Material characterization and selection for 3D-printed spine models

Hao, John; Nangunoori, Raj; Ying, Wei; Rajaraman, M. K.; Cook, Daniel; Yu, Alexander; Cheng, Boyle C.; Shimada, Kenji

doi:10.1186/s41205-018-0032-9

Cited by 23 publications

(13 citation statements)

References 7 publications

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“…Since natural tooth enamel is the hardest and most resilient tissue in the human body, 38 it is a great challenge for 3D printing to develop such a printable material. In a study by Hao et al, 39 an attempt has already been made to print 3D vertebral bodies for the training of neurosurgeons. Amongst other things, a photopolymer resin from Formlabs was used to produce bone‐like material.…”

Section: Discussionmentioning

confidence: 99%

The “Painting by Numbers Method” for education of students in crown preparation

Höhne

Jentzsch

Schmitter

2020

Eur J Dental Education

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Introduction No commercially available solution to improve the teaching of a crown preparation directly on typodont teeth exists at the moment. To fill this gap and support the supervisors of dental courses, a printable and inexpensive tooth was created for structured self‐assessment. The aim of this study was to test this printable tooth under realistic pre‐clinical situations. Materials and methods A two‐coloured, double‐layer practice tooth was developed. This tooth was consisting of a layer for a correct preparation and the crown. All printed teeth were produced with a stereolithographic printer. 35 voluntary second‐year dental students in the second pre‐clinical course in prosthodontics were randomly divided into two groups. All students had experience with typodont teeth and models. The first group was trained on four standard model teeth. The second group used model teeth for the first and fourth attempt and printed teeth for second and third attempt. The preparations of the students were scanned by an in‐lab scanner and the surface deviations in contrast to a perfect preparation were measured. The differences between the first and fourth attempt were calculated. Benefits of the printed tooth were also evaluated by a questionnaire using German school grades completed by the students (1 = Excellent, 2 = Good, 3 = Satisfactory, 4 = Adequate, 5 = Poor, 6 = Unsatisfactory). Results The workflow was feasible and cost‐effective regarding the production of the printed teeth. The overall rating of the printed tooth in the questionnaire was good (Ø 2.1 ± 0.22). Students reported different advantages of this method in the free text. The comparison of the preparation between the first and fourth attempt showed that there was a significant better preparation with the printed teeth. The complete preparation had median values of 0.05 mm (Group1: standard model tooth) and −0.03 mm (Group2: printed tooth) (P = .005). Divided into single surfaces, the vestibular and occlusal regions were significantly better. The vestibular surface was 0.11 mm (Group1) and −0.04 mm (Group2) (P = .018). The occlusal surface was 0.13 mm (Group1) and −0.05 mm (Group2) (P = .009). Conclusions The aim of this study was fulfilled. The printed tooth was tested successfully in a pre‐clinical course. The feasibility of this teaching concept was confirmed by the questionnaire and the analysis of the preparation form. A significant difference to a standard model tooth was measurable. The students had the possibility to learn a correct crown preparation on a standardised two‐layered tooth with included preparation. This printed tooth enabled the students to control the crown preparation directly on their own.

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Section: Discussionmentioning

confidence: 99%

The “Painting by Numbers Method” for education of students in crown preparation

Höhne

Jentzsch

Schmitter

2020

Eur J Dental Education

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“…Sawbones® demonstrated to be a reliable alternative to the fresh cadaveric speciements for biomechanical testing purposes, and have been widely employed in several experimental settings [ 16 – 21 ]. On the other hand, Sawbones® offer a uniform and consisten density [ 22 ]; thereby, it suppresses inter-specimen variability that occur in cadaveric experimental tests [ 23 – 25 ]. Thus, whist results may be more accurte, on the other hand they do not fully minic the heterogeneous caderic bone features.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of an occipito-cervico fusion with a new implant design: a biomechanical study

Migliorini

Baroncini

Mansy

et al. 2021

BMC Musculoskelet Disord

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Background A novel implant for occipitocervical fusion consisting of a median plate with an additional hook inserting in the foramen magnum was tested. Aim of this study was to test the stability of a new implant for occipitocervical fusion against the already available and employed median plate implant without hook. Material and method 36 rigid polyurethane foams occipital artificial bones were used. The two occipital implants, namely the occipital plate with hook (Group 1) and the one without hook (Group 2), were applied to the artificial occiput trough three occipital screws and ensured into the experimental setup trough a crossbar. The test parameters were set using the testing machine software as follows: (1) test speed: 10 mm/ min, with 25 mm/ min maximum; (2) preload: 5 N; (3) force switch-off threshold: 90% force drop from F_max. Failure force and path were recorded. Failure force is defined as the maximum reaction force under which failure occurs (F_max), while failure path is the travel path during which failure occurs (dL). Results Group 1 (plate with hook) showed a mean failure force of 459.3 ± 35.9 N and a mean failure path of 5.8 ± 0.3 mm Group 2 (plate without hook) showed a mean failure force of 323.9 ± 20.2 N and a mean failure path of 7.2 ± 0.4 mm. The Shapiro-Wilk test score was not significant (P > 0.1), assuming that data were normally distributed. Group 1 had a statistically significant greater F_max (+ 135.37; P > 0.0001) and less dL (− 1.52; P > 0.0001) compared to group 2. Conclusions Medial plates with foramen magnum hooks showed to be more stable that plates without a hook. These new implants may represent a new tool in OCJ fixation, but further studies are required to investigate their behavior in an anatomical setting.

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“…3D-printed materials that have been used to simulate vertebral bony anatomy for biomechanical testing and instrumentation include various resins, acryl butadiene styrene (ABS), nylon, polylactic acid (PLA), and thermoplastic urethane (TPU), with varying results [4,[15][16]. Resin printing has become very popular in the medical community due to its ability to create finely detailed prints and vibrant colors.…”

Section: Discussionmentioning

confidence: 99%

“…Resin printing has become very popular in the medical community due to its ability to create finely detailed prints and vibrant colors. However, the material resins that have been used for previous spine models are very hard and must be drilled in some instances in order to instrument [15,[17][18]. This technique does not reflect actual intraoperative procedure for spinal instrumentation and thus makes it suboptimal for simulation use.…”

Section: Discussionmentioning

confidence: 99%

A Feasibility Study for the Production of Three-dimensional-printed Spine Models Using Simultaneously Extruded Thermoplastic Polymers

Clifton¹,

Nottmeier²,

Damon³

et al. 2019

Cureus

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Background Medical simulation is an emerging field for resident training. Three-dimensional printing has accelerated the development of models for spine surgical simulation. Previous models have utilized augmented infill ratios to simulate the density difference between cortical and cancellous bone; however, this does not fully account for differences in the material properties of these components of human vertebrae. In order to replicate the differences in both density and material characteristics for realistic spinal simulation, we created a three-dimensional model composed of multiple thermoplastic polymers. Materials and methods Three lumbar vertebrae and 20 C2 vertebrae models using an experimental dual material fabrication method were printed on an Ultimaker S5 3D printer. Assessment of model integrity during instrumentation as well as user tactile feedback were points of interest to determine prototype viability for educational and biomechanical use. The experimental cohort was compared with a control cohort consisting of a single material print, resin print, and polyurethane mold. Results Based on tactile feedback, the experimental dual material print (polylactic acid [PLA]/polyvinyl alcohol [PVA]) more accurately represented the sensation of in vivo instrumentation during pedicle probing, pedicle tapping, and screw placement. There were no instrumentation or material failures in the PLA/PVA experimental model cohort. Conclusions This feasibility study indicates that multiple material printing using PLA and PVA is a viable method to replicate the cortico-cancellous interface in vertebral models. This concept and design using our unique infill algorithm have not been yet reported in the medical literature. Further educational and biomechanical testing on our design is currently underway to establish this printing method as a new standard for spinal biomimetic modeling.

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Material characterization and selection for 3D-printed spine models

Cited by 23 publications

References 7 publications

The “Painting by Numbers Method” for education of students in crown preparation

The “Painting by Numbers Method” for education of students in crown preparation

Evaluation of an occipito-cervico fusion with a new implant design: a biomechanical study

A Feasibility Study for the Production of Three-dimensional-printed Spine Models Using Simultaneously Extruded Thermoplastic Polymers

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