Introduction to Medical 3D Printing and 3D Printers for Healthcare
Personalized, precision medicine is on the rise. New tools and advanced technologies are bringing doctors closer to patients, delivering treatments and devices customized to better serve each unique individual.
Advances in medical 3D printing technology have made tremendous contributions to fields throughout healthcare. For patients, new tools and therapeutic methods developed through 3D printing can bring new degrees of comfort and personalization to treatment. For doctors, this newly accessible technology allows for a greater understanding of complex cases and provides new tools that can ultimately result in a higher standard of care.
From surgical planning models to 3D printed vasculature and bioreactors, read on to discover five ways 3D printing in healthcare is taking off and why many medical professionals are excited about the potential of 3D printing in the medical field. Then, learn about the most popular 3D printers for healthcare and how to choose a solution for specific use cases.
Intro to Medical 3D Printing
Join Formlabs for this introduction to learn best practices for medical 3D printing and see the latest Formlabs Medical ecosystem, including multiple new medical-grade products!
Medical 3D Printing Applications
1. Patient-Specific Surgical Models
3D printed anatomical models from patient scan data are becoming increasingly useful tools in today’s practice of personalized, precision medicine. As cases become more complex and operating room efficiency becomes more important for routine cases, visual and tactile reference models can enhance understanding and communication within OR teams and with patients.
Healthcare professionals, hospitals, and research organizations across the globe are using 3D printed anatomical models as reference tools for preoperative planning, intraoperative visualization, and sizing or pre-fitting medical equipment for both routine and highly complex procedures that have been documented in hundreds of publications.
Producing patient-specific, tactile reference models from CT and MRI scans is affordable and straightforward with 3D printing. Peer-reviewed literature shows that they provide an additional view that helps physicians prepare better for surgeries, leading to drastically reduced time and cost in the operating room while improving patient satisfaction, lowering anxiety, and reducing recovery time.
Learning from preoperative models can influence the course of treatment as well. This was true of the experience of Dr. Michael Eames. After replicating a young patient’s forearm bones, Dr. Eames realized the injury differed from what he’d previously thought.
Dr. Eames settled on a new, soft-tissue procedure—one that was much less invasive, decreased rehabilitation time, and produced far less scarring. Using the printed bone replica, Dr. Eames walked the young patient and his parents through the procedure and obtained their consent.
The result? A surgery time of less than 30 minutes, instead of the initially planned surgery of three hours. This difference in surgery time led to an estimated $5,500 in cost avoidance for the hospital and meant the patient would need to spend less recovery time in postoperative care.
In the words of Dr. Alexis Dang, an orthopedic surgeon at the University of California San Francisco (UCSF) and the San Francisco Veteran's Affairs Medical Center: “Every one of our full-time orthopedic surgeons and nearly all of our part-time surgeons have utilized 3D printed models for care of patients at the San Francisco VA. We’ve all seen that 3D printing improves performance on game day.”
New biocompatible medical 3D printing materials have also enabled new surgical tools and techniques to be developed for the express purpose of further improving clinical experience during surgery. These include sterilizable fixation trays, contouring templates, and implant sizing models that can be used to size implants in the OR before the first cut, helping surgeons reduce time and increase accuracy of complex procedures.
Todd Goldstein, PhD, Instructor at the Feinstein Institute for Medical Research, is unequivocal in his estimation of how central 3D printing technology has become to his department. He estimates that if Northwell uses 3D printed models in 10-15% of its cases, it could save $1,750,000 a year.
“From medical device prototypes, complicated anatomical models for our children’s hospital, to creating training systems, and finally entering the dental clinic with implant surgical guides, [3D printing technology] has increased our capabilities and decreased our costs, all while allowing us to provide tools to treat patients that would be next to impossible to replicate without our go-to SLA 3D printer,” said Goldstein.
How to 3D Print Anatomical Models for Preoperative Planning and Enhanced Patient Consent
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2. New Medical Devices and Instruments
3D printing has virtually become a synonym for rapid prototyping. The ease of use and low cost of in-house 3D printing has also revolutionized product development and many manufacturers of medical tools have adopted the technology to produce brand new medical devices and surgical instruments.
Over 90 percent of the top 50 medical device companies use 3D printing to create accurate prototypes of medical devices, jigs and fixtures to simplify testing, as well as directly 3D printing medical devices.
In the words of Alex Drew, a mechanical project engineer at DJO Surgical, a global provider of medical devices. “Before DJO Surgical brought the [Formlabs 3D printer] on board, we relied almost exclusively on outside print vendors for prototypes. Today, we are running four Formlabs machines, and the impact has been profound. Our rate of 3D printing has doubled, cost has been reduced by 70 percent, and the level of print detail allows for clear communication of designs with orthopedic surgeons.”
3D printing can accelerate the design process by iterating complex designs in days instead of weeks. When Coalesce was tasked to create an inhaler device that can digitally assess an asthma patient’s inspiratory flow profile outsourcing to service providers would have resulted in lengthy lead times for each prototype. Design files would have had to be painstakingly refined through various iterations before being sent off-site to be built.
Instead, desktop SLA 3D printing allowed Coalesce to keep the entire prototyping process in-house. The prototypes were fit for use in clinical studies and looked just like a finished product. In fact, when they showcased the device, their clients mistook the prototype for the final product.
Overall, in-house represented an enormous 80–90% reduction in lead time for prototypes. What’s more, the parts took only eight hours to print and could be finished and painted within a few days, while the same process would have taken a week or two through an external contractor.
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3. Affordable Prostheses
Each year hundreds of thousands of people lose a limb, but only a subset of them get access to a prosthesis to recover its function.
Simple prostheses are only available in a few sizes, so patients must make do with what fits best, while custom-fit bionic devices designed to mimic the motions and grips of real limbs that rely on muscles in a person’s residual limb to control their functions are so expensive that they’re only accessible to patients with the best health insurance in developed countries. This particularly affects prostheses for children. As children grow and get into adventures, they inevitably outgrow their prostheses and require expensive repairs.
The difficulty is the lack of manufacturing processes that can produce custom parts affordably. But increasingly, prosthetists can take advantage of 3D printing’s much-noted design freedom to mitigate these high financial barriers to treatment.
Initiatives such as e-NABLE allow entire communities around the world to form around 3D printed prostheses. They’re driving an independent movement in prosthetic production by sharing information and open-source designs freely online, so patients can get a custom-designed prosthesis that is well-adapted for them for as little as $50.
Other inventors like Lyman Connor, take this one step further. With only a small facility of four desktop 3D printers, Lyman was able to complete and fit his first production prostheses. His ultimate objective? To create a customizable, fully bionic hand to be sold at a fraction of the current tens of thousands of dollars retail price tag for such advanced prostheses.
Elsewhere, researchers at MIT have also identified 3D printing as an optimal means of producing more comfortable prosthesis sockets.
Needless to say, the low cost of producing these prostheses, along with the freedom that comes with custom designs, has proved revelatory. Prostheses made with 3D printing can be turned around in as little as two weeks and then can be trialed and maintained at a much lower cost than their traditional counterparts.
As the costs continue to decrease and material properties improve, 3D printing will undoubtedly play an increasing role in this department of healthcare.
4. Corrective Insoles and Orthoses
Many of the same high financial barriers to treatment seen in prosthetics are also native to fields such as orthoses and insoles. Like many other patient-specific medical devices, custom orthoses are often inaccessible due to their high cost and take weeks or months to get manufactured. With 3D printing, that no longer needs to be the case.
The example of Matej and his son Nik springs to our mind. Born prematurely in 2011, difficulties during childbirth caused Nik to have cerebral palsy, a condition that affects almost twenty million people worldwide. Matej was inspired by his son’s unwavering will to transcend the limitations of his condition, but he was faced with a choice between a standard, pre-made orthosis that would have been inadequate and uncomfortable for his son, or an expensive custom solution that would take weeks or months to be delivered, only to be made quickly obsolete by a growing child.
He decided to take matters into his own hands and sought out new solutions to achieve this goal. With the freedom offered by digital technologies including 3D scanning and 3D printing, Matej and Nik's physical therapists were able to experiment liberally and develop an entirely new innovative workflow for ankle foot orthoses (AFOs).
The resulting custom-made, 3D printed orthosis provided Nik with support, comfort, and correction precisely where it was needed, helping Nik to at last take his first independent steps. This custom orthotic device reprised the highly-adjusted finish of high-end orthotics, at a fraction of the price, and with no further adjustments required.
Professionals around the world are using 3D printing to reinvent patient- and customer-specific insoles and orthoses, as well as a range of other tools for improving physical therapy. In the past, the course of physical therapy using customized tools had proved difficult. Patients often faced long wait times and finished pieces that led to discomfort. 3D printing is on the path to change this status quo. 3D printed insoles and orthoses have proved to be a better fit, led to better therapeutic outcomes, and provided a greater degree of comfort and use for patients.
5. Bioprinting, Tissue Engineering, 3D Printed Organs and Beyond
The conventional means of treating patients with grave organ failures currently involve using autografts, a graft of tissue from one point to another of the same individual's body, or organ transplants from a donor. Researchers in the fields of bioprinting and tissue engineering are hoping to soon change that and be able to create tissues, blood vessels, and organs on demand.
3D bioprinting refers to the use of additive manufacturing processes to deposit materials known as bioinks to create tissue-like structures that can be used in medical fields. Tissue engineering refers to the various evolving technologies, including bioprinting, to grow replacement tissues and organs in the laboratory for use in treating injury and disease.
With the help of high-precision 3D printing, researchers like Dr. Sam Pashneh-Tala from the University of Sheffield have brought new possibilities to tissue engineering.
To direct cellular growth so that the required tissue is formed, Dr. Pashneh-Tala grows living cells on a scaffold in the lab, that provides a template of the required shape, size, and geometry. For example, a tubular structure is needed to create a blood vessel for a cardiovascular patient. The cells will multiply and cover the scaffold, taking on its shape. The scaffold then gradually breaks down, leaving the living cells arranged into the shape of the target tissue, that is cultured in a bioreactor, a chamber that contains the developing tissue and can reproduce the internal environment of the body, to acquire mechanical and biological performance of organic tissue.
This will empower scientists to create patient-specific vascular graft designs, improved surgical options and provides a unique testing platform for new vascular medical devices for those suffering from cardiovascular disease, that is currently the number one cause of death worldwide. Following that, the ultimate goal is to create blood vessels that are ready to be implanted into the patients. As tissue engineering uses cells that are taken from the patient requiring the treatment, it eliminates the possibility of rejection by the immune system—a major issue in conventional organ transplant procedures today.
3D printing has proven capable of responding to the challenges of producing synthetic blood vessels by solving the difficulties of recreating the precise shapes, sizes and geometries of the vessel required. Being able to closely match printed solutions to the specific needs of patients has proved revelatory.
In Dr. Pashneh-Tala’s words: “[Creating blood vessels through 3D printing] offers the potential for improved surgical options and even patient-matched blood vessel designs. Without access to high-precision, affordable 3D printing, creating these shapes would not be possible.”
We have seen exciting breakthroughs in biological materials suitable for use in 3D printers. Scientists are developing new hydrogel materials that have the same consistency as organ tissue that can be found in the human brain and lungs and can be compatible with various 3D printing processes. Scientists are hoping to be able to implant them onto an organ, to act as ‘scaffold’ onto which cells would be encouraged to grow.
While bioprinting fully functional internal organs such as hearts, kidneys, and livers still sounds futuristic, advancements with hybrid 3D printing techniques are happening at a very rapid rate.
Sooner or later, building biological matter in laboratory printers is expected to lead to the ability to generate new, fully functional 3D printed organs. In April 2019, scientists created the first 3D heart using a patient's biological materials at Tel Aviv University. The tiny replica was created using the patient’s own biological materials, engendering a complete match of the patient’s immunological, cellular, biochemical, and anatomical profile.
"At this stage, our 3D heart is small, the size of a rabbit's heart, but larger human hearts require the same technology," said Professor Tal Dvir.
3D Printers for Healthcare
When it comes to 3D printers for healthcare, not all methods are created equal. It is important to choose the right printing technology for specific use cases.
The most popular medical 3D printing technologies include stereolithography (SLA), selective laser sintering (SLS), and fused deposition modeling (FDM) for plastic parts, and direct metal laser sintering (DMLS) and selective laser melting (SLM) for metals.
SLA 3D printers use a laser to cure liquid resin into hardened plastic in a process called photopolymerization. SLA is one of the most popular processes among medical professionals due to its high resolution, precision, and material versatility.
Advantages of SLA
SLA parts have the highest resolution and accuracy, the clearest details, and the smoothest surface finish of all plastic 3D printing technologies. The main benefit of SLA, however, lies in its versatility. SLA resin formulations offer a wide range of optical, mechanical, and thermal properties to match those of standard, engineering, and industrial thermoplastics.
SLA is a great option for highly detailed anatomical models, medical device prototypes requiring tight tolerances and smooth surfaces, as well as molds, tooling, patterns, and functional end-use parts. SLA also offers the widest selection of biocompatible materials for dental and medical applications. With Draft Resin, the Formlabs SLA printers are also the fastest options for 3D printing large prototypes, up to 10X faster than FDM.
Disadvantages of SLA
SLA’s wide versatility comes with a slightly higher price tag than FDM, but it is still more affordable than all other 3D printing processes. SLA resin parts also require post-processing after printing, which includes washing the parts and post-curing.
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Selective Laser Sintering (SLS)
SLS 3D printers use a high-powered laser to fuse small particles of polymer powder. The unfused powder supports the part during printing and eliminates the need for dedicated support structures, making SLS a particularly effective choice for complex mechanical parts.
Its ability to produce parts with excellent mechanical capabilities makes SLS the most common polymer additive manufacturing technology for industrial applications. Depending on the material, SLS nylon parts may also be biocompatible and sterilizable.
Advantages of SLS
Since SLS printing doesn’t require dedicated support structures, it’s ideal for complex geometries, including interior features, undercuts, thin walls, and negative features. Parts produced with SLS printing have excellent mechanical characteristics, with strength resembling that of injection-molded parts.
The most common material for SLS is nylon, a popular engineering thermoplastic with excellent mechanical properties. Nylon is lightweight, strong, and flexible, as well as stable against impact, chemicals, heat, UV light, water, and dirt. 3D printed nylon parts can also be biocompatible and not sensitizing, which means that they are ready to wear and safe to use in many contexts.
The combination of low cost per part, high productivity, established materials, and biocompatibility makes SLS a popular choice among medical device developers for functional prototyping, and a cost-effective alternative to injection molding for limited-run or bridge manufacturing.
Disadvantages of SLS
SLS 3D printers have a higher entry price than FDM or SLA technologies. While nylon is a versatile material, material selection for SLS is also more limited than for FDM and SLA. Parts come out of the printer with a slightly rough surface finish and require media blasting for a smooth finish.
Fused Deposition Modeling (FDM)
FDM, also known as fused filament fabrication (FFF), is a printing method that builds parts by melting and extruding thermoplastic filament, which a printer nozzle deposits layer by layer in the build area.
FDM is the most widely used form of 3D printing at the consumer level, fueled by the emergence of hobbyist 3D printers. Industrial FDM printers are, however, also popular with professionals.
Advantages of FDM
FDM works with an array of standard thermoplastics, such as ABS, PLA, and their various blends. This results in a low price of entry and materials. FDM best suits basic proof-of-concept models and the low-cost prototyping of simpler parts. Some FDM materials are also biocompatible.
Disadvantages of FDM
FDM has the lowest resolution and accuracy when compared to other 3D printing technologies for plastics such as SLA or SLS, which means that it is not the best option for printing complex designs or parts with intricate features, such as anatomical models. Higher-quality finishes require labor-intensive and lengthy chemical and mechanical polishing processes. Some industrial FDM 3D printers use soluble supports to mitigate some of these issues and offer a wider range of engineering thermoplastics, but they also come at a steep price. When creating large parts, FDM printing also tends to be slower than SLA or SLS.
Direct Metal Laser Sintering (DMLS) and Selective Laser Melting (SLM)
Direct metal laser sintering (DMLS) and selective laser melting (SLM) 3D printers work similarly to SLS printers, but fuse metal powder particles together layer by layer using a laser instead of polymers.
DMLS and SLM 3D printers can create strong, accurate, and complex metal products, making this process ideal for a variety of medical applications.
Advantages of DMLS and SLM
The biggest advantage of these processes is obviously the materials, as DMLS and SLM 3D printers are capable of producing high-performing end-use medical devices and components from metal. These processes can reproduce complex geometries and the finished products are strong, durable, and biocompatible. They can be used to manufacture generic implants (hips, knees, spine implants, etc.), custom implants for cancer or trauma treatment, dentures, as well as medical and orthopedic technology products.
Disadvantages of DMLS and SLM
While the prices of metal 3D printers have also begun to decrease, with costs ranging from $200,000 to $1 million+, these systems are still not accessible to most businesses. Metal 3D printing processes also have an involved and complex workflow.
Alternatively, SLA 3D printing is well-suited for casting workflows that produce metal parts at a lower cost, with greater design freedom, and in less time than traditional methods.
Compare 3D Printers for Healthcare
The table below highlights the 3D printing technologies that are best equipped to handle the different medical 3D printing applications.
|Stereolithography (SLA)||Selective Laser Sintering (SLS)||Fused Deposition Modeling (FDM)||Metal 3D Printing (DMLS, SLM)|
|Build volume||Up to 300 x 335 x 200 mm (desktop and benchtop 3D printers)||Up to 165 x 165 x 300 mm (benchtop industrial 3D printers)||Up to 300 x 300 x 600 mm (desktop and benchtop 3D printers)||Up to 400 x 400 x 400 mm (large industrial DMLS/SLM)|
|Price range||Starting from $3,750||Starting from $18,500||Starting from $2,500||Starting from $200,000|
|Materials||Varieties of resin (thermosetting plastics). Standard, engineering (ABS-like, PP-like, silicone-like, flexible, heat-resistant, rigid), castable, dental, and medical (biocompatible).||Engineering thermoplastics, typically nylon and its composites (nylon is biocompatible + compatible with sterilization).||Standard thermoplastics, such as ABS, PLA, and their various blends.||Stainless steel, tool steel, titanium, cobalt chrome, and aluminum.|
|Ideal applications||Anatomical models, highly detailed prototypes requiring tight tolerances and smooth surfaces; molds, tooling, patterns, functional parts, dental and medical end-use devices.||Complex geometries, functional prototypes, short-run or bridge manufacturing of medical devices, including orthotics and prosthetics.||Basic proof-of-concept models, low-cost prototyping of simple parts.||Strong, durable parts with complex geometries, implants, dentures, medical and orthopedic components out of metal.|
Get Started With Medical 3D Printing
Precise and affordable medical 3D printing processes are democratizing access to the technology, empowering healthcare professionals to develop new clinical solutions and quickly manufacture custom devices, and allowing physicians to deliver new treatments across the globe. As medical 3D printing technologies and materials continue to improve, they will pave the path for personalized care and high-impact medical applications.
Every medical facility should have access to the latest tools to improve care and provide the best patient experience. Get started now or expand your in-house production with Formlabs, a proven, cutting-edge partner in medical 3D printing.
Reach out to our medical experts to learn more about how in-house 3D printing can provide better treatment and supplement your current medical device design and manufacturing workflow.