In the late 1990s, a young patient required a bladder replacement, something for which a transplant wasn’t possible. The doctors treating that patient came up with an alternative solution: make one. They called on the expertise of the Wake Forest Institute for Regenerative Medicine to build a scaffolding in the shape of the required organ, and on that framework, they grew a bladder using the patient’s cells. This was one of the first uses of 3D printing in the healthcare sector. Since then, 3D printing has become a significant tool in healthcare.
At the start of the 21st Century, the hearing aid industry worldwide used injection moulding and traditional handcrafts to form inner ear implants. In that first decade, though, 3D printing began to be used, making the case into which the delicate electronics was sat such that each fitting was shaped to the ear canal of each individual patient, something that would have been prohibitively expensive, with long lead times to deliver if done using traditional techniques. In the USA, the entire hearing aid industry shifted to 3D printed implants within 12 months, and today over 90% of the industry uses 3D printing.
That same shift is now happening in dentistry, where crowns and implants are scanned or moulds taken by a dentist, who send the required shapes to a 3D printing laboratory that then makes the necessary items to the exact specification for that patient, all in a fraction of the time that it traditionally takes.
So what is 3D printing? Have we invented Star Trek-like replicators that can make anything in any shape, in any material?
All 3D printing, or additive manufacture as it is traditionally known, involves making things by building them layer upon layer. The techniques may involve laying plastic or powders on a base in the desired shape then heating or treating them to form a layer, then repeatedly doing so, building an item from the bottom up. More recent technologies use lasers to melt metal powers and electrostatics to solidify liquid resins.
It surprises many to find that the technology is over 30 years old, and it was used primarily in designing and prototyping for much of the first 20 years, particularly in the automotive and architectural sectors. The last 10 year has seen a significant change, though.
Today, 3D printing is a widely used, fast growing technique that is already transforming medicine. Everyday sees news stories about an amazing application of the technology. These range from helping surgeons to plan complicated procedures by using a 3D printed exact model of a patient’s internal organs or bones, to producing implants for joints or replace shattered bones. Why the sudden interest and acceleration? That comes from advances in the technology, allowing for faster manufacture and new materials to be made with higher strengths and tolerances. It comes from the flexibility of 3D printed parts to have complex structures, and for the economic viability of producing single items with a unique shape just as cheaply as making thousands of a standard form.
In one example of how it is changing medicine, Joel Gibbard, CEO of Open Bionics, was recently quoted in the engineering magazine E&T describing how “the capability to produce bionic prosthetic arms for children as young as eight years old is only possible through the use of 3D printing”. The technology reduces the time to make a prosthetic ready to wear from measurement from 3 months – when considering visiting a specialist consultant for fitting, the time taken to order and receive parts and the manufacturing process – to one day. Moreover, the finished arm can be made lighter as the density of components can be reduced by using complex lattices rather than solid structures, something that isn’t possible with injection moulding or traditional manufacture. This has also reduced the cost of making more sophisticated prosthetics by up to a factor of ten.
3D printing is now entering into new areas and the developments are exciting. In the pharmaceutical space, companies are using 3D printers to make tablets with the precise dosage a patient needs, rather than treating everyone with a one-size-fits-all approach. Some are using 3D printers to make tablets in shapes that make them more acceptable to children, easing the burden of getting them to take their medicine.
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ne company, Organvo, is producing 3D printed liver tissues that allows for the faster development of pharmaceutical treatments. Other companies are developing 3D printed organs, such as hearts, out of materials that the body doesn’t reject as strongly as a transplanted organ would. Others are developing 3D printed skin for the treatment of burns. The success of early trials of these has been very positive, and promises to revolutionise healthcare.
As the technology evolves, the cost of a 3D printed item is dropping, opening up the range of patients who can benefit from it. What does this mean to all of us? It means that medicine is moving towards treating us more and more as individuals, with medicines, implants, and prosthetics tuned to our exact needs, and available to us faster than has historically been the case.
3D printing is one technology that is improving healthcare. To read about others, click here.
