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Abstract
An implants' effectiveness depends upon the form of biomaterial used in its manufacture. A suitable material for implants should be biocompatible, sterile, mechanically stable and simple to shape. 3D printing technologies have been breaking new ground in the medical and medical industries in order to build patient-specific devices embedded in bioactive drugs, cells and proteins. Widespread use in medical 3D printing is a broad range of biomaterials including metals, ceramics, polymers and composites. Continuous work and developments in biomaterials used in 3D printing have contributed to significant growth of 3D printing applications in the production of personalised joints, prostheses, medication delivery system and 3D tissue engineering and regenerative medicine scaffolds. The present analysis focuses on the biomaterials used for therapeutic applications in different 3D printing technologies. Many specific forms of medical 3D printing technology are explored in depth, including fused deposition modelling, extrusion-based bioprinting, inkjet and poly-jet printing processes, their therapeutic uses, various types of biomaterial used today and the major shortcoming , are being studied in depth.
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Affiliation(s)
- Abhay Mishra
- Department of Mechanical Engineering, DIT University, Dehradun, India
| | - Vivek Srivastava
- Department of Mechanical Engineering, DIT University, Dehradun, India
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Niu J, Qin X, Bai J, Li H. Reconstruction and optimization of the 3D geometric anatomy structure model for subject-specific human knee joint based on CT and MRI images. Technol Health Care 2021; 29:221-238. [PMID: 33682761 PMCID: PMC8150550 DOI: 10.3233/thc-218022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: Nowadays, the total knee arthroplasty (TKA) technique plays an important role in surgical treatment for patients with severe knee osteoarthritis (OA). However, there are still several key issues such as promotion of osteotomy accuracy and prosthesis matching degree that need to be addressed. OBJECTIVE: It is significant to construct an accurate three-dimensional (3D) geometric anatomy structure model of subject-specific human knee joint with major bone and soft tissue structures, which greatly contributes to obtaining personalized osteotomy guide plate and suitable size of prosthesis. METHODS: Considering different soft tissue structures, magnetic resonance imaging (MRI) scanning sequences involving two-dimensional (2D) spin echo (SE) sequence T1 weighted image (T1WI) and 3D SE sequence T2 weighted image (T2WI) fat suppression (FS) are selected. A 3D modeling methodology based on computed tomography (CT) and two sets of MRI images is proposed. RESULTS: According to the proposed methods of image segmentation and 3D model registration, a novel 3D knee joint model with high accuracy is finally constructed. Furthermore, remeshing is used to optimize the established model by adjusting the relevant parameters. CONCLUSIONS: The modeling results demonstrate that reconstruction and optimization model of 3D knee joint can clearly and accurately reflect the key characteristics, including anatomical structure and geometric morphology for each component.
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Affiliation(s)
- Junlong Niu
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, Shaanxi 710072, China
| | - Xiansheng Qin
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, Shaanxi 710072, China
| | - Jing Bai
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, Shaanxi 710072, China
| | - Haiyan Li
- Department of Magnetic Resonance Imaging, Xi'an Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China
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Li C, Cai Y, Wang W, Sun Y, Li G, Dimachkieh AL, Tian W, Sun R. Combined application of virtual surgery and 3D printing technology in postoperative reconstruction of head and neck cancers. BMC Surg 2019; 19:182. [PMID: 31779609 PMCID: PMC6883711 DOI: 10.1186/s12893-019-0616-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 09/26/2019] [Indexed: 12/18/2022] Open
Abstract
Background The complex anatomy of the head and neck creates a formidable challenge for surgical reconstruction. However, good functional reconstruction plays a vital role in the quality of life of patients undergoing head and neck surgery. Precision medical treatment in the field of head and neck surgery can greatly improve the prognosis of patients with head and neck tumors. In order to achieve better shape and function, a variety of modern techniques have been introduced to improve the restoration and reconstruction of head and neck surgical defects. Digital surgical technology has great potential applications in the clinical treatment of head and neck cancer because of its advantages of personalization and accuracy. Case presentation Our department has identified the value of modern digital surgical techniques in the field of head and neck surgery and has explored its utility, including CAD/CAM technology and VR technology. We have achieved good results in the reconstruction of head and neck surgical resection defects. Conclusion In this article, we share five typical cases from the department of head and neck surgery where the reconstruction was performed with the assistance of digital surgical technology.
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Affiliation(s)
- Chao Li
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, No.55, 4th Section of Southern Renmin Road, Chengdu, 610041, Sichuan, China
| | - Yongchong Cai
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, No.55, 4th Section of Southern Renmin Road, Chengdu, 610041, Sichuan, China
| | - Wei Wang
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, No.55, 4th Section of Southern Renmin Road, Chengdu, 610041, Sichuan, China
| | - Yan Sun
- Department of Otorhinolaryngology and Head and Neck Surgery, Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Guojun Li
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amy L Dimachkieh
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. .,Department of Pediatric Otolaryngology, Texas Children's Hospital, Houston, TX, USA. .,Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, 6701 Fannin Street, Suite 540, Houston, TX, 77030, USA.
| | - Weidong Tian
- Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, China.
| | - Ronghao Sun
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, No.55, 4th Section of Southern Renmin Road, Chengdu, 610041, Sichuan, China.
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Chepelev L, Wake N, Ryan J, Althobaity W, Gupta A, Arribas E, Santiago L, Ballard DH, Wang KC, Weadock W, Ionita CN, Mitsouras D, Morris J, Matsumoto J, Christensen A, Liacouras P, Rybicki FJ, Sheikh A. Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): guidelines for medical 3D printing and appropriateness for clinical scenarios. 3D Print Med 2018; 4:11. [PMID: 30649688 PMCID: PMC6251945 DOI: 10.1186/s41205-018-0030-y] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/19/2018] [Indexed: 02/08/2023] Open
Abstract
Medical three-dimensional (3D) printing has expanded dramatically over the past three decades with growth in both facility adoption and the variety of medical applications. Consideration for each step required to create accurate 3D printed models from medical imaging data impacts patient care and management. In this paper, a writing group representing the Radiological Society of North America Special Interest Group on 3D Printing (SIG) provides recommendations that have been vetted and voted on by the SIG active membership. This body of work includes appropriate clinical use of anatomic models 3D printed for diagnostic use in the care of patients with specific medical conditions. The recommendations provide guidance for approaches and tools in medical 3D printing, from image acquisition, segmentation of the desired anatomy intended for 3D printing, creation of a 3D-printable model, and post-processing of 3D printed anatomic models for patient care.
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Affiliation(s)
- Leonid Chepelev
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Nicole Wake
- Center for Advanced Imaging Innovation and Research (CAI2R), Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU School of Medicine, New York, NY USA
- Sackler Institute of Graduate Biomedical Sciences, NYU School of Medicine, New York, NY USA
| | | | - Waleed Althobaity
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Ashish Gupta
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Elsa Arribas
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Lumarie Santiago
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO USA
| | - Kenneth C Wang
- Baltimore VA Medical Center, University of Maryland Medical Center, Baltimore, MD USA
| | - William Weadock
- Department of Radiology and Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI USA
| | - Ciprian N Ionita
- Department of Neurosurgery, State University of New York Buffalo, Buffalo, NY USA
| | - Dimitrios Mitsouras
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | | | | | - Andy Christensen
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Peter Liacouras
- 3D Medical Applications Center, Walter Reed National Military Medical Center, Washington, DC, USA
| | - Frank J Rybicki
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Adnan Sheikh
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
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Wang YT, Chen CH, Wang PF, Lin CL. Development of a novel anatomical thin titanium mesh plate with reduction guidance and fixation function for Asian zygomatic-orbitomaxillary complex fracture. J Craniomaxillofac Surg 2018; 46:547-557. [PMID: 29422224 DOI: 10.1016/j.jcms.2017.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 10/15/2017] [Accepted: 11/13/2017] [Indexed: 10/18/2022] Open
Abstract
For this study we developed an anatomical thin titanium mesh (ATTM) plate for Asian zygomaticomaxillary complex (ZMC) fracture repair with reduction guidance and fixation function. The ATTM plate profile was designed as an L-shape to fix at the anterior maxilla and lateral buttress of the ZMC. Computer-aided stamping analysis was performed on four screw-hole patterns in the ATTM plate - a control without screw-holes, square screw-holes, double screw-holes, and large-diameter, double screw-holes - using upper/lower dies of averaged ZMC reconstruction models. A regular ATTM plate of 0.6 mm thickness was manufactured and pre-bent using a patient-matched stamping process to verify its feasibility on three ZMC fracture models with one, two, and three fracture segments. The stamping analysis found that the double screw-holes design resulted in the most favorable performance among all the designs because of maximum von Mises stress (408 MPa) under the ultimate tensile strength. Positioning practice showed that the stamped, pre-bent ATTM plate can be used as a reduction guide to provide precise ZMC segment fixation in a completely passive fashion while limiting redundant rotation/micromovement between the separate bones in all directions. This study concluded that the ATTM plate with double screw-hole pattern design, using a patient-matched, pre-bent technique, can fit the ATTM plate/ZMC interface well, decrease mobility of unstable fracture segments, and provide good original facial contour recovery, while improving reduction efficiency.
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Affiliation(s)
- Yu-Tzu Wang
- Department of Biomedical Engineering, National Yang-Ming University, No. 155, Sec. 2, Linong Street, 112, Taipei, Taiwan.
| | - Chih-Hao Chen
- Craniofacial Research Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; Chang Gung University, College of Medicine, 5, Fu-Hsin Street, Kwei-Shan, Taoyuan, Taiwan.
| | - Po-Fang Wang
- Department of Plastic and Reconstruction Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Kueishan, 333, Linkou, Taoyuan, Taiwan.
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang-Ming University, No. 155, Sec. 2, Linong Street, 112, Taipei, Taiwan.
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Ahadian S, Civitarese R, Bannerman D, Mohammadi MH, Lu R, Wang E, Davenport-Huyer L, Lai B, Zhang B, Zhao Y, Mandla S, Korolj A, Radisic M. Organ-On-A-Chip Platforms: A Convergence of Advanced Materials, Cells, and Microscale Technologies. Adv Healthc Mater 2018; 7. [PMID: 29034591 DOI: 10.1002/adhm.201700506] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/15/2017] [Indexed: 12/11/2022]
Abstract
Significant advances in biomaterials, stem cell biology, and microscale technologies have enabled the fabrication of biologically relevant tissues and organs. Such tissues and organs, referred to as organ-on-a-chip (OOC) platforms, have emerged as a powerful tool in tissue analysis and disease modeling for biological and pharmacological applications. A variety of biomaterials are used in tissue fabrication providing multiple biological, structural, and mechanical cues in the regulation of cell behavior and tissue morphogenesis. Cells derived from humans enable the fabrication of personalized OOC platforms. Microscale technologies are specifically helpful in providing physiological microenvironments for tissues and organs. In this review, biomaterials, cells, and microscale technologies are described as essential components to construct OOC platforms. The latest developments in OOC platforms (e.g., liver, skeletal muscle, cardiac, cancer, lung, skin, bone, and brain) are then discussed as functional tools in simulating human physiology and metabolism. Future perspectives and major challenges in the development of OOC platforms toward accelerating clinical studies of drug discovery are finally highlighted.
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Affiliation(s)
- Samad Ahadian
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto M5S 3G9 Ontario Canada
| | - Robert Civitarese
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto M5S 3G9 Ontario Canada
| | - Dawn Bannerman
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto M5S 3G9 Ontario Canada
- Department of Chemical Engineering and Applied Chemistry; University of Toronto; Toronto M5S 3G9 Ontario Canada
| | - Mohammad Hossein Mohammadi
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto M5S 3G9 Ontario Canada
- Department of Chemical Engineering and Applied Chemistry; University of Toronto; Toronto M5S 3G9 Ontario Canada
| | - Rick Lu
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto M5S 3G9 Ontario Canada
| | - Erika Wang
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto M5S 3G9 Ontario Canada
| | - Locke Davenport-Huyer
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto M5S 3G9 Ontario Canada
- Department of Chemical Engineering and Applied Chemistry; University of Toronto; Toronto M5S 3G9 Ontario Canada
| | - Ben Lai
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto M5S 3G9 Ontario Canada
| | - Boyang Zhang
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto M5S 3G9 Ontario Canada
- Department of Chemical Engineering and Applied Chemistry; University of Toronto; Toronto M5S 3G9 Ontario Canada
| | - Yimu Zhao
- Department of Chemical Engineering and Applied Chemistry; University of Toronto; Toronto M5S 3G9 Ontario Canada
| | - Serena Mandla
- Department of Chemical Engineering and Applied Chemistry; University of Toronto; Toronto M5S 3G9 Ontario Canada
| | - Anastasia Korolj
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto M5S 3G9 Ontario Canada
- Department of Chemical Engineering and Applied Chemistry; University of Toronto; Toronto M5S 3G9 Ontario Canada
| | - Milica Radisic
- Institute of Biomaterials and Biomedical Engineering; University of Toronto; Toronto M5S 3G9 Ontario Canada
- Department of Chemical Engineering and Applied Chemistry; University of Toronto; Toronto M5S 3G9 Ontario Canada
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Ho D, Squelch A, Sun Z. Modelling of aortic aneurysm and aortic dissection through 3D printing. J Med Radiat Sci 2017; 64:10-17. [PMID: 28134482 PMCID: PMC5355365 DOI: 10.1002/jmrs.212] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 11/25/2016] [Accepted: 12/13/2016] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION The aim of this study was to assess if the complex anatomy of aortic aneurysm and aortic dissection can be accurately reproduced from a contrast-enhanced computed tomography (CT) scan into a three-dimensional (3D) printed model. METHODS Contrast-enhanced cardiac CT scans from two patients were post-processed and produced as 3D printed thoracic aorta models of aortic aneurysm and aortic dissection. The transverse diameter was measured at five anatomical landmarks for both models, compared across three stages: the original contrast-enhanced CT images, the stereolithography (STL) format computerised model prepared for 3D printing and the contrast-enhanced CT of the 3D printed model. For the model with aortic dissection, measurements of the true and false lumen were taken and compared at two points on the descending aorta. RESULTS Three-dimensional printed models were generated with strong and flexible plastic material with successful replication of anatomical details of aortic structures and pathologies. The mean difference in transverse vessel diameter between the contrast-enhanced CT images before and after 3D printing was 1.0 and 1.2 mm, for the first and second models respectively (standard deviation: 1.0 mm and 0.9 mm). Additionally, for the second model, the mean luminal diameter difference between the 3D printed model and CT images was 0.5 mm. CONCLUSION Encouraging results were achieved with regards to reproducing 3D models depicting aortic aneurysm and aortic dissection. Variances in vessel diameter measurement outside a standard deviation of 1 mm tolerance indicate further work is required into the assessment and accuracy of 3D model reproduction.
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Affiliation(s)
- Daniel Ho
- Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia, Australia
| | - Andrew Squelch
- Department of Exploration Geophysics, Western Australian School of Mines, Curtin University, Perth, Western Australia, Australia
- Pawsey Supercomputing Centre, Kensington, Western Australia, Australia
| | - Zhonghua Sun
- Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia, Australia
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He Y, Tuck CJ, Prina E, Kilsby S, Christie SDR, Edmondson S, Hague RJM, Rose FRAJ, Wildman RD. A new photocrosslinkable polycaprolactone-based ink for three-dimensional inkjet printing. J Biomed Mater Res B Appl Biomater 2016; 105:1645-1657. [PMID: 27177716 DOI: 10.1002/jbm.b.33699] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 04/08/2016] [Accepted: 04/14/2016] [Indexed: 11/09/2022]
Abstract
A new type of photocrosslinkable polycaprolactone (PCL) based ink that is suitable for three-dimensional (3D) inkjet printing has been developed. Photocrosslinkable Polycaprolactone dimethylacrylate (PCLDMA) was synthesized and mixed with poly(ethylene glycol) diacrylate (PEGDA) to prepare an ink with a suitable viscosity for inkjet printing. The ink performance under different printing environments, initiator concentrations, and post processes was studied. This showed that a nitrogen atmosphere during printing was beneficial for curing and material property optimization, as well as improving the quality of structures produced. A simple structure, built in the z-direction, demonstrated the potential for this material for the production of 3D printed objects. Cell tests were carried out to investigate the biocompatibility of the developed ink. © 2016 The Authors Journal of Biomedical Materials Research Part B: Applied Biomaterials Published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1645-1657, 2017.
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Affiliation(s)
- Yinfeng He
- Faculty of Engineering, University of Nottingham, Nottingham, UK
| | | | - Elisabetta Prina
- School of Pharmacy, Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Sam Kilsby
- Department of Chemistry, Loughborough University, Loughborough, UK
| | | | | | | | - Felicity R A J Rose
- School of Pharmacy, Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Ricky D Wildman
- Faculty of Engineering, University of Nottingham, Nottingham, UK
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Martelli N, Serrano C, van den Brink H, Pineau J, Prognon P, Borget I, El Batti S. Advantages and disadvantages of 3-dimensional printing in surgery: A systematic review. Surgery 2016; 159:1485-1500. [PMID: 26832986 DOI: 10.1016/j.surg.2015.12.017] [Citation(s) in RCA: 328] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/02/2015] [Accepted: 12/11/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND Three-dimensional (3D) printing is becoming increasingly important in medicine and especially in surgery. The aim of the present work was to identify the advantages and disadvantages of 3D printing applied in surgery. METHODS We conducted a systematic review of articles on 3D printing applications in surgery published between 2005 and 2015 and identified using a PubMed and EMBASE search. Studies dealing with bioprinting, dentistry, and limb prosthesis or those not conducted in a hospital setting were excluded. RESULTS A total of 158 studies met the inclusion criteria. Three-dimensional printing was used to produce anatomic models (n = 113, 71.5%), surgical guides and templates (n = 40, 25.3%), implants (n = 15, 9.5%) and molds (n = 10, 6.3%), and primarily in maxillofacial (n = 79, 50.0%) and orthopedic (n = 39, 24.7%) operations. The main advantages reported were the possibilities for preoperative planning (n = 77, 48.7%), the accuracy of the process used (n = 53, 33.5%), and the time saved in the operating room (n = 52, 32.9%); 34 studies (21.5%) stressed that the accuracy was not satisfactory. The time needed to prepare the object (n = 31, 19.6%) and the additional costs (n = 30, 19.0%) were also seen as important limitations for routine use of 3D printing. CONCLUSION The additional cost and the time needed to produce devices by current 3D technology still limit its widespread use in hospitals. The development of guidelines to improve the reporting of experience with 3D printing in surgery is highly desirable.
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Affiliation(s)
- Nicolas Martelli
- Pharmacy Department, Georges Pompidou European Hospital, Paris, France; University Paris-Sud, GRADES, Faculty of Pharmacy, Châtenay-Malabry, France.
| | - Carole Serrano
- Pharmacy Department, Georges Pompidou European Hospital, Paris, France
| | | | - Judith Pineau
- Pharmacy Department, Georges Pompidou European Hospital, Paris, France
| | - Patrice Prognon
- Pharmacy Department, Georges Pompidou European Hospital, Paris, France
| | - Isabelle Borget
- University Paris-Sud, GRADES, Faculty of Pharmacy, Châtenay-Malabry, France; Department of Health Economics, Gustave Roussy Institute, Villejuif, France
| | - Salma El Batti
- Department of Cardiac and Vascular Surgery, Georges Pompidou European Hospital, Paris, France; URDIA - Unité de Recherche en Développement, Imagerie et Anatomie - EA 4465, Université Paris Descartes, Paris, France
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Fan H, Fu J, Li X, Pei Y, Li X, Pei G, Guo Z. Implantation of customized 3-D printed titanium prosthesis in limb salvage surgery: a case series and review of the literature. World J Surg Oncol 2015; 13:308. [PMID: 26537339 PMCID: PMC4632365 DOI: 10.1186/s12957-015-0723-2] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 10/26/2015] [Indexed: 11/25/2022] Open
Abstract
Background Although modular prosthesis is commercially available to meet requirements in most limb salvage surgeries, customized prosthesis is still needed. In contrast to traditional complicated procedures, rapid prototyping (RP) technique can directly manufacture customized titanium prosthesis. The objectives of this study were to describe the workflow of this technique and show the follow-up results of patients. Methods Three patients with clavicle Ewing’s sarcoma (ES), scapular ES, and pelvic chondrosarcoma (CS) were scanned by computer tomography (CT). The images were segmented and reconstructed for preoperative planning and prosthesis design. Then, the data of prosthesis were imported into an electron beam melting system to manufacture implants. These three patients received prosthesis implantation after tumor excision. They were followed up to evaluate survival rate, functional outcome, and complications. Results All patients were alive with no evidence of disease. The Musculoskeletal Tumor Society (MSTS) scores were 93, 73, and 90 % for patients with clavicle ES, scapular ES, and pelvic CS, respectively. No surgical complications including limb length discrepancy, screw loosening, and implant breakage were observed in current study. Conclusions Electron beam melting (EBM) is a useful method to directly manufacture customized titanium prostheses. It might improve the effectiveness of limb salvage surgery for sarcomas in unusual sites.
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Affiliation(s)
- Hongbin Fan
- Department of Orthopaedic Surgery, Xi-Jing Hospital, Fourth Military Medical University, West Chang-le Road, Xi'an, 710032, China.
| | - Jun Fu
- Department of Orthopaedic Surgery, Xi-Jing Hospital, Fourth Military Medical University, West Chang-le Road, Xi'an, 710032, China.
| | - Xiangdong Li
- Department of Orthopaedic Surgery, Xi-Jing Hospital, Fourth Military Medical University, West Chang-le Road, Xi'an, 710032, China.
| | - Yanjun Pei
- Department of Orthopaedic Surgery, Xi-Jing Hospital, Fourth Military Medical University, West Chang-le Road, Xi'an, 710032, China.
| | - Xiaokang Li
- Department of Orthopaedic Surgery, Xi-Jing Hospital, Fourth Military Medical University, West Chang-le Road, Xi'an, 710032, China.
| | - Guoxian Pei
- Department of Orthopaedic Surgery, Xi-Jing Hospital, Fourth Military Medical University, West Chang-le Road, Xi'an, 710032, China.
| | - Zheng Guo
- Department of Orthopaedic Surgery, Xi-Jing Hospital, Fourth Military Medical University, West Chang-le Road, Xi'an, 710032, China.
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Eltorai AEM, Nguyen E, Daniels AH. Three-Dimensional Printing in Orthopedic Surgery. Orthopedics 2015; 38:684-7. [PMID: 26558661 DOI: 10.3928/01477447-20151016-05] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 07/14/2015] [Indexed: 02/03/2023]
Abstract
Three-dimensional (3D) printing is emerging as a clinically promising technology for rapid prototyping of surgically implantable products. With this commercially available technology, computed tomography or magnetic resonance images can be used to create graspable objects from 3D reconstructed images. Models can enhance patients' understanding of their pathology and surgeon preoperative planning. Customized implants and casts can be made to match an individual's anatomy. This review outlines 3D printing, its current applications in orthopedics, and promising future directions.
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Schwam ZG, Chang MT, Barnes MA, Paskhover B. Applications of 3-Dimensional Printing in Facial Plastic Surgery. J Oral Maxillofac Surg 2015; 74:427-8. [PMID: 26611375 DOI: 10.1016/j.joms.2015.10.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 10/15/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Zachary G Schwam
- Fourth-Year Medical Student, Yale University School of Medicine, New Haven, CT.
| | - Michael T Chang
- Fourth-Year Medical Student, Yale University School of Medicine, New Haven, CT
| | - Melynda A Barnes
- Assistant Professor of Surgery, Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Boris Paskhover
- Chief Resident, Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, CT
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Ibrahim AMS, Jose RR, Rabie AN, Gerstle TL, Lee BT, Lin SJ. Three-dimensional Printing in Developing Countries. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 3:e443. [PMID: 26301132 PMCID: PMC4527617 DOI: 10.1097/gox.0000000000000298] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 01/30/2015] [Indexed: 01/24/2023]
Abstract
The advent of 3-dimensional (3D) printing technology has facilitated the creation of customized objects. The lack of regulation in developing countries renders conventional means of addressing various healthcare issues challenging. 3D printing may provide a venue for addressing many of these concerns in an inexpensive and easily accessible fashion. These may potentially include the production of basic medical supplies, vaccination beads, laboratory equipment, and prosthetic limbs. As this technology continues to improve and prices are reduced, 3D printing has the potential ability to promote initiatives across the entire developing world, resulting in improved surgical care and providing a higher quality of healthcare to its residents.
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Affiliation(s)
- Ahmed M. S. Ibrahim
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.; Department of Biomedical Engineering, Tufts University, Medford, Mass.; and Department of Otolaryngology, Ain Shams University, Faculty of Medicine, Cairo, Egypt
| | - Rod R. Jose
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.; Department of Biomedical Engineering, Tufts University, Medford, Mass.; and Department of Otolaryngology, Ain Shams University, Faculty of Medicine, Cairo, Egypt
| | - Amr N. Rabie
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.; Department of Biomedical Engineering, Tufts University, Medford, Mass.; and Department of Otolaryngology, Ain Shams University, Faculty of Medicine, Cairo, Egypt
| | - Theodore L. Gerstle
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.; Department of Biomedical Engineering, Tufts University, Medford, Mass.; and Department of Otolaryngology, Ain Shams University, Faculty of Medicine, Cairo, Egypt
| | - Bernard T. Lee
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.; Department of Biomedical Engineering, Tufts University, Medford, Mass.; and Department of Otolaryngology, Ain Shams University, Faculty of Medicine, Cairo, Egypt
| | - Samuel J. Lin
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.; Department of Biomedical Engineering, Tufts University, Medford, Mass.; and Department of Otolaryngology, Ain Shams University, Faculty of Medicine, Cairo, Egypt
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Pietruski P, Majak M, Światek-Najwer E, Popek M, Jaworowski J, Zuk M, Nowakowski F. Image-guided bone resection as a prospective alternative to cutting templates—A preliminary study. J Craniomaxillofac Surg 2015; 43:1021-7. [PMID: 26165759 DOI: 10.1016/j.jcms.2015.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 05/12/2015] [Accepted: 06/08/2015] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the accuracy of craniomaxillofacial resections performed with an image-guided surgical sagittal saw. MATERIAL AND METHODS Twenty-four craniomaxillofacial resections were performed using an image-guided sagittal saw. Surgical outcomes were compared with a preoperative virtual plan in terms of the resected bone volume, control point position and osteotomy trajectory angle. Each measurement was performed twice by two independent observers. RESULTS The best convergence between the planned and actual bone resection was observed for the orbital region (6.33 ± 4.04%). The smallest mean difference between the preoperative and postoperative control point positions (2.00 ± 0.66 mm) and the lowest mean angular deviation between the virtual and actual osteotomy (5.49 ± 3.17 degrees) were documented for the maxillary region. When all the performed procedures were analyzed together, mean difference between the planned and actual bone resection volumes was 9.48 ± 4.91%, mean difference between the preoperative and postoperative control point positions amounted to 2.59 ± 1.41 mm, and mean angular deviation between the planned and actual osteotomy trajectory equaled 8.21 ± 5.69 degrees. CONCLUSION The results of this study are encouraging but not fully satisfactory. If further improved, the hereby presented navigation technique may become a valuable supporting method for craniomaxillofacial resections.
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Affiliation(s)
- Piotr Pietruski
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 Street, 02-781 Warsaw, Poland; Department of Plastic, Reconstructive and Aesthetic Surgery, Norbert Barlicki Memorial Hospital, Kopcinskiego 22 Street, 90-153 Lodz, Poland.
| | - Marcin Majak
- Department of Biomedical Engineering, Mechatronics and Theory of Mechanisms, Wroclaw University of Technology, Lukasiewicza 7/9 Street, 50-371 Wroclaw, Poland
| | - Ewelina Światek-Najwer
- Department of Biomedical Engineering, Mechatronics and Theory of Mechanisms, Wroclaw University of Technology, Lukasiewicza 7/9 Street, 50-371 Wroclaw, Poland
| | - Michal Popek
- Department of Biomedical Engineering, Mechatronics and Theory of Mechanisms, Wroclaw University of Technology, Lukasiewicza 7/9 Street, 50-371 Wroclaw, Poland
| | - Janusz Jaworowski
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 Street, 02-781 Warsaw, Poland
| | - Magdalena Zuk
- Department of Biomedical Engineering, Mechatronics and Theory of Mechanisms, Wroclaw University of Technology, Lukasiewicza 7/9 Street, 50-371 Wroclaw, Poland
| | - Filip Nowakowski
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 Street, 02-781 Warsaw, Poland
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Yoong W, Cresswell K, Moffatt J, Mead R, Laverick B, Szarko M. The application of 3D printing technology in obstetrics and gynaecology. ACTA ACUST UNITED AC 2015. [DOI: 10.1111/tog.12169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Wai Yoong
- Department of Obstetrics and Gynaecology; North Middlesex University Hospital; London
| | | | - James Moffatt
- Department of Anatomy; Institute of Medical and Biomedical Education; St. George's, University of London
| | - Rachel Mead
- Department of Anatomy; Institute of Medical and Biomedical Education; St. George's, University of London
| | - Beth Laverick
- ST3; Department of Obstetrics and Gynaecology; North Middlesex University Hospital; London
| | - Matthew Szarko
- Department of Anatomy; Institute of Medical and Biomedical Education; St. George's, University of London
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Hespel AM, Wilhite R, Hudson J. INVITED REVIEW-APPLICATIONS FOR 3D PRINTERS IN VETERINARY MEDICINE. Vet Radiol Ultrasound 2014; 55:347-58. [DOI: 10.1111/vru.12176] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 03/25/2014] [Indexed: 12/14/2022] Open
Affiliation(s)
| | - Ray Wilhite
- Anatomy, Physiology, and Pharmacology; Auburn University; Auburn AL 36849
| | - Judith Hudson
- Clinical Sciences; Auburn University; Auburn AL 36849
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Abstract
BACKGROUND Three-dimensional printing represents an evolving technology still in its infancy. Currently, individuals and small business entities have the ability to manufacture physical objects from digital renderings, computer-aided design, and open source files. Design modifications and improvements in extrusion methods have made this technology much more affordable. This article explores the potential uses of three-dimensional printing in plastic surgery. METHODS A review was performed detailing the known uses of three-dimensional printing in medicine. The potential applications of three-dimensional printing in plastic surgery are discussed. RESULTS Various applications for three-dimensional printing technology have emerged in medicine, including printing organs, printing body parts, bio-printing, and computer-aided tissue engineering. In plastic surgery, these tools offer various prospective applications for surgical planning, resident education, and the development of custom prosthetics. CONCLUSIONS Numerous applications exist in medicine, including the printing of devices, implants, tissue replacements, and even whole organs. Plastic surgeons may likely find this technology indispensable in surgical planning, education, and prosthetic device design and development in the near future.
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Feng F, Wang H, Guan X, Tian W, Jing W, Long J, Tang W, Liu L. Mirror imaging and preshaped titanium plates in the treatment of unilateral malar and zygomatic arch fractures. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2011; 112:188-94. [PMID: 21216634 DOI: 10.1016/j.tripleo.2010.10.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Revised: 10/08/2010] [Accepted: 10/12/2010] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of this study is to discuss the application of mirror imaging and preshaped titanium plates in the treatment of unilateral malar and zygomatic arch fractures. STUDY DESIGN Four patients with unilateral malar and zygomatic arch fractures were included in this study. All patients underwent preoperative CT scan. CT data were processed with Surgicase. Two 3D skull models were reconstructed using a rapid prototyping device. The first model was the original model obtained from CT scanning; the other model was obtained by mirroring the unaffected side onto the fractured side. Simulation surgery was performed on the first model. For the second model, titanium plates were shaped in advance and a resinous guide plate was created to guide surgical reduction. When using the resinous guide plates, 4 patients' fractures were reduced and fixed with preshaped titanium plates. The pre- and postoperative displacement of zygomatic markers were analyzed in Surgicase. RESULTS According to the measurement of fracture displacements, the facial asymmetry of all 4 patients was greatly improved at the 1-month follow-up. CONCLUSIONS Mirror imaging and preshaped titanium plates are viable choices for the treatment of unilateral malar and zygomatic arch fractures. Combined use of these techniques can improve facial symmetry.
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Affiliation(s)
- Fan Feng
- Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Zhou LB, Shang HT, He LS, Bo B, Liu GC, Liu YP, Zhao JL. Accurate reconstruction of discontinuous mandible using a reverse engineering/computer-aided design/rapid prototyping technique: a preliminary clinical study. J Oral Maxillofac Surg 2010; 68:2115-21. [PMID: 20542365 DOI: 10.1016/j.joms.2009.09.033] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2009] [Revised: 06/04/2009] [Accepted: 09/14/2009] [Indexed: 12/01/2022]
Abstract
PURPOSE To improve the reconstructive surgical outcome of a discontinuous mandibular defect, we used reverse engineering (RE), computer-aided design (CAD), and rapid prototyping (RP) technique to fabricate customized mandibular trays to precisely restore the mandibular defects. Autogenous bone grafting was also used to restore the bony continuity for occlusion rehabilitation. PATIENTS AND METHODS Six patients who had undergone block resection of the mandible underwent reconstruction using a custom titanium tray combining autogenous iliac grafts. The custom titanium tray was made using a RE/CAD/RP technique. A virtual 3-dimensional model was obtained by spiral computed tomography scanning. The opposite side of the mandible was mirrored to cover the defect area to restore excellent facial symmetry. A bone grafting tray was designed from the mirrored image and manufactured using RP processing and casting. The mandibular defects were restored using the trays in combination of autologous iliac grafting. An implant denture was made for 1 of the 6 patients at 24 weeks postoperatively for occlusion rehabilitation. RESULTS The trays fabricated using this technique fit well in all 6 patients. The reconstructive procedures were easy and time saving. Satisfactory facial symmetry was restored. No severe complications occurred in the 5 patients without occlusion rehabilitation during a mean 50-month follow-up period. The reconstruction in the patient with occlusion lasted for only 1 year and failed eventually because of bone resorption and infection. CONCLUSIONS Mandibular reconstruction was facilitated using the RE/CAD/RP technique. Satisfactory esthetic results were achieved. However, the rigidity of the cast tray could cause severe stress shielding to the grafts, which could lead to disuse atrophy. Therefore, some modification is needed for functional reconstruction.
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Affiliation(s)
- Li-bin Zhou
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Shaanxi, People's Republic of China
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Rengier F, Mehndiratta A, von Tengg-Kobligk H, Zechmann CM, Unterhinninghofen R, Kauczor HU, Giesel FL. 3D printing based on imaging data: review of medical applications. Int J Comput Assist Radiol Surg 2010; 5:335-41. [DOI: 10.1007/s11548-010-0476-x] [Citation(s) in RCA: 1066] [Impact Index Per Article: 76.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 04/21/2010] [Indexed: 11/28/2022]
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