3D-printing & healthcare

Technology serving the healthcare sector and wellbeing20.2.2020

3D-printing: One name for many processes

• 3D-printing (additive manufacturing, AM) refers to a varietyof additive manufacturing processes: it meansmanufacturing a part, or part of one, from digital 3D-models to physical parts by adding material.

• Different 3D-printing processes use different raw materials, require different pre- & post-processes and parts will havedifferent properties.

• Each process has benefits and drawbacks

• Relatively fast. Manufacturing parts by 3D-printing can take from hours to days dependingon AM-technology, material and required partproperties.

• The actual manufacturing process (3D-printing) is often the fastest step – designing and post processing the part usually takes a lot of time.

3D-printing trends

• “By 2021, 25% of surgeons will practice on 3D-printed models of the patient prior to surgery.” (Gartner, 2018)• In-house 3D-printing facilities in hospitals are increasing (US: 2018, 99 kpl)• New EU Medical Device Regulation 26.5.2020->

• New MDR defines the term "medical device" as an "instrument, apparatus, appliance, software, implant, reagent, material, or other article" that is used for patient care. This will affect 3D-printed parts and software used for 3D-printed parts.

Industrial/business machines

20 %

Motor Vehicles20 %

Aerospace18 %

Consumer products/electronics

13 %

Medical/dental11 %

Government/military5 %

Other5 %

Academic institutions5 % Architectural

3 %

3D-printing customers for service providers*

End-use part28 %

Functional prototypes

28 %

Cosmetic models11 %

Education/research10 %

Polymer patterns and molds

8 %

Jigs/fixtures6 %

Metal tooling5 %

Other4 %

3D-printed part use*

*Source: Wohler’s Report 2019

3D-printing: 3 benefits for healthcare applications

New possibilities1. Manufacturing process not as

constrained by ”design-for-manufacture” rule

2. New materials, material propertiesand multimaterials

Fast product development cycle1. 3D-printing speeds up the development cycle:

Time required when stepping from design to prototype is short

2. Manufacturing directly from 3D-model allowsfast changes up to the printing process -> even up to point-of-care manufacturing

Cost optimization1. Cost-efficient way to produce

single products and small lot sizes2. Product customization does not

necessarily add any costs to manufacturing

Known application areas for healthcare

• Anatomical and surgical models• Custom prosthetic design• Virtual Surgical planning

• 3D-printed cutting guides, templates and models• Personalized surgical instruments• Implant manufacturing

• Spinal cages, acetabular cups, tibial baseplates, etc…• Customized equipment spare parts and tools• Dental healthcare applications

• EOS: over 5 million metal dental crowns & bridges are printed every year (by EOS 3D-printers)

• Invisalign (2018): >220.000 clear aligners per day

3D-printing: One name for many processes

… and many more. There is an increasing amount of different 3D-printing processesand some systems combine more than one process.

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mat

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Fused Filament Fabrication Selective Laser Sintering VAT Photopolymerization Material JettingSRN** SRN*SR1 SRN*

Typical process with patient specific data

• DICOM -> STL -> 3D-MODEL PROCESSING -> 3D-PRINT• Free DICOM to STL tools: InVesalius 3, 3D Slicer• Commercial software (eg. Magics InPrint, 3DSystems D2P) are easier and faster to

use, but software license can easily cost over 10 000 € / year depending on functionalities.

Example 1: Blood vessels / aneurysm model

• End use: training model for surgery planning• 3D-model source: patient specific DICOM –data

Example 2: Thorax phantom

• 4-D thorax phantom• Ongoing project, started with simplified phantoms• Modular structure allows different cardiac models• 2 levels of movement (respiratory, cardiac)• Plan for the final version

• Fillable torso (background)• Main organs included• Lungs, liver, diaphragm, ribs, spine, heart (modeled based

on CT images)

• More information• Mikko Hakulinen, Kuopio University Hospital,

Diagnostic Imaging Center• Kortelainen M, Koivumäki T, Vauhkonen M, Hakulinen

M, Effect of respiratory motion on cardiac defect contrast in myocardial perfusion SPECT: a physical phantom study, Annals of Nuclear Medicine, 2019

Example 3: Skull with skin (navigation)

• 3D printed skull with silicone skin and different anatomical craniotomies for neurosurgical training

• Silicone skin allows the use as a location tool for AR/VR navigation training

• Manufactured using SLS and silicone casting. Both the skull and the casting mold were printed with SLS (Selective Laser Sintering) 3D-printer.

• More information• Ahmed Hussein, Eastern Finland

Microsurgery Center

Example 3: Skull (with craniotomies)

• 3D printed skull with different anatomical craniotomies for neurosurgical training

• Customized 3D printed skull with inside holder (placenta holder) and standard (true sizes) craniotomy (bone windows) opening that neurosurgeons usually use in the real surgery

• the placental vessel dissection has big similarity with intracranial vessel dissection and putting it inside 3D printed skull would provide the authentic microscopic ergonomics concerning :

• adjustment of body posture during work• adjustment of hand support • adjustment of Microscope light to work through narrow work field • adjustment of focus and zoom due to frequent changes of depth of work and

angles • adjustment of instruments handling and placement not to be in the way of the

visual field.• increase the visual fidelity by continuous visualizing true anatomical land marks

around.

• Manufactured using SLS & HP MJF• More information

• Ahmed Hussein, Eastern Finland Microsurgery Center

Example 4: Training pills

• Training pills for educational purposes• Used in Savonias “basics of medication in nursing, midwifery

and emergency care” –courses• Identifying and distribution correct medicines

• Requirement: realistics and cost-efficient training pills• 3D-printing the molds and mold cores allows for easy and complete

customization of the end product• Pills/molds modeled with Solidworks• Pill material: plaster/gypsum (+ dye)• Mold: Silicone (3D-printed mold for the silicone mold)• Mold core: 3D-printed model of the end product

• More information: • Sari Husso, lecturer, Savonia• Sari.Husso@savonia.fi

Example 5: Training model

• A child respiratory symptons training model for educational purposes

• Educating doctors to recognize some rare cases of childrens respiratory symptons is challenging.

• 3D-printing is used for rapid prototyping in R&D –phase and most likely to manufacture parts of the final product as well.

• Both direct 3D-printing and 3D-printing of silicon molds are currently used.

• Collaboration with Sense4Health Oy

Savonia’s 3D-printing environment 2020-

PLASTIC 3D-PRINTING METAL 3D-PRINTING R&D -SERVICES

3D – SCANNING3D – DESIGN3D – MODELINGFEM – ANALYSISMATERIAL TESTING

LOCAL COLLABORATION

Kuopio University HospitalUniversity of Eastern FinlandSavo Consortium for EducationYlä-Savo Vocational College

3D-tulostusympäristön investointi- ja kehityshanke, 1.10.2018 – 31.12.2020

The eye 3D-print: process steps 1/3

• Process steps1. 3D-model (3 objects)

• Blender, Netfabb

2. Textures (2 files)• Photoshop

3. Texture mapping4. Displacement

mapping5. 3D-print6. Post-process

The eye 3D-print: process steps 2/3

• Process steps1. 3D-model (3 objects)2. Textures (2 files)3. Texture mapping

• Blender

4. Displacement mapping• Blender

5. 3D-print6. Post-process

The eye 3D-print: process steps 3/3

• Process steps1. 3D-model (3 objects)2. Textures (2 files)3. Texture mapping4. Displacement

mapping5. 3D-print

• Stratasys J735

6. Post-process• Grinding, polishing

Thank you for your attention!

Instagram: https://www.instagram.com/savonia3dtulostus/www: https://3dtulostus.savonia.fi/en/

• (*english pages available in March 2020)

Antti AlonenR&D AdviserSchool of Engineering and TechnologySavonia University of Applied Sciencestel: +358 44 785 5767antti.alonen@savonia.fi