How does 3D printing work?
3D printing is part of the innovative process called additive manufacturing, which means the production of three dimensional solid objects from a digital file. The printer uses a kind of layering process, by which one layer is added after the other until you have a fully formed object. It allows designers and engineers to create complex parts for cars, machines or airplanes much cheaper and in much less time than any other production method. Currently, rapid technological development enables start-ups and other companies to bring 3D printers out of factories into smaller businesses and even people’s homes.
The first step in the 3D printing process is the creation of the blueprint of a given object. For this step, you can use special software or you can go to various websites and see for yourself, what other people already 3D modeled. Once you finish the design, you can send it to the chosen printer. Take for example the MakerBot Replicator. It has removable bioplastic spools in the back of the device, so when the printer receives the data, it pulls the material through a tube, melts it, deposits it to the plate, where it instantly cools. Then, the printer repeats this process for as long as it is necessary to create the wanted object. For example, a complete house.
In medicine and healthcare, 3D printing could not only revolutionize drug creation and the production of medical equipment, but it could also offer new methods for practicing medicine, optimizing supply chains, and propose cheaper and way more personalized medical services. Let’s see the most promising examples!
Medical equipment quickly and in a cheap way
It is a well-known fact that medical equipment is expensive. Total spending on medical devices in the U.S. reached about $150 billion in 2010, or roughly a nickel of every health-care dollar, according to the Advanced Medical Technology Association (AdvaMed), the industry’s trade group. Thus, 3D printing splints, medical models used before surgeries or other necessary means for healing could result in saving huge amounts of money. And there are already brilliant examples on the market how to do it!
a) Finger splints
Ian McHale, a senior at the US Steinert High School created a blueprint for producing finger splints. A low-end 3D printer can print his splint quickly and affordably, about 2¢ worth of ABS plastic in about ten minutes! For developing countries, where splints can often be ordered from oversees only in bulk, it could mean the cheapest solution for poor communities. At the same time, it could easily serve personal needs.
b) Tumor models
3D printing can also help medical research as well as the outcome of complex operations and especially difficult cases. Researchers in China and the US have both 3D printed models of cancerous tumors to aid discovery of new anti–cancer drugs and to better understand how tumors develop, grow, and spread.
c) Organ models
Researchers have also used scans of animal hearts to create printed models, and then added stretchy electronics on top of those models. The material can be peeled off the printed model and wrapped around the real heart for a perfect fit. The next step is to enhance the electronics with multiple sensors.
How 3D printed medical equipment saves lives
Kaiba Gionfriddo was born prematurely in 2011. After 8 months his lung development caused concerns, although he was sent home with his parents as his breathing was normal. Six weeks later, Kaiba stopped breathing and turned blue. He was diagnosed with tracheobronchomalacia, a long Latin word that means his windpipe was so weak that it collapsed. He had a tracheostomy and was put on a ventilator––the conventional treatment. Still, Kaiba would stop breathing almost daily. His heart would stop, too. His caregivers 3D printed a bioresorbable device that instantly helped Kaiba breathe.
A nine-month-old baby was born with a fatal heart defect in China. He was suffering from a rare condition extremely difficult to repair. The team of experienced doctors decided to build a full-sized model of his tiny heart with the use of a 3D printer to pre-plan the complicated surgery. This was the first time someone used this method in China. The doctors completed the extremely risky and complicated surgery in March 2016. They were successful and the little boy is expected to survive with little to no lasting ill-effects.
Plastic 3D printed implants
Not only prosthetics, but also implants could be 3D printed in a personalized way. This is especially important in complex and rare cases, such as the following. Dutch surgeons replaced the entire top of a 22 year–old woman’s skull with a customized printed implant made from plastic. The unnamed 22-year-old patient was suffering from a rare condition that caused the inside of her skull to grow extra bone, which squeezed her brain. The growth was discovered after she reported severe headaches and then lost her sight and motor control. If untreated, the extra bone would have killed her.
Personalized plaster casts
3D printing casts could finally transform the experience of breaking a bone. In 2014, designers have experimented with 3D printed wrist braces which they printed in an open shape, then bended on the wrist of the patient after heating in hot water. I also came across the invention of a Dutch student named Pieter Smakman, who created a scanner using cheap laser pointers, 32 cameras, and a Raspberry Pi computer. His system is able to precisely digitize the hand and fingers and may also help in fitting prosthetic devices to each individual patient.
In 2015, I met Scott Summit, Design Director of 3DSystems. He’s had ongoing issues with his wrist and finally tailored a 3D printed cast specifically for himself, becoming perhaps the first patient ever to have a shower with a cast on, but without a bunch of plastic bags wrapped around the limb. As the cast was printed to match his anatomy, his physician could open and close it in seconds, but it still held his wrist tightly. And it cost Scott around 50 USD and took a few hours to create.
The Spanish 3D printing startup Exovite‘s system consists of a 3D scanner capable of modelling the patient’s limb precisely, and generates a personalized custom made, 3D printed splint, such as the one I’m wearing below. Printing the cast only takes a few minutes. The system also includes a rehabilitation module that stimulates the muscles below the cast with electric signals, speeding up recovery and preventing muscle atrophy.
Low-Cost Prosthetic Parts
Globally, over 30 million people need mobility devices such as prosthetics, while 80 percent of the world’s amputees do not have access to modern prosthetics. However, creating traditional prosthetics is very time–consuming and destructive, which means that any modifications would destroy the original molds. Researchers at the University of Toronto, in collaboration with Autodesk Research and CBM Canada, used 3D printing to quickly produce cheap and easily customizable prosthetic sockets for patients in the developing world.
Another solution comes from the e-NABLING the Future project. it is basically a global network of passionate volunteers who by sharing 3-D printing designs, video tutorials and other information about building prosthetic hands enable volunteers, doctors or anyone on the field to make a difference by literally “giving a helping hand” to those in need. Success stories come from all over the world: there are now children and adults with super-hero style or more traditionally shaped prosthetic hands in Chile, Ghana, Indonesia and many more countries.
“Not Impossible Labs” does something similar. The company based in Venice, California took 3D printers to Sudan where the chaos of war has left many people with amputated limbs. The organization’s founder, Mick Ebeling, trained locals how to operate the machinery, create patient specific limbs, and fit these new, very inexpensive prosthetics.
3D Printing biomaterials
3D printing is emerging as a powerful tool for tissue engineering. No matter, whether it is about blood, bones, heart or skin. It is the technology that lets your jaw drop and scares the hell out of you at the same time, when you first encounter it.
a) Blood vessels
Researchers at Harvard University were the first to use a custom–built 3D printer and a dissolving ink to create a swatch of tissue that contains skin cells interwoven with structural material that can potentially function as blood vessels in the future. The vasculature network enables fluids, nutrients, and cell growth factors to be perfused uniformly throughout the tissue.
Professor Susmita Bose of Washington State University modified a 3D printer to bind chemicals to a ceramic powder creating intricate ceramic scaffolds that promote the growth of the bone in any shape. It helps hip and knee replacements last longer through developing a body-friendly calcium phosphate-based coating for the implant materials. In 2015, the National Institutes of Health awarded her a $1.8 million grant that will enable her team to continue refining the coating and improve the way in which implants integrate into the body. Once integrated, the coated implants are expected to last longer – possibly doubling the life of cemented implants.
c) Heart valve
Jonathan Butcher of Cornell University has 3D printed a heart valve possessing the same anatomical architecture as the original valve. It will soon be tested in sheep. He used a combination of cells and biomaterials to control the valve’s stiffness. Butcher believes bioprinting will gain much more traction in the tissue engineering and biomedical community over the next five years, potentially even becoming the standard in complex tissue fabrication.
d) Replicating human ears
Lawrence Bonassar of Cornell University used 3D photos of human ears to create ear molds. The molds were then filled with a gel containing bovine cartilage cells suspended in collagen, which held the shape of the ear while cells grew their extracellular matrix. It is mind-blowing! They not only created the exact replica of a human ear!
e) Synthetic skin
James Yoo at the Wake Forest School of Medicine in the US as well as researchers at the University of Madrid have developed the prototype of a 3D printer that can create synthetic skin. It is adequate for transplanting to patients, who suffered burn injuries or have other skin issues. It may also be used in research or the testing of cosmetic, chemical, and pharmaceutical products.
f) Synthetic organs
Organovo successfully bioprinted liver tissues already in 2014. They seemed to be 4-6 years away from printing liver parts for transplantation. Bioprinted livers could also be used in the pharmaceutical industry to replace animal models for analyzing the toxicity of new drugs. A few months ago, Organovo launched its second commercial product, bioprinted human kidney tissue.
The company suggests that within a decade we will be able to print solid organs such as liver, heart, and kidney. Hundreds of thousands of people worldwide are waiting for an organ donor. Imagine how such a technology could transform their lives! The bioprinted liver tissue could make it to the FDA in 2019.
The future of pharma: 3D printed drugs
Last year, the FDA just approved an epilepsy drug called Spritam that is made by 3D printers. It prints out the powdered drug layer by layer to make it dissolve faster than average pills. Imagine how fast the distribution of medication could be with a 3D printer in every second or third pharmacy! Or imagine how different our attitude towards drugs of pharmacies would be, if we could print out drugs at homes on our own 3D printers!
Lee Cronin, a chemist at the University of Glasgow, wants to do the same with the discovery and distribution of prescription drugs that Apple did with music. In a TED talk he described a prototype 3D printer capable of assembling chemical compounds at the molecular level. Patients would go to an online drugstore with their digital prescription, buy the blueprint and the chemical ink needed, and then print the drug at home. In the future he said we might sell not drugs but rather blueprints or apps.
3D printing is one of the most disruptive technologies that truly have the potential to change medicine and healthcare by making care affordable, accessible and personalized. It can bring a new era if printers become more sophisticated, printing biomaterials gets safely regulated and the general public acquires a common sense about how 3D printing works. We will do everything from advocacy to sharing information to make it happen.