3-d printing for bio-medical...

le centre collectif de l’industrie technologique belge

The collective centre of the Belgian technology industry

3-D printing for bio-medical applications

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Our centre

Federation

for the technology industry

Collective centre

of the technology industry

• Nonprofit organisation

• Industry owned

“Increase the competitiveness of companies of the Agoria

sectors through technological innovations”

Our mission:

© sirris 2012 | www.sirris.be | [email protected] | 5/06/2014

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Our technological sectors

Aerospace Automotive Construction products

Contracting & Maintenance Electrical engineering

Industrial automation Mechatronical engineering

Information and communication technologies (ICT)

Metals & materials Metal processing Mounting & cranes

Plastics & composites Security & defence Medical


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Local presence,

near the companies

Leuven

Mechatronics

Technology Coaching

Sirris Leuven Composites Application Lab

Hasselt

Materials Engineering

Production Technology

Smart Coating Application Lab

Charleroi

Additive Manufacturing

Bio-Manufacturing Platform

Brussels

Software Engineering & ICT

Technology Coaching

Ghent


Materials Research Cluster Gent

Liège

Additive Manufacturing


Sirris Microfabrication Application Lab

Antwerp

Offshore Wind Infrastructure

Application Lab

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Additive Manufacturing : Basic Principles

Basic data :

Layer by layer manufacturing

3D CAD File 3D STL File Sliced File

Starting point:

3D CAD file

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© sirris 2012 Charleroi | www.sirris.be | [email protected] | 05/06/2014

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(…)


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Bulk material:

Metals, Ceramics, Polymers, Others

Powder, paste, liquids, cartridges, filaments or wire, plates

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Attention,liste non exhaustive et en constante évolution !!

PLASTICS

METALS

CERAMICS

ABS, PC, PPS, PLA, PMMA, … and other thermoplastics.

PA, PA composites of carbon fibers, PA + glass, …PS, …

PU (different grades)

Elastomers (silicone, …PU, Acrylics)

Stereolithography (materials): Transparents

Filled with nano-particles (rigidity, high

temperatures (>200°C, …))

Biocompatibles

Choc resistant

Inconel and different alloys

Bronze, Titanium - alloys, Aluminium - alloys, Cobalt Chromium, …

Special metals (lunar powder) - combinations

Alumina, Zirconia, Hydroxiapatite, Tri-Calciumphosphate, HA/TCP, …

Others Wood, Polystyrene, Paper, Glass, Hydrogels & stem cells,


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AM generalities…

Reduction of the bulk material

Milling drilling tools : ratio of 20/1

Freight reduction costs & logistics:

Localized production vs decentralisation (no molds)

Energy consumption reduction

Global CO2 production reduction

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Concept of « customization »

• Client needs: personalized products

• Concernec sectors: Sports, fashion,…

• NIKE: color choice of each element

• Snowboards: form, size, decoration, ...

• Glasses

• More and more: Internet consumers

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AM generalities…

Variety of materials still not vast enough

Lack of precision on some technologies

Machines still very pricy (industrial)

Need of certification and qualification of materials & process

Lack of surface quality and finishing (direct process)

Not suited for big series (automobile)

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Additive Manufacturing technologies @ Sirris

SIRRIS – European leader: Most complete machine park

• 15 engineers and technicians

• Two locations: Liège (10 p.) and Charleroi (5 p.)

Rapid Prototyping / Tooling / Manufacturing

• Stereolithography (normal & hi-res)

• Paste polymerisation for ceramics and metals (Optoform)

• 3D Printing of plaster and metal powder

• Laser sintering of polymeric powder (PA,…): P360 – P390

• Objet Connex 500: bi-material

• Laser sintering of metal powder (parts and mould inserts)

• Electron Beam Melting (Arcam A2)

• 3D Printing of wax (Thermojet)

• Vacuum Casting of Alu, Bronze, Zamak

• Laser Cladding (EasyClad)

• Selective Laser melting (MTT)

• Bi-material FDM system

• Fab@home system (for students)

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Custom medical implants, a necessity?

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25/11/2011 © sirris 2012 Charleroi | www.sirris.be | [email protected] |

Yes, it will work. But ….

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Current advanced pre-operative manufactured implants:

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CT scan Rapid Prototyping model

Manual manufactured wax model Implant PMMA injection moulded

[Dr J. Poukens - UHasselt]

© sirris 2012 Charleroi | www.sirris.be | [email protected] |

Implant manufacturing (current & past)

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Next generation pre-operative manufactured implants:

• Custom implant manufacture :

• CT-Scan

• CAD File of the patient is produced

• Engineer + Surgeon 3D implant approved

• FEM analysis (when needed)

• Custom manufacturing (low cost)

• Surgery

• Follow up


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[Sirris ADD]

[Sirris ADD] [Sirris ADD]

The utility of Additive Manufacturing technologies

in the medical field

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The utility of Rapid Prototyping / Manufacturing in

the medical field

Trends in biocompatible materials used in Rapid Prototyping / Manufacturing:

Metals:

• Titanium (Ti6Al4V) • Stainless steel • Shape memory alloys (Ni-Ti) – in research • Noble materials (Gold) • …

Ceramics:

• Hydroxyapatite (HAP) • Zirconia • Tricalcium phosphate (TCP) • Aluminium oxide • HAP/TCP combined • …


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Polymers:

• PTFE (Polytetrafluoroethylene)

• PMMA (Polymethyl methaacrylate)

• PE (Polyethylene)

• PEEK

• PEKK

• … others, too but not implantable

Others:

• Hydrogels + Human cells

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the medical field

Leading applications:

• Pre-surgical planning:

• Custom implant manufacture

• Physician to physician communication

• Powerful patient presentation tool

• Medical student/resident education

• 3D Surface Scanning/Custom Prosthesis Design


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[Z. Corp Medical Modeling Solutions]

[Z. Corp Medical Modeling Solutions]

[Arcam & Objet technology]

[Sirris ADD]

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Leading applications:

• Pre-surgical planning:

• Implant pre-contouring • Screw trajectory • Screw selection/location • Instrument selection • Technique rehearsal


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[Objet]

[Objet]

[Objet Connex Eden 500]

[Objet]

“No matter how good our 3-D graphics are, there is

nothing like a model in your hands . . .”


the medical field

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Medical Field: CASE STUDIES in the world

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[Dr J. Poukens - UHasselt]

[Walter Reed Army Medical Center, Washington DC, USA ]


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[Dr J. Poukens – Uhasselt, Xilloc Medical (Maastricht)]

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World’s first total mandible implant in Titanium


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05/06/2014

[UHasselt, Layerwise, Xilloc, Sirris, CamBioceramics, Orbis Medisch Centrum, Xios, KUL]

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05/06/2014

Problem description:

• Female patient (83 years) suffering from severe infection of the lower jawbone

(osteomyelitis)

• No other treatment options

• Need for reconstruction of:

Form:

• Continuity of missing bone segment

• Reconstruction of Temporo-mandibular joint

Function:

• Provide foundation for dental restoration

• Mastication

• Speech

• Airway support

• Motor and sensitive function

Aesthetics


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Current treatments:

• Free Bone transplants

• Vascularized bone transplants

• Rib

• Iliac crest

• Radius

• Fibula


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Current treatments:

Custom bended reconstruction plate with condylar head part


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Conclusions:

Successful and fast recovery of the patient !

• Advantages of custom-made implant:

• Short operation time: 4hours instead of 12-20hours !

• Perfect fit - no intra-operative adjustments

• Recovery of vital functions:

• Jaw movement – mastication

• Speech

• Breathing

• Nerve functions

• No secondary operation for bone grafting

• Shorter hospital admissions

• Minimal complication rates

• Excellent tissue attachment

• Best aesthetic and reconstructive result


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Medical field: Industrial Case studies


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Project: “In vitro testing models - arteries”

Goals:

• Functional models for in-vitro testing; cut, saw, flow,...

• Flexible models for more realistic artery models

• Technologies involved: Connex Eden 500 bi-material 3D inkjet printing

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Medical field: Industrial Case studies


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Project: “In vitro testing models - arteries”

• Goals:

• To gain biomechanical know-how

• Virtual prototyping, device testing, virtual design iterations

• Diagnostic research

• Technologies involved: Connex Eden 500 bi-material 3D inkjet printing

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Medical field: Case studies

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Project « Optobio » :

• Porous scaffolds in Hydroxyapatite Ca5(PO4)3(OH)

• Diameter ~= 10mm

• Macro-porosity ~= 0,5mm

• Tests various scaffold structures for bone integration

• In vivo testing (rabbits & rats)

• Field: Spinal implants & Maxillofacial Surgery

• Client: Osseomatrix (France) – Dr. Didier Nimal

[Sirris ADD] [Sirris ADD] [Sirris ADD]

05/06/2014 © Sirris | www.sirris.be | [email protected] |

[Sirris ADD]

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Medical Field: CASE STUDIES @ SIRRIS


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Project: “Optobio”

Client: Osseomatrix (Dr Nimal)

• Porous & dense orbital implant in Hydroxyapatite Ca5(PO4)3(OH)


0,5mm

1,4mm

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Medical Field: Case studies


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Spinal & CMF case studies in HAP/TCP:

• Porous scaffolds in Hydroxyapatite Ca5(PO4)3(OH)

• Diameter ~= 10mm

• Macro-porosity ~= 0,5mm

• Tests various scaffold structures for bone integration

• In vivo testing (rabbits)

• Machine: Optoform

• Field: Maxillofacial Surgery in France (Client is confidential)

• Spinal implants (HAP/TCP): 12.000 implants manufactured in 2011

[Sirris ADD]


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05/06/2014

The future of bio-manufacturing…not so far away!


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05/06/2014

Additive Manufacturing: Organ printing

Case study (USA): Artificial bladder

• Pioneers in 3D printing of artificial organs: Wake Forest University School of Medicine

• World’s first artificial bladders built by an additive manufacturing technology (3D Ink-jet printer technology) in lab ! • Development of artifical bladder first tested on dogs (1999). Transplantation successful.

• 2006: Transplantation on 7 human patients

• No risk of transplantation rejection (patient’s own cells)

• Procedure: « Orthotopic Neobladder Procedure » • CT-Scan of the bladder (for the geometry) • Tissue sample is taken from the patient’s bladder • Biodegradable scaffolds are built usink ink-jet printer • Cells are grown into biodegradable scaffold (hydrogels) • Transplantation of the artifical bladder • Scaffold is safely degraded within the patient’s body

• Ink-jet printer: cartridges use stem cells & cross-linker

[Wake Forest University School of Medicine]


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05/06/2014


Case study (USA): Artificial liver

• Bio-engineering of human liver (5.7g)

• 3D printing of collagen skeleton • Application of human liver cells on skeleton matrix

• Artificial liver is then placed in a bioreactor (nutrients & oxygen)

• After one week: widespread cell growth inside the bioengineered organ with progressive formation of liver tissue as well as liver-associated functions. • Promising for the future!

[Wake Forest University School of Medicine]


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05/06/2014


Case study (Europe): Artifical trachea

• World’s first articial trachea built by an additive manufacturing technology ! • Bioartifical matrix (CT-Scan to CAD file)

• Stem cells sprayed on matrix

• Swedish hospital & european team (University Hospital of Karolinska – Prof. Paolo Macchiariini) • Operation time: 12h

• Trauma: cancer (size of a golf ball)

• Material of the matrix: Synthetic nanocomposite polymer

[Karolinska Institute in Stockholm ]


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05/06/2014


Case study: In situ skin bio-printing for burn wounds

• Portable skin printing system • Uses living cells to create tissue-engineered skin grafts to cover burn wounds • Future application: battlefield burn wounds

• Fibroblasts and keratinocytes are printed directly onto skin • Suspensions with cells are mixed with fibrinogen, type 1 collagen and thrombin at the moment of application • Application already tested on mice


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05/06/2014


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« Medical Additive Manufacturing & Rapid Prototyping »

Contact: [email protected]


3-d printing for bio-medical...

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