Abstract
Additive manufacturing's attributes include print customization, low per-unit cost for small- to mid-batch production, seamless interfacing with mainstream medical 3D imaging techniques, and feasibility to create free-form objects in materials that are biocompatible and biodegradable. Consequently, additive manufacturing is apposite for a wide range of biomedical applications including custom biocompatible implants that mimic the mechanical response of bone, biodegradable scaffolds with engineered degradation rate, medical surgical tools, and biomedical instrumentation. This review surveys the materials, 3D printing methods and technologies, and biomedical applications of metal 3D printing, providing a historical perspective while focusing on the state of the art. It then identifies a number of exciting directions of future growth: (a) the improvement of mainstream additive manufacturing methods and associated feedstock; (b) the exploration of mature, less utilized metal 3D printing techniques; (c) the optimization of additively manufactured load-bearing structures via artificial intelligence; and (d) the creation of monolithic, multimaterial, finely featured, multifunctional implants.
Highlights
SS 316 and SS 316L and nitinol having niche uses
The metal Additive manufacturing (AM) techniques covered encompass (a) bulk-supplied powder feedstock selectively joined into a solid object using light, electrons, or binder and (b) liquid/paste, filament/wire, or powder feedstock directly fed to the integrating agent, that is, light, electrons, plasma, heat, or binder, to create a printed object
Additive manufacturing (AM)’s attributes, such as print customization, low per-unit cost for small- to mid-batch production, seamless interfacing with mainstream medical 3D imaging techniques, and feasibility to create free-form objects in materials that are biocompatible and biodegradable, are a great fit to a wide range of biomedical applications
Summary
This section summarizes the metallic materials most commonly used in biomedical applications: titanium, titanium alloys, Co-Cr alloys, SS, tantalum, gold, magnesium, gallium alloys, and iron (Table 1); each material can be processed via one or more AM methods (see Section 3). The most common biomedical use of metal is orthopedic implants, and the different material options available result from addressing changes in clinical requirements (24). Some uses require inertness (e.g., Co-Cr alloys, gold); some require bonding with the host tissue (e.g., titanium, titanium alloys); and some require tissue growth and subsequent taking over of the implant (e.g., magnesium alloys, iron). Stress shielding can be addressed either by using a material with stiffness close to that of cortical bone (e.g., magnesium) or by engineering a porosity that reduces the implant’s stiffness
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