Medical Applications of Additive Manufacturing

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1 Medical Applications of Additive Manufacturing Prof. Antti Mäkitie Helsinki University Hospital and University of Helsinki FIRPA Seminar

2 Additive Manufacturing (AM) within the medical paradigm

3 Additive Manufacturing (AM) within the medical paradigm AM is used as part of the manufacturing process Integration of anatomical data into the product Adaptation of design to suit an individual Mass customization Helps to make products fit and work better Added value

4 Do the AM technologies differ? Cost Range of materials Speed Versatility Ease of use Layer thickness Accuracy Process chain and planning Maintenance requirements and service

5 Why is AM so useful for medical applications? Used to represent specific patient data Integrates well with CT/MRI Layer-wise format Can produce tactile models for surgeons Improves spatial awareness Can fabricate complex geometry Integrates engineering and medicine

6 Problems with AM Speed Not always fast enough. Ok for tissue engineering Cost Overhead costs for single components high Helpful if increase in surgical efficiency can be justified Accuracy Initial requirements for accuracy were low (this is now changing) Materials Issues with contamination Need to develop more biocompatible materials Ease of use Make technology safe, clean and easy to use

7 Additive Manufacturing (AM) within the medical paradigm Why should we classify? Class-specific and case-specific characteristics and requirements

8 Preoperative models Medical aids, supportive guides and prostheses Tools, instruments & parts for medical devices Inert implants Biomanufacturing

9 Kuvantaminen 3D-lääket. Mallinnus Ainetta Lisäävä Valmistus Viimeistely Kliininen sovellus 1. Preoperatiiviset mallit 2. Implantit ORBITAN- POHJA 3. Erikois- Instrumentit, työvälineet 4. Postoperatiiviset tuet ja apuvälineet 5. Keinokudospikavalmistus

10 Preoperative models Medical aids, supportive guides and prostheses Tools, instruments & parts for medical devices Inert implants Biomanufacturing

spatial awareness Permits viewing from any angle Reduces ambiguity Used in various stages of

11 Models for preoperative planning,education and training The earliest medical application of AM Planning or simulating a surgical procedure Educating students, patients and family Enhances spatial awareness Permits viewing from any angle Reduces ambiguity Used in various stages of complex surgery Treatment plans Informed consent Communication within the teams Design template for prosthetics

Medical aids, supportive guides, splints & prostheses Improvements in CT More precise imaging More precise models To provide patient-specific fit Specific emphasis on prostheses AM d piece placed

13 Medical aids, supportive guides, splints & prostheses Improvements in CT More precise imaging More precise models To provide patient-specific fit Specific emphasis on prostheses AM d piece placed external to body Integrate medical data with engineering data Integrate surgical simulation Development of new medical products Drill-guides, orthopedic appliances and braces Personalized splints External prostheses

implantable, sterilizable Contact with body fluids, mucous membranes, tissues No immediate

14 Tools, instruments & parts for medical devices To enable or improve the efficacy of a medical procedure Patient-specific dimensions and shapes may be incorporated Invasive but not implantable, sterilizable Contact with body fluids, mucous membranes, tissues No immediate toxicity or allergic reactions No shedding of particles E.g. surgical instruments, orthodontic appliances

15 Inert Implants Directly or indirectly Additive Manufactured (AM d) implant Biocompatibility, strict material requirements Long-term, durability, mechanical properties, surface properties Implant will not change its characteristics in vivo May attract cell adhesion on surface but mainly stays inactive Includes dental app s: crowns & bridges

may not change material properties Polished, smooth

16 Orbital implant Anatomical accuracy Implantable material Light but durable structure Sterilization may not change material properties Polished, smooth surfaces to prevent tear damage Minimal heat conductivity

17 AM and Tissue Engineering Direct manufacture of replacement organs Both hard and soft tissue constructs organ manufacturing Conventional method is to use a scaffold Geometry and functionality Material should be biocompatible and preferably bioresorbable or biodegradable, cell growth conductive The scaffold should also encourage cellular regeneration both in vitro and in vivo Polymers, ceramics and composites, porous structures Shape of AM d piece personalized to match tissue defect, optimal morphologies depend on cell type

19 Acknowledgements Jari Salo, Jan Lindahl, HUS Risto Kontio, Karri Mesimäki, Christian Lindqvist, HUS Tuomas Klockars, HUS Jyri Hukki, HUS Risto Renkonen, HY Anders Westermark, Karolinska Institutet Yongnian Yan, Xiaohong Wang, Tsinghua University Tekes, Planmeca, DeskArtes, EOS Finland, Hoffmanco Consulting

20 Acknowledgements Jukka Tuomi Kaija-Stiina Paloheimo Markku Paloheimo Mika Salmi Roy Björkstrand Lotta Vihtonen Eero Huotilainen Juho Vehviläinen Jouni Partanen Xiaohong Wang Yongnian Yan

22 Application Types of materials Skeletal system: Joint replacement (hip, knee) Titanium, Ti-Al-V alloy, stainless steel, polyethylene Bone plate for fracture fixation Stainless steel, cobalt-chromium alloy Bone cement Poly(methyl methacrylate) Bone defect repair Hydroxylapatite Oral implants Titanium, calcium phosphate Cardiovascular system: Blood vessel prosthesis Dacron, Teflon, polyurethane Heart valve Reprocessed tissue, stainless steel, carbon Catheter Silicone rubber, Teflon, polyurethane Organs: Artificial heart Polyurethane Skin repair template Silicone-collagen composite Artifical kidney (hemodialyzer) Cellulose, polyacrylonitrile Senses: Intraocular lens Poly (methyl methacrylate), silicone rubber, hydrogel Cochlear replacement Platinum electrodes

23 Class Purpose Relation of AM'd piece to patient Preoperative models Plan or simulate surgical procedure; Educate students, patients and family, train surgeons No patient contact Primary description Requirements Other Based on patient geometry but magnification or miniaturization possible; Anatomical accuracy requirements depend on case Transportability, storability, behavior in process, haptic response requirements depend on case Medical aids, supportive guides, splints & prostheses Enhance healing from trauma, anomaly or defect External to body non invasive May be combined to standard devices to provide patient-specific fit; Long term and postoperative supports, (motion) guides and fixators Non-allergic if in contact with skin, mechanical and surface requiements depend on case Includes external prostheses and prosthetic sockets, personalized splints, drill-guiding microtables, orthopedic appliances and braces Tools, instruments & parts for medical devices Enable or improve the efficacy of a medical or surgical procedure Contact with body fluids, mucous membranes, tissues or organs for a limited time: Invasive but not implantable, Patient-specific dimensions and shapes may be incorporated; Sterilizable; No immediate toxicity or allergic reactions, no shedding of particles; mechanical and surface requirements depend on case Includes drill guides, specialty surgical instruments, orthodontic appliances Inert implants Tissue replacement Wholly or partly implanted, long term contact with body fluids, tissues or organs Biocompatible; will not change its characteristics (much) in vivo May attract cell adhesion on surface but mainly stays inactive; durability, mechanical properties, surface properties depend on case Strict material requirements, long approval processes; Includes dental applications: crowns & bridges Biomanu facturing Biologically active tissue replacement; organ manufacturing Incorporated into body Shape personalized to match tissue defect, porous structures, optimal morphology depends on cell type and application site Porous structures; Scaffolds must be cell growth conductive, inductive, resorbable, controlled Polymers, ceramics and composites; Freeform culture media in vitro; Additive manufacturing + tissue engineering;

Introduction to Biomaterials

Introduction to Biomaterials Objective To introduce the different biomaterials used in Biomedical Engineering To provide some fundamentals properties of these materials, And to indicate how they are used.