Exposure to emissions generated by 3-dimensional printing with polycarbonate: effects on peripheral vascular function, cardiac vascular morphology and expression of markers of oxidative stress in male rat cardiac tissue

Three-dimensional (3D) printing with polycarbonate (PC) plastic occurs in manufacturing settings, homes, and schools. Emissions generated during printing with PC stock and bisphenol-A (BPA), an endocrine disrupter in PC, may induce adverse health effects. Inhalation of 3D printer emissions, and changes in endocrine function may lead to cardiovascular dysfunction. The goal of this study was to determine whether there were any changes in markers of peripheral or cardiovascular dysfunction in animals exposed to PC-emissions. Male Sprague Dawley rats were exposed to PC-emissions generated by 3D printing for 1, 4, 8, 15 or 30 d. Exposure induced a reduction in the expression of the antioxidant catalase (Cat) and endothelial nitric oxide synthase (eNos). Endothelin and hypoxia-induced factor 1α transcripts increased after 30 d. Alterations in transcription were associated with elevations in immunostaining for estrogen and androgen receptors, nitrotyrosine, and vascular endothelial growth factor in cardiac arteries of PC-emission exposed animals. There was also a reduction eNOS immunostaining in cardiac arteries from rats exposed to PC-emissions. Histological analyses of heart sections revealed that exposure to PC-emissions resulted in vasoconstriction of cardiac arteries and thickening of the vascular smooth muscle wall, suggesting there was a prolonged vasoconstriction. These findings are consistent with studies showing that inhalation 3D-printer emissions affect cardiovascular function. Although BPA levels in animals were relatively low, exposure-induced changes in immunostaining for estrogen and androgen receptors in cardiac arteries suggest that changes in the action of steroid hormones may have contributed to the alterations in morphology and markers of cardiac function.

Investigation of the Effectiveness of Silicon Nitride as a Reinforcement Agent for Polyethylene Terephthalate Glycol in Material Extrusion 3D Printing

Polyethylene terephthalate glycol (PETG) and silicon nitride (Si3N4) were combined to create five composite materials with Si3N4 loadings ranging from 2.0 wt.% to 10.0 wt.%. The goal was to improve the mechanical properties of PETG in material extrusion (MEX) additive manufacturing (AM) and assess the effectiveness of Si3N4 as a reinforcing agent for this particular polymer. The process began with the production of filaments, which were subsequently fed into a 3D printer to create various specimens. The specimens were manufactured according to international standards to ensure their suitability for various tests. The thermal, rheological, mechanical, electrical, and morphological properties of the prepared samples were evaluated. The mechanical performance investigations performed included tensile, flexural, Charpy impact, and microhardness tests. Scanning electron microscopy and energy-dispersive X-ray spectroscopy mapping were performed to investigate the structures and morphologies of the samples, respectively. Among all the composites tested, the PETG/6.0 wt.% Si3N4 showed the greatest improvement in mechanical properties (with a 24.5% increase in tensile strength compared to unfilled PETG polymer), indicating its potential for use in MEX 3D printing when enhanced mechanical performance is required from the PETG polymer.

Exploiting Pharma 4.0 Technologies in the Non-Biological Complex Drugs Manufacturing: Innovations and Implications

The pharmaceutical industry has entered an era of transformation with the emergence of Pharma 4.0, which leverages cutting-edge technologies in manufacturing processes. These hold tremendous potential for enhancing the overall efficiency, safety, and quality of non-biological complex drugs (NBCDs), a category of pharmaceutical products that pose unique challenges due to their intricate composition and complex manufacturing requirements. This review attempts to provide insight into the application of select Pharma 4.0 technologies, namely machine learning, in silico modeling, and 3D printing, in the manufacturing process of NBCDs. Specifically, it reviews the impact of these tools on NBCDs such as liposomes, polymeric micelles, glatiramer acetate, iron carbohydrate complexes, and nanocrystals. It also addresses regulatory challenges associated with the implementation of these technologies and presents potential future perspectives, highlighting the incorporation of digital twins in this field of research as it seems to be a very promising approach, namely for the optimization of NBCDs manufacturing processes.

Synchronized 3D Printing and Corona Charging for One-Step Prototyping of Polarized Polylactic Acid Electrets

Three-dimensional (3D) printing technology is advantageous in the fast prototyping of complex structures, but its utilization in functional material fabrication is still limited due to a lack of activation capability. To fabricate and activate the functional material of electrets, a synchronized 3D printing and corona charging method is presented to prototype and polarize polylactic acid electrets in one step. By upgrading the 3D printer nozzle and incorporating a needle electrode to apply high voltage, parameters such as needle tip distance and applied voltage level were compared and optimized. Under different experimental conditions, the average surface distribution in the center of the samples was -1498.87 V, -1115.73 V, and -814.51 V. Scanning electron microscopy results showed that the electric field contributes to keeping the printed fiber structure straight. The polylactic acid electrets exhibited relatively uniform surface potential distribution on a sufficiently large sample surface. In addition, the average surface potential retention rate was improved by 12.021-fold compared to ordinary corona-charged samples. The above advantages are unique to the 3D-printed and polarized polylactic acid electrets, proving that the proposed method is suitable for quickly prototyping and effectively polarizing the polylactic acid electrets simultaneously.

Three Dimensional Printing and Its Applications Focusing on Microneedles for Drug Delivery

Microneedles (MNs) are considered to be a novel smart injection system that causes significantly low skin invasion upon puncturing, due to the micron-sized dimensions that pierce into the skin painlessly. This allows transdermal delivery of numerous therapeutic molecules, such as insulin and vaccines. The fabrication of MNs is carried out through conventional old methods such as molding, as well as through newer and more sophisticated technologies, such as three-dimensional (3D) printing, which is considered to be a superior, more accurate, and more time- and production-efficient method than conventional methods. Three-dimensional printing is becoming an innovative method that is used in education through building intricate models, as well as being employed in the synthesis of fabrics, medical devices, medical implants, and orthoses/prostheses. Moreover, it has revolutionary applications in the pharmaceutical, cosmeceutical, and medical fields. Having the capacity to design patient-tailored devices according to their dimensions, along with specified dosage forms, has allowed 3D printing to stand out in the medical field. The different techniques of 3D printing allow for the production of many types of needles with different materials, such as hollow MNs and solid MNs. This review covers the benefits and drawbacks of 3D printing, methods used in 3D printing, types of 3D-printed MNs, characterization of 3D-printed MNs, general applications of 3D printing, and transdermal delivery using 3D-printed MNs.

Optimization of 3D printing and in vitro characterization of alginate/gelatin lattice and angular scaffolds for potential cardiac tissue engineering

Background: Engineering cardiac tissue that mimics the hierarchical structure of cardiac tissue remains challenging, raising the need for developing novel methods capable of creating structures with high complexity. Three-dimensional (3D)-printing techniques are among promising methods for engineering complex tissue constructs with high precision. By means of 3D printing, this study aims to develop cardiac constructs with a novel angular structure mimicking cardiac architecture from alginate (Alg) and gelatin (Gel) composite. The 3D-printing conditions were optimized and the structures were characterized in vitro, with human umbilical vein endothelial cells (HUVECs) and cardiomyocytes (H9c2 cells), for potential cardiac tissue engineering. Methods: We synthesized the composites of Alg and Gel with varying concentrations and examined their cytotoxicity with both H9c2 cells and HUVECs, as well as their printability for creating 3D structures of varying fibre orientations (angular design). The 3D-printed structures were characterized in terms of morphology by both scanning electron microscopy (SEM) and synchrotron radiation propagation-based imaging computed tomography (SR-PBI-CT), and elastic modulus, swelling percentage, and mass loss percentage as well. The cell viability studies were conducted via measuring the metabolic activity of the live cells with MTT assay and visualizing the cells with live/dead assay kit. Results: Among the examined composite groups of Alg and Gel, two combinations with ratios of 2 to 1 and 3 to 1 (termed as Alg2Gel1 and Alg3Gel1) showed the highest cell survival; they accordingly were used to fabricate two different structures: a novel angular and a conventional lattice structure. Scaffolds made of Alg3Gel1 showed higher elastic modulus, lower swelling percentage, less mass loss, and higher cell survival compared to that of Alg2Gel1. Although the viability of H9c2 cells and HUVECs on all scaffolds composed of Alg3Gel1 was above 99%, the group of the constructs with the angular design maintained significantly more viable cells compared to other investigated groups. Conclusion: The group of angular 3D-ptinted constructs has illustrated promising properties for cardiac tissue engineering by providing high cell viability for both endothelial and cardiac cells, high mechanical strength as well as appropriate swelling, and degradation properties during 21 days of incubation. Statement of Significance: 3D-printing is an emerging method to create complex constructs with high precision in a large scale. In this study, we have demonstrated that 3D-printing can be used to create compatible constructs from the composite of Alg and Gel with endothelial cells and cardiac cells. Also, we have demonstrated that these constructs are able to enhance the viability of cardiac and endothelial cells via creating a 3D structure mimicking the alignment and orientation of the fibers in the native heart.

Fabrication of 3D-Printed Contact Lens Composed of Polyethylene Glycol Diacrylate for Controlled Release of Azithromycin

Since three-dimensional (3D)-printed tablets were approved by the United States Food and Drug Administration (FDA), 3D printing technology has garnered increasing interest for the fabrication of medical and pharmaceutical devices. With various dosing devices being designed for manufacture by 3D printing, 3D-printed ophthalmic formulations to release drugs have been one such target of investigation. In the current study, 3D-printed contact lenses designed for the controlled release of the antibiotic azithromycin were produced by vat photopolymerization, and the effect of the printer ink composition and a second curing process was investigated. The azithromycin-loaded contact lenses were composed of the cross-linking reagent polyethylene glycol diacrylate (PEGDA), PEG 400 as a solvent, a photoinitiator, and azithromycin. The 3D-printed contact lenses were fabricated successfully, and formulations with lower PEGDA concentrations produced thicker lenses. The mechanical strength of the PEGDA-based contact lenses was dependent on the amount of PEGDA and was improved by a second curing process. Drug release from 3D-printed contact lenses was reduced in the samples with a second curing process. The azithromycin-loaded contact lenses exhibited antimicrobial effects in vitro for both Gram-positive and -negative bacteria. These results suggest that 3D-printed contact lenses containing antibiotics are an effective model for treating eye infections by controlling drug release.

Improvement of the Thermal Conductivity and Mechanical Properties of 3D-Printed Polyurethane Composites by Incorporating Hydroxylated Boron Nitride Functional Fillers

Recently, the use of fused deposition modeling (FDM) in the three-dimensional (3D) printing of thermal interface materials (TIMs) has garnered increasing attention. Because fillers orient themselves along the direction of the melt flow during printing, this method could effectively enhance the thermal conductivity of existing composite materials. However, the poor compatibility and intensive aggregation of h-BN fillers in polymer composites are still detrimental to their practical application in thermally conductive materials. In this study, hydroxyl-functionalized boron nitride (OH-BN) particles were prepared by chemical modification and ultrasonic-assisted liquid-phase exfoliation to explore their impact on the surface compatibility, mechanical properties and the final anisotropic thermal conductivity of thermoplastic polyurethane (TPU) composites fabricated by FDM printing. The results show that the surface-functionalized OH-BN fillers are homogeneously dispersed in the TPU matrix via hydrogen bonding interactions, which improve the interfacial adhesion between the filler and matrix. For the same concentration of loaded filler, the OH-BN/TPU composites exhibit better mechanical properties and thermal conductivities than composites incorporating non-modified h-BN. These composites also show higher heat conduction along the stand-vertical direction, while simultaneously exhibiting a low dielectric constant and dielectric loss. This work therefore provides a possible strategy for the fabrication of thermal management polymers using 3D-printing methods.

Thermomechanical Response of Polycarbonate/Aluminum Nitride Nanocomposites in Material Extrusion Additive Manufacturing

Polycarbonate-based nanocomposites were developed herein through a material extrusion (MEX) additive manufacturing (AM) process. The fabrication of the final nanocomposite specimens was achieved by implementing the fused filament fabrication (FFF) 3D printing process. The impact of aluminum nitride (AlN) nanoparticles on the thermal and mechanical behavior of the polycarbonate (PC) matrix was investigated thoroughly for the fabricated nanocomposites, carrying out a range of thermomechanical tests. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) provided information about the morphological and surface characteristics of the produced specimens. Using energy dispersive spectroscopy (EDS), the elemental composition of the nanocomposite materials was validated. Raman spectroscopy revealed no chemical interactions between the two material phases. The results showed the reinforcement of most mechanical properties with the addition of the AlN nanoparticles. The nanocomposite with 2 wt.% filler concentration exhibited the best mechanical performance overall, with the highest improvements observed for the tensile strength and toughness of the fabricated specimens, with a percentage of 32.8% and 51.6%, respectively, compared with the pure polymer. The successful AM of PC/AlN nanocomposites with the MEX process is a new paradigm, which expands 3D printing technology and opens a new route for the development of nanocomposite materials with multifunctional properties for industrial applications.

Application of three-dimensional printing technology in renal diseases

Three-dimensional (3D) printing technology involves the application of digital models to create 3D objects. It is used in construction and manufacturing and has gradually spread to medical applications, such as implants, drug development, medical devices, prosthetic limbs, and in vitro models. The application of 3D printing has great prospects for development in orthopedics, maxillofacial plastic surgery, cardiovascular conditions, liver disease, and other fields. With in-depth research on 3D printing technology and the continuous update of printing materials, this technology also shows broad development prospects in renal medicine. In this paper, the author mainly summarizes the basic theory of 3D printing technology, its research progress, application status, and development prospect in renal diseases.

Formulation and characterization of immediate-release oral dosage forms with zolpidem tartrate fabricated by digital light processing (DLP) 3D printing technique

The introduction of three-dimensional (3D) printing in the pharmaceutical field has made great strides towards innovations in the way drugs are designed and manufactured. In this study, digital light processing (DLP) technique was used to fabricate oral dosage forms of different shapes with zolpidem tartrate (ZT), incorporated within its therapeutic range. Formulation factors, such as poly(ethylene glycol) diacrylate (PEGDA) and poly(ethylene glycol) 400 (PEG 400) ratio, as well as water content, were varied in combination with the surface area/volume (SA/V) ratio to achieve immediate drug release. Hypromellose (HPMC) was used as a stabilizing agent of photoreactive suspensions in an attempt to prevent drug sedimentation and subsequent variations in drug content uniformity. Oral dosage forms with doses in the range from 0.15 mg to 6.37 mg, showing very rapid and rapid drug dissolution, were successfully fabricated, confirming the potential of this technique in drug manufacturing with the ability to provide flexible dose adjustments and desirable release profiles by varying formulation factors and geometry of 3D models. DSC (differential scanning calorimetry), XRPD (X-ray powder diffraction) and scanning electron microscopy (SEM) showed that ZT remained in a crystalline form within printed dosage forms and no interactions were found between ZT and polymers.

High Performance Polycarbonate Nanocomposites Mechanically Boosted with Titanium Carbide in Material Extrusion Additive Manufacturing

Herein, a polycarbonate (PC) polymer is melt extruded together with titanium carbide (TiC) nano powder for the development of advanced nanocomposite materials in material extrusion (MEX) 3D printing. Raw material for the 3D printing process was prepared in filament form with a thermomechanical extrusion process and specimens were built to be tested according to international standards. A thorough mechanical characterization testing course (tensile, flexural, impact, microhardness, and dynamic mechanical analysis-DMA) was conducted on the 3D printed specimens. The effect of the ceramic filler loading was also investigated. The nanocomposites' thermal and stoichiometric properties were investigated with thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), energy-dispersive X-ray spectroscopy (EDS), and Raman respectively. The specimens' 3D printing morphology, quality, and fracture mechanism were investigated with atomic force microscopy (AFM) and scanning electron microscopy (SEM) respectively. The results depicted that the addition of the filler decidedly enhances the mechanical response of the virgin polymer, without compromising properties such as its processability or its thermal stability. The highest improvement of 41.9% was reported for the 2 wt.% filler loading, making the nanocomposite suitable for applications requiring a high mechanical response in 3D printing, in which the matrix material cannot meet the design requirements.

Effect of Different Filler Contents and Printing Directions on the Mechanical Properties for Photopolymer Resins

Photopolymer resins are widely used in the production of dental prostheses, but their mechanical properties require improvement. We evaluated the effects of different zirconia filler contents and printing directions on the mechanical properties of photopolymer resin. Three-dimensional (3D) printing was used to fabricate specimens using composite photopolymers with 0 (control), 3, 5, and 10 wt.% zirconia filler. Two printing directions for fabricating rectangular specimens (25 mm × 2 mm × 2 mm) and disk-shaped specimens (φ10 mm × 2 mm) were used, 0° and 90°. Three-point bending tests were performed to determine the flexural strengths and moduli of the specimens. The Vickers hardness test was performed to determine the hardness of the specimens. Tukey’s multiple comparison tests were performed on the average values of the flexural strengths, elastic moduli, and Vickers hardness after one-way ANOVA (α = 0.05). The flexural strengths and elastic moduli at 0° from high to low were in the order of 0, 3, 10, and 5 wt.%, and those at 90° were in the order of 3, 0, 10, and 5 wt.% (p < 0.05). For 5 and 10 wt.%, no significant differences were observed in mechanical properties at 0° and 90° (p < 0.05). The Vickers hardness values at 0° and 90° from low to high were in the order of 0, 3, 5, and 10 wt.% (p < 0.05). Within the limits of this study, the optimal zirconia filler content in the photopolymer resin for 3D printing was 0 wt.% at 0° and 3 wt.% at 90°.

3D printing of glass by additive manufacturing techniques: a review

Additive manufacturing (AM), which is also known as three-dimensional (3D) printing, uses computer-aided design to build objects layer by layer. Here, we focus on the recent progress in the development of techniques for 3D printing of glass, an important optoelectronic material, including fused deposition modeling, selective laser sintering/melting, stereolithography (SLA) and direct ink writing. We compare these 3D printing methods and analyze their benefits and problems for the manufacturing of functional glass objects. In addition, we discuss the technological principles of 3D glass printing and applications of 3D printed glass objects. This review is finalized by a summary of the current achievements and perspectives for the future development of the 3D glass printing technique.

Strain Rate Sensitivity of Polycarbonate and Thermoplastic Polyurethane for Various 3D Printing Temperatures and Layer Heights

In this work, strain rate sensitivity was studied for 3D-printed polycarbonate (PC) and thermoplastic polyurethane (TPU) materials. Specimens were fabricated through fused filament fabrication (FFF) additive manufacturing (AM) technology and were tested at various strain rates. The effects of two FFF process parameters, i.e., nozzle temperature and layer thickness, were also investigated. A wide analysis for the tensile strength (MPa), the tensile modulus of elasticity (MPa), the toughness (MJ/m³) and the strain rate sensitivity index ‘m’ was conducted. Additionally, a morphological analysis was conducted using scanning electron microscopy (SEM) on the side and the fracture area of the specimens. Results from the different strain rates for each material were analyzed, in conjunction with the two FFF parameters tested, to determine their effect on the mechanical response of the two materials. PC and TPU materials exhibited similarities regarding their temperature response at different strain rates, while differences in layer height emerged regarding the appropriate choice for the FFF process. Overall, strain rate had a significant effect on the mechanical response of both materials.

Three-Dimensional (3D) Printing: Implications for Risk Assessment and Management in Occupational Settings

The widespread application of additive manufacturing (AM) technologies, commonly known as three-dimensional (3D) printing, in industrial and home-business sectors, and the expected increase in the number of workers and consumers that use these devices, have raised concerns regarding the possible health implications of 3D printing emissions. To inform the risk assessment and management processes, this review evaluates available data concerning exposure assessment in AM workplaces and possible effects of 3D printing emissions on humans identified through in vivo and in vitro models in order to inform risk assessment and management processes. Peer-reviewed literature was identified in Pubmed, Scopus, and ISI Web of Science databases. The literature demonstrated that a significant fraction of the particles released during 3D printing could be in the ultrafine size range. Depending upon the additive material composition, increased levels of metals and volatile organic compounds could be detected during AM operations, compared with background levels. AM phases, specific job tasks performed, and preventive measures adopted may all affect exposure levels. Regarding possible health effects, printer emissions were preliminary reported to affect the respiratory system of involved workers. The limited number of workplace studies, together with the great variety of AM techniques and additive materials employed, limit generalizability of exposure features. Therefore, greater scientific efforts should be focused at understanding sources, magnitudes, and possible health effects of exposures to develop suitable processes for occupational risk assessment and management of AM technologies.

On the Mechanical Response of Silicon Dioxide Nanofiller Concentration on Fused Filament Fabrication 3D Printed Isotactic Polypropylene Nanocomposites

Utilization of advanced engineering thermoplastic materials in fused filament fabrication (FFF) 3D printing process is critical in expanding additive manufacturing (AM) applications. Polypropylene (PP) is a widely used thermoplastic material, while silicon dioxide (SiO₂) nanoparticles (NPs), which can be found in many living organisms, are commonly employed as fillers in polymers to improve their mechanical properties and processability. In this work, PP/SiO₂ nanocomposite filaments at various concentrations were developed following a melt mixing extrusion process, and used for FFF 3D printing of specimens’ characterization according to international standards. Tensile, flexural, impact, microhardness, and dynamic mechanical analysis (DMA) tests were conducted to determine the effect of the nanofiller loading on the mechanical and viscoelastic properties of the polymer matrix. Scanning electron microscopy (SEM), Raman spectroscopy and atomic force microscopy (AFM) were performed for microstructural analysis, and finally melt flow index (MFI) tests were conducted to assess the melt rheological properties. An improvement in the mechanical performance was observed for silica loading up to 2.0 wt.%, while 4.0 wt.% was a potential threshold revealing processability challenges. Overall, PP/SiO₂ nanocomposites could be ideal candidates for advanced 3D printing engineering applications towards structural plastic components with enhanced mechanical performance.

Optimization of the Filler Concentration on Fused Filament Fabrication 3D Printed Polypropylene with Titanium Dioxide Nanocomposites

Polypropylene (PP) is an engineered thermoplastic polymer widely used in various applications. This work aims to enhance the properties of PP with the introduction of titanium dioxide (TiO₂) nanoparticles (NPs) as nanofillers. Novel nanocomposite filaments were produced at 0.5, 1, 2, and 4 wt.% filler concentrations, following a melt mixing extrusion process. These filaments were then fed to a commercially available fused filament fabrication (FFF) 3D printer for the preparation of specimens, to be assessed for their mechanical, viscoelastic, physicochemical, and fractographic properties, according to international standards. Tensile, flexural, impact, and microhardness tests, as well as dynamic mechanical analysis (DMA), Raman, scanning electron microscopy (SEM), melt flow volume index (MVR), and atomic force microscopy (AFM), were conducted, to fully characterize the filler concentration effect on the 3D printed nanocomposite material properties. The results revealed an improvement in the nanocomposites properties, with the increase of the filler amount, while the microstructural effect and processability of the material was not significantly affected, which is important for the possible industrialization of the reported protocol. This work showed that PP/TiO₂ can be a novel nanocomposite system in AM applications that the polymer industry can benefit from.

Enhanced Mechanical, Thermal and Antimicrobial Properties of Additively Manufactured Polylactic Acid with Optimized Nano Silica Content

The scope of this work was to create, with melt mixing compounding process, novel nanocomposite filaments with enhanced properties that industry can benefit from, using commercially available materials, to enhance the performance of three-dimensional (3D) printed structures fabricated via fused filament fabrication (FFF) process. Silicon Dioxide (SiO₂) nanoparticles (NPs) were selected as fillers for a polylactic acid (PLA) thermoplastic matrix at various weight % (wt.%) concentrations, namely, 0.5, 1.0, 2.0 and 4.0 wt.%. Tensile, flexural and impact test specimens were 3D printed and tested according to international standards and their Vickers microhardness was also examined. It was proven that SiO₂ filler enhanced the overall strength at concentrations up to 1 wt.%, compared to pure PLA. Atomic force microscopy (AFM) was employed to investigate the produced nanocomposite extruded filaments roughness. Raman spectroscopy was performed for the 3D printed nanocomposites to verify the polymer nanocomposite structure, while thermogravimetric analysis (TGA) revealed the 3D printed samples' thermal stability. Scanning electron microscopy (SEM) was carried out for the interlayer fusion and fractography morphological characterization of the specimens. Finally, the antibacterial properties of the produced nanocomposites were investigated with a screening process, to evaluate their performance against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus).

Point of care virtual surgical planning and 3D printing in facial gender confirmation surgery: a narrative review

Facial gender confirmation surgery (FGCS) is a powerful set of procedures in the armamentarium of plastic surgeons that can transform the male face into a gender-congruent female face and provide the transgender individual with improved quality of life, positive body image and help in social integration. The goals of the FGCS procedures are to address the individual patients' concerns and expectations about their facial appearance, offer safely executed surgery, minimize complications, and optimize surgical outcomes. Pre-operative computed tomography (CT) scanning and three-dimensional (3D) reconstruction before facial feminization or masculinization delineates important skeletal and sinus anatomy and can also be a useful tool in patient consultation. Virtual surgical planning (VSP) is a valuable tool in facial surgery. From free flap bony reconstruction after tumor resection and orthognathic surgery to craniosynostosis planning, VSP has become widely utilized in modern day cranio-maxillofacial surgery. The use of patient-specific cutting guides and implants helps in improving symmetry and safety of these procedures. Furthermore, 3D printed models are valuable tools in patient education and counseling prior to surgery. In this article we describe our approach to FGCS through the integration of point of care (POC) VSP and 3D printing (3DP) to help deliver safer and accurate FGCS outcomes.

Sustainable Additive Manufacturing: Mechanical Response of Polyethylene Terephthalate Glycol over Multiple Recycling Processes

The continuous demand for thermoplastic polymers in a great variety of applications, combined with an urgent need to minimize the quantity of waste for a balanced energy-from-waste strategy, has led to increasing scientific interest in developing new recycling processes for plastic products. Glycol-modified polyethylene terephthalate (PETG) is known to have some enhanced properties as compared to polyethylene terephthalate (PET) homopolymer; this has recently attracted the interest from the fused filament fabrication (FFF) three-dimensional (3D) printing community. PET has shown a reduced ability for repeated recycling through traditional processes. Herein, we demonstrate the potential for using recycled PETG in consecutive 3D printing manufacturing processes. Distributed recycling additive manufacturing (DRAM)-oriented equipment was chosen in order to test the mechanical and thermal response of PETG material in continuous recycling processes. Tensile, flexure, impact strength, and Vickers micro-hardness tests were carried out for six (6) cycles of recycling. Finally, Raman spectroscopy as well as thermal and morphological analyses via scanning electron microscopy (SEM) fractography were carried out. In general, the results revealed a minor knockdown effect on the mechanical properties as well as the thermal properties of PETG following the process proposed herein, even after six rounds of recycling.

The effect of three-dimensional (3D) printing on quantitative and qualitative outcomes in paediatric orthopaedic osteotomies: a systematic review

Three-dimensional (3D) printing technology is increasingly being utilized in various surgical specialities. In paediatric orthopaedics it has been applied in the pre-operative and intra-operative stages, allowing complex deformities to be replicated and patient-specific instrumentation to be used. This systematic review analyses the literature on the effect of 3D printing on paediatric orthopaedic osteotomy outcomes.A systematic review of several databases was conducted according to PRISMA guidelines. Studies evaluating the use of 3D printing technology in orthopaedic osteotomy procedures in children (aged ≤ 16 years) were included. Spinal and bone tumour surgery were excluded. Data extracted included demographics, disease pathology, target bone, type of technology, imaging modality used, qualitative/quantitative outcomes and follow-up. Articles were further categorized as either 'pre-operative' or 'intra-operative' applications of the technology.Twenty-two articles fitting the inclusion criteria were included. The reported studies included 212 patients. There were five articles of level of evidence 3 and 17 level 4.A large variety of outcomes were reported with the most commonly used being operating time, fluoroscopic exposure and intra-operative blood loss.A significant difference in operative time, fluoroscopic exposure, blood loss and angular correction was found in the 'intra-operative' application group. No significant difference was found in the 'pre-operative' category.Despite a relatively low evidence base pool of studies, our aggregate data demonstrate a benefit of 3D printing technology in various deformity correction applications, especially when used in the 'intra-operative' setting. Further research including paediatric-specific core outcomes is required to determine the potential benefit of this novel addition. Cite this article: EFORT Open Rev 2021;6:130-138. DOI: 10.1302/2058-5241.6.200092.

Sustainable Additive Manufacturing: Mechanical Response of Polyamide 12 over Multiple Recycling Processes

Plastic waste reduction and recycling through circular use has been critical nowadays, since there is an increasing demand for the production of plastic components based on different polymeric matrices in various applications. The most commonly used recycling procedure, especially for thermoplastic materials, is based on thermomechanical process protocols that could significantly alter the polymers’ macromolecular structure and physicochemical properties. The study at hand focuses on recycling of polyamide 12 (PA12) filament, through extrusion melting over multiple recycling courses, giving insight for its effect on the mechanical and thermal properties of Fused Filament Fabrication (FFF) manufactured specimens throughout the recycling courses. Three-dimensional (3D) FFF printed specimens were produced from virgin as well as recycled PA12 filament, while they have been experimentally tested further for their tensile, flexural, impact and micro-hardness mechanical properties. A thorough thermal and morphological analysis was also performed on all the 3D printed samples. The results of this study demonstrate that PA12 can be successfully recycled for a certain number of courses and could be utilized in 3D printing, while exhibiting improved mechanical properties when compared to virgin material for a certain number of recycling repetitions. From this work, it can be deduced that PA12 can be a viable option for circular use and 3D printing, offering an overall positive impact on recycling, while realizing 3D printed components using recycled filaments with enhanced mechanical and thermal stability.

Tailoring Atomoxetine Release Rate from DLP 3D-Printed Tablets Using Artificial Neural Networks: Influence of Tablet Thickness and Drug Loading

Various three-dimensional printing (3DP) technologies have been investigated so far in relation to their potential to produce customizable medicines and medical devices. The aim of this study was to examine the possibility of tailoring drug release rates from immediate to prolonged release by varying the tablet thickness and the drug loading, as well as to develop artificial neural network (ANN) predictive models for atomoxetine (ATH) release rate from DLP 3D-printed tablets. Photoreactive mixtures were comprised of poly(ethylene glycol) diacrylate (PEGDA) and poly(ethylene glycol) 400 in a constant ratio of 3:1, water, photoinitiator and ATH as a model drug whose content was varied from 5% to 20% (w/w). Designed 3D models of cylindrical shape tablets were of constant diameter, but different thickness. A series of tablets with doses ranging from 2.06 mg to 37.48 mg, exhibiting immediate- and modified-release profiles were successfully fabricated, confirming the potential of this technology in manufacturing dosage forms on demand, with the possibility to adjust the dose and release behavior by varying drug loading and dimensions of tablets. DSC (differential scanning calorimetry), XRPD (X-ray powder diffraction) and microscopic analysis showed that ATH remained in a crystalline form in tablets, while FTIR spectroscopy confirmed that no interactions occurred between ATH and polymers.

On the Strain Rate Sensitivity of Fused Filament Fabrication (FFF) Processed PLA, ABS, PETG, PA6, and PP Thermoplastic Polymers

In this study, the strain rate sensitivity of five different thermoplastic polymers processed via Fused Filament Fabrication (FFF) Additive Manufacturing (AM) is reported. Namely, Polylactic Acid (PLA), Acrylonitrile-Butadiene-Styrene (ABS), Polyethylene Terephthalate Glycol (PETG), Polyamide 6 (PA6), and Polypropylene (PP) were thoroughly investigated under static tensile loading conditions at different strain rates. Strain rates have been selected representing the most common applications of polymeric materials manufactured by Three-Dimensional (3D) Printing. Each polymer was exposed to five different strain rates in order to elucidate the dependency and sensitivity of the tensile properties, i.e., stiffness, strength, and toughness on the applied strain rate. Scanning Electron Microscopy (SEM) was employed to investigate the 3D printed samples’ fractured surfaces, as a means to derive important information regarding the fracture process, the type of fracture (brittle or ductile), as well as correlate the fractured surface characteristics with the mechanical response under certain strain rate conditions. An Expectation–Maximization (EM) analysis was carried out. Finally, a comparison is presented calculating the strain rate sensitivity index “m” and toughness of all materials at the different applied strain rates.

Biocompatibility of Blank, Post-Processed and Coated 3D Printed Resin Structures with Electrogenic Cells

The widespread adaptation of 3D printing in the microfluidic, bioelectronic, and Bio-MEMS communities has been stifled by the lack of investigation into the biocompatibility of commercially available printer resins. By introducing an in-depth post-printing treatment of these resins, their biocompatibility can be dramatically improved up to that of a standard cell culture vessel (99.99%). Additionally, encapsulating resins that are less biocompatible with materials that are common constituents in biosensors further enhances the biocompatibility of the material. This investigation provides a clear pathway toward developing fully functional and biocompatible 3D printed biosensor devices, especially for interfacing with electrogenic cells, utilizing benchtop-based microfabrication, and post-processing techniques.

Digital Light Processing (DLP) 3D Printing of Atomoxetine Hydrochloride Tablets Using Photoreactive Suspensions

Three-dimensional (3D) printing technologies are based on successive material printing layer-by-layer and are considered suitable for the production of dosage forms customized for a patient’s needs. In this study, tablets of atomoxetine hydrochloride (ATH) have been successfully fabricated by a digital light processing (DLP) 3D printing technology. Initial materials were photoreactive suspensions, composed of poly(ethylene glycol) diacrylate 700 (PEGDA 700), poly(ethylene glycol) 400 (PEG 400), photoinitiator and suspended ATH. The amount of ATH was varied from 10.00 to 25.00% (w/w), and a range of doses from 12.21 to 40.07 mg has been achieved, indicating the possibility of personalized therapy. The rheological characteristics of all photoreactive suspensions were appropriate for the printing process, while the amount of the suspended particles in the photoreactive suspensions had an impact on the 3D printing process, as well as on mechanical and biopharmaceutical characteristics of tablets. Only the formulation with the highest content of ATH had significantly different tensile strength compared to other formulations. All tablets showed sustained drug release during at least the 8h. ATH crystals were observed with polarized light microscopy of photoreactive suspensions and the cross-sections of the tablets, while no interactions between ATH and polymers were detected by FT-IR spectroscopy.

Synthetic Polymers for Organ 3D Printing

Three-dimensional (3D) printing, known as the most promising approach for bioartificial organ manufacturing, has provided unprecedented versatility in delivering multi-functional cells along with other biomaterials with precise control of their locations in space. The constantly emerging 3D printing technologies are the integration results of biomaterials with other related techniques in biology, chemistry, physics, mechanics and medicine. Synthetic polymers have played a key role in supporting cellular and biomolecular (or bioactive agent) activities before, during and after the 3D printing processes. In particular, biodegradable synthetic polymers are preferable candidates for bioartificial organ manufacturing with excellent mechanical properties, tunable chemical structures, non-toxic degradation products and controllable degradation rates. In this review, we aim to cover the recent progress of synthetic polymers in organ 3D printing fields. It is structured as introducing the main approaches of 3D printing technologies, the important properties of 3D printable synthetic polymers, the successful models of bioartificial organ printing and the perspectives of synthetic polymers in vascularized and innervated organ 3D printing areas.

A 3D Printed Jet Mixer for Centrifugal Microfluidic Platforms

Homogeneous mixing of microscopic volume fluids at low Reynolds number is of great significance for a wide range of chemical, biological, and medical applications. An efficient jet mixer with arrays of micronozzles was designed and fabricated using additive manufacturing (three-dimensional (3D) printing) technology for applications in centrifugal microfluidic platforms. The contact surface of miscible liquids was enhanced significantly by impinging plumes from two opposite arrays of micronozzles to improve mixing performance. The mixing efficiency was evaluated and compared with the commonly used Y-shaped micromixer. Effective mixing in the jet mixer was achieved within a very short timescale (3s). This 3D printed jet mixer has great potential to be implemented in applications by being incorporated into multifarious 3D printing devices in microfluidic platforms.

3D Printed Thermoelectric Polyurethane/Multiwalled Carbon Nanotube Nanocomposites: A Novel Approach towards the Fabrication of Flexible and Stretchable Organic Thermoelectrics

Three-dimensional (3D) printing of thermoelectric polymer nanocomposites is reported for the first time employing flexible, stretchable and electrically conductive 3D printable thermoplastic polyurethane (TPU)/multiwalled carbon nanotube (MWCNT) filaments. TPU/MWCNT conductive polymer composites (CPC) have been initially developed employing melt-mixing and extrusion processes. TPU pellets and two different types of MWCNTs, namely the NC-7000 MWCNTs (NC-MWCNT) and Long MWCNTs (L-MWCNT) were used to manufacture TPU/MWCNT nanocomposite filaments with 1.0, 2.5 and 5.0 wt.%. 3D printed thermoelectric TPU/MWCNT nanocomposites were fabricated through a fused deposition modelling (FDM) process. Raman and scanning electron microscopy (SEM) revealed the graphitic nature and morphological characteristics of CNTs. SEM and transmission electron microscopy (TEM) exhibited an excellent CNT nanodispersion in the TPU matrix. Tensile tests showed no significant deterioration of the moduli and strengths for the 3D printed samples compared to the nanocomposites prepared by compression moulding, indicating an excellent interlayer adhesion and mechanical performance of the 3D printed nanocomposites. Electrical and thermoelectric investigations showed that L-MWCNT exhibits 19.8 ± 0.2 µV/K Seebeck coefficient (S) and 8.4 × 10³ S/m electrical conductivity (σ), while TPU/L-MWCNT CPCs at 5.0 wt.% exhibited the highest thermoelectric performance (σ = 133.1 S/m, S = 19.8 ± 0.2 µV/K and PF = 0.04 μW/mK²) among TPU/CNT CPCs in the literature. All 3D printed samples exhibited an anisotropic electrical conductivity and the same Seebeck coefficient in the through- and cross-layer printing directions. TPU/MWCNT could act as excellent organic thermoelectric material towards 3D printed thermoelectric generators (TEGs) for potential large-scale energy harvesting applications.

Drug Incorporation into Polymer Filament Using Simple Soaking Method for Tablet Preparation Using Fused Deposition Modeling

The use of three-dimensional (3D) printing technology is expanding in various fields. The application of 3D printing is expected to increase in the pharmaceutical industry after 3D-printed tablets were approved by the U.S. Food and Drug Administration (FDA). Fused deposition modeling (FDM), a type of 3D printing, has been extensively studied for the manufacturing of tablets. A drug-loaded polymer filament, the ink of FDM 3D printers, can be prepared using the hot melt extrusion method or a simple drug-soaking method. In the present study, we investigate the influence of the experimental conditions on the loading of curcumin (model drug with fluorescence) into a polyvinylalcohol polymer filament using the soaking method. We show that organic solvent type (isopropanol, methanol, acetone, and ethanol), temperature (25 and 80°C), and drug concentration (2-333 mg/mL) greatly affect drug loading. Around 5% curcumin can be incorporated into the polyvinylalcohol filament using the soaking method. The drug dissolution from 3D-printed tablets depends on the drug content in the polymer filament. The incorporation of a higher amount of curcumin, which has poor water solubility, greatly delays drug dissolution. These results provide useful information on the preparation of 3D-printed tablets using a drug-loaded polymer filament obtained with the soaking method.

Advanced Polymers for Three-Dimensional (3D) Organ Bioprinting

Three-dimensional (3D) organ bioprinting is an attractive scientific area with huge commercial profit, which could solve all the serious bottleneck problems for allograft transplantation, high-throughput drug screening, and pathological analysis. Integrating multiple heterogeneous adult cell types and/or stem cells along with other biomaterials (e.g., polymers, bioactive agents, or biomolecules) to make 3D constructs functional is one of the core issues for 3D bioprinting of bioartificial organs. Both natural and synthetic polymers play essential and ubiquitous roles for hierarchical vascular and neural network formation in 3D printed constructs based on their specific physical, chemical, biological, and physiological properties. In this article, several advanced polymers with excellent biocompatibility, biodegradability, 3D printability, and structural stability are reviewed. The challenges and perspectives of polymers for rapid manufacturing of complex organs, such as the liver, heart, kidney, lung, breast, and brain, are outlined.

Personalized 3D printed coronary models in coronary stenting

Background

3D printing has shown great promise in cardiovascular disease, with reports mainly focusing on pre-surgical planning and medical education. Research on utilization of 3D printed models in simulating coronary stenting has not been reported. In this study, we presented our experience of placing coronary stents into personalized 3D printed coronary models with the aim of determining stent lumen visibility with images reconstructed with different postprocessing views and algorithms.

Methods

A total of six coronary stents with diameter ranging from 2.5 to 4.0 mm were placed into 3 patient-specific 3D printed coronary models for simulation of coronary stenting. The 3D printed models were placed in a plastic container and scanned on a 192-slice third generation dual-source CT scanner with images reconstructed with soft (Bv36) and sharp (Bv59) kernel algorithms. Thick and thin slab maximum-intensity projection (MIP) images were also generated from the original CT data for comparison of stent lumen visibility. Stent lumen diameter was measured on 2D axial and MIP images, while stent diameter was measured on 3D volume rendering images. 3D virtual intravascular endoscopy (VIE) images were generated to provide intraluminal views of the coronary wall and stent appearances.

Results

All of these stents were successfully placed into the right and left coronary arteries but 2 of them did not obtain wall apposition along the complete length. The stent lumen visibility ranged from 54 to 97%, depending on the stent location in the coronary arteries. The mean stent lumen diameters measured on 2D axial, thin and thick slab MIP images were found to be significantly smaller than the actual size (P<0.01). Thick slab MIP images resulted in measured stent lumen diameters smaller than those from thin slab MIP images, with significant differences noticed in most of the measurements (4 out of 6 stents) (P<0.05), and no significant differences in the remaining 2 stents (P=0.19-0.38). In contrast, 3D volume rendering images allowed for more accurate measurements with measured stent diameters close to the actual dimensions in most of these coronary stents, except for the stent placed at the right coronary artery in one of the models due to insufficient expansion of the stent. Images reconstructed with sharp kernel Bv59 significantly improved stent lumen visibility when compared to the smooth Bv36 kernel (P=0.01). 3D VIE was successfully generated in all of the datasets with clear visualization of intraluminal views of the stents in relation to the coronary wall.

Conclusions

This preliminary report shows the feasibility of using 3D printed coronary artery models in coronary stenting for investigation of optimal coronary CT angiography protocols. Future studies should focus on placement of more stents with a range of stent diameters in the quest to reduce the need for invasive angiography for surveillance.

Bioartificial Organ Manufacturing Technologies

Bioartificial organ manufacturing technologies are a series of enabling techniques that can be used to produce human organs based on bionic principles. During the last ten years, significant progress has been achieved in the development of various organ manufacturing technologies. According to the degree of automation, organ manufacturing technologies can be divided into three main groups: (1) fully automated; (2) semi-automated; (3) handworked (or handmade); each has the advantages and disadvantages for bioartificial organ manufacturing. One of the most promising bioartificial organ manufacturing technologies is to use combined multi-nozzle three-dimensional printing techniques to automatically assemble personal cells along with other biomaterials to build exclusive organ substitutes for defective/failed human organs. This is the first time that advanced bioartificial organ manufacturing technologies have been reviewed. These technologies hold the promise to greatly improve the quality of health and average lifespan of human beings in the near future.

Patient-specific 3D printed model of biliary ducts with congenital cyst

BACKGROUND

3D printing has shown great promise in medical applications, with increasing reports in liver diseases. However, research on 3D printing in biliary disease is limited with lack of studies on validation of model accuracy. In this study, we presented our experience of creating a realistic 3D printed model of biliary ducts with congenital cyst. Measurements of anatomical landmarks were compared at different stages of model generation to determine dimensional accuracy.

METHODS

Contrast-enhanced computed tomography (CT) images of a patient diagnosed with congenital cyst in the common bile duct with dilated hepatic ducts were used to create the 3D printed model. The 3D printed model was scanned on a 64-slice CT scanner using the similar abdominal CT protocol. Measurements of anatomical structures including common hepatic duct (CHD), right hepatic duct (RHD), left hepatic duct (LHD) and the cyst at left to right and anterior to posterior dimensions were performed and compared between original CT images, the standard tessellation language (STL) image and CT images of the 3D model.

RESULTS

The 3D printing model was successfully generated with replication of biliary ducts and cyst. Significant differences in measurements of these landmarks were found between the STL and the original CT images, and the CT images of the 3D printed model and the original CT images (P<0.05). Measurements of the RHD and LHD diameters from the original CT images were significantly larger than those from the CT images of 3D model or STL file (P<0.05), while measurements of the CHD diameters were significantly smaller than those of the other two datasets (P<0.05). No significant differences were reached in measurements of the CHD, RHD, LHD and the biliary cyst between CT images of the 3D printed model and STL file (P=0.08-0.98).

CONCLUSIONS

This study shows our experience in producing a realistic 3D printed model of biliary ducts and biliary cyst. The model was found to replicate anatomical structures and cyst with high accuracy between the STL file and the CT images of the 3D model. Large discrepancy in dimensional measurements was noted between the original CT and STL file images, and the original CT and CT images of the 3D model, highlighting the necessity of further research with inclusion of more cases of biliary disease to validate accuracy of 3D printed biliary models.

Impact of 3D printing on the surgical management of tracheal stenosis associated to pulmonary sling: a case report

Congenital tracheal stenosis (CTS) is rare lesions frequently associated with pulmonary sling (PS). Despite the recent improvement in the results by the introduction of slide tracheoplasty (ST) and multidisciplinary approach, surgical management remains difficult and several authors, for this reason, debate for a conservative approach in these cases. Preoperative planning, require hence the use of the most innovative technology to gain the best possible result. This report describes a complicated, unsuccessful surgically treated case of CTS associated to PS. Based on this result and in order to improve the outcomes, we have built a 3D model of patient's trachea simulating preoperative surgical planning. We have hypnotized that having the model preoperatively the choice of surgical technique would have been different. Since that case, 3D models are introduced in our practice and built before tracheal or cardiac cases considered to have complex anatomy. Future investigations are required but at the moment this experience confirms the utility of 3D model in the evaluation of children considered for tracheal surgery.

Fully digital workflow for presurgical orthodontic plate in cleft lip and palate patients

OBJECTIVE

In most cases, according to our treatment concept, a presurgical orthodontic treatment (POT) is performed on patients with cleft lip and palate (CLP). The aim of this case report is to demonstrate a completely digital workflow for the production of a palate plate.

MATERIALS AND METHODS

For the assessment of the maxillary arch, a digital impression of the jaw was made on two patients with an intraoral scanner (Cerec Omnicam Ortho). After reconstruction of a virtual model from the scan data, appropriate areas of the jaw could be blocked out and a plate constructed. This was printed with a DLP three-dimensional (3D) printer (SHERA EcoPrint D30) with class IIa biocompatible material. After minor surface finishing, the plates could be incorporated in the patients' mouths.

RESULTS

The scans could be performed in a short time without affecting the very young patients. All clinically relevant areas for the production and digital measurement of the models could be recorded. The plates showed an extremely good fit, and there were no differences in wear compared with a conventionally manufactured plate.

CONCLUSION

For the first time, a risk-free digital impression of the edentulous jaw in CLP babies with a subsequently completely digitally constructed and 3D-printed palatal plate could be shown.

3D printing for drug manufacturing: A perspective on the future of pharmaceuticals

Since a three-dimensional (3D) printed drug was first approved by the Food and Drug Administration in 2015, there has been a growing interest in 3D printing for drug manufacturing. There are multiple 3D printing methods - including selective laser sintering, binder deposition, stereolithography, inkjet printing, extrusion-based printing, and fused deposition modeling - which are compatible with printing drug products, in addition to both polymer filaments and hydrogels as materials for drug carriers. We see the adaptability of 3D printing as a revolutionary force in the pharmaceutical industry. Release characteristics of drugs may be controlled by complex 3D printed geometries and architectures. Precise and unique doses can be engineered and fabricated via 3D printing according to individual prescriptions. On-demand printing of drug products can be implemented for drugs with limited shelf life or for patient-specific medications, offering an alternative to traditional compounding pharmacies. For these reasons, 3D printing for drug manufacturing is the future of pharmaceuticals, making personalized medicine possible while also transforming pharmacies.

Investigation of Quasi-Static Indentation Response of Inkjet Printed Sandwich Structures under Various Indenter Geometries

The objective of this investigation was to determine the quasi-static indentation response and failure mode in three-dimensional (3D) printed trapezoidal core structures, and to characterize the energy absorbed by the structures. In this work, the trapezoidal sandwich structure was designed in the following two ways. Firstly, the trapezoidal core along with its facesheet was 3D printed as a single element comprising a single material for both core and facesheet (type A); Secondly, the trapezoidal core along with facesheet was 3D printed, but with variation in facesheet materials (type B). Quasi-static indentation was carried out using three different indenters, namely standard hemispherical, conical, and flat indenters. Acoustic emission (AE) technique was used to capture brittle cracking in the specimens during indentation. The major failure modes were found to be brittle failure and quasi-brittle fractures. The measured indentation energy was at a maximum when using a conical indenter at 9.40 J and 9.66 J and was at a minimum when using a hemispherical indenter at 6.87 J and 8.82 J for type A and type B series specimens respectively. The observed maximum indenter displacements at failure were the effect of material variations and composite configurations in the facesheet.

Three-Dimensional Nanoprinting via Scanning Probe Lithography-Delivered Layer-by-Layer Deposition

Three-dimensional (3D) printing has been a very active area of research and development due to its capability to produce 3D objects by design. Miniaturization and improvement of spatial resolution are major challenges in current 3D printing technology development. This work reports advances in miniaturizing 3D printing to the nanometer scale using scanning probe microscopy in conjunction with local material delivery. Using polyelectrolyte polymers and complexes, we have demonstrated the concept of layer-by-layer nanoprinting by design. Nanometer precision is achieved in all three dimensions, as well as in interlayer registry. The approach enables production of designed functional 3D materials with nanometer resolution and, as such, creates a platform for conducting scientific research in designed 3D nanoenvironments as well. In doing so, it enables production of nanomaterials and scaffolds for photonics devices, biomedicine, and tissue engineering.

Three-Dimensional Modeling May Improve Surgical Education and Clinical Practice

BACKGROUND

Three-dimensional (3D) printing has been used in the manufacturing industry for rapid prototyping and product testing. The aim of our study was to assess the feasibility of creating anatomical 3D models from a digital image using 3D printers. Furthermore, we sought face validity of models and explored potential opportunities for using 3D printing to enhance surgical education and clinical practice.

METHODS

Computed tomography and magnetic resonance images were reviewed, converted to computer models, and printed by stereolithography to create near exact replicas of human organs. Medical students and surgeons provided feedback via survey at the 2014 Surgical Education Week conference.

RESULTS

There were 51 respondents, and 95.8% wanted these models for their patients. Cost was a concern, but 82.6% found value in these models at a price less than $500. All respondents thought the models would be useful for integration into the medical school curriculum.

CONCLUSION

Three-dimensional printing is a potentially disruptive technology to improve both surgical education and clinical practice. As the technology matures and cost decreases, we envision 3D models being increasingly used in surgery.

In vitro vascularization of a combined system based on a 3D printing technique

A vital challenge in complex organ manufacturing is to vascularize large combined tissues. The aim of this study is to vascularize in vitro an adipose-derived stem cell (ADSC)/fibrin/collagen incorporated three-dimensional (3D) poly(d,l-lactic-co-glycolic acid) (PLGA) scaffold (10 × 10 × 10 mm³ ) with interconnected channels. A low-temperature 3D printing technique was employed to build the PLGA scaffold. A step-by-step cocktail procedure was designed to engage or steer the ADSCs in the PLGA channels towards both endothelial and smooth muscle cell lineages. The combined system had sufficient mechanical properties to support the cell/fibrin/collagen hydrogel inside the predefined PLGA channels. The ADSCs encapsulated in the fibrin/collagen hydrogel differentiated to endothelial and smooth muscle cell lineage, respectively, corresponding to their respective locations in the construct and formed vascular-like structures. This technique allows in vitro vascularization of the predefined PLGA channels and provides a choice for complex organ manufacture. Copyright © 2014 John Wiley & Sons, Ltd.