Design and manufacturing of custom 3D printed bone implants (original) (raw)
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Revista Brasileira de Engenharia Biomédica, 2014
Introduction: This work aims to pre-operatively manufacture custom-made low-cost implants and physical models ('biomodels') of fractured skulls. The pre-operative manufacturing of biomodels and implants allows physicians to study and plan surgery with a greater possibility of achieving the expected result. Customization contributes to both the esthetic and functional outcome of the implant because it considers the anatomy of each patient, while the low cost allows a greater number of people to potentially benefi t. Methods: From CT images of a fractured skull, a CAD model of the skull (biomodel) and a restorative implant were constructed digitally. The biomodel was then physically constructed with 3D Printing, and Incremental Sheet Forming (ISF) was used to manufacture the implant from a sheet of pure grade 2 titanium. Before cutting the implant's fi nal shape from a pre-formed sheet, heat treatment was performed to avoid deformations caused by residual stresses generated during the ISF process. Results: A comparison of the dimensions of the implant and its respective CAD biomodel revealed geometric discrepancies that can affect both functional and aesthetic effi ciency. Nevertheless, the fi nal shape preserved symmetry between the right and left sides of the skull. Electron microscopy analysis did not indicate the presence of elements other than pure titanium. Conclusions: Dimensional variability can be decreased with changes in the manufacturing process (i.e., forming and cutting) and the heating ramp. Despite biomedical characteristics, there was no contamination of the implant by harmful chemical elements. 3D Printing was effective in making the biomodel, enabling pre-operative planning and improving physicianpatient communication. Current results indicate that ISF is a process that can be used to obtain custom-made implants.
Engineering, 2020
Craniomaxillofacial reconstruction implants, which are extensively used in head and neck surgery, are conventionally made in standardized forms. During surgery, the implant must be bended manually to match the anatomy of the individual bones. The bending process is time-consuming, especially for inexperienced surgeons. Moreover, repetitive bending may induce undesirable internal stress concentration, resulting in fatigue under masticatory loading in vivo and causing various complications such as implant fracture, screw loosening, and bone resorption. There have been reports on the use of patient-specific 3D-printed implants for craniomaxillofacial reconstruction, although few reports have considered implant quality. In this paper, we present a systematic approach for making 3D-printed patientspecific surgical implants for craniomaxillofacial reconstruction. The approach consists of three parts: First, an easy-to-use design module is developed using Solidworks Ò software, which helps surgeons to design the implants and the axillary fixtures for surgery. Design engineers can then carry out the detailed design and use finite-element modeling (FEM) to optimize the design. Second, the fabrication process is carried out in three steps: ① testing the quality of the powder; ② setting up the appropriate process parameters and running the 3D printing process; and ③ conducting post-processing treatments (i.e., heat and surface treatments) to ensure the quality and performance of the implant. Third, the operation begins after the final checking of the implant and sterilization. After the surgery, postoperative rehabilitation follow-up can be carried out using our patient tracking software. Following this systematic approach, we have successfully conducted a total of 41 surgical cases. 3D-printed patient-specific implants have a number of advantages; in particular, their use reduces surgery time and shortens patient recovery time. Moreover, the presented approach helps to ensure implant quality.
Design and Manufacturing of a Custom Skull Implant
Problem statement: Cranioplasty is defined as a neurosurgical procedure to cover an injured bone in the skull. This procedure is carried out in order to protect and restore intracranial structures and to restore the appearance and psychological stability of the patient. Advances in medical imaging, such as MRI and CT, have allowed the 3D reconstruction of anatomical structures for several medical applications, including the design of custom-made implants. This study describes the methodology used to design a custom-made cranial implant for a 13-year-old patient who suffered a lesion in the left frontoparietal region of the skull caused by a fall. Approach: The design of the implant was based on the 3D reconstruction of the skull of the patient, obtained by a CT scan, using Rapid Form® 2006. Once the preliminary design was completed, 3D models of the injured region of the skull and of the implant were fabricated in a Rapid Prototyping (RP) machine using Fused Deposition Modeling Technology (FDM) with the purpose of functionally and dimensionally validating the implant. Subsequently, the implant was fabricated using a 1.2-mm-thick Titanium Alloy (Ti6Al4V) plate. Results: The prosthesis was successfully implanted. The surgical time was 85% shorter than that for the same type of surgery in which standard commercial implants and titanium meshes are used. This decrease in surgery time is primarily the result of eliminating the need for trial and error procedures to achieve a good fit for the implant. Finally, the appearance of the patient was restored, allowing the patient to safely perform daily activities. Conclusion: The use of 3D reconstruction techniques from medical images reduces the possibility of errors during surgery, improves fit and provides better implant stability. The use of 3D models designed in RP proved to be an effective practice in the design process.
Cranial reconstruction: 3D biomodel and custom-built implant created using additive manufacturing
Journal of Cranio-Maxillofacial Surgery, 2014
Additive manufacturing (AM) technology from engineering has helped to achieve several advances in the medical field, particularly as far as fabrication of implants is concerned. The use of AM has made it possible to carry out surgical planning and simulation using a three-dimensional physical model which accurately represents the patient's anatomy. AM technology enables the production of models and implants directly from a 3D virtual model, facilitating surgical procedures and reducing risks. Furthermore, AM has been used to produce implants designed for individual patients in areas of medicine such as craniomaxillofacial surgery, with optimal size, shape and mechanical properties. This work presents AM technologies which were applied to design and fabricate a biomodel and customized implant for the surgical reconstruction of a large cranial defect. A series of computed tomography data was obtained and software was used to extract the cranial geometry. The protocol presented was used to create an anatomic biomodel of the bone defect for surgical planning and, finally, the design and manufacture of the patient-specific implant.
Summarization of 3D-Printing Technology in Processing & Development of Medical Implants
2019
3D-printing technology is otherwise called added substance assembling or fast prototyping, is an advanced manufacturing technique which builds 3D parts directly in layer by layer from the computer aided plan model in raster way with minimal wastage of material. Rather than in conventional manufacturing process where material is removed by the hard tool to bring the 3D component in desired model, 3D printing is completely contrast to it where material is added in sequence parts are built in layer by layer, it doesn't require any post processing as in conventional process. 3D printed parts are more performing under different loading conditions and easy to build and repair parts any stage of design cycle. Due its flexibility of manufacturing, it shows its applications in auto ancillaries, aerospace and medical filed. 3D printing technology showing it influencing in making medical implants. Manufacturing of medical implants in conventional process is very expensive. As these implants vary patient to patient, and it is difficult to make tailor made implants in conventional manufacturing processes. Hence 3D printing technology can overcome this issue with minimal cost for making tailor made implants for individual patients
Method for translating 3D bone defects into personalized implants made by Additive Manufacturing
Materials Today: Proceedings, 2019
3D printing technology penetrates into the medical field at an accelerated pace. Although there is still a long way to go towards organ printing, and despite existing ethical and technical changes, 3D printing can form three-dimensional support structures in a revolutionary and controllable way. 3D printing has penetrated into areas such as tissue and regenerative engineering. In clinical interventions, 3D printing, as a new prosthesis manufacturing technique, applies mainly to orthopaedics and dentistry. In this paper, the authors propose a method for translating 3D bone defects into personalized implants, to be further produced by AM (additive manufacturing) techniques, based on CT (computed tomography) imaging. The method consists of delimiting bone defect areas in computed tomography, isolation of defects, and the construction of a virtual implant model that is saved in the .stl format for 3D printing. If the bone defect is located in a symmetrical area in respect to a central plane, which is correct from the anatomical and medical point of view, the mirror image will be used as a virtual model for the implant. This ensures a very good imitation of the implant with the healthy area. If the bone defect area is singular, reconstruction is done with so-called "reconstruction pieces" made with CAD (computer-aided design) software and assembled in the 3D Slicer software so as to repair defects in the problematic area. The robustness and efficiency of the proposed method is demonstrated through numerical experiments and compared to experimental results for validation purposes.
Adaptive Mechanism for Designing a Personalized Cranial Implant and Its 3D Printing Using PEEK
Polymers
The rehabilitation of the skull’s bones is a difficult process that poses a challenge to the surgical team. Due to the range of design methods and the availability of materials, the main concerns are the implant design and material selection. Mirror-image reconstruction is one of the widely used implant reconstruction techniques, but it is not a feasible option in asymmetrical regions. The ideal design approach and material should result in an implant outcome that is compact, easy to fit, resilient, and provides the perfect aesthetic and functional outcomes irrespective of the location. The design technique for the making of the personalized implant must be easy to use and independent of the defect’s position on the skull. As a result, this article proposes a hybrid system that incorporates computer tomography acquisition, an adaptive design (or modeling) scheme, computational analysis, and accuracy assessment. The newly developed hybrid approach aims to obtain ideal cranial implant...
Procedia Manufacturing, 2021
Decompressive craniectomy (DC) is a surgical procedure where a portion of the skull (flap) is removed to relieve the built-up pressure from the patient’s brain due to swelling of the brain tissue after a traumatic injury to the head. Subsequently, another surgical procedure called cranioplasty is carried out to fix an implant or bone flap in patients who have undergone DC. In this paper, an automatic design methodology for additive manufacturing of a PSCI (patient-specific cranial implant) has been proposed. The input is the DICOM digital data from a CT scan and the output is the STL file geometry of the cranial implant. The proposed method has been tested and validated using real de-identified DICOM data, and the resultant implant was 3D printed and fit to the skull of a cadaver. The key contribution made in this paper is the complete automation of the design of a PSCI based on the skull’s unique geometry using a combination of image-processing and computational geometry techniques...