Abstract
Additive manufacturing (AM) and related digital technologies have enabled several advanced solutions in medicine and dentistry, in particular, the design and fabrication of patient-specific implants. In this study, the feasibility of metal fused filament fabrication (MF3) to manufacture patient-specific maxillofacial implants is investigated. Here, the design and fabrication of a maxillofacial implant prototype in Ti-6Al-4V using MF3 is reported for the first time. The cone-beam computed tomography (CBCT) image data of the patient’s oral anatomy was digitally processed to design a 3D CAD model of the hard tissue and fabricate a physical model by stereolithography (SLA). Using the digital and physical models, bone loss condition was analyzed, and a maxillofacial implant initial design was identified. Three-dimensional (3D) CAD models of the implant prototypes were designed that match the patient’s anatomy and dental implant requirement. In this preliminary stage, the CAD models of the prototypes were designed in a simplified form. MF3 printing of the prototypes was simulated to investigate potential deformation and residual stresses. The patient-specific implant prototypes were fabricated by MF3 printing followed by debinding and sintering using a support structure for the first time. MF3 printed green part dimensions fairly matched with simulation prediction. Sintered parts were characterized for surface integrity after cutting the support structures off. An overall 18 ± 2% shrinkage was observed in the sintered parts relative to the green parts. A relative density of 81 ± 4% indicated 19% total porosity including 11% open interconnected porosity in the sintered parts, which would favor bone healing and high osteointegration in the metallic implants. The surface roughness of Ra: 18 ± 5 µm and a Rockwell hardness of 6.5 ± 0.8 HRC were observed. The outcome of the work can be leveraged to further investigate the potential of MF3 to manufacture patient-specific custom implants out of Ti-6Al-4V.
Highlights
Several developments in digital technology have made it feasible to fabricate custom-made implants that perfectly match the anatomy and local morphology of the patient [7,12]. Modern technologies such as cone beam computed tomography (CBCT) for patient data acquisition, high-speed intraoral scanner to capture a direct optical impression, digital software for clinical analyses and surgical planning, 3D printers for a wide range of high-performance materials have fueled the progress in implant dentistry and maxillofacial reconstruction [8,11,13]
Using the STL files, implant components were printed by MF3 with the filament which has 59% volume of Ti-6Al-4V powder dispersed in a multi-component custom polymer matrix using a desktop printer, Pulse (MatterHackers, Lake Forest, CA, USA)
Support structures were not removed in the green stage
Summary
Apart from dental rehabilitation, maxilla and mandible reconstructions find applications in treating bone defects caused by tumors, injuries, or infections [9,10] Such reconstruction represents major challenges from both engineering and medical aspect [9]. Several developments in digital technology have made it feasible to fabricate custom-made implants that perfectly match the anatomy and local morphology of the patient [7,12] Modern technologies such as cone beam computed tomography (CBCT) for patient data acquisition, high-speed intraoral scanner to capture a direct optical impression, digital software for clinical analyses and surgical planning, 3D printers for a wide range of high-performance materials have fueled the progress in implant dentistry and maxillofacial reconstruction [8,11,13]
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