2023-01-17, Zarean, Paridokht, Zarean, Parichehr, de Wild, Michael, Thieringer, Florian M., Sharma, Neha, Seiler, Daniel, Malgaroli, Patrick

Additive manufacturing (AM) of polyetheretherketone (PEEK) biomaterials using the material-extrusion (MEX) method has been studied for years. Because of the challenging manufacturing process, precisely controlling printing parameters is crucial. This study aimed to investigate the effects of printing parameters such as orientation and position of printing on mechanical properties. Thus, 34 samples were printed using PEEK filament and the MEX process. Samples were divided into two main groups (A,B) according to their printing orientations (A: groups 1–3) and positions on the build plate (B: groups 4–8). Mechanical tensile tests were performed to evaluate the effects of different printing orientations and positions on mechanical properties. The means of the tensile modulus in samples 3D-printed in XY (group 1), XZ (group 2), and ZX (group 3) orientations were not significantly different (p-value = 0.063). Groups 1 and 2 had smaller distributions than group 3 in the means of tensile strength. The t-test showed that the overall means of the measurements in groups 4–8 did not differ significantly (p-value = 0.315). The tensile tests indicated that printing in vertical and horizontal orientations had no significant influence on mechanical properties. There were no significant differences in mechanical strength between top/bottom printed samples in five different lateral positions. Reliability of printing with good mechanical properties could be a step forward to manufacturing patient-specific implants.

2022-09-02, Maintz, Michaela, Seiler, Daniel, Thieringer, Florian M., de Wild, Michael

Patient-specific osteosynthesis plates can be used to reduce complications related to bone fracture treatment, such as infection, malocclusion and fatigue fractures of plates and screws. However, the implant design process is tedious. We propose a semi-automatic workflow to computationally design patient-specific titanium osteosynthesis plates for mandibular angle fractures. In this process, the plate stiffness is maximized while the mass is reduced. Two plate designs with different numbers of screw holes (implant #1 with four holes, implant #2 with eight holes) were generated with identical topology optimization settings and compared in a finite element model simulating various biomechanical masticatory loads. Differences in von Mises stresses in the implants and screws were observed. The load case of clenching the jaw on the opposite side of the fracture showed the highest stress distribution in implant #1 and higher peak stresses in implant #2. Stress concentrations were observed in sharp corners of the implant and could be reduced using local stress-based topology optimization. We conclude that the design process is an effective method to generate patientspecific implants.

2023, Lee, Seunghun S., Du, Xiaoyu, Smit, Thijs, Bissacco, Elisa G., Seiler, Daniel, de Wild, Michael, Ferguson, Stephen J.

Despite the recent advances in 3D-printing, it is often difficult to fabricate implants that optimally fit a defect size or shape. There are some approaches to resolve this issue, such as patient-specific implant/scaffold designs based on CT images of the patients, however, this process is labor-intensive and costly. Especially in developing countries, affordable treatment options are required, while still not excluding these patient groups from potential material and manufacturing advances. Here, a selective laser melting (SLM) 3D-printing strategy was used to fabricate a hierarchical, LEGO®-inspired Assemblable Titanium Scaffold (ATS) system, which can be manually assembled in any shape or size with ease. A surgeon can quickly create a scaffold that would fit to the defect right before the implantation during the surgery. Additionally, the direct inclusion of micro- and macroporous structures via 3D-printing, as well as a double acid-etched surface treatment (ST) in the ATS, ensure biocompatibility, sufficient nutrient flow, cell migration and enhanced osteogenesis. Three different structures were designed (non-porous:NP, semi-porous:SP, ultra-porous:UP), 3D-printed with the SLM technique and then surface treated for the ST groups. After analyzing characteristics of the ATS such as printing quality, surface roughness and interconnected porosity, mechanical testing and finite element analysis (FEA) demonstrated that individual and stacked ATS have sufficient mechanical properties to withstand loading in a physiological system. All ATS showed high cell viability, and the SP and UP groups demonstrated enhanced cell proliferation rates compared to the NP group. Furthermore, we also verified that cells were well-attached and spread on the porous structures and successful cell migration between the ATS units was seen in the case of assemblies. The UP and SP groups exhibited higher calcium deposition and RT-qPCR proved higher osteogenic gene expression compared to NP group. Finally, we demonstrate a number of possible medical applications that reveal the potential of the ATS through assembly. © 2023 The Authors

2021-08-07, Seiler, Daniel, Dalcanale, Federico, Sharma, Neha, Aghlmandi, Soheila, Zeilhofer, Hans-Florian, Thieringer, Florian, Honigmann, Philipp

Recent advancements in medical imaging, virtual surgical planning (VSP), and three-dimensional (3D) printing have potentially changed how today’s craniomaxillofacial surgeons use patient information for customized treatments. Over the years, polyetheretherketone (PEEK) has emerged as the biomaterial of choice to reconstruct craniofacial defects. With advancements in additive manufacturing (AM) systems, prospects for the point-of-care (POC) 3D printing of PEEK patient-specific implants (PSIs) have emerged. Consequently, investigating the clinical reliability of POC-manufactured PEEK implants has become a necessary endeavor. Therefore, this paper aims to provide a quantitative assessment of POC-manufactured, 3D-printed PEEK PSIs for cranial reconstruction through characterization of the geometrical, morphological, and biomechanical aspects of the in-hospital 3D-printed PEEK cranial implants. The study results revealed that the printed customized cranial implants had high dimensional accuracy and repeatability, displaying clinically acceptable morphologic similarity concerning fit and contours continuity. From a biomechanical standpoint, it was noticed that the tested implants had variable peak load values with discrete fracture patterns and failed at a mean (SD) peak load of 798.38 ± 211.45 N. In conclusion, the results of this preclinical study are in line with cranial implant expectations; however, specific attributes have scope for further improvements.

2023, Maevskaia, Ekaterina, Khera, Nupur, Ghayor, Chafik, Bhattacharya, Indranil, Guerrero, Julien, Nicholls, Flora, Waldvogel, Christian, Bärtschi, Ralph, Fritschi, Lea, Salamon, Dániel, Özcan, Mutlu, Malgaroli, Patrick, Seiler, Daniel, de Wild, Michael, Weber, Franz E.

2021, Simeunovic, Sven, Jung, Christiane, Mory, Dominik, Seiler, Daniel, de Wild, Michael

With the introduction of novel automated polishing methods, more attention has recently been paid to post-processing methods of metallic implants. One such method is the polishing process known as DryLyte®. The most significant difference to previous electropolishing methods is the use of solid organic polymer particles activated with sulfonic acid acting as the electrolyte. The solid particle electrolyte raises new question in terms of polishing results for small features as well as overall polishing quality of metallic surfaces. The aim of this study was to determine the quality of the polishing process for titanium rods with different initial surface roughness and with tapped holes in three different orientations (0°, 45°, 90°) by subjecting them to the DryLyte® polishing process for 30 min. In addition, the influence of the process parameters voltage and the anodic time T2 during the treatment on the resulting surface quality and the polishing efficiency was determined. In conclusion, the dry electro-chemical finishing process has shown great smoothing capabilities for titanium even with small, tapped holes. The Ra values were lowered significantly throughout all titanium samples after 30 min polishing time.