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Implementation of Computer-Assisted Design, Analysis, and Additive Manufactured Customized Mandibular Implants

Original Article
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Abstract

Additive manufacturing (AM) in medical applications has been gradually attracting interest due to its customizability, cost-effective production, and fast delivery. For the past decade, the majority of implants have been traditionally produced using casting, forging, machining, and powder metallurgy techniques. These traditional implants require manual bending before surgery using trial and error to custom fit the patient’s bone contour. Any mismatch between the implant and the bone contours would result in implant failure and physiological stress and pain to the patient. The objective of this study is to present an integrated framework model to design, analyze, validate, and develop a new customized mandibular implant from the computed tomography scan, that can precisely fit patients’ bone contours and can effectively withstand chewing load conditions. In this study, a customized implant is designed based on a patient’s Digital Imaging and Communications in Medicine files. A three dimensional finite element model of the designed implant is generated to simulate the mechanical behavior based on the chewing load conditions. Finally, the designed implant is fabricated using electron beam melting and AM technology from Ti6Al4 V ELI [Titanium-6 Aluminium-4 Vanadium (Wt%) extra low interstitials] powder. The finite element analysis results revealed that the designed reconstruction plate model can withstand the maximum stresses (168.79 MPa), which is significantly less than the determined failure limit of the implant material. Moreover, the location of the maximum strain on the reconstruction plate is away from the screw holes, thus providing better stability and fewer chances of the implant screw loosening. The study reveals that the newly designed reconstruction plate can be recommended in the repair of mandibular bone defects, which can effectively improve stability and can guarantee a perfect fit.

Keywords

Implant Design Finite element analysis (FEA) Additive manufacturing (AM) Mandibular reconstruction Titanium alloy 

Notes

Acknowledgements

The author is grateful to the Deanship of Scientific Research, king Saud University for funding through Vice Deanship of Scientific Research Chairs. The author would also like to thank Dr. Saqib Anwar for his advice and assistance during the research work.

Compliance with Ethical Standards

Conflict of interest

The authors declare that there is no conflict of interest.

References

  1. 1.
    UW Medicine. (2015). Facial and mandibular fractures. Facial and Mandibular Fractures. Retrieved from http://www.rad.washington.edu/academics/academic-sections/msk/teaching-materials/online-musculoskeletal-radiology-book/facial-and-mandibular-fractures.
  2. 2.
    Peterson’s principles of oral and maxillofacial surgery. (2012). PMPH-USA.Google Scholar
  3. 3.
    Shah, J. (2013). Cancer of the head and neck, mandible reconstruction (Vol. 19). Cancer of the head and neck.Google Scholar
  4. 4.
    Mazzoli, A., Germani, M., & Raffaeli, R. (2009). Direct fabrication through electron beam melting technology of custom cranial implants designed in a PHANToM-based haptic environment. Materials and Design, 30, 3186–3192.  https://doi.org/10.1016/j.matdes.2008.11.013.CrossRefGoogle Scholar
  5. 5.
    Hermawan, H., Ramdan, D., & P. Djuansjah, J. R. (2011). Metals for biomedical applications. In R. Fazel (Ed.), Biomedical engineeringfrom theory to applications. InTech. Retrieved from http://www.intechopen.com/books/biomedical-engineering-from-theory-to-applications/metals-for-biomedical-applications.
  6. 6.
    Samman, N., Luk, W. K., Chow, T. W., Cheung, L. K., Tideman, H., & Clark, R. K. (1999). Custom-made titanium mandibular reconstruction tray. Australian Dental Journal, 44(3), 195–199.  https://doi.org/10.1111/j.1834-7819.1999.tb00221.x.CrossRefGoogle Scholar
  7. 7.
    Seol, G.-J., Jeon, E.-G., Lee, J.-S., Choi, S.-Y., Kim, J.-W., Kwon, T.-G., et al. (2014). Reconstruction plates used in the surgery for mandibular discontinuity defect. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 40(6), 266–271.  https://doi.org/10.5125/jkaoms.2014.40.6.266.CrossRefGoogle Scholar
  8. 8.
    Bioimplants. (2013). Scitechstory. Tracking the impact of science and technology. Body implants. http://scitechstory.com/impact-areas/body-implants/. Scitechstory.
  9. 9.
    Wood, S. D., Blackmore, M. L., & Todd, I. (2014). Additive layer manufacturing method (Patent no: 20140367367). United States. Retrieved from http://www.freepatentsonline.com/y2014/0367367.html.
  10. 10.
    Singare, S., Dichen, L., Bingheng, L., Zhenyu, G., & Yaxiong, L. (2005). Customized design and manufacturing of chin implant based on rapid prototyping. Rapid Prototyping Journal, 11(2), 113–118.  https://doi.org/10.1108/13552540510589485.CrossRefGoogle Scholar
  11. 11.
    Jardini, A. L., Larosa, M. A., Filho, R. M., de Zavaglia, C. A., Bernardes, L. F., Lambert, C. S., et al. (2014). Cranial reconstruction: 3D biomodel and custom-built implant created using additive manufacturing. Journal of Cranio-Maxillofacial Surgery, 42(8), 1877–1884.  https://doi.org/10.1016/j.jcms.2014.07.006.CrossRefGoogle Scholar
  12. 12.
    Niinomi, M. (2008). Mechanical biocompatibilities of titanium alloys for biomedical applications. Journal of the Mechanical Behavior of Biomedical Materials, 1(1), 30–42.  https://doi.org/10.1016/j.jmbbm.2007.07.001.CrossRefGoogle Scholar
  13. 13.
    Shrivastava, S. (2004). Medical device materials: Proceedings from the Materials & Processes for Medical Devices Conference 2003, 810 September 2003, Anaheim, California: ASM International.Google Scholar
  14. 14.
    Oshida, Y., Tuna, E. B., Aktören, O., & Gençay, K. (2010). Dental implant systems. International Journal of Molecular Sciences, 11(4), 1580–1678.  https://doi.org/10.3390/ijms11041580.CrossRefGoogle Scholar
  15. 15.
    Harrysson, O. L., Cansizoglu, O., Marcellin-Little, D. J., Cormier, D. R., & West, H. A., II. (2008). Direct metal fabrication of titanium implants with tailored materials and mechanical properties using electron beam melting technology. Materials Science and Engineering C, 28, 366–373.CrossRefGoogle Scholar
  16. 16.
    Parthasarathy, J. (2014). 3D modeling, custom implants and its future perspectives in craniofacial surgery. Annals of Maxillofacial Surgery, 4(1), 9–18.  https://doi.org/10.4103/2231-0746.133065.CrossRefGoogle Scholar
  17. 17.
    Dérand, P., Rännar, L.-E., & Hirsch, J.-M. (2012). Imaging, virtual planning, design, and production of patient-specific implants and clinical validation in craniomaxillofacial surgery. Craniomaxillofacial Trauma and Reconstruction, 05(03), 137–144.  https://doi.org/10.1055/s-0032-1313357.CrossRefGoogle Scholar
  18. 18.
    Harrysson, O., Deaton, B., & Bardin, J. (2006). Evaluation of titanium implant components directly fabricated through electron beam melting technology (pp. 15–20). Presented at the Proc. Conf. Mat. Proc. Med. Dev.Google Scholar
  19. 19.
    Cronskär, Marie, Bäckström, Mikael, & Rännar, Lars-Erik. (2013). Production of customized hip stem prostheses—a comparison between conventional machining and electron beam melting (EBM). Rapid Prototyping Journal, 19(5), 365–372.  https://doi.org/10.1108/RPJ-07-2011-0067.CrossRefGoogle Scholar
  20. 20.
    Orthopaedic implants, Arcam, A. (2015). Ebm for orthopaedic implants. Arcam AB. Retrieved April 21, 2015, from http://www.arcam.com/solutions/orthopedic-implants/.
  21. 21.
    Harrysson, O. L., D. Cormier, Marcellin-Little, D. & Jajal, K. (2003). Direct fabrication of metal orthopedic implants using electron beam melting technology (pp. 439–446). Presented at the Solid Freeform Fabrication Symposium Proceedings, Austin,Texas.Google Scholar
  22. 22.
    FDA Clearance, Arcam. (2015). Arcam announces FDA clearance of implants produced with Additive Manufacturing. Arcam AB. Retrieved March 31, 2015, from http://www.arcam.com/arcam-announces-fda-clearance-of-implants-produced-with-additive-manufacturing/.
  23. 23.
    Moiduddin, K., Al-Ahmari, A., Kindi, M. A., Nasr, E. S. A., Mohammad, A., & Ramalingam, S. (n.d.). Customized porous implants by additive manufacturing for zygomatic reconstruction. Biocybernetics and Biomedical Engineering.  https://doi.org/10.1016/j.bbe.2016.07.005.
  24. 24.
    Merdji, A., Bachir Bouiadjra, B., Achour, T., Serier, B., Ould Chikh, B., & Feng, Z. O. (2010). Stress analysis in dental prosthesis. Computational Materials Science, 49(1), 126–133.  https://doi.org/10.1016/j.commatsci.2010.04.035.CrossRefGoogle Scholar
  25. 25.
    Jędrusik-Pawłowska, M., Kromka-Szydek, M., Katra, M., & Niedzielska, I. (2013). Mandibular reconstruction–biomechanical strength analysis (FEM) based on a retrospective clinical analysis of selected patients. Acta of Bioengineering and Biomechanics/Wrocław University of Technology, 15(2), 23–31.Google Scholar
  26. 26.
    El-Anwar, M. I., & Mohammed, M. S. (2014). Comparison between two low profile attachments for implant mandibular overdentures. Journal of Genetic Engineering and Biotechnology, 12(1), 45–53.  https://doi.org/10.1016/j.jgeb.2014.03.006.CrossRefGoogle Scholar
  27. 27.
    Arcam. (2014). Ti6Al4 V ELI Titanium Alloy. Ti6Al4 V ELI Titanium Alloy. Retrieved from http://www.arcam.com/wp-content/uploads/Arcam-Ti6Al4V-ELI-Titanium-Alloy.pdf.
  28. 28.
    Szucs, A., Bujtár, P., Sándor, G. K. B., & Barabás, J. (2010). Finite element analysis of the human mandible to assess the effect of removing an impacted third molar. Journal (Canadian Dental Association), 76, a72.Google Scholar
  29. 29.
    Simonovics, J., Bujtár, P., & Váradi, K. (2013). Effect of preloading on lower jaw implant. Biomechanica Hungarica.  https://doi.org/10.17489/biohun/2013/1/03.Google Scholar
  30. 30.
    Perren, S. M. (2002). Evolution of the internal fixation of long bone fractures: The scientific basis of biological internal fixation: Choosing a new balance between stability and biology. The Journal of Bone and Joint Surgery, 84(8), 1093–1110.  https://doi.org/10.1302/0301-620x.84b8.13752.CrossRefGoogle Scholar
  31. 31.
    Singh, R., Singh, S., & Kapoor, P. (2014). Development of biomedical implant (Hip Joint) by combining fused deposition modelling and investment casting. In S. S. Khangura, P. Singh, H. Singh, & G. S. Brar (Eds.), Proceedings of the International Conference on Research and Innovations in Mechanical Engineering (pp. 225–232). India: Springer. Retrieved from http://link.springer.com/chapter/10.1007/978-81-322-1859-3_20.
  32. 32.
    Harrysson, O. L., & Cormier, D. R. (2003). Direct fabrication of custom orthopaedic implants using electron beam melting technology (Vol. 9). Chapter. Advanced Manufacturing Technology for Medicine Applications, pp. 191–206.  https://doi.org/10.1002/0470033983.ch9.
  33. 33.
    Park, J. H., Olivares-Navarrete, R., Baier, R. E., Meyer, A. E., Tannenbaum, R., Boyan, B. D., et al. (2012). Effect of cleaning and sterilization on titanium implant surface properties and cellular response. Acta Biomaterialia, 8(5), 1966–1975.  https://doi.org/10.1016/j.actbio.2011.11.026.CrossRefGoogle Scholar

Copyright information

© Taiwanese Society of Biomedical Engineering 2018

Authors and Affiliations

  1. 1.Princess Fatima Alnijiris’s Research Chair for Advanced Manufacturing Technology (FARCAMT Chair), Advanced Manufacturing InstituteKing Saud UniversityRiyadhSaudi Arabia

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