particularly relevant to fabricate auxetic mechanical metamaterials. Although these metamaterials exhibit exotic mechanical properties with potential applications in several engineering fields, biomedical applications seem to be one of the most relevant with a growing number of articles published over recent years. As a result, special focus is needed to understand the potential of these structures and foster theoretical and experimental investigations on the potential benefits of the unusual mechanical properties of these materials on the way to high performance biomedical applications. The present Review provides up to date information on the recent progress of polymer-based auxetic mechanical metamaterials mainly fabricated using additive manufacturing methods with a special focus toward biomedical applications including tissue engineering as well as medical devices including stents and sensors.

Application of the Digital Workflow in Orofacial Orthopedics and Orthodontics: Printed Appliances with Skeletal Anchorage

As digital workflows are gaining popularity, novel treatment options have also arisen in orthodontics. By using selective laser melting (SLM), highly customized 3D-printed appliances can be manufactured and combined with preformed components. When combined with temporary anchorage devices (TADs), the advantages of the two approaches can be merged, which might improve treatment efficacy, versatility, and patient comfort. This article summarizes state-of-the-art technologies and digital workflows to design and install 3D-printed skeletally anchored orthodontic appliances. The advantages and disadvantages of digital workflows are critically discussed, and examples for the clinical application of mini-implant and mini-plate borne appliances are demonstrated.

Direct sound printing

Photo- and thermo-activated reactions are dominant in Additive Manufacturing (AM) processes for polymerization or melting/deposition of polymers. However, ultrasound activated sonochemical reactions present a unique way to generate hotspots in cavitation bubbles with extraordinary high temperature and pressure along with high heating and cooling rates which are out of reach for the current AM technologies. Here, we demonstrate 3D printing of structures using acoustic cavitation produced directly by focused ultrasound which creates sonochemical reactions in highly localized cavitation regions. Complex geometries with zero to varying porosities and 280 μm feature size are printed by our method, Direct Sound Printing (DSP), in a heat curing thermoset, Poly(dimethylsiloxane) that cannot be printed directly so far by any method. Sonochemiluminescnce, high speed imaging and process characterization experiments of DSP and potential applications such as remote distance printing are presented. Our method establishes an alternative route in AM using ultrasound as the energy source.

Photo- and thermo-activated polymerization and melting processes are dominant in Additive Manufacturing (AM) while ultrasound activated sonochemical reactions have not been explored for AM so far. Here, the authors demonstrate 3D printing of structures using acoustic cavitation produced directly by focused ultrasound which creates sonochemical reactions in highly localized cavitation regions.

(Bio)manufactured Solutions for Treatment of Bone Defects with Emphasis on US-FDA Regulatory Science Perspective

Bone defects, with second highest demand for surgeries around the globe, may lead to serious health issues and negatively influence patient lives. The advances in biomedical engineering and sciences have led to the development of several creative solutions for bone defect treatment. This review provides a brief summary of bone graft materials, an organized overview of top-down and bottom-up (bio)manufacturing approaches, plus a critical comparison between advantages and limitations of each method. We specifically discuss additive manufacturing techniques and their operation mechanisms in detail. Next, we review the hybrid methods and promising future directions for bone grafting, while giving a comprehensive US-FDA regulatory science perspective, biocompatibility concepts and assessments, and clinical considerations to translate a technology from a research laboratory to the market. The topics covered in this review could potentially fuel future research efforts in bone tissue engineering, and perhaps could also provide novel insights for other tissue engineering applications.

Biodegradable Microparticles for Regenerative Medicine: A State of the Art and Trends to Clinical Application

Tissue engineering and cell therapy are very attractive in terms of potential applications but remain quite challenging regarding the clinical aspects. Amongst the different strategies proposed to facilitate their implementation in clinical practices, biodegradable microparticles have shown promising outcomes with several advantages and potentialities. This critical review aims to establish a survey of the most relevant materials and processing techniques to prepare these micro vehicles. Special attention will be paid to their main potential applications, considering the regulatory constraints and the relative easiness to implement their production at an industrial level to better evaluate their application in clinical practices.

Anatomical Engineering and 3D Printing for Surgery and Medical Devices: International Review and Future Exponential Innovations

Three-dimensional printing (3DP) has recently gained importance in the medical industry, especially in surgical specialties. It uses different techniques and materials based on patients' needs, which allows bioprofessionals to design and develop unique pieces using medical imaging provided by computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, the Department of Biology and Medicine and the Department of Physics and Engineering, at the Bioastronautics and Space Mechatronics Research Group, have managed and supervised an international cooperation study, in order to present a general review of the innovative surgical applications, focused on anatomical systems, such as the nervous and craniofacial system, cardiovascular system, digestive system, genitourinary system, and musculoskeletal system. Finally, the integration with augmented, mixed, virtual reality is analyzed to show the advantages of personalized treatments, taking into account the improvements for preoperative, intraoperative planning, and medical training. Also, this article explores the creation of devices and tools for space surgery to get better outcomes under changing gravity conditions.

Fabrication and Characterization of PCL/HA Filament as a 3D Printing Material Using Thermal Extrusion Technology for Bone Tissue Engineering

The most common three-dimensional (3D) printing method is material extrusion, where a pre-made filament is deposited layer-by-layer. In recent years, low-cost polycaprolactone (PCL) material has increasingly been used in 3D printing, exhibiting a sufficiently high quality for consideration in cranio-maxillofacial reconstructions. To increase osteoconductivity, prefabricated filaments for bone repair based on PCL can be supplemented with hydroxyapatite (HA). However, few reports on PCL/HA composite filaments for material extrusion applications have been documented. In this study, solvent-free fabrication for PCL/HA composite filaments (HA 0%, 5%, 10%, 15%, 20%, and 25% weight/weight PCL) was addressed, and parameters for scaffold fabrication in a desktop 3D printer were confirmed. Filaments and scaffold fabrication temperatures rose with increased HA content. The pore size and porosity of the six groups’ scaffolds were similar to each other, and all had highly interconnected structures. Six groups’ scaffolds were evaluated by measuring the compressive strength, elastic modulus, water contact angle, and morphology. A higher amount of HA increased surface roughness and hydrophilicity compared to PCL scaffolds. The increase in HA content improved the compressive strength and elastic modulus. The obtained data provide the basis for the biological evaluation and future clinical applications of PCL/HA material.

Reconstruction of Cranial Bone Defects Using Polyamide 12 Patient-Specific Implant: Long Term Follow Up

ABSTRACT

The main objective of this study was to evaluate the use of patient-specific polyamide 12 implants in cranial bone defect reconstruction.Ten patients who underwent prior decompression craniectomy were selected for the current study. Skull scanning by computerized tomography was performed and used to make virtual planning of the implants to be transformed into physical implant using selective laser sintering. Cranioplasty was performed through coronal surgical approach where cranial implants were fixated using 2.0-mm mini-screws, and plates. Patients follow-up was from 12 to 36 months. Glasgow Outcome Score recorded 1 (good recovery) for all patients. Patient and surgeon satisfaction for the esthetic outcome were measured using visual analog scale as mean of 10 ± 0 and 9 ± 1, respectively. Cranial symmetry index was calculated as mean score of 98% ± 1%, indicating highly accurate symmetry, and preoperative virtual planning and postoperative outcome were compared for accuracy analysis with a mean difference of 0.3197 ± 0.1649, which indicates high accuracy.Polyamide12 cranial implants seem to offer a promising option to cranial bone reconstruction with patient-specific implants. This study ensures proper cosmetic and clinical outcome.

Conventional and Recent Trends of Scaffolds Fabrication: A Superior Mode for Tissue Engineering

Tissue regeneration is an auto-healing mechanism, initiating immediately following tissue damage to restore normal tissue structure and function. This falls in line with survival instinct being the most dominant instinct for any living organism. Nevertheless, the process is slow and not feasible in all tissues, which led to the emergence of tissue engineering (TE). TE aims at replacing damaged tissues with new ones. To do so, either new tissue is being cultured in vitro and then implanted, or stimulants are implanted into the target site to enhance endogenous tissue formation. Whichever approach is used, a matrix is used to support tissue growth, known as ‘scaffold’. In this review, an overall look at scaffolds fabrication is discussed, starting with design considerations and different biomaterials used. Following, highlights of conventional and advanced fabrication techniques are attentively presented. The future of scaffolds in TE is ever promising, with the likes of nanotechnology being investigated for scaffold integration. The constant evolvement of organoids and biofluidics with the eventual inclusion of organ-on-a-chip in TE has shown a promising prospect of what the technology might lead to. Perhaps the closest technology to market is 4D scaffolds following the successful implementation of 4D printing in other fields.

Conventional and Recent Trends of Scaffolds Fabrication: A Superior Mode for Tissue Engineering

Tissue regeneration is an auto-healing mechanism, initiating immediately following tissue damage to restore normal tissue structure and function. This falls in line with survival instinct being the most dominant instinct for any living organism. Nevertheless, the process is slow and not feasible in all tissues, which led to the emergence of tissue engineering (TE). TE aims at replacing damaged tissues with new ones. To do so, either new tissue is being cultured in vitro and then implanted, or stimulants are implanted into the target site to enhance endogenous tissue formation. Whichever approach is used, a matrix is used to support tissue growth, known as ‘scaffold’. In this review, an overall look at scaffolds fabrication is discussed, starting with design considerations and different biomaterials used. Following, highlights of conventional and advanced fabrication techniques are attentively presented. The future of scaffolds in TE is ever promising, with the likes of nanotechnology being investigated for scaffold integration. The constant evolvement of organoids and biofluidics with the eventual inclusion of organ-on-a-chip in TE has shown a promising prospect of what the technology might lead to. Perhaps the closest technology to market is 4D scaffolds following the successful implementation of 4D printing in other fields.

Selective Laser Sintering of High-Temperature Thermoset Polymer

Thermoplastic materials such as PA12 and PA6 have been extensively employed in Selective Laser Sintering (SLS) 3D printing applications due to their printability, processability, and crystalline structure. However, thermoplastic-based materials lack polymer inter-chain bonding, resulting in inferior mechanical and thermal properties and relatively low fatigue behavior. Therefore, 3D printing of high-performance crosslinked thermosets using SLS technology is paramount to pursue as an alternative to thermoplastics. In this work, a thermoset resin was successfully 3D printed using SLS, and its thermal stability of printed parts after a multi-step post-curing process was investigated. Dimensionally stable and high glass transition temperature (Tg: ~300 °C) thermoset parts were fabricated using SLS. The polymer crosslinking mechanism during the printing and curing process was investigated through FTIR spectra, while the mechanical stability of the SLS 3D-printed thermoset was characterized through compression tests. It is found that 100% crosslinked thermoset can be 3D printed with 900% higher compressive strength than printed green parts.

Microbial-Derived Polyhydroxyalkanoate-Based Scaffolds for Bone Tissue Engineering: Biosynthesis, Properties, and Perspectives

Polyhydroxyalkanoates (PHAs) are a class of structurally diverse natural biopolyesters, synthesized by various microbes under unbalanced culture conditions. PHAs as biomedical materials have been fabricated in various forms to apply to tissue engineering for the past years due to their excellent biodegradability, inherent biocompatibility, modifiable mechanical properties, and thermo-processability. However, there remain some bottlenecks in terms of PHA production on a large scale, the purification process, mechanical properties, and biodegradability of PHA, which need to be further resolved. Therefore, scientists are making great efforts via synthetic biology and metabolic engineering tools to improve the properties and the product yields of PHA at a lower cost for the development of various PHA-based scaffold fabrication technologies to widen biomedical applications, especially in bone tissue engineering. This review aims to outline the biosynthesis, structures, properties, and the bone tissue engineering applications of PHA scaffolds with different manufacturing technologies. The latest advances will provide an insight into future outlooks in PHA-based scaffolds for bone tissue engineering.

Advanced Strategies for 3D Bioprinting of Tissue and Organ Analogs Using Alginate Hydrogel Bioinks

Alginate is a natural polysaccharide that typically originates from various species of algae. Due to its low cost, good biocompatibility, and rapid ionic gelation, the alginate hydrogel has become a good option of bioink source for 3D bioprinting. However, the lack of cell adhesive moieties, erratic biodegradability, and poor printability are the critical limitations of alginate hydrogel bioink. This review discusses the pivotal properties of alginate hydrogel as a bioink for 3D bioprinting technologies. Afterward, a variety of advanced material formulations and biofabrication strategies that have recently been developed to overcome the drawbacks of alginate hydrogel bioink will be focused on. In addition, the applications of these advanced solutions for 3D bioprinting of tissue/organ mimicries such as regenerative implants and in vitro tissue models using alginate-based bioink will be systematically summarized.

Virtual Surgical Planning and 3D Printing in Veterinary Dentistry and Oromaxillofacial Surgery

Virtual surgical planning and three-dimensional (3D) printing are preoperative processes requiring the acquisition of high-quality imaging data. A surgical treatment plan is created and rehearsed virtually as the operator manipulates the 3D images of the patient within the software. When the operator is satisfied with the plan, including anticipated osteotomies, tumor excision margins, and reconstruction options, physical 3D prints can be produced. This article introduces the reader to the basic concepts involved in virtual surgical planning and 3D printing as well as their implementation in veterinary oromaxillofacial surgery.

A Review on Development of Bio-Inspired Implants Using 3D Printing

Biomimetics is an emerging field of science that adapts the working principles from nature to fine-tune the engineering design aspects to mimic biological structure and functions. The application mainly focuses on the development of medical implants for hard and soft tissue replacements. Additive manufacturing or 3D printing is an established processing norm with a superior resolution and control over process parameters than conventional methods and has allowed the incessant amalgamation of biomimetics into material manufacturing, thereby improving the adaptation of biomaterials and implants into the human body. The conventional manufacturing practices had design restrictions that prevented mimicking the natural architecture of human tissues into material manufacturing. However, with additive manufacturing, the material construction happens layer-by-layer over multiple axes simultaneously, thus enabling finer control over material placement, thereby overcoming the design challenge that prevented developing complex human architectures. This review substantiates the dexterity of additive manufacturing in utilizing biomimetics to 3D print ceramic, polymer, and metal implants with excellent resemblance to natural tissue. It also cites some clinical references of experimental and commercial approaches employing biomimetic 3D printing of implants.

Selective Laser Melting of Hydroxyapatite: Perspectives for 3D Printing of Bioresorbable Ceramic Implants

Hydroxyapatite, being the major mineral component of tooth enamel and natural bones, is a good candidate for bone tissue engineering applications. One of the promising approaches for manufacturing of three-dimensional objects is selective laser sintering/melting which enables the creation of a dense structure directly during 3D printing by adding material layer-by-layer. The effect of laser irradiation with a wavelength of 10.6 μm on the behavior of mechanochemically synthesized hydroxyapatite under different treatment conditions was studied for the first time in this work. It was shown that, in contrast to laser treatment, the congruent melting is impossible under conditions of a relatively slow rate of heating in a furnace. Depending on the mode of laser treatment, hydroxyapatite can be sintered or melted, or partially decomposed into the more resorbable calcium phosphates. It was found that the congruent selective laser melting of hydroxyapatite can be achieved by treating the dense powder layer with a 0.2 mm laser spot at a power of 4 W and at a scanning speed of 700 mm/s. Melting was shown to be accompanied by the crystallization of a dense monolayer of oxyhydroxyapatite while preserving the initial apatite crystal lattice. The thickness of the melted layer, the presence of micron-sized pores, and the phase composition can be controlled by varying the scanning speed and laser power. This set of parameters permits the use of selective laser melting technology for the production of oxyhydroxyapatite biodegradable implants with acceptable properties by 3D printing.

Bioactive Ceramic Scaffolds for Bone Tissue Engineering by Powder Bed Selective Laser Processing: A Review

The implementation of a powder bed selective laser processing (PBSLP) technique for bioactive ceramics, including selective laser sintering and melting (SLM/SLS), a laser powder bed fusion (L-PBF) approach is far more challenging when compared to its metallic and polymeric counterparts for the fabrication of biomedical materials. Direct PBSLP can offer binder-free fabrication of bioactive scaffolds without involving postprocessing techniques. This review explicitly focuses on the PBSLP technique for bioactive ceramics and encompasses a detailed overview of the PBSLP process and the general requirements and properties of the bioactive scaffolds for bone tissue growth. The bioactive ceramics enclosing calcium phosphate (CaP) and calcium silicates (CS) and their respective composite scaffolds processed through PBSLP are also extensively discussed. This review paper also categorizes the bone regeneration strategies of the bioactive scaffolds processed through PBSLP with the various modes of functionalization through the incorporation of drugs, stem cells, and growth factors to ameliorate critical-sized bone defects based on the fracture site length for personalized medicine.