Optimizing your Medical & Dental Additive Manufacturing Workflow

Ana Carolina Rocha | September 27, 2016 | 5 min read

How to combine existing and innovating technology to improve quality, and reduce costs of medical supplies. Medical costs are one of the major problems that societies face, especially in countries with aging populations. One of the biggest cost considerations for medical and dental solutions is producing small batch custom parts that are adjusted to patient's unique body form. 

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Photo Source: ytimg

Because these are mostly 1-time products, they have high production costs. But with the introduction of new technologies like 3D scanning and 3D printing those costs are being significantly reduced. As more companies experiment with the technologies, they are also moving them into wider adoption. Workflows and tools are becoming available to integrate this innovative technology into existing practices to improve performance, quality and reduce costs of medical supplies.


A core advantage of 3D printing is that it can utilize models from existing scanning technologies, like MRI or ultrasound

Substantial improvements in terms of image quality and accuracy have come over the past years. It has created a much more detailed picture of the individual human anatomy, but none of these features have provided specialists with a three dimensional view.

3D-Printing provided a missing link. By leveraging existing technologies, it is possible with minimal additional effort, to visualize in 3D without going through surgery. The implementation of 3D-Printing technology in healthcare has expanded to many different aspects of Medicinal praxis.

How does it work?

Imagine holding a patient’s brain or heart in hand for examination. Tumours, inherited disease pathologies, and injuries can become tangible, prior to surgery.

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Image Source: Resin heart, held by Stanford cardiologist Dr. Paul Wang

3D models are produced through the images generated by the existing managed technologies, such as MRI or ultrasound. Because it can work with existing workflows, there has been a quick adoption in many facilities. The printable files can be generated with a realistic colour, finishing, and consistency. As online services providers are also becoming more common, including those specializing in medical models, even the requirement to acquire a 3D printing machine has fallen away. Those models then become a reference point for discussions with the patient about upcoming procedures or a visual reference for the doctor prior to surgery to improve accuracy. According to the ”Three-dimensional print of a liver for preoperative planning in living donor liver transplantation” study (2013), supported by Mikati Foundation Endowed Chair in Liver Diseases (Nizar N. Zein), Online Library,

“3D organ printing is a valuable tool for understanding the spatial relationships between vascular and biliary anatomical structures and ultimately for facilitating surgery and potentially minimizing intraoperative complications.Through a direct comparative validation protocol, these models were shown to have a very high accuracy with mean dimensional errors of less than 4 mm for the entire model and less than 1.3 mm for vascular diameters.” 

Materials

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Image Source: 3ders Bioprinters

One of the next frontiers for medical 3D printing is printing for implantation. While the field of materials for additive manufacturing is wide, those which can be used medically are strictly regulated. A variety of companies are developing metal, plastic, ceramic, and other bio-compatible materials to solve different problems. While Plastic and ceramic are regularly implemented for less invasive praxis such as dental or prosthetics, a combination of plastic and metal is commonly used for knee or joint replacements. In recent news published by 3D Printing Industry researches on hybrid polymer, Lucas Albrecht, Stephen Sawyer and Pranav Soman, from Syracuse University in New York, showed how materials like PLA, PCL, PCL+HA and PCL+PLA can be implemented to print scaffolds for cells to grow and creating engineered tissues.

For other medical implants, titanium, silicone, and apatite, among other bio-materials, have all been accepted for use within human organic tissue. As more professional 3d printing services target medical applications, the price of 3D implants will fall and they will show a larger presence in medicine.

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Image source: Textually

Role for 3D Printing in Aesthetic Surgery

Aesthetics play a central role in society. 3D printing can “relatively” cheaply create body parts such as prosthetic arms and legs that are custom fit to the bodies of the patients. For those in their younger age, personalized 3D printed solutions can, for example, make children with disabilities feel more integrated and avoid the unpleasant experience of feeling rejected or bullied at school for being different.

But adults are also not detached from social pressure and also benefit from using 3D printing for aesthetic results. As a result of cancer radiation treatment, Shirley Anderson lost his jaw in 2012.

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Image Source: aolcdn Indiana University by Abigail Watson.

Through desktop 3D printing, Dr. Bellicchi created a detailed prosthetic model, directly based to Anderson’s face and skin tone in order to produce a human facial prostheses which was more realistic and significantly easier to incorporate.

“The digitally-modeled piece is not only much lighter, but far more natural-looking -- the creators could create more natural borders and account for fine details like skin pores. The result is good enough that Anderson could comfortably wear the prosthesis in public without drawing significant attention.”  (Aolcdn)

3D printing technology provides higher quality alternatives for patients who have suffered critical traumas, or markable degenerative damages, like in the previous example, due to cancer in visible parts of the body.

Complexity

Additive manufacturing is extremely efficient when to complexity is concerned. If a perfectly customized prosthetic cost exactly the same as a mass-produced one, which one would you choose?

We expect to see this roll into designs for heart valves, orthopedic devices, dental components, as well as for glasses frames, and the already well known case of hearing aids. And the lower costs will continue to fall as more production moves from traditional production methods to this much more cost effective method of production.

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Image source: 3dprint

Impact on medical supplies and suppliers

Many medical supplies are already being made with 3D printers, such hearing-aids and  dental crowns. As 3D technology customized devices become more commonplace, suppliers are also able to provide a more compliant and comfortable experience to complex problems of individualization, while maintaining competitiveness in terms of manufacturing costs and improving quality. In fact, once confirmed as a viable solution, suppliers were given 500 days to all suppliers to implement the new technology across the market. Shortly after that, traditional manufacturers who couldn’t make the change were displaced from the market for lack of competitivity.

These very fundamental shifts in the industry provide large opportunities for 3D printing services to provide a key enabling role. We initially foresee significant side-industries dedicated to the specific production and creation of the devices for the shift to additive manufacturing off-site. But as additive manufacturing machinery matures, we expect that even complex prints will eventually be done onsite by dedicated machines.

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Image source: Dental Printing Conference

3D Printing in Medical and Dental in the Short Future

3D printing will make a big impact on how healthcare is performed, and is growing as a sector at 20% annually. A clear proof of this is the behavior of Chinese and Japanese investors in particularly, as well as the efforts of the South Korean government in terms of tax, to bring 3D printing to the core of their industry. (Read More)

3D Printing is not limited to prosthetic use and implantation. Recreating human organs for transplantation is already being carefully studied and tested. (Read More) This would mean the withdrawal of organs waiting lists, and specially transplant’s major problem, which is organ rejection.

 

 

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