Multimaterial 3D Printing of Highly Stretchable Silicone Elastomers

4D Printing for Biomedical Applications

4D (bio-)printing endows 3D printed (bio-)materials with multiple functionalities and dynamic properties. 4D printed materials have been recently used in biomedical engineering for the design and fabrication of biomedical devices, such as stents, occluders, microneedles, smart 3D-cell engineered microenvironments, drug delivery systems, wound closures, and implantable medical devices. However, the success of 4D printing relies on the rational design of 4D printed objects, the selection of smart materials, and the availability of appropriate types of external (multi-)stimuli. Here, this work first highlights the different types of smart materials, external stimuli, and design strategies used in 4D (bio-)printing. Then, it presents a critical review of the biomedical applications of 4D printing and discusses the future directions of biomedical research in this exciting area, including in vivo tissue regeneration studies, the implementation of multiple materials with reversible shape memory behaviors, the creation of fast shape-transformation responses, the ability to operate at the microscale, untethered activation and control, and the application of (machine learning-based) modeling approaches to predict the structure-property and design-shape transformation relationships of 4D (bio)printed constructs.

Voxel Design of Grayscale DLP 3D-Printed Soft Robots

Grayscale digital light processing (DLP) printing is a simple yet effective way to realize the variation of material properties by tuning the grayscale value. However, there is a lack of available design methods for grayscale DLP 3D-printed structures due to the complexities arising from the voxel-level grayscale distribution, nonlinear material properties, and intricate structures. Inspired by the dexterous motions of natural organisms, a design and fabrication framework for grayscale DLP-printed soft robots is developed by combining a grayscale-dependent hyperelastic constitutive model and a voxel-based finite-element model. The constitutive model establishes the relationship between the projected grayscale value and the nonlinear mechanical properties, while the voxel-based finite-element model enables fast and efficient calculation of the mechanical performances with arbitrarily distributed material properties. A multiphysics modeling and experimental method is developed to validate the homogenization assumption of the degree of conversion (DoC) variation in a single voxel. The design framework is used to design structures with reduced stress concentration and programmable multimodal motions. This work paves the way for integrated design and fabrication of functional structures using grayscale DLP 3D printing.

Analytical model of friction at low shear rates for soft materials in 3D printing

BACKGROUND

The biological properties of silicone elastomers such as polydimethylsiloxane (PDMS) have widespread use in biomedicine for soft tissue implants, contact lenses, soft robots, and many other small medical devices, due to its exceptional biocompatibility. Additive manufacturing of soft materials still has significant challenges even with major advancements that have occurred in development of these technologies for customized medical devices and tissue engineering.

OBJECTIVE

The aim of this study was to develop a mathematical model of tangential stress in relation to shear stress, shear rate, 3D printing pressure and velocity, for non-Newtonian gels and fluids that are used as materials for 3D printing.

METHOD

This study used FENE (finitely extensible nonlinear elastic model) model, for non-Newtonian gels and fluids to define the dependences between tangential stress, velocity, and pressure, considering viscosity, shear stress and shear rates as governing factors in soft materials friction and adhesion. Experimental samples were fabricated as showcases, by SLA and FDM 3D printing technologies: elastic polymer samples with properties resembling elastic properties of PDMS and thermoplastic polyurethane (TPU) samples. Experimental 3D printing parameters were used in the developed analytical solution to analyse the relationships between governing influential factors (tangential stress, printing pressure, printing speed, shear rate and friction coefficient). Maple software was used for numerical modelling.

RESULTS

Analytical model applied on a printed elastic polymer, at low shear rates, exhibited numerical values of tangential stress of 0.208-0.216 N m - 2 at printing velocities of 0.9 to 1.2 mm s - 1, while the coefficient of friction was as low as 0.09-0.16. These values were in accordance with experimental data in literature. Printing pressure did not significantly influence tangential stress, whereas it was slightly influenced by shear rate changes. Friction coefficient linearly increased with tangential stress.

CONCLUSION

Simple analytical model of friction for elastic polymer in SLA 3D printing showed good correspondence with experimental literature data for low shear rates, thus indicating possibility to use it for prediction of printing parameters towards desired dimensional accuracy of printed objects. Further development of this analytical model should enable other shear rate regimes, as well as additional soft materials and printing parameters.

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.

Accuracy and resolution of conventional and additively manufactured silicone elastomers as applied in maxillofacial therapies

STATEMENT OF PROBLEM

Silicone elastomers are becoming more readily available for additive manufacturing, which may be advantageous for fabricating maxillofacial prostheses. However, the properties of three-dimensionally (3D) printed silicone as compared with conventionally processed silicone have not been well studied.

PURPOSE

The purpose of this in vitro study was to compare the dimensional accuracy and surface resolution of additively manufactured with conventional room-temperature vulcanized (RTV) silicones.

MATERIAL AND METHODS

A custom aluminum mold was used to generate hand-spatulated specimens (A103 and VerSilTal-50F, n=20). A computer-aided design and computer-aided manufacturing workflow was used to generate additively manufactured specimens (Sil30 and TrueSil, n=20). Digital surface scans of each specimen were recorded; a scan of the mold served as the control. Surface dimensions were measured with a digital metrology software program, while digital overlays were made using a 3D processing software program. The surface resolution of the specimens was assessed by analyzing 4 topographical landmarks (flat surfaces, raised lines, domes, and scribed lines) with a visual qualitative grading scale. The data were analyzed with 1-way analysis of variance, followed by a Student-Newman-Keuls post hoc test (α=.05).

RESULTS

The specimens demonstrated statistical differences in trueness and precision (P<.001). The TrueSil specimens showed the largest deviation in measurements of trueness and precision (up to -1.374%). The other specimens yielded percentage mean differences that were more consistently within the range of the American Dental Association International Organization for Standardization standard for elastomers. The manually fabricated specimens yielded more consistently ideal ratings for resolution than did the additively manufactured ones, with the Sil30 specimens receiving the most Charlie (not clinically acceptable) ratings.

CONCLUSIONS

Numerical differences between each specimen and the control were considered negligible for maxillofacial applications. Notable discrepancies related to the quality of resolution, wherein the benchtop-manufactured specimens consistently generated better results compared with additively manufactured ones. Other factors, such as resiliency, odor, and cost, posed limitations in justifying the use of silicones in a direct-to-print workflow.

Three-Dimensional Printing of Ultrasoft Silicone with a Functional Stiffness Gradient

A methodology for three-dimensionally printing ultrasoft silicone with a functional stiffness gradient is presented. Ultraviolet-cure silicone was deposited via two independently controlled extruders into a thixotropic, gel-like, silicone oil-based support matrix. Each extruder contained a different liquid silicone formulation. The extrusion rates were independently varied during printing such that the combined selectively deposited material contained different ratios of the two silicones, resulting in localized control of material stiffness. Tests to validate the process are reported, including tensile testing of homogeneous cubic specimens to quantify the range of material stiffness that could be printed, indentation testing of cuboid specimens to characterize printed stiffness gradients, and vibratory testing of synthetic multilayer vocal fold (VF) models to demonstrate that the method may be applied to the fabrication of biomechanical models for voice production research. The cubic specimens exhibited linear stress-strain data with tensile elasticity modulus values between 1.11 and 27.1 kPa, more than a factor of 20 in stiffness variation. The cuboid specimens exhibited material variations that were visually recognizable and quantifiable via indentation testing. The VF models withstood rigorous phonatory flow-induced vibration and exhibited vibratory characteristics comparable to those of previous models. Overall, while process refinements are needed, the results of these tests demonstrate the ability to print ultrasoft silicone with stiffness gradients.

3D Printing of Double Network Granular Elastomers with Locally Varying Mechanical Properties

Fast advances in the design of soft actuators and robots demand for new soft materials whose mechanical properties can be changed over short length scales. Elastomers can be formulated as highly stretchable or rather stiff materials and hence, are attractive for these applications. They are most frequently cast such that their composition cannot be changed over short length scales. A method that allows to locally change the composition of elastomers on hundreds of micrometer lengths scales is direct ink writing (DIW). Unfortunately, in the absence of rheomodifiers, most elastomer precursors cannot be printed through DIW. Here, 3D printable double network granular elastomers (DNGEs) whose ultimate tensile strain and stiffness can be varied over an unprecedented range are introduced. The 3D printability of these materials is leveraged to produce an elastomer finger containing rigid bones that are surrounded by a soft skin. Similarly, the rheological properties of the microparticle-based precursors are leveraged to cast elastomer slabs with locally varying stiffnesses that deform and twist in a predefined fashion. These DNGEs are foreseen to open up new avenues in the design of the next generation of smart wearables, strain sensors, prosthesis, soft actuators, and robots.

A Guide to Printed Stretchable Conductors

Printing of stretchable conductors enables the fabrication and rapid prototyping of stretchable electronic devices. For such applications, there are often specific process and material requirements such as print resolution, maximum strain, and electrical/ionic conductivity. This review highlights common printing methods and compatible inks that produce stretchable conductors. The review compares the capabilities, benefits, and limitations of each approach to help guide the selection of a suitable process and ink for an intended application. We also discuss methods to design and fabricate ink composites with the desired material properties (e.g., electrical conductance, viscosity, printability). This guide should help inform ongoing and future efforts to create soft, stretchable electronic devices for wearables, soft robots, e-skins, and sensors.

Direct-Ink-Writing 3D-Printed Bioelectronics

The development of wearable and implantable bioelectronics has garnered significant momentum in recent years, driven by the ever-increasing demand for personalized health monitoring, remote patient management, and real-time physiological data collection. The elevated sophistication and advancement of these devices have thus led to the use of many new and unconventional materials which cannot be fulfilled through traditional manufacturing techniques. Three-dimension (3D) printing, also known as additive manufacturing, is an emerging technology that opens new opportunities to fabricate next-generation bioelectronic devices. Some significant advantages include its capacity for material versatility and design freedom, rapid prototyping, and manufacturing efficiency with enhanced capabilities. This review provides an overview of the recent advances in 3D printing of bioelectronics, particularly direct ink writing (DIW), encompassing the methodologies, materials, and applications that have emerged in this rapidly evolving field. This review showcases the broad range of bioelectronic devices fabricated through 3D printing including wearable biophysical sensors, biochemical sensors, electrophysiological sensors, energy devices, multimodal systems, implantable devices, and soft robots. This review will also discuss the advantages, existing challenges, and outlook of applying DIW 3D printing for the development of bioelectronic devices toward healthcare applications.

Pressure-Activatable Liquid Metal Composites Flexible Sensor with Antifouling and Drag Reduction Functional Surface

Flexible sensors produced through three-dimensional (3D) printing have exhibited promising results in the context of underwater sensing detection (for applications in navigational vehicles and human activities). However, underwater vehicles and activities such as swimming and diving are highly susceptible to drag, which can cause negative impacts such as reduced speed and increased energy consumption. Additionally, microbial adhesion can shorten the service life of these vehicles. However, natural organisms are able to circumvent such problems, with shark skin offering excellent barrier properties and ruffled papillae providing effective protection against fouling. Here, we show that a sandwich system consisting of a spraying layer, conductive elastomer composite, and encapsulation layer can be printed for multifunctional integrated underwater sensors. The modulated viscoelastic properties of liquid metal form the foundation for printing features, while its pressure-activated properties offer the potential for switchable sensors. An integrated drag reduction and antifouling layer were created by combining the shark skin surface shield scale structure with the lotus leaf surface papillae structure. A 3D-printed flexible sensor was designed using our approach to monitor attitude changes and strain in underwater environments, showcasing its capabilities. Our printed sensors can reduce biological attachment density by more than 50% and reduce underwater drag by 8.6-10.3%.

Controlled swelling of biomaterial devices for improved antifouling polymer coatings

Nonspecific interactions between cells and implantable elastomers often leads to failure modes for devices such as catheters, cosmetic and reconstructive implants, and sensors. To reduce these interactions, device surfaces can be coated with hydrophilic polymers, where greater polymer density enhances antifouling properties. Although graft-from coating techniques result in higher density polymer films and lower fouling in controlled settings, simpler graft-to methods show similar results on complex implanted devices, despite limited density. To address the need for improved graft-to methods, we developed Graft then shrink (GtS) where elastomeric materials are temporarily swollen during polymer grafting. Herein, we demonstrate a graft-to based method for poly(oligo(ethylene glycol) methyl ether methacrylate) (pOEGMA) on swollen silicone, GtS, that enhances grafted polymer content and fouling resistance. Total grafted polymer content of pOEGMA on toluene swollen silicone increased over ~ 13 × compared to non-swollen controls, dependent on the degree of silicone swelling. Increases in total grafted polymer within the top 200 µm of the material led to bacterial and mammalian cell adhesion reductions of 75% and 91% respectively, compared to Shrink then Graft (StG) antifouling polymer coated controls. GtS allows for the simple 3D coating of swellable elastomers (e.g., silicone medical devices) with improved antifouling pOEGMA coatings.

Application of 3D Transparent Facemasks in Long-Term Outpatient Rehabilitation of Facial Scars After Burns: A Retrospective Cohort Study of Improved Appearance of Target Scars With Different Healing Time

Severe facial burns may cause scarring problems and affect living quality of patients. With the advent of 3D facemasks, it is being used to treat facial scars; however, its efficacy must be confirmed by adequate studies. A retrospective analysis of 26 patients who visited rehabilitation outpatient clinic from 2017 to 2022. Patients were separated into two groups based on the time to healing (TTH) following burn injury: early healing group (TTH ≤ 21 days) and late healing group (TTH > 21 days). To compare treatment outcomes and differences between the two groups, 3D facemask application was assessed using the Vancouver Scar Scale (VSS), patient satisfaction, and complications. In both groups, there were significant improvements in the total VSS scores (P < .01) and each VSS subscore (P < .01). These scar characteristics improved over time as the treatment progressed. Compared with the late healing group, the early healing group had more obvious effects on improving scar pigmentation (P < .05) and vascularity (P < .05) at similar assessment time points after burns. At the last assessment, there was a significant difference in total VSS scores between groups (P = .009). For the early and late healing groups, respectively, the mean gradient value (SE) of the total VSS scores was 1.550 (0.373) and 1.283 (0.224) over the course of the treatment periods. 3D facemasks are effective in the rehabilitation of facial scars caused by burns, which should be used for prevention and treatment in the initial stages of scar development.

Thermal and UV Curable Formulations of Poly(propylene glycol)-Poly(hydroxyurethane) Elastomers toward Nozzle-Based 3D Photoprinting

In this work, isocyanate-free formulations for poly(propylene glycol) polyurethane elastomers are studied. These formulations are based on poly(propylene glycol) end-capped by CO2-sourced cyclic carbonate (bisCC PPG) macromonomers able to react with amines leading to poly(hydroxyurethane)s. In order to obtain covalent networks, two curing approaches are studied. First, the direct thermally activated cross-linking of bisCC PPG with a mixture of various aliphatic or aromatic diamines and a triamine is investigated, and in particular the nature of the diamine on the mechanical properties. In the second approach, UV-activated formulations are developed by reacting bisCC PPG with allylamine followed by the addition of a trithiol by photoactivated thiol-ene reaction. The swelling tests show that both systems provide highly cross-linked polymer networks and complementary characterizations highlighted excellent mechanical properties. Thanks to the fast curing and adapted viscosity of the developed photoactive formulation, the latter was found suitable for use as a photoresin for 3D printing as demonstrated by printing a vaginal ring by a nozzle-based photoprinter.

Selective Laser Sintering of Polydimethylsiloxane Composites

Conductive silicone elastomer carbon nanotubes (CNTs) composites possess potential applications in a variety of fields, including electronic skin, wearable electronics, and human motion detection. Based on a novel self-made covalent adaptable network (CANs) of polydimethylsiloxane (PDMS) containg dynamic steric-hindrance pyrazole urea bond (PDMS-CANs), CNTs wrapped PDMS-CANs (CNTs@PDMS-CANs) powders were prepared by a liquid phase adsorption and deposition, and were successfully used for selective laser sintering (SLS) three-dimensional printing. SLS-printed PDMS-CANs/CNTs nanocomposites possess high electrical conductivity and low percolation threshold as SLS is one kind of quasi-static processing, which leads to the formation of conductive segregated CNTs network by using the PDMS powders with special CNTs wrapped structure. The introduction of dynamic pyrazole urea bond endows the materials self-healing capability under electrothermal and photothermal stimulus. In addition, due to the resistance difference of the damaged and intact areas, crack diagnosing can be realized by infrared thermograph under electricity. In an application demonstration in strain sensor, the composite exhibits a regular cyclic electrical resistance change at cyclic compression and bending, indicating a relative high reliability.

3D Printing of Ionogels with Complementary Functionalities Enabled by Self-Regulating Ink

Shaping soft and conductive materials into sophisticated architectures through 3D printing is driving innovation in myriad applications, such as robotic counterparts that emulate the synergic functions of biological systems. Although recently developed multi-material 3D printing has enabled on-demand creation of intricate artificial counterparts from a wide range of functional viscoelastic materials. However, directly achieving complementary functionalities in one ink design remains largely unexplored, given the issues of printability and synergy among ink components. In this study, an easily accessible and self-regulating tricomponent ionogel-based ink design to address these challenges is reported. The resultant 3D printed objects, based on the same component but with varying ratios of ink formulations, exhibit distinct yet complementary properties. For example, their Young's modulus can differ by three orders of magnitude, and some structures are rigid while others are ductile and viscous. A theoretical model is also employed for predicting and controlling the printing resolution. By integrating complementary functionalities, one further demonstrates a representative bioinspired prototype of spiderweb, which mimics the sophisticated structure and multiple functions of a natural spiderweb, even working and camouflaging underwater. This ink design strategy greatly extends the material choice and can provide valuable guidance in constructing diverse artificial systems by 3D printing.

Multimaterial Embedded 3D Printing of Composite Reinforced Soft Actuators

Soft pneumatic actuators (SPAs) have attracted enormous attention in the growing field of robotics. Among different SPAs, composite reinforced actuators (CRAs) are widely used because of their simple structure and high controllability. However, multistep molding, a time-consuming method, is still the predominant fabrication method. Here, we propose a multimaterial embedded printing method (ME3P) to fabricate CRAs. In comparison with other 3-dimensional printing methods, our method improves fabrication flexibility greatly. Via the design and fabrication of the reinforced composites' patterns and different geometries of the soft body, we demonstrate actuators with programmable responses (elongation, contraction, twisting, bending, and helical and omnidirectional bending). Finite element analysis is employed for the prediction of pneumatic responses and the inverse design of actuators based on specific actuation needs. Lastly, we use tube-crawling robots as a model system to demonstrate our ability to fabricate complex soft robots for practical applications. This work demonstrates the versatility of ME3P for the future manufacturing of CRA-based soft robots.

Additive Manufacturing by Heating at a Patterned Photothermal Interface

Direct additive manufacturing (AM) of commercial silicones is an unmet need with high demand. We report a new technology, heating at a patterned photothermal interface (HAPPI), which achieves AM of commercial thermoset resins without any chemical modifications. HAPPI integrates desirable aspects of stereolithography with the thermally driven chemical modalities of commercial silicone formulations. In this way, HAPPI combines the geometric advantages of vat photopolymerization with the materials properties of, for example, injection molded silicones. We describe the realization of the new technology, HAPPI printing using a commercial Sylgard 184 polydimethylsiloxane resin, comparative analyses of material properties, and demonstration of HAPPI in targeted applications.

Single-vat single-cure grayscale digital light processing 3D printing of materials with large property difference and high stretchability

Multimaterial additive manufacturing has important applications in various emerging fields. However, it is very challenging due to material and printing technology limitations. Here, we present a resin design strategy that can be used for single-vat single-cure grayscale digital light processing (g-DLP) 3D printing where light intensity can locally control the conversion of monomers to form from a highly stretchable soft organogel to a stiff thermoset within in a single layer of printing. The high modulus contrast and high stretchability can be realized simultaneously in a monolithic structure at a high printing speed (z-direction height 1 mm/min). We further demonstrate that the capability can enable previously unachievable or hard-to-achieve 3D printed structures for biomimetic designs, inflatable soft robots and actuators, and soft stretchable electronics. This resin design strategy thus provides a material solution in multimaterial additive manufacture for a variety of emerging applications.

Biomedical Silicones: Leveraging Additive Strategies to Propel Modern Utility

Silicones have a long history of use in biomedical devices, with unique properties stemming from the siloxane (Si-O-Si) backbone that feature a high degree of flexibility and chemical stability. However, surface, rheological, mechanical, and electrical properties of silicones can limit their utility. Successful modification of silicones to address these limitations could lead to superior and new biomedical devices. Toward improving such properties, recent additive strategies have been leveraged to modify biomedical silicones and are highlighted herein.

Conductive and elastic bottlebrush elastomers for ultrasoft electronics

Understanding biological systems and mimicking their functions require electronic tools that can interact with biological tissues with matched softness. These tools involve biointerfacing materials that should concurrently match the softness of biological tissue and exhibit suitable electrical conductivities for recording and reading bioelectronic signals. However, commonly employed intrinsically soft and stretchable materials usually contain solvents that limit stability for long-term use or possess low electronic conductivity. To date, an ultrasoft (i.e., Young's modulus <30 kPa), conductive, and solvent-free elastomer does not exist. Additionally, integrating such ultrasoft and conductive materials into electronic devices is poorly explored. This article reports a solvent-free, ultrasoft and conductive PDMS bottlebrush elastomer (BBE) composite with single-wall carbon nanotubes (SWCNTs) as conductive fillers. The conductive SWCNT/BBE with a filler concentration of 0.4 - 0.6 wt% reveals an ultralow Young's modulus (<11 kPa) and satisfactory conductivity (>2 S/m) as well as adhesion property. Furthermore, we fabricate ultrasoft electronics based on laser cutting and 3D printing of conductive and non-conductive BBEs and demonstrate their potential applications in wearable sensing, soft robotics, and electrophysiological recording.

3D Printed Silicones with Shape Morphing and Low-Temperature Ultraelasticity

3D printed silicones have demonstrated great potential in diverse areas by combining the advantageous physiochemical properties of silicones with the unparalleled design freedom of additive manufacturing. However, their low-temperature performance, which is of particular importance for polar and space applications, has not been addressed. Herein, a 3D printed silicone foam with unprecedented low-temperature elasticity is presented, which is featured with extraordinary fatigue resistance, excellent shape recovery, and energy-absorbing capability down to a low temperature of -60 °C after extreme compression (an intensive load of over 66000 times its own weight). The foam is achieved by direct writing of a phenyl silicone-based pseudoplastic ink embedded with sodium chloride as sacrificial template. During the water immersion process to create pores in the printed filaments, a unique osmotic pressure-driven shape morphing strategy is also reported, which offers an attractive alternative to traditional 4D printed hydrogels in virtue of the favorable mechanical robustness of the silicone material. The underlying mechanisms for shape morphing and low-temperature elasticity are discussed in detail.

Present and future of extraoral maxillofacial prosthodontics: Cancer rehabilitation

Historically, facial prosthetics have successfully rehabilitated individuals with acquired or congenital anatomical deficiencies of the face. This history includes extensive efforts in research and development to explore best practices in materials, methods, and artisanal techniques. Presently, extraoral maxillofacial rehabilitation is managed by a multiprofessional team that has evolved with a broadened scope of knowledge, skills, and responsibility. This includes the mandatory integration of different professional specialists to cover the bio-psycho-social needs of the patient, systemic health and pathology surveillance, and advanced restorative techniques, which may include 3D technologies. In addition, recent digital workflows allow us to optimize this multidisciplinary integration and reduce the active time of both patients and clinicians, as well as improve the cost-efficiency of the care system, promoting its access to both patients and health systems. This paper discusses factors that affect extraoral maxillofacial rehabilitation's present and future opportunities from teamwork consolidation, techniques utilizing technology, and health systems opportunities.

Mini Review of Reliable Fabrication of Electrode under Stretching for Supercapacitor Application

Currently, there is an increasing demand for portable and wearable electronics. This has necessitated the development of stretchable energy storage devices, while simultaneously maintaining performance. Hence, the electrodes and electrolyte materials used in stretchable supercapacitors should be robust under severe mechanical deformation. Polymers are widely used in the fabrication of stretchable supercapacitors. It is not only crucial to choose good polymer candidates with inherent advantages, but it is also important to design suitable polymer materials for both electrodes and electrolytes. This mini-review explains the concept of stretchable supercapacitors, the theoretical background of polymer-based electrodes for supercapacitors, and the fabrication strategies of stretchable electrodes for supercapacitors. Finally, we present the drawbacks and areas that still need to be developed.

Leveraging ultra-low interfacial tension and liquid-liquid phase separation in embedded 3D bioprinting

Many recently developed 3D bioprinting strategies operate by extruding aqueous biopolymer solutions directly into a variety of different support materials constituted from swollen, solvated, aqueous, polymer assemblies. In developing these 3D printing methods and materials, great care is often taken to tune the rheological behaviors of both inks and 3D support media. By contrast, much less attention has been given to the physics of the interfaces created when structuring one polymer phase into another in embedded 3D printing applications. For example, it is currently unclear whether a dynamic interfacial tension between miscible phases stabilizes embedded 3D bioprinted structures as they are shaped while in a liquid state. Interest in the physics of interfaces between complex fluids has grown dramatically since the discovery of liquid-liquid phase separation (LLPS) in living cells. We believe that many new insights coming from this burst of investigation into LLPS within biological contexts can be leveraged to develop new materials and methods for improved 3D bioprinting that leverage LLPS in mixtures of biopolymers, biocompatible synthetic polymers, and proteins. Thus, in this review article, we highlight work at the interface between recent LLPS research and embedded 3D bioprinting methods and materials, and we introduce a 3D bioprinting method that leverages LLPS to stabilize printed biopolymer inks embedded in a bioprinting support material.

Color variations during digital imaging of facial prostheses subjected to unfiltered ambient light and image calibration techniques within dental clinics: An in vitro analysis

Background

The study aimed to evaluate 1) the amount of color variations presents within clinical images of maxillofacial prosthetic silicone specimens when photographed under different clinically relevant ambient lighting conditions, and 2) whether white balance calibration (WBC) methods were able to mitigate variations in ambient lighting.

Methods

432 measurements were acquired from standardized images of the pigmented prosthetic silicone specimens within different ambient lighting conditions (i.e., 2 windowed and 2 windowless clinics) at noon with no light modifying apparatus. The specimens were photographed once without any white balance calibration (raw), then independently alongside an 18% neutral gray card and Macbeth color chart for calibration in a post-processing (PPWBC) software, and once after camera calibration (CWBC) using a gray card. The LAB color values were extracted from the images and color variations (ΔE) were calculated after referring to the corresponding spectrophotometric values as control.

Results

Images in windowless and windowed clinics exhibited highly significant differences (p < 0.001) with spectrophotometer (control). CWBC demonstrated no significant differences (p > 0.05) in LAB values across windowed clinics. PPWBC using Macbeth color chart produced no significant differences for a* values (p > 0.05) across all clinics while PPWBC by gray card showed no significant differences (p > 0.05) in LAB values when only similar clinics (either windowed or windowless) were compared.

Conclusion

Significant color variations were present for maxillofacial prosthetic specimens owing to natural ambient light. CWBC and PPWBC using color charts were more suitable for color correction across windowed clinics while CWBC and PPWBC using gray cards had better outcomes across windowless setups.

Variable Stiffness Conductive Composites by 4D Printing Dual Materials Alternately

Materials that can be designed with programmable properties and which change in response to external stimuli are of great importance in numerous fields of soft actuators, involving robotics, drug delivery and aerospace applications. In order to improve the interaction of human and robots, materials with variable stiffness are introduced to develop their compliance. A variable stiffness composite has been investigated in this paper, which is composed of liquid metals (LMs) and silicone elastomers. The phase changing materials (LMs) have been encapsulated into silicone elastomer by printing the dual materials alternately with three-dimensional direct ink writing. Such composites enable the control over their own stiffness between soft and rigid states through LM effective phase transition. The tested splines demonstrated that the stiffness changes approximately exceeded 1900%, and the storage modulus is 4.75 MPa and 0.2 MPa when LM is rigid and soft, respectively. In the process of heating up, the stretching strain can be enlarged by at least three times, but the load capacity is weakened. At a high temperature, the resistance of the conductive composites changes with the deformation degree, which is expected to be applied in the field of soft sensing actuators.

3D Printing of Silicone Elastomers for Soft Actuators

A procedure for 3D printing of silicone elastomers with a direct ink writing (DIW) process has demonstrated great potential in areas as diverse as flexible electronics, medical devices, and soft robotics. In this report, we propose a comprehensive guide for printing highly stretchable silicones in response to material, equipment and process dilemmas. Specifically, we first tested the material properties of Dow Corning 737, then modeled and simulated two commonly used needles to select a suitable needle, followed by parameter optimization experiments using the built DIW printer to find out the appropriate printing speed and layer height with a defined air pressure and needle diameter. Finally, the optimal combination of parameters was obtained. For further demonstration, artificial muscles and structurally complex soft grippers were also printed directly to verify the feasibility of high-precision 3D printing of soft actuators with soft materials. We believe that this work could provide a guide for further work using the DIW process to print soft matter in a wide range of application scenarios.

Three-Dimensional Printed Bimodal Electronic Skin with High Resolution and Breathability for Hair Growth

People with neurological deficits face difficulties perceiving their surroundings, resulting in an urgent need for wearable electronic skin (e-skin) that can monitor external stimuli and temperature changes. However, the monolithic structure of e-skin is not conducive to breathability and hinders hair growth, limiting its wearing comfort. In this work, we prepared fully three-dimensional (3D) printed e-skin that allowed hair penetration and growth. This e-skin also achieved simultaneous pressure and temperature detection and a high tactile resolution of 100 cm^-2, which is close to that of human fingertips. The temperature sensor maintained linear measurements within 10-60 °C. The pore microstructure prepared by a sacrificial template method helped the pressure-sensing unit achieve a high sensitivity of 0.213 kPa^-1. Considering the distribution of human hair, the design of the main structure of the e-skin was studied to realize hair penetration and growth. High-performance pressure-sensitive inks and transparent flexible substrate inks for 3D printing were developed, and e-skins combining these functions were realized through multimaterial in situ 3D printing with high accuracy and high consistency. The temperature and pressure sensors separately performed simultaneous detection without interference, and the tactile sensor array accurately identified stimuli at different locations.

High Precision 3D Printing for Micro to Nano Scale Biomedical and Electronic Devices

Three dimensional printing (3DP), or additive manufacturing, is an exponentially growing process in the fabrication of various technologies with applications in sectors such as electronics, biomedical, pharmaceutical and tissue engineering. Micro and nano scale printing is encouraging the innovation of the aforementioned sectors, due to the ability to control design, material and chemical properties at a highly precise level, which is advantageous in creating a high surface area to volume ratio and altering the overall products’ mechanical and physical properties. In this review, micro/-nano printing technology, mainly related to lithography, inkjet and electrohydrodynamic (EHD) printing and their biomedical and electronic applications will be discussed. The current limitations to micro/-nano printing methods will be examined, covering the difficulty in achieving controlled structures at the miniscule micro and nano scale required for specific applications.

Biomimetic and Biologically Compliant Soft Architectures via 3D and 4D Assembly Methods: A Perspective

Recent progress in soft material chemistry and enabling methods of 3D and 4D fabrication-emerging programmable material designs and associated assembly methods for the construction of complex functional structures-is highlighted. The underlying advances in this science allow the creation of soft material architectures with properties and shapes that programmably vary with time. The ability to control composition from the molecular to the macroscale is highlighted-most notably through examples that focus on biomimetic and biologically compliant soft materials. Such advances, when coupled with the ability to program material structure and properties across multiple scales via microfabrication, 3D printing, or other assembly techniques, give rise to responsive (4D) architectures. The challenges and prospects for progress in this emerging field in terms of its capacities for integrating chemistry, form, and function are described in the context of exemplary soft material systems demonstrating important but heretofore difficult-to-realize biomimetic and biologically compliant behaviors.

Phase-Change-Enabled, Rapid, High-Resolution Direct Ink Writing of Soft Silicone

Soft silicone is an ideal flexible material for application, e.g., in soft robotics, flexible electronics, bionics, or implantable biomedical devices. However, gravity-driven sagging, filament stretching, and deformation can cause inevitable defects during rapid manufacturing, making it hard to obtain complex, high-resolution 3D silicone structures with direct ink writing (DIW) technology. Here, rapid DIW of soft silicone enabled by a phase-change-induced, reversible change of the ink's hierarchical microstructure is presented. During printing, the silicone-based ink, containing silica nanoparticles and wax microparticles, is extruded from a heated nozzle into a cold environment under controlled stress. The wax phase change (solid-liquid-solid) during printing rapidly destroys and rebuilds the particle networks, realizing fast control of the ink flow behavior and printability. This high-operating-temperature DIW method is fast (maximum speed ≈3100 mm min^-1 ) and extends the DIW scale range of soft silicone. The extruded filaments have small diameters (50 ± 5 µm), and allow for large spans (≈13-fold filament diameter) and high aspect ratios (≈1), setting a new benchmark in the DIW of soft silicone. Printed silicone structures exhibit excellent performance as flexible sensors, superhydrophobic surfaces, and shape-memory bionic devices, illustrating the potential of the new 3D printing strategy.

Noncovalent reversible binding-enabled facile fabrication of leak-free PDMS microfluidic devices without plasma treatment for convenient cell loading and retrieval

The conventional approach for fabricating polydimethylsiloxane (PDMS) microfluidic devices is a lengthy and inconvenient procedure and may require a clean-room microfabrication facility often not readily available. Furthermore, living cells can't survive the oxygen-plasma and high-temperature-baking treatments required for covalent bonding to assemble multiple PDMS parts into a leak-free device, and it is difficult to disassemble the devices because of the irreversible covalent bonding. As a result, seeding/loading cells into and retrieving cells from the devices are challenging. Here, we discovered that decreasing the curing agent for crosslinking the PDMS prepolymer increases the noncovalent binding energy of the resultant PDMS surfaces without plasma or any other treatment. This enables convenient fabrication of leak-free microfluidic devices by noncovalent binding for various biomedical applications that require high pressure/flow rates and/or long-term cell culture, by simply hand-pressing the PDMS parts without plasma or any other treatment to bind/assemble. With this method, multiple types of cells can be conveniently loaded into specific areas of the PDMS parts before assembly and due to the reversible nature of the noncovalent bonding, the assembled device can be easily disassembled by hand peeling for retrieving cells. Combining with 3D printers that are widely available for making masters to eliminate the need of photolithography, this facile yet rigorous fabrication approach is much faster and more convenient for making PDMS microfluidic devices than the conventional oxygen plasma-baking-based irreversible covalent bonding method.

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The stability of noncovalent PDMS-PDMS binding is dependent on the binding energy instead of the binding strength.

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The noncovalent binding of a special formulation of PDMS is sufficient for reversible assembly of leak-free microfluidic devices.

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The noncovalent binding method enables loading multiple types of cells into PDMS parts before assembling into the final device.

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The PDMS device can be easily dissembled due to the reversible nature of the noncovalent binding for retrieving cells.

A Parametric Study for Tensile Properties of Silicone Rubber Specimen Using the Bowden-Type Silicone Printer

Silicone printing can enable a lot more accessibility and customizability towards utilizing silicone in different applications, including medicine for its biocompatibility. However, challenges existed for printing in specific geometries due to the lack of guidelines and studies on the mechanical properties. To support the understanding of printing three-dimensional silicone structure having different infill patterns and gel-like material, this paper conducted a parametric study for the specimens printed using a Bowden-type silicone printer and measurements of the tensile properties. Four printing parameters of print speed, infill density, flow rate, and infill pattern, are categorized following the Taguchi L9 method, and arranged into the four-parameter-three-level orthogonal array. The signal-to-noise (S/N) ratio was calculated based on the principle of the-larger-the-better, and analysis of variance (ANOVA) was also obtained. Tensile performance was further discussed with the characterization of internal structure, using the cross-sections of the printed specimens. It was found that the change of flow rate is the most significant to the tensile stress; and for the tensile strain, infill pattern was found to be the most significant parameter. The Line infill pattern consistently presented the highest tensile stress. Agglomeration can be seen inside the printed structure, hence optimal printing parameters play an important role for complicated geometry, while ensuring the flow rate and infill density do not exceed a reasonable value. This study would serve as the guideline for printing three-dimensional silicone structures.

Flexible and Stretchable Bioelectronics

Medical science technology has improved tremendously over the decades with the invention of robotic surgery, gene editing, immune therapy, etc. However, scientists are now recognizing the significance of 'biological circuits' i.e., bodily innate electrical systems for the healthy functioning of the body or for any disease conditions. Therefore, the current trend in the medical field is to understand the role of these biological circuits and exploit their advantages for therapeutic purposes. Bioelectronics, devised with these aims, work by resetting, stimulating, or blocking the electrical pathways. Bioelectronics are also used to monitor the biological cues to assess the homeostasis of the body. In a way, they bridge the gap between drug-based interventions and medical devices. With this in mind, scientists are now working towards developing flexible and stretchable miniaturized bioelectronics that can easily conform to the tissue topology, are non-toxic, elicit no immune reaction, and address the issues that drugs are unable to solve. Since the bioelectronic devices that come in contact with the body or body organs need to establish an unobstructed interface with the respective site, it is crucial that those bioelectronics are not only flexible but also stretchable for constant monitoring of the biological signals. Understanding the challenges of fabricating soft stretchable devices, we review several flexible and stretchable materials used as substrate, stretchable electrical conduits and encapsulation, design modifications for stretchability, fabrication techniques, methods of signal transmission and monitoring, and the power sources for these stretchable bioelectronics. Ultimately, these bioelectronic devices can be used for wide range of applications from skin bioelectronics and biosensing devices, to neural implants for diagnostic or therapeutic purposes.

Unprecedented Strength Polysiloxane-Based Polyurethane for 3D Printing and Shape Memory

Thermoplastic polysiloxane-based polyurethane (Si-TPU) has been attracting a great deal of attention because of the dual advantages of polysiloxane and polyurethane. However, the strength of Si-TPU with a traditional structure is low, and improvement is urgently needed for diverse applications. Herein, we design a polysiloxane-based soft segment (SS) with two urethane groups at the end of the polysiloxane chain, and then we prepare a series of Si-TPUs through a designed SS, isophorone diisocyanate and 1,4-butanediol. Such structural design improves the polarity of the SS and endows more regular hydrogen bonds to the polymer molecular chain. As a result, the prepared Si-TPUs exhibit a good microphase separation structure, unprecedentedly high strength, repeatable processing, noncytotoxicity, shape memory properties, and three-dimensional printing capabilities. Moreover, a maximum tensile strength of Si-TPUs can reach 20.3 MPa, exceeding that of other existing Si-based polymer materials. Si-TPUs show great potential for biomedical applications.

Conceptualization of a Sensory Feedback System in an Anthropomorphic Replacement Hand

(1) Background: This paper presents a conceptual design for an anthropomorphic replacement hand made of silicone that integrates a sensory feedback system. In combination with a motorized orthosis, it allows performing movements and registering information on the flexion and the pressure of the fingers. (2) Methods: To create the replacement hand, a three-dimensional (3D) scanner was used to scan the hand of the test person. With computer-aided design (CAD), a mold was created from the hand, then 3D-printed. Bending and force sensors were attached to the mold before silicone casting to implement the sensory feedback system. To achieve a functional and anthropomorphic appearance of the replacement hand, a material analysis was carried out. In two different test series, the properties of the used silicones were analyzed regarding their mechanical properties and the manufacturing process. (3) Results: Individual fingers and an entire hand with integrated sensors were realized, which demonstrated in several tests that sensory feedback in such an anthropomorphic replacement hand can be realized. Nevertheless, the choice of silicone material remains an open challenge, as there is a trade-off between the hardness of the material and the maximum mechanical force of the orthosis. (4) Conclusion: Apart from manufacturing-related issues, it is possible to cost-effectively create a personalized, anthropomorphic replacement hand, including sensory feedback, by using 3D scanning and 3D printing techniques.

3D Printing Polymer-based Bolus Used for Radiotherapy

Bolus is a kind of auxiliary device used in radiotherapy for the treatment of superficial lesions such as skin cancer. It is commonly used to increase skin dose and overcome the skin-sparing effect. Despite the availability of various commercial boluses, there is currently no bolus that can form full contact with irregular surface of patients' skin, and incomplete contact would result in air gaps. The resulting air gaps can reduce the surface radiation dose, leading to a discrepancy between the delivered dose and planned dose. To avoid this limitation, the customized bolus processed by three-dimensional (3D) printing holds tremendous potential for making radiotherapy more efficient than ever before. This review mainly summarized the recent development of polymers used for processing bolus, 3D printing technologies suitable for polymers, and customization of 3D printing bolus. An ideal material for customizing bolus should not only have the feature of 3D printability for customization, but also possess radiotherapy adjuvant performance as well as other multiple compound properties, including tissue equivalence, biocompatibility, antibacterial activity, and antiphlogosis.

Strand-Morphology-Based Process Optimization for Extrusion-Based Silicone Additive Manufacturing

In the silicone material extrusion (MEX) process, product profile error and performance defects are common problems due to changes in strand shape. A process optimization method considering strand morphology, denoted as SMO, which allows adjustment of the strand shape by adjusting process parameters during the printing process is presented. The relation between process parameters (extrusion speed, moving speed, nozzle height, and nozzle radius) and the geometric parameters (strand width and strand height) of the cross-section, as well as the relationship between strand spacing, layer height, and process parameters in no void constraint is discussed and verified. SMO was utilized to produce specimens with tunable strand width and strand height. Tensile tests and profile scans were performed to compare SMO with other methods to verify its feasibility. Specimens fabricated using the SMO method have up to a 7% increase in tensile strength, up to a 10% reduction in processing time, and about a 60% reduction in strand height error over unused ones. The results show that the SMO method with adjustable strand width can effectively balance efficiency and mechanical properties compared to uniform infill, and the SMO method with adjustable strand height can provide higher accuracy compared to uniform strand height. The proposed method is validated and improves the efficiency and accuracy of silicone MEX.

ADDITIVE MANUFACTURING AND VULCANIZATION OF CARBON BLACK–FILLED NATURAL RUBBER–BASED COMPONENTS

Additive manufacturing of thermoplastics or metals is a well-approved sustainable process for obtaining rapidly precise and individual technical components. Except for crosslinked silicone rubber or thermoplastic elastomers, there is no method of additive manufacturing of elastomers. Based on the development of the additive manufacturing of elastomers (AME) process, the material group of rubber-based cured elastomers may gain first access to the process field of three-dimensional (3D) printing. Printing and crosslinking of rubber is separated into two steps. In the first step, printing is realized by extrusion of the rubber by using a twin-screw extruder, which works according to the derived fused-filament-fabrication principle. In the second step, the component is vulcanized in a high-pressure hot-air autoclave. Because of the plastic flow behavior of non–crosslinked rubber materials, a thermoplastic shell is probably needed to maintain the geometry and position of the additively manufactured rubber. In this way, one layer of thermoplastic and one layer of rubber are printed alternatingly until the component is finished. Afterward, the manufactured binary component is placed in an autoclave to obtain the elastomer after vulcanization under a hot-air and high-pressure atmosphere. Then, the thermoplastic shell is removed from the elastomer and can subsequently be recycled. As compared with conventional thermoplastics, the high viscosity of rubber during processing and its instable shape after extrusion are challenging factors in the development of the AME. This contribution will show a modified 3D printer; explain the printing process from the designed component, via shell generation, to the vulcanized component; and show first printed components.

3D Printing of Physical Organ Models: Recent Developments and Challenges

Physical organ models are the objects that replicate the patient-specific anatomy and have played important roles in modern medical diagnosis and disease treatment. 3D printing, as a powerful multi-function manufacturing technology, breaks the limitations of traditional methods and provides a great potential for manufacturing organ models. However, the clinical application of organ model is still in small scale, facing the challenges including high cost, poor mimicking performance and insufficient accuracy. In this review, the mainstream 3D printing technologies are introduced, and the existing manufacturing methods are divided into "directly printing" and "indirectly printing", with an emphasis on choosing suitable techniques and materials. This review also summarizes the ideas to address these challenges and focuses on three points: 1) what are the characteristics and requirements of organ models in different application scenarios, 2) how to choose the suitable 3D printing methods and materials according to different application categories, and 3) how to reduce the cost of organ models and make the process simple and convenient. Moreover, the state-of-the-art in organ models are summarized and the contribution of 3D printed organ models to various surgical procedures is highlighted. Finally, current limitations, evaluation criteria and future perspectives for this emerging area are discussed.

Magneto-sensitive photonic crystal ink for quick printing of smart devices with structural colors

In this paper, we report a facile strategy to combine magneto-responsive photonic crystal (MRPC) ink with 3D printing technology. The building blocks of MRPC are based on Fe₃O₄ magnetic nanoparticle clusters (MNCs) with uniform and tunable size. The MNC dispersion is able to change its photonic band gap from red to blue as the external magnetic field strength is increased. The magneto-responsive photonic crystal ink can be readily obtained by taking advantage of an ethylene glycol (EG)-in-oil emulsion with a reinforced silicone rubber prepolymer as the outer phase. Using the well-designed formula, the MNC dispersion can be well-preserved inside the emulsion droplets of the ink, maintaining its original contactless magnetic field response. As a proof of concept, custom quick response code and butterfly patterns were successfully printed and showed vivid and tunable color as a function of the external magnetic field strength with good repeatability.

High-Performance Auxetic Bilayer Conductive Mesh-Based Multi-Material Integrated Stretchable Strain Sensors

High-performance stretchable strain sensors, particularly those with high sensitivity and broad sensing range, are highly important for wearable devices. Herein, a novel auxetic bilayer conductive mesh strain sensor (ABSS), composed of multi-hardness silicones, is proposed and fabricated by the direct ink writing 3D printing and ink spraying technique. The bilayer conductive mesh comprises a thin layer of high-conductive and crack-prone single-walled carbon nanotubes (SWCNTs) coated on a stretchable carbon-black-doped Ecoflex silicone rubber (CB/Ecoflex) mesh. The former serves as the dominant sensing material by generating SWCNT cracks in the full strain range, while the latter mainly plays the roles of both generating the resistance change and maintaining the conductive paths under high strain conditions. The presence of high-hardness auxetic frame contributes to the formation of longitudinal SWCNT cracks on transverse meshes, enhancing the sensitivity of the sensors. It is shown that the synergistic effect of the bilayer conductive mesh, strain concentration, and auxetic deformation strategy endow ABSS with a high gauge factor (∼ 13.4) that is 6.6 times larger than that of the common sensor. Additionally, this study demonstrates the superior sensing performance of the ABSS for wearable applications including swallowing recognition, respiration monitoring, and joint movement detection.

Materials, Electrical Performance, Mechanisms, Applications, and Manufacturing Approaches for Flexible Strain Sensors

With the recent great progress made in flexible and wearable electronic materials, the upcoming next generation of skin-mountable and implantable smart devices holds extensive potential applications for the lifestyle modifying, including personalized health monitoring, human-machine interfaces, soft robots, and implantable biomedical devices. As a core member within the wearable electronics family, flexible strain sensors play an essential role in the structure design and functional optimization. To further enhance the stretchability, flexibility, sensitivity, and electricity performances of the flexible strain sensors, enormous efforts have been done covering the materials design, manufacturing approaches and various applications. Thus, this review summarizes the latest advances in flexible strain sensors over recent years from the material, application, and manufacturing strategies. Firstly, the critical parameters measuring the performances of flexible strain sensors and materials development contains different flexible substrates, new nano- and hybrid- materials are introduced. Then, the developed working mechanisms, theoretical analysis, and computational simulation are presented. Next, based on different material design, diverse applications including human motion detection and health monitoring, soft robotics and human-machine interface, implantable devices, and biomedical applications are highlighted. Finally, synthesis consideration of the massive production industry of flexible strain sensors in the future; different fabrication approaches that are fully expected are classified and discussed.

Modeling the printability of photocuring and strength adjustable hydrogel bioink during projection-based 3D bioprinting

As a projection based three-dimensional printing method, digital light processing bioprinting (DLPBP) has higher printing resolution and is suitable for constructing finer structures to mimic tissues when compared to extrusion based bioprinting. However, there is a lack of understanding about printing behavior during DLPBP. Herein, a photo crosslinking theory for ink was established and a specified amount of light absorber was added to control crosslinking depth. Then, a standardized methodology was established to quantitatively evaluate printing resolution using different parameters. Complex biostructures, such as the ear, hand, and heart, were precisely printed after understanding the mechanism. Additionally, the mechanical properties of printed samples were accurately adjusted by changing the hydrogel concentration, as well as the degree of substitution and photocrosslinking time. The tissue types printed were from ultra-soft tissues, such as liver (6-8 kPa) to soft tissue, such as the skin (0.3-0.4 MPa). A branching vessel with cells in a real tensile modulus was printed as a demonstration. After 1 week of culture, proliferation and function of human umbilical vein endothelial cells were characterized. Overall, we made it possible to print a mimic complex tissue with high precision, required physical properties and functionalized living cells.

A flexible porous chiral auxetic tracheal stent with ciliated epithelium

Tracheal stent placement is a principal treatment for tracheobronchial stenosis, but complications such as mucus plugging, secondary stenosis, migration, and strong foreign body sensation remain unavoidable challenges. In this study, we designed a flexible porous chiral tracheal stent intended to reduce or overcome these complications. The stent was innovatively designed with a flexible tetrachiral and anti-tetrachiral hybrid structure as the frame and hollows filled with porous silicone sponge. Detailed finite element analysis (FEA) showed that the designed frame can maintain a Poisson's ratio that is negative or close to zero at up to 50% tensile strain. This contributes to improved airway ventilation and better resistance to migration during physiological activities such as respiration and neck movement. The preparation process combined indirect 3D printing with gas foaming and particulate leaching methods to efficiently fabricate the stent. The stent was then subjected to uniaxial tension and local radial compression tests, which indicated that it not only has the same desirable auxetic performance but also has flexibility similar to the native trachea. The porous sponge facilitated the adhesion of cells, allowed nutrient diffusion, and would prevent the ingrowth of granulation tissue. Furthermore, a ciliated tracheal epithelium similar to that of the native trachea was differentiated from normal human bronchial primary epithelial cells on the internal wall of the stent under air-liquid interface conditions. These results suggest that the designed stent has the potential for application in the treatment of tracheobronchial stenosis.

Fused Filament Fabrication 4D Printing of a Highly Extensible, Self-Healing, Shape Memory Elastomer Based on Thermoplastic Polymer Blends

A polymer blend with high extensibility, exhibiting both shape memory and self-healing, was 4D printed using a low-cost fused filament fabrication (FFF, or fused deposition modeling, FDM) 3D printer. The material is composed of two commercially available commodity polymers, polycaprolactone (PCL), a semi-crystalline thermoplastic, and polystyrene-block-poly(ethylene-co-butylene)-block-polystyrene (SEBS), a thermoplastic elastomer. The shape memory and self-healing properties of the blends were studied systematically through thermo-mechanical and morphological characterization, providing insight into the shape memory mechanism useful for tuning the material properties. In 3D-printed articles, the orientation of the semi-crystalline and micro-phase-separated domains leads to improvement of the shape memory property and extensibility of this material compared to compression-molded samples. By controlling the orientation of the printed fibers, we achieved a high strain at break over 1200%, outperforming previously reported flexible 4D-printed materials. The self-healing agent, PCL, enables the material to heal scratches and cracks and adhere two surfaces after annealing at 80 °C for 30 min. The high performance, multi-functionality, and potential scalability make it a promising candidate for a broad spectrum of applications, including flexible electronics, soft actuators, and deployable devices.