The future of 3D printing by medical consultant Dr. Thirumurugan S V Mahadhevan

Innovations in the technology of 3D printing and scanning have been tremendous. The hype that was already being created in 3D printing is huge and the R&D is happening to fulfil the expectations in different parts of the world.

Though the technology erupted in 1980’s, 3D printing for healthcare has been getting familiar in the last decade. Let us see how, across all areas, 3D printing of healthcare can have a bigger impact in coming years.

Whenever the words “3D printing in healthcare” are uttered, most people will ask, “is it possible to 3D print an organ like heart or brain?” These are possible in the future, but it will take decades at least as it involves lot of complexity to design every critical part, including cells, tissues, nerve while keeping it alive and fully functional.

Scaffold printing is widely catching up and it is a cost cutting measure for pharmaceutical companies by reducing animal and toxicity tests while being the anchor to create tissues and organs in future. Hydrogels and bio-inks will be developed, so that most of the researchers will involve in R&D activities. Research is being done in most countries including USA, Europe, Japan, China and India.

FDA approved 3D printed drug for epilepsy (Spiritam) is commercially available, where the pill dissolves in less than 5 seconds with a large dose. This technology can be utilised to make more lifesaving and essential drugs to reach the systemic circulation faster in large and various drug dosages.

For example, if a prescription includes an antacid, anti-biotic and a painkiller to be taken, a single 3D printed drug can be made in such a way considering his/her weight and disease progression. The pill can be designed in a controlled way to decide on where, when and to what extent the drug needs to be released. This technology will help in creating drugs in a personalised way while increasing efficiency and reducing the over dosage complications in a ‘One pill for all’ concept.

Gone are days when an amputated person waits for months to get their prosthetic extremities. Combining 3D printing and 3D scanning can help get a finished prosthesis in a few hours. These technologies helps make any prosthesis very accurate, highly durable and aesthetic too.

Furthermore, 3D printed prosthetics are being incorporated with smart electronic chips or sensors to make them fully functional, at a very low cost with less waiting time. Developing better 3D printed prosthetics with advanced sensors will create revolution in Smart Prosthetics. Even skin grafts which perfectly matches the exact skin tone can be 3D printed.

The usage of nanomaterials will have a great impact in every discipline. These materials can replace stainless steel and other elements with lesser weight and enhanced properties. Carbon fibre reinforced implants showed better osteointegration, toughness and flexibility for Knee replacement implants.

Likewise, more medical devices and smart sensors will be developed in accordance with 3D printing to evolve efficient diagnostic devices and implants.

Dentistry is one of the discipline which utilises 3D printing technology to its fullest. Stratasys and EnvisionTEC are the leading companies in dental 3D printing.

The 3D scanner, 3D printer and 3D software combined makes the requisite for Digital Dentistry. Crowns, bridges, wax burnouts, implants and denture bases can be already made in 3D printers and the procedures will be done in hours, fulfilling demand rather than waiting for days. The development of new resin materials will replace almost all conventional lab procedures with rapid production and faster delivery.

3D printing will be the best available technology for surgical planning, teaching and training purposes. Printers like Stratasys have the capability to produce patient specific organ models obtained from the diagnostic images.

It is possible to make organ models with multiple colours for critical structures, transparent models and structures mimicking the natural consistency and texture. Blood vessel models can be 3D printed, which gives the exact feel of real blood vessels. The teaching and training through these models will overcome the issues associated with Cadaver availability. Realistic surgical simulators will be the educating platform for everyone in coming years.

One of the biggest hurdle in the development of 3D printing in healthcare will be on the regulatory and patenting aspects. Getting an approval from the regulatory bodies like FDA and EMA takes time and it is a rigorous procedure.

The cost is another big issue which makes 3D printing in healthcare out of reach in most countries. Most of the implants and other drugs will be commercialized after going through clinical trials it will take minimum of 10 to 15 years. Most of the patents are already pending and there will be a revolution of 3D Printing in Healthcare industry in the coming years with the support of regulations.

We purchased our first 3D printer last November. Along with open source freeware, there is an incredible amount of professional design software made available to hobbyists by the developers for free. My favorite’s are Autodesk’s Fusion 3D and Autodesk’s 123D Design.

I have printed out a wide variety of the typical objects that can be found on thingyverse.com and other download sites, but I have used it to make many parts for repairing various items around the house. I have also designed a few interesting projects that I will eventually share myself when they are perfected.

The next big project that I intend to work on is the MPCNC open source project which stands for Mostly Printed CNC. It is a CNC router that is scalable and can be used for a wide variety of projects. The electronics, stepper motors, router and other parts that are not printed will still cost several hundred dollars, but it is a very capable machine with a lot of support in the community.

If we want to sum up the idea of 3D printing in health care, it is that health care is moving from the older factory model of mass production and interchangeable parts, to personalized medicine. Devices are printed to meet an individual's body, they don't have to accept a general device that doesn't fit anyone perfectly.

Drugs and organs will also be just as individualized. Right now, drugs are approved based upon mass testing with lots of people, and either approved for everyone or denied on those groups. In the future, before giving you a drug, the hospital will grow a liver from your stem cells, then test your own reactions to the drug with the printed liver. They will know what drugs you can handle before they inject you with them.

We’re in a rural area and I’ve often thought that 3d printing will be a very useful technology once perfected - especially once there is a method for manufacturing metal parts that is cost-efficient.

I’m particularly thinking of things like tractor parts where a farmer is down and crop is spoiling because a machine is broken.

However, I think we’re on the cusp of it being economical now.

I’ve always thought gasket inventories could be replaced by a water jet or laser cutting machine and a supply of gasket stock. I already keep a roll of gasket material at home and some simple tools that allow me to cut my own gaskets if I find I need one in the middle of a job and the local places don’t have it in stock.

Just as that was becoming feasible, most gaskets had moved from simple flat paper type to more complicated MLM or a metal/plastic backing with an elastomer seal surface. A lot of those are 3d printable now along with a myriad of plastic parts. Assuming the original manufacturers will make the specs available or allow duplication, huge inventories of parts could be replaced by a few local machines that turned out whatever is needed and likely the same day.

It’s truly going to be a revolution when it happens.

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