Pub Date : 2022-09-28DOI: 10.1186/s41205-022-00157-5
Maryam Koopaie, Duha Hayder Mohammad Ali Nassar, Mahvash Shokrolahi
Background: Chronic oral lesions could be a part of some diseases, including mucocutaneous diseases, immunobullous diseases, gastrointestinal diseases, and graft versus host diseases. Systemic steroids are an effective treatment, but they cause unfavorable and even severe systemic side effects. Discontinuation of systemic corticosteroids or other immunosuppressive drugs leads to relapse, confirming the importance of long-term corticosteroid use. The present study aims to fabricate a mucoadhesive scaffold using three-dimensional (3D) bioprinting for sustained drug delivery in oral mucosal lesions to address the clinical need for alternative treatment, especially for those who do not respond to routine therapy.
Methods: 3D bioprinting method was used for the fabrication of the scaffolds. Scaffolds were fabricated in three layers; adhesive/drug-containing, backing, and middle layers. For evaluation of the release profile of the drug, artificial saliva was used as the release medium. Mucoadhesive scaffolds were analyzed using a scanning electron microscope (SEM) and SEM surface reconstruction. The pH of mucoadhesive scaffolds and swelling efficacy were measured using a pH meter and Enslin dipositive, respectively. A microprocessor force gauge was used for the measurement of tensile strength. For the evaluation of the cytotoxicity, oral keratinocyte cells' survival rate was evaluated by the MTT method. Folding endurance tests were performed using a stable microsystem texture analyzer and analytic probe mini tensile grips.
Results: All scaffolds had the same drug release trend; An initial rapid explosive release during the first 12 h, followed by a gradual release. The scaffolds showed sustained drug release and continued until the fourth day. The pH of the surface of the scaffolds was 5.3-6.3, and the rate of swelling after 5 h was 28 ± 3.2%. The tensile strength of the scaffolds containing the drug was 7.8 ± 0.12 MPa. The scaffolds were non-irritant to the mucosa, and the folding endurance of the scaffolds was over three hundred times.
Conclusion: The scaffold fabricated using the 3D bioprinting method could be suitable for treating oral mucosal lesions.
{"title":"Three-dimensional bioprinting of mucoadhesive scaffolds for the treatment of oral mucosal lesions; an in vitro study.","authors":"Maryam Koopaie, Duha Hayder Mohammad Ali Nassar, Mahvash Shokrolahi","doi":"10.1186/s41205-022-00157-5","DOIUrl":"https://doi.org/10.1186/s41205-022-00157-5","url":null,"abstract":"<p><strong>Background: </strong>Chronic oral lesions could be a part of some diseases, including mucocutaneous diseases, immunobullous diseases, gastrointestinal diseases, and graft versus host diseases. Systemic steroids are an effective treatment, but they cause unfavorable and even severe systemic side effects. Discontinuation of systemic corticosteroids or other immunosuppressive drugs leads to relapse, confirming the importance of long-term corticosteroid use. The present study aims to fabricate a mucoadhesive scaffold using three-dimensional (3D) bioprinting for sustained drug delivery in oral mucosal lesions to address the clinical need for alternative treatment, especially for those who do not respond to routine therapy.</p><p><strong>Methods: </strong>3D bioprinting method was used for the fabrication of the scaffolds. Scaffolds were fabricated in three layers; adhesive/drug-containing, backing, and middle layers. For evaluation of the release profile of the drug, artificial saliva was used as the release medium. Mucoadhesive scaffolds were analyzed using a scanning electron microscope (SEM) and SEM surface reconstruction. The pH of mucoadhesive scaffolds and swelling efficacy were measured using a pH meter and Enslin dipositive, respectively. A microprocessor force gauge was used for the measurement of tensile strength. For the evaluation of the cytotoxicity, oral keratinocyte cells' survival rate was evaluated by the MTT method. Folding endurance tests were performed using a stable microsystem texture analyzer and analytic probe mini tensile grips.</p><p><strong>Results: </strong>All scaffolds had the same drug release trend; An initial rapid explosive release during the first 12 h, followed by a gradual release. The scaffolds showed sustained drug release and continued until the fourth day. The pH of the surface of the scaffolds was 5.3-6.3, and the rate of swelling after 5 h was 28 ± 3.2%. The tensile strength of the scaffolds containing the drug was 7.8 ± 0.12 MPa. The scaffolds were non-irritant to the mucosa, and the folding endurance of the scaffolds was over three hundred times.</p><p><strong>Conclusion: </strong>The scaffold fabricated using the 3D bioprinting method could be suitable for treating oral mucosal lesions.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9516826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40380024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-14DOI: 10.1186/s41205-022-00148-6
Helen Xun, Christopher Shallal, Justin Unger, Runhan Tao, Alberto Torres, Michael Vladimirov, Jenna Frye, Mohit Singhala, Brockett Horne, Bo Soo Kim, Broc Burke, Michael Montana, Michael Talcott, Bradford Winters, Margaret Frisella, Bradley S Kushner, Justin M Sacks, James K Guest, Sung Hoon Kang, Julie Caffrey
Background: Mechanical ventilators are essential to patients who become critically ill with acute respiratory distress syndrome (ARDS), and shortages have been reported due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods: We utilized 3D printing (3DP) technology to rapidly prototype and test critical components for a novel ventilator multiplexer system, Vent-Lock, to split one ventilator or anesthesia gas machine between two patients. FloRest, a novel 3DP flow restrictor, provides clinicians control of tidal volumes and positive end expiratory pressure (PEEP), using the 3DP manometer adaptor to monitor pressures. We tested the ventilator splitter circuit in simulation centers between artificial lungs and used an anesthesia gas machine to successfully ventilate two swine.
Results: As one of the first studies to demonstrate splitting one anesthesia gas machine between two swine, we present proof-of-concept of a de novo, closed, multiplexing system, with flow restriction for potential individualized patient therapy.
Conclusions: While possible, due to the complexity, need for experienced operators, and associated risks, ventilator multiplexing should only be reserved for urgent situations with no other alternatives. Our report underscores the initial design and engineering considerations required for rapid medical device prototyping via 3D printing in limited resource environments, including considerations for design, material selection, production, and distribution. We note that optimization of engineering may minimize 3D printing production risks but may not address the inherent risks of the device or change its indications. Thus, our case report provides insights to inform future rapid prototyping of medical devices.
{"title":"Translational design for limited resource settings as demonstrated by Vent-Lock, a 3D-printed ventilator multiplexer.","authors":"Helen Xun, Christopher Shallal, Justin Unger, Runhan Tao, Alberto Torres, Michael Vladimirov, Jenna Frye, Mohit Singhala, Brockett Horne, Bo Soo Kim, Broc Burke, Michael Montana, Michael Talcott, Bradford Winters, Margaret Frisella, Bradley S Kushner, Justin M Sacks, James K Guest, Sung Hoon Kang, Julie Caffrey","doi":"10.1186/s41205-022-00148-6","DOIUrl":"https://doi.org/10.1186/s41205-022-00148-6","url":null,"abstract":"<p><strong>Background: </strong>Mechanical ventilators are essential to patients who become critically ill with acute respiratory distress syndrome (ARDS), and shortages have been reported due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).</p><p><strong>Methods: </strong>We utilized 3D printing (3DP) technology to rapidly prototype and test critical components for a novel ventilator multiplexer system, Vent-Lock, to split one ventilator or anesthesia gas machine between two patients. FloRest, a novel 3DP flow restrictor, provides clinicians control of tidal volumes and positive end expiratory pressure (PEEP), using the 3DP manometer adaptor to monitor pressures. We tested the ventilator splitter circuit in simulation centers between artificial lungs and used an anesthesia gas machine to successfully ventilate two swine.</p><p><strong>Results: </strong>As one of the first studies to demonstrate splitting one anesthesia gas machine between two swine, we present proof-of-concept of a de novo, closed, multiplexing system, with flow restriction for potential individualized patient therapy.</p><p><strong>Conclusions: </strong>While possible, due to the complexity, need for experienced operators, and associated risks, ventilator multiplexing should only be reserved for urgent situations with no other alternatives. Our report underscores the initial design and engineering considerations required for rapid medical device prototyping via 3D printing in limited resource environments, including considerations for design, material selection, production, and distribution. We note that optimization of engineering may minimize 3D printing production risks but may not address the inherent risks of the device or change its indications. Thus, our case report provides insights to inform future rapid prototyping of medical devices.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9471031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40357395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-12DOI: 10.1186/s41205-022-00156-6
Brian Beitler, Gregory R Roytman, Grace Parmer, Steven M Tommasini, Daniel H Wiznia
Background: Polymethyl methacrylate, or "bone cement," can be used intraoperatively to replace damaged or diseased bone and to deliver local antibiotics. 3D printed molds allow surgeons to form personalized and custom shapes with bone cement. One factor hindering the clinical utility of anatomically accurate 3D printed molds is that cured bone cement can be difficult to remove due to the strong adhesion between the mold and the bone cement. One way to reduce the adhesion between the 3D printed mold and the cured bone cement is with the use of a surface coating, such as a lubricant. This study sought to determine the optimal surface coating to prevent bone cement adhesion to 3D printed molds that could be utilized within a sterile operating room environment.
Methods: Hemispheric molds were 3D printed using a stereolithography printer. The molds were coated with four sterile surface coatings available in most operating theatres (light mineral oil, bacitracin ointment, lubricating jelly, and ultrasound transmission gel). Polymethyl methacrylate with tobramycin antibiotic was mixed and poured into the molds. The amount of force needed to "push out" the cured bone cement from the molds was measured to determine the efficacy of each surface coating. Tukey's multiple comparison test was performed to compare the results of the pushout test.
Results: The average pushout force for the surface coatings, in increasing order, were as follows (mean ± standard deviation) --- bacitracin ointment: 9.10 ± 6.68 N, mineral oil: 104.93 ± 69.92 N, lubricating jelly: 147.76 ± 63.77 N, control group: 339.31 ± 305.20 N, ultrasound transmission gel 474.11 ± 94.77 N. Only the bacitracin ointment required significantly less pushout force than the control (p = 0.0123).
Conclusions: The bacitracin ointment was the most effective surface coating, allowing the bone cement to be pushed out of the mold using the least amount of force. In addition, the low standard deviation speaks to the reliability of the bacitracin ointment to reduce mold adhesion compared to the other surface coatings. Given its efficacy as well as its ubiquitous presence in the hospital operating room setting, bacitracin ointment is an excellent choice to prevent adhesion between bone cement and 3D printed molds intraoperatively.
{"title":"Evaluating surface coatings to reduce bone cement adhesion to point of care 3D printed molds in the intraoperative setting.","authors":"Brian Beitler, Gregory R Roytman, Grace Parmer, Steven M Tommasini, Daniel H Wiznia","doi":"10.1186/s41205-022-00156-6","DOIUrl":"https://doi.org/10.1186/s41205-022-00156-6","url":null,"abstract":"<p><strong>Background: </strong>Polymethyl methacrylate, or \"bone cement,\" can be used intraoperatively to replace damaged or diseased bone and to deliver local antibiotics. 3D printed molds allow surgeons to form personalized and custom shapes with bone cement. One factor hindering the clinical utility of anatomically accurate 3D printed molds is that cured bone cement can be difficult to remove due to the strong adhesion between the mold and the bone cement. One way to reduce the adhesion between the 3D printed mold and the cured bone cement is with the use of a surface coating, such as a lubricant. This study sought to determine the optimal surface coating to prevent bone cement adhesion to 3D printed molds that could be utilized within a sterile operating room environment.</p><p><strong>Methods: </strong>Hemispheric molds were 3D printed using a stereolithography printer. The molds were coated with four sterile surface coatings available in most operating theatres (light mineral oil, bacitracin ointment, lubricating jelly, and ultrasound transmission gel). Polymethyl methacrylate with tobramycin antibiotic was mixed and poured into the molds. The amount of force needed to \"push out\" the cured bone cement from the molds was measured to determine the efficacy of each surface coating. Tukey's multiple comparison test was performed to compare the results of the pushout test.</p><p><strong>Results: </strong>The average pushout force for the surface coatings, in increasing order, were as follows (mean ± standard deviation) --- bacitracin ointment: 9.10 ± 6.68 N, mineral oil: 104.93 ± 69.92 N, lubricating jelly: 147.76 ± 63.77 N, control group: 339.31 ± 305.20 N, ultrasound transmission gel 474.11 ± 94.77 N. Only the bacitracin ointment required significantly less pushout force than the control (p = 0.0123).</p><p><strong>Conclusions: </strong>The bacitracin ointment was the most effective surface coating, allowing the bone cement to be pushed out of the mold using the least amount of force. In addition, the low standard deviation speaks to the reliability of the bacitracin ointment to reduce mold adhesion compared to the other surface coatings. Given its efficacy as well as its ubiquitous presence in the hospital operating room setting, bacitracin ointment is an excellent choice to prevent adhesion between bone cement and 3D printed molds intraoperatively.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9373469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9169897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-09DOI: 10.1186/s41205-022-00150-y
Y Lan Pham, Jonathan Beauchamp, Alexander Clement, Felix Wiegandt, Olaf Holz
The growing use of 3D printing in the biomedical sciences demonstrates its utility for a wide range of research and healthcare applications, including its potential implementation in the discipline of breath analysis to overcome current limitations and substantial costs of commercial breath sampling interfaces. This technical note reports on the design and construction of a 3D-printed mouthpiece adapter for sampling exhaled breath using the commercial respiration collector for in-vitro analysis (ReCIVA) device. The paper presents the design and digital workflow transition of the adapter and its fabrication from three commercial resins (Surgical Guide, Tough v5, and BioMed Clear) using a Formlabs Form 3B stereolithography (SLA) printer. The use of the mouthpiece adapter in conjunction with a pulmonary function filter is appraised in comparison to the conventional commercial silicon facemask sampling interface. Besides its lower cost - investment cost of the printing equipment notwithstanding - the 3D-printed adapter has several benefits, including ensuring breath sampling via the mouth, reducing the likelihood of direct contact of the patient with the breath sampling tubes, and being autoclaveable to enable the repeated use of a single adapter, thereby reducing waste and associated environmental burden compared to current one-way disposable facemasks. The novel adapter for breath sampling presented in this technical note represents an additional field of application for 3D printing that further demonstrates its widespread applicability in biomedicine.
3D打印在生物医学科学领域的应用越来越广泛,这表明了它在广泛的研究和医疗保健应用中的实用性,包括它在呼吸分析学科中的潜在实施,以克服当前商业呼吸采样接口的局限性和大量成本。本技术说明报告了3d打印口器适配器的设计和结构,用于使用商业呼吸收集器进行体外分析(receva)设备对呼出气体进行采样。本文介绍了适配器的设计和数字工作流程转换,以及使用Formlabs Form 3B立体光版(SLA)打印机从三种商业树脂(Surgical Guide, Tough v5和BioMed Clear)制造适配器。与传统的商用硅口罩采样接口相比,对与肺功能过滤器结合使用的口器适配器进行了评估。除了其较低的成本(尽管打印设备的投资成本)之外,3d打印适配器还有几个好处,包括确保通过口腔进行呼吸采样,减少患者与呼吸采样管直接接触的可能性,并且可高压灭菌,以便重复使用单个适配器,从而减少浪费和相关的环境负担,与目前的单向一次性口罩相比。本技术说明中介绍的用于呼吸采样的新型适配器代表了3D打印的另一个应用领域,进一步证明了其在生物医学中的广泛适用性。
{"title":"3D-printed mouthpiece adapter for sampling exhaled breath in medical applications.","authors":"Y Lan Pham, Jonathan Beauchamp, Alexander Clement, Felix Wiegandt, Olaf Holz","doi":"10.1186/s41205-022-00150-y","DOIUrl":"https://doi.org/10.1186/s41205-022-00150-y","url":null,"abstract":"<p><p>The growing use of 3D printing in the biomedical sciences demonstrates its utility for a wide range of research and healthcare applications, including its potential implementation in the discipline of breath analysis to overcome current limitations and substantial costs of commercial breath sampling interfaces. This technical note reports on the design and construction of a 3D-printed mouthpiece adapter for sampling exhaled breath using the commercial respiration collector for in-vitro analysis (ReCIVA) device. The paper presents the design and digital workflow transition of the adapter and its fabrication from three commercial resins (Surgical Guide, Tough v5, and BioMed Clear) using a Formlabs Form 3B stereolithography (SLA) printer. The use of the mouthpiece adapter in conjunction with a pulmonary function filter is appraised in comparison to the conventional commercial silicon facemask sampling interface. Besides its lower cost - investment cost of the printing equipment notwithstanding - the 3D-printed adapter has several benefits, including ensuring breath sampling via the mouth, reducing the likelihood of direct contact of the patient with the breath sampling tubes, and being autoclaveable to enable the repeated use of a single adapter, thereby reducing waste and associated environmental burden compared to current one-way disposable facemasks. The novel adapter for breath sampling presented in this technical note represents an additional field of application for 3D printing that further demonstrates its widespread applicability in biomedicine.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9364600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40596621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-09DOI: 10.1186/s41205-022-00153-9
Gregory R Roytman, Alim F Ramji, Brian Beitler, Brad Yoo, Michael P Leslie, Michael Baumgaertner, Steven Tommasini, Daniel H Wiznia
{"title":"Correction: Accuracy of guide wire placement for femoral neck stabilization using 3D printed drill guides.","authors":"Gregory R Roytman, Alim F Ramji, Brian Beitler, Brad Yoo, Michael P Leslie, Michael Baumgaertner, Steven Tommasini, Daniel H Wiznia","doi":"10.1186/s41205-022-00153-9","DOIUrl":"https://doi.org/10.1186/s41205-022-00153-9","url":null,"abstract":"","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9361542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9222449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-08DOI: 10.1186/s41205-022-00151-x
Henra Muller, Annabel Fossey
Background: Facial deformities often demand reconstructive surgery and the placement of three-dimensional (3D) printed craniomaxillofacial prostheses. Prostheses manufacturing requires patients' computed tomography (CT) images. Poor quality images result in incorrectly sized prostheses, necessitating repeat imaging and refitting. The Centre for Rapid Prototyping and Manufacturing (CRPM) produces most facial prostheses in South Africa but does not have a prescribed optimised CT protocol. Therefore, this study was undertaken.
Methods: A collection of CRPM STLs used in the design and manufacturing of craniomaxillofacial prostheses is available. The image quality of stereolithography (STL) files of CRPM CT scans was evaluated to determine what constitutes good image quality. This collection was scrutinised for inclusion in the image quality evaluation. After scrutiny, 35 STLs of individuals ≥15 years of age were selected and included metadata attached to the DICOM file. Furthermore, only STLs created without manipulation by the same designer were included in the collection. Before the qualitative evaluation of the STLs, eight different critical anatomical reference points (CARPs) were identified with the assistance of an expert team. A visual acuity rating scale of three categories was devised for each CARP, where 1 was allocated to poor visual acuity, 2 to partial, and 3 to good visual acuity. Similarly, rating scales were devised for the presence of concentric rings and the overall impression score awarded by the two designers involved in the design and manufacturing of the prostheses. This stereolithography measurement rubric (SMR) was then applied to the 35 STLs by a team of three experts, including the two designers, during a structured evaluation session. The scores were used to calculate summary and inferential statistics.
Results: Scores grouped around the central rating of partial visual acuity. The three evaluators' mean total CARP scores ranged from 13.1 to 14.4 (maximum possible score 24), while the mean total CARP + ring scores ranged from 15.8 to 17.1 (maximum possible score 27). No significant differences were detected between the evaluators' scores.
Conclusion: This SMR appears to be the first of its kind. This image quality assessment of STLs provides the groundwork for finer CT image quality evaluation to formulate a CT imaging protocol for the CRPM to design and manufacture accurate internal cranial prostheses.
{"title":"Stereolithography (STL) measurement rubric for the evaluation of craniomaxillofacial STLs.","authors":"Henra Muller, Annabel Fossey","doi":"10.1186/s41205-022-00151-x","DOIUrl":"https://doi.org/10.1186/s41205-022-00151-x","url":null,"abstract":"<p><strong>Background: </strong>Facial deformities often demand reconstructive surgery and the placement of three-dimensional (3D) printed craniomaxillofacial prostheses. Prostheses manufacturing requires patients' computed tomography (CT) images. Poor quality images result in incorrectly sized prostheses, necessitating repeat imaging and refitting. The Centre for Rapid Prototyping and Manufacturing (CRPM) produces most facial prostheses in South Africa but does not have a prescribed optimised CT protocol. Therefore, this study was undertaken.</p><p><strong>Methods: </strong>A collection of CRPM STLs used in the design and manufacturing of craniomaxillofacial prostheses is available. The image quality of stereolithography (STL) files of CRPM CT scans was evaluated to determine what constitutes good image quality. This collection was scrutinised for inclusion in the image quality evaluation. After scrutiny, 35 STLs of individuals ≥15 years of age were selected and included metadata attached to the DICOM file. Furthermore, only STLs created without manipulation by the same designer were included in the collection. Before the qualitative evaluation of the STLs, eight different critical anatomical reference points (CARPs) were identified with the assistance of an expert team. A visual acuity rating scale of three categories was devised for each CARP, where 1 was allocated to poor visual acuity, 2 to partial, and 3 to good visual acuity. Similarly, rating scales were devised for the presence of concentric rings and the overall impression score awarded by the two designers involved in the design and manufacturing of the prostheses. This stereolithography measurement rubric (SMR) was then applied to the 35 STLs by a team of three experts, including the two designers, during a structured evaluation session. The scores were used to calculate summary and inferential statistics.</p><p><strong>Results: </strong>Scores grouped around the central rating of partial visual acuity. The three evaluators' mean total CARP scores ranged from 13.1 to 14.4 (maximum possible score 24), while the mean total CARP + ring scores ranged from 15.8 to 17.1 (maximum possible score 27). No significant differences were detected between the evaluators' scores.</p><p><strong>Conclusion: </strong>This SMR appears to be the first of its kind. This image quality assessment of STLs provides the groundwork for finer CT image quality evaluation to formulate a CT imaging protocol for the CRPM to design and manufacture accurate internal cranial prostheses.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9358852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40686589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-06DOI: 10.1186/s41205-022-00154-8
Bengi Yilmaz, Bilge Yilmaz Kara
Background: Three-dimensional (3D) printing is a method applied to build a 3D object of any shape from a digital model, and it provides crucial advantages especially for transferring patient-specific designs to clinical settings. The main purpose of this study is to introduce the newly designed complex airway stent models that are created through mathematical functions and manufactured with 3D printing for implementation in real life.
Methods: A mathematical modeling software (MathMod) was used to design five different airway stents. The highly porous structures with designated scales were fabricated by utilizing a stereolithography-based 3D printing technology. The fine details in the microstructure of 3D printed parts were observed by a scanning electron microscope (SEM). The mechanical properties of airway stents with various designs and porosity were compared by compression test.
Results: The outputs of the mathematical modeling software were successfully converted into 3D printable files and airway stents with a porosity of more than 85% were 3D printed. SEM images revealed the layered topography of high-resolution 3D printed parts. Compression tests have shown that the mathematical function-based design offers the opportunity to adjust the mechanical strength of airway stents without changing the material or manufacturing method.
Conclusions: A novel approach, which includes mathematical function-based design and 3D printing technology, is proposed in this study for the fabrication of airway stents as a promising tool for future treatments of central airway pathologies.
{"title":"Mathematical surface function-based design and 3D printing of airway stents.","authors":"Bengi Yilmaz, Bilge Yilmaz Kara","doi":"10.1186/s41205-022-00154-8","DOIUrl":"https://doi.org/10.1186/s41205-022-00154-8","url":null,"abstract":"<p><strong>Background: </strong>Three-dimensional (3D) printing is a method applied to build a 3D object of any shape from a digital model, and it provides crucial advantages especially for transferring patient-specific designs to clinical settings. The main purpose of this study is to introduce the newly designed complex airway stent models that are created through mathematical functions and manufactured with 3D printing for implementation in real life.</p><p><strong>Methods: </strong>A mathematical modeling software (MathMod) was used to design five different airway stents. The highly porous structures with designated scales were fabricated by utilizing a stereolithography-based 3D printing technology. The fine details in the microstructure of 3D printed parts were observed by a scanning electron microscope (SEM). The mechanical properties of airway stents with various designs and porosity were compared by compression test.</p><p><strong>Results: </strong>The outputs of the mathematical modeling software were successfully converted into 3D printable files and airway stents with a porosity of more than 85% were 3D printed. SEM images revealed the layered topography of high-resolution 3D printed parts. Compression tests have shown that the mathematical function-based design offers the opportunity to adjust the mechanical strength of airway stents without changing the material or manufacturing method.</p><p><strong>Conclusions: </strong>A novel approach, which includes mathematical function-based design and 3D printing technology, is proposed in this study for the fabrication of airway stents as a promising tool for future treatments of central airway pathologies.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9356489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40685163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.1186/s41205-022-00155-7
Amika A Kamath, Marielle J Kamath, Selin Ekici, Anna Sofia Stans, Christopher E Colby, Jane M Matsumoto, Mark E Wylam
Background: Continuous positive airway pressure (CPAP) is a common mode of respiratory support used in neonatal intensive care units. In preterm infants, nasal CPAP (nCPAP) therapy is often delivered via soft, biocompatible nasal mask suitable for long-term direct skin contact and held firmly against the face. Limited sizes of nCPAP mask contribute to mal-fitting related complications and adverse outcomes in this fragile population. We hypothesized that custom-fit nCPAP masks will improve the fit with less skin pressure and strap tension improving efficacy and reducing complications associated with nCPAP therapy in neonates.
Methods: After IRB approval and informed consent, we evaluated several methods to develop 3D facial models to test custom 3D nCPAP masks. These methods included camera-based photogrammetry, laser scanning and structured light scanning using a Bellus3D Face Camera Pro and iPhone X running either Bellus3D FaceApp for iPhone, or Heges application. This data was used to provide accurate 3D neonatal facial models. Using CAD software nCPAP inserts were designed to be placed between proprietary nCPAP mask and the model infant's face. The resulted 3D designed nCPAP mask was form fitted to the model face. Subsequently, nCPAP masks were connected to a ventilator to provide CPAP and calibrated pressure sensors and co-linear tension sensors were placed to measures skin pressure and nCPAP mask strap tension.
Results: Photogrammetry and laser scanning were not suited to the neonatal face. However, structured light scanning techniques produced accurate 3D neonatal facial models. Individualized nCPAP mask inserts manufactured using 3D printed molds and silicon injection were effective at decreasing surface pressure and mask strap pressure in some cases by more than 50% compared to CPAP masks without inserts.
Conclusions: We found that readily available structured light scanning devices such as the iPhone X are a low cost, safe, rapid, and accurate tool to develop accurate models of preterm infant facial topography. Structured light scanning developed 3D nCPAP inserts applied to commercially available CPAP masks significantly reduced skin pressure and strap tension at clinically relevant CPAP pressures when utilized on model neonatal faces. This workflow maybe useful at producing individualized nCPAP masks for neonates reducing complications due to misfit.
背景:持续气道正压通气(CPAP)是新生儿重症监护病房常用的呼吸支持模式。在早产儿中,鼻腔CPAP (nCPAP)治疗通常通过柔软的、生物相容性的鼻罩进行,适合长期直接接触皮肤,并牢固地贴在脸上。在这个脆弱的人群中,有限尺寸的nCPAP口罩会导致不合适的并发症和不良后果。我们假设定制的nCPAP口罩可以改善新生儿的贴合度,减少皮肤压力和带张力,提高疗效并减少nCPAP治疗相关的并发症。方法:在获得IRB批准和知情同意后,我们评估了几种方法来开发3D面部模型来测试定制的3D nCPAP口罩。这些方法包括基于相机的摄影测量,激光扫描和结构光扫描,使用Bellus3D Face Camera Pro和iPhone X运行Bellus3D FaceApp for iPhone或Heges应用程序。这些数据被用来提供精确的新生儿面部三维模型。利用CAD软件设计nCPAP插入件,将其放置在专有的nCPAP面罩和模型婴儿的面部之间。三维设计的nCPAP口罩与模型面部贴合。随后,将nCPAP口罩连接到呼吸机以提供CPAP,并放置校准的压力传感器和共线性张力传感器以测量皮肤压力和nCPAP口罩带张力。结果:摄影测量和激光扫描不适合新生儿面部。然而,结构光扫描技术产生了精确的新生儿面部3D模型。与没有植入物的CPAP口罩相比,使用3D打印模具和硅注入制造的个性化nCPAP口罩插入物可以有效地降低表面压力和口罩带压力,在某些情况下降低了50%以上。结论:我们发现现成的结构光扫描设备,如iPhone X,是一种低成本、安全、快速和准确的工具,可以建立准确的早产儿面部地形模型。结构光扫描开发了3D nCPAP插入物,应用于市售的CPAP面罩,当用于模型新生儿面部时,可显著降低临床相关CPAP压力下的皮肤压力和带张力。该工作流程可能有助于为新生儿生产个性化的nCPAP口罩,减少因不匹配而引起的并发症。
{"title":"Workflow to develop 3D designed personalized neonatal CPAP masks using iPhone structured light facial scanning.","authors":"Amika A Kamath, Marielle J Kamath, Selin Ekici, Anna Sofia Stans, Christopher E Colby, Jane M Matsumoto, Mark E Wylam","doi":"10.1186/s41205-022-00155-7","DOIUrl":"https://doi.org/10.1186/s41205-022-00155-7","url":null,"abstract":"<p><strong>Background: </strong>Continuous positive airway pressure (CPAP) is a common mode of respiratory support used in neonatal intensive care units. In preterm infants, nasal CPAP (nCPAP) therapy is often delivered via soft, biocompatible nasal mask suitable for long-term direct skin contact and held firmly against the face. Limited sizes of nCPAP mask contribute to mal-fitting related complications and adverse outcomes in this fragile population. We hypothesized that custom-fit nCPAP masks will improve the fit with less skin pressure and strap tension improving efficacy and reducing complications associated with nCPAP therapy in neonates.</p><p><strong>Methods: </strong>After IRB approval and informed consent, we evaluated several methods to develop 3D facial models to test custom 3D nCPAP masks. These methods included camera-based photogrammetry, laser scanning and structured light scanning using a Bellus3D Face Camera Pro and iPhone X running either Bellus3D FaceApp for iPhone, or Heges application. This data was used to provide accurate 3D neonatal facial models. Using CAD software nCPAP inserts were designed to be placed between proprietary nCPAP mask and the model infant's face. The resulted 3D designed nCPAP mask was form fitted to the model face. Subsequently, nCPAP masks were connected to a ventilator to provide CPAP and calibrated pressure sensors and co-linear tension sensors were placed to measures skin pressure and nCPAP mask strap tension.</p><p><strong>Results: </strong>Photogrammetry and laser scanning were not suited to the neonatal face. However, structured light scanning techniques produced accurate 3D neonatal facial models. Individualized nCPAP mask inserts manufactured using 3D printed molds and silicon injection were effective at decreasing surface pressure and mask strap pressure in some cases by more than 50% compared to CPAP masks without inserts.</p><p><strong>Conclusions: </strong>We found that readily available structured light scanning devices such as the iPhone X are a low cost, safe, rapid, and accurate tool to develop accurate models of preterm infant facial topography. Structured light scanning developed 3D nCPAP inserts applied to commercially available CPAP masks significantly reduced skin pressure and strap tension at clinically relevant CPAP pressures when utilized on model neonatal faces. This workflow maybe useful at producing individualized nCPAP masks for neonates reducing complications due to misfit.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9341126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40661756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-18DOI: 10.1186/s41205-022-00152-w
Eric J Hsu, David Parsons, Tsuicheng Chiu, Andrew R Godley, David J Sher, Dat T Vo
Background: Malignancies of the head and neck region, encompassing cutaneous, mucosal, and sarcomatous histologies, are complex entities to manage, comprising of coordination between surgery, radiation therapy, and systemic therapy. Malignancies of the posterior scalp are particular challenging to treat with radiation therapy, given its irregular contours and anatomy as well as the superficial location of the target volume. Bolus material is commonly used in radiation therapy to ensure that the dose to the skin and subcutaneous tissue is appropriate and adequate, accounting for the buildup effect of megavoltage photon treatment. The use of commercially available bolus material on the posterior scalp potentially creates air gaps between the bolus and posterior scalp.
Case presentations: In this report, we created and utilized a custom 3D-printed integrated bolus and headrest for 5 patients to irradiate malignancies involving the posterior scalp, including those with cutaneous squamous cell carcinoma, melanoma, malignant peripheral nerve sheath tumor, and dermal sarcoma. Treatment setup was consistently reproducible, and patients tolerated treatment well without any unexpected adverse effects.
Conclusions: We found that the use of this custom 3D-printed integrated bolus/headrest allowed for comfortable, consistent, and reproducible treatment set up while minimizing the risk of creating significant air gaps and should be considered in the radiotherapeutic management of patients with posterior scalp malignancies.
{"title":"3D printed integrated bolus/headrest for radiation therapy for malignancies involving the posterior scalp and neck.","authors":"Eric J Hsu, David Parsons, Tsuicheng Chiu, Andrew R Godley, David J Sher, Dat T Vo","doi":"10.1186/s41205-022-00152-w","DOIUrl":"https://doi.org/10.1186/s41205-022-00152-w","url":null,"abstract":"<p><strong>Background: </strong>Malignancies of the head and neck region, encompassing cutaneous, mucosal, and sarcomatous histologies, are complex entities to manage, comprising of coordination between surgery, radiation therapy, and systemic therapy. Malignancies of the posterior scalp are particular challenging to treat with radiation therapy, given its irregular contours and anatomy as well as the superficial location of the target volume. Bolus material is commonly used in radiation therapy to ensure that the dose to the skin and subcutaneous tissue is appropriate and adequate, accounting for the buildup effect of megavoltage photon treatment. The use of commercially available bolus material on the posterior scalp potentially creates air gaps between the bolus and posterior scalp.</p><p><strong>Case presentations: </strong>In this report, we created and utilized a custom 3D-printed integrated bolus and headrest for 5 patients to irradiate malignancies involving the posterior scalp, including those with cutaneous squamous cell carcinoma, melanoma, malignant peripheral nerve sheath tumor, and dermal sarcoma. Treatment setup was consistently reproducible, and patients tolerated treatment well without any unexpected adverse effects.</p><p><strong>Conclusions: </strong>We found that the use of this custom 3D-printed integrated bolus/headrest allowed for comfortable, consistent, and reproducible treatment set up while minimizing the risk of creating significant air gaps and should be considered in the radiotherapeutic management of patients with posterior scalp malignancies.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9290275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40512089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-11DOI: 10.1186/s41205-022-00147-7
Kristy M Shine, Lauren Schlegel, Michelle Ho, Kaitlyn Boyd, Robert Pugliese
Background: 3D printing is a popular technology in many industries secondary to its ability to rapidly produce inexpensive, high fidelity models/products, mainly through layer-by-layer fusion of various substrate materials. In healthcare, 3D printing has garnered interest for its applications in surgery, simulation, education, and medical device development, and 3D printing facilities are now being integrated into hospital-based settings. Yet, little is known regarding the leadership, resources, outputs, and role of these new onsite entities.
Methods: The purpose of this research was to survey features of North American hospital-based 3D printing facilities to understand their design and utility in anticipation of future expansion. Hospital-based 3D printing labs were recruited through online special interest groups to participate via survey response. Anonymous, voluntary data were collected from 21 facilities over 9 weeks and reported/analyzed in aggregate.
Results: Of the respondents, > 50% were founded in the past 5 years and 80% in the past decade, indicating recent and rapid growth of such facilities. Labs were most commonly found within large, university-affiliated hospitals/health systems with administration frequently, but not exclusively, through radiology departments, which was shown to enhance collaboration. All groups reported collaborating with other medical specialties/departments and image segmentation as part of the workflow, showing widespread interest in high fidelity, personalized medicine applications. Lab leadership was most often multidisciplinary, with physicians present on nearly all leadership teams. Budgets, personnel, and outputs varied among groups, however, all groups reported engagement in multiple 3D printing applications.
Conclusion: This preliminary study provides a foundation for understanding the unique nature of hospital-based 3D printing labs. While there is much to learn about such in-house facilities, the data obtained reveal important baseline characteristics. Further research is indicated to validate these early findings and create a detailed picture of the developing infrastructure of 3D printing in healthcare settings.
{"title":"From the ground up: understanding the developing infrastructure and resources of 3D printing facilities in hospital-based settings.","authors":"Kristy M Shine, Lauren Schlegel, Michelle Ho, Kaitlyn Boyd, Robert Pugliese","doi":"10.1186/s41205-022-00147-7","DOIUrl":"https://doi.org/10.1186/s41205-022-00147-7","url":null,"abstract":"<p><strong>Background: </strong>3D printing is a popular technology in many industries secondary to its ability to rapidly produce inexpensive, high fidelity models/products, mainly through layer-by-layer fusion of various substrate materials. In healthcare, 3D printing has garnered interest for its applications in surgery, simulation, education, and medical device development, and 3D printing facilities are now being integrated into hospital-based settings. Yet, little is known regarding the leadership, resources, outputs, and role of these new onsite entities.</p><p><strong>Methods: </strong>The purpose of this research was to survey features of North American hospital-based 3D printing facilities to understand their design and utility in anticipation of future expansion. Hospital-based 3D printing labs were recruited through online special interest groups to participate via survey response. Anonymous, voluntary data were collected from 21 facilities over 9 weeks and reported/analyzed in aggregate.</p><p><strong>Results: </strong>Of the respondents, > 50% were founded in the past 5 years and 80% in the past decade, indicating recent and rapid growth of such facilities. Labs were most commonly found within large, university-affiliated hospitals/health systems with administration frequently, but not exclusively, through radiology departments, which was shown to enhance collaboration. All groups reported collaborating with other medical specialties/departments and image segmentation as part of the workflow, showing widespread interest in high fidelity, personalized medicine applications. Lab leadership was most often multidisciplinary, with physicians present on nearly all leadership teams. Budgets, personnel, and outputs varied among groups, however, all groups reported engagement in multiple 3D printing applications.</p><p><strong>Conclusion: </strong>This preliminary study provides a foundation for understanding the unique nature of hospital-based 3D printing labs. While there is much to learn about such in-house facilities, the data obtained reveal important baseline characteristics. Further research is indicated to validate these early findings and create a detailed picture of the developing infrastructure of 3D printing in healthcare settings.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40584380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}