Patient-specific reconstruction with 3D modeling and DMLS additive manufacturing

摘要

Purpose - The purpose of this paper is to develop a workflow for 3D modeling and additive manufacturing (AM) of patient-specific medical implants. The comprehensive workflow consists of four steps: medical imaging; 3D modelling; additive manufacturing; and clinical application. Implants are used to reconstruct bone damage or defects caused by trauma or disease. Traditionally, implants have been manually bent and shaped, either preoperatively or intraoperatively, with the help of anatomic solid models. The proposed workflow obviates the manual procedure and may result in more accurate and cost-effective implants. Design/methodology/approach - A patient-specific implant was digitally designed to reconstruct a facial bone defect. Several test pieces were additive manufactured from stainless steel and titanium by direct metal laser sintering (DMLS) technology. An additive manufactured titanium EOS Titanium Ti64 ELI reconstruction plate was successfully implanted onto the patient's injured orbital wall. Findings - This method enables exact fitting of implants to surrounding tissues. Creating implants before surgery improves accuracy, may reduce operation time and decrease patient morbidity, hence improving quality of surgery. By using AM methods it is possible to manufacture a volumetric net structure, which also allows cells and tissues to grow through it to and from surrounding tissues. The net is created from surface and its thickness and hole size are adjustable. The implant can be designed so that its mass is low and therefore sensitivity to hot and cold temperatures is reduced. Originality/value - The paper describes a novel technique to create patient-specific reconstruction implants for facial bony defects.