Additive Manufacturing Serving Bone: Hopes, Reality and Future Challenges for Clinical Applications

Abstract

For the past 20 years, the democratization of additive manufacturing (AM) technologies have made many of us dream: low cost, waste-free, and on-demand production of functional parts, fully customized tools, designs limited by imagination only, etc. As every patient is unique, potential of AM for the medical field, has been foreseen as considerable: AM would allow to devise dedicated patient-specific healthcare solutions, entirely adapted to their clinical needs. More specifically, this review offers an extensive overview of bone related clinical applications of AM and ongoing research trends, from 3D anatomical models for patients and students education to ephemeral structures supporting and promoting bone regeneration. Today, AM has undoubtably improved patient care – and should bring much more in a near future. However, despite extensive research, AM-based strategies for bone regeneration remain the only bone-related field not to have provided yet compelling clinical proofs of concept. This may be due to a lack of understanding of the biological mechanisms guiding and promoting bone formation, as well as limitations with the current multipurpose AM technologies/material couples which restrict the production of biologically relevant scaffolds. Facing these obstacles, a slower but incremental research dynamic has occurred for the last few years, and recent progresses suggest notable improvement in the years to come, with in view the clinical patient-specific regeneration of large bone defects.