Additive Manufacturing in Medicine

Additive Manufacturing (AM) as an engineering technology has enabled several advances in the medical field, particularly as far as surgical planning is concerned. The use of AM in medicine has added, in an era in which so many new technologies are constantly being developed, the possibility of carrying out surgical planning and simulation using a three-dimensional physical model that is realistic and very true to the patient’s own anatomy. AM is a technology that enables the production of physical object or anatomic models – called “biomodels” – directly from a 3D virtual model (obtained by computed tomography or magnetic resonance imaging techniques) from microscopic powder. This article presents AM technologies applied to the design and manufacture of a biomodel, in this case, an implant for the surgical reconstruction of large cranial defects. The protocol presented was used to create an anatomic biomodel of the bone defect for the surgical planning stage, and the design and manufacture of the patient-specific implant, for the actual surgery, reducing the duration of the surgery in addition to improving the surgical accuracy due to preoperative planning of the anatomical details.

[1]  Donald L. Wise,et al.  Biomaterials in Orthopedics , 2003 .

[2]  Fábio Pinto da Silva,et al.  Medical design: Direct metal laser sintering of Ti–6Al–4V , 2010 .

[3]  Timothy Douglas,et al.  Rapid prototyping: porous titanium alloy scaffolds produced by selective laser melting for bone tissue engineering. , 2009, Tissue engineering. Part C, Methods.

[4]  J. Vander Sloten,et al.  Design for medical rapid prototyping of cranioplasty implants , 2003 .

[5]  P. Chu,et al.  Surface modification of titanium, titanium alloys, and related materials for biomedical applications , 2004 .

[6]  G. Booysen,et al.  Using RP to promote collaborative design of customised medical implants , 2007 .

[7]  Erik Neovius,et al.  Craniofacial reconstruction with bone and biomaterials: review over the last 11 years. , 2010, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[8]  J. Courtney,et al.  Influence on blood of plasticized polyvinyl chloride: significance of the plasticizer. , 1999, Artificial organs.

[9]  Jonathan Black,et al.  Orthopaedic Biomaterials in Research and Practice , 1988 .

[10]  Martin Klein,et al.  Long-term results following titanium cranioplasty of large skull defects. , 2009, Neurosurgical focus.

[11]  A. Bandyopadhyay,et al.  Influence of porosity on mechanical properties and in vivo response of Ti6Al4V implants. , 2010, Acta biomaterialia.

[12]  J. Kruth,et al.  Selective laser melting of biocompatible metals for rapid manufacturing of medical parts , 2006 .

[13]  Vydehi Arun Joshi,et al.  Titanium Alloys: An Atlas of Structures and Fracture Features , 2006 .

[14]  Alida Mazzoli,et al.  Selective laser sintering in biomedical engineering , 2012, Medical & Biological Engineering & Computing.

[15]  E Maravelakis,et al.  Reverse engineering techniques for cranioplasty: a case study , 2008, Journal of medical engineering & technology.

[16]  André Luiz Jardini,et al.  Microchannels Fabrication In Direct Metal Laser Sintering (dmls) , 2012 .

[17]  Emeka Nkenke,et al.  In vivo performance of selective electron beam-melted Ti-6Al-4V structures. , 2010, Journal of biomedical materials research. Part A.

[18]  Miroslav Trajanović,et al.  Medical applications of rapid prototyping , 2007 .

[19]  H. Machado,et al.  Reconstruction of a large complex skull defect in a child: a case report and literature review , 2007, Child's Nervous System.

[20]  Ming-Chuan Leu,et al.  Progress in Additive Manufacturing and Rapid Prototyping , 1998 .

[21]  André Luiz Jardini,et al.  Microstructural and Mechanical Characterization of a Custom-Built Implant Manufactured in Titanium Alloy by Direct Metal Laser Sintering , 2014 .

[22]  Shivakumar Raman,et al.  Mechanical evaluation of porous titanium (Ti6Al4V) structures with electron beam melting (EBM). , 2010, Journal of the mechanical behavior of biomedical materials.

[23]  J. Mei,et al.  Microstructure study of direct laser fabricated Ti alloys using powder and wire , 2006 .

[24]  J J Kuttenberger,et al.  Long-term results following reconstruction of craniofacial defects with titanium micro-mesh systems. , 2001, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[25]  L. Murr,et al.  Microstructure and mechanical behavior of Ti-6Al-4V produced by rapid-layer manufacturing, for biomedical applications. , 2009, Journal of the mechanical behavior of biomedical materials.

[26]  K. Iserson The origins of the gauge system for medical equipment. , 1987, The Journal of emergency medicine.

[27]  Cecília Amélia de Carvalho Zavaglia,et al.  Paired evaluation of calvarial reconstruction with prototyped titanium implants with and without ceramic coating. , 2014, Acta cirurgica brasileira.

[28]  Ian Gibson,et al.  The use of rapid prototyping to assist medical applications , 2006 .

[29]  S. Gopakumar RP in medicine: a case study in cranial reconstructive surgery , 2004 .

[30]  H. J. Rack,et al.  Phase transformations during cooling in α+β titanium alloys , 1998 .

[31]  Emanuel M. Sachs,et al.  Surface macro‐texture design for rapid prototyping , 2000 .

[32]  Bingheng Lu,et al.  Rapid prototyping assisted surgery planning and custom implant design , 2009 .

[33]  Yang Zhang,et al.  Fabrication of Repairing Skull Bone Defects Based on the Rapid Prototyping , 2009 .

[34]  Amália Moreno,et al.  Prototyping for Surgical and Prosthetic Treatment , 2011, The Journal of craniofacial surgery.

[35]  A Linney,et al.  A prospective study of computer-aided design and manufacture of titanium plate for cranioplasty and its clinical outcome. , 1999, British journal of neurosurgery.

[36]  K. Krishnan,et al.  The Application of Rapid Prototyping Techniques in Cranial Reconstruction and Preoperative Planning in Neurosurgery , 2003, The Journal of craniofacial surgery.

[37]  J. H. Harrison Synthetic materials as vascular prostheses. I. A comparative study in small vessels of nylon, dacron, orlon, ivalon sponge and teflon. , 1958, American journal of surgery.

[38]  John A Jansen,et al.  Bone formation in transforming growth factor beta-I-loaded titanium fiber mesh implants. , 2002, Clinical oral implants research.

[39]  J. Colton,et al.  Fabrication and analysis of plastic hypodermic needles , 2005, Journal of medical engineering & technology.

[40]  T. Bieler,et al.  Effects of working, heat treatment, and aging on microstructural evolution and crystallographic texture of α, α′, α″ and β phases in Ti–6Al–4V wire , 2005 .