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Ermawan R, Corrigan H, Wiyono N. Current update and trend of 3D printing in spinal surgery: A bibliometric analysis and review of literature. J Orthop 2024; 50:22-28. [PMID: 38162258 PMCID: PMC10755500 DOI: 10.1016/j.jor.2023.11.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/19/2023] [Indexed: 01/03/2024] Open
Abstract
Incorporation of three-dimensional (3D) printing technology into the field of spinal surgery is on the rise. A bibliometric analysis of the current topic was carried out to elaborate the trend and to navigate future research. A Scopus database search was conducted with keywords related to 3D printing, spine, and surgery. The final 792 articles were extracted and further analyzed with VOSviewer 1.6.19 and Biblioshiny. The first published article was in 2002. A notable increase in articles in 2014 might be attributable to the availability of cheaper 3D printers which rose significantly on a global scale in 2011. China leads in terms of published research on 3D printing in spinal surgery, followed by the US, Australia, and India. The author's keyword co-occurrence analysis reveals 8 theme clusters, including preoperative and intraoperative measures, biomodelling, spinal neoplasms, biomechanics of 3D-printed materials, degenerative spinal diseases, minimally invasive surgery, and bioprinting. The top 15 of the most recently cited keywords are listed to provide future researchers to produce impactful articles. Two strategic diagrams of 2 periods (2002-2018 and 2018-2023) show the theme's evolution. We found 6 consistent themes in keyword co-occurrence analysis and the strategic diagram analysis, that are promising subjects for future research. Overall, this bibliographic study indicates the expanding importance of 3D printing in spinal surgery and suggests several critical themes and impactful keywords for future researchers.
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Affiliation(s)
- Rieva Ermawan
- Department of Orthopaedic and Traumatology Dr. Moewardi General Province Hospital, Surakarta, Indonesia
- Department of Orthopaedic, Faculty of Medicine Sebelas Maret University Surakarta, Central Java, Indonesia
| | - Hubertus Corrigan
- Department of Orthopaedic and Traumatology Dr. Moewardi General Province Hospital, Surakarta, Indonesia
- Department of Orthopaedic, Faculty of Medicine Sebelas Maret University Surakarta, Central Java, Indonesia
- Department of Anatomy, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Nanang Wiyono
- Department of Anatomy, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
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Zheng Y, Zheng XG, Zhang JK, Wu JL, Yuan XH. [Digital study on proximal clavicle anatomical plate based on 3D printing technology]. Zhongguo Gu Shang 2024; 37:278-80. [PMID: 38515415 DOI: 10.12200/j.issn.1003-0034.20220965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
OBJECTIVE To explore feasibility of 3D metal printing technology combined with virtual design proximal clavicle anatomical plate. METHODS A 52-year-old male healthy volunteer was retrospectively selected to design proximal clavicle anatomical plate system by using Mimics15.01,NX12.0 and other software. STL data were input into 3D printer to print 1:1 clavicle model and proximal clavicle anatomical plate. The fit of the plate was tested in vitro and the accuracy of screw position was evaluated by imaging. Printing time of model,nail path design and fabrication time of the anatomical plate at proximal clavicle were recorded. RESULTS The 3D metal printing proximal clavicle anatomical plate fitted well to clavicle model,orientation of proximal clavicle locking screw was accurate,and X-ray and CT scan showed the screw position was good. Printing time of model,the time of nail path design,and the time of making anatomical plate of proximal clavicle were 120,15 and 300 min respectively. CONCLUSION The proximal clavicular anatomical plate system based on 3D metal printing technology could achieve good lamination of proximal clavicular fracture plate and precise screw placement,providing a new and accurate surgical method for the treatment of the proximal clavicular fracture.
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Affiliation(s)
- Yi Zheng
- Department of Orthopaedics, Hwamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China
| | - Xing-Guo Zheng
- Department of Orthopaedics, Hwamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China
| | - Jia-Kai Zhang
- Department of Orthopaedics, Hwamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China
| | - Jun-Long Wu
- Department of Orthopaedics, Hwamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China
| | - Xin-Hua Yuan
- Department of Orthopaedics, Hwamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China
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Maintz M, Msallem B, de Wild M, Seiler D, Herrmann S, Feiler S, Sharma N, Dalcanale F, Cattin P, Thieringer FM. Parameter optimization in a finite element mandibular fracture fixation model using the design of experiments approach. J Mech Behav Biomed Mater 2023; 144:105948. [PMID: 37348171 DOI: 10.1016/j.jmbbm.2023.105948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 06/24/2023]
Abstract
Only a few mandibular bone finite element (FE) models have been validated in literature, making it difficult to assess the credibility of the models. In a comparative study between FE models and biomechanical experiments using a synthetic polyamide 12 (PA12) mandible model, we investigate how material properties and boundary conditions affect the FE model's accuracy using the design of experiments approach. Multiple FE parameters, such as contact definitions and the materials' elastic and plastic deformation characteristics, were systematically analyzed for an intact mandibular model and transferred to the fracture fixation model. In a second step, the contact definitions for the titanium screw and implant (S-I), implant and PA12 mandible (I-M), and interfragmentary (IF) PA12 segments were optimized. Comparing simulated deformations (from 0 to -5 mm) and reaction forces (from 10 to 1'415 N) with experimental results showed a strong sensitivity to FE mechanical properties and contact definitions. The results suggest that using the bonded definition for the screw-implant contact of the fracture plate is ineffective. The contact friction parameter set with the highest agreement was identified: titanium screw and implant μ = 0.2, implant and PA12 mandible μ = 0.2, interfragmentary PA12 mandible μ = 0.1. The simulated reaction force (RMSE = 26.60 N) and surface displacement data (RMSE = 0.19 mm) of the FE analysis showed a strong agreement with the experimental biomechanical data. The results were generated through parameter optimization which means that our findings need to be validated in the event of a new dataset with deviating anatomy. Conclusively, the predictive capability of the FE model can be improved by FE model calibration through experimental testing. Validated preoperative quasi-static FE analysis could allow engineers and surgeons to accurately estimate how the implant's choice and placement suit the patient's biomechanical needs.
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Affiliation(s)
- Michaela Maintz
- 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; Institute for Medical Engineering and Medical Informatics IM(2), University of Applied Sciences and Arts Northwestern Switzerland FHNW, Muttenz, Switzerland.
| | - Bilal Msallem
- 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
| | - Michael de Wild
- Institute for Medical Engineering and Medical Informatics IM(2), University of Applied Sciences and Arts Northwestern Switzerland FHNW, Muttenz, Switzerland
| | - Daniel Seiler
- Institute for Medical Engineering and Medical Informatics IM(2), University of Applied Sciences and Arts Northwestern Switzerland FHNW, Muttenz, Switzerland
| | | | - Stefanie Feiler
- Group of Applied Mathematics in Life Sciences, Initial and Continuing Education, University of Applied Sciences and Arts Northwestern Switzerland FHNW, Muttenz, Switzerland, AICOS Technologies Ltd., Allschwil, Switzerland
| | - Neha Sharma
- 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
| | - Federico Dalcanale
- Institute for Medical Engineering and Medical Informatics IM(2), University of Applied Sciences and Arts Northwestern Switzerland FHNW, Muttenz, Switzerland
| | - Philippe Cattin
- Center of Medical Image Analysis and Navigation (CIAN), Department of Biomedical Engineering, University of Basel, Allschwil, Basel, Switzerland
| | - Florian Markus 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
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Yammine K, Karbala J, Maalouf A, Daher J, Assi C. Clinical outcomes of the use of 3D printing models in fracture management: a meta-analysis of randomized studies. Eur J Trauma Emerg Surg 2021; 48:3479-3491. [PMID: 34383092 DOI: 10.1007/s00068-021-01758-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/27/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The use of three-dimensional printing models in medical practice has been booming recently and its application to orthopedic surgery is gaining popularity. When treating fractures by open reduction and internal fixation, potential benefits have been associated with the use of 3D printing models. This review aims to quantitatively analyze the effectiveness of using 3D printing models in fracture management. MATERIALS AND METHODS A structured systematic review was conducted, and multiple databases were searched using a combination of terms related to 3D printing in fracture management. The literature search was limited from inception to Nov 2020. Only comparative randomized studies were accepted for inclusion. Any software or material using 3D printing versus no technological assistance was included. All types of fracture treated by open reduction and internal fixation were included. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was applied with the Joanna Briggs Institute's critical appraisal tool used to assess the quality of the included studies. Quantitative analysis was performed. RESULTS Based on 13 RCTs including 673 patients (325 and 348 in the 3D and control groups, respectively), the weighted effect size outcomes were as follows: (a) operative duration - 1.47 (95% CI = - 1.759 to - 1.182), (b) intraoperative blood loss - 1.41 (95% CI = - 1.792 to - 1.029), (c) fluoroscopy use - 1.25 (95% CI = - 1.637 to - 0.867), in favor of the 3D group. The weighted Odds ratio outcomes were: (a) overall good or excellent result 2.05 (95% CI = 1.119 to 3.845) and (b) anatomic fracture reduction 2.64 (95% CI = 1.150 to 6.051) in favor of the 3D group. The mean residual displacement and time to union showed no significant difference. The mean JBI appraisal tool score for the randomized studies was of 9, out of a maximum of 13. CONCLUSIONS When compared to the non-use of 3D technology for open reduction and internal fixation of fractures, the review demonstrated evidence that 3D printing yielded significantly better perioperative results. Further studies are needed to evaluate the effect of 3D printing on union and long-term function. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Kaissar Yammine
- Department of Orthopedic Surgery, School of Medicine, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, Beirut, Lebanon. .,Center for Evidence-Based Anatomy, Sport and Orthopedics Research, Beirut, Lebanon.
| | - Jad Karbala
- School of Medicine, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, Beirut, Lebanon
| | - Anthony Maalouf
- School of Medicine, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, Beirut, Lebanon
| | - Jimmy Daher
- Department of Orthopedic Surgery, School of Medicine, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, Beirut, Lebanon.,Center for Evidence-Based Anatomy, Sport and Orthopedics Research, Beirut, Lebanon
| | - Chahine Assi
- Department of Orthopedic Surgery, School of Medicine, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, Beirut, Lebanon.,Center for Evidence-Based Anatomy, Sport and Orthopedics Research, Beirut, Lebanon
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Marew T, Birhanu G. Three dimensional printed nanostructure biomaterials for bone tissue engineering. Regen Ther 2021; 18:102-111. [PMID: 34141834 PMCID: PMC8178073 DOI: 10.1016/j.reth.2021.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/29/2021] [Accepted: 05/04/2021] [Indexed: 12/13/2022] Open
Abstract
The suffering from organ dysfunction due to damaged or diseased tissue/bone has been globally on the rise. Current treatment strategies for non-union bone defects include: the use of autografts, allografts, synthetic grafts and free vascularized fibular grafts. Bone tissue engineering has emerged as an alternative for fracture repair to satisfy the current unmet need of bone grafts and to alleviate the problems associated with autografts and allografts. The technology offers the possibility to induce new functional bone regeneration using synergistic combination of functional biomaterials (scaffolds), cells, and growth factors. Bone scaffolds are typically made of porous biodegradable materials that provide the mechanical support during repair and regeneration of damaged or diseased bone. Significant progress has been made towards scaffold materials for structural support, desired osteogenesis and angiogenesis abilities. Thanks for innovative scaffolds fabrication technologies, bioresorbable scaffolds with controlled porosity and tailored properties are possible today. Despite the presence of different bone scaffold fabrication methods, pore size, shape and interconnectivity have not yet been fully controlled in most of the methods. Moreover, scaffolds with tailored porosity for specific defects are still difficult to manufacture. Nevertheless, such scaffolds can be designed and fabricated using three dimensional (3D) printing approaches. 3D printing technology, as an advanced tissue scaffold fabrication method, offers the opportunity to produce complex geometries with distinct advantages. The technology has been used for the production of various types of bodily constructs such as blood vessels, vascular networks, bones, cartilages, exoskeletons, eyeglasses, cell cultures, tissues, organs and novel drug delivery devices. This review focuses on 3D printed scaffolds and their application in bone repair and regeneration. In addition, different classes of biomaterials commonly employed for the fabrication of 3D nano scaffolds for bone tissue engineering application so far are briefly discussed.
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Affiliation(s)
- Tesfa Marew
- Department of Pharmaceutics & Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gebremariam Birhanu
- Department of Pharmaceutics & Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Wang TH, Zhao JC, Xiong F, Yang Y. Use of three dimensional-printing in the management of floating aortic thrombus due to occult aortic dissection: A case report. World J Clin Cases 2021; 9:1755-1760. [PMID: 33728322 PMCID: PMC7942031 DOI: 10.12998/wjcc.v9.i7.1755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Floating thrombus within the thoracic aorta is a rare entity but may cause systemic embolism. The pathogenesis of floating aortic thrombi is not yet fully understood. No definitive guidelines are available for the management of floating aortic thrombus.
CASE SUMMARY We report a 48-year-old patient, without a history of trauma and infection, who presented with sudden severe back pain. A floating thrombus within the aortic arch was found by computed tomography angiography (CTA). No evidence of coagulopathies was found. However, with the assistance of a three dimensional-printed model, this floating thrombus was identified to be caused by occult aortic dissection (AD). Subsequently, an emergency thoracic endovascular repair was performed. The patient’s back pain was rapidly alleviated postoperatively. CTA at 1 year showed no filling defect in the stent-graft and aorta.
CONCLUSION Occult AD is a potential factor causing floating aortic thrombi, endovascular stent-graft exclusion may be an optimal therapeutic choice with promising results. Moreover, the combination of CTA and three dimensional-printed models can contribute to the diagnosis and treatment of floating aortic thrombi due to occult AD.
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Affiliation(s)
- Tie-Hao Wang
- Department of Vascular Surgery, Sichuan University West China Hospital, Chengdu 610000, Sichuan Province, China
| | - Ji-Chun Zhao
- Department of Vascular Surgery, Sichuan University West China Hospital, Chengdu 610000, Sichuan Province, China
| | - Fei Xiong
- Department of Vascular Surgery, Sichuan University West China Hospital, Chengdu 610000, Sichuan Province, China
| | - Yi Yang
- Department of Vascular Surgery, Sichuan University West China Hospital, Chengdu 610000, Sichuan Province, China
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Cano-Zárate R, Hernández-Barajas EK, Hernández-Barajas HH, Meave-González A, Espínola-Zavaleta N. [Impact of 3D printing in surgical planning of congenital heart disease]. Arch Cardiol Mex 2021; 91:1-6. [PMID: 33661871 PMCID: PMC8258902 DOI: 10.24875/acm.20000395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introducción Los defectos cardíacos congénitos constituyen el 30% de todas las anomalías congénitas. La prevalencia es de 8/1,000 recién nacidos vivos, sin predominio de género. Para una planificación quirúrgica óptima es esencial una evaluación precisa de la anatomía en los defectos cardíacos congénitos. Las modalidades de imagen como el ecocardiograma, la angiografía por cateterismo cardíaco, la tomografía computarizada (TC) o la resonancia magnética (RM) se utilizan de forma regular para el diagnóstico de las cardiopatías congénitas. Estos métodos pueden proporcionar reconstrucciones virtuales en reconstrucción volumétrica o 3D, pero no réplicas táctiles reales de la anatomía cardíaca. Objetivo Realizar modelos de corazón impresos en 3D con la finalidad de proporcionar réplicas táctiles 3D reales de la anatomía cardíaca para visualizar de forma detallada todas las perspectivas posibles de las estructuras extracardíacas o intracardíacas. Métodos Los datos de la imagen se obtuvieron en formato DICOM, se editaron en el paquete de software "3D slicer 4.3" y se exportaron para la impresión en formato de archivo (.stl). Resultados y conclusiones Con la impresión 3D se puede evaluar de forma detallada la anatomía intracardíaca y extracardíaca con modelos cardíacos en tiempo real. Esta técnica es de gran utilidad, sobre todo en los defectos cardíacos congénitos complejos, ya que permite hacer una planificación precisa del procedimiento quirúrgico. Introduction Congenital heart disease makes up for 30% of all congenital anomalies. The prevalence is 8/1,000 live newborns, without predominance of gender. Imaging methods such as echocardiography, angiography, computed tomography or magnetic resonance imaging must be routinely used in congenital heart disease. The mentioned methods can provide virtual reconstructions in volumetric reconstruction or in three dimensional (3D), but only 3D-printed heart models can provide real 3D tactile replicas of cardiac anatomy. Objective To make 3D printed heart models in order to provide real 3D tactile replicas of the cardiac anatomy that allow a detailed visualization from all possible perspectives, either of extracardiac or intracardiac structures. Methods This information is useful for surgical decision making, especially in patients with complex cardiac defects. DICOM, edited in a software package “3D slicer 4.3” and exported for printing in file format (.stl). Results and conclusions With 3D printing, the intracardiac and extracardiac anatomy can be evaluated in detail with real-scale cardiac models of the patient, avoiding unexpected findings. This technique is very useful especially in complex congenital heart defects, since it allows precise planning of the surgical procedure.
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Affiliation(s)
- Roberto Cano-Zárate
- Departamento de Resonancia Magnética, Instituto Nacional de Cardiología Ignacio Chávez
| | | | | | - Aloha Meave-González
- Departamento de Resonancia Magnética, Instituto Nacional de Cardiología Ignacio Chávez
| | - Nilda Espínola-Zavaleta
- Departamento de Cardiología Nuclear, Instituto Nacional de Cardiología Ignacio Chávez. Ciudad de México, México
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Fleischhacker E, Ehrl D, Fürmetz J, Meller R, Böcker W, Zeckey C. [Reconstruction of large osteochondral defects of the distal femur and proximal tibia : Adaptation of fresh frozen allografts using 3D-printed models]. Unfallchirurg 2021; 124:74-9. [PMID: 32776223 DOI: 10.1007/s00113-020-00846-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Die Rekonstruktion großer osteochondraler Defekte stellt nach wie vor eine Herausforderung in der muskuloskeletalen Chirurgie dar. Frisch gefrorene Allografts sind eine häufig genutzte Ressource für die Behandlung solcher Gewebedefekte. Darüber hinaus ermöglichen 3D-gedruckte Kunststoffmodelle vielfältige Optionen in der präoperativen Planung und bei der intraoperativen Anpassung der Transplantate, sodass sie optimal einheilen und das bestmögliche funktionelle Ergebnis für den Patienten erreicht wird.
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Goyanes A, Madla CM, Umerji A, Duran Piñeiro G, Giraldez Montero JM, Lamas Diaz MJ, Gonzalez Barcia M, Taherali F, Sánchez-Pintos P, Couce ML, Gaisford S, Basit AW. Automated therapy preparation of isoleucine formulations using 3D printing for the treatment of MSUD: First single-centre, prospective, crossover study in patients. Int J Pharm 2019; 567:118497. [PMID: 31279771 DOI: 10.1016/j.ijpharm.2019.118497] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 02/04/2023]
Abstract
Maple syrup urine disease (MSUD) is a rare metabolic disorder with a worldwide prevalence of 1 in every 185,000 live births. However, certain populations display a significant overexpression of the disorder where incidence is reported to be 1 in every 52,541 new-borns. The first-line therapy for MSUD involves a strict dietary leucine restriction and oral supplementation of isoleucine and valine. The dose administered to patients requires strict tailoring according to age, weight and blood levels. In current clinical practice, however, practitioners still have to prepare extemporaneous formulations due to the lack of suitable oral treatments for MSUD. Herein, we evaluate the first time use of 3D printing in a hospital setting for the preparation of personalised therapies with the aim of improving safety and acceptability to isoleucine supplementation in paediatric patients suffering from MSUD. This investigation was a single-centre, prospective crossover experimental study. Four paediatric patients with MSUD (aged 3-16 years) were treated at the Clinic University Hospital in Santiago de Compostela, Spain which is a MSUD reference hospital in Europe. The primary objective was to evaluate isoleucine blood levels after six months of treatment with two types of formulations; conventional capsules prepared by manual compounding and personalised chewable formulations prepared by automated 3D printing. A secondary investigation was to evaluate patient acceptability of 3D printed formulations prepared with different flavours and colours. Isoleucine blood levels in patients were well controlled using both types of formulations, however, the 3D printed therapy showed mean levels closer to the target value and with less variability (200-400 µM). The 3D printed formulations were well accepted by patients regarding flavour and colour. The study demonstrates for the first time that 3D printing offers a feasible, rapid and automated approach to prepare oral tailored-dose therapies in a hospital setting. 3D printing has shown to be an effective manufacturing technology in producing chewable isoleucine printlets as a treatment of MSUD with good acceptability.
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Affiliation(s)
- Alvaro Goyanes
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK; Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma Group (GI-1645), Universidade de Santiago de Compostela, 15782, Spain.
| | - Christine M Madla
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Aysha Umerji
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Goretti Duran Piñeiro
- Pharmacy Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Travesía Choupana s/n, Santiago de Compostela 15706, Spain
| | - Jose Maria Giraldez Montero
- Pharmacy Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Travesía Choupana s/n, Santiago de Compostela 15706, Spain
| | - María Jesús Lamas Diaz
- Pharmacy Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Travesía Choupana s/n, Santiago de Compostela 15706, Spain
| | - Miguel Gonzalez Barcia
- Pharmacy Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Travesía Choupana s/n, Santiago de Compostela 15706, Spain
| | - Farhan Taherali
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Paula Sánchez-Pintos
- Servicio de Neonatología, Unidad de Diagnóstico y Tratamiento de Enfermedades Metabólicas Congénitas, Hospital Clínico Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, IDIS, CIBERER, MetabERN, Spain
| | - Maria-Luz Couce
- Servicio de Neonatología, Unidad de Diagnóstico y Tratamiento de Enfermedades Metabólicas Congénitas, Hospital Clínico Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, IDIS, CIBERER, MetabERN, Spain
| | - Simon Gaisford
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK; UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Abdul W Basit
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK; UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK.
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Goyanes A, Allahham N, Trenfield SJ, Stoyanov E, Gaisford S, Basit AW. Direct powder extrusion 3D printing: Fabrication of drug products using a novel single-step process. Int J Pharm 2019; 567:118471. [PMID: 31252147 DOI: 10.1016/j.ijpharm.2019.118471] [Citation(s) in RCA: 130] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/23/2019] [Accepted: 06/24/2019] [Indexed: 12/24/2022]
Abstract
Three-dimensional (3D) printing is revolutionising how we envision manufacturing in the pharmaceutical field. Here, we report for the first time the use of direct powder extrusion 3D printing: a novel single-step printing process for the production of printlets (3D printed tablets) directly from powdered materials. This new 3D printing technology was used to prepare amorphous solid dispersions of itraconazole using four different grades of hydroxypropylcellulose (HPC - UL, SSL, SL and L). All of the printlets showed good mechanical and physical characteristics and no drug degradation. The printlets showed sustained drug release characteristics, with drug concentrations higher than the solubility of the drug itself. The printlets prepared with the ultra-low molecular grade (HPC - UL) showed faster drug release compared with the other HPC grades, attributed to the fact that itraconazole was found in a higher percentage as an amorphous solid dispersion. This work demonstrates the potential of this innovate technology to overcome one of the major disadvantages of fused deposition modelling (FDM) 3D printing by avoiding the need for preparation of filaments by hot melt extrusion (HME). This novel single-step technology could revolutionise the preparation of amorphous solid dispersions as final formulations and it may be especially suited for preclinical studies, where the quantity of drugs is limited and without the need of using traditional HME.
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Affiliation(s)
- Alvaro Goyanes
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK; Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, R+D Pharma Group (GI-1645), Universidade de Santiago de Compostela, 15782, Spain.
| | - Nour Allahham
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK
| | - Sarah J Trenfield
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK; UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Edmont Stoyanov
- Nisso Chemical Europe GmbH, Berliner Allee 42, 40212 Dusseldorf, Germany
| | - Simon Gaisford
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK; UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Abdul W Basit
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK; UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK.
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11
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Kalenderer Ö, Erkuş S, Turgut A, İnan İH. Preoperative planning of femoral head reduction osteotomy using 3D printing model: A report of two cases. Acta Orthop Traumatol Turc 2019; 53:226-229. [PMID: 30709647 PMCID: PMC6599387 DOI: 10.1016/j.aott.2019.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 12/10/2018] [Accepted: 01/10/2019] [Indexed: 12/05/2022]
Abstract
The deformed and enlarged femoral head secondary to hip diseases such as Legg Calve Perthes and Developmental Dysplasia usually causes impingement between the aspherical head and the acetabulum. To restore and reduce the size of enlarged femoral head, a femoral head reduction technique has been described previously. The goal is to obtain a spherical femoral head and to cover the gliding surface with best available cartilage. Planning of osteotomy to achieve spherical head is the crucial point of surgery. It is usually done intra-operatively and dependent on experience of surgeon. Preoperative 3- Dimension (D) modeling of femoral head is commonly preferred to minimize this risk. In this technical note, preoperative planning with 3-D printing was demonstrated in two separate patients with Legg-Calve-Perthes Disease and developmental hip dysplasia. Surgical time was approximately 150 and 120 min, respectively. Blood loss was 230 and 300 cc, respectively. Patients were followed up 9 months and 12 months, respectively. None of the patients in this study developed avascular necrosis; however, the follow-up period is very limited. Moreover, none of the patients developed post-operative complications or required additional surgery. With a more detailed preoperative planning done on computer model and printed in 3-D, one can mimic the surgical procedure before the procedure. Finally, this technique is advantageous both for the patient and surgeon.
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Affiliation(s)
- Önder Kalenderer
- Tepecik Training and Research Hospital, Department of Orthopaedics and Traumatology, İzmir, Turkey.
| | - Serkan Erkuş
- Tepecik Training and Research Hospital, Department of Orthopaedics and Traumatology, İzmir, Turkey
| | - Ali Turgut
- Tepecik Training and Research Hospital, Department of Orthopaedics and Traumatology, İzmir, Turkey
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12
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Kaye R, Goldstein T, Grande DA, Zeltsman D, Smith LP. A 3-dimensional bioprinted tracheal segment implant pilot study: Rabbit tracheal resection with graft implantation. Int J Pediatr Otorhinolaryngol 2019; 117:175-178. [PMID: 30579077 DOI: 10.1016/j.ijporl.2018.11.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/06/2018] [Accepted: 11/08/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Surgical reconstruction of tracheal disease has expanded to include bioengineering and three dimensional (3D) printing. This pilot study investigates the viability of introducing a living functional tracheal replacement graft in a rabbit animal model. METHODS Seven New Zealand White rabbits were enrolled and six completed participation (one intraoperative mortality). Tracheal replacement grafts were created by impregnating 3D printed biodegradable polycaprolactone (PCL) tracheal scaffolds with rabbit tracheal hyaline chondrocytes. 2 cm of native trachea was resected and the tracheal replacement graft implanted. Subjects were divided into two equal groups (n = 3) that differed in their time of harvest following implantation (three or six weeks). Tracheal specimens were analyzed with intraluminal telescopic visualization and histopathology. RESULTS The two groups did not significantly differ in histopathology or intraluminal diameter. All sections wherein the implant telescoped over native trachea (anastomotic ends) contained adequate hyaline cartilage formation (i.e. chondrocytes within lacuna, surrounding extracellular matrix, and strong Safranin O staining). Furthermore, the PCL scaffold was surrounded by a thin layer of fibrous tissue. All areas without membranous coverage contained inadequate or immature cartilage formation with inflammation. The average intraluminal stenosis was 83.4% (range 34.2-95%). CONCLUSIONS We report normal cartilage growth in a tracheal replacement graft when chondrocytes are separated from the tracheal lumen by an intervening membrane. When no such membrane exists there is a propensity for inflammation and stenosis. These findings are important for future construction and implantation of tracheal replacement grafts. LEVEL OF EVIDENCE Not applicable: this is an in vivo animal trial.
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Affiliation(s)
- Rachel Kaye
- Rutgers New Jersey Medical School, Newark, NJ, USA.
| | - Todd Goldstein
- The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Daniel A Grande
- The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - David Zeltsman
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Division of Thoracic Surgery, Northwell Health System, New Hyde Park, NY, USA
| | - Lee P Smith
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Division of Pediatric Otolaryngology, Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, NY, USA
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13
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Luo H, Xie WG, Zhang W, Tang YL, Ru TF, Lei F, Chen P. [Design and manufacture of a utility artificial hand for a burned child by three-dimensional printing technology and its application]. Zhonghua Shao Shang Za Zhi 2018; 34:526-8. [PMID: 30157556 DOI: 10.3760/cma.j.issn.1009-2587.2018.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In May 2015, a child with absence of most of the five fingers with scar formation after healing of a left hand burn wound hospitalized in our burn ward. According to the free online design program for making artificial limbs using three-dimensional printing technology on the internet, a utility artificial hand, most of which made of plastic parts, was designed for the child and printed by a three-dimensional printer. The child was instructed to wear and use the utility artificial hand, including driving the finger part of the utility artificial hand to make a grasping action by flexing the wrist joint. On the first day of using the utility artificial hand, the time the right hand and the utility artificial hand took to finish the Nine-Hole Peg Test (NHPT) was 24 and 325 s, respectively. After training, the child could grab some light and rough objects. After 3 months of follow-up, the child could use the utility artificial hand to cooperate with the upper limb of the healthy side to make the movements of picking up the basketball and keeping the balance of body on the bicycle. The time the right hand and the utility artificial hand took to finish NHPT was 21 and 193 s, respectively. The time the utility artificial hand took increased by 40.6% compared with the initial period. By assembling the three-dimensionally printed utility artificial hand, the partial appearance image of the child was restored, and some of the hand functions were compensated, which improved the self-care ability of the child in daily life and was beneficial to his physical and mental development.
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14
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Roushangar Zineh B, Shabgard MR, Roshangar L. Mechanical and biological performance of printed alginate/methylcellulose/halloysite nanotube/polyvinylidene fluoride bio-scaffolds. Mater Sci Eng C Mater Biol Appl 2018; 92:779-789. [PMID: 30184807 DOI: 10.1016/j.msec.2018.07.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 12/27/2017] [Accepted: 07/12/2018] [Indexed: 01/15/2023]
Abstract
Use of artificial cartilage due to its poor regenerative characteristics is a challenging issue in the field of tissue engineering. In this regard, three-dimensional printing (3D) technique because of its perfect structural control is one of the best methods for producing biological scaffolds. Proper biomaterials for cartilage repairs with good mechanical and biological properties and the high ability for 3D printing are limited. In this paper, a novel biomaterial consisting of Alginate (AL), Methylcellulose (MC), Halloysite Nanotube (HNT), and Polyvinylidene Fluoride (PVDF) was printed and characterized for cartilage scaffold applications. Calcium chloride (CaCl2) was used as a crosslinker for biomaterial after printing. Scanning Electron Microscopy (SEM), Energy-Dispersive X-Ray Spectroscopy (EDX), X-Ray Diffraction (XRD), Fourier-Transform Infrared Spectroscopy (FT-IR), Differential Scanning Calorimetry (DSC), tensile and compressive tests, chondrocytes seeding, cells staining, and MTT assay were carried out in the present work. The results show that in constant concentrations of AL, MC, and PVDF (40 mg/ml AL, 30 mg/ml MC, and 1% PVDF) when concentration of HNT increased from 20 mg/ml (S2) to 40 mg/ml (S14) tensile strength increased from 164 up to 381 kPa and compressive stress increased from 426 up to 648 kPa. According to spectroscopy and calorimetry results, Biomaterial shows an amorphous structure with good miscibility and a high percentage of water in its structure. PVDF reduces mechanical properties by 7% while increases cell viability by 8.75%. Histological studies and MTT assay results showed a high improvement in the percentage of living cells at the first 4 days of cell cultivation.
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Affiliation(s)
| | | | - Leila Roshangar
- Stem Cells Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Iran
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15
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Arafat B, Qinna N, Cieszynska M, Forbes RT, Alhnan MA. Tailored on demand anti-coagulant dosing: An in vitro and in vivo evaluation of 3D printed purpose-designed oral dosage forms. Eur J Pharm Biopharm 2018; 128:282-289. [PMID: 29673871 DOI: 10.1016/j.ejpb.2018.04.010] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/08/2018] [Accepted: 04/14/2018] [Indexed: 11/30/2022]
Abstract
Coumarin therapy has been associated with high levels of inter- and intra-individual variation in the required dose to reach a therapeutic anticoagulation outcome. Therefore, a dynamic system that is able to achieve accurate delivery of a warfarin dose is of significant importance. Here we assess the ability of 3D printing to fabricate and deliver tailored individualised precision dosing using in-vitro and in-vivo models. Sodium warfarin loaded filaments were compounded using hot melt extrusion (HME) and further fabricated via fused deposition modelling (FDM) 3D printing to produce capsular-ovoid-shaped dosage forms loaded at 200 or 400 µg dose. The solid dosage forms and comparator warfarin aqueous solutions were administered by oral gavage to Sprague-Dawley rats. A novel UV imaging approach indicated that the erosion of the methacrylate matrix was at a rate of 16.4 and 15.2 µm/min for horizontal and vertical planes respectively. In vivo, 3D printed forms were as proportionately effective as their comparative solution form in doubling plasma exposure following a doubling of warfarin dose (184% versus 192% respectively). The 3D printed ovoids showed a lower Cmax of warfarin (1.51 and 3.33 mg/mL versus 2.5 and 6.44 mg/mL) and a longer Tmax (6 and 3.7 versus 4 and 1.5 h) in comparison to liquid formulation. This work demonstrates for the first time in vivo, the potential of FDM 3D printing to produce a tailored specific dosage form and to accurately titrate coumarin dose response to an individual patient.
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Affiliation(s)
- Basel Arafat
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire, UK; Faculty of Medical Sciences and Public Health, Anglia Ruskin University, Chelmsford, UK
| | - Nidal Qinna
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Milena Cieszynska
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire, UK
| | - Robert T Forbes
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire, UK
| | - Mohamed A Alhnan
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire, UK.
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16
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Yan X, Lin H. [Research progress in CoCr metal-ceramic alloy fabricated by selective laser melting]. Zhonghua Kou Qiang Yi Xue Za Zhi 2018; 53:141-144. [PMID: 29429239 DOI: 10.3760/cma.j.issn.1002-0098.2018.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cobalt-chromium alloys have been applied to dental porcelain fused to metal (PFM) restorations over the past decades owing to their excellent corrosion resistance, good biocompatibility and low price. The production of CoCr metal-ceramic restorations has always been based on traditional lost-wax casting techniques. However, in recent years, selective laser melting (SLM) is becoming more and more highly valued by dental laboratories and dental practitioners due to its individuation, precision and efficiency. This paper mainly reviews the recent researches on the production process of copings, microstructure, mechanical property, metal-ceramic bond strength, fit of copings, corrosion resistance and biocompatibility of SLM CoCr metal-ceramic alloy.
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Affiliation(s)
- X Yan
- Dental Material Research Center, Dental Medical Devices Testing Centre, Peking University and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - H Lin
- Dental Material Research Center, Dental Medical Devices Testing Centre, Peking University and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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17
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Goyanes A, Scarpa M, Kamlow M, Gaisford S, Basit AW, Orlu M. Patient acceptability of 3D printed medicines. Int J Pharm 2017; 530:71-78. [PMID: 28750894 DOI: 10.1016/j.ijpharm.2017.07.064] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 07/19/2017] [Accepted: 07/21/2017] [Indexed: 11/20/2022]
Abstract
Patient-centric medicine is a derivative term for personalised medicine, whereby the pharmaceutical product provides the best overall benefit by meeting the comprehensive needs of the individual; considering the end-user from the beginning of the formulation design process right through development to an end product is a must. One way in which to obtain personalised medicines, on-site and on-demand is by three-dimensional printing (3DP). The aim of this study was to investigate the influence of the shape, size and colour of different placebo 3D printed tablets (Printlets™) manufactured by fused deposition modelling (FDM) 3DP on end-user acceptability regarding picking and swallowing. Ten different printlet shapes were prepared by 3DP for an open-label, randomised, exploratory pilot study with 50 participants. Participant-reported outcome (PRO) and researcher reported outcome (RRO) were collected after picking and swallowing of selected printlet geometries including sphere, torus, disc, capsule and tilted diamond shapes. The torus printlet received the highest PRO cores for ease of swallowing and ease of picking. Printlets with a similar appearance to conventional formulations (capsule and disc shape) were also found to be easy to swallow and pick which demonstrates that familiarity is a critical acceptability attribute for end-users. RRO scores were in agreement with the PRO scores. The sphere was not perceived to be an appropriate way of administering an oral solid medicine. Smaller printlet sizes were found to be preferable; however it was found that the perception of size was driven by the type of shape. Printlet colour was also found to affect the perception of the end-user. Our study is the first to guide the pharmaceutical industry towards developing patient-centric medicine in different geometries via 3DP. Overall, the highest acceptability scores for torus printlets indicates that FDM 3DP is a promising fabrication technology towards increasing patient acceptability of solid oral medicines.
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Affiliation(s)
| | - Mariagiovanna Scarpa
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK
| | - Michael Kamlow
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK
| | - Simon Gaisford
- FabRx Ltd., 3 Romney Road, Ashford, Kent, TN24 0RW, UK; UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK
| | - Abdul W Basit
- FabRx Ltd., 3 Romney Road, Ashford, Kent, TN24 0RW, UK; UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK
| | - Mine Orlu
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK.
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18
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Goyanes A, Kobayashi M, Martínez-Pacheco R, Gaisford S, Basit AW. Fused-filament 3D printing of drug products: Microstructure analysis and drug release characteristics of PVA-based caplets. Int J Pharm 2017; 514:290-295. [PMID: 27863674 DOI: 10.1016/j.ijpharm.2016.06.021] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 10/20/2022]
Abstract
Fused deposition modeling (FDM) 3-Dimensional (3D) printing is becoming an increasingly important technology in the pharmaceutical sciences, since it allows the manufacture of personalized oral dosage forms by deposition of thin layers of material. Here, a filament extruder was used to obtain filaments of polyvinyl alcohol (PVA) containing paracetamol or caffeine appropriate for 3D printing. The filaments were used to manufacture caplets for oral administration by FDM 3D printing, with the aim of evaluating the effect of the internal structure (micropore volume), drug loading and composition on drug dissolution behaviour. Micropore volume of the caplets was primarily determined by the presence of large pores due to gaps in the printed layers/net while printing, and the porosity of the caplets was 10 fold higher than the porosity of the extruded filament. Dynamic dissolution drug release tests on the caplets in biorelevant bicarbonate media revealed distinctive release profiles, which were dependent on drug solubility and drug loading. Porosity of the caplets did not help to predict the different drug release profiles. This study confirms the potential of 3D printing to fabricate caplets and helps to elucidate which factors influence drug release from this type of new dosage form.
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Affiliation(s)
- Alvaro Goyanes
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK; Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Masanori Kobayashi
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK; Pharmaceutical Research and Technology Labs., Astellas Pharma Inc., 180 Ozumi, Yaizu-shi, Shizuoka 425-0072, Japan
| | - Ramón Martínez-Pacheco
- Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Simon Gaisford
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK; FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK
| | - Abdul W Basit
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK; FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK.
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Li Q, Wen H, Jia D, Guan X, Pan H, Yang Y, Yu S, Zhu Z, Xiang R, Pan W. Preparation and investigation of controlled-release glipizide novel oral device with three-dimensional printing. Int J Pharm 2017; 525:5-11. [PMID: 28377316 DOI: 10.1016/j.ijpharm.2017.03.066] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 03/06/2017] [Accepted: 03/26/2017] [Indexed: 01/19/2023]
Abstract
The purpose of this study was to explore the feasibility of combining fused deposition modeling (FDM) 3D printing technology with hot melt extrusion (HME) to fabricate a novel controlled-release drug delivery device. Glipizide used in the treatment of diabetes was selected as model drug, and was successfully loaded into commercial polyvinyl alcohol (PVA) filaments by HME method. The drug-loaded filaments were printed through a dual-nozzle 3D printer, and finally formed a double-chamber device composed by a tablet embedded within a larger tablet (DuoTablet), each chamber contains different contents of glipizide. The drug-loaded 3D printed device was evaluated for drug release under in vitro dissolution condition, and we found the release profile fit Korsmeyer-Peppas release kinetics. With the double-chamber design, it is feasible to design either controlled drug release or delayed drug release behavior by reasonably arranging the concentration distribution of the drug in the device. The characteristics of the external layer performed main influence on the release profile of the internal compartment such as lag-time or rate of release. The results of this study suggest the potential of 3D printing to fabricate controlled-release drug delivery system containing multiple drug concentration distributions via hot melt extrusion method and specialized design configurations.
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Affiliation(s)
- Qijun Li
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Haoyang Wen
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Danyang Jia
- Department of Pharmaceutical Information, School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Xiaoying Guan
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Hao Pan
- College of Pharmacy, Liaoning University, 66 Chongshan Middle Road, Shenyang 110036, China
| | - Yue Yang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Shihui Yu
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Zhihong Zhu
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Rongwu Xiang
- School of Medical Instrument, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China.
| | - Weisan Pan
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China.
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20
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Sun Y, Ruan X, Li H, Kathuria H, Du G, Kang L. Fabrication of non-dissolving analgesic suppositories using 3D printed moulds. Int J Pharm 2016; 513:717-24. [PMID: 27686053 DOI: 10.1016/j.ijpharm.2016.09.073] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 09/22/2016] [Accepted: 09/25/2016] [Indexed: 12/16/2022]
Abstract
Conventional suppositories sometimes fail in exerting their therapeutic activity as the base materials melt inside body cavities. Also they are not suitable to provide long term treatment. Biomedical grade silicone elastomers may be used to fabricate non-dissolvable suppositories to overcome these disadvantages. We kneaded 4 analgesics into the 2 kinds of silicone polymers at 1%, 5% and 10% drug loading, respectively, to test their mechanical properties and drug release profiles. The optimized drug-polymer combinations were used to fabricate suppositories, and three dimensional printing (3DP) was used to create the suppository moulds. Subsequently, the drug release profiles and biocompatibility of the suppositories were studied. It was found that, the mechanical properties of the drug laden silicone elastomers and the rate of drug release from the elastomers can be tuned by varying drug-polymer combinations. The silicone elastomers containing 1% (w/w) and 5% (w/w) diclofenac sodium were the optimal formulations with prolonged drug release and biocompatibility at cellular level. These properties, together with complex geometries offered by 3DP technique, potentially made the non-dissolving suppositories promising therapeutic agents for personalized medicine.
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21
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Goyanes A, Chang H, Sedough D, Hatton GB, Wang J, Buanz A, Gaisford S, Basit AW. Fabrication of controlled-release budesonide tablets via desktop (FDM) 3D printing. Int J Pharm 2015; 496:414-20. [PMID: 26481468 DOI: 10.1016/j.ijpharm.2015.10.039] [Citation(s) in RCA: 187] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/09/2015] [Accepted: 10/11/2015] [Indexed: 10/22/2022]
Abstract
The aim of this work was to explore the feasibility of using fused deposition modelling (FDM) 3D printing (3DP) technology with hot melt extrusion (HME) and fluid bed coating to fabricate modified-release budesonide dosage forms. Budesonide was sucessfully loaded into polyvinyl alcohol filaments using HME. The filaments were engineered into capsule-shaped tablets (caplets) containing 9mg budesonide using a FDM 3D printer; the caplets were then overcoated with a layer of enteric polymer. The final printed formulation was tested in a dynamic dissolution bicarbonate buffer system, and two commercial budesonide products, Cortiment® (Uceris®) and Entocort®, were also investigated for comparison. Budesonide release from the Entocort® formulation was rapid in conditions of the upper small intestine while release from the Cortiment® product was more delayed and very slow. In contrast, the new 3D printed caplet formulation started to release in the mid-small intestine but release then continued in a sustained manner throughout the distal intestine and colon. This work has demonstrated the potential of combining FDM 3DP with established pharmaceutical processes, including HME and film coating, to fabricate modified release oral dosage forms.
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Affiliation(s)
- Alvaro Goyanes
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Hanah Chang
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Daniel Sedough
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Grace B Hatton
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Jie Wang
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Asma Buanz
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Simon Gaisford
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK
| | - Abdul W Basit
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK.
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22
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Inzana JA, Olvera D, Fuller SM, Kelly JP, Graeve OA, Schwarz EM, Kates SL, Awad HA. 3D printing of composite calcium phosphate and collagen scaffolds for bone regeneration. Biomaterials. 2014;35:4026-4034. [PMID: 24529628 DOI: 10.1016/j.biomaterials.2014.01.064] [Citation(s) in RCA: 449] [Impact Index Per Article: 44.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 01/24/2014] [Indexed: 02/07/2023]
Abstract
Low temperature 3D printing of calcium phosphate scaffolds holds great promise for fabricating synthetic bone graft substitutes with enhanced performance over traditional techniques. Many design parameters, such as the binder solution properties, have yet to be optimized to ensure maximal biocompatibility and osteoconductivity with sufficient mechanical properties. This study tailored the phosphoric acid-based binder solution concentration to 8.75 wt% to maximize cytocompatibility and mechanical strength, with a supplementation of Tween 80 to improve printing. To further enhance the formulation, collagen was dissolved into the binder solution to fabricate collagen-calcium phosphate composites. Reducing the viscosity and surface tension through a physiologic heat treatment and Tween 80, respectively, enabled reliable thermal inkjet printing of the collagen solutions. Supplementing the binder solution with 1-2 wt% collagen significantly improved maximum flexural strength and cell viability. To assess the bone healing performance, we implanted 3D printed scaffolds into a critically sized murine femoral defect for 9 weeks. The implants were confirmed to be osteoconductive, with new bone growth incorporating the degrading scaffold materials. In conclusion, this study demonstrates optimization of material parameters for 3D printed calcium phosphate scaffolds and enhancement of material properties by volumetric collagen incorporation via inkjet printing.
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Murugesan K, Anandapandian PA, Sharma SK, Vasantha Kumar M. Comparative evaluation of dimension and surface detail accuracy of models produced by three different rapid prototype techniques. J Indian Prosthodont Soc 2011; 12:16-20. [PMID: 23449946 DOI: 10.1007/s13191-011-0103-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 09/07/2011] [Indexed: 12/28/2022] Open
Abstract
Rapid prototyping (RP) is a technology that produces physical models by selectively solidifying ultra violet (UV) sensitive liquid resin using a laser beam. These models can be formed using various techniques. A study was undertaken to compare the dimensional accuracy and surface details of three prototype models with a 3D STL (standard template library) image. In this study the STL file was used to produce three different rapid prototype models namely; model 1-fused deposition model (FDM) using ABS (acrylonitrile butadiene styrene), model 2-Polyjet using a clear resin and model 3-a 3 dimensional printing using a composite material. Measurements were made at various anatomical points. For surface detail reproductions the models were subjected to scanning electron microscopy analysis. The dimensions of the model created by Polyjet were closest to the 3D STL virtual image followed by the 3DP model and FDM. SEM analysis showed uniform smooth surface on Polyjet model with adequate surface details.
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Affiliation(s)
- K Murugesan
- 1/1, Angadi Street, V P Colony, Ayanavaram, Chennai, Tamil Nadu 600023 India ; Department of Prosthodontics, SRM Dental College, Ramapuram, Chennai, India
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