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I
Mahatma Gandhi Mission’s
College of Engineering and Technology
Noida, U.P., India
Seminar Report
On
“APPLICATIONS OF 3D PRINTING IN MEDICAL”
As
Part of B. Tech Curriculum
Submitted by:
Lokesh chaudhary
VIII Semester
1609540014
Under the Guidance of:
Mr. Umesh Yadav
(Assistant Professor)
MGM’s COET, Noida
(Seminar Coordinator)
Mr. Ravindra ram
Submitted to:
HOD
Mechanical Engineering Department
MGM’s COET, Noida
ii
Mahatma Gandhi Mission’s
College of Engineering and Technology
Noida, U.P., India
Department of Mechanical Engineering
CERTIFICATE
This is to certify that Mr. LOKESH CHAUDHARY B. Tech. Mechanical Engineering, Class
TT-ME and Roll No. 1609540014has delivered seminar on the topic “APPLICATIONS
OF 3D PRINTING IN MEDICAL”. His seminar presentation and report during
the academic year 2019-2020 as the part of B. Tech Mechanical Engineering curriculum was
good.
(Guide) (Seminar coordinator) (Head of the Department)
iii
ACKNOWLEDGEMENT
I would like to express my deep sense of gratitude to my supervisor Mr. Umesh Yadav
(Assistant Professor, Department of Mechanical Engineering, M.G.M College of
Engineering and Technology, Noida, India) for his guidance, support and encouragement
throughout this seminar. Moreover, I would like to acknowledge the Department of Mechanical
Engineering, M.G.M College of Engineering and Technology, Noida, for providing me all
possible help during this seminar work. Moreover, I would like to sincerely thank everyone who
directly and indirectly helped me in completing this work.
(Lokesh chaudhary)
iv
ABSTRACT
3D printing is a new technology in constant evolution. It has rapidly expanded and is now being
used in health education. Patient-specific models with anatomical fidelity created from imaging
dataset have the potential to significantly improve the knowledge and skills of a new generation
of surgeons. This review outlines five technical steps required to complete a printed model:
They include selecting the anatomical area of interest, the creation of the 3D geometry, the
optimization of the file for the printing and the appropriate selection of the 3D printer and
materials. All of these steps require time, expertise and money. A thorough understanding of
educational needs is therefore essential in order to optimize educational value. At present, most
of the available printing materials are rigid and therefore not optimum for flexibility and
elasticity unlike biological tissue. We believe that the manipulation and tuning of material
properties through the creation of composites and/or blending materials will eventually allow for
the creation of patient-specific models which have both anatomical and tissue fidelity.
v
TABLE OF CONTENT
Certificate ii
Acknowledgement iii
Abstract iv
Table of Content v
List of Figure vi
CHAPTER 1: INTRODUCTION 1
1.1 Introduction 1
1.2 History 2
CHAPTER 2: TYPES OF 3D PRINTING 4
2.1 Stereolithography (Sla) Technology 4
2.2 Selective Laser Sintering (SLS) Technology 5
2.3 Laminated Object Manufacturing (Lom) Technology 6
CHAPTER 3: APPLICATIONS OF 3D PRINTERS IN MEDICAL 7
3.1 Hearing Aids 8
3.2 Surgical Guides and Tools 9
3.3 Prosthetics 10
3.4 Surgical Learning Tools 11
3.5 Implants 12
3.6 Anatomy of Patient 14
3.7 Bandages 15
CONCLUSION 17
REFERENCE 18
vi
LIST OF FIGURES
FIG.NO. DETAILS OF FIGURES PAGE NO.
1.1 3d Structure 1
2.1 Stereolithography (SLA) Technology 4
2.2 Selective Laser Sintering (SLS) Technology 5
2.3 Laminated Object Manufacturing (LOM) Technology 6
3.1 Hearing Aids 8
3.2 Surgical Guides and Tools 9
3.3 Surgery Tools 10
3.4 Prosthetics 11
3.5 Surgical Learning Tools 12
3.6 Implants 13
3.7 Anatomy of Patient 14
3.8 Bandages 15
1
CHAPTER 1
INTRODUCTUON
1.1 Introduction
The rapid development of 3D printing has created new learning and teaching tool for medical
education. The ability to produce patient-specific in silicon models from digital imaging and
communication in medicine (DICOM) data derived during CT, MRI,or ultrasound scanning
has been coupled with new, less expensive 3D printing technology. Depending on the area of
interest, these printed models demonstrate anatomical and structural fidelity consistent with
the patient’s actual disease process. This fidelity has allowed learners to view and understand
gross pathology and structural relationships prior to surgical intervention. An improved
understanding and visualization have in turn allowed surgical teams to plan interventions
more accurately and guide margins of resection, model appropriate implant dimensions and
sometimes create the implant itself using 3D printing technology as shown in fig.1.1
Fig. 1.1 3D Structure
However, the vast majority of printed models are made with hard materials and only a few
presents some flexibility and elasticity. Although hard materials are sufficient to recreate
anatomical fidelity, it has been challenging to recreate models with tissue characteristics
2
1.2 History
1974: David E. H. Jones laid out the concept of 3D printing in his regular column Ariadne in
the journal New Scientist
1981: Early additive manufacturing equipment and materials were developed in the 1980s. In
1981: Hideo Kodama of Nagoya Municipal Industrial Research Institute invented two additive
methods for fabricating three-dimensional plastic models with photo-hardening thermoset
polymer, where the UV exposure area is controlled by a mask pattern or a scanning fiber
transmitter
1984: On July 2nd 1984, American Entrepreneur Bill Masters filed a patent for his Computer
Automated Manufacturing Process and System (US 4665492).This filing is on record at
the USPTO as the first 3D printing patent in history; it was the first of three patents belonging
to Masters that laid the foundation for the 3D printing systems used today On 16 July
1984, Alain Le Mahout, Olivier de Witte, and Jean Claude André filed their patent for
the stereolithography process. The application of the French inventors was abandoned by the
French General Electric Company (now Alcatel-Alston) and CILAS (The Laser
Consortium). The claimed reason was "for lack of business perspective “Three weeks later in
1984, Chuck Hull of 3D Systems Corporation filed his own patent for a stereolithography fabrication
system, in curing photopolymers with ultraviolet light lasers. Hull defined the process as a "system for
generating three-dimensional objects by creating a cross-sectional pattern of the object to be
formed,” Hull's contribution was the STL (Stereolithography) file format and the digital slicing and
infill strategies common to many processes today.
1986: Charles Hull was granted a patent for his system, and his company, 3D Systems
Corporation released the first commercial 3D printer, the SLA-1.
1988: The technology used by most 3D printers to date—especially hobbyist and consumer-
oriented models—is fused deposition modeling, a special application of plastic extrusion,
developed in 1988 by S. Scott Crump and commercialized by his company Stratasys, which
marketed its first FDM machine in 1992.
AM processes for metal sintering or melting (such as selective laser sintering, direct metal
laser sintering, and selective laser melting) usually went by their own individual names in
the 1980s and 1990s. At the time, all metalworking was done by processes that are now called
non-additive (casting, fabrication, stamping, and machining); although plenty
of automation was applied to those technologies (such as by robot welding and CNC), the idea
of a tool or head moving through a 3D work envelope transforming a mass of raw
3
material into a desired shape with a tool path was associated in metalworking only with
processes that removed metal (rather than adding it), such as CNC milling, CNC EDM, and
many others. But the automated techniques that added metal, which would later be called
additive manufacturing, were beginning to challenge that assumption. By the mid-1990s, new
techniques for material deposition were developed at Stanford and Carnegie Mellon
University, including micro casting]
and sprayed materials. Sacrificial and support materials
had also become more common, enabling new object geometries.
1993: The term 3D printing originally referred to a powder bed process employing standard
and custom inkjet print heads, developed at MIT by Emanuel Sachs in 1993 and
commercialized by Solingen Technologies, Extrude Hone Corporation, and Z Corporation.[
The year 1993 also saw the start of a company called Solids cape, introducing a high-
precision polymer jet fabrication system with soluble support structures, (categorized as a
"dot-on-dot" technique).
1995: In 1995 the Fraunhofer Society developed the selective laser melting process.
2009: Fused Deposition Modeling (FDM) printing process patents expired in 2009.
As the various additive processes matured, it became clear that soon metal removal would no
longer be the only metalworking process done through a tool or head moving through a 3D
work envelope transforming a mass of raw material into a desired shape layer by layer.
The 2010s were the first decade in which metal end use parts such as engine brackets and
large nuts would be grown (either before or instead of machining) in job production rather
than obligately being machined from bar stock or plate. It is still the case that casting,
fabrication, stamping, and machining are more prevalent than additive manufacturing in
metalworking, but AM is now beginning to make significant inroads, and with the advantages
of design for additive manufacturing, it is clear to engineers that much more is to come. As
technology matured, several authors had begun to speculate that 3D printing could aid
in sustainable development in the developing world.
2012: Folio develops a system for closing the loop with plastic and allows for any FDM or
FFF 3D printer to be able to print with a wider range of plastics.
4
CHAPTER 2
DIFFERENT TYPES OF 3D PRINTERS
There are several types of 3d printers which are given below:
2.1 Stereo lithography (Sla) Technology
SLA is a fast prototyping process. Those who use this technology are serious about accuracy
and precision. It can produce objects from 3D CAD data (computer-generated) files in just a
few hours. This is a 3D printing process that’s popular for its fine details and exactness.
Machines that use this technology produce unique models, patterns, prototypes, and various
production parts. They do this by converting liquid photopolymers (a special type of plastic)
into solid 3D objects, one layer at a time. The plastic is first heated to turn it into a semi-liquid
form, and then it hardens on contact. The printer constructs each of these layers using an ultra
violet laser, directed by X and Y scanning mirrors. Just before each print cycle, a recoated
blade moves across the surface to ensure each thin layer of resin spreads evenly across the
object. The print cycle continues in this way, building 3D objects from the bottom up as
shown fig.2.1
Fig. 2.1 SLA Technology
5
Once completed, someone takes the 3D object from the printer and detaches it carefully from
the platform. The 3D part will usually have a chemical bath to remove any excess resin. It’s
also common practice to post-cure the object in an ultra violet oven. What this does is render
the finished item stronger and more stable. Depending on the part, it may then go through a
hand sanding process and have some professional painting done. SLA printing has become a
favored economical choice for a wide variety of industries. Some of these include automotive,
medical, aerospace, entertainment, and also to create various consumer products.
2.2Selective Laser Sintering (SLS) Technology
The build platform, or bed, lowers incrementally with each successive laser scan. It’s a
process that repeats one layer at a time until it reaches the object’s height. There is un-sintered
support from other powders during the build process that surround and protect the model. This
means the 3D objects don’t need other support structures during the build. Someone will
remove the un-sintered powders manually after printing.
Fig. 2.2 SLS Technology
SLS produces durable, high precision parts, and it can use a wide range of materials. It’s a
perfect technology for fully-functional, end-use parts and prototypes. SLS is quite similar to
SLA technology with regards to speed and quality. The main difference is with the materials,
6
as SLS uses powdered substances, whereas SLA uses liquid resins. It’s this wide variety of
available materials that makes SLA technology so popular for printing customized objects.
This technology as shown in fig2.2
2.3 Laminated Object Manufacturing (Lom) Technology
A Californian company called Helices Inc. (now Cubic Technologies), first developed LOM
as an effective and affordable method of 3D printing. A US design engineer called Fergana
pioneer in 3D printed technologies originally patented LOM.
Fig. 2.3 LOM Technology
LOM is a rapid prototyping system that works by fusing or laminating layers of plastic or
paper using both heat and pressure. A computer-controlled blade or laser cuts the object to the
desired shape. Once each printed layer is complete, the platform moves down by about 1/16th
of an inch, ready for the next layer. The printer then pulls a new sheet of material across the
substrate where it’s adhered by a heated roller. This basic process continues over and over
until the 3D part is complete. This technology is shown in fig.2.3
7
CHAPTER 3
APPLICATIONS OF 3D PRINTERS IN MEDICAL
Every year, 3D printing offers more and more applications in the healthcare field helping to
save and improve lives in ways never imagined up to now. In fact, the 3D printing has been
used in a wide range of healthcare settings including, but not limited to cardiothoracic
surgery,cardiology,gastroenterology,neurosurgery,oralsurgery,ophthalmology,otolaryngology,
orthopedicsurgery,plasticsurgery,podiatry,pulmonology, radiation oncology], transplant
surgery], urology, and vascular surgery.Thanks to the different benefits that this technology
could induce in the field, the main direct applications of 3D printing in the medical and
clinical field are Used for personalized presurgical/treatment and for preoperative planning.
This will lead to a multistep procedure that, integrating clinical and imaging information, will
determine the best therapeutic option. Several studies have demonstrated that patient-specific
presurgical planning may potentially reduce time spent in the operating room (OR) and result
in fewer complications. Moreover, this may lead to reduced postoperative stays, decreased
reintervention rates, and lower healthcare costs. The 3D-printing technology allows to provide
to the surgeon a physical 3D model of the desired patient anatomy that could be used to
accurately plan the surgical approach along with cross-sectional imaging or, alternatively,
modeling custom prosthetics (or surgical tool) based on patient-specific anatomy. In this way,
a better understanding of a complex anatomy unique to each case is allowed. Furthermore, the
3D printing gives the possibility to choose before the implantation the size of the prosthesis’s
components with very high accuracy. Customize surgical tools and prostheses: the 3D printing
can be used to manufacture custom implants or surgical guides and instruments. Therefore,
the customization of surgical tools and prostheses means a reduction of cost given by the
additive manufacturing technique. Study of osteoporotic conditions: following a
pharmacological treatment, 3D printing is useful in validating the results achieved by the
patient. This enables a more accurate estimation of patient’s bone condition and a better
decision on the surgical treatment. Testing different device in specific pathways: a clear
example is the reproduction of different vascular patterns to test the effectiveness of a
cardiovascular system used to treat peripheral and coronary artery disease. In this way, the 3D
printing enables us to quickly produce prototypes of new design concepts or improvements to
8
existing devices. Improving medical education: 3D-printed patient-specific models have
demonstrated that they can increase performance and foster rapid learning, while significantly
ameliorating the knowledge, management, and confidence of the trainees regardless of the
area of expertise. The benefits of 3D printing in education are the reproducibility and safety of
the 3D-printed model with respect to the cadaver dissection, the possibility to model different
physiologic and pathologic anatomy from a huge dataset of images, and the possibility to
share 3D models among different institutions, especially with ones that have fewer resources.
3D printers that have the capability to print with different densities and colors can be used to
accentuate the anatomical details.
3.1 Hearing Aids
Much too many people's surprise hearing aids are one of the greatest success stories to come
from the continued development of AM. Over 10,000,000 people are now wearing 3D printed
hearing aids with 97% of all hearing aids globally now being created using AM. Not only has
AM technology significantly reduced the cost of custom hearing aids when compared to
traditional manufacturing but the ability to produce the complex and organic surfaces required
for a hearing aid has reduced returns because of bad fit from 40% to 10%.
Fig. 3.1 Hearing Aids
Limitations
Some of limitations of AM when applied to the medical industry include:
 While time to print parts is often much faster when compared to traditional manufacturing
methods there is still significant time required for the conversion of scan data to produce a
9
printable STL file. Because of this, for more urgent cases like trauma surgery, generic
implants or medical devices may be a more desirable solution.
 While the purchase of a desktop FDM or SLA machine typically ranges from $1000 - $5000,
high-end AM printers (SLS, material jetting and metal printing) range from $200,000 to
$850,000. Materials for these AM technologies are also currently very expensive. Currently,
for these technologies, the optimal solution is to get products made out of house.
 A sound understanding of each AM technology is critical and needs to be determined within
the context of the desired outputs. Each technology has strengths and weaknesses and the
variation in price to get parts made can be significant.
3.2 Surgical Guides and Tools
Much like a drill jig is used in manufacturing to ensure a hole is placed in the exact right
location; physicians also implement guides and tools to assist in surgery. Historically, surgical
guides and tools were generic devices made of titanium or aluminum. By implementing AM,
physicians are able to create guides that precisely follow a patient's unique anatomy,
accurately locating drills or other instruments used during surgery. AM guides and tools are
used to make the placement of restorative treatments (screws, plates, and implants) more
precise, resulting in better postoperative results.
Fig. 3.2 Surgical Tools
Orthopedic surgeons and craniofacial (cranium and face) surgeons are one of the most regular
users of AM guides and tools. In 2014, 23 custom surgical guides and templates were
fabricated to assist partial or total knee replacement surgeries, more than 112 surgical guides
were fabricated to assist various craniofacial surgeries and nine different titanium alloy Ti-
6Al-4V craniofacial implants were surgically implanted into patients in Egypt alone. Surgical
10
guides, derived from patient scans to precisely match their anatomy and made from PC-ISO (a
sterilizable FDM plastic), are compatible with human tissue for short-term contact. This
allows them to be placed against the patient’s anatomy for a more precise cut or drill hole.
Fig.3.3 Surgery Tools
Anatomical models (bone models) and surgical guides are also regularly both produced via
AM and used collaboratively to plan and test the best locations for stabilizing screws or plates
that conform to the patient’s bone surface before performing surgery.
3.3 Prosthetics
In the United States alone, close to 200,000 amputations are performed each year, with
prosthetics priced from $5,000-$50,000 replacement or alterations can be time consuming and
expensive. Because prosthetics are such personal items, each one has to be custom-made or fit
to the needs of the wearer. AM technology is now regularly being used to produce patient
specific components of prosthetics that match perfectly with the user's anatomy. The ability to
produce complex geometries from a range of materials has resulted in AM being adapted at
the locations where prosthetics are in contact with a patient. AM technology has been used to
produce everything from prosthetic leg connections that fit comfortably onto a user through to
a complex and highly customized facial prosthetic for a cancer patient.AM is also being used
in the manufacture of low-cost prosthetics. The collaborative nature of the AM industry has
meant that a quick internet for 3D printed prosthetics reveals a huge range of peer-reviewed
products that can be printed on desktop AM printers at a very low cost. These designs can
easily be scaled or altered to perfectly match the size of the user. The e-NABLE
Community comprises of a group of individuals from all over the world who are using their
3D printers to create free 3D printed hands and arms for those in need of an upper limb
11
assistive device. Concepts like this are now becoming more commonplace as AM continues to
move into the mainstream.
Fig. 3.4 Prosthetics Legs
Typically, traditional manufacturing techniques and materials are used to produce the
structural section of functional prosthetics. AM is often then implemented at the interface
section by producing complex contours that fit perfect to the users' anatomy improving
comfort and fit. AM is also implemented on the external outer surface of prosthetics to
produce life-like and organic outer shells that hide the mechanical nature of prosthetics. This
also allows the wearer to fully customize their prosthetics to whatever design or style they
prefer.
3.4 Surgical Learning Tools
While much of the focus for 3D printing in the medical industry has been around implants and
medical devices used by patients, one of the largest areas of application has concentrated on
anatomical replicas. Historically, clinical training, education, and device testing have relied on
the use of animal models, human cadavers, and mannequins for hands-on experience in a
clinical simulation. These options have several deficiencies including limited supply, expense
of handling and storage, the lack of pathology within the models, inconsistencies with human
anatomy, and the inability to accurately represent tissue characteristics of living humans.
Physicians are now using models produced by AM from patient scan data to improve the
12
diagnosis of illnesses, elucidate treatment decisions, plan, and, in some cases, even practice
selected surgical interventions in advance of the actual treatments. The models help
physicians understand patient anatomy that is difficult to visualize, especially when using
minimally invasive techniques. Models also assist in accurately sizing medical devices.
Physicians can also use the models to explain an upcoming surgery to patients and their
families and to communicate the surgical steps to the clinical team.
Fig. 3.5 Model of Patient Heart
To help reduce cost some facilities have developed procedures where surgeons practice and
plan operations on low cost mannequins that are transplanted with patient-specific AM
models. This coupled with the fact that AM technologies are able to produce both hard and
soft materials in a single part, allowing the accurate replication of human tissue, calcification,
and bone, means that surgeons can now obtain an even better understanding of exactly how a
procedure needs to be performed right down to the touch and feel of the different parts of a
patient's anatomy.
13
3.5 Implants
AM’s ability to produce fine mesh or lattice structures on the surface of surgical implants can
promote better osseointegration and reduce rejection rates. Biocompatible materials such as
titanium and cobalt– chrome alloys are available for applications in maxillofacial (jaw and
face) surgery and orthopedics. The superior surface geometry produced by AM has been
shown to improve implant survival rate by a factor of 2 when compared to traditional
products. The porosity of these AM products coupled with the high level of customization and
ability to manufacture them from traditional medical materials has resulted in AM implants
becoming one of the fastest growing segments of the AM medical industry.
Fig. 3.6 Hip Replacement Sockets
Technology Best suited for
Metal printing Very high accuracy and strength and able to
Produce very complex geometries that accurately
Match to the contours of a patient's anatomy.).
Uses common medical metals (titanium and
Aluminum Porous surfaces and intricate scaffolds
are able to be printed.
14
3.6 Anatomy of Patient
Eindhoven’s University of Technology is home to PhD candidate and Healthcare Flagship
Program participant, Mark Thielen, who is aiming to increase surgical and procedural success
for neonatal patients. Using 3D printing and 3D Hubs, Mark has developed an optimized
training experience using lifelike newborn models with functional organs capable of
intelligent sensor feedback.
Fig. 3.7 Model of Anatomy of Patient
For surgeons and nurses, interacting with anatomical models is important to the success of
surgeries and medical procedures. Within the neonatal field, it’s incredibly difficult to practice
correctly with the current state of practice mannequins which lack the complexity and feel of a
newborn patient. Mark’s research is to develop mannequins which have all their major
internal organs functioning and equipped with sensors to monitor key measurements such as
pressure, stress and impact during trial procedures (e.g. CPR, intubation).3D printing is
utilized because of the vast materials available for testing and, most importantly, the organic
shapes the technology is able to create. There are two key components to the mannequin: the
ribcage/spine, which acts as the housing for the second component, the internal organs. The
15
sheer complexity of human anatomy is very hard to recreate realistically with any other
production method as well as increased cost and lead times. Testing was initially done with
various thermoplastic elastomers on a desktop FDM 3D printer to create the larger parts of the
model such as the rib cage. After finalizing on a design, Selective Laser Sintering (SLS) was
used because of the accuracy and dimensional freedom the technology offers. To create the
functional organs material jetting 3D printing was used to create molds. When compared to
traditional manufacturing methods, 3D printed molds allowed for rapid design changes.
Material jetting also allowed the combination of materials (rigid and flexible plastics) when
creating the molds. A heart, for example, needed to have highly detailed working valves. Due
to the extremely small sizes of neonatal organs, as well as their minuscule detail, the only way
to create a mold for these parts was to 3D print them.
3.7 Bandages
Severe burns or other wounds that penetrate many layers of skin are difficult to heal. In fact,
in some developing countries, infections from serious wounds can be fatal. This is the main
reason why 3D printed bandages came into existence. Compared to their conventional
counterparts, 3D printed bandages offer a number of advantages. Some of the key benefits
include customizing bandages to particular wounds, infusing the material with special
substances, and increasing accessibility in developing or war-torn parts of the world. One
fascinating example comes from a team of students at Grand Canyon University. They
developed a low-cost, 3D printed hydro-colloidal bandage, which aids in treating infections
more effectively than a regular one.
Fig. 3.8 Bandages
16
Essentially, it’s partially composed of a gel-like substance that sucks in and traps bacteria.
According to Geek, researchers at the University of Toronto built a 3D imprinter, called Print
alive, which could print living bandages. This 3D printed band-aid both heals the wound and
grows into and around the surrounding skin.
17
CONCLUSION
The 3D printing in medical field and design needs to think outside the norm for changing the
health care. The three main pillars of this new technology are the ability to treat more people
where it previously was not feasible, to obtain outcomes for patients and less time required
under the direct case of medical specialists. In few words, 3D printing consists in “enabling
doctors to treat more patients, without sacrificing results”. Therefore, like any new
technology, 3D printing has introduced many advantages and possibilities in the medical field.
Each specific case in which 3D printing has found application shown in this analysis is a
demonstration of this. However, it must be accompanied by an updated and current legislation
in order to guarantee its correct use.3DP is widely used in healthcare. The domain of hearing
aids is the first manufacturing branch fully overtaken by 3DP, and dentistry seems to be
following suit. Implants and prostheses, the application of models in virtual surgical planning
and teaching in healthcare, traditional and novel medical devices, 3DP of drugs – all these are
rapidly developing areas of the 3DP applications in medicine. In most fields they offer
considerably less expensive alternatives to the classical devices and procedures, release
creativity accelerated by the ease of prototyping of novel devices and help through diagnostics
and medical procedures. Think about the effect of virtual surgical planning or that of
inexpensive limb prostheses presented above. An important feature of 3DP is its contribution
to personalized medicine. According to Wikipedia, “the term has risen in usage in recent years
given the growth of new diagnostic and informatics approaches that provide understanding of
the molecular basis of disease, particularly genomics”. One could call it personalized
medicine on the nanoscale. 3DP offers personalized medicine on the macro scale, since
implants and prostheses and numerous devices for medical use are patient-specific.
Apart from the tissue model exVive3D Liver developed by Organovo; 3D imprinting is still in
the development phase, since 3D imprinter organs are beyond our reach. But it certainly will
bring revolutionary changes in medicine. Introduction of new (bio) printers and (bio)
compatible materials will accelerate medical applications of 3DP.
18
REFERENCES
 C.L. Ventola, “Medical applications for 3D printing: current and projected
uses,” Pharmacy and Therapeutics, vol. 39, no. 10, pp. 704–711, 2014.
 H. Dodziuk, “Application of 3D printing in healthcare,” Kardiochirurgia I
Torakochirurgia Polska, vol. 13, no. 3, pp. 283–293, 2017.
 M. Randazzo, J. M. Pisapia, N. Singh, and J. P. Thawani, “3D printing in
neurosurgery: a systematic review,” Surgical Neurology International, vol. 7, no. 34,
pp. 801–809, 2016.
 N. Guilbert, L. Mhanna, A. Didier et al., “Integration of 3D printing and additive
manufacturing in the interventional pulmonologist’s toolbox,” Respiratory Medicine,
vol. 134, pp. 139–142, 2018.
 D. H. Ballard, A. P. Trace, S. Ali et al., “Clinical applications of 3D
printing,” Academic Radiology, vol. 25, no. 1, pp. 52–65, 2018.

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1609540014 lokesh

  • 1. I Mahatma Gandhi Mission’s College of Engineering and Technology Noida, U.P., India Seminar Report On “APPLICATIONS OF 3D PRINTING IN MEDICAL” As Part of B. Tech Curriculum Submitted by: Lokesh chaudhary VIII Semester 1609540014 Under the Guidance of: Mr. Umesh Yadav (Assistant Professor) MGM’s COET, Noida (Seminar Coordinator) Mr. Ravindra ram Submitted to: HOD Mechanical Engineering Department MGM’s COET, Noida
  • 2. ii Mahatma Gandhi Mission’s College of Engineering and Technology Noida, U.P., India Department of Mechanical Engineering CERTIFICATE This is to certify that Mr. LOKESH CHAUDHARY B. Tech. Mechanical Engineering, Class TT-ME and Roll No. 1609540014has delivered seminar on the topic “APPLICATIONS OF 3D PRINTING IN MEDICAL”. His seminar presentation and report during the academic year 2019-2020 as the part of B. Tech Mechanical Engineering curriculum was good. (Guide) (Seminar coordinator) (Head of the Department)
  • 3. iii ACKNOWLEDGEMENT I would like to express my deep sense of gratitude to my supervisor Mr. Umesh Yadav (Assistant Professor, Department of Mechanical Engineering, M.G.M College of Engineering and Technology, Noida, India) for his guidance, support and encouragement throughout this seminar. Moreover, I would like to acknowledge the Department of Mechanical Engineering, M.G.M College of Engineering and Technology, Noida, for providing me all possible help during this seminar work. Moreover, I would like to sincerely thank everyone who directly and indirectly helped me in completing this work. (Lokesh chaudhary)
  • 4. iv ABSTRACT 3D printing is a new technology in constant evolution. It has rapidly expanded and is now being used in health education. Patient-specific models with anatomical fidelity created from imaging dataset have the potential to significantly improve the knowledge and skills of a new generation of surgeons. This review outlines five technical steps required to complete a printed model: They include selecting the anatomical area of interest, the creation of the 3D geometry, the optimization of the file for the printing and the appropriate selection of the 3D printer and materials. All of these steps require time, expertise and money. A thorough understanding of educational needs is therefore essential in order to optimize educational value. At present, most of the available printing materials are rigid and therefore not optimum for flexibility and elasticity unlike biological tissue. We believe that the manipulation and tuning of material properties through the creation of composites and/or blending materials will eventually allow for the creation of patient-specific models which have both anatomical and tissue fidelity.
  • 5. v TABLE OF CONTENT Certificate ii Acknowledgement iii Abstract iv Table of Content v List of Figure vi CHAPTER 1: INTRODUCTION 1 1.1 Introduction 1 1.2 History 2 CHAPTER 2: TYPES OF 3D PRINTING 4 2.1 Stereolithography (Sla) Technology 4 2.2 Selective Laser Sintering (SLS) Technology 5 2.3 Laminated Object Manufacturing (Lom) Technology 6 CHAPTER 3: APPLICATIONS OF 3D PRINTERS IN MEDICAL 7 3.1 Hearing Aids 8 3.2 Surgical Guides and Tools 9 3.3 Prosthetics 10 3.4 Surgical Learning Tools 11 3.5 Implants 12 3.6 Anatomy of Patient 14 3.7 Bandages 15 CONCLUSION 17 REFERENCE 18
  • 6. vi LIST OF FIGURES FIG.NO. DETAILS OF FIGURES PAGE NO. 1.1 3d Structure 1 2.1 Stereolithography (SLA) Technology 4 2.2 Selective Laser Sintering (SLS) Technology 5 2.3 Laminated Object Manufacturing (LOM) Technology 6 3.1 Hearing Aids 8 3.2 Surgical Guides and Tools 9 3.3 Surgery Tools 10 3.4 Prosthetics 11 3.5 Surgical Learning Tools 12 3.6 Implants 13 3.7 Anatomy of Patient 14 3.8 Bandages 15
  • 7. 1 CHAPTER 1 INTRODUCTUON 1.1 Introduction The rapid development of 3D printing has created new learning and teaching tool for medical education. The ability to produce patient-specific in silicon models from digital imaging and communication in medicine (DICOM) data derived during CT, MRI,or ultrasound scanning has been coupled with new, less expensive 3D printing technology. Depending on the area of interest, these printed models demonstrate anatomical and structural fidelity consistent with the patient’s actual disease process. This fidelity has allowed learners to view and understand gross pathology and structural relationships prior to surgical intervention. An improved understanding and visualization have in turn allowed surgical teams to plan interventions more accurately and guide margins of resection, model appropriate implant dimensions and sometimes create the implant itself using 3D printing technology as shown in fig.1.1 Fig. 1.1 3D Structure However, the vast majority of printed models are made with hard materials and only a few presents some flexibility and elasticity. Although hard materials are sufficient to recreate anatomical fidelity, it has been challenging to recreate models with tissue characteristics
  • 8. 2 1.2 History 1974: David E. H. Jones laid out the concept of 3D printing in his regular column Ariadne in the journal New Scientist 1981: Early additive manufacturing equipment and materials were developed in the 1980s. In 1981: Hideo Kodama of Nagoya Municipal Industrial Research Institute invented two additive methods for fabricating three-dimensional plastic models with photo-hardening thermoset polymer, where the UV exposure area is controlled by a mask pattern or a scanning fiber transmitter 1984: On July 2nd 1984, American Entrepreneur Bill Masters filed a patent for his Computer Automated Manufacturing Process and System (US 4665492).This filing is on record at the USPTO as the first 3D printing patent in history; it was the first of three patents belonging to Masters that laid the foundation for the 3D printing systems used today On 16 July 1984, Alain Le Mahout, Olivier de Witte, and Jean Claude André filed their patent for the stereolithography process. The application of the French inventors was abandoned by the French General Electric Company (now Alcatel-Alston) and CILAS (The Laser Consortium). The claimed reason was "for lack of business perspective “Three weeks later in 1984, Chuck Hull of 3D Systems Corporation filed his own patent for a stereolithography fabrication system, in curing photopolymers with ultraviolet light lasers. Hull defined the process as a "system for generating three-dimensional objects by creating a cross-sectional pattern of the object to be formed,” Hull's contribution was the STL (Stereolithography) file format and the digital slicing and infill strategies common to many processes today. 1986: Charles Hull was granted a patent for his system, and his company, 3D Systems Corporation released the first commercial 3D printer, the SLA-1. 1988: The technology used by most 3D printers to date—especially hobbyist and consumer- oriented models—is fused deposition modeling, a special application of plastic extrusion, developed in 1988 by S. Scott Crump and commercialized by his company Stratasys, which marketed its first FDM machine in 1992. AM processes for metal sintering or melting (such as selective laser sintering, direct metal laser sintering, and selective laser melting) usually went by their own individual names in the 1980s and 1990s. At the time, all metalworking was done by processes that are now called non-additive (casting, fabrication, stamping, and machining); although plenty of automation was applied to those technologies (such as by robot welding and CNC), the idea of a tool or head moving through a 3D work envelope transforming a mass of raw
  • 9. 3 material into a desired shape with a tool path was associated in metalworking only with processes that removed metal (rather than adding it), such as CNC milling, CNC EDM, and many others. But the automated techniques that added metal, which would later be called additive manufacturing, were beginning to challenge that assumption. By the mid-1990s, new techniques for material deposition were developed at Stanford and Carnegie Mellon University, including micro casting] and sprayed materials. Sacrificial and support materials had also become more common, enabling new object geometries. 1993: The term 3D printing originally referred to a powder bed process employing standard and custom inkjet print heads, developed at MIT by Emanuel Sachs in 1993 and commercialized by Solingen Technologies, Extrude Hone Corporation, and Z Corporation.[ The year 1993 also saw the start of a company called Solids cape, introducing a high- precision polymer jet fabrication system with soluble support structures, (categorized as a "dot-on-dot" technique). 1995: In 1995 the Fraunhofer Society developed the selective laser melting process. 2009: Fused Deposition Modeling (FDM) printing process patents expired in 2009. As the various additive processes matured, it became clear that soon metal removal would no longer be the only metalworking process done through a tool or head moving through a 3D work envelope transforming a mass of raw material into a desired shape layer by layer. The 2010s were the first decade in which metal end use parts such as engine brackets and large nuts would be grown (either before or instead of machining) in job production rather than obligately being machined from bar stock or plate. It is still the case that casting, fabrication, stamping, and machining are more prevalent than additive manufacturing in metalworking, but AM is now beginning to make significant inroads, and with the advantages of design for additive manufacturing, it is clear to engineers that much more is to come. As technology matured, several authors had begun to speculate that 3D printing could aid in sustainable development in the developing world. 2012: Folio develops a system for closing the loop with plastic and allows for any FDM or FFF 3D printer to be able to print with a wider range of plastics.
  • 10. 4 CHAPTER 2 DIFFERENT TYPES OF 3D PRINTERS There are several types of 3d printers which are given below: 2.1 Stereo lithography (Sla) Technology SLA is a fast prototyping process. Those who use this technology are serious about accuracy and precision. It can produce objects from 3D CAD data (computer-generated) files in just a few hours. This is a 3D printing process that’s popular for its fine details and exactness. Machines that use this technology produce unique models, patterns, prototypes, and various production parts. They do this by converting liquid photopolymers (a special type of plastic) into solid 3D objects, one layer at a time. The plastic is first heated to turn it into a semi-liquid form, and then it hardens on contact. The printer constructs each of these layers using an ultra violet laser, directed by X and Y scanning mirrors. Just before each print cycle, a recoated blade moves across the surface to ensure each thin layer of resin spreads evenly across the object. The print cycle continues in this way, building 3D objects from the bottom up as shown fig.2.1 Fig. 2.1 SLA Technology
  • 11. 5 Once completed, someone takes the 3D object from the printer and detaches it carefully from the platform. The 3D part will usually have a chemical bath to remove any excess resin. It’s also common practice to post-cure the object in an ultra violet oven. What this does is render the finished item stronger and more stable. Depending on the part, it may then go through a hand sanding process and have some professional painting done. SLA printing has become a favored economical choice for a wide variety of industries. Some of these include automotive, medical, aerospace, entertainment, and also to create various consumer products. 2.2Selective Laser Sintering (SLS) Technology The build platform, or bed, lowers incrementally with each successive laser scan. It’s a process that repeats one layer at a time until it reaches the object’s height. There is un-sintered support from other powders during the build process that surround and protect the model. This means the 3D objects don’t need other support structures during the build. Someone will remove the un-sintered powders manually after printing. Fig. 2.2 SLS Technology SLS produces durable, high precision parts, and it can use a wide range of materials. It’s a perfect technology for fully-functional, end-use parts and prototypes. SLS is quite similar to SLA technology with regards to speed and quality. The main difference is with the materials,
  • 12. 6 as SLS uses powdered substances, whereas SLA uses liquid resins. It’s this wide variety of available materials that makes SLA technology so popular for printing customized objects. This technology as shown in fig2.2 2.3 Laminated Object Manufacturing (Lom) Technology A Californian company called Helices Inc. (now Cubic Technologies), first developed LOM as an effective and affordable method of 3D printing. A US design engineer called Fergana pioneer in 3D printed technologies originally patented LOM. Fig. 2.3 LOM Technology LOM is a rapid prototyping system that works by fusing or laminating layers of plastic or paper using both heat and pressure. A computer-controlled blade or laser cuts the object to the desired shape. Once each printed layer is complete, the platform moves down by about 1/16th of an inch, ready for the next layer. The printer then pulls a new sheet of material across the substrate where it’s adhered by a heated roller. This basic process continues over and over until the 3D part is complete. This technology is shown in fig.2.3
  • 13. 7 CHAPTER 3 APPLICATIONS OF 3D PRINTERS IN MEDICAL Every year, 3D printing offers more and more applications in the healthcare field helping to save and improve lives in ways never imagined up to now. In fact, the 3D printing has been used in a wide range of healthcare settings including, but not limited to cardiothoracic surgery,cardiology,gastroenterology,neurosurgery,oralsurgery,ophthalmology,otolaryngology, orthopedicsurgery,plasticsurgery,podiatry,pulmonology, radiation oncology], transplant surgery], urology, and vascular surgery.Thanks to the different benefits that this technology could induce in the field, the main direct applications of 3D printing in the medical and clinical field are Used for personalized presurgical/treatment and for preoperative planning. This will lead to a multistep procedure that, integrating clinical and imaging information, will determine the best therapeutic option. Several studies have demonstrated that patient-specific presurgical planning may potentially reduce time spent in the operating room (OR) and result in fewer complications. Moreover, this may lead to reduced postoperative stays, decreased reintervention rates, and lower healthcare costs. The 3D-printing technology allows to provide to the surgeon a physical 3D model of the desired patient anatomy that could be used to accurately plan the surgical approach along with cross-sectional imaging or, alternatively, modeling custom prosthetics (or surgical tool) based on patient-specific anatomy. In this way, a better understanding of a complex anatomy unique to each case is allowed. Furthermore, the 3D printing gives the possibility to choose before the implantation the size of the prosthesis’s components with very high accuracy. Customize surgical tools and prostheses: the 3D printing can be used to manufacture custom implants or surgical guides and instruments. Therefore, the customization of surgical tools and prostheses means a reduction of cost given by the additive manufacturing technique. Study of osteoporotic conditions: following a pharmacological treatment, 3D printing is useful in validating the results achieved by the patient. This enables a more accurate estimation of patient’s bone condition and a better decision on the surgical treatment. Testing different device in specific pathways: a clear example is the reproduction of different vascular patterns to test the effectiveness of a cardiovascular system used to treat peripheral and coronary artery disease. In this way, the 3D printing enables us to quickly produce prototypes of new design concepts or improvements to
  • 14. 8 existing devices. Improving medical education: 3D-printed patient-specific models have demonstrated that they can increase performance and foster rapid learning, while significantly ameliorating the knowledge, management, and confidence of the trainees regardless of the area of expertise. The benefits of 3D printing in education are the reproducibility and safety of the 3D-printed model with respect to the cadaver dissection, the possibility to model different physiologic and pathologic anatomy from a huge dataset of images, and the possibility to share 3D models among different institutions, especially with ones that have fewer resources. 3D printers that have the capability to print with different densities and colors can be used to accentuate the anatomical details. 3.1 Hearing Aids Much too many people's surprise hearing aids are one of the greatest success stories to come from the continued development of AM. Over 10,000,000 people are now wearing 3D printed hearing aids with 97% of all hearing aids globally now being created using AM. Not only has AM technology significantly reduced the cost of custom hearing aids when compared to traditional manufacturing but the ability to produce the complex and organic surfaces required for a hearing aid has reduced returns because of bad fit from 40% to 10%. Fig. 3.1 Hearing Aids Limitations Some of limitations of AM when applied to the medical industry include:  While time to print parts is often much faster when compared to traditional manufacturing methods there is still significant time required for the conversion of scan data to produce a
  • 15. 9 printable STL file. Because of this, for more urgent cases like trauma surgery, generic implants or medical devices may be a more desirable solution.  While the purchase of a desktop FDM or SLA machine typically ranges from $1000 - $5000, high-end AM printers (SLS, material jetting and metal printing) range from $200,000 to $850,000. Materials for these AM technologies are also currently very expensive. Currently, for these technologies, the optimal solution is to get products made out of house.  A sound understanding of each AM technology is critical and needs to be determined within the context of the desired outputs. Each technology has strengths and weaknesses and the variation in price to get parts made can be significant. 3.2 Surgical Guides and Tools Much like a drill jig is used in manufacturing to ensure a hole is placed in the exact right location; physicians also implement guides and tools to assist in surgery. Historically, surgical guides and tools were generic devices made of titanium or aluminum. By implementing AM, physicians are able to create guides that precisely follow a patient's unique anatomy, accurately locating drills or other instruments used during surgery. AM guides and tools are used to make the placement of restorative treatments (screws, plates, and implants) more precise, resulting in better postoperative results. Fig. 3.2 Surgical Tools Orthopedic surgeons and craniofacial (cranium and face) surgeons are one of the most regular users of AM guides and tools. In 2014, 23 custom surgical guides and templates were fabricated to assist partial or total knee replacement surgeries, more than 112 surgical guides were fabricated to assist various craniofacial surgeries and nine different titanium alloy Ti- 6Al-4V craniofacial implants were surgically implanted into patients in Egypt alone. Surgical
  • 16. 10 guides, derived from patient scans to precisely match their anatomy and made from PC-ISO (a sterilizable FDM plastic), are compatible with human tissue for short-term contact. This allows them to be placed against the patient’s anatomy for a more precise cut or drill hole. Fig.3.3 Surgery Tools Anatomical models (bone models) and surgical guides are also regularly both produced via AM and used collaboratively to plan and test the best locations for stabilizing screws or plates that conform to the patient’s bone surface before performing surgery. 3.3 Prosthetics In the United States alone, close to 200,000 amputations are performed each year, with prosthetics priced from $5,000-$50,000 replacement or alterations can be time consuming and expensive. Because prosthetics are such personal items, each one has to be custom-made or fit to the needs of the wearer. AM technology is now regularly being used to produce patient specific components of prosthetics that match perfectly with the user's anatomy. The ability to produce complex geometries from a range of materials has resulted in AM being adapted at the locations where prosthetics are in contact with a patient. AM technology has been used to produce everything from prosthetic leg connections that fit comfortably onto a user through to a complex and highly customized facial prosthetic for a cancer patient.AM is also being used in the manufacture of low-cost prosthetics. The collaborative nature of the AM industry has meant that a quick internet for 3D printed prosthetics reveals a huge range of peer-reviewed products that can be printed on desktop AM printers at a very low cost. These designs can easily be scaled or altered to perfectly match the size of the user. The e-NABLE Community comprises of a group of individuals from all over the world who are using their 3D printers to create free 3D printed hands and arms for those in need of an upper limb
  • 17. 11 assistive device. Concepts like this are now becoming more commonplace as AM continues to move into the mainstream. Fig. 3.4 Prosthetics Legs Typically, traditional manufacturing techniques and materials are used to produce the structural section of functional prosthetics. AM is often then implemented at the interface section by producing complex contours that fit perfect to the users' anatomy improving comfort and fit. AM is also implemented on the external outer surface of prosthetics to produce life-like and organic outer shells that hide the mechanical nature of prosthetics. This also allows the wearer to fully customize their prosthetics to whatever design or style they prefer. 3.4 Surgical Learning Tools While much of the focus for 3D printing in the medical industry has been around implants and medical devices used by patients, one of the largest areas of application has concentrated on anatomical replicas. Historically, clinical training, education, and device testing have relied on the use of animal models, human cadavers, and mannequins for hands-on experience in a clinical simulation. These options have several deficiencies including limited supply, expense of handling and storage, the lack of pathology within the models, inconsistencies with human anatomy, and the inability to accurately represent tissue characteristics of living humans. Physicians are now using models produced by AM from patient scan data to improve the
  • 18. 12 diagnosis of illnesses, elucidate treatment decisions, plan, and, in some cases, even practice selected surgical interventions in advance of the actual treatments. The models help physicians understand patient anatomy that is difficult to visualize, especially when using minimally invasive techniques. Models also assist in accurately sizing medical devices. Physicians can also use the models to explain an upcoming surgery to patients and their families and to communicate the surgical steps to the clinical team. Fig. 3.5 Model of Patient Heart To help reduce cost some facilities have developed procedures where surgeons practice and plan operations on low cost mannequins that are transplanted with patient-specific AM models. This coupled with the fact that AM technologies are able to produce both hard and soft materials in a single part, allowing the accurate replication of human tissue, calcification, and bone, means that surgeons can now obtain an even better understanding of exactly how a procedure needs to be performed right down to the touch and feel of the different parts of a patient's anatomy.
  • 19. 13 3.5 Implants AM’s ability to produce fine mesh or lattice structures on the surface of surgical implants can promote better osseointegration and reduce rejection rates. Biocompatible materials such as titanium and cobalt– chrome alloys are available for applications in maxillofacial (jaw and face) surgery and orthopedics. The superior surface geometry produced by AM has been shown to improve implant survival rate by a factor of 2 when compared to traditional products. The porosity of these AM products coupled with the high level of customization and ability to manufacture them from traditional medical materials has resulted in AM implants becoming one of the fastest growing segments of the AM medical industry. Fig. 3.6 Hip Replacement Sockets Technology Best suited for Metal printing Very high accuracy and strength and able to Produce very complex geometries that accurately Match to the contours of a patient's anatomy.). Uses common medical metals (titanium and Aluminum Porous surfaces and intricate scaffolds are able to be printed.
  • 20. 14 3.6 Anatomy of Patient Eindhoven’s University of Technology is home to PhD candidate and Healthcare Flagship Program participant, Mark Thielen, who is aiming to increase surgical and procedural success for neonatal patients. Using 3D printing and 3D Hubs, Mark has developed an optimized training experience using lifelike newborn models with functional organs capable of intelligent sensor feedback. Fig. 3.7 Model of Anatomy of Patient For surgeons and nurses, interacting with anatomical models is important to the success of surgeries and medical procedures. Within the neonatal field, it’s incredibly difficult to practice correctly with the current state of practice mannequins which lack the complexity and feel of a newborn patient. Mark’s research is to develop mannequins which have all their major internal organs functioning and equipped with sensors to monitor key measurements such as pressure, stress and impact during trial procedures (e.g. CPR, intubation).3D printing is utilized because of the vast materials available for testing and, most importantly, the organic shapes the technology is able to create. There are two key components to the mannequin: the ribcage/spine, which acts as the housing for the second component, the internal organs. The
  • 21. 15 sheer complexity of human anatomy is very hard to recreate realistically with any other production method as well as increased cost and lead times. Testing was initially done with various thermoplastic elastomers on a desktop FDM 3D printer to create the larger parts of the model such as the rib cage. After finalizing on a design, Selective Laser Sintering (SLS) was used because of the accuracy and dimensional freedom the technology offers. To create the functional organs material jetting 3D printing was used to create molds. When compared to traditional manufacturing methods, 3D printed molds allowed for rapid design changes. Material jetting also allowed the combination of materials (rigid and flexible plastics) when creating the molds. A heart, for example, needed to have highly detailed working valves. Due to the extremely small sizes of neonatal organs, as well as their minuscule detail, the only way to create a mold for these parts was to 3D print them. 3.7 Bandages Severe burns or other wounds that penetrate many layers of skin are difficult to heal. In fact, in some developing countries, infections from serious wounds can be fatal. This is the main reason why 3D printed bandages came into existence. Compared to their conventional counterparts, 3D printed bandages offer a number of advantages. Some of the key benefits include customizing bandages to particular wounds, infusing the material with special substances, and increasing accessibility in developing or war-torn parts of the world. One fascinating example comes from a team of students at Grand Canyon University. They developed a low-cost, 3D printed hydro-colloidal bandage, which aids in treating infections more effectively than a regular one. Fig. 3.8 Bandages
  • 22. 16 Essentially, it’s partially composed of a gel-like substance that sucks in and traps bacteria. According to Geek, researchers at the University of Toronto built a 3D imprinter, called Print alive, which could print living bandages. This 3D printed band-aid both heals the wound and grows into and around the surrounding skin.
  • 23. 17 CONCLUSION The 3D printing in medical field and design needs to think outside the norm for changing the health care. The three main pillars of this new technology are the ability to treat more people where it previously was not feasible, to obtain outcomes for patients and less time required under the direct case of medical specialists. In few words, 3D printing consists in “enabling doctors to treat more patients, without sacrificing results”. Therefore, like any new technology, 3D printing has introduced many advantages and possibilities in the medical field. Each specific case in which 3D printing has found application shown in this analysis is a demonstration of this. However, it must be accompanied by an updated and current legislation in order to guarantee its correct use.3DP is widely used in healthcare. The domain of hearing aids is the first manufacturing branch fully overtaken by 3DP, and dentistry seems to be following suit. Implants and prostheses, the application of models in virtual surgical planning and teaching in healthcare, traditional and novel medical devices, 3DP of drugs – all these are rapidly developing areas of the 3DP applications in medicine. In most fields they offer considerably less expensive alternatives to the classical devices and procedures, release creativity accelerated by the ease of prototyping of novel devices and help through diagnostics and medical procedures. Think about the effect of virtual surgical planning or that of inexpensive limb prostheses presented above. An important feature of 3DP is its contribution to personalized medicine. According to Wikipedia, “the term has risen in usage in recent years given the growth of new diagnostic and informatics approaches that provide understanding of the molecular basis of disease, particularly genomics”. One could call it personalized medicine on the nanoscale. 3DP offers personalized medicine on the macro scale, since implants and prostheses and numerous devices for medical use are patient-specific. Apart from the tissue model exVive3D Liver developed by Organovo; 3D imprinting is still in the development phase, since 3D imprinter organs are beyond our reach. But it certainly will bring revolutionary changes in medicine. Introduction of new (bio) printers and (bio) compatible materials will accelerate medical applications of 3DP.
  • 24. 18 REFERENCES  C.L. Ventola, “Medical applications for 3D printing: current and projected uses,” Pharmacy and Therapeutics, vol. 39, no. 10, pp. 704–711, 2014.  H. Dodziuk, “Application of 3D printing in healthcare,” Kardiochirurgia I Torakochirurgia Polska, vol. 13, no. 3, pp. 283–293, 2017.  M. Randazzo, J. M. Pisapia, N. Singh, and J. P. Thawani, “3D printing in neurosurgery: a systematic review,” Surgical Neurology International, vol. 7, no. 34, pp. 801–809, 2016.  N. Guilbert, L. Mhanna, A. Didier et al., “Integration of 3D printing and additive manufacturing in the interventional pulmonologist’s toolbox,” Respiratory Medicine, vol. 134, pp. 139–142, 2018.  D. H. Ballard, A. P. Trace, S. Ali et al., “Clinical applications of 3D printing,” Academic Radiology, vol. 25, no. 1, pp. 52–65, 2018.