增材制造技术的临床应用

Clinical application of additive manufacturing technology

背景:增材制造技术由于其快速成型及其数字化、个性化等特点,为个性化、精准化的医疗提供了强有力的技术支持,因此其医疗器械产品在骨科、口腔、术前规划、颅颌面部等临床应用中快速发展。目的:简要介绍国内外增材制造技术研究进展及其产品在临床应用领域中的商业化应用情况。方法:以“增材制造,医疗器械,临床应用,3D打印”为中文检索词,以“additive manufacturing(AM),additive manufacturing technology,medical device,clinical application,3D printing”为英文检索词,分别检索万方数据、中国知网及PubMed、Elsevier、Springer Link数据库,以及国家药品监督管理局及FDA网站。检索时间范围重点为2010年1月至2023年3月,同时纳入少数经典远期文献。结果与结论:增材制造技术以原材料形态(液体基、固体基、粉末基)为分类方式,目前已有的增材制造工艺有熔融沉积成型技术、立体光固化成型技术、粉末床熔融技术、定向能量沉积技术、黏结剂喷射打印3D技术、喷墨打印技术、分层实体制造技术等7种。已上市的增材制造产品有骨科产品、口腔科产品、术前规划导板/骨模型产品和颅颌面部产品,骨科产品有匹配式长段骨缺损修复体、椎间融合器、膝关节矫形器、椎体假体、胸腰椎融合匹配式假体系统、膝关节假体和髋关节假体;口腔科产品有增材制造用光固化临时冠桥树脂和BB Base 3D Printing Resin for Denture Base;术前规划导板/骨模型产品有骨模型、医用骨科手术导板、定制式牙科种植用导板、人体器官模型;颅颌面部产品有聚己内酯支架、患者专用颅骨植入物、OsteoFab患者专用面部设备、SpinFab VBR假体、TruMatch CMF钛合金3D打印假体系统。

BACKGROUND:Additive manufacturing technology provides strong technical support for personalized and precise medical treatment due to its rapid prototyping,digitalization,and personalization.Therefore,its medical devices have developed rapidly in orthopedics,oral,preoperative planning,craniomaxillofacial,and other clinical applications.OBJECTIVE:To briefly introduce the progress of additive manufacturing technology and its commercial application in the clinic in and outside China.METHODS:Wanfang Data,China National Knowledge Infrastructure(CNKI),PubMed,Elsevier,Springer Link databases,and the websites of National Medical Products Administration and FDA were searched using“additive manufacturing,medical device,clinical application,3D printing”as Chinese search terms and“additive manufacturing(AM),additive manufacturing technology,medical device,clinical application,3D printing”as English search terms.The search time ranged from January 2010 to March 2023,and a few classical long-term articles were included.RESULTS AND CONCLUSION:Additive manufacturing technology is classified by the form of raw materials(liquid-based,solid-based,and powder-based).At present,there are seven kinds of additive manufacturing processes,including fused deposition molding,stereo-curing molding,powder bed melting,directed energy deposition,binder jet 3D printing,inkjet printing,and layered solid manufacturing.The marketed additive manufacturing products include orthopedic products,dental products,preoperative planning guide plate/bone model products,and craniomaxillofacial products.The orthopedic products include matching long-segment bone defect restoration,interbody fusion cage,knee joint orthosis,vertebral prosthesis,thoracolumbar fusion matching prosthesis system,knee prosthesis,and hip prosthesis.Dental products include light-curing resin for additive manufacturing and BB Base 3D Printing Resin for Denture Base.The products of preoperative planning guide plates/bone models include bone models,medical orthopedic surgical guide plates,customized dental implant guide plates,and human organ models.The craniomaxillofacial products include polycaprolactone scaffolds,patient-specific skull implants,OsteoFab patient-specific face device,SpinFab VBR prosthesis,and TruMatch CMF titanium alloy 3D printing prosthesis system.