3D print healthcare

Contributed: Top 8 healthcare uses for 3D printing

New technology developments have enabled healthcare advances in 3D printing with an estimated $6.08 billion by 2027 in terms of software, hardware, services and materials. The technology has given a boost to customized medicine, allowing a more accurate understanding of patient symptoms and treatment, and generating increased efficiency in the operating room (OR). Advent of 3D printing technology is leaving its mark in specialties such as orthopedics, pediatrics, radiology and oncology, as well as in cardiothoracic and vascular surgery.

Doctors, hospitals and researchers around the world are using 3D printing for:

• preoperative planning and customized surgery.
• medical devices and surgical instruments.
• molds, prostheses and customizable implants.
• 3D digital dentistry and drug administration.

3D printing allows specialists to create reference models using MRI scans and CT in order to help surgeons prepare better for surgeries.

In 2016, a child in Northern Ireland had two unhealed bones injuries his forearm. The child could not rotate his arm more than 50% and was suffering from increased pain. CT scanning and X-rays showed deformed bones, and the treatment required an osteotomy – a four-hour invasive surgery in which the surgeon reshapes the bones to improve rotation. However, the surgeon, printed a 3D model that changed the diagnosis, the surgical intervention and the recovery of the patient:

• It was the tight structures between the bones and not the shape of the bones that limited the child’s rotation ability.
• The procedure was completed in less than 30 minutes, instead of four hours.
• The patient was able to gain 90% arm-range movement four weeks after the intervention.
• The recovery time, the post-operation pain and the scarring decreased considerably.

Such 3D printing is changing preoperative planning which translates into less time spent in the OR, better surgery outcomes for the patients, faster post-op recovery and lower costs for hospitals.

Due to decreased costs of 3D printers and increased availability of CAD/CAM medical software, more hospitals are creating in-house 3D-printed anatomical models. The process entails several steps:

• MRI and CT scans are processed in a stage known as segmentation.
• Each organ and body part type is modeled.
• Models are translated into STL file formats, arranged for printing and sent to the 3D printer.

Rady Children’s Hospital created its own 3D Innovations Laboratory for printing 3D models, including models that mimic human tissue such as airways, hearts and bones. In 2019, the hospital admitted a 7-year-old child born with a single functional heart ventricle (instead of the normal two). The medical team created a 3D-printed model that detailed every vein, artery and valve of the child’s heart, which enabled surgeons to identify the location where blood flow needed rerouting.

Anatomical models that are 3D-printed enable surgeons to plan the operation efficiently and establish better treatment solutions, decrease the operation's duration, and improve research and training for medical students.

In order to serve their purpose, medical devices must meet several requirements:

• They need to comprise the perfect balance in terms of size and weight.
• The must match the particular shapes of the human body.
• They have to be functional, and they have to pass specific endurance tests.

Producing medical device to meet these criteria traditionally required extensive time. The alternative found by medical device manufacturers was stereolithography – a process in which a moving laser beam controlled by computer builds the required structure layer by layer. Thus 3D printing has been used to create the prototype of an inhaler, including the needed fixtures and jigs, aiming to:

• Reduce production from one to two weeks to one to two days.
• Reduce cost 90% (from £250 to £11 or $343 to $15).

Customized 3D-printed surgical instruments such as scalpel handles, forceps or clamps help surgeons perform better in the OR, reduce operating time and promote better surgical outcomes for the patients.

Manufactured from materials such as stainless steel, nylon, titanium alloys or nickel, customized surgical instruments are well suited for sterilization. Endocon GmbH – a German medical device producer – has used metal 3D printing to create an alternative surgical tool for hip cup removal. This is traditionally a 30-minute procedure performed with a chisel, but the chisel can sometimes damage the tissue and bones, which results in an uneven surface, making the insertion of a new hip implant difficult.

Endocon’s stainless steel alloy 3D-printed blades, called endoCupcut, enabled precise cutting along the acetabular cup in three minutes and decreased the rejection rate for the replacement, while reducing production time and cost.

While simple prostheses are available in predefined sizes, customized bionic prostheses cost thousands of dollars. This situation affects many children who outgrow their prostheses and need customized replacement parts, which are produced by a handful of manufacturers.

In 2016, Lyman Connor and Eduardo Salcedo created the Lyman’s Mano-matic prosthesis to provide bionic prosthetics to those who need them and cannot afford them. Globally, prostheses designers can use 3D printing to overcome the financial obstacles and time line constraints entailed by this process. The costs of this manufacturing method are significantly lower than traditional methods, and the prostheses are ready in approximately two weeks, making 3D printing a viable solution for customized bionic devices that replicate a human limb's motions and grips.

Metal 3D printing enables medical devices designers to produce implants that perform better, match better and last longer, for knees, spine, skull or hips.

Electron Beam Melting (EBM) is a technology that melts a metal powder layer by layer with the help of an electron beam, thus generating high-accuracy parts. These orthopedic implants provide spongy structures that mimic regular bone tissue, resulting in a higher percentage of osseointegration – the in-growth of a bone into a metal implant.

In 2016, a patient suffering from a tumor that eroded five of his vertebrae was admitted to Peking University Third Hospital. The tumor, caused by a rare form of malignant chordoma, could be removed only through surgery. However, the healing of the extended size bones defects might not have been completely and correctly possible once the lesion would have been removed.

To address this challenge, researchers designed five artificial vertebrae similar to the body structure of the patient using EBM technology. The prosthesis enabled increased stability of the spine, reducing pain and increasing the durability of the device, which allowed the patient to walk without braces two months after the surgical intervention.

Customized 3D printed implants represent a flexible solution for difficult orthopedic cases and may generate more treatment opportunities in the future.

A recent report indicates that, by 2022, cumulative manufacturing will produce around 500 million dentistry devices and restorations every year, with an estimated $9 billion for the entire dental segment by 2028.

In the dental industry, 3D printing is used for the manufacturing of dentures, surgical guides, bridge models and, most of all, for clear aligners – invisible devices that straighten teeth.

Compared to metal braces, clear aligners are actually invisible and can be taken off when the wearers need to brush their teeth or eat. The traditional production method of clear aligners is a combination of manual and milling processes that requires time and effort. The 3D printing technique speeds up the process, since customized molds for clear aligners can be manufactured directly from digital scans of patients.

Looking for cost-efficient solutions, one dental start-up has perfected an easy process to produce molds for clear aligners:

• Customers take impressions of their teeth with an at-home impression kit or an intraoral scan at a specialized center.
• Impressions and scans are checked by a dental professional, who creates a plan for treatment.
• The company then sends the 3D-printed aligners to the customers.

Therefore 3D printing is a cost-effective method to produce clear aligners, since the setup and tools are not expensive, and their customization is, as proven, direct and simple. 

3D printing can also simplify drug administration with the help of 3D-printed pills. Polypill is a concept designed for patients suffering from several affections, containing five different drugs compartments and two separate release profiles.

Patients affected by several health issues often take their medication at different hours within the day, and this can be confusing in setting a schedule. This 3D printed pill handles both medication dosage and potential interactions between drugs treating different conditions, so eliminating the need for this scheduling and close monitoring.

The administration of a single customized pill to treat several ailments has multiple advantages:

• increased medication adherence to prescribed treatments.
• customized medication or drug combinations.
• lower production costs, due to the ability to treat more affections at the same time.
• greater accessibility in developing countries to affordable and efficient drugs.

As the price of high-performance 3D printers decreases, more medical professionals use 3D printing to produce cost-efficient customized devices in short periods of time, to design patient-tailored anatomical models, to identify revolutionizing clinical solutions and to create new treatments adapted to patients’ needs.

The advances in 3D-printing technology will attract more customized care and more high-precision medical instruments. At the same time, 3D printing is expected to make an impact in other medical specialties such as ophthalmology, regenerative medicine and bio-printing.

About the Author

Dr. Liz Kwo a serial healthcare entrepreneur, physician and Harvard Medical School faculty lecturer. She received an MD from Harvard Medical School, an MBA from Harvard Business School and an MPH from the Harvard T.H. Chan School of Public Health.

3 Ways 3D Printing Is Revolutionizing Health Care

3D printing is rapidly approaching a critical juncture in health care. The technology has shown success in improving surgical techniques through the development of organ models, bone and joint implants and precision instruments. Research is also underway to use the technology to manufacture medications, skin tissue and organs.

The number of hospitals with in-house 3D printing facilities also is growing. In 2019, 113 hospitals had centralized 3D facilities for point-of-care manufacturing, compared with just three in 2010, according to a Statista report. Meanwhile, the FDA has approved hundreds of medical products made with 3D technology, according to Pew Trust. The 3D printing health care market increased dramatically during the COVID-19 pandemic, when some hospitals relied on the technology for rapid rollout of personal protective equipment and medical devices.

These developments, along with the fact that medical device manufacturers are making ever greater use of 3D printing to drive down costs and more consistently meet supply demands have more provider organizations taking a closer look at the technology. And while questions remain about just how commonplace 3D printing will become in health care, reimbursement policies regarding these products and more, here are some of the top ways hospitals and health systems are benefiting from existing technology and how 3D printing might transform clinical care in the future.

How 3D Printing Is Impacting Clinical Care

3D printing creates a three-dimensional solid object from a digital model. The 3D printer creates the object by reading a digital blueprint and reproducing it layer by layer with filament and ultraviolet light.

One of the chief benefits of 3D printing is that it doesn’t require the cumbersome and costly equipment needed in traditional manufacturing, which greatly accelerates the speed of producing products. For example, 3D technology has reduced the production of hearing aids from more than one week to one day.

1 | Implants and Prosthetics

Dental implants were one of the first medically approved uses of 3D technology. Since then, the FDA has approved 3D technology to develop other complex implants. A 2021 study in the Journal of the American Academy of Orthopaedic Surgeons concluded that 3D printing has “significantly impacted bone and cartilage restoration and has the potential to completely transform how we treat patients with debilitating musculoskeletal injuries.”

Others note that 3D technology can improve how prosthetics fit and function. The technology has become accessible and affordable and some are using it to create their own limbs. e-NABLE, a global community of volunteers, has created more than 8,000 prosthetic hands and arms for people worldwide.

2 | Anatomical Models

3D printers can produce highly accurate and detailed anatomical models, assisting surgeons in preparing for complex procedures, improving outcomes and reducing costs. For example, in 2022, researchers at Florida Atlantic University and the University of Virginia designed a robotic model of the human spine to help surgeons predict how interventions would perform before surgery. Results of a study on the replica showed that the system can determine the candidacy of disc implants in five distinct postures with 100% accuracy.

A 2020 study in Academic Radiology reported that using 3D anatomic models as surgical guides reduced surgical time by a mean of 62 minutes, resulting in a cost savings of $3,720 per case. Another 2021 study concluded that lengthy surgeries were reduced between 1. 5 to 2.5 hours when 3D-generated anatomical models were used as guides.

3 | Medical Equipment

Fabrication of customized medical devices — including forceps, clamps, hemostats and retractors — are among the most common medical uses for 3D printing. A key benefit is that precise design modifications can be made rapidly based on surgeon feedback.

The technology is playing an instrumental role in the increased need for the rapid deployment of medical equipment, helping to mitigate supply chain challenges. A team from Oregon Health & Science University responded to the recent global shortage of ventilators by developing a low-cost version that can be produced using 3D-printing technology. The ventilators can be replicated for less than $10 worth of material.

The Future of 3D Printing

In 2019, bioengineers at the University of Washington School of Medicine and the UW College of Engineering developed a breakthrough 3D technique for bioprinting tissues, as reported by ScienceAdvances. This success, along with 3D techniques created by the University of California Berkeley and other institutions, show promise in producing on-demand living body tissue, blood vessels, bones and organs.

Although 3D printing presents significant opportunities for clinical innovation, many institutions are challenged by reimbursement and safety issues related to integrating the rapidly evolving technology into the highly regulated field. Among the issues that still need to be resolved are:

1. What will reimbursement models be for 3D printing services and products?
2. Do the benefits of establishing in-house 3D manufacturing facilities outweigh startup costs?
3. How will FDA regulatory scrutiny pivot to meet the demand for 3D products?
4. What products fall outside of FDA oversight and what potential risks might they present for patient safety?

Using 3D printing in healthcare to empower the industry in 2022

Technologies such as 3D printing and microfluidics are “starting to deliver the results that personalized medicine has long promised,” says Savi Bawei, director of strategy and development at HP. Many hospital labs are using 3D printing to create surgical models and manuals. , and many companies are using this technology to make personalized prostheses and orthoses, splints and other assistive devices.3D printing helps doctors better control the process of patients' rehabilitation, and patients better understand what is happening in their bodies. nine0003

"Demand is already very high - the market for personalized medical devices, including custom orthotics and prostheses, is estimated at about $10 billion, and the need for them is growing exponentially," writes Bawea. assistive devices, and by 2030 it is expected that more than two billion people worldwide will need at least one such device. nine0003

In its annual Additive Technology Market Outlook, Shapeways shared a similar sentiment on the positive impact 3D printing is having on the development of personalized healthcare and patient-centric care.

"The ability to create new products, digitally account for replacement parts, and even bring obsolete parts back to life, all find their way into the automotive, rail and aerospace industries," writes Shapeways. "However, for the medical industry, 3D printing has a unique value because it offers incredible opportunities to improve the quality of life and save lives, as has been proven in a variety of personal medical devices, prostheses and robotic arms." nine0006