Abstract

Unlike subtractive manufacturing technologies, additive manufacturing (AM) can fabricate complex shapes from the macro to the micro scale, thereby allowing the design of patient-specific implants following a biomimetic approach for the reconstruction of complex bone configurations. Nevertheless, factors such as high design variability and changeable customer needs are re-shaping current medical standards and quality control strategies in this sector. Such factors necessitate the urgent formulation of comprehensive AM quality control procedures. To address this need, this study explored and reported on a variety of aspects related to the production and the quality control of additively manufactured patient-specific implants in three different AM companies. The research goal was to develop an integrated quality control procedure based on the synthesis and the adaptation of the best quality control practices with the three examined companies and/or reported in literature. The study resulted in the development of an integrated quality control procedure consisting of 18 distinct gates based on the best identified industry practices and reported literature such as the Food and Drug Administration (FDA) guideline for AM medical devices and American Society for Testing and Materials (ASTM) standards, to name a few. This integrated quality control procedure for patient-specific implants seeks to prepare the AM industry for the inevitable future tightening in related medical regulations. Moreover, this study revealed some critical success factors for companies developing additively manufactured patient-specific implants, including ongoing research and development (R&D) investment, investment in advanced technologies for controlling quality, and fostering a quality improvement organizational culture.

Highlights

  • A total of 10 invitations to participate in this study were sent to different companies in America, Europe, and Australia to explore the design, the manufacturing, and the quality control processes of Additively Manufactured (AM) medical devices produced by these companies

  • This study explored a variety of aspects related to the production and the quality control of additively manufactured patient-specific implants in three different companies

  • This study developed an innovative quality control workflow composed of 18 gates

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Summary

Introduction

The existing AM processes are classified into seven main categories: binder jetting; directed energy deposition; material extrusion; material jetting; powder bed fusion; sheet lamination; and vat photopolymerization [3] Within these AM categories, the most used AM systems in the biomedical industry are stereolithography, selective laser sintering, Inkjet 3D printing, electron beam melting, polyjet photopolymer, and fused deposition modeling [4,5], especially in orthopedics, dentistry, and maxillofacial surgery [6,7]. To replace hard tissue for load bearing applications, metals have been the best choice due to their mechanical properties, corrosion resistance, and biocompatibility. Most of these materials are alloys, such as 316L stainless steel (316LSS), cobalt chromium (Co-Cr), and titanium alloys [20].

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