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Smith JA, Basgul C, Mohammadlou BS, Allen M, Kurtz SM. Investigating the Feasibility and Performance of Hybrid Overmolded UHMWPE 3D-Printed PEEK Structural Composites for Orthopedic Implant Applications: A Pilot Study. Bioengineering (Basel) 2024; 11:616. [PMID: 38927852 PMCID: PMC11201260 DOI: 10.3390/bioengineering11060616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 05/29/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Ultra-high-molecular-weight polyethylene (UHMWPE) components for orthopedic implants have historically been integrated into metal backings by direct-compression molding (DCM). However, metal backings are costly, stiffer than cortical bone, and may be associated with medical imaging distortion and metal release. Hybrid-manufactured DCM UHMWPE overmolded additively manufactured polyetheretherketone (PEEK) structural components could offer an alternative solution, but are yet to be explored. In this study, five different porous topologies (grid, triangular, honeycomb, octahedral, and gyroid) and three surface feature sizes (low, medium, and high) were implemented into the top surface of digital cylindrical specimens prior to being 3D printed in PEEK and then overmolded with UHMWPE. Separation forces were recorded as 1.97-3.86 kN, therefore matching and bettering the historical industry values (2-3 kN) recorded for DCM UHMWPE metal components. Infill topology affected failure mechanism (Type 1 or 2) and obtained separation forces, with shapes having greater sidewall numbers (honeycomb-60%) and interconnectivity (gyroid-30%) through their builds, tolerating higher transmitted forces. Surface feature size also had an impact on applied load, whereby those with low infill-%s generally recorded lower levels of performance vs. medium and high infill strategies. These preliminary findings suggest that hybrid-manufactured structural composites could replace metal backings and produce orthopedic implants with high-performing polymer-polymer interfaces.
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Affiliation(s)
- James A. Smith
- Implant Research Core, School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA; (C.B.); (S.M.K.)
| | - Cemile Basgul
- Implant Research Core, School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA; (C.B.); (S.M.K.)
| | | | | | - Steven M. Kurtz
- Implant Research Core, School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA; (C.B.); (S.M.K.)
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2
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Periferakis A, Periferakis AT, Troumpata L, Dragosloveanu S, Timofticiuc IA, Georgatos-Garcia S, Scheau AE, Periferakis K, Caruntu A, Badarau IA, Scheau C, Caruntu C. Use of Biomaterials in 3D Printing as a Solution to Microbial Infections in Arthroplasty and Osseous Reconstruction. Biomimetics (Basel) 2024; 9:154. [PMID: 38534839 DOI: 10.3390/biomimetics9030154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
The incidence of microbial infections in orthopedic prosthetic surgeries is a perennial problem that increases morbidity and mortality, representing one of the major complications of such medical interventions. The emergence of novel technologies, especially 3D printing, represents a promising avenue of development for reducing the risk of such eventualities. There are already a host of biomaterials, suitable for 3D printing, that are being tested for antimicrobial properties when they are coated with bioactive compounds, such as antibiotics, or combined with hydrogels with antimicrobial and antioxidant properties, such as chitosan and metal nanoparticles, among others. The materials discussed in the context of this paper comprise beta-tricalcium phosphate (β-TCP), biphasic calcium phosphate (BCP), hydroxyapatite, lithium disilicate glass, polyetheretherketone (PEEK), poly(propylene fumarate) (PPF), poly(trimethylene carbonate) (PTMC), and zirconia. While the recent research results are promising, further development is required to address the increasing antibiotic resistance exhibited by several common pathogens, the potential for fungal infections, and the potential toxicity of some metal nanoparticles. Other solutions, like the incorporation of phytochemicals, should also be explored. Incorporating artificial intelligence (AI) in the development of certain orthopedic implants and the potential use of AI against bacterial infections might represent viable solutions to these problems. Finally, there are some legal considerations associated with the use of biomaterials and the widespread use of 3D printing, which must be taken into account.
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Affiliation(s)
- Argyrios Periferakis
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Akadimia of Ancient Greek and Traditional Chinese Medicine, 16675 Athens, Greece
- Elkyda, Research & Education Centre of Charismatheia, 17675 Athens, Greece
| | - Aristodemos-Theodoros Periferakis
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Elkyda, Research & Education Centre of Charismatheia, 17675 Athens, Greece
| | - Lamprini Troumpata
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Serban Dragosloveanu
- Department of Orthopaedics and Traumatology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Orthopaedics, "Foisor" Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Iosif-Aliodor Timofticiuc
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Spyrangelos Georgatos-Garcia
- Tilburg Institute for Law, Technology, and Society (TILT), Tilburg University, 5037 DE Tilburg, The Netherlands
- Corvers Greece IKE, 15124 Athens, Greece
| | - Andreea-Elena Scheau
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Konstantinos Periferakis
- Akadimia of Ancient Greek and Traditional Chinese Medicine, 16675 Athens, Greece
- Pan-Hellenic Organization of Educational Programs (P.O.E.P.), 17236 Athens, Greece
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, "Carol Davila" Central Military Emergency Hospital, 010825 Bucharest, Romania
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Ioana Anca Badarau
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Radiology and Medical Imaging, "Foisor" Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
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3
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Wong KI, Zhong Y, Yu Z, Jiang T, Wei M. Combining Patient-specific Implant With Malar Reduction to Repair Mid-facial Asymmetry Caused by Craniofacial Fractures in Asians. J Craniofac Surg 2024; 35:241-242. [PMID: 37643059 DOI: 10.1097/scs.0000000000009661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 06/04/2023] [Indexed: 08/31/2023] Open
Abstract
Mid-facial asymmetry caused by bone defect or deformation resulted from craniofacial fracture was a common secondary complication needed to repair. Patient-specific implant (PSI) designed with the unaffected side as a template is a good choice to repair this kind of facial asymmetry. However, in Asians, the broad and prominent zygomatic bone in unaffected side is not an optimal template, because the oval facial shape was considered as a more attractive appearance in Asian esthetic concept. To repair the mid-facial asymmetry and to improve the facial contour, the authors combined PSI implantation with malar reduction in one-stage surgery. The authors referred the facial proportion index (the optimal ratio of mid and lower face was 1.27) as a basis for preoperative precise design to determine the ideal facial shape of unaffected side, and used mirror image overlay technique with the ideal shape of unaffected side as a template to design the PSI. With this surgical strategy, patients not only can repair facial asymmetry but also can get a more attractive appearance.
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Affiliation(s)
- Ka Ioi Wong
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Yehong Zhong
- Department of Maxillofacial Surgery and Digital Plastic Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P. R. China
| | - Zheyuan Yu
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Taoran Jiang
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Min Wei
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai
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Hoene G, Moser N, Schminke B, Wiechens B, Leha A, Khromov T, Schliephake H, Brockmeyer P. Postoperative facial appearance of patients with extensive oral squamous cell carcinoma can be adequately preserved with in‑house virtually planned mandibular reconstruction. Mol Clin Oncol 2023; 19:97. [PMID: 37953859 PMCID: PMC10636699 DOI: 10.3892/mco.2023.2693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/27/2023] [Indexed: 11/14/2023] Open
Abstract
The present study aimed to assess the concordance of preoperative and postoperative hard and soft tissues in patients with advanced oral squamous cell carcinoma (OSCC) following virtual surgical planning (VSP) mandibular reconstruction. In the present study, a cohort of 32 patients with OSCC underwent in-house VSP, followed by guided mandibular reconstruction utilizing vascularized free tissue grafts sourced from the fibula or scapula. A morphometric analysis was conducted comparing preoperative and postoperative three-dimensional virtual models to evaluate discrepancies and identify potential risk factors associated with poor reconstruction outcomes. The outcome variables were the differences in root mean square (RMS) and mean surface distance (MSD) resulting from the application of an iterative closest point algorithm to the virtual data. The validity of soft tissue comparison data is limited due to its susceptibility to various confounding variables. The present study conducted a comprehensive re-evaluation of these variables. High tumor stage, positive N status and the use of adjuvant therapy contributed to more noticeable differences in preoperative and postoperative facial soft tissue appearance. The accuracy of postoperative bone reconstruction results was higher in patients who underwent neomandibular formation using a fibular graft compared with those who received a scapular graft. Preoperative and postoperative soft tissue analyses were conducted for comparison. The MSD showed a deviation of 3.2 mm (± 2.0 mm SD; range 1.3-9.5 mm), whereas the RMS was 5.3 (± 2.9 SD; range 2.1-14). In conclusion, in-house VSP and guided mandibular reconstructions can yield clinically accurate results, preserving patient appearance and offering the advantage of rapid feasibility.
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Affiliation(s)
- Georg Hoene
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, D-37075 Goettingen, Germany
| | - Norman Moser
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, D-37075 Goettingen, Germany
| | - Boris Schminke
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, D-37075 Goettingen, Germany
| | - Bernhard Wiechens
- Department of Orthodontics, University Medical Center Goettingen, D-37075 Goettingen, Germany
| | - Andreas Leha
- Institute of Medical Statistics, University Medical Center Goettingen, D-37073 Goettingen, Germany
| | - Tatjana Khromov
- Institute of Clinical Chemistry, University Medical Center Goettingen, D-37075 Goettingen, Germany
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, D-37075 Goettingen, Germany
| | - Phillipp Brockmeyer
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, D-37075 Goettingen, Germany
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5
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Zhou J, See CW, Sreenivasamurthy S, Zhu D. Customized Additive Manufacturing in Bone Scaffolds-The Gateway to Precise Bone Defect Treatment. RESEARCH (WASHINGTON, D.C.) 2023; 6:0239. [PMID: 37818034 PMCID: PMC10561823 DOI: 10.34133/research.0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/07/2023] [Indexed: 10/12/2023]
Abstract
In the advancing landscape of technology and novel material development, additive manufacturing (AM) is steadily making strides within the biomedical sector. Moving away from traditional, one-size-fits-all implant solutions, the advent of AM technology allows for patient-specific scaffolds that could improve integration and enhance wound healing. These scaffolds, meticulously designed with a myriad of geometries, mechanical properties, and biological responses, are made possible through the vast selection of materials and fabrication methods at our disposal. Recognizing the importance of precision in the treatment of bone defects, which display variability from macroscopic to microscopic scales in each case, a tailored treatment strategy is required. A patient-specific AM bone scaffold perfectly addresses this necessity. This review elucidates the pivotal role that customized AM bone scaffolds play in bone defect treatment, while offering comprehensive guidelines for their customization. This includes aspects such as bone defect imaging, material selection, topography design, and fabrication methodology. Additionally, we propose a cooperative model involving the patient, clinician, and engineer, thereby underscoring the interdisciplinary approach necessary for the effective design and clinical application of these customized AM bone scaffolds. This collaboration promises to usher in a new era of bioactive medical materials, responsive to individualized needs and capable of pushing boundaries in personalized medicine beyond those set by traditional medical materials.
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Affiliation(s)
- Juncen Zhou
- Department of Biomedical Engineering,
Stony Brook University, Stony Brook, NY, USA
| | - Carmine Wang See
- Department of Biomedical Engineering,
Stony Brook University, Stony Brook, NY, USA
| | - Sai Sreenivasamurthy
- Department of Biomedical Engineering,
Stony Brook University, Stony Brook, NY, USA
| | - Donghui Zhu
- Department of Biomedical Engineering,
Stony Brook University, Stony Brook, NY, USA
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Liu Y, Yi N, Davies R, McCutchion P, Ghita O. Powder Bed Fusion Versus Material Extrusion: A Comparative Case Study on Polyether-Ether-Ketone Cranial Implants. 3D PRINTING AND ADDITIVE MANUFACTURING 2023; 10:941-954. [PMID: 37886420 PMCID: PMC10599438 DOI: 10.1089/3dp.2021.0300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
As the choice of additive manufacturing (AM) technologies is becoming wider with reliable processes and a wider range of materials, the selection of the right technology to fabricate a certain product is becoming increasingly difficult from a technical and cost perspective. In this study polyether-ether-ketone cranial implants were manufactured by two AM techniques: powder bed fusion (PBF) and fused filament fabrication (FFF) and their dimensional accuracy, compression performance, and drop tower impact behavior were evaluated and compared. The results showed that both types of specimens differed from the original computer-aided design; although the origin of the deviation was different, the PBF samples were slightly inaccurate owing to the printing process where the accuracy of the FFF samples was influenced by postprocessing and removal of the scaffolds. The cranial implants fabricated using the FFF method absorbed more energy during the compression and impact tests in comparison with the PBF process. The failure mechanisms revealed that FFF samples have a higher ability to deform and a more consistent failure mechanisms, with the damage localized around the puncture head region. The brittle nature of the PBF samples, a feature observed with other polymers as well, led to complete failure of the cranial implants into several pieces.
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Affiliation(s)
- Yaan Liu
- Engineering, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
| | - Nan Yi
- Engineering, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
| | - Richard Davies
- Engineering, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
| | - Paul McCutchion
- Engineering, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
| | - Oana Ghita
- Engineering, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
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7
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Smith JA, Petersmann S, Arbeiter F, Schäfer U. Optimization and manufacture of polyetheretherketone patient specific cranial implants by material extrusion - A clinical perspective. J Mech Behav Biomed Mater 2023; 144:105965. [PMID: 37343357 DOI: 10.1016/j.jmbbm.2023.105965] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/23/2023]
Abstract
Polyetheretherketone (PEEK) is a high performing thermoplastic that has established itself as a 'gold-standard' material for cranial reconstruction. Traditionally, milled PEEK patient specific cranial implants (PSCIs) exhibit uniform levels of smoothness (excusing suture/drainage holes) to the touch (<1 μm) and homogenous coloration throughout. They also demonstrate predictable and repeatable levels of mechanical performance, as they are machined from isotropic material blocks. The combination of such factors inspires confidence from the surgeon and in turn, approval for implantation. However, manufacturing lead-times and affiliated costs to fabricate a PSCI are high. To simplify their production and reduce expenditure, hospitals are exploring the production of in-house PEEK PSCIs by material extrusion-based additive manufacturing. From a geometrical and morphological perspective, such implants have been produced with good-to-satisfactory clinical results. However, lack of clinical adoption persists. To determine the reasoning behind this, it was necessary to assess the benefits and limitations of current printed PEEK PSCIs in order to establish the status quo. Afterwards, a review on individual PEEK printing variables was performed in order to identify a combination of parameters that could enhance the aesthetics and performance of the PSCIs to that of milled implants/cranial bone. The findings from this review could be used as a baseline to help standardize the production of PEEK PSCIs by material extrusion in the hospital.
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Affiliation(s)
- James A Smith
- Research Unit Experimental Neurotraumatology, Department of Neurosurgery, Medical University of Graz, Auenbruggerplatz 2(9), 8036, Graz, Austria.
| | - Sandra Petersmann
- Materials Science and Testing of Polymers, Montanuniversitaet Leoben, Otto Gloeckel-Straße 2, 8700, Leoben, Austria
| | - Florian Arbeiter
- Materials Science and Testing of Polymers, Montanuniversitaet Leoben, Otto Gloeckel-Straße 2, 8700, Leoben, Austria
| | - Ute Schäfer
- Research Unit Experimental Neurotraumatology, Department of Neurosurgery, Medical University of Graz, Auenbruggerplatz 2(9), 8036, Graz, Austria; BioTechMed-Graz, Graz, Austria
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Sharma N, Zubizarreta-Oteiza J, Tourbier C, Thieringer FM. Can Steam Sterilization Affect the Accuracy of Point-of-Care 3D Printed Polyetheretherketone (PEEK) Customized Cranial Implants? An Investigative Analysis. J Clin Med 2023; 12:jcm12072495. [PMID: 37048579 PMCID: PMC10094830 DOI: 10.3390/jcm12072495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/19/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Polyetheretherketone (PEEK) has become the biomaterial of choice for repairing craniofacial defects over time. Prospects for the point-of-care (POC) fabrication of PEEK customized implants have surfaced thanks to the developments in three-dimensional (3D) printing systems. Consequently, it has become essential to investigate the characteristics of these in-house fabricated implants so that they meet the necessary standards and eventually provide the intended clinical benefits. This study aimed to investigate the effects of the steam sterilization method on the dimensional accuracy of POC 3D-printed PEEK customized cranial implants. The objective was to assess the influence of standard sterilization procedures on material extrusion-based 3D-printed PEEK customized implants with non-destructive material testing. Fifteen PEEK customized cranial implants were fabricated using an in-house material extrusion-based 3D printer. After fabrication, the cranial implants were digitalized with a professional-grade optical scanner before and after sterilization. The dimensional changes for the 3D-printed PEEK cranial implants were analyzed using medically certified 3D image-based engineering software. The material extrusion 3D-printed PEEK customized cranial implants displayed no statistically significant dimensional difference with steam sterilization (p > 0.05). Evaluation of the cranial implants’ accuracy revealed that the dimensions were within the clinically acceptable accuracy level with deviations under 1.00 mm. Steam sterilization does not significantly alter the dimensional accuracy of the in-house 3D-printed PEEK customized cranial implants.
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Affiliation(s)
- Neha Sharma
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167C, 4123 Allschwil, Switzerland
- Correspondence:
| | - Jokin Zubizarreta-Oteiza
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167C, 4123 Allschwil, Switzerland
| | - Céline Tourbier
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167C, 4123 Allschwil, Switzerland
| | - Florian M. Thieringer
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167C, 4123 Allschwil, Switzerland
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Pepelnjak T, Stojšić J, Sevšek L, Movrin D, Milutinović M. Influence of Process Parameters on the Characteristics of Additively Manufactured Parts Made from Advanced Biopolymers. Polymers (Basel) 2023; 15:polym15030716. [PMID: 36772018 PMCID: PMC9922018 DOI: 10.3390/polym15030716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
Over the past few decades, additive manufacturing (AM) has become a reliable tool for prototyping and low-volume production. In recent years, the market share of such products has increased rapidly as these manufacturing concepts allow for greater part complexity compared to conventional manufacturing technologies. Furthermore, as recyclability and biocompatibility have become more important in material selection, biopolymers have also become widely used in AM. This article provides an overview of AM with advanced biopolymers in fields from medicine to food packaging. Various AM technologies are presented, focusing on the biopolymers used, selected part fabrication strategies, and influential parameters of the technologies presented. It should be emphasized that inkjet bioprinting, stereolithography, selective laser sintering, fused deposition modeling, extrusion-based bioprinting, and scaffold-free printing are the most commonly used AM technologies for the production of parts from advanced biopolymers. Achievable part complexity will be discussed with emphasis on manufacturable features, layer thickness, production accuracy, materials applied, and part strength in correlation with key AM technologies and their parameters crucial for producing representative examples, anatomical models, specialized medical instruments, medical implants, time-dependent prosthetic features, etc. Future trends of advanced biopolymers focused on establishing target-time-dependent part properties through 4D additive manufacturing are also discussed.
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Affiliation(s)
- Tomaž Pepelnjak
- Faculty of Mechanical Engineering, University of Ljubljana, Aškerčeva 6, 1000 Ljubljana, Slovenia
- Correspondence: ; Tel.: +386-1-47-71-734
| | - Josip Stojšić
- Mechanical Engineering Faculty in Slavonski Brod, University of Slavonski Brod, Trg Ivane Brlić Mažuranić 2, 35000 Slavonski Brod, Croatia
| | - Luka Sevšek
- Faculty of Mechanical Engineering, University of Ljubljana, Aškerčeva 6, 1000 Ljubljana, Slovenia
| | - Dejan Movrin
- Department for Production Engineering, Faculty of Technical Sciences, University of Novi Sad, Trg Dositeja Obradovića 6, 21000 Novi Sad, Serbia
| | - Mladomir Milutinović
- Department for Production Engineering, Faculty of Technical Sciences, University of Novi Sad, Trg Dositeja Obradovića 6, 21000 Novi Sad, Serbia
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Charbe NB, Tambuwala M, Palakurthi SS, Warokar A, Hromić‐Jahjefendić A, Bakshi H, Zacconi F, Mishra V, Khadse S, Aljabali AA, El‐Tanani M, Serrano‐Aroca Ã, Palakurthi S. Biomedical applications of three-dimensional bioprinted craniofacial tissue engineering. Bioeng Transl Med 2023; 8:e10333. [PMID: 36684092 PMCID: PMC9842068 DOI: 10.1002/btm2.10333] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 02/06/2023] Open
Abstract
Anatomical complications of the craniofacial regions often present considerable challenges to the surgical repair or replacement of the damaged tissues. Surgical repair has its own set of limitations, including scarcity of the donor tissues, immune rejection, use of immune suppressors followed by the surgery, and restriction in restoring the natural aesthetic appeal. Rapid advancement in the field of biomaterials, cell biology, and engineering has helped scientists to create cellularized skeletal muscle-like structures. However, the existing method still has limitations in building large, highly vascular tissue with clinical application. With the advance in the three-dimensional (3D) bioprinting technique, scientists and clinicians now can produce the functional implants of skeletal muscles and bones that are more patient-specific with the perfect match to the architecture of their craniofacial defects. Craniofacial tissue regeneration using 3D bioprinting can manage and eliminate the restrictions of the surgical transplant from the donor site. The concept of creating the new functional tissue, exactly mimicking the anatomical and physiological function of the damaged tissue, looks highly attractive. This is crucial to reduce the donor site morbidity and retain the esthetics. 3D bioprinting can integrate all three essential components of tissue engineering, that is, rehabilitation, reconstruction, and regeneration of the lost craniofacial tissues. Such integration essentially helps to develop the patient-specific treatment plans and damage site-driven creation of the functional implants for the craniofacial defects. This article is the bird's eye view on the latest development and application of 3D bioprinting in the regeneration of the skeletal muscle tissues and their application in restoring the functional abilities of the damaged craniofacial tissue. We also discussed current challenges in craniofacial bone vascularization and gave our view on the future direction, including establishing the interactions between tissue-engineered skeletal muscle and the peripheral nervous system.
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Affiliation(s)
- Nitin Bharat Charbe
- Irma Lerma Rangel College of PharmacyTexas A&M Health Science CenterKingsvilleTexasUSA
| | - Murtaza Tambuwala
- School of Pharmacy and Pharmaceutical ScienceUlster UniversityColeraineUK
| | | | - Amol Warokar
- Department of PharmacyDadasaheb Balpande College of PharmacyNagpurIndia
| | - Altijana Hromić‐Jahjefendić
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural SciencesInternational University of SarajevoSarajevoBosnia and Herzegovina
| | - Hamid Bakshi
- School of Pharmacy and Pharmaceutical ScienceUlster UniversityColeraineUK
| | - Flavia Zacconi
- Departamento de Quimica Orgánica, Facultad de Química y de FarmaciaPontificia Universidad Católica de ChileSantiagoChile
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological SciencesPontificia Universidad Católica de ChileSantiagoChile
| | - Vijay Mishra
- School of Pharmaceutical SciencesLovely Professional UniversityPhagwaraIndia
| | - Saurabh Khadse
- Department of Pharmaceutical ChemistryR.C. Patel Institute of Pharmaceutical Education and ResearchDhuleIndia
| | - Alaa A. Aljabali
- Faculty of Pharmacy, Department of Pharmaceutical SciencesYarmouk UniversityIrbidJordan
| | - Mohamed El‐Tanani
- Pharmacological and Diagnostic Research Centre, Faculty of PharmacyAl‐Ahliyya Amman UniversityAmmanJordan
| | - Ãngel Serrano‐Aroca
- Biomaterials and Bioengineering Lab Translational Research Centre San Alberto MagnoCatholic University of Valencia San Vicente MártirValenciaSpain
| | - Srinath Palakurthi
- Irma Lerma Rangel College of PharmacyTexas A&M Health Science CenterKingsvilleTexasUSA
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Basgul C, Thieringer FM, Kurtz SM. Heat Transfer-Based Non-isothermal Healing Model for the Interfacial Bonding Strength of Fused Filament Fabricated Polyetheretherketone. ADDITIVE MANUFACTURING 2022; 46:102097. [PMID: 35155134 PMCID: PMC8827803 DOI: 10.1016/j.addma.2021.102097] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Fused Filament Fabrication (FFF) as an Additive Manufacturing (AM) method for Polyetheretherketone (PEEK) has established a promising future for medical applications so far, however interlayer delamination as a failure mechanism for FFF implants has raised critical concerns. A one-dimensional (1D) heat transfer model (HTM) was developed to compute the layer and interlayer temperatures by considering the nature of 3D printing for FFF PEEK builds. The HTM was then coupled with a non-isothermal healing model to predict the interlayer strength through thickness of a FFF PEEK part. We then conducted a parametric study of the primary temperature effects of the FFF system, including the print bed, nozzle, and chamber temperatures, on layer healing. The heat transfer component of the model for the FFF PEEK layer healing assessment was validated separately. An idealized PEEK cube design (10x10x10 mm3) was used for model development and 3D printed in commercially available industrial and medical FFF machines. During the printing and cooling processes of FFF, thermal videos were recorded in both printers using a calibrated infrared camera. Thermal images were then processed to obtain time-dependent layer temperature profiles of FFF PEEK prints. Both the theoretical model and experiments confirmed that the upper layers in reference to the print bed exhibited higher temperatures, thus higher healing degrees than the lower layers. Increasing the print bed temperature increased the healing of the layers allowing more layers to heal 100%. The nozzle temperature showed the most significant effect on the layer healing, and under certain nozzle temperature, none of the layers healed adequately. Although environment temperature had less impact on the lower layers closer to the print bed, 100% healed layer number increased when the chamber temperature increased. The model predictions were in good agreement with the experimental data, particularly for the mid-part of FFF PEEK cubes printed in both FFF machines.
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Affiliation(s)
- Cemile Basgul
- Implant Research Center, School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA
| | - Florian M. Thieringer
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland
| | - Steven M. Kurtz
- Implant Research Center, School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA
- Exponent, Inc., Philadelphia, PA
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12
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Antimicrobial incorporation on 3D-printed polymers used as potential dental materials and biomaterials: a systematic review of the state of the art. Polym Bull (Berl) 2022. [DOI: 10.1007/s00289-022-04427-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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13
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Bone grafting in maxillofacial trauma. Curr Opin Otolaryngol Head Neck Surg 2022; 30:260-264. [PMID: 35906979 DOI: 10.1097/moo.0000000000000809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of this article is to review the recent grafting strategies in maxillofacial trauma. RECENT FINDINGS Recent technological advancements have applications in the management of maxillofacial trauma; advancements in imaging modalities such as 3D imaging can help surgeons in both the preoperative and intraoperative periods. These may be coupled with navigational systems to further facilitate complex reconstructions. 3D printing has been used in reconstruction and 3D, 4D, and 5D bioprinting technologies continue to improve and to find new uses, and stem cells and growth factors in maxillofacial trauma are also among the most studied topics. Maxillofacial traumas have decreased in number during the COVID-19 pandemic, as more conservative approaches have been preferred in COVID pandemic conditions. SUMMARY Preoperative planning is the most important step in the reconstruction of maxillofacial trauma defects, and early bone and soft tissue reconstructions are recommended in severe maxillofacial traumas. Autogenous grafts are the gold standard in bone grafting. Nonvascularized grafts are planned according to the size, shape, and location of the defect, with vascularized bone flaps preferred in large defects, wide soft tissue defects, and contaminated defects. Alloplastic grafts or xenografts may be used if autogenous grafts are not available.
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14
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Ji T, Yao P, Zeng Y, Qian Z, Wang K, Gao L. Subgaleal Effusion and Brain Midline Shift After Cranioplasty: A Retrospective Study Between Polyetheretherketone Cranioplasty and Titanium Cranioplasty After Decompressive Craniectomy. Front Surg 2022; 9:923987. [PMID: 35937601 PMCID: PMC9351718 DOI: 10.3389/fsurg.2022.923987] [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: 04/20/2022] [Accepted: 06/10/2022] [Indexed: 11/21/2022] Open
Abstract
Cranioplasty with polyetheretherketone (PEEK) has recently shown better cerebral protection performance, improved brain function, and aesthetic contour compared with titanium mesh. However, whether patients undergoing PEEK cranioplasty tend to develop subgaleal effusions remains elusive. This retrospective study included patients who underwent cranioplasty with PEEK implants or titanium mesh after decompressive craniectomy between July 2017 and July 2020. Patient information, including general information, location, size of the defect, subgaleal depth, and brain midline shift was collected and statistically analyzed. There were 130 cases of cranioplasty, including 35 with PEEK implants and 95 with a titanium mesh. Patients who underwent cranioplasty with a PEEK implant had a higher subgaleal effusion rate than those who underwent cranioplasty with titanium mesh (85.71% vs. 53.68%, P < 0.001), while a midline shift >5 mm was more frequently observed in the PEEK group than in the titanium group (20% vs. 6.3%, P = 0.021). The PEEK material was the only factor associated with subgaleal effusion after cranioplasty (OR 5.589, P = 0.002). Logistic regression analysis further showed that age was a protective factor against midline shift in the PEEK cranioplasty group (OR 0.837, P = 0.029). Patients who underwent cranioplasty with PEEK implants were more likely to develop severe subgaleal effusion and significant brain midline shifts than those with titanium mesh implants.
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Affiliation(s)
- Tao Ji
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Peiwen Yao
- School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Yu Zeng
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Zhouqi Qian
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Ke Wang
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
- Correspondence: Liang Gao Ke Wang
| | - Liang Gao
- School of Clinical Medicine, Nanjing Medical University, Nanjing, China
- Correspondence: Liang Gao Ke Wang
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15
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Yu D, Lei X, Zhu H. Modification of polyetheretherketone (PEEK) physical features to improve osteointegration. J Zhejiang Univ Sci B 2022; 23:189-203. [PMID: 35261215 DOI: 10.1631/jzus.b2100622] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Polyetheretherketone (PEEK) has been widely applied in orthopedics because of its excellent mechanical properties, radiolucency, and biocompatibility. However, the bioinertness and poor osteointegration of PEEK have greatly limited its further application. Growing evidence proves that physical factors of implants, including their architecture, surface morphology, stiffness, and mechanical stimulation, matter as much as the composition of their surface chemistry. This review focuses on the multiple strategies for the physical modification of PEEK implants through adjusting their architecture, surface morphology, and stiffness. Many research findings show that transforming the architecture and incorporating reinforcing fillers into PEEK can affect both its mechanical strength and cellular responses. Modified PEEK surfaces at the macro scale and micro/nano scale have positive effects on cell-substrate interactions. More investigations are necessary to reach consensus on the optimal design of PEEK implants and to explore the efficiency of various functional implant surfaces. Soft-tissue integration has been ignored, though evidence shows that physical modifications also improve the adhesion of soft tissue. In the future, ideal PEEK implants should have a desirable topological structure with better surface hydrophilicity and optimum surface chemistry.
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Affiliation(s)
- Dan Yu
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Xiaoyue Lei
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Huiyong Zhu
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
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16
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Dua R, Rashad Z, Spears J, Dunn G, Maxwell M. Applications of 3D-Printed PEEK via Fused Filament Fabrication: A Systematic Review. Polymers (Basel) 2021; 13:4046. [PMID: 34833346 PMCID: PMC8619676 DOI: 10.3390/polym13224046] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 12/17/2022] Open
Abstract
Polyether ether ketone (PEEK) is an organic polymer that has excellent mechanical, chemical properties and can be additively manufactured (3D-printed) with ease. The use of 3D-printed PEEK has been growing in many fields. This article systematically reviews the current status of 3D-printed PEEK that has been used in various areas, including medical, chemical, aerospace, and electronics. A search of the use of 3D-printed PEEK articles published until September 2021 in various fields was performed using various databases. After reviewing the articles, and those which matched the inclusion criteria set for this systematic review, we found that the printing of PEEK is mainly performed by fused filament fabrication (FFF) or fused deposition modeling (FDM) printers. Based on the results of this systematic review, it was concluded that PEEK is a versatile material, and 3D-printed PEEK is finding applications in numerous industries. However, most of the applications are still in the research phase. Still, given how the research on PEEK is progressing and its additive manufacturing, it will soon be commercialized for many applications in numerous industries.
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Affiliation(s)
- Rupak Dua
- Department of Chemical Engineering, School of Engineering & Technology, Hampton University, Hampton, VA 23668, USA; (Z.R.); (J.S.)
| | - Zuri Rashad
- Department of Chemical Engineering, School of Engineering & Technology, Hampton University, Hampton, VA 23668, USA; (Z.R.); (J.S.)
| | - Joy Spears
- Department of Chemical Engineering, School of Engineering & Technology, Hampton University, Hampton, VA 23668, USA; (Z.R.); (J.S.)
| | - Grace Dunn
- The Governor’s School for Science and Technology, Hampton, VA 23666, USA;
| | - Micaela Maxwell
- Department of Chemistry and Biochemistry, School of Science, Hampton University, Hampton, VA 23668, USA;
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17
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Sharma N, Welker D, Aghlmandi S, Maintz M, Zeilhofer HF, Honigmann P, Seifert T, Thieringer FM. A Multi-Criteria Assessment Strategy for 3D Printed Porous Polyetheretherketone (PEEK) Patient-Specific Implants for Orbital Wall Reconstruction. J Clin Med 2021; 10:3563. [PMID: 34441859 PMCID: PMC8397160 DOI: 10.3390/jcm10163563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/02/2021] [Accepted: 08/10/2021] [Indexed: 12/18/2022] Open
Abstract
Pure orbital blowout fractures occur within the confines of the internal orbital wall. Restoration of orbital form and volume is paramount to prevent functional and esthetic impairment. The anatomical peculiarity of the orbit has encouraged surgeons to develop implants with customized features to restore its architecture. This has resulted in worldwide clinical demand for patient-specific implants (PSIs) designed to fit precisely in the patient's unique anatomy. Material extrusion or Fused filament fabrication (FFF) three-dimensional (3D) printing technology has enabled the fabrication of implant-grade polymers such as Polyetheretherketone (PEEK), paving the way for a more sophisticated generation of biomaterials. This study evaluates the FFF 3D printed PEEK orbital mesh customized implants with a metric considering the relevant design, biomechanical, and morphological parameters. The performance of the implants is studied as a function of varying thicknesses and porous design constructs through a finite element (FE) based computational model and a decision matrix based statistical approach. The maximum stress values achieved in our results predict the high durability of the implants, and the maximum deformation values were under one-tenth of a millimeter (mm) domain in all the implant profile configurations. The circular patterned implant (0.9 mm) had the best performance score. The study demonstrates that compounding multi-design computational analysis with 3D printing can be beneficial for the optimal restoration of the orbital floor.
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Affiliation(s)
- Neha Sharma
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland; (N.S.); (H.-F.Z.)
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland; (D.W.); (M.M.); (P.H.)
| | - Dennis Welker
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland; (D.W.); (M.M.); (P.H.)
| | - Soheila Aghlmandi
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, CH-4031 Basel, Switzerland;
| | - Michaela Maintz
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland; (D.W.); (M.M.); (P.H.)
- Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts Northwestern Switzerland, CH-4132 Muttenz, Switzerland
| | - Hans-Florian Zeilhofer
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland; (N.S.); (H.-F.Z.)
| | - Philipp Honigmann
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland; (D.W.); (M.M.); (P.H.)
- Hand Surgery, Cantonal Hospital Baselland, CH-4410 Liestal, Switzerland
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, NL-1105 Amsterdam, The Netherlands
| | - Thomas Seifert
- Department of Mechanical and Process Engineering, University of Applied Sciences, DE-77652 Offenburg, Germany;
| | - Florian M. Thieringer
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland; (N.S.); (H.-F.Z.)
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland; (D.W.); (M.M.); (P.H.)
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18
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Sharma N, Aghlmandi S, Dalcanale F, Seiler D, Zeilhofer HF, Honigmann P, Thieringer FM. Quantitative Assessment of Point-of-Care 3D-Printed Patient-Specific Polyetheretherketone (PEEK) Cranial Implants. Int J Mol Sci 2021; 22:8521. [PMID: 34445228 PMCID: PMC8395180 DOI: 10.3390/ijms22168521] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 07/26/2021] [Accepted: 08/05/2021] [Indexed: 12/18/2022] Open
Abstract
Recent advancements in medical imaging, virtual surgical planning (VSP), and three-dimensional (3D) printing have potentially changed how today's craniomaxillofacial surgeons use patient information for customized treatments. Over the years, polyetheretherketone (PEEK) has emerged as the biomaterial of choice to reconstruct craniofacial defects. With advancements in additive manufacturing (AM) systems, prospects for the point-of-care (POC) 3D printing of PEEK patient-specific implants (PSIs) have emerged. Consequently, investigating the clinical reliability of POC-manufactured PEEK implants has become a necessary endeavor. Therefore, this paper aims to provide a quantitative assessment of POC-manufactured, 3D-printed PEEK PSIs for cranial reconstruction through characterization of the geometrical, morphological, and biomechanical aspects of the in-hospital 3D-printed PEEK cranial implants. The study results revealed that the printed customized cranial implants had high dimensional accuracy and repeatability, displaying clinically acceptable morphologic similarity concerning fit and contours continuity. From a biomechanical standpoint, it was noticed that the tested implants had variable peak load values with discrete fracture patterns and failed at a mean (SD) peak load of 798.38 ± 211.45 N. In conclusion, the results of this preclinical study are in line with cranial implant expectations; however, specific attributes have scope for further improvements.
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Affiliation(s)
- Neha Sharma
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland; (N.S.); (H.-F.Z.)
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland;
| | - Soheila Aghlmandi
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, CH-4031 Basel, Switzerland;
| | - Federico Dalcanale
- Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts North-Western Switzerland, CH-4132 Muttenz, Switzerland; (F.D.); (D.S.)
| | - Daniel Seiler
- Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts North-Western Switzerland, CH-4132 Muttenz, Switzerland; (F.D.); (D.S.)
| | - Hans-Florian Zeilhofer
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland; (N.S.); (H.-F.Z.)
| | - Philipp Honigmann
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland;
- Hand Surgery, Cantonal Hospital Baselland, CH-4410 Liestal, Switzerland
- Amsterdam UMC, Department of Biomedical Engineering and Physics, University of Amsterdam, Amsterdam Movement Sciences, NL-1105 Amsterdam, The Netherlands
| | - Florian M. Thieringer
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland; (N.S.); (H.-F.Z.)
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland;
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19
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20
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Fabrication and Characterization of Fiber-Reinforced Composite Sandwich Structures Obtained by Fused Filament Fabrication Process. COATINGS 2021. [DOI: 10.3390/coatings11050601] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The application of fused filament fabrication processes is rapidly expanding in many domains such as aerospace, automotive, medical, and energy, mainly due to the flexibility of manufacturing structures with complex geometries in a short time. To improve the mechanical properties of lightweight sandwich structures, the polymer matrix can be strengthened with different materials, such as carbon fibers and glass fibers. In this study, fiber-reinforced composite sandwich structures were fabricated by FFF process and their mechanical properties were characterized. In order to conduct the mechanical tests for three-point bending, tensile strength, and impact behavior, two types of skins were produced from chopped carbon-fiber-reinforced skin using a core reinforced with chopped glass fiber at three infill densities of 100%, 60%, and 20%. Using microscopic analysis, the behavior of the breaking surfaces and the most common defects on fiber-reinforced composite sandwich structures were analyzed. The results of the mechanical tests indicated a significant influence of the filling density in the case of the three-point bending and impact tests. In contrast, the filling density does not decisively influence the structural performance of tensile tests of the fiber-reinforced composite sandwich structures. Composite sandwich structures, manufactured by fused filament fabrication process, were analyzed in terms of strength-to-mass ratio. Finite element analysis of the composite sandwich structures was performed to analyze the bending and tensile behavior.
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21
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Schönhoff LM, Mayinger F, Eichberger M, Reznikova E, Stawarczyk B. 3D printing of dental restorations: Mechanical properties of thermoplastic polymer materials. J Mech Behav Biomed Mater 2021; 119:104544. [PMID: 33901966 DOI: 10.1016/j.jmbbm.2021.104544] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 11/17/2022]
Abstract
In the seminal field of 3D printing of dental restorations, the time and cost saving manufacturing of removable and fixed dental prostheses from thermoplastic polymer materials employing fused filament fabrication (FFF) is gaining momentum. As of today, the additive manufacturing of the established semi-crystalline polyetheretherketone (PEEK) requires extensive post-processing and lacks precision. In this context, the amorphous polyphenylene sulfone (PPSU) may provide a higher predictability and reliability of the results. The aim of this study was to investigate the mechanical properties of PPSU and PEEK processed by FFF (PPSU1-3D (PPSU Radel) and PPSU2-3D (Ultrason P 3010 NAT)) or extrusion (PPSU1-EX (Radel R-5000 NT) and PEEK-CG (PEEK Juvora)). Three-point flexural strength, two-body wear, and Martens hardness (HM) and indentation modulus (EIT) were tested after aging. One-way ANOVA, the Kruskal-Wallis and the Pearson's and Spearman's correlation tests were computed (α = 0.05). PPSU1-3D and PPSU2-3D showed lower flexural strength values than PPSU1-EX and PEEK-CG. PPSU1-3D showed the highest, and PEEK-CG and PPSU1-EX the lowest height loss. The highest HM and EIT results were observed for PEEK-CG and the lowest for PPSU1-3D. Correlations were observed between all parameters except for the application height. In conclusion, the manufacturing process affected the flexural strength of PPSU, with 3D printed specimens presenting lower values than specimens cut from prefabricated molded material. This finding indicates that the 3D printing parameters employed for the additive manufacturing of PPSU specimens in the present investigation require further optimization. For 3D printed specimens, the quality of the filament showed an impact on the mechanical properties, underlining the importance of adhering to high quality standards during filament fabrication. Extruded PPSU led to comparable results with PEEK for flexural strength and two-body wear, indicating this novel dental restorative material to be a suitable alternative to the established PEEK for the manufacturing of both removable and fixed dental prostheses.
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Affiliation(s)
- Lisa Marie Schönhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Felicitas Mayinger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany.
| | - Marlis Eichberger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Elena Reznikova
- Apium Additive Technologies GmbH, Siemensallee 84, 76187, Karlsruhe, Germany
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
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22
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Sharma N, Ostas D, Rotar H, Brantner P, Thieringer FM. Design and Additive Manufacturing of a Biomimetic Customized Cranial Implant Based on Voronoi Diagram. Front Physiol 2021; 12:647923. [PMID: 33897455 PMCID: PMC8063040 DOI: 10.3389/fphys.2021.647923] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/15/2021] [Indexed: 12/21/2022] Open
Abstract
Reconstruction of cranial defects is an arduous task for craniomaxillofacial surgeons. Additive manufacturing (AM) or three-dimensional (3D) printing of titanium patient-specific implants (PSIs) made its way into cranioplasty, improving the clinical outcomes in complex surgical procedures. There has been a significant interest within the medical community in redesigning implants based on natural analogies. This paper proposes a workflow to create a biomimetic patient-specific cranial prosthesis with an interconnected strut macrostructure mimicking bone trabeculae. The method implements an interactive generative design approach based on the Voronoi diagram or tessellations. Furthermore, the quasi-self-supporting fabrication feasibility of the biomimetic, lightweight titanium cranial prosthesis design is assessed using Selective Laser Melting (SLM) technology.
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Affiliation(s)
- Neha Sharma
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (SwissMAM), University of Basel, Allschwil, Switzerland
| | - Daniel Ostas
- Department of Oral and Cranio-Maxillofacial Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horatiu Rotar
- Department of Oral and Cranio-Maxillofacial Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Philipp Brantner
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (SwissMAM), University of Basel, Allschwil, Switzerland.,Department of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Florian Markus Thieringer
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (SwissMAM), University of Basel, Allschwil, Switzerland
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23
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Matschinski A, Ziegler P, Abstreiter T, Wolf T, Drechsler K. Fiber Formation of Printed Carbon Fiber/Poly (Ether Ether Ketone) with Different Nozzle Shapes. POLYM INT 2021. [DOI: 10.1002/pi.6196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- A Matschinski
- Chair of Carbon Composites, TUM Department of Aerospace and Geodesy Technical University of Munich Garching Germany
| | - P Ziegler
- Chair of Carbon Composites, TUM Department of Aerospace and Geodesy Technical University of Munich Garching Germany
| | - T Abstreiter
- Chair of Astronautics, TUM Department of Aerospace and Geodesy Technical University of Munich Garching Germany
| | - T Wolf
- Chair of Carbon Composites, TUM Department of Aerospace and Geodesy Technical University of Munich Garching Germany
| | - K Drechsler
- Chair of Carbon Composites, TUM Department of Aerospace and Geodesy Technical University of Munich Garching Germany
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