Additive Manufacturing of Medical Implants: A Review

E. Gordon

Wayne State University College of Engineering


Comprehensive manufacturing has close impressions and is gaining attention in the biomedical room. The description of comprehensively misrepresentd compatpower is constantly befitting, which contributes to their increased truth coercion medical propagates in unrepinings. This article revisals the learning on surgical comprehensive manufacturing impressions truthd on unrepinings, with a standpoint on the fashionization of 3D stereotypeed propagates and the power to commingle scaffolds on the propagate deportment. Scholarly learning axiomsbases were truthd to confront public not attributable attributable attributable attributable attributableice on the standpoint topics, as courteous as event studies of surgical impressions of comprehensive manufacturing propagates in rodents and humans. The utilitys of comprehensive manufacturing medical propagates sunkerstand emendd medical remainder, claim agency, and deep surgery date, as courteous as fashionization and commingled scaffold. Overall, the most able kind of comprehensive manufacturing coercion the medical propagate impression is electron shine mellifluous using Ti-6Al-4V becatruth it can result a proud description, proud immaculateness biocompatible propagate that has the claimd unreflective properties.

Keywords: Comprehensive Manufacturing, Fashionized propagates, Scaffold, 3D Stereotypeing, Ti-6Al-4V


In strange-fangled years, comprehensive manufacturing technologies entertain emendd tellingly, thus expanding the rooms and impressions coercion which they can be truthd. These 3D stereotypeing technologies cem embodied moulds from digital moulds externally the want coercion cat's-paw and fade and regularity planning. Comprehensive manufacturing can misrepresent prototypes of multifold fashions in a medley of embodieds such as metals, polymers, and nylon. Metal components, in point, can be truthd coercion authenticationful impressions such as medical propagates: devices misrepresentd to supply or livelihood a biological erection. The biocompatibility of these ringing devices must be considered, creating unfeeling claimments coercion the embodied excerption and definite embodied properties of the erection. Studies entertain shown that comprehensive manufacturing coerciontunately results propagates with biocompatible embodieds that encounter the structural claimments [1-6].

3D stereotypeing medical propagates can contribute multifarious boons such as the fashionization and personalization of the propagates, claim-effectiveness, increased productivity, and the power to commingle scaffold. Using fashion made propagates, fixtures and surgical cat's-paws can aid subside surgery date and unrepining replacement date, opportunity increasing the relishlihood of a coerciontunate surgery [7]. Another boon is the claim aptitude of 3D stereotypeing medial propagates. Oral manufacturing arrangements are cheaper coercion abundant quantities, barring are further valuable coercion personalized pur-poses and trivial evolution runs [8, 9]. 3D stereotypeing is specially claim able coercion trivial-sized propagates relish spinal or dental propagates. 3D stereotypeing is besides faster than oral manufacturing if a fashion propagate wants to be made; oral arrangements claim milling, coercionging, and a desire exhibition date opportunity 3D stereotypeing may simply admit environing a day [1]. Another exalted boon of comprehensive manufacturing is the power to divide axioms emends of pur-poses. Emends saved as an .STL can be downloaded and stereotypeed anywhere in the cosmos-people. The National Institutes of Health regular a 3D Stereoidea Exchange to further open-source sharing of 3D stereoidea emends coercion medical moulds [7]. The most telling boons coercion the biomedical toil, nevertheless, are the power to composition biocompatible embodieds, fashionize propagates, and commingle a ceaminous scaffold deportment.

Types of Comprehensive Manufacturing

The comprehensive manufacturing vestibule truths computer software to hunch a multifold 3D mould into flakes of 2D cross-sections with a parted density. The flakes are then stereotypeed flake by flake depending on the point arrangement selected coercion the impression. There are dozens of kinds of comprehensive manufacturing rules on the communicate, some of the most spiritless life stereolithography (SLA), straightforward metal laser sintering (DMLS), exceptive laser sintering (SLS), exceptive laser mellifluous (SLM), 3D stereotypeing (3DP), and electron shine mellifluous (EBM). These rules are classified according to the coercionm of the bald embodied, which can be scatter, fluid, or impenetrable coercionm [8]. The brace kinds of comprehensive manufacturing that are most commsimply truthd coercion medical propagates are SLS and EBM.

Figure 1: Regularity obligation coercion SLM and EBM. The pre-processing antecedently manufacturing sunkerstands 3D moulding, emend provision, and slicing of the 3D mould into flakes. Post-processing may sunkerstand ebullition treatment and polishing of misrepresentd compatpower [10].

Exceptive Laser Sintering

An SLS stereotypeer truths a scatter coercionm of embodied coercion stereotypeing goals. A laser commingles a unmarried flake of scatter by intent the fashion of the goal according to the restraintemost 2D cross-section of the 3D mould. Immediately, the elevate platmould is sunkered by the defined flake density and another flake of scatter is rolled over [10]. The regularity repeats, fusing each flake individual at a date to coercionm the goal. SLS can be truthd with metal, ceramic, and extensile scatters. The exactness of the laser and the transversion of the scatter determines the class of part of the definite goal, so it is likely to cem parted erections with an SLS stereotypeer [11].


Figure 2: Schematic of SLS rule. The explanation components of SLM sunkerstand the laser rule (a fiber laser, F-theta and galvanometer truthd to moderate the laser shine motion) and the unreflective rule (distinguishable elevate platmould and scatter roller) [10].

Electron Shine Mellifluous

An EBM stereotypeer truths a scatter coercionm of embodied coercion stereotypeing goals, resembling to SLS. Nevertheless, opportunity SLS truths a laser to ftruth each flake of the scatter, EBM truths an electron shine. This motive is delivered thcoarse an electric tour among a tungsten filament wiunsubstantial of the electron gun and the elevate platmould [10]. An electric prevalent ebullitions the filament to discharge a shine of electrons [1]. Electric motive is transformed to ebullition motive which melts the scatter on the elevate platform. The regularity continues resemblingly to SLS, where scatter is diffauthentication over the platmould in a unsubstantial flake, the cross-section of the goal is melted, and then the elevate platmould sunkers by the flake density. A explanation part of EBM is that the elevate lodging is kept sunker vacuum, which allows the goal to be preserve huge part (70-100μm) [1].


Figure 3: Schematic of EBM rule. The explanation components of EBM sunkerstand an electron shine rule (electron gun nock, electron shine standpointing lens and curvity coils truthd to moderate the electron shine) and the unreflective rule (distinguishable scatter debauchee and agricultural scatter cassettes) [10].

Materials of Medical Propagates

The most spiritless metals truthd coercion surgical propagates are guiltless steel 316L (ASTM F138), Cobalt established debasements (ASTM F75 and ASTM F799) and titanium debasement Ti-6Al-4V (ASTM F67 and F136) [12, 13]. Nevertheless, these metals entertain disadvantages such as the possible discharge of toxic ions and particles imputable to inactivity that catruth inflammation and allergic reactions, solemn biocompatibility [14]. Besides, the embodieds that entertain an springy modulus that is not attributable attributable attributable attributable attributable attributable resembling to probable bindividual stimulate strange bindividual development diseased [12]. Despite this, the sunk Young’s modulus, proud power, and nonlinear springyity of titanium-established debasements bring-about it the smallest hurtful valuable [3]. The most commsimply truthd titanium debasement is Ti-6Al-4V (Ti64) becatruth it besides has a ameliorate hindrance to inactivity compared to guiltless steels and cobalt-established debasements [15]. Comprehensive manufacturing has besides been dindividual using Tantalum. Tantalum is biocompatible, unfeeling, extensile, and chemically stable, barring it is valuable and obscure to channel [6]. Titanium established debasements are remarkable, thus Ti-6Al-V4 is the best embodied coercion comprehensive manufacturing medical propagates.


Young’s modulus (GPa)

Ultimate tensile power (MPa)

Yield power (MPa)

Elongation (%)


75.77 ± 4.04

924.64 ± 9.06

882.77 ± 19.60

11.72 ± 1.13


131.51 ± 16.40

1165.69 ± 107.25

1055.59 ± 63.63

6.10 ± 2.57


111.59 ± 2.65

703.05 ± 16.22

619.57 ± 20.25

5.19 ± 0.32

Table 1: Tensile properties of SLS resultd TiTa, Ti6Al4V and interchangeablely guiltless titanium samples (n = 5) [16].

Customized Propagates

Comprehensive manufacturing allows coercion the pur-pose and untrue of fashionized prosthetic propagates that are cemd to encounter the restricted wants of a unrepining, such as the magnitude, fashion, and unreflective properties of the propagate. Comprehensive Manufacturing reduces pur-pose date as courteous as manufacturing date becatruth the propagate archeidea is computer generated with CT and MRI superintends, thus removing the want coercion a embodied mould [8]. The power to result fashion propagates promptly solves a spiritless gist with orthopedics where trutination propagates do not attributable attributable attributable attributable attributable attributable constantly serve the wants of regular unrepinings. Previously, surgeons had to manually modify propagates to bring-about them serve the unrepining [7]. These techniques can be truthd by professionals in a medley of specialties such as neurosurgery, orthopedics, craniofacial and extensile surgery, oncology, and propagate dentistry [8].

Individual illustration of an impression in which a fashionized propagate is claimd is craniofacial reconstruction. Craniofacial abnormalities are a incongruous clump of inherent defects that move a abundant enumerate of herd and can be adventitious at source or imputable to injuries or tumors [8]. Trutination cranial propagates rarely serve a unrepining certainly becatruth skulls entertain riotous fashions [7]. The fashion propagate can be cemd by using a CT superintend to cem a 3D substantial mould of the unrepining’s skull. Then the mould can be truthd with CAD software to pur-pose an propagate that would fully serve the unrepining [8]. Using fashion propagates has shown to emend the morphology coercion abundant and multifold-shaped cranial abnormalities, and some researchers entertain observed a hugeer emendment in neurological functions than following resembling surgeries using orally misrepresentd propagates [17, 18].


Figure 4: Skull mould and fashionized propagate coercion craniofacial reconstruction surgery [8].


Comprehensive manufacturing medical propagates allows the porosity of the deportment to be pur-poseed, moderateled, and interconnected, which contributes ameliorate bindividual development into propagates, thus decreasing the chances of the substantiality rejecting the propagate. Additionally, the coarse deportment description of 3D stereotypeed propagates enhances curse-propagate fixation [1]. Externally scaffold, there is a caauthentication of bindividual weakening and bindividual dropping about the propagate, which is a result of emphasis shielding imputable to proud slang of embodieds [19]. The probpower of this gist occurring is lessened when bindividual can become into a ceaminous deportment of the propagate [19].

Cellular lattice erections are classified by stochastic and non-stochastic geometries. The pores in stochastic erections entertain unpremeditated variations in magnitude and fashion, opportunity the pores in non-stochastic erections entertain repeating archetypes of point fashions and magnitudes [10]. The main brave in comprehensively manufacturing scaffolds is the obscurey to suppress the flowing scatter from wiunsubstantial the pores, barring an utility is that comprehensive manufacturing technology allows coercion the manufacturing of incongruous kinds of scaffolds if a pur-pose claims it; incongruous regions of the propagate could entertain incongruous porosities [1, 10].

The process truthd to terminate the ceaminous areas with oral manufacturing arrangements sunkerstands plaster a ease deportment with other embodieds such as plasma-sprayed titanium or a titanium wire mesh; nevertheless, combining incongruous metals increases the caauthentication of the substantiality rejecting the propagate. Comprehensive manufacturing allows the ease and ceaminous deportments to be misrepresentd with the identical embodied, thus decreasing that cause. A medley of comprehensive manufacturing techniques can be truthd to cem the lattice erection, barring scaffold can be misrepresentd by SLS or EBM externally the want coercion livelihood erections, thus making it the most able arrangement [5].


Figure 5: Acetabular cup with pur-poseedFigure 6: (a) Ceaminous femoral stock on the elevateing

foraminous deportment [10].platform, (b) post-processed femoral stock [5].


There are multifarious utilitys to using comprehensive manufacturing to misrepresent surgical propagates. These boons sunkerstand emendd medical remainder, claim agency, deep surgery date, as courteous as fashionization and scaffold. Overall, the most able kind of comprehensive manufacturing coercion the medical propagate impression is Electron Shine Mellifluous becatruth it can result a proud description, proud immaculateness biocompatible propagate that has the claimd unreflective properties. The recommended metal to truth coercion most propagates is the titanium-established debasement Ti-6Al-4V becatruth of its sunk Young’s modulus, proud power, nonlinear springyity, and inactivity hindrance. Overall, comprehensive manufacturing is an laudable evolution arrangement coercion medical propagates becatruth it allows surgeons to fashionize propagates and scaffold to the restricted wants of the unrepining.



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