Mechanical properties of polymeric implant materials produced by extrusion-based additive manufacturing

Exploring the potential of intermetallic alloys as implantable biomaterials: A comprehensive review

This review delves into the utilization of intermetallic alloys (IMAs) as advanced biomaterials for medical implants, scrutinizing their conceptual framework, fabrication challenges, and diverse manufacturing techniques such as casting, powder metallurgy, and additive manufacturing. Manufacturing techniques such as casting, powder metallurgy, additive manufacturing, and injection molding are discussed, with specific emphasis on achieving optimal grain sizes, surface roughness, and mechanical properties. Post-treatment methods aimed at refining surface quality, dimensional precision, and mechanical properties of IMAs are explored, including the use of heat treatments to enhance biocompatibility and corrosion resistance. The review presents an in-depth examination of IMAs-based implantable biomaterials, covering lab-scale developments and commercial-scale implants. Specific IMAs such as Nickel Titanium, Titanium Aluminides, Iron Aluminides, Magnesium-based IMAs, Zirconium-based IMAs, and High-entropy alloys (HEAs) are highlighted, with detailed discussions on their mechanical properties, including strength, elastic modulus, and corrosion resistance. Future directions are outlined, with an emphasis on the anticipated growth in the orthopedic devices market and the role of IMAs in meeting this demand. The potential of porous IMAs in orthopedics is explored, with emphasis on achieving optimal pore sizes and distributions for enhanced osseointegration. The review concludes by highlighting the ongoing need for research and development efforts in IMAs technologies, including advancements in design and fabrication techniques.

An Insight into the Characteristics of 3D Printed Polymer Materials for Orthoses Applications: Experimental Study

Knee orthoses assist patients with impaired gait through the amendment of knee abnormalities, restoration of mobility, alleviation of pain, shielding, and immobilization. The inevitable issues with laborious traditional plaster molding procedures for orthoses can be resolved with 3D printing. However, a number of challenges have limited the adoption of 3D printing, the most significant of which is the proper material selection for orthoses. This is so because the material used to make an orthosis affects its strength, adaptability, longevity, weight, moisture response, etc. This study intends to examine the mechanical, physical, and dimensional characteristics of three-dimensional (3D) printing materials (PLA, ABS, PETG, TPU, and PP). The aim of this investigation is to gain knowledge about these materials' potential for usage as knee orthosis materials. Tensile testing, Olympus microscope imaging, water absorption studies, and coordinate measuring machine-based dimension analysis are used to characterize the various 3D printing materials. Based on the investigation, PLA outperforms all other materials in terms of yield strength (25.98 MPa), tensile strength (30.89 MPa), and shrinkage (0.46%). PP is the least water absorbent (0.15%) and most flexible (407.99%); however, it is the most difficult to fabricate using 3D printing. When producing knee orthoses with 3D printing, PLA can be used for the orthosis frame and other structural elements, PLA or ABS for moving parts like hinges, PP for padding, and TPU or PP for the straps. This study provides useful information for scientists and medical professionals who are intrigued about various polymer materials for 3D printing and their effective utilization to fabricate knee orthoses.

Printing Parameter Optimization of Additive Manufactured PLA Using Taguchi Design of Experiment

Three-dimensional printing (3DP), known as additive layer manufacturing (ALM), is a manufacturing process in which a three-dimensional structure is constructed by successive addition of deposited layers. Fused Deposition Modeling (FDM) has evolved as the most frequently utilized ALM process because of its cost-effectiveness and ease of operation. Nevertheless, layer adhesion, delamination, and quality of the finished product remain issues associated with the FDM process parameters. These issues need to be addressed in order to satisfy the requirements commonly imposed by the conventional manufacturing industry. This work is focused on the optimization of the FDM process and post-process parameters for Polylactic acid (PLA) samples in an effort to maximize their tensile strength. Infill density and pattern type, layer height, and print temperature are the process parameters, while annealing temperature is the post-process parameter considered for the investigation. Analysis based on the Taguchi L18 orthogonal array shows that the gyroid infill pattern and annealing cycle at 90 °C results in a maximum ultimate tensile strength (UTM) of 37.15 MPa. Furthermore, the regression model developed for the five variables under study was able to predict the UTS with an accuracy of more than 96%.

Development, Physiochemical characterization, Mechanical and Finite element analysis of 3D printed Polylactide-β-TCP/α-Al2O3 composite

Herein, material extrusion (MEX) technique is utilized to develop 3D printed models based on reinforcing β-Ca3(PO4)2/α-Al2O3 composite in polylactide (PLA) matrix. β-Ca3(PO4)2/α-Al2O3 composite has been synthesized through co-precipitation method and the phase content of β-Ca3(PO4)2 and α-Al2O3 components are respectively determined as 64 and 36 wt%. The resultant β-Ca3(PO4)2/α-Al2O3 composite mixed with PLA at various weight ratios were extruded as filaments and subsequently 3D printed into definite shapes for the physiochemical, morphological and mechanical evaluation. 3D printed bodies that comprise 5 wt % β-Ca3(PO4)2/α-Al2O3 composite yielded an increasing tensile, compressive and flexural strength in the corresponding order of ∼15, ∼15 and 22% than 3D printed pure PLA. Further, the Representative volume element (RVE) unit cells developed based on the various investigated compositions of PLA-β-Ca3(PO4)2/α-Al2O3 were subjected to mechanical evaluation through Finite element analysis (FEA) under both static and dynamic loading conditions on ASTM standard specimens. The results from experimental and FEA analysis demonstrated good uniformity that confirmed the reinforcement of 5 wt % β-Ca3(PO4)2/α-Al2O3 in PLA matrix as an optimum combination to yield better mechanical strength.

Optimization and manufacture of polyetheretherketone patient specific cranial implants by material extrusion - A clinical perspective

Polyetheretherketone (PEEK) is a high performing thermoplastic that has established itself as a 'gold-standard' material for cranial reconstruction. Traditionally, milled PEEK patient specific cranial implants (PSCIs) exhibit uniform levels of smoothness (excusing suture/drainage holes) to the touch (<1 μm) and homogenous coloration throughout. They also demonstrate predictable and repeatable levels of mechanical performance, as they are machined from isotropic material blocks. The combination of such factors inspires confidence from the surgeon and in turn, approval for implantation. However, manufacturing lead-times and affiliated costs to fabricate a PSCI are high. To simplify their production and reduce expenditure, hospitals are exploring the production of in-house PEEK PSCIs by material extrusion-based additive manufacturing. From a geometrical and morphological perspective, such implants have been produced with good-to-satisfactory clinical results. However, lack of clinical adoption persists. To determine the reasoning behind this, it was necessary to assess the benefits and limitations of current printed PEEK PSCIs in order to establish the status quo. Afterwards, a review on individual PEEK printing variables was performed in order to identify a combination of parameters that could enhance the aesthetics and performance of the PSCIs to that of milled implants/cranial bone. The findings from this review could be used as a baseline to help standardize the production of PEEK PSCIs by material extrusion in the hospital.

3D Printing in the Fight Against Covid-19

Purpose

The paper describes the design concept and findings from technological and initial clinical trials conducted to develop a helmet for non-invasive oxygen therapy using positive pressure, known as hCPAP (Helmet Continuous Positive Airway Pressure).

Methods

The study utilized PET-G filament, a recommended material for medical applications, along with the FFF 3D printing technique. Additional technological investigations were performed for the production of fitting components. The authors proposed a parameter identification method for 3D printing, which reduced the time and cost of the study while ensuring high mechanical strength and quality of the manufactured elements.

Results

The proposed 3D printing technique facilitated the rapid development of an ad hoc hCPAP device, which was utilized in preclinical testing and treatment of Covid-19 patients, and yielded positive results. Based on the promising outcomes of the preliminary tests, further development of the hCPAP device's current version was pursued.

Conclusion

The proposed approach offered a crucial benefit by significantly reducing the time and costs involved in developing customized solutions to aid in the fight against the Covid-19 pandemic.

Bulk-Material Bond Strength Exists in Extrusion Additive Manufacturing for a Wide Range of Temperatures, Speeds, and Layer Times

Do extrusion temperature, printing speed, and layer time affect mechanical performance of interlayer bonds in material extrusion additive manufacturing (MEAM)? The question is one of the main challenges in 3D printing of polymers. This article aims to analyze the independent effect of printing parameters on interlayer bonding in MEAM. In previous research, printing parameters were unavoidably interrelated, such as printing speed and layer cooling time. Here, original specimen designs allow the effects to be studied independently for the first time to provide new understanding of the effects of a wide range of thermal factors on mechanical properties of 3D-printed polylactide. The experimental approach used direct GCode design to manufacture specially designed single-filament-thick specimens for tensile testing to measure mechanical and thermal properties normal to the interface between layers. In total, five different extrusion temperatures (a range of 60°C), five different printing speeds (a 16-fold change in the magnitude) and four different layer times (an 8-fold change) were independently studied. The results demonstrate interlayer bond strength to be equivalent to that of the bulk material within experimental scatter. This study provides strong evidence about the crucial role of microscale geometry for apparent interlayer bond strength relative to the role of thermal factors. By designing specimens specifically for the MEAM process, this study clearly demonstrates that bulk-material strength can be achieved for interlayer bonds in MEAM even when printing parameters change severalfold. Widespread industrial and academic efforts to improve interlayer bonding should be refocused to study extrusion geometry-the primary cause of anisotropy in MEAM.

Energy Consumption vs. Tensile Strength of Poly[methyl methacrylate] in Material Extrusion 3D Printing: The Impact of Six Control Settings

The energy efficiency of material extrusion additive manufacturing has a significant impact on the economics and environmental footprint of the process. Control parameters that ensure 3D-printed functional products of premium quality and mechanical strength are an established market-driven requirement. To accomplish multiple objectives is challenging, especially for multi-purpose industrial polymers, such as the Poly[methyl methacrylate]. The current paper explores the contribution of six generic control factors (infill density, raster deposition angle, nozzle temperature, print speed, layer thickness, and bed temperature) to the energy performance of Poly[methyl methacrylate] over its mechanical performance. A five-level L25 Taguchi orthogonal array was composed, with five replicas, involving 135 experiments. The 3D printing time and the electrical consumption were documented with the stopwatch approach. The tensile strength, modulus, and toughness were experimentally obtained. The raster deposition angle and the printing speed were the first and second most influential control parameters on tensile strength. Layer thickness and printing speed were the corresponding ones for the energy consumption. Quadratic regression model equations for each response metric over the six control parameters were compiled and validated. Thus, the best compromise between energy efficiency and mechanical strength is achievable, and a tool creates significant value for engineering applications.

Additive manufacturing technologies in the oral implant clinic: A review of current applications and progress

Additive manufacturing (AM) technologies can enable the direct fabrication of customized physical objects with complex shapes, based on computer-aided design models. This technology is changing the digital manufacturing industry and has become a subject of considerable interest in digital implant dentistry. Personalized dentistry implant treatments for individual patients can be achieved through Additive manufacturing. Herein, we review the applications of Additive manufacturing technologies in oral implantology, including implant surgery, and implant and restoration products, such as surgical guides for implantation, custom titanium meshes for bone augmentation, personalized or non-personalized dental implants, custom trays, implant casts, and implant-support frameworks, among others. In addition, this review also focuses on Additive manufacturing technologies commonly used in oral implantology. Stereolithography, digital light processing, and fused deposition modeling are often used to construct surgical guides and implant casts, whereas direct metal laser sintering, selective laser melting, and electron beam melting can be applied to fabricate dental implants, personalized titanium meshes, and denture frameworks. Moreover, it is sometimes required to combine Additive manufacturing technology with milling and other cutting and finishing techniques to ensure that the product is suitable for its final application.

Long-Term Antibody Release Polycaprolactone Capsule and the Release Kinetics in Natural and Accelerated Degradation

Although therapy using monoclonal antibodies (mAbs) has been steadily successful over the last 20 years, the means of delivery of mAbs has not been optimized, especially for long-term delivery. Frequent injections or infusions have been the current standard of care. In this study, we have developed a long-term antibody biodegradable implant using a porous polycaprolactone (PCL) capsule. It released bevacizumab (Bev) slowly for 8 months to date. The Bev release kinetics fit a drug release model with experimental data of the diffusion coefficient and partition coefficient through the polymer capsule. Since screening drug release profiles for the long term (>6 months) is time consuming, an accelerated degradation method was used after validating the characteristics of the PCL capsule in natural and accelerated degradation conditions. The correlation of the time period between natural and accelerated degradation was determined. Overall, the study suggests that mAbs can be released from a porous PCL capsule without an effect of the polymer degradation over a long period (∼6 months) and the long-term release kinetics can be determined by the accelerated degradation within 14 days.

Continuous Processing of Micropellets via Hot-Melt Extrusion

Microparticulate drug delivery systems, e.g., micropellets (MPs), are used in a variety of pharmaceutical formulations such as suspensions, injectable systems, and capsules. MPs are currently manufactured mainly via batch, solvent-based processes, e.g., spray-drying and solvent evaporation-extraction. In this paper, we present a novel, solvent-free, continuous hot-melt extrusion-based approach with an inline cold pelletization step and the potential of unprecedented on-the-fly formulation changes, aiming at producing the smallest particles usable for injectable applications. A biodegradable, crystalline dispersion consisting of poly(DL-lactic acid) (PLA) filled with metformin as the model drug was chosen on purpose to elucidate the broad applicability of the process also to formulations with limited stretchability and complex pelletizability. Next to optical/statistical particle analyses and in-line high-speed camera investigations providing insights into the pelletization process, the injectability of the most promising micropellets was compared to that of one marketed formulation. Fast extrudate haul-off speeds and high numbers of pelletizer knives resulted in particles with a narrow and small particle size distribution with a d₅₀ below 270 µm and aspect ratios close to 1. To omit protruding drug particles to ensure sufficient extrudate stretchability and allow for the smallest MPs, it was found that the d₉₀ of the embedded drug must be significantly below the extrudate diameter. Upon adapting the syringe diameter, the produced micropellets revealed similar injectability parameters to the marketed formulation, showcasing the potential that the proposed setup has for the manufacturing of novel microparticulate formulations.

Resistance of 3D-Printed Components, Test Specimens and Products to Work under Environmental Conditions-Review

The development of additive manufacturing methods known as "3D printing" started in the 1980s. In these methods, spatial models are created from a semi-finished product such as a powder, filament or liquid. The model is most often created in layers, which are created from the semi-finished product, which is most often subjected to thermal treatment or using light or ultraviolet rays. The technology of additive manufacturing has both advantages and disadvantages when compared to the traditionally used methods of processing thermoplastic materials, such as, for example, injection or extrusion. The most important advantages are low cost, flexibility and speed of manufacturing of elements with different spatial shapes. From the point of view of the user of the product, the most important disadvantages are the lower mechanical properties and lower resistance to environmental factors that occur during the use of the manufactured products. The purpose of this review is to present current information and a compilation of features in the field of research on the effects of the interactions of different types of environments on the mechanical properties of 3D-manufactured thermoplastic products. Changes in the structure and mechanical properties of the material under the influence of factors such as humidity, salt, temperature, UV rays, gasoline and the environment of the human body are presented. The presented article enables the effects of environmental conditions on common materials used in 3D printing technology to be collated in one place.

Surgical planning and finite element analysis for the neurocraneal protection in cranioplasty with PMMA: A case study

New developments in terms of additive manufacturing, computational tools and mathematical simulation techniques have favored the development of successful methodologies for the restoration or restitution of bone structures in the human body. Likewise, achievements in Materials Science have allowed the development of biocompatible composites capable of achieving mechanical characteristics and biological similarities comparable to those of natural bone. Without considering the advantages and disadvantages of some biomaterials with respect to others, this research aims to evaluate the surgical planning, the design process, the impact resistance and the critical deflection of a customized cranial implant manufactured from polymethylmethacrylate (PMMA). With the support of finite element methods (FEM), the level of neurocranial protection offered by the implant is assessed.

Low-Cost Cranioplasty—A Systematic Review of 3D Printing in Medicine

The high cost of biofabricated titanium mesh plates can make them out of reach for hospitals in low-income countries. To increase the availability of cranioplasty, the authors of this work investigated the production of polymer-based endoprostheses. Recently, cheap, popular desktop 3D printers have generated sufficient opportunities to provide patients with on-demand and on-site help. This study also examines the technologies of 3D printing, including SLM, SLS, FFF, DLP, and SLA. The authors focused their interest on the materials in fabrication, which include PLA, ABS, PET-G, PEEK, and PMMA. Three-dimensional printed prostheses are modeled using widely available CAD software with the help of patient-specific DICOM files. Even though the topic is insufficiently researched, it can be perceived as a relatively safe procedure with a minimal complication rate. There have also been some initial studies on the costs and legal regulations. Early case studies provide information on dozens of patients living with self-made prostheses and who are experiencing significant improvements in their quality of life. Budget 3D-printed endoprostheses are reliable and are reported to be significantly cheaper than the popular counterparts manufactured from polypropylene polyester.

Studying the effect of polymethyl methacrylate polymer opticals fibers (POFs) on the performance of composite materials based on the polyether ether ketone (PEEK) polymer matrix

More recently, various techniques have been implemented for the sensors manufacturing purpose, such as fiber Bragg gratings fibers (FBG) that allows variable core refractive index suitable for a large scale of measurements types, fiber optic evanescent waves (FOEW) for water parameters measurement, microstructured and crystal photonic optical fibers, polymers optical fiber (POFs), and so on. In this perspective, the objective of this work is to study the reliability and the origin of the resistance of each fiber-matrix interface of the composite materials PMMA/PEEK, Topas/PEEK, and Topas-Zeonex/PEEK. The genetic simulation is based on the probabilistic approach of Weibull to calculate the damage at the interface by crossing the two damages of the matrix and the fiber respectively. The results show that the PMMA/PEEK composite is the most resistant to the mechanical stresses applied compared to those Topas/PEEK and Topas-Zeonex/PEEK; these results were confirmed by the level of damage to the interface observed for the studied materials. The performed calculations are in good agreement with the analytical results of Cox, where he demonstrated that Young's modulus of fibers have an important influence on the shear strength of the fiber-matrix interface of composite materials. Based on the obtained results, the present study gives the opportunity for the proposed materials (PMMA/PEEK and Zeonex/PEEK) to be as potential candidates for the smart digital applications and telecoms aims.

The Surface Characteristics, Microstructure and Mechanical Properties of PEEK Printed by Fused Deposition Modeling with Different Raster Angles

Additive manufacturing provides a novel and robust way to prepare medical product with anatomic matched geometry and tailored mechanical performance. In this study, the surface characteristics, microstructure, and mechanical properties of fused deposition modeling (FDM) prepared polyether-ether-ketone (PEEK) were systematically studied. During the FDM process, the crystal unit cell and thermal attribute of PEEK material remained unchanged, whereas the surface layer generally became more hydrophilic with an obvious reduction in surface hardness. Raster angle has a significant effect on the mechanical strength but not on the failure mechanism. In practice, FDM fabricated PEEK acted more like a laminate rather than a unified structure. Its main failure mechanism was correlated to the internal voids. The results show that horizontal infill orientation with 30° raster angle is promising for a better comprehensive mechanical performance, and the corresponding tensile, flexural, and shear strengths are (76.5 ± 1.4) MPa, (149.7 ± 3.0) MPa, and (55.5 ± 1.8) MPa, respectively. The findings of this study provide guidelines for FDM-PEEK to enable its realization in applications such as orthopedic implants.

Development of Dental Poly(methyl methacrylate)-Based Resin for Stereolithography Additive Manufacturing

Poly(methyl methacrylate) (PMMA) is widely used in dental applications. However, PMMA specialized for stereolithography (SLA) additive manufacturing (3D-printing) has not been developed yet. This study aims to develop a novel PMMA-based resin for SLA 3D-printing by mixing methyl methacrylate (MMA), ethylene glycol dimethacrylate (EGDMA), and PMMA powder in various mixing ratios. The printability and the viscosity of the PMMA-based resins were examined to determine their suitability for 3D-printing. The mechanical properties (flexural strength and Vickers hardness), shear bond strength, degree of conversion, physicochemical properties (water sorption and solubility), and cytotoxicity for L929 cells of the resulting resins were compared with those of three commercial resins: one self-cured resin and two 3D-print resins. EGDMA and PMMA were found to be essential components for SLA 3D-printing. The viscosity increased with PMMA content, while the mechanical properties improved as EGDMA content increased. The shear bond strength tended to decrease as EGDMA increased. Based on these characteristics, the optimal composition was determined to be 30% PMMA, 56% EGDMA, 14% MMA with flexural strength (84.6 ± 7.1 MPa), Vickers hardness (21.6 ± 1.9), and shear bond strength (10.5 ± 1.8 MPa) which were comparable to or higher than those of commercial resins. The resin’s degree of conversion (71.5 ± 0.7%), water sorption (19.7 ± 0.6 μg/mm³), solubility (below detection limit), and cell viability (80.7 ± 6.2% at day 10) were all acceptable for use in an oral environment. The printable PMMA-based resin is a potential candidate material for dental applications.

Personalised urethra pessaries prepared by material extrusion-based additive manufacturing

Material extrusion-based additive manufacturing, commonly referred to as 3D-printing, is regarded as the key technology to pave the way for personalised medical treatment. This study explores the technique's potential in customising vaginal inserts with complex structures, so-called urethra pessaries. A novel, flawlessly 3D-printable and biocompatible polyester-based thermoplastic elastomer serves as the feedstock. Next to the smart selection of the 3D-printing parameters cross-sectional diameter and infill to tailor the pessary's mechanical properties, we elaborate test methods accounting for its application-specific requirements for the first time. The key property, i.e. the force the pessary exerts on the urethra to relief symptoms of urinary incontinence, is reliably adjusted within a broad range, including that of the commercial injection-moulded silicone product. The pessaries do not change upon long-term exposure to vaginal fluid simulant and compression (in-vivo conditions), satisfying the needs of repeated pessary use. Importantly, the vast majority of the 3D-printed pessaries allows for self-insertion and self-removal without any induced pessary rupture. Summarising, 3D-printed pessaries are not only a reasonable alternative to the commercial products, but build the basis to effectively treat inhomogeneous patient groups. They make the simple but very effective pessary therapy finally accessible to every woman.

Effect of Printing Parameters on the Thermal and Mechanical Properties of 3D-Printed PLA and PETG, Using Fused Deposition Modeling

Fused Deposition Modeling (FDM) can be used to manufacture any complex geometry and internal structures, and it has been widely applied in many industries, such as the biomedical, manufacturing, aerospace, automobile, industrial, and building industries. The purpose of this research is to characterize the polylactic acid (PLA) and polyethylene terephthalate glycol (PETG) materials of FDM under four loading conditions (tension, compression, bending, and thermal deformation), in order to obtain data regarding different printing temperatures and speeds. The results indicated that PLA and PETG materials exhibit an obvious tensile and compression asymmetry. It was observed that the mechanical properties (tension, compression, and bending) of PLA and PETG are increased at higher printing temperatures, and that the effect of speed on PLA and PETG shows different results. In addition, the mechanical properties of PLA are greater than those of PETG, but the thermal deformation is the opposite. The above results will be a great help for researchers who are working with polymers and FDM technology to achieve sustainability.

3D printed PEEK/HA composites for bone tissue engineering applications: Effect of material formulation on mechanical performance and bioactive potential

Polyetheretherketone (PEEK) is a biocompatible polymer widely used for biomedical applications. Because it is biologically inert, bioactive phases, such as nano-hydroxyapatite (HA), have been added to PEEK in order to improve its bioactivity. 3D printing (3DP) technologies are being increasingly used today to manufacture patient specific devices and implants. However, processing of PEEK is challenging due to its high melting point which is above 340 °C. In this study, PEEK-based filaments containing 10 wt% of pure nano-HA, strontium (Sr)- doped nano-HA and Zinc (Zn)-doped nano-HA were produced via hot-melt extrusion and subsequently 3D printed via fused deposition modelling (FDM), following an initial optimization process. The raw materials, extruded filaments and 3D printed samples were characterized in terms of physicochemical, thermal and morphological analysis. Moreover, the mechanical performance of 3D printed specimens was assessed via tensile tensing. Although an increase in the melting point and a reduction in crystallization temperature was observed with the addition of HA and doped HA to pure PEEK, there was no noticeable increase in the degree of crystallinity. Regarding the mechanical behavior, no significant differences were detected following the addition of the inorganic phases to the polymeric matrix, although a small reduction in the ultimate tensile strength (~14%) and Young's modulus (~5%) in PEEK/HA was observed in comparison to pure PEEK. Moreover, in vitro bioactivity of 3D printed samples was evaluated via a simulated body fluid immersion test for up to 28 days; the formation of apatite was observed on the surfaces of sample surfaces containing HA, SrHA and ZnHA. These results indicate the potential to produce bioactive, 3DP PEEK composites for challenging applications such as in craniofacial bone repair.

Novel polyester-based thermoplastic elastomers for 3D-printed long-acting drug delivery applications

To improve patient compliance and personalised drug delivery, long-acting drug delivery devices (LADDDs), such as implants and inserts, greatly benefit from a customisation in their shape through the emerging 3D-printing technology, since their production usually follows a one-size-fits-most approach. The use of 3D-printing for LADDDs, however, is mainly limited by the shortage of flawlessly 3D-printable, yet biocompatible materials. The present study tackles this issue by introducing a novel, non-biodegradable material, namely a polyester-based thermoplastic elastomer (TPC) - a multi-block copolymer containing alternating semi-crystalline polybutylene terephthalate hard segments and poly-ether-terephthalate amorphous soft segments. Next to a detailed description of the material's 3D-printability by mechanical, rheological and thermal analyses, which was found to be superior to that of conventional polymers (ethylene-vinyl acetates (EVA)), this study establishes the fundamental understandings of the interactions between progesterone (P4) and TPC and drug-releasing properties of TPC for the first time. P4-loaded LADDDs based on TPC, prepared via an elaborated solvent-immersion technique, enable the release of P4 at pharmacologically relevant rates, similar to those of marketed formulations based on EVA and silicones. Additionally, TPC demonstrated an exceptional 3D-printability for a wide selection of implant sizes and complex geometries.

Strength and elastic properties of 3D printed PVDF-based parts for lightweight biomedical applications

Research results on 3D printed fluoropolymers are scarce since the filaments were introduced commercially only in the last several years to enable fused filament fabrication (FFF) of structural components for more demanding service conditions, where chemical, UV or fire resistance, high purity, sterilizability or biocompatibility are critical such as in biomedical industry. This experimental study reports on additive manufacturing and quasi-static mechanical testing of polyvinylidene fluoride (PVDF) and in-vitro cytocompatible polyvinylidene fluoride-co-hexafluoropropylene (PVDF-HFP) specimens that were 3D printed with different infill patterns at 75% density (linear, cubic, cross, concentric, octet, zigzag, triangular). Recommendations are provided for addressing issues related to weak adhesion and obtrusive warping, which occur in open-chamber FFF printer due to semi-crystalline and hydrophobic nature of PVDF-based thermoplastics. The measured tensile and flexural stress-strain curves are analyzed to determine the influence of strut-based infills on the strength and elastic performance by including comparisons in ratios between strength, modulus of elasticity and weight of the specimens. The concentric pattern demonstrates the highest tensile strength, while the cross and triangular lattices - the lowest one. In three-point bending, the linear pattern delivers the lowest strength, while the rest exhibit comparable mechanical properties. The results are conducive to the design of 3D printable PVDF homopolymer and copolymer load-bearing structures serving as lightweight high-performance components in biomedical applications.

Structure, properties, and bioactivity of 3D printed PAEKs for implant applications: A systematic review

Additive manufacturing (AM) of high temperature polymers, specifically polyaryletherketones (PAEK), is gaining significant attention for medical implant applications. As 3D printing systems evolve toward point of care manufacturing, research on this topic continues to expand. Specific regulatory guidance is being developed for the safe management of 3D printing systems in a hospital environment. PAEK implants can benefit from many advantages of AM such as design freedom, material and antibacterial drug incorporation, and enhanced bioactivity provided by cancellous bone-like porous designs. In addition to AM PAEK bioactivity, the biomechanical strength of 3D printed implants is crucial to their performance and thus widely studied. In this review, we discuss the printing conditions that have been investigated so far for additively manufactured PAEK implant applications. The effect of processing parameters on the biomechanical strength of implants is summarized, and the bioactivity of PAEKs, along with material and drug incorporation, is also covered in detail. Finally, the therapeutic areas in which 3D printed PAEK implants are investigated and utilized are reviewed.

Personalized Biomechanical Analysis of the Mandible Teeth Behavior in the Treatment of Masticatory Muscles Parafunction

A 3D finite element model of the mandible dentition was developed, including 14 teeth, a periodontal ligament (PDL), and a splint made of polymethylmethacrylate (PMMA). The study considered three design options: 1—the case of splint absence; 2—the case of the splint presence installed after manufacture; and 3—the case of splint presence installed after correction (grinding) performed to ensure a uniform distribution of occlusal force between the teeth. For cases of absence and presence of splint, three measurements of the functional load were performed using the T-Scan III software and hardware complex (TekScan, Boston, MA, USA). It was found that the presence of a splint led to a decrease in the total value of the occlusive load and to a uniform distribution between all the mandible teeth. The occlusal force was considered as a static vertical force evenly distributed between the nodes belonging to the occlusive surface of the corresponding tooth for the first design option and the occlusal surface of the splint for the second and third ones, respectively. As a result of the study, it was concluded that the splint usage was effective in order to change the distribution of the functional load during the treatment of proved masticatory muscles’ parafunction; the safety of using a splint for teeth and surrounding tissues under the influence of the considered functional load was shown; the potential applicability of PMMA as a structural material of a splint that had been used for the treatment of masticatory muscles’ parafunction was established.

Effects of printing path and material components on mechanical properties of 3D-printed polyether-ether-ketone/hydroxyapatite composites

Polyether-ether-ketone (PEEK) exhibits excellent mechanical properties and biocompatibility. Three-dimensional (3D) printing of PEEK bone substitutes has been widely used in clinical application. However, the inertness of pure PEEK hinders its integration with the surrounding bone tissue. In this study, for the first time, PEEK/hydroxyapatite (HA) composite specimens were fabricated using fused filament fabrication (FFF) technology. PEEK/HA filaments with HA contents of 0-30 wt% were fabricated via mechanical mixing and extrusion. The HA distributions inside the composite matrix and the surface morphology characteristics of the PEEK/HA composites were examined. The effects of the printing path and HA content on the mechanics of the PEEK/HA composites were systematically investigated. The results indicated that the HA particles were uniformly distributed on the composite matrix. With an increase in the HA content, the modulus of the PEEK/HA composite increased, while the strength and failure strain concomitantly decreased. When the HA content increased to 30 wt%, the tensile modulus of the composite increased by 68.6% compared with that of pure PEEK printed along the horizontal 90° path, while the tensile strength decreased by 48.2% compared with that of pure PEEK printed along the vertical 90° path. The fracture elongation of the printed specimens with different HA contents decreased in the following order: horizontal 0° > horizontal 90° > vertical 90°. The best comprehensive mechanical properties were achieved for pure PEEK fabricated along the horizontal 0° path. The results indicate that FFF technology is applicable for additive manufacturing of PEEK/HA composites with controllable compositions. Printed PEEK/HA composites have potential for applications in the design and manufacturing of personalized bone substitutes.

Mechanical properties of HA@Ag/PLA nanocomposite structures prepared by extrusion-based additive manufacturing

This research deals with understanding the directional mechanical performance of polylactide (PLA) thermoplastic polymer during 3D-printing based on material extrusion technology, as influenced by the incorporation of silver-modified hydroxyapatite (HA) nanoparticles between layer-upon-layer deposits. Formation of perfect bonding between the stacked layers upon additive manufacturing (AM) consolidation and homogenous dispersion of developed nanoparticles between the layers characterized in correlation with the induced thermo-mechanical history during the deposition process. Subsequently, by conducting tensile, bending, and impact energy tests across different sections, the ultimate level and anisotropy in mechanical properties of produced 3D-layered nanocomposite structures were assessed. The results revealed the admirable dependency of mechanical properties on the testing plane specifically for the Z-section compared to the others, which indicates the strong vertical bonding between the layers as its impact effect significantly improved by the role of HA@Ag nanoparticles. The optimized consolidated nanocomposite material exhibited an excellent combination of various mechanical properties for a polymer-based structure that under the extreme state they can express as the tensile strength of up to ~120 MPa, bending strength of up to ~90 MPa, and absorbed impact energy of up to ~17 J/m.

Processing Conditions of a Medical Grade Poly(Methyl Methacrylate) with the Arburg Plastic Freeforming Additive Manufacturing Process

The Arburg Plastic Freeforming process (APF) is a unique additive manufacturing material jetting method. In APF, a thermoplastic material is supplied as pellets, melted and selectively deposited as droplets, enabling the use of commercial materials in their original shape instead of filaments. The medical industry could significantly benefit from the use of additive manufacturing for the onsite fabrication of customized medical aids and therapeutic devices in a fast and economical way. In the medical field, the utilized materials need to be certified for such applications and cannot be altered in any way to make them printable, because modifications annul the certification. Therefore, it is necessary to modify the processing conditions rather than the materials for successful printing. In this research, a medical-grade poly(methyl methacrylate) was analyzed. The deposition parameters were kept constant, while the drop aspect ratio, discharge rate, melt temperatures, and build chamber temperature were varied to obtain specimens with different geometrical accuracy. Once satisfactory geometrical accuracy was obtained, tensile properties of specimens printed individually or in batches of five were tested in two different orientations. It was found that parts printed individually with an XY orientation showed the highest tensile properties; however, there is still room for improvement by optimizing the processing conditions to maximize the mechanical strength of printed specimens.

Experimental and Numerical Analysis for the Mechanical Characterization of PETG Polymers Manufactured with FDM Technology under Pure Uniaxial Compression Stress States for Architectural Applications

This paper presents the numerical and experimental analysis performed on the polymeric material Polyethylene Terephthalate Glycol (PETG) manufactured with Fused Deposition Modeling Technology (FDM) technology, aiming at obtaining its mechanical characterization under uniaxial compression loads. Firstly, with the objective of evaluating the printing direction that poses a greater mechanical strength, eighteen test specimens were manufactured and analyzed according to the requirements of the ISO-604 standards. After that, a second experimental test analyzed the mechanical behavior of an innovative structural design manufactured in Z and X–Y directions under uniaxial compression loads according to the requirements of the Spanish CTE standard. The experimental results point to a mechanical linear behavior of PETG in X, Y and Z manufacturing directions up to strain levels close to the yield strength point. SEM micrographs show different structural failures linked to the specimen manufacturing directions. Test specimens manufactured along X present a brittle fracture caused by a delamination process. On the contrary, test specimens manufactured along X and Y directions show permanent plastic deformations, great flexibility and less strength under compression loads. Two numerical analyses were performed on the structural part using Young’s compression modulus obtained from the experimental tests and the load specifications required for the Spanish CTE standards. The comparison between numerical and experimental results presents a percentage of relative error of 2.80% (Z-axis), 3.98% (X-axis) and 3.46% (Y-axis), which allows characterizing PETG plastic material manufactured with FDM as an isotropic material in the numerical simulation software without modifying the material modeling equations in the data software. The research presented here is of great help to researchers working with polymers and FDM technology for companies that might need to numerically simulate new designs with the PETG polymer and FDM technology.