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3D Printing in Medicine

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15 thg 4 2020


3D Printing (3DP) is a process that is used for fabricating solid prototypes from a computer-aided design (CAD) data file. The field of 3DP has become one of the fastest growing fields in the engineering industry today. One area in 3DP that is progressing quickly and one which 3DP is having a pronounced impact is that of the medical field. Using 3DP technologies in the field of medicine is no simple task though. It is a complex process and requires a multidisciplinary approach with collaboration between doctors and engineers. The number of medical applications of 3DP is increasing everyday. The uses of 3DP can be classified in many categories including creation of customized prosthetics, implants, anatomical models, and tissue and organ fabrication. In addition, research is being done on drug dosage forms, delivery, and discovery. The benefits of uses of 3DP in medicine are many including the customization and personalization of medical prod- ucts, drugs, equipment, cost-effectiveness, increased productivity, and the customization of design and fabrication. The benefits of 3DP in the medical field are numerous. It has the potential to help cut costs in medical proce- dures, save time during surgeries, and even help end the donor shortage.

This chapter describes the many uses of 3DP in medicine, types of medical imaging, software for medical models, medical materials, and a case study. The case study will describe a detailed procedure for printing c1 vertebrate from the CT scan data.

2 Medical Applications of 3DP

The applications of 3DP in medicine are expanding rapidly and are expected to revolutionize the healthcare industry. A number of applications in which

3DP has had an effect will be discussed next.

2.1 Teaching Aids and Simulators

The rapid prototyping (RP) may be used as a means to make models of any given body part or even recreate a medical condition. These models provide useful tools for researchers and educators. Models are able to be distributed in kits to schools, and provide a hands-on illustration of certain body parts, allowing the students to practice procedures or gain a better understand- ing of the human anatomy. Being able to look at a 3D model of a bone is a much better learning tool than staring at a picture of it in a book. These 3DP models may be used in medical schools and in training courses, allowing students to perfect their skill without causing harm to an actual person or using cadavers.

2.2 Presurgical Planning Models

Surgery tends to be a complex and time-consuming procedure. Through the use of 3DP, surgical procedures can become safer as well as less time- consuming. Models of a patient’s anatomy may be created through 3DP methods and then used to rehearse complex procedures. Though doctors practice and study each surgical procedure they perform, no person is exactly the same, thus no surgery is exactly the same. Taking a CT scan of the patient allows the doctor performing the surgery to rehearse with that par- ticular patient’s exact anatomy, effectively reducing the actual time spent in surgery and preparing the doctor for surgery. Surgeries that were previously inoperable or extremely difficult and potentially dangerous have become a more accessible option for doctors. Just as an actor in a play, it may not always be a perfect performance the first time; it takes rehearsal to get every line and movement right. 3DP allows for doctors to go through their own

rehearsal, ensuring each surgery is executed to perfection. The models may also be used by the doctors as visual aids in order to better plan a surgery, increasing the chances of a successful surgery. In a recent case, doctors find a tumor in a woman’s brain and proposed an invasive surgery. The man’s wife sought a less-invasive procedure, so he used magnetic resonance imag- ing (MRI) files to create models of her skull and then mailed them to the surgeon who eventually performed the surgery. By analyzing and practic- ing on the model of the woman’s skull, the surgeon was able to remove the tumor through a small opening, a much less-invasive procedure. The benefit of using 3DP in this application is only exemplified in the case that a patient has any anatomical abnormalities or deformities.

2.3 Customized Surgical Implants

Through the use of 3DP, customized surgical implants may be created for a patient. Currently, implants are typically standardized, and a patient is left on the surgery table while the implant is being customized to fit. However, with 3DP scan of the patient may be done and then a customized model created that already matches the anatomy of the patient. This allows for the customized implant to be made beforehand, decreasing the amount of time spent in surgery and reducing the risk of surgical complications.

2.4 Mechanical Bone Replicas

Bones are not solid homogeneous, but have two distinct regions: the cor- tical and trabecular bones. 3DP allows for the creation of a nonhomo- geneous model that accurately reflects these two regions, providing a replica that is more true to life. A lattice structure of an stereolithography apparatus (SLA) can be used to create these two distinct regions and pro- vide mechanically correct bones. This allows doctors to observe the bone strength under various conditions and recreate events that may cause fractures, stresses, and other changes in the bone.

2.5 Prosthetics and Orthotics

The use of 3DP in prosthetics or orthotic devices is different from conven- tional methods because it starts with each individual patient’s anatomy, making it one of the most obvious fields that 3DP can benefit. As in other applications, medical image data files may be used to study the patient’s anatomy and create designs that already account for the patient’s specific alignment characteristics. This reduces the number of times a prosthetic needs to be refitted, cutting down cost. The use of 3DP allows for a prosthetic or orthotic that has biomechanically correct geometry to be created the first time and provides the patient with an improved fit, comfort, and stability.

2.6 Bioprinting

Bioprinting is a term that has been referring to 3D printing actual living organs and tissues. In this process, the first step is to take a biopsy of the organ or tissue to be replaced. This biopsy is examined and certain cells with regenerative potential are isolated and multiplied. These cells are then mixed with a liquid material that provides oxygen and other nutrients in order to keep the cells alive. This mixture of cells is then placed into a printer cartridge, while a separate printer cartridge is filled with a biomaterial that will be printed into the organ- or tissue-shaped structure. The structure itself is created on the computer through the assistance of a patient’s medical scans. Once the printer is ready to print, it builds the structure layer by layer while it embeds the cells into each layer. If the cell is provided with the right mixture of nutrients, growth factors, and placed in the right environment, it will grow and perform its functions. This function of RP to print organs is only a scaled-up version of current processes to grow organs in laboratories. However, using 3DP allows for the process to be more precise and reproduc- ible. The ability to print organs and tissues is a huge breakthrough in the

3DP world and one that has many benefits, and the goal of this application is to help solve the shortage of donor organs. 3DP organs also have a huge benefit over donor organs in the sense that the organs are engineered with a patient’s own cells, thus eliminating the risk of rejection. The ability to 3DP organs for a patient is one of the most exciting breakthroughs in recent years; it has the ability to end the shortage of organ donors and save many lives.

In addition to the aforementioned applications, 3DP is used to print organs, stem cells, skins, heart, and blood vessels. In the same way as the tissue and organ cells are printed and studied, cancer cells are also being bioprinted for effective studies.

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