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Wu Y, Liu J, Kang L, Tian J, Zhang X, Hu J, Huang Y, Liu F, Wang H, Wu Z. An overview of 3D printed metal implants in orthopedic applications: Present and future perspectives. Heliyon 2023; 9:e17718. [PMID: 37456029 PMCID: PMC10344715 DOI: 10.1016/j.heliyon.2023.e17718] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 06/12/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
With the ability to produce components with complex and precise structures, additive manufacturing or 3D printing techniques are now widely applied in both industry and consumer markets. The emergence of tissue engineering has facilitated the application of 3D printing in the field of biomedical implants. 3D printed implants with proper structural design can not only eliminate the stress shielding effect but also improve in vivo biocompatibility and functionality. By combining medical images derived from technologies such as X-ray scanning, CT, MRI, or ultrasonic scanning, 3D printing can be used to create patient-specific implants with almost the same anatomical structures as the injured tissues. Numerous clinical trials have already been conducted with customized implants. However, the limited availability of raw materials for printing and a lack of guidance from related regulations or laws may impede the development of 3D printing in medical implants. This review provides information on the current state of 3D printing techniques in orthopedic implant applications. The current challenges and future perspectives are also included.
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Affiliation(s)
- Yuanhao Wu
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jieying Liu
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Lin Kang
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jingjing Tian
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Xueyi Zhang
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jin Hu
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yue Huang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Fuze Liu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Hai Wang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Zhihong Wu
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
- Beijing Key Laboratory for Genetic Research of Bone and Joint Disease, Beijing, China
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Guo ZX, Zhao XL, Zhao ZY, Zhu QY, Wang ZY, Xu M. Malignant melanoma resection and reconstruction with the first manifestation of lumbar metastasis: A case report. World J Clin Cases 2023; 11:3571-3577. [PMID: 37383908 PMCID: PMC10294206 DOI: 10.12998/wjcc.v11.i15.3571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/05/2023] [Accepted: 04/19/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Malignant melanoma (MM) has shown an increasing incidence worldwide, and a potential to metastasize to almost any part of the body. Clinically, MM with bone metastasis as the initial manifestation is extremely rare. Spinal metastatic MM can cause spinal cord or nerve root compression, resulting in severe pain and paralysis. Currently, the primary clinical treatments for MM are surgical resection in conjunction with chemotherapy, radiotherapy, and immunotherapy.
CASE SUMMARY Here, we report the case of a 52-year-old male who presented to the clinic with progressive low back pain and limited nerve function. No primary lesion or spinal cord compression was detected from computed tomography and magnetic resonance imaging of the lumbar vertebrae and positron emission tomography scan. A lumbar puncture biopsy confirmed the diagnosis of lumbar spine metastatic MM. Following surgical resection, the patient’s quality of life improved, symptoms were relieved, and comprehensive treatment was initiated, which prevented recurrence.
CONCLUSION Spinal metastatic MM is clinically rare, and may cause neurological symptoms, including paraplegia. Currently, the clinical treatment plan consists of surgical resection in combination with chemotherapy, radiotherapy, and immunotherapy.
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Affiliation(s)
- Zi-Xuan Guo
- Graduate School, Medical School of Chinese PLA, Beijing 100853, China
| | - Xue-Lin Zhao
- Graduate School, Medical School of Chinese PLA, Beijing 100853, China
| | - Zi-Yi Zhao
- Graduate School, Medical School of Chinese PLA, Beijing 100853, China
| | - Qing-Yan Zhu
- Graduate School, Medical School of Chinese PLA, Beijing 100853, China
| | - Zi-Ying Wang
- Graduate School, Medical School of Chinese PLA, Beijing 100853, China
| | - Meng Xu
- Department of Orthopedics, The Forth Medical Center of PLA General Hospital, Beijing 100037, China
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Lv J, Jin W, Liu W, Qin X, Feng Y, Bai J, Wu Z, Li J. Selective Laser Melting Fabrication of Porous Ti6Al4V Scaffolds With Triply Periodic Minimal Surface Architectures: Structural Features, Cytocompatibility, and Osteogenesis. Front Bioeng Biotechnol 2022; 10:899531. [PMID: 35694229 PMCID: PMC9178116 DOI: 10.3389/fbioe.2022.899531] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/02/2022] [Indexed: 11/24/2022] Open
Abstract
The relationship between pore architecture and structure performance needs to be explored, as well as confirm the optimized porous structure. Because of the linear correlation between constant C and pore architecture, triply periodic minimal surface (TPMS) based porous structures could be a controllable model for the investigation of the optimized porous structure. In the present work, three types of TPMS porous scaffolds (S, D and G) combined with four constants (0.0, 0.2, 0.4 and 0.6) were designed, and built successfully via the selective laser melting (SLM) technology. The designed feature and mechanical property of porous scaffolds were investigated through mathematical method and compression test. And the manufactured samples were co-cultured with rMSCs for the compatibility study. The results indicated that the whole manufacturing procedure was good in controllability, repeatability, and accuracy. The linear correlation between the porosity of TPMS porous scaffolds and the constant C in equations was established. The different TPMS porous scaffolds possess the disparate feature in structure, mechanical property and cell compatibility. Comprehensive consideration of the structure features, mechanical property and biology performance, different TPMS structures should be applied in appropriate field. The results could guide the feasibility of apply the different TPMS architectures into the different part of orthopedic implants.
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Affiliation(s)
- Jia Lv
- Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan, China
- *Correspondence: Jia Lv,
| | - Wenxuan Jin
- Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Wenhao Liu
- Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiuyu Qin
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Yi Feng
- Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Junjun Bai
- Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhuangzhuang Wu
- Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Jian Li
- Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan, China
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Jian Q, Liu Z, Duan W, Guan J, Jian F, Chen Z. Reconstruction of the cervical lateral mass using 3D-printed prostheses. Neurospine 2022; 19:202-211. [PMID: 35130422 PMCID: PMC8987545 DOI: 10.14245/ns.2143008.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/28/2021] [Indexed: 11/20/2022] Open
Abstract
Objective This study aimed to investigate the outcome of using 3-dimensional (3D)-printed prostheses to reconstruct a cervical lateral mass to maintain cervical stability.
Methods We retrospectively analyzed data of 7 patients who underwent cervical lateral mass reconstruction using a 3D-printed prosthesis, comprising axial and subaxial lateral mass reconstruction in 2 and 5 patients, respectively. Bilateral mass was reconstructed in 1 patient and unilateral mass in the remaining 6 patients.
Results Using a 3D-printed lateral mass prosthesis, internal fixation was stable for all 7 patients postoperatively. No implant-related complications such as prosthesis loosening, displacement, and compression were observed at the last follow-up.
Conclusion Reconstruction of the lateral mass structure is beneficial in restoring load transfer in the cervical spine under physiological conditions. A 3D-printed prosthesis can be considered a good option for reconstruction of the lateral mass as fusion was achieved, with no subsequent complications observed.
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Affiliation(s)
- Qiang Jian
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhenlei Liu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wanru Duan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jian Guan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Fengzeng Jian
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zan Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- Corresponding Author Zan Chen https://orcid.org/0000-0002-0104-115X Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China
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Bioprinting on 3D Printed Titanium Scaffolds for Periodontal Ligament Regeneration. Cells 2021; 10:cells10061337. [PMID: 34071316 PMCID: PMC8229613 DOI: 10.3390/cells10061337] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/21/2021] [Accepted: 05/21/2021] [Indexed: 01/09/2023] Open
Abstract
The three-dimensional (3D) cell-printing technique has been identified as a new biofabrication platform because of its ability to locate living cells in pre-defined spatial locations with scaffolds and various growth factors. Osseointegrated dental implants have been regarded as very reliable and have long-term reliability. However, host defense mechanisms against infections and micro-movements have been known to be impaired around a dental implant because of the lack of a periodontal ligament. In this study, we fabricated a hybrid artificial organ with a periodontal ligament on the surface of titanium using 3D printing technology. CEMP-1, a known cementogenic factor, was enhanced in vitro. In animal experiments, when the hybrid artificial organ was transplanted to the calvarial defect model, it was observed that the amount of connective tissue increased. 3D-printed hybrid artificial organs can be used with dental implants, establishing physiological tooth functions, including the ability to react to mechanical stimuli and the ability to resist infections.
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Veronesi F, Torricelli P, Martini L, Tschon M, Giavaresi G, Bellini D, Casagranda V, Alemani F, Fini M. An alternative ex vivo method to evaluate the osseointegration of Ti-6Al-4V alloy also combined with collagen. Biomed Mater 2021; 16:025007. [PMID: 33445161 DOI: 10.1088/1748-605x/abdbda] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Due to the increasing number of orthopedic implantation surgery and advancements in biomaterial manufacturing, chemistry and topography, there is an increasing need of reliable and rapid methods for the preclinical investigation of osseointegration and bone ingrowth. Implant surface composition and topography increase osteogenicity, osteoinductivity, osteoconductivity and osseointegration of a prosthesis. Among the biomaterials used to manufacture an orthopedic prosthesis, titanium alloy (Ti-6Al-4V) is the most used. Type I collagen (COLL I) induces cell function, adhesion, differentiation and bone extracellular matrix component secretion and it is reported to improve osseointegration if immobilized on the alloy surface. The aim of the present study was to evaluate the feasibility of an alternative ex vivo model, developed by culturing rabbit cortical bone segments with Ti-6Al-4V alloy cylinders (Ti-POR), fabricated through the process of electron beam melting (EBM), to evaluate osseointegration. In addition, a comparison was made with Ti-POR coated with COLL I (Ti-POR-COLL) to evaluate osseointegration in terms of bone-to-implant contact (BIC) and new bone formation (nBAr/TAr) at 30, 60 and 90 d of culture. After 30 and 60 d of culture, BIC and nBAr/TAr resulted significantly higher in Ti-POR-COLL implants than in Ti-POR. No differences have been found at 90 d of culture. With the developed model it was possible to distinguish the biomaterial properties and behavior. This study defined and confirmed for the first time the validity of the alternative ex vivo method to evaluate osseointegration and that COLL I improves osseointegration and bone growth of Ti-6Al-4V fabricated through EBM.
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Affiliation(s)
- Francesca Veronesi
- Complex Structure of Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136 Bologna, Italy
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Wang Y, Zhang X, Zhang Y, Zhang H, Sun H, Hao D, Wang B. One-stage posterior en-bloc spondylectomy following reconstruction with individualized 3D printed artificial vertebrae for multi-segment thoracolumbar metastases: case report and literature review. Am J Transl Res 2021; 13:115-123. [PMID: 33527012 PMCID: PMC7847514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
In thoracolumbar vertebral tumors, reconstruction of complex multi-segment thoracolumbar vertebrae after total en-bloc spondylectomy (TES) is still challenging. In recent years, with the development of 3D printing technology, individualized 3D printed artificial vertebrae have been attempted to reconstruct complex multi-segment thoracolumbar spine. Compared with traditional titanium mesh or bone transplantation, it helps reduce long-term complications, bringing a new dawn for reconstructing multi-segment thoracolumbar spine. A 69-year-old female complained of low back pain with limited motion for 1 month. More than 2 months ago, she underwent radical mastectomy due to breast cancer (Luminal A subtype). Imageology examination revealed an osteolytic lesion involving the T11-L1 vertebra. She was performed one-stage 3-segment (T11-L1) en-bloc spondylectomy via posterior approach, and then an artificial vertebrae produced by a novel individualized 3D printing technology was used for reconstruction. The patient was follow-up for 2 years, and she recovered well, with no tumor recurrence, and no complications after spinal reconstruction. The application of individualized 3D printed artificial vertebrae in multi-segment thoracolumbar spine reconstruction can not only reconstruct the bone defect more accurately through the individualized design, but the porous design is able to achieve biomechanical performance comparable to that of cancellous bone, and it is conducive to inducing bone growth, all of which help reduce long-term mechanical complications. Furthermore, the application of artificial vertebrae in surgery can significantly shorten the operation time, reduce intraoperative blood loss and reduce the risk of perioperative complications. Therefore, individualized 3D printed artificial vertebrae is a good choice for complex multi-segment thoracolumbar spine reconstruction.
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Affiliation(s)
- Yuhang Wang
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University College of MedicineXi’an 710054, Shaanxi, China
- Xi’an Medical UniversityXi’an 710068, Shaanxi, China
| | - Xinliang Zhang
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University College of MedicineXi’an 710054, Shaanxi, China
| | - Yongyuan Zhang
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University College of MedicineXi’an 710054, Shaanxi, China
| | - Haiping Zhang
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University College of MedicineXi’an 710054, Shaanxi, China
| | - Honghui Sun
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University College of MedicineXi’an 710054, Shaanxi, China
| | - Dingjun Hao
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University College of MedicineXi’an 710054, Shaanxi, China
| | - Biao Wang
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University College of MedicineXi’an 710054, Shaanxi, China
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Wei F, Xu N, Li Z, Cai H, Zhou F, Yang J, Yu M, Liu X, Sun Y, Zhang K, Pan S, Wu F, Liu Z. A prospective randomized cohort study on 3D-printed artificial vertebral body in single-level anterior cervical corpectomy for cervical spondylotic myelopathy. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1070. [PMID: 33145289 PMCID: PMC7575998 DOI: 10.21037/atm-19-4719] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background This was a prospective randomized cohort study aiming at examining the safety and efficacy of artificial vertebral body (AVB) fabricated by electron beam melting (EBM) in comparison to conventional titanium mesh cage (TMC) used in single-level anterior cervical corpectomy and fusion (SL-ACCF). Methods Forty patients with cervical spondylotic myelopathy (CSM) underwent SL-ACCF using either the EBM-AVB or the TMC. Patients were evaluated for their demographics, radiological characteristics, neurologic function [using the Japanese Orthopaedic Association (JOA) scale], and health-related quality-of-life (HRQoL) aspects [using the Short Form 36 (SF-36)] before and after the surgery and comparison was made between the two groups both at baseline and the last follow-up. The Student t-text, paired-sample t-text, and Fisher's exact test were used when appropriate to detect any statistical significance at the level of α=0.05. Results Post-operative recovery was uneventful for all patients and no revision surgery was required. There were no significant differences between the EBM-AVB group and the TMC group at baseline. Patients in both groups demonstrated significant improvement in cervical alignment, JOA score, and SF-36 score after the surgery. Six months post-operatively, patients in the EBM-AVB group were found to have significantly less loss of fusion height and lower incidence for severe implant subsidence compared with the TMC group. Patients in the two groups were comparable at the last follow-up regarding their rate of fusion, cervical alignment, JOA recovery rate, SF-36 score, and by Odom's criteria. Conclusions For CSM patients undergoing SL-ACCF, the EBM-AVB group demonstrated comparable outcomes regarding patient cervical alignment, neurologic function, and HRQoL in comparison with the TMC group. Furthermore, the use of EBM-AVB was associated with decreased loss of the height of the fusion mass and a lower rate for severe implant subsidence.
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Affiliation(s)
- Feng Wei
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Nanfang Xu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Zihe Li
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Hong Cai
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Feifei Zhou
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Jun Yang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Miao Yu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Xiaoguang Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Yu Sun
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Ke Zhang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Shengfa Pan
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Fengliang Wu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Zhongjun Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
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Han Q, Wang C, Chen H, Zhao X, Wang J. Porous Tantalum and Titanium in Orthopedics: A Review. ACS Biomater Sci Eng 2019; 5:5798-5824. [PMID: 33405672 DOI: 10.1021/acsbiomaterials.9b00493] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Porous metal is metal with special porous structures, which can offer high biocompatibility and low Young's modulus to satisfy the need for orthopedic applications. Titanium and tantalum are the most widely used porous metals in orthopedics due to their excellent biomechanical properties and biocompatibility. Porous titanium and tantalum have been studied and applied for a long history until now. Here in this review, various manufacturing methods of titanium and tantalum porous metals are introduced. Application of these porous metals in different parts of the body are summarized, and strengths and weaknesses of these porous metal implants in clinical practice are discussed frankly for future improvement from the viewpoint of orthopedic surgeons. Then according to the requirements from clinics, progress in research for clinical use is illustrated in four aspects. Various creative designs of microporous and functionally gradient structure, surface modification, and functional compound systems of porous metal are exhibited as reference for future research. Finally, the directions of orthopedic porous metal development were proposed from the clinical view based on the rapid progress of additive manufacturing. Controllable design of both macroscopic anatomical bionic shape and microscopic functional bionic gradient porous metal, which could meet the rigorous mechanical demand of bone reconstruction, should be developed as the focus. The modification of a porous metal surface and construction of a functional porous metal compound system, empowering stronger cell proliferation and antimicrobial and antineoplastic property to the porous metal implant, also should be taken into consideration.
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Affiliation(s)
- Qing Han
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| | - Chenyu Wang
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| | - Hao Chen
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| | - Xue Zhao
- Department of Endocrine and Metabolism, The First Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| | - Jincheng Wang
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, 130000 Jilin Province, China
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Elshaer A, Nair S, Hassanin H. Near Net Shape Manufacturing of Dental Implants Using Additive Processes. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/978-3-030-10579-2_4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Ruppert DS, Harrysson OLA, Marcellin-Little DJ, Dahners LE, Weinhold PS. Improved osseointegration with as-built electron beam melted textured implants and improved peri‑implant bone volume with whole body vibration. Med Eng Phys 2018; 58:S1350-4533(18)30088-2. [PMID: 29903535 DOI: 10.1016/j.medengphy.2018.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 05/28/2018] [Indexed: 11/19/2022]
Abstract
Transcutaneous osseointegrated prostheses provide stable connections to the skeleton while eliminating skin lesions experienced with socket prosthetics. Additive manufacturing can create custom textured implants capable of interfacing with amputees' residual bones. Our objective was to compare osseointegration of textured surface implants made by electron beam melting (EBM), an additive manufacturing process, to machine threaded implants. Whole body vibration was investigated to accelerate osseointegration. Two cohorts of Sprague-Dawley rats received bilateral, titanium implants (EBM vs. threaded) in their tibiae. One cohort comprising five groups vibrated at 45 Hz: 0.0 (control), 0.15, 0.3, 0.6 or 1.2 g was followed for six weeks. Osseointegration was evaluated through torsional testing and bone volume fraction (BV/TV). A second cohort, divided into two groups (control and 0.6 g), was followed for 24 days and evaluated for resonant frequency, bone-implant contact (BIC) and fluorochrome labeling. The EBM textured implants exhibited significantly improved mechanical stability independent of vibration, highlighting the benefits of using EBM to produce custom textured surfaces. Bone formation on and around the EBM textured implants increased compared to machined implants, as seen by BIC and fluorescence. No difference in torque, BIC or fluorescence among vibration levels was detected. BV/TV significantly increased at 0.6 g compared to control for both implant types.
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Affiliation(s)
- David S Ruppert
- Department of Biomedical Engineering, UNC-NCSU, United States.
| | - Ola L A Harrysson
- Department of Biomedical Engineering, UNC-NCSU, United States; Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina, United States
| | - Denis J Marcellin-Little
- Department of Biomedical Engineering, UNC-NCSU, United States; Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina, United States; Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - Laurence E Dahners
- Department of Orthopaedics School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States
| | - Paul S Weinhold
- Department of Biomedical Engineering, UNC-NCSU, United States; Department of Orthopaedics School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States
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Mandibular Reconstruction Using a Customized Three-Dimensional Titanium Implant Applied on the Lingual Surface of the Mandible. J Craniofac Surg 2018; 29:415-419. [DOI: 10.1097/scs.0000000000004119] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Phan K, Sgro A, Maharaj MM, D'Urso P, Mobbs RJ. Application of a 3D custom printed patient specific spinal implant for C1/2 arthrodesis. JOURNAL OF SPINE SURGERY 2016; 2:314-318. [PMID: 28097249 DOI: 10.21037/jss.2016.12.06] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The study aims to describe a three-dimensional printed (3DP) posterior fixation implant used for C1/C2 fusion in a 65-year-old female. Spinal fusion remains a common intervention for a range of spinal pathologies including degenerative disc and facet disease when conservative methods are unsuccessful. However, fusion devices are not always entirely efficacious in providing the desired fixation, and surgeons rely on 'off the shelf' implants which may not provide an anatomical fit to address the particular pathology. 3DP refers to a process where three-dimensional objects are created through successive layering of material, so called 'additive manufacturing'. Although this technology enables accurate fabrication of patient-specific orthopaedic and spinal implants, literature on its utilization in this regard is rare. A 65-year-old female, with severe facet arthropathy at the C1/C2 level, osteophyte formation and impingement of the exiting C2 nerve root underwent a C1/C2 posterior fusion and rhizolysis of the C2 nerve roots. A custom posterior fixation implant was designed and on-laid over the C2 spinous process and lamina, with screw holes made to a depth and angulation that was pre-calculated based on the preoperative CT based 3D modelling. The patient had an uneventful recovery and reported a significant reduction in occipital neuralgia and sub-occipital pain and 2-month follow-up. We report the first case of a customized 3DP spinal prosthesis for posterior C1/C2 fusion. The implant added significant value reducing the overall time of the procedure, and safety with a reduced risk of neurovascular compromise.
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Affiliation(s)
- Kevin Phan
- Neuro Spine Surgery Research Group (NSURG), Sydney, Australia;; Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Alessandro Sgro
- Neuro Spine Surgery Research Group (NSURG), Sydney, Australia
| | - Monish M Maharaj
- Neuro Spine Surgery Research Group (NSURG), Sydney, Australia;; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | | | - Ralph J Mobbs
- Neuro Spine Surgery Research Group (NSURG), Sydney, Australia;; Faculty of Medicine, University of New South Wales, Sydney, Australia;; Department of Neurosurgery, Prince of Wales Hospital, Sydney, Australia
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Lee UL, Kwon JS, Woo SH, Choi YJ. Simultaneous Bimaxillary Surgery and Mandibular Reconstruction With a 3-Dimensional Printed Titanium Implant Fabricated by Electron Beam Melting: A Preliminary Mechanical Testing of the Printed Mandible. J Oral Maxillofac Surg 2016; 74:1501.e1-1501.e15. [DOI: 10.1016/j.joms.2016.02.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/26/2016] [Accepted: 02/26/2016] [Indexed: 11/25/2022]
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Ramakrishnaiah R, Al Kheraif AA, Mohammad A, Divakar DD, Kotha SB, Celur SL, Hashem MI, Vallittu PK, Rehman IU. Preliminary fabrication and characterization of electron beam melted Ti-6Al-4V customized dental implant. Saudi J Biol Sci 2016; 24:787-796. [PMID: 28490947 PMCID: PMC5415127 DOI: 10.1016/j.sjbs.2016.05.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 04/10/2016] [Accepted: 05/01/2016] [Indexed: 11/21/2022] Open
Abstract
The current study was aimed to fabricate customized root form dental implant using additive manufacturing technique for the replacement of missing teeth. The root form dental implant was designed using Geomagic™ and Magics™, the designed implant was directly manufactured by layering technique using ARCAM A2™ electron beam melting system by employing medical grade Ti–6Al–4V alloy powder. Furthermore, the fabricated implant was characterized in terms of certain clinically important parameters such as surface microstructure, surface topography, chemical purity and internal porosity. Results confirmed that, fabrication of customized dental implants using additive rapid manufacturing technology offers an attractive method to produce extremely pure form of customized titanium dental implants, the rough and porous surface texture obtained is expected to provide better initial implant stabilization and superior osseointegration.
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Affiliation(s)
- Ravikumar Ramakrishnaiah
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Abdulaziz Abdullah Al Kheraif
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Ashfaq Mohammad
- FARCAMT, Advanced Manufacturing Institute, College of Engineering, King Saud University, Riyadh 11421, Saudi Arabia
| | - Darshan Devang Divakar
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Sunil Babu Kotha
- Department of Pediatric Dentistry, Riyadh Colleges of Dentistry and Pharmacy, Riyadh 11681, Saudi Arabia
| | - Sree Lalita Celur
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Princess Noura bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Mohamed I Hashem
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Pekka K Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre, Professor and Chair of Biomaterials Science, Director of Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku and City of Turku Welfare Division, Turku, Finland
| | - Ihtesham Ur Rehman
- Department of Material Science and Engineering, The Kroto Research Institute, The University of Sheffield, Sheffield S3 7HQ, United Kingdom
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Reconstruction of the Upper Cervical Spine Using a Personalized 3D-Printed Vertebral Body in an Adolescent With Ewing Sarcoma. Spine (Phila Pa 1976) 2016; 41:E50-4. [PMID: 26335676 DOI: 10.1097/brs.0000000000001179] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Case report. OBJECTIVE To describe a three-dimensional (3D) printed axial vertebral body used in upper cervical spine reconstruction after a C2 Ewing sarcoma resection in an adolescent boy. SUMMARY OF BACKGROUND DATA Ewing sarcoma is a malignant musculoskeletal neoplasm with a peak incidence in adolescents. Cervical spine as the primary site of the tumor has been related to a worse prognosis. Tumor resection is particularly challenging in the atlantoaxial region due to complexity of the anatomy, necessity for extensive resection according to oncological principles, and a lack of specialized implants for reconstruction. 3D printing refers to a process where 3D objects are created through successive layering of material under computer control. Although this technology potentially enables accurate fabrication of patient-specific orthopedic implants, literature on its utilization in this regard is rare. METHODS A 12-year-old boy with a C2 Ewing sarcoma underwent a staged spondylectomy. Wide resection of the posterior elements was first performed. Two weeks later, a high anterior retropharyngeal approach was taken to remove the remains of the C2 vertebra. A customized artificial vertebral body fabricated according to a computer model using titanium alloy powder was inserted to replace the defect between C1 and C3. The microstructure of the implant was optimized for better biomechanical stability and enhanced bone healing. RESULTS Patient had an uneventful recovery and began to ambulate on postoperative day 7. Adjuvant treatment commenced 3 weeks after the surgery. He was tumor-free at the 1-year follow-up. Computed tomography studies revealed evidence of implant osseointegration and no subsidence or displacement of the construct. CONCLUSION This is a case example on the concept of personalized precision medicine in a surgical setting and demonstrates how 3D-printed, patient-specific implants may bring individualized solutions to rare problems wherein restoration of the specific anatomy of each patient is a key prognostic factor.
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Effect of Photofunctionalization on Ti6Al4V Screw Stability Placed in Segmental Bone Defects in Rat Femurs. J Oral Maxillofac Surg 2015; 74:861.e1-16. [PMID: 26704430 DOI: 10.1016/j.joms.2015.11.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 11/18/2015] [Accepted: 11/18/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE Ultraviolet-mediated photofunctionalization is a new technology to improve bone and titanium integration. We hypothesized that photofunctionalization would enhance the stability of titanium screws used for segmental bone defects. MATERIALS AND METHODS Disks were prepared of a titanium alloy (Ti6Al4V) for an in vitro study to evaluate the attachment, proliferation, and differentiation of osteoblasts. Commercially available Ti6Al4V screws were used in vivo. Segmental bone defects were created in rat femurs as an immediate loading reconstruction model. The defects were reconstructed with commercially available titanium plates and Ti6Al4V screws, with or without photofunctionalization. The screw survival rates and mechanical stability were evaluated at 2 and 4 weeks, and the bone formation around the screws was analyzed. RESULTS Osteoblasts showed greater attachment, proliferation, and differentiation on the photofunctionalized Ti6Al4V disks. Photofunctionalized screws had significantly greater survival rates and mechanical stability at 2 and 4 weeks. The bone formation around the photofunctionalized screws was significantly greater than that around the untreated screws at 4 weeks. CONCLUSIONS The results of the present study have demonstrated the efficacy of photofunctionalization on enhancing the survival and stability of Ti6Al4V screws under a loaded condition in the reconstruction of segmental defects. This was associated with increased bioactivity and bone formation around the photofunctionalized Ti6Al4V material.
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Cai H. Application of 3D printing in orthopedics: status quo and opportunities in China. ANNALS OF TRANSLATIONAL MEDICINE 2015; 3:S12. [PMID: 26046057 DOI: 10.3978/j.issn.2305-5839.2015.01.38] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 01/23/2015] [Indexed: 01/13/2023]
Affiliation(s)
- Hong Cai
- Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China
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