Abstract
Additive manufacturing processes are being increasingly explored by researchers around the world for a variety of medical applications, such as patient-specific models, implants, prosthetics, orthotics, drug delivery devices and tissue engineering scaffolds. The objective of this study is to obtain patient-specific models and implants from computed tomography (CT) scan data and validate the strength of implant using finite element analysis. For this purpose, CT scan data of two patients were obtained in digital imaging and communication in medicine (DICOM) file format. DICOM files were converted into computer-aided design models using open source image processing software DeVIDE and saved in stereolithography (STL) format. The STL files were cleaned and corrected in Materialise’s Magics RP software. These models were loaded into 3D systems’ Geomagic Freeform software to design the customized implants. Finite element analysis was performed to check the strength of cranium implant. Maximum von Mises stress and deformation were found well below the allowable limit of the material. Finally, physical models of cranium, pelvic bone and implant prototypes, namely cranial, ilium, pubic symphysis and ischium were manufactured in polyamide PA2200 on a selective laser sintering machine. A simulation-based surface roughness evaluation was also performed to assess the range of surface roughness values (Ra) of various implant prototypes. The Ra values for implants were observed between 14.4 and 34.67 µm.
Similar content being viewed by others
References
Bowers CA, McMullin JH, Brimley C, Etherington L, Siddiqi FA, Riva-Cambrin J (2015) Minimizing bone gaps when using custom pediatric cranial implants is associated with implant success. J Neurosurg Pediatr 16(4):439–444
Tuomi JT, Björkstrand RV, Pernu ML, Salmi MV, Huotilainen EI, Wolff JE, Vallittu PK, Mäkitie AA (2017) In vitro cytotoxicity and surface topography evaluation of additive manufacturing titanium implant materials. J Mater Sci–Mater Med 28(3):53
Ahn DG, Lee JY, Yang DY (2006) Rapid prototyping and reverse engineering application for orthopedic surgery planning. J Mech Sci Technol 20(01):19–128
Salmi M (2016) Possibilities of preoperative medical models made by 3D printing or additive manufacturing. J Med Eng. https://doi.org/10.1155/2016/6191526
Yap YL, Tan YSE, Tan HKJ, Peh ZK, Low XY, Yeong WY, Tan CSH, Laude A (2017) 3D printed bio-models for medical applications. Rapid Prototyp J 23(2):227–235
Thomas DJ, Azmi MM, Tehrani Z (2014) 3D additive manufacture of oral and maxillofacial surgical models for preoperative planning. Int J Adv Manuf Technol 71(9–12):1643–1651
Jelena M, Miroslav T (2007) Medical applications of rapid prototyping. Facta Univ Ser Mech Eng 5(01):79–85
Berce P, Chezan H and Balc N (2005) The application of rapid prototyping technologies for manufacturing the custom implants. In: Proceedings of the ESAFORM conference in Cluj-Napoca, Romania, pp 679–682
Sanadhya S, Vij N, Chaturvedi P, Tiwari S, Arora B, Modi YK (2015) Medical applications of additive manufacturing. Int J Sci Progress Res 12(1):11–17
Ngan E, Rebeyka I, Ross D et al (2006) The rapid prototyping of anatomic models in pulmonary atresia. J Thorac Cardiovasc Surg 132(02):264–269
Dhakshyani R, Nukman Y, Abu Osman AN, Vijay C (2011) Preliminary report: rapid prototyping models for dysplastic hip surgery. Central Eur J Med 6(03):266–270
Tuomi J, Paloheimo KS, Vehviläinen J, Björkstrand R, Salmi M, Huotilainen E, Kontio R, Rouse S, Gibson I, Mäkitie AA (2014) A novel classification and online platform for planning and documentation of medical applications of additive manufacturing. Surg Innov 21(6):553–559
Negi S, Dhiman S, Sharma RK (2014) Basics and applications of rapid prototyping medical models. Rapid Prototyp J 20(3):256–267
Modi YK, Agrawal S, de Beer DJ (2015) Direct generation of STL files from USGS DEM data for additive manufacturing of terrain models. Virtual Phys Prototyp 10(3):137–148
Agrawal S, de Beer DJ, Modi YK (2014) Conversion of a GIS surface data directly to a 3D STL part for terrain modeling. Rapid Prototyp J 20(5):422–430
Gibson I, Cheung LK, Chow SP et al (2006) The use of rapid prototyping to assist medical applications. Rapid Prototyp J 12(01):53–58
Ma D, Lin F, Chua CK (2001) Rapid prototyping applications in medicine Part 2: STL file generation and case studies. Int J Adv Manuf Technol 18:118–127
Winder J, Bibb R (2005) Medical rapid prototyping technologies: state of the art and current limitations for application in oral and maxillofacial surgery. J Oral Maxillofac Surg 63(07):1006–1015
Huotilainen E, Paloheimo M, Salmi M, Paloheimo KS, Björkstrand R, Tuomi J, Markkola A, Mäkitie A (2014) Imaging requirements for medical applications of additive manufacturing. Acta Radiol 55(1):78–85
Hieu LC, Zlatov N (2005) Medical rapid prototyping applications and methods. Assem Autom 25(4):284–292
Comaneanu RM, Tarcolea M, Vlasceanu D, Cotrut MC (2012) Virtual 3D reconstruction, diagnosis and surgical planning with Mimics software. Int J Nano Biomater 4(1):69–77
Singare S, Lian Q, Ping Wang W, Wang J, Liu Y, Li D, Lu B (2009) Rapid prototyping assisted surgery planning and custom implant design. Rapid Prototyp J 15(1):19–23
Mishra S (2016) Application of 3D printing in medicine. Indian Heart J 68:108–109
Sherekar RM, Pawar AN (2014) Application of biomodels for surgical planning by using rapid prototyping: a review and case studies. Int J Innov Res Adv Eng 1(6):263–271
Da Rosa EL, Oleskovicz CF, Aragao BN (2004) Rapid prototyping in maxillofacial surgery and traumatology: case report. Braz Dental J 15(03):243–247
Cohen A, Laviv A, Berman P, Nashef R, Abu TJ (2009) Mandibular reconstruction using stereolithographic 3-dimensional printing modeling technology. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 108(05):661–666
Bertol LS, Junior WK, Silva FP, Kopp CA (2010) Medical design: direct metal laser sintering of Ti6Al4V. Mater Des 31(08):3982–3988
Ciocca L, Crescenzio FD, Fantini M, Scotti R (2009) CAD/CAM and rapid prototyped scaffold construction for bone regenerative medicine and surgical transfer of virtual planning: a pilot study. Comput Med Imaging Gr 33(01):58–62
Robiony M, Costa F, Bazzocchi M, Bandera C, Felice M (2007) Virtual reality surgical planning for maxillofacial distraction osteogenesis: the role of reverse engineering rapid prototyping and cooperative work. J Oral Maxillofac Surg 65(06):1198–1208
Chua CK, Jacob GGK, Mei T (1997) Interface between CAD and rapid prototyping systems Part 1: a study of existing interface. Int J Adv Manuf Technol 13(8):566–570
Chua CK, Jacob GGK, Mei T (1997) Interface between CAD and rapid prototyping systems Part 2: LMI–an improved interface. Int J Adv Manuf Technol 13(8):571–576
Bailey M (2005) Layered manufacturing for scientific visualization. Commun ACM 48(6):42–48
Chandramohan D, Marimuthu K (2011) Rapid prototyping/rapid tooling—a Overview and its applications in orthopaedics. Int J Adv Eng Technol 2(04):435–448
Park JH, Olivares-Navarrete R, Baier RE, Meyer AE, Tannenbaum R, Boyan BD, Schwartz Z (2012) Effect of cleaning and sterilization on titanium implant surface properties and cellular response. Acta Biomater 8(5):1966–1975
Delashaw J, Persing J (1996) Repair of cranial defects. In: Youmans JR (ed) Neurological surgery vol 4, pp 1853–1864
Salmi M, Tuomi J, Paloheimo KS, Björkstrand R, Paloheimo M, Salo J, Kontio R, Mesimäki K, Mäkitie AA (2012) Patient-specific reconstruction with 3D modeling and DMLS additive manufacturing. Rapid Prototyp J 18(3):209–214
Sanan A (1997) Repairing holes in the head: a history of cranioplasty. Neurosurgery 40:588–603
D’Urso P, Earwaker W, Barker T, Redmond M, Thompson R, Effeney D, Tomlinson F (2000) Custom cranioplasty using stereolithography and acrylic. Br J Plast Surg 53:200–204
Saringer W, Nobauer-Huhmann I, Knosp E (2002) Cranioplasty with individual carbon fibre reinforced polymere (CFRP)medical grade implants based on CAD/CAM technique. Acta Neurochir 144:1193–1203
Foustanos AP, Anagnostopoulos D, Kotsianos G, Rapidis AD (1983) Cranioplasty: a review of 10 cases. J Maxillofac Surg 11:83–86
Gladstone HB, McDermott MW, Cooke DD (1995) Implants for cranioplasty. Otolaryngol Clin North Am 28:381–400
Dujovny M, Aviles A, Agner C, Fernandez P, Charbel F (1997) Cranioplasty: cosmetic or therapeutic? Surg Neurol 47:238–241
Girod S, Teschner M, Schrell U, Kevekordes B, Girod B (2001) Computer-aided 3D simulation and prediction of craniofacial surgery: a new approach. J Cranio-Maxillofac Surg 29:156–158
Material data sheet PA2200: EOS GmbH. http://www.shapeways.com/topics/udesign/materials/white_strong_flexible/pa2200_material_data_sheet_12_08_en__.pdf. Accessed on September 14, 2018
Bonda DJ, Manjila S, Selman WR, Dean D (2015) The recent revolution in the design and manufacture of cranial implants: modern advancements and future directions. Neurosurgery 77(5):814–824
E-Foundry, online learning resources in casting design and simulation by IIT Bombay, http://efoundry.iitb.ac.in/Academy/index.jsp
Lacefield William R (2007) Materials characteristics of uncoated/ceramic-coated implant materials. Adv Dent Res 13:21–26
Albrektsson T, Berglundh T, Lindhe J (2003) Osseointegration: historic background and current concepts. In: Clinical periodontology and implant dentistry, 4th ed., Blackwell Munksgaard, Oxford, pp 809–820
Acknowledgements
Authors gratefully acknowledge the help and support extended by the 3D Systems, USA, by providing access to trial versions of Geomagic Freeform and Geomagic Freeform Plus to design the patient-specific implants.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Additional information
Technical Editor: Fernando Antonio Forcellini.
Rights and permissions
About this article
Cite this article
Modi, Y.K., Sanadhya, S. Design and additive manufacturing of patient-specific cranial and pelvic bone implants from computed tomography data. J Braz. Soc. Mech. Sci. Eng. 40, 503 (2018). https://doi.org/10.1007/s40430-018-1425-9
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s40430-018-1425-9