Additive Manufacturing of Medical Implants: A Review

E. Gordon

Wayne State University College of Engineering


Implied manufacturing has compact impressions and is gaining attention in the biomedical opportunity. The disposition of impliedly constructd magnitude is eternally neat, which contributes to their increased authentication restraint medical establishs in resigneds. This tract critiques the erudition on surgical implied manufacturing impressions authenticationd on resigneds, with a centre on the prescriptionization of 3D sculptureed establishs and the power to weld scaffolds on the establish manner. Scholarly erudition axiomsbases were authenticationd to experience public advice on the centre topics, as well-behaved-mannered-behaved-mannered-mannered as fact studies of surgical impressions of implied manufacturing establishs in rodents and humans. The customs of implied manufacturing medical establishs involve reformd medical fruit, absorb agency, and frugal surgery space, as well-behaved-mannered-behaved-mannered-mannered as prescriptionization and weldd scaffold. Overall, the most potent mould of implied manufacturing restraint the medical establish impression is electron shine limpid using Ti-6Al-4V becaauthentication it can yield a noble disposition, noble guiltlessness biocompatible establish that has the claimd effortless properties.

Keywords: Implied Manufacturing, Prescriptionized establishs, Scaffold, 3D Sculptureing, Ti-6Al-4V


In late years, implied manufacturing technologies enjoy reformd indicatively, thus expanding the opportunitys and impressions restraint which they can be authenticationd. These 3D sculptureing technologies repressm corporeal copys from digital copys outside the scarcity restraint utensil and fade and regularity planning. Implied manufacturing can construct prototypes of deep moulds in a miscellany of representatives such as metals, polymers, and nylon. Metal components, in part, can be authenticationd restraint serviceable impressions such as medical establishs: devices constructd to reinstate or savetress a biological composition. The biocompatibility of these loud devices must be considered, creating arduous claimments restraint the representative gathering and definite representative properties of the composition. Studies enjoy shown that implied manufacturing auspiciously yields establishs with biocompatible representatives that coalesce the structural claimments [1-6].

3D sculptureing medical establishs can arrange numerous favors such as the prescriptionization and personalization of the establishs, absorb-effectiveness, increased productivity, and the power to weld scaffold. Using prescription made establishs, fixtures and surgical utensils can aid subside surgery space and resigned regaining space, opportunity increasing the approveness of a auspicious surgery [7]. Another favor is the absorb pliancy of 3D sculptureing medial establishs. Unwritten manufacturing manners are cheaper restraint majestic quantities, save are more claimly restraint personalized plans and fine product runs [8, 9]. 3D sculptureing is in-part absorb potent restraint fine-sized establishs approve spinal or dental establishs. 3D sculptureing is besides faster than unwritten manufacturing if a prescription establish scarcitys to be made; unwritten manners claim milling, restraintging, and a covet delivery space opportunity 3D sculptureing may singly conduct encircling a day [1]. Another famous favor of implied manufacturing is the power to portion-out axioms perfects of plans. Perfects saved as an .STL can be downloaded and sculptureed anywhere in the universe. The National Institutes of Health ruleatic a 3D Sculpture Exchange to exalt open-source sharing of 3D sculpture perfects restraint medical copys [7]. The most indicative favors restraint the biomedical diligence, referablewithstanding, are the power to composition biocompatible representatives, prescriptionize establishs, and weld a repressaminous scaffold manner.

Types of Implied Manufacturing

The implied manufacturing adit authentications computer software to slice a deep 3D copy into laminas of 2D cross-sections with a parted obesity. The laminas are then sculptureed lamina by lamina depending on the part manner separated restraint the impression. There are dozens of moulds of implied manufacturing rules on the communicate, some of the most feeble entity stereolithography (SLA), plain metal laser sintering (DMLS), broad laser sintering (SLS), broad laser limpid (SLM), 3D sculptureing (3DP), and electron shine limpid (EBM). These rules are classified according to the restraintm of the unfinished representative, which can be interlard, limpid, or firm restraintm [8]. The brace moulds of implied manufacturing that are most commsingly authenticationd restraint medical establishs are SLS and EBM.

Figure 1: Regularity compact restraint SLM and EBM. The pre-processing antecedently manufacturing involves 3D copying, perfect provision, and slicing of the 3D copy into laminas. Post-processing may involve intensity treatment and polishing of constructd magnitude [10].

Broad Laser Sintering

An SLS sculptureer authentications a interlard restraintm of representative restraint sculptureing motives. A laser amalgamates a only lamina of interlard by sketch the mould of the motive according to the principal 2D cross-section of the 3D copy. Immediately, the construct platmould is feebleered by the defined lamina obesity and another lamina of interlard is rolled counter [10]. The regularity repeats, fusing each lamina undivided at a space to restraintm the motive. SLS can be authenticationd with metal, ceramic, and tractile interlards. The nicety of the laser and the bisection of the interlard determines the position of part of the definite motive, so it is feasible to repressm parted compositions with an SLS sculptureer [11].


Figure 2: Schematic of SLS rule. The explanation components of SLM involve the laser rule (a fiber laser, F-theta and galvanometer authenticationd to repress the laser shine motion) and the effortless rule (reaccidental construct platmould and interlard roller) [10].

Electron Shine Limpid

An EBM sculptureer authentications a interlard restraintm of representative restraint sculptureing motives, harmonious to SLS. Referablewithstanding, opportunity SLS authentications a laser to fauthentication each lamina of the interlard, EBM authentications an electron shine. This activity is delivered thgruff an electric tour betwixt a tungsten filament wiflimsy of the electron gun and the construct platmould [10]. An electric running intensitys the filament to emit a shine of electrons [1]. Electric activity is transformed to intensity activity which melts the interlard on the construct platform. The regularity continues harmoniously to SLS, where interlard is publish counter the platmould in a flimsy lamina, the cross-section of the motive is melted, and then the construct platmould feebleers by the lamina obesity. A explanation part of EBM is that the construct room is kept beneath vacuum, which allows the motive to be celebrate majestic part (70-100μm) [1].


Figure 3: Schematic of EBM rule. The explanation components of EBM involve an electron shine rule (electron gun constellation, electron shine centreing lens and swerving coils authenticationd to repress the electron shine) and the effortless rule (reaccidental interlard roue and urban interlard cassettes) [10].

Materials of Medical Establishs

The most feeble metals authenticationd restraint surgical establishs are chaste steel 316L (ASTM F138), Cobalt fixed debasements (ASTM F75 and ASTM F799) and titanium debasement Ti-6Al-4V (ASTM F67 and F136) [12, 13]. Referablewithstanding, these metals enjoy disadvantages such as the possible liberate of toxic ions and particles imputable to inactivity that caauthentication inflammation and allergic reactions, restraintcible biocompatibility [14]. Besides, the representatives that enjoy an springy modulus that is referable harmonious to normal bundivided stimulate fantastic bundivided development out-of-sorts [12]. Despite this, the feeble Young’s modulus, noble restraintce, and nonlinear springyity of titanium-fixed debasements figure it the last hurtful rare [3]. The most commsingly authenticationd titanium debasement is Ti-6Al-4V (Ti64) becaauthentication it besides has a meliorate opposition to inactivity compared to chaste steels and cobalt-fixed debasements [15]. Implied manufacturing has besides been dundivided using Tantalum. Tantalum is biocompatible, stubborn, tractable, and chemically sound, save it is claimly and unamenable to agent [6]. Titanium fixed debasements are eminent, thus Ti-6Al-V4 is the best representative restraint implied manufacturing medical establishs.


Young’s modulus (GPa)

Ultimate tensile restraintce (MPa)

Yield restraintce (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 yieldd TiTa, Ti6Al4V and wholesalely chaste titanium samples (n = 5) [16].

Customized Establishs

Implied manufacturing allows restraint the plan and untrue of prescriptionized prosthetic establishs that are repressmd to coalesce the inequitable scarcitys of a resigned, such as the extent, mould, and effortless properties of the establish. Implied Manufacturing reduces plan space as well-behaved-mannered-behaved-mannered-mannered as manufacturing space becaauthentication the establish mould is computer generated with CT and MRI scans, thus removing the scarcity restraint a corporeal copy [8]. The power to yield prescription establishs undeviatingly solves a feeble amount with orthopedics where plummet establishs do referable frequently adapt the scarcitys of positive resigneds. Previously, surgeons had to manually disagree establishs to figure them adapt the resigned [7]. These techniques can be authenticationd by professionals in a miscellany of specialties such as neurosurgery, orthopedics, craniofacial and tractile surgery, oncology, and establish dentistry [8].

Undivided sample of an impression in which a prescriptionized establish is claimd is craniofacial reconstruction. Craniofacial abnormalities are a distinct cluster of incarnate defects that feign a majestic calculate of mass and can be extraneous at lineage or imputable to injuries or tumors [8]. Plummet cranial establishs rarely adapt a resigned precisely becaauthentication skulls enjoy riotous moulds [7]. The prescription establish can be repressmd by using a CT scan to repressm a 3D indirect copy of the resigned’s skull. Then the copy can be authenticationd with CAD software to plan an establish that would exactly adapt the resigned [8]. Using prescription establishs has shown to reform the morphology restraint majestic and deep-shaped cranial abnormalities, and some researchers enjoy observed a majesticer reformment in neurological functions than behind harmonious surgeries using unwrittenly constructd establishs [17, 18].


Figure 4: Skull copy and prescriptionized establish restraint craniofacial reconstruction surgery [8].


Implied manufacturing medical establishs allows the porosity of the manner to be planed, repressled, and interconnected, which arranges meliorate bundivided development into establishs, thus decreasing the chances of the collection rejecting the establish. Additionally, the gruff manner disposition of 3D sculptureed establishs enhances curse-establish fixation [1]. Outside scaffold, there is a waste of bundivided weakening and bundivided detriment environing the establish, which is a effect of importance shielding imputable to noble barbarism of representatives [19]. The probpower of this amount occurring is lessened when bundivided can become into a repressaminous manner of the establish [19].

Cellular lattice compositions are classified by stochastic and non-stochastic geometries. The pores in stochastic compositions enjoy casual variations in extent and mould, opportunity the pores in non-stochastic compositions enjoy repeating moulds of part moulds and extents [10]. The ocean question in impliedly manufacturing scaffolds is the unamenabley to separate the detached interlard from wiflimsy the pores, save an custom is that implied manufacturing technology allows restraint the manufacturing of divergent moulds of scaffolds if a plan claims it; divergent regions of the establish could enjoy divergent porosities [1, 10].

The act authenticationd to terminate the repressaminous areas with unwritten manufacturing manners involves plaster a level manner with other representatives such as plasma-sprayed titanium or a titanium wire mesh; referablewithstanding, combining divergent metals increases the waste of the collection rejecting the establish. Implied manufacturing allows the level and repressaminous manners to be constructd with the identical representative, thus decreasing that waste. A miscellany of implied manufacturing techniques can be authenticationd to repressm the lattice composition, save scaffold can be constructd by SLS or EBM outside the scarcity restraint savetress compositions, thus making it the most potent manner [5].


Figure 5: Acetabular cup with planedFigure 6: (a) Repressaminous femoral parent on the constructing

foraminous manner [10].platform, (b) post-processed femoral parent [5].


There are numerous customs to using implied manufacturing to construct surgical establishs. These favors involve reformd medical fruit, absorb agency, frugal surgery space, as well-behaved-mannered-behaved-mannered-mannered as prescriptionization and scaffold. Overall, the most potent mould of implied manufacturing restraint the medical establish impression is Electron Shine Limpid becaauthentication it can yield a noble disposition, noble guiltlessness biocompatible establish that has the claimd effortless properties. The recommended metal to authentication restraint most establishs is the titanium-fixed debasement Ti-6Al-4V becaauthentication of its feeble Young’s modulus, noble restraintce, nonlinear springyity, and inactivity opposition. Overall, implied manufacturing is an meritorious product manner restraint medical establishs becaauthentication it allows surgeons to prescriptionize establishs and scaffold to the inequitable scarcitys of the resigned.



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