3D printed prosthetic jaw!

http://www.abc.net.au/news/2015-06-20/melbourne-man-receives-titanium-3d-printed-prosthetic-jaw/6536788

3D printed titanium prosthetic jaw joint bone

Titanium, 3D printed prosthetic jaw implanted in Melbourne man in Australian first surgery

Surgeons have successfully implanted a titanium 3D-printed prosthetic jaw in a Melbourne man in an Australian-first operation.

It is hoped the success of the locally designed and tested part will lead to high-tech export opportunities.

The patient, 32-year-old psychologist Richard Stratton, was missing part of his jawbone including the left condyle, the joint to the skull.

He believed part of his jaw never grew properly after he received a bad knock to the jaw during childhood.

In the past few years, he has suffered increasing pain while chewing or moving his jaw and he has not been able to fully open his mouth.

Oral and maxillofacial surgeon Dr George Dimitroulis designed a prototype prosthesis that was refined and tested by experts at Melbourne University’s mechanical engineering department.

Dr Dimitroulis said that while there had been a handful of 3D-printed jaw operations worldwide, he was not aware of any that incorporated a titanium part and a 3D-printed plastic jaw joint.

“In terms of joint replacement specifically, what we call the TMJ – the temporomandibular joint – we suspect that this may be the first 3D-printed jaw joint in the world,” he said.

It was designed to protect the skull from a rubbing metal joint which would wear and erode into the cranial cavity.

“The beauty of this particular joint itself is that it was designed in Australia and manufactured [by an Australian firm] … and not just manufactured in the common sense, but 3D printed,” he said.

“It really makes the fit truly patient-fitted, truly customised, as opposed to ‘we’re close enough’ and it’s something that I think will become the norm in the future as technology [becomes] cheaper.”

Dr Dimitroulis said it was a great example of “smart Australia” and 3D printing would lead to “revolutionary” changes in jaw prosthesis surgery.

Richard Stratton before and after surgery

Sunrise of a whole new industry

Before the operation, Mr Stratton said he was excited to be “patient X on the Australian joint” and joked that he had put in an order for a “Brad Pitt” jaw.

He hoped many more patients would benefit from having their replacement joints 3D printed and personalised to them.

“It sounds a bit [like] science fiction … I don’t really understand 3D printing that much but it’s exciting,” he said.

“They have a 3D model of my skull and the fact that they’ve made the joint to fit that perfectly, I feel a lot safer in knowing that it’s not just a factory made, off-the-shelf joint.

“Hopefully all the time they’ve spent on their computers and designing my new jaw, hopefully that will make the short-term recovery better for me and also the longer-term outcome is that it will last a lot longer and hopefully work a lot more efficiently.”

Port Melbourne firm 3D Medical used powdered titanium that was heated and fused one layer at a time to print the prosthesis.

Technicians also used CT scan images to print a 3D plastic model of Mr Stratton’s skull and then refined the titanium part to provide a perfect fit.

While this part was manufactured in New Zealand, future parts will be locally produced.

Company chairman Dr Nigel Finch said about 30 versions of the part had to be printed during the customisation process but he predicted that any future adaptation would take much less time.

“It really is the sunrise of a whole new industry,” he said.

“I think that greater support, better understanding by the regulators and better understanding by hospitals and the healthcare system, will see the adoption of 3D medical implants and other technologies starting to become mainstream.

“Most of the implants that patients receive now are generic sizing, and of course nobody really is small, medium or large.”

New 3D printed titanium jaw part for Richard Stratton attached to a 3D printed version of his skull.

On-demand printing the way of the future

Dr Finch said the cost of the technology had come down to a “truly competitive” price point compared with conventional manufacturing of parts.

The use of highly-automated machines also eliminated much of the labour cost that had traditionally made Australian manufacturing uncompetitive.

“One of the things that’s really personally exciting for me is this whole idea about bringing a manufacturing base back to Australia and focusing around the digital aspect of it,” Dr Finch said.

“We currently have a model where the hospitals are carrying inventory of generic implants, and this is very costly on the hospital’s balance sheets, very costly on the healthcare system and I can see a future where we’re manufacturing parts on an as-required basis so we’re printing on demand.”

Melbourne University biomedical engineer, Dr David Ackland, said it was “quite unusual and unexpected” to be approached by an oral and maxillofacial surgeon with a design prototype as computer simulations had mostly been performed on knee, shoulder and hip joints in the past.

“It’s very very important before you put an implant into the human body that you know that it’s going to be able to withstand the normal forces, the internal forces in the human body,” he said.

“We performed computer simulations [on the jaw prosthesis] to determine the joint loading and the loading on the implant and the screws, which of course the prosthesis would be subject to during biting and chewing.

“So we’ve done quite a comprehensive set of musculoskeletal modelling studies … to make sure that it doesn’t fail.”

Dr Ackland said 3D printing technology was still in its infancy so there were not a lot of customised components being developed or placed inside the human body.

“It’s incredibly exciting and there’s enormous potential for use of 3D printing technology to develop customised, patient-specific joint replacements and prosthetic components for a range of patients with different musculoskeletal disorders,” he said.

‘The excitement was unbearable’

Just after completing the five-hour operation, Dr Dimitroulis said he was “very proud” that three years of hard work had paid off.

“The excitement was unbearable I think, just at the last minute we thought it just wasn’t going to fit in but it just slid in nicely,” he said.

Dr Dimitroulis said patients with severe osteoarthritis of the jaw would benefit from the new implant and two patients had already signed on to receive one.

Mr Stratton said he found the pain and swelling confronting in the first few days after surgery but one month later and he was already able to open his mouth wider than before the surgery.

“The physiotherapist is really impressed and she works with these joints every day, and she says the range of movement … is a lot more than other patients that she’s worked with,” he said.

As for the “Brad Pitt” look, Mr Stratton has been clearly amused by his new chiselled jawline.

“People have have been really politely saying that it’s a huge improvement,” he laughed.

“I didn’t notice that I didn’t have a chin before, but people are now saying, ‘Wow, you’ve got such a great chin!'”

X-ray front shot

abc.net.au

by Stephanie Ferrier | 22 Jun 2015, 4:45am

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3D printed titanium jaw implant for a sea turtle

http://3dprint.com/65476/sea-turtle-3d-printed-jaw/

turtleani

Turkish Turtle Receives 3D Printed Titanium Jaw

3DPrint.com head office is stationed in sunny Florida, I’m here in northeast Ohio, where we’re still waiting in mid-May for spring to settle in for sure. Back in February, I skipped out on Cleveland’s -20°F cold front and hopped a plane down to visit a friend in south Florida for a week. As my fiancé and family continued to freeze, my friend asked if I wanted to go down to the ocean one evening, so we could see if the sea turtles were coming in. Aside from my obvious cheer at weather that was actually a ‘real feel’ of a solid 100° temperature difference (it’s a different world, going from -20° to 80° in one day) and frolicking beachside, I was so excited to go see the turtles–few animals in nature are quite as impressive, long-lived, and stately as the sea turtle.

Seven species of sea turtle currently live around the world, and four are classified as either “endangered” or “critically endangered,” with another two being “vulnerable” to joining their ranks. One of the endangered species, the Caretta caretta or loggerhead sea turtle, has a lifespan of up to almost 70 years and can be found in the Atlantic, Indian, and Pacific Oceans, as well as the Mediterranean Sea–all places where, especially since they need to lay their eggs on land, they are unfortunately susceptible to the negative environmental influence brought about by humans.

turtle

In Turkey, a loggerhead sea turtle was recently brought to the Sea Turtle Research, Rescue and Rehabilitation Center at Pamukkale University (PAU). The turtle, which they called AKUT3, had significant damage to its upper and lower jaws, and the team at PAU noted that the turtle was unable to feed on its own in the wild.

The Sea Turtle Research, Rescue and Rehabilitation Center at PAU was quick to help, and it turned out that the turtle’s best chance for healing came courtesy of 3D printing. The Center’s director, Prof. Dr. Yakup Kaska, noted that 3D technology proved to be the best hope for the turtle–and this particular operation would represent the first time in the world that a sea turtle would benefit from the technology.

btech

BTech Innovation, “the first private R&D corporation in Turkey,” has extensive experience with 3D technology for medical applications–creating medical-grade implants, models, and prostheses–and came to the turtle’s aid. Using CT scans from the turtle’s veterinary care, the BTech team used the Mimics Innovation Suite from Materialise to create a 3D model of the affected areas of the turtle’s jaws. Ultimately, BTech took the models created to design an implant for the turtle, 3D printing it in titanium.

jaw closeup

The surgery was a success and the patient is recovering quite nicely, though that process is sure in itself to require some time. The turtle’s veterinary surgeon, Prof. Dr. Anas M. Anderson, noted that the turtle did not show any signs of rejecting the implant, following a post-op examination 18 days after the procedure.

While I didn’t actually get to see any sea turtles on my Floridian jaunt a few months ago, it’s wonderful to know that thanks to the efforts of caring veterinary teams around the world, there will still be more chances to see these incredible, endangered gentle giants as their health needs can be met and their lives saved.

Have you heard of similar stories of 3D printed implants in the veterinary world? Let us know what you think of this one in the 3D Printed Titanium Jaw Implant for a Sea Turtle forum thread over at 3DPB.com.

turtle jaw

btech

3dprint.com

by   | MAY 14, 2015