This document discusses 3D printed medical implants for craniofacial defects. It describes the process of medical reverse engineering using scanning, computer aided design (CAD) to design implants, and computer aided manufacturing (CAM) to 3D print the implants. Examples are given of a 3D printed titanium implant to reconstruct a girl's skull after a car accident, and a 3D printed titanium implant with hydroxyapatite coating to reconstruct an elderly woman's mandible that had extensive bone destruction from osteomyelitis. The advantages of 3D printed patient-specific implants are optimal reconstruction and functional and aesthetic outcomes in a single surgery.

1. 3D PRINTED MEDICAL IMPLANTS
SIRRIS INAUGURATION 21.06.2012
Prof. Dr. J. Poukens
Dr. I. van Kroonenburgh
Ing. M. Beerens
Dr. Peter Mercelis
Ing. Ruben Wauthle
Ing. Carsten Engel
Prof. Dr. J. Vander Sloten
Prof. Dr. I. Lambrichts

2. WHAT ARE CRANIO-MAXILLOFACIAL DEFECTS ?

3. MEDICAL CAD-CAM
RAPID DESIGN AND MANUFACTURING
1. MEDICAL REVERSE ENGINEERING (SCANNING)
2. COMPUTER AIDED DESIGN (CAD)
3. COMPUTER AIDED MANUFACTURING (CAM)

4. REVERSE ENGINEERING
LASERSCAN
MRI SCAN
CT, MRI, ULTRASOUND
CT SCAN
OPTICAL SCAN

7. MIMICS

8. 3D VISUALISATION OF BONE AND SOFT TISSUE

9. CRANIAL DEFECT

10. PATIENT
Young girl
- Car accident with large skull defect
- Reconstruction with titanium
implant
(electron beam melting)

11. 3-matic

13. DESIGN

14. Design

15. Final design

16. Implant
Ti6Al4V
ELECTRON BEAM MELTED
(ARCAM)

18. Now follows operation video
Not suited for sensitive viewers !

19. VIDEO SKULL

20. CLINICAL RESULT

21. NEW DEVELOPMENTS
NEW MATERIALS : PEEK

23. INTERFIX©
EASY FIXATION
TANGENTIAL SCREW
FIXATION

24. MANDIBULAR CASE
• WOMEN 83 y.
• Med. Hist. : Osteoporosis
• Medication: Bifosfonates peroral
• Problem : large chronic wound /ulcer chin area
• Diagnostics
– No Bacteria
– CBCT extensive bone destruction
– CT-scan
– Nuclear Scan fast progressive osteomyelitis
– Biopsy

25. Case

26. PRE-OP X-RAY
CT-SCAN
NUCLEAR SCAN

27. CURRENT STANDARD CLINICAL PROCEDURE
• Vascularized bone transplants
• Fibula

28. CURRENT STANDARD CLINICAL PROCEDURE
Custom bended reconstruction plate with condylar head
part

29. Computer Aided Design (CAD)

30. Computer Aided Design (CAD)

31. RENDERED FINAL DESIGN

32. Computer Aided Manufacturing (CAM)
Raw material :
titanium powder 3D CAD design
SLM
Selective Laser
Melting

33. PLASMA COATED HYDROXY-APATITE

34. OPERATION VIDEO
• NOW FOLLOWS OPERATION
VIDEO
• NOT SUITED FOR SENSITIVE
VIEWERS !

35. OPERATION VIDEO

36. POSTOP X-RAY
NEXT STEP : FIXED DENTAL BRIDGE

37. ADVANTAGES
o Shortened OR time(4h)
o Shortened hospital stay
o Perfect fit, no adjustements needed in OR
o Functional reconstruction in one go:
o Movement-Mastication
o Speech
o Airway
o Sensibility
o Esthetical reconstruction

38. CONCLUSION
o 3D PRINTED PATIENT SPECIFIC IMPLANTS
ARE AT THIS MOMENT NECESSARY FOR
OPTIMAL TREATMENT IN SOME PATIENTS
o CUSTOM AND PATIENT SPECIFIC IMPLANTS
MANUFACTURED BY 3D PRINTING
WILL BECOME STATE OF THE ART
TREATMENT IN NEAR FUTURE FOR ALL
PATIENTS

39. THANKS FOR YOUR ATTENTION !