In this review, recent techniques and applications of 3D printing in medical materials are well summarized. Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): guidelines for medical 3D printing and appropriateness for clinical scenarios. Clinical value of 3D-printed models in the craniomaxillofacial area has been confirmed since the late 1980s (21,22). Three dimensional (3D) printing is the latest innovative technology that has been revolutionary in engineering, product design, and manufacturing and has a great promise to revolutionalize medicine. Medical applications for 3D printing are expanding rapidly and are expected to revolutionize health care.1 Medical uses for 3D printing, both actual and potential, can be organized into several broad categories, including: tissue and organ fabrication; creation of customized prosthetics, implants, and anatomical models; and pharmaceutical research regarding drug dosage forms, delivery, and discovery.2 The application of 3D printing in medicine can provide many benefits, including: the customization and personalization of medical products, drugs, and equipment; cost-effectiveness; increased productivity; the democratization of design and manufacturing; and enhanced collaboration.1,36 However, it should be cautioned that despite recent significant and exciting medical advances involving 3D printing, notable scientific and regulatory challenges remain and the most transformative applications for this technology will need time to evolve.35,7, Three-dimensional (3D) printing is a manufacturing method in which objects are made by fusing or depositing materialssuch as plastic, metal, ceramics, powders, liquids, or even living cellsin layers to produce a 3D object.1,8,9 This process is also referred to as additive manufacturing (AM), rapid prototyping (RP), or solid free-form technology (SFF).6 Some 3D printers are similar to traditional inkjet printers; however, the end product differs in that a 3D object is produced.1 3D printing is expected to revolutionize medicine and other fields, not unlike the way the printing press transformed publishing.1, There are about two dozen 3D printing processes, which use varying printer technologies, speeds, and resolutions, and hundreds of materials.9 These technologies can build a 3D object in almost any shape imaginable as defined in a computer-aided design (CAD) file (Figure 1).9 In a basic setup, the 3D printer first follows the instructions in the CAD file to build the foundation for the object, moving the printhead along the xy plane.5 The printer then continues to follow the instructions, moving the printhead along the z-axis to build the object vertically layer by layer.5 It is important to note that two-dimensional (2D) radiographic images, such as x-rays, magnetic resonance imaging (MRI), or computerized tomography (CT) scans, can be converted to digital 3D print files, allowing the creation of complex, customized anatomical and medical structures (Figure 2).3,5,10, A 3D printer uses instructions in a digital file to create a physical object.12, Radiographic images can be converted to 3D print files to create complex, customized anatomical and medical structures.12, Charles Hull invented 3D printing, which he called stereolithography, in the early 1980s.1 Hull, who has a bachelors degree in engineering physics, was working on making plastic objects from photopolymers at the company Ultra Violet Products in California.6 Stereolithography uses an .stl file format to interpret the data in a CAD file, allowing these instructions to be communicated electronically to the 3D printer.6 Along with shape, the instructions in the .stl file may also include information such as the color, texture, and thickness of the object to be printed.6, Hull later founded the company 3D Systems, which developed the first 3D printer, called a stereolithography apparatus. 6 In 1988, 3D Systems introduced the first commercially available 3D printer, the SLA-250.6 Many other companies have since developed 3D printers for commercial applications, such as DTM Corporation, Z Corporation, Solidscape, and Objet Geometries.6 Hulls work, as well as advances made by other researchers, has revolutionized manufacturing, and is poised to do the same in many other fieldsincluding medicine.6, 3D printing has been used by the manufacturing industry for decades, primarily to produce product prototypes.1,9 Many manufacturers use large, fast 3D printers called rapid prototyping machines to create models and molds.11 A large number of .stl files are available for commercial purposes.1 Many of these printed objects are comparable to traditionally manufactured items.1, Companies that use 3D printing for commercial medical applications have also emerged.2 These include: Helisys, Ultimateker, and Organovo, a company that uses 3D printing to fabricate living human tissue.2 At present, however, the impact of 3D printing in medicine remains small.1 3D printing is currently a $700 million industry, with only $11 million (1.6%) invested in medical applications.1 In the next 10 years, however, 3D printing is expected to grow into an $8.9 billion industry, with $1.9 billion (21%) projected to be spent on medical applications.1, 3D printing technology is rapidly becoming easy and inexpensive enough to be used by consumers.9,11 The accessibility of downloadable software from online repositories of 3D printing designs has proliferated, largely due to expanding applications and decreased cost.2,4,11 It is now possible to print anything, from guns, clothing, and car parts to designer jewelry.2 Thousands of premade designs for 3D items are available for download, many of them for free.11, Since 2006, two open-source 3D printers have become available to the public, Fab@Home (www.fabathome.org) and RepRap (www.reprap.org/wiki/RepRap).6,9 The availability of these open-source printers greatly lowered the barrier of entry for people who want to explore and develop new ideas for 3D printing.9 These open-source systems allow anyone with a budget of about $1,000 to build a 3D printer and start experimenting with new processes and materials.9, This low-cost hardware and growing interest from hobbyists has spurred rapid growth in the consumer 3D printer market.11 A relatively sophisticated 3D printer costs about $2,500 to $3,000, and simpler models can be purchased for as little as $300 to $400.8,11 For consumers who have difficulty printing 3D models themselves, several popular 3D printing services have emerged, such as Shapeways, (www.shapeways.com), Thingiverse (www.thingiverse.com), MyMiniFactory (www.myminifactory.com), and Threeding (www.threeding.com).11. Loke YH, Harahsheh AS, Krieger A, Olivieri LJ. (29) who divided 60 pediatric residents into two groups, 29 participating in the control group and 31 in the intervention group. the contents by NLM or the National Institutes of Health. Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Western Australia, Australia. National Library of Medicine Both 2D and 3D assessments showed that the high-resolution images (acquired with resolutions between 0.095 and 0.302 mm) allow for accurate assessment of coronary plaques and lumen stenosis, while images acquired with a slice thickness of 0.491 mm result in significant overestimation of stenosis due to calcified plaques (Figure 3). Let's have a look at the most intressting applications of 3D printing in medicine and healthcare. 3D Printing in medicine: Technology overview and drug delivery 3D printing guiding stent graft fenestration: A novel technique for fenestration in endovascular aneurysm repair. Researchers have used 3D printers to create a knee meniscus, heart valve, spinal disk, other types of cartilage and bone, and an artificial ear.4,6,7 Cui and colleagues applied inkjet 3D printing technology to repair human articular cartilage.13 Wang et al used 3D bioprinting technology to deposit different cells within various biocompatible hydrogels to produce an artificial liver.13 Doctors at the University of Michigan published a case study in the New England Journal of Medicine reporting that use of a 3D printer and CT images of a patients airway enabled them to fabricate a precisely modeled, bioresorbable tracheal splint that was surgically implanted in a baby with tracheobronchomalacia.7 The baby recovered, and full resorption of the splint is expected to occur within three years.7, A number of biotech companies have focused on creating tissues and organs for medical research.7 It may be possible to rapidly screen new potential therapeutic drugs on patient tissue, greatly cutting research costs and time.1 Scientists at Organovo are developing strips of printed liver tissue for this purpose; soon, they expect the material will be advanced enough to use in screening new drug treatments.7 Other researchers are working on techniques to grow complete human organs that can be used for screening purposes during drug discovery.6 An organ created from a patients own stem cells could also be used to screen treatments to determine if a drug will be effective for that individual.3, Proof-of-concept studies regarding bioprinting have been performed successfully, but the organs that have been produced are miniature and relatively simple.1,9,10 They are also often avascular, aneural, alymphatic, thin, or hollow, and are nourished by the diffusion from host vasculature.1,6,9,10 However, when the thickness of the engineered tissue exceeds 150200 micro meters, it surpasses the limitation for oxygen diffusion between host and transplanted tissue.10 As a result, bioprinting complex 3D organs will require building precise multicellular structures with vascular network integration, which has not yet been done.6, Most organs needed for transplantation are thick and complex, such as the kidney, liver, and heart.11 Cells in these large organ structures cannot maintain their metabolic functions without vascularization, which is normally provided by blood vessels.13 Therefore, functional vasculature must be bioprinted into fabricated organs to supply the cells with oxygen/gas exchange, nutrients, growth factors, and waste-product removalall of which are needed for maturation during perfusion.10,13 Although the conventional tissue engineering approach is not now capable of creating complex vascularized organs, bioprinting shows promise in resolving this critical limitation.10 The precise placement of multiple cell types is required to fabricate thick and complex organs, and for the simultaneous construction of the integrated vascular or microvascular system that is critical for these organs to function.10, TIJ printers are considered to be the most promising for this use. The Complete History of 3D Printing: From 1980 to 2022 101843). In addition to publishing techniques and trials that will advance medicine with 3D printing, the journal covers "how to" papers to provide a . Thermal inkjet printing in tissue engineering and regenerative medicine. Huang and colleagues in their case report further applied the 3D-printed model to guide fenestrated stent grafting in a patient diagnosed with juxtarenal aortic aneurysm (37). Three dimensional printed models for surgical planning of complex congenital heart defects: an international multicenter study. However, time and investment made it real. Received 2018 Nov 30; Accepted 2018 Dec 10. Jun 2, 2014. (A,B) 3D printing of all components of TAAD (aortic wall, TL, FL and flap).
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