Application of three-dimensional printed biomodels in endoscopic spinal surgery.

Background: Three-dimensional printing (3DP) is increasingly used to individualise surgery and may be an effective tool for representing patient anatomy. Current literature on patient-specific anatomical models (biomodels) for minimally invasive spinal surgery is a limited number of case series and cohort studies. However, studies investigating 3DP in other specialties have reported multiple benefits. Methods: This prospective study considered a series of patients (n=33) undergoing elective endoscopic spinal surgery, including combinations of microdiscectomy (n=27), foraminotomy (n=7), and laminectomy (n=3). These surgeries were conducted at vertebral levels ranging from L2/3 to L5/S1. The surgeon then recorded the impact on preoperational planning, intraoperative decision-making and accelerating the learning curve with a qualitative questionnaire. Results: There were benefits to planning in 54.5% of cases (n=18), improved intraoperative decision-making in 60.6% of cases (n=20). These benefits were reported more frequently earlier in the cases, with improvements to learning reported in 60% of the first five cases and not in subsequent cases. The surgeon commented that the biomodels were more useful on. Conclusions: The rates of preoperative and intraoperative benefits are consistent with existing studies, and the early benefit to the learning curve may be suitable for applications to surgical training. Additional research is required to determine the practicality of biomodels and their impact on patient outcomes for endoscopic spinal surgery.

Canine Upper Digestive Tract 3D Model: Assessing Its Utility for Anatomy and Upper Endoscopy Learning.

A teaching strategy using 3D-printed models of the canine upper digestive tract (UDT) for anatomy demonstration and upper endoscopy instruction was evaluated. The canine UDT (esophagus-stomach-duodenum) was scanned and 3D-printed molds were manufactured using silicone casting. First-year students were introduced to these 3D models in practical sessions alongside real specimens. Simultaneously, fifth-year students were trained in endoscope handling and anatomical recognition using 3D specimens. Both groups completed an anonymous survey. Results showed that overall, first-year (n = 93) and fifth-year (n = 45) students agreed or strongly agreed that the 3D-printed model was effective for learning purposes. In summary, first-year students highlighted an improved understanding of size, volume, topography, and easier manipulation of the 3D model compared to fresh specimens. Fifth-year students were more enthusiastic, finding the 3D model valuable for spatial vision and clinical training. While both groups were against completely replacing the natural UDT with the 3D model, first-year students were more hesitant. These findings suggest that the 3D model of the canine UDT is an effective tool for hands-on training in clinical endoscopy and a valuable, albeit complementary, resource for teaching anatomy and topography.

Posterior endpoint determination of the lumbar pedicle central axis on the anterior-posterior fluoroscopic image for pedicle screw insertion.

The transpedicular procedure has been widely used in spinal surgery. The determination of the best entry point is the key to perform a successful transpedicular procedure. Various techniques have been used to determine this point, but the results are variable. This study was carried out to determine the posterior endpoint of the lumbar pedicle central axis on the standard anterior-posterior (AP) fluoroscopic images. Computer-aided design technology was used to determine the pedicle central axis and the posterior endpoint of the pedicle central axis on the posterior aspect of the vertebra. The standard AP fluoroscopic image of the lumbar vertebral models by three-dimensional printing was achieved. The endpoint projection on the AP fluoroscopic image was determined in reference to the pedicle cortex projection by the measurements of the angle and distance on the established X-Y coordinate system of the radiologic image. The projection of posterior endpoint of the lumbar pedicle central axis were found to be superior to the X-axis of the established X-Y coordinate system and was located on the pedicle cortex projection on the standard AP fluoroscopic image of the vertebra. The projection point was distributed in different sectors in the coordinate system. It was located superior to the X-axis by 18° to 26° at L1, while they were located superior to the X-axis by 12° to 14° at L2 to L5. The projections of posterior endpoints of the lumbar pedicle central axis were located in different positions on the standard AP fluoroscopic image of the vertebra. The determination method of the projection point was helpful for selecting an entry point for a transpedicular procedure with a fluoroscopic technique.

Post-polymerization of three-dimensional printing resin using a dental light curing unit.

Background/Purpose: In vat photopolymerization, post-polymerization of the three-dimensional (3D) printing resin is necessary to ensure the optimum physical properties of the printed objects. This study aimed to evaluate the potential use of a handheld polywave light-emitting diode (LED) dental light-curing unit (LCU) for post-polymerizing 3D printed resins by measuring the microhardness and biaxial flexural strength of the post-polymerized resin. Material and methods: 3D printed 1- and 2-mm-thick disks were irradiated with a dental LCU at 3200 mW/cm2. Post-polymerization was repeated either on one side from the top surface: two cycles (T2), four cycles (T4), and eight cycles (T8), or on both sides from the top and bottom surfaces: one cycle (T1B1), two cycles (T2B2), and four cycles (T4B4) for each side. The microhardness and biaxial strength of the disks were compared to those post-polymerized by a conventional desktop polymerizing unit (PC) and those without post-polymerization (NC). Results: Microhardness of the disks varied between the top and bottom surfaces of the 1-mm and 2-mm-thick disks, depending on the post-polymerization methods. T8 and T4B4 produced comparable microhardness on the top surface to PC for both thicknesses. In contrast, PC, T2B2, and T4B4 exhibited the highest microhardness on the bottom surface. Except for NC, the 1-mm-thick disks had a higher biaxial flexural strength than the 2-mm-thick disks. T4B4 resulted in the highest biaxial flexural strength for both thicknesses, which was comparable to that of the desktop polymerizing unit. Conclusion: The microhardness and biaxial flexural strengths of the post-polymerized 3D-printed disks increase with polymerization time. With sufficient polymerization from both sides, the polywave LCU has the potential to be a viable alternative to desktop polymerization units.

Application of a Novel 3D-Printed Nasal Plug as a Conservative Treatment for Empty Nose Syndrome.

OBJECTIVE: Empty nose syndrome (ENS) is commonly treated by surgery, albeit with limited success. Herein, we introduce our experience of applying a newly developed "3D-printed nasal plug" as an alternative conservative treatment modality. METHODS: This retrospective study included 20 patients (14 males, 6 females; mean age 46.5 ± 13.5 years) with ENS who underwent the application of the 3D-printed nasal plug at Asan Medical Center between June 2022 and May 2023. Symptom improvement was assessed by Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) before and after applying the nasal plug. Clinical results, such as duration and frequency of plug use, discomfort, and level of satisfaction, were investigated. RESULTS: The mean follow-up duration was 40.3 ± 24.2 weeks. The average duration of nasal plug usage was 10.8 h per day and 5.3 days a week. The ENS6Q scores improved from 19.6 ± 4.6 to 6.8 ± 5.1 (mean reduction 12.8 ± 5.9) after 30 minutes of wearing. Symptom "nose feelings too open" was improved most by a score of 3.0 ± 1.5 (p < 0.001). Thirteen patients (65.0%) reported that the effectiveness of the plug, initially confirmed at the first wearing, was well maintained during the entire follow-up. Four patients (20.0%) wore the nasal plug uninterruptedly throughout the week, whereas nine patients (45.0%) wore it intermittently as needed. Frequently reported complaints with plug usage were 'displacement of the plug' and 'cosmetic concerns' about the visible hook portion. CONCLUSION: A 3D-designed nasal plug can be a useful conservative treatment option for ENS patients. LEVEL OF EVIDENCE: 4 Laryngoscope, 2024.

Evaluating the benefit of virtual surgical planning on bony union rates in head and neck reconstructive surgery.

OBJECTIVES: Virtual surgical planning (VSP) has gained acceptance because of its benefits in obtaining adequate resection, achieving cephalometric accuracy, and reducing operative time. The aim of this study is to compare the rate of union between VSP and free-hand surgery (FHS), identify predictors of non-union and evaluate the difference in operative time. METHODS: Post-operative CT were retrospectively reviewed for 123 patients who underwent maxillary or mandibular reconstruction between 2014 and 2021 using either VSP or FHS. Each apposition was graded as complete, partial or non-union. The rate of union, risk difference and inter-rater reliability were calculated. The difference in operative time was assessed. Predictors of non-union were identified using logistic regression. RESULTS: A total of 326 appositions were graded (VSP n = 150; FHS n = 176). The rates of complete and partial union were higher with VSP than FHS (74.7% vs. 65.3%; 18% vs. 15.9%, respectively, p = 0.01). Non-union was found at a higher rate with FHS than with VSP (18.7% vs. 7.3%). The non-union risk difference was 11.4. FHS, major complications and apposition at the native bone were predictors of non-union (OR 2.9, p = 0.02; OR 3.4, p = 0.01; OR 2.5, p = 0.05, respectively). The mean surgical time was shorter with VSP than with FHS (265.3 vs. 381.5 min, p < 0.001). The inter-rater agreement was high (k = 0.85; ICC = 0.86). CONCLUSION: VSP demonstrated significantly higher bony union rates and shorter operative time. FHS, development of major complications and apposition with native bone correlated with non-union.

Influence of Post-Curing in Nitrogen-Saturated Condition on the Degree of Conversion and Color Stability of 3D-Printed Resin Crowns.

Post-curing is the process of applying extra light to complete the polymerization process of 3D printing. The mechanical properties of light-cured three-dimensional (3D) printed resin can be improved by decreasing the oxygen concentrations during post-curing, and nitrogen-saturated post-curing has been applied for this purpose. This study aimed to evaluate and compare the color stability of 3D-printed resin crowns that were post-cured in both normal air and nitrogen-saturated conditions. Crowns were fabricated with a 3D printer and post-cured in normal air (control group; air) or nitrogen-saturated conditions (experimental group; nitrogen). The specimens in each group were subdivided into four subgroups, each exposed to different discoloration agents: distilled water, coffee, wine, and curry. Post-immersion color changes were measured using a digital spectrophotometer and analyzed using repeated-measures ANOVA. Fourier transform infrared (FT-IR) spectroscopy evaluated the degree of conversion of resin over immersion times for both post-curing conditions. Upon comparing the effects of post-curing conditions, a significant difference between the control and experimental groups in terms of immersion time in the wine and curry subgroups was found. FT-IR analysis showed a significant difference in the degree of conversion between the air and nitrogen groups from 10 to 300 s. These findings suggest that nitrogen-saturated post-curing can potentially enhance the conversion rate of 3D-printed resin crowns, thereby improving their color stability.

Utility of three-dimensional printing in the surgical management of intra-articular distal humerus fractures: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Clinical outcomes after fixation of distal humerus intraarticular fractures are directly related to the quality of reduction. The use of three-dimensional (3D)-printed fracture models can benefit preoperative planning to ensure good reduction. This review aims to determine if surgery performed with 3D printing assistance are faster and result in fewer complications and improved clinical outcomes than conventional methods. We also outline the benefits and drawbacks of this novel technique in surgical management of distal humerus fractures. METHODS: A systematic literature search was carried out in various electronic databases. Search results were screened based on title and abstract. Data from eligible studies were extracted into spreadsheets. Meta-analysis was performed using appropriate computer software. RESULTS: Three randomized controlled trials with 144 cases were included in the final analysis. The 3D-printed group had significantly shorter mean operating time (mean difference, 16.25 minutes; 95% confidence interval [CI], 12.74-19.76 minutes; P<0.001) and mean intraoperative blood loss (30.40 mL; 95% CI, 10.45-60.36 mL; P=0.005) compared with the conventional group. The 3D-printed group also tended to have fewer complications and a better likelihood of good or excellent outcomes as per the Mayo elbow performance score, but this did not reach statistical significance. CONCLUSIONS: Three-dimensional-printing-assisted surgery in distal humerus fractures has several benefits in reduced operating time and lower blood loss, indirectly decreasing other complications such as infection and anemia-related issues. Future good-quality studies are required to conclusively demonstrate the benefits of 3D printing in improving clinical outcomes. Level of evidence: I.

Three-dimensional finite element analysis on the effects of maxillary protraction with an individual titanium plate at multiple directions and locations.

Objective: : A three-dimensional-printed individual titanium plate was applied for maxillary protraction to eliminate side effects and obtain the maximum skeletal effect. This study aimed to explore the stress distribution characteristics of sutures during maxillary protraction using individual titanium plates in various directions and locations. Methods: : A protraction force of 500 g per side was applied at forward and downward angles between 0° and 60° with respect to the Frankfort horizontal plane, after which the titanium plate was moved 2 and 4 mm upward and downward, respectively. Changes in sutures with multiple protraction directions and various miniplate heights were quantified to analyze their impact on the maxillofacial bone. Results: : Protraction angle of 0-30° with respect to the Frankfort horizontal plane exhibited a tendency for counterclockwise rotation in the maxilla. At a 40° protraction angle, translational motion was observed in the maxilla, whereas protraction angles of 50-60° tended to induce clockwise rotation in the maxilla. Enhanced protraction efficiency at the lower edge of the pyriform aperture was associated with increased height of individual titanium plates. Conclusions: : Various protraction directions are suitable for patients with different types of vertical bone surfaces. Furthermore, when the titanium plate was positioned lower, the protraction force exhibited an increase.

[Study on NaOH improving the surface morphology of three-dimensional printed poly- L- lactic acid mesh scaffolds].

Objective: To explore the effect of NaOH on the surface morphology of three-dimensional (3D) printed poly- L-lactic acid (PLLA) mesh scaffolds. Methods: The 3D printed PLLA mesh scaffolds were prepared by fused deposition molding technology, then the scaffold surfaces were etched with the NaOH solution. The concentrations of NaOH solution were 0.01, 0.1, 0.5, 1.0, and 3.0 mol/L, and the treatment time was 1, 3, 6, 9, and 12 hours, respectively. There were a total of 25 concentration and time combinations. After treatment, the microstructure, energy spectrum, roughness, hydrophilicity, compressive strength, as well as cell adhesion and proliferation of the scaffolds were observed. The untreated scaffolds were used as a normal control. Results: 3D printed PLLA mesh scaffolds were successfully prepared by using fused deposition molding technology. After NaOH etching treatment, a rough or micro porous structure was constructed on the surface of the scaffold, and with the increase of NaOH concentration and treatment time, the size and density of the pores increased. The characterization of the scaffolds by energy dispersive spectroscopy showed that the crystal contains two elements, Na and O. The surface roughness of NaOH treated scaffolds significantly increased ( P<0.05) and the contact angle significantly decreased ( P<0.05) compared to untreated scaffolds. There was no significant difference in compressive strength between the untreated scaffolds and treated scaffolds under conditions of 0.1 mol/L/12 h and 1.0 mol/L/3 h ( P>0.05), while the compression strength of the other treated scaffolds were significantly lower than that of the untreated scaffolds ( P<0.05). After co-culturing the cells with the scaffold, NaOH treatment resulted in an increase in the number of cells on the surface of the scaffold and the spreading area of individual cells, and more synapses extending from adherent cells. Conclusion: NaOH treatment is beneficial for increasing the surface hydrophilicity and cell adhesion of 3D printed PLLA mesh scaffolds.

Three-Dimensional-Printed Spherical Hollow Structural Scaffolds for Guiding Critical-Sized Bone Regeneration.

The treatment of bone tissue defects continues to be a complex medical issue. Recently, three-dimensional (3D)-printed scaffold technology for bone tissue engineering (BTE) has emerged as an important therapeutic approach for bone defect repair. Despite the potential of BTE scaffolds to contribute to long-term bone reconstruction, there are certain challenges associated with it including the impediment of bone growth within the scaffolds and vascular infiltration. These difficulties can be resolved by using scaffold structural modification strategies that can effectively guide bone regeneration. This study involved the preparation of biphasic calcium phosphate spherical hollow structural scaffolds (SHSS) with varying pore sizes using 3D printing (photopolymerized via digital light processing). The chemical compositions, microscopic morphologies, mechanical properties, biocompatibilities, osteogenic properties, and impact on repairing critical-sized bone defects of SHSS were assessed through characterization analyses, in vitro cytological assays, and in vivo biological experiments. The results revealed the biomimetic properties of SHSS and their favorable biocompatibility. The scaffolds stimulated cell adhesion, proliferation, differentiation, and migration and facilitated the expression of osteogenic genes and proteins, including Col-1, OCN, and OPN. Furthermore, they could effectively repair a critical-sized bone defect in a rabbit femoral condyle by establishing an osteogenic platform and guiding bone regeneration in the defect region. This innovative strategy presents a novel therapeutic approach for assessing critical-sized bone defects.

Platelet rich fibrin and simvastatin-loaded pectin-based 3D printed-electrospun bilayer scaffold for skin tissue regeneration.

Designing multifunctional wound dressings is a prerequisite to prevent infection and stimulate healing. In this study, a bilayer scaffold (BS) with a top layer (TL) comprising 3D printed pectin/polyacrylic acid/platelet rich fibrin hydrogel (Pec/PAA/PRF) and a bottom nanofibrous layer (NL) containing Pec/PAA/simvastatin (SIM) was produced. The biodegradable and biocompatible polymers Pec and PAA were cross-linked to form hydrogels via Ca2+ activation through galacturonate linkage and chelation, respectively. PRF as an autologous growth factor (GF) source and SIM together augmented angiogenesis and neovascularization. Because of 3D printing, the BS possessed a uniform distribution of PRF in TL and an average fiber diameter of 96.71 ± 18.14 nm was obtained in NL. The Young's modulus of BS was recorded as 6.02 ± 0.31 MPa and its elongation at break was measured as 30.16 ± 2.70 %. The wound dressing gradually released growth factors over 7 days of investigation. Furthermore, the BS significantly outperformed other groups in increasing cell viability and in vivo wound closure rate (95.80 ± 3.47 % after 14 days). Wounds covered with BS healed faster with more collagen deposition and re-epithelialization. The results demonstrate that the BS can be a potential remedy for skin tissue regeneration.

[Digital study on proximal clavicle anatomical plate based on 3D printing technology].

OBJECTIVE: To explore feasibility of 3D metal printing technology combined with virtual design proximal clavicle anatomical plate. METHODS: A 52-year-old male healthy volunteer was retrospectively selected to design proximal clavicle anatomical plate system by using Mimics15.01,NX12.0 and other software. STL data were input into 3D printer to print 1:1 clavicle model and proximal clavicle anatomical plate. The fit of the plate was tested in vitro and the accuracy of screw position was evaluated by imaging. Printing time of model,nail path design and fabrication time of the anatomical plate at proximal clavicle were recorded. RESULTS: The 3D metal printing proximal clavicle anatomical plate fitted well to clavicle model,orientation of proximal clavicle locking screw was accurate,and X-ray and CT scan showed the screw position was good. Printing time of model,the time of nail path design,and the time of making anatomical plate of proximal clavicle were 120,15 and 300 min respectively. CONCLUSION: The proximal clavicular anatomical plate system based on 3D metal printing technology could achieve good lamination of proximal clavicular fracture plate and precise screw placement,providing a new and accurate surgical method for the treatment of the proximal clavicular fracture.

3D Printing for Left Ventricular Assist Device Exchange: Insights From Real-World Experience.

Left ventricular assist devices (LVADs) are used in end-stage heart failure. Inadequate positioning of the inflow cannula may necessitate replacement of the LVAD. We present the successful use of a three-dimensional printed model used to optimize surgical planning and allow for simulation and training for the LVAD exchange procedure.

Fabrication of 3D-printed scaffolds loaded with gallium acetylacetonate for potential application in osteoclastic bone resorption.

We recently reported the potential of a new gallium compound, gallium acetylacetonate (GaAcAc) in combating osteoclastic bone resorption through inhibition of osteoclast differentiation and function. Herein, we focused on 3D-printed polylactic acid scaffolds that were loaded with GaAcAc and investigated the impact of scaffold pretreatment with polydopamine (PDA) or sodium hydroxide (NaOH). We observed a remarkable increase in scaffold hydrophilicity with PDA or NaOH pretreatment while biocompatibility and in vitro degradation were not affected. NaOH-pretreated scaffolds showed the highest amount of GaAcAc loading when compared to other scaffolds (p < 0.05). NaOH-pretreated scaffolds with GaAcAc loading showed effective reduction of osteoclast counts and size. The trend was supported by suppression of key osteoclast differentiation markers such as NFAT2, c-Fos, TRAF6, & TRAP. All GaAcAc-loaded scaffolds, regardless of surface pretreatment, were effective in inhibiting osteoclast function as evidenced by reduction in the number of resorptive pits in bovine cortical bone slices (p < 0.01). The suppression of osteoclast function according to the type of scaffold followed the ranking: GaAcAc loading without surface pretreatment > GaAcAc loading with NaOH pretreatment > GaAcAc loading with PDA pretreatment. Additional studies will be needed to fully elucidate the impact of surface pretreatment on the efficacy and safety of GaAcAc-loaded 3D-printed scaffolds.

Micro-computed tomographic evaluation of the shaping ability of three nickel-titanium rotary systems in the middle mesial canal of mandibular first molars: an ex vivo study based on 3D printed tooth replicas.

BACKGROUND: The preparation of the middle mesial (MM) canal of mandibular molars represents a challenge because it is often curved, narrow, and close to the root concave. The purpose of this study was to evaluate the ex vivo shaping ability of 3 nickel-titanium (NiTi) rotary systems in the MM canal using 3D printed resin tooth replicas. METHODS: A permanent mandibular first molar with a MM canal was acquired from a pool of extracted teeth and reproduced by a 3D printer. The resin tooth replicas (n = 18) were equally assigned to 3 groups for the evaluation of the shaping abilities of 3 NiTi rotary systems (OneShape [OS], Twisted Files [TF], and ProTaper Gold [PTG]) according to the manufacturer's recommendations. The tooth replicas were scanned by micro-computed tomography (micro-CT) twice before and after instrumentation of the mesiobuccal (MB), mesiolingual (ML), and MM root canals. After 3D reconstruction, the canal straightening, change of root canal volume and surface area, the mesial and distal canal wall thickness and canal transportation at the levels of 1, 2, and 3 mm below furcation were assessed. One-way variance analysis and Turkey's post hoc test were used for comparisons of the means among different groups, and paired-t test was used to compare the mesial and distal sides of the mesial roots. RESULTS: As compared with OS and TF, the use of PTG in preparation of MM canals resulted in significantly more straightening of canal curvature (p < 0.05), greater post-instrumentation canal volume and surface area, and thinner mesial and distal remaining canal wall thickness at 1, 2 and 3 mm below furcation (all p < 0.05). Regarding the root canal transportation in the mesiodistal direction, there was no significant difference among the 3 instruments (all p > 0.05) after the preparation of the MB and ML canals. However, in the MM canal, more pronounced transportation was detected in the PTG group at 2 mm below furcation, and in the TF group at 3 mm below furcation as compared with the other 2 systems (both p < 0.05). CONCLUSIONS: 3D printed tooth replicas have the advantages of consistency and can be an ideal model to evaluate the shaping ability of different instruments in the MM canal. OS and TF files performed similarly and both are appropriate for shaping the MM canal, while PTG may cause excessive and uneven resin removal, especially near the furcation, and may lead to root fragility and procedural errors.

[Virtual preoperative planning and 3D-printed templates for pre-contoured plates in treatment of acetabular posterior wall fractures].

OBJECTIVE: To evaluate the feasibility and accuracy of virtual preoperative planning and 3D-printed templates for pre-contoured plates for the treatment of posterior wall fractures of the acetabulum. METHODS: A retrospective analysis of 29 patients with posterior acetabular wall fractures treated between August 2017 and March 2021 were divided into 2 groups based on whether to use preoperative virtual planning and 3D printed template. In 3D-printing group, there were 14 patients, including 10 males and 4 females； aged from 21 to 53 years old；CT-based virtual surgical planning was done using Mimics and 3-Matic software and 3D-printed templates for pre-contoured plates were adopted. In conventional group, there were 15 patients, including 10 males and 5 females；aged from 19 to 55 years old；conventional method of intra-operative contouring to adapt the plate to the fracture region was adopted. Blood loss, surgical time, radiographic quality of reduction, and hip function were compared between groups. RESULTS: The difference in operation time and intraoperative blood loss was significant（P<0.05）. Twenty-three patients were followed up from 12 to 30 months, and the fractures in both groups healed with a healing time of 3 to 6 months. At the last follow-up, the Merle d'Aubign-Postel score of the 3D printed group was lower than that of the conventional group（P<0.05）, with no significant differences in walking ability, hip mobility and total score（P>0.05）. In 3D printing group, 6 cases were excellent, 5 cases were good, 3 cases were fair；in conventional group, 5 cases were excellent, 5 cases were good, 4 cases were fair, 1 case was worse；no significant difference between two groups（P>0.05）. CONCLUSION: Virtual preoperative planning and 3D-printed templates for pre-contoured plates can reduce operative time and the blood loss of surgery, improve the quality of reduction. This method is efficient, accurate and reliable to treat acetabular posterior wall fractures.

Effect of a collagen peptide-fish oil high internal phase emulsion on the printability and gelation of 3D-printed surimi gel inks.

The effect of a high internal phase emulsion (HIPE) on three-dimensional-printed surimi gel inks was studied. Increasing the concentration of collagen peptide decreased the particle size of HIPE droplets and improved the viscoelasticity and stability. For example, when the collagen peptide concentration was 5 wt%, the viscoelasticity of the HIPE was high, as indicated by the presence of small and uniform particles, which formed a monolayer in the outer layer of the oil droplets to form stable a HIPE. A HIPE was used as the filling material to fill the surimi gel network, which reduced the porosity of the network. Surimi protein and peptides have dual emulsifying effects on the stabilization of oil. After adding the emulsion, the texture, gel properties and rheological properties of the surimi were reduced, and its printing adaptability was improved. This study provides new ideas for the production of surimi and its application in 3D printing.

Effect of different storage conditions on dimensional accuracy of 3D-printed dental models.

PURPOSE: The objective was to determine the accuracy of 3D-printed dental models subjected to different storage conditions using six different material and printer combinations. MATERIALS AND METHODS: Three completely dentate models were designed using dental CAD software (3Shape Dental System). A horseshoe-shaped solid base with a posterior horizontal bar was used. The models were printed in a horizontal direction against the building platform without support. The models were printed using six printers with the corresponding recommended resin material: Carbon M2 (DPR10), HeyGears A2D4K (Model HP UV2.0), Stratasys J5 (MED610), Stratasys Origin One (DM200), Envision One (E-Model LightDLP), and Asiga Pro4K (VeriModel) with a standard layer thickness of 50 µm. All printed models underwent scanning using a laboratory scanner (Sirona inEOS X5) after printing. Subsequently, the models were randomly assigned into three groups of storage conditions, LT: cold environment (4 ± 1°C), HT: hot and dry environment (50 ± 2°C), and RT: room temperature (25 ± 2°C) serving as the control. Each group was kept under the designated condition and was scanned at 1, 2, 3, 4, and 8 weeks. The total number of models (N) was 72, with 6 printers producing 12 models per printer for 3 storage conditions, resulting in 4 models for each storage condition and each printer. The generated STL files were imported into a 3D inspection software for comparison with the original STL files. In-tolerance percentage, the deviation RMS, trueness, and precision were obtained and analyzed with least square mean linear regression using JMP Pro 15 to identify the significant effects (α = 0.05). RESULTS: The in-tolerance percentage as-printed was significantly different among different printers. Significant dimension deviations were observed after the first week of storage at HT and with subsequent weeks of storage. RT and LT did not show significant dimensional changes. Models printed with Carbon M2 showed the highest in-tolerance percentages compared to the other printers. CONCLUSIONS: The model deviations were affected by storage conditions and the printer used, with high-temperature storage showed least stability compared to low and room temperatures. No significant difference was observed between low and room temperature storage conditions. The Carbon M2 printer showed the highest accuracy among all printers tested. The region had a significant effect on the deviation measured, with the abutment body showing the least deviation. Among the 3D printers evaluated, A2D4K by HeyGears and Carbon M2 printers demonstrated the highest accuracy in terms of both precision and trueness.

Unsuspected Limitations of 3D Printed Model in Planning of Complex Aortic Aneurysm Endovascular Treatment.

OBJECTIVE: Static 3-dimensional (3D) printing became attractive for operative planning in cases that involve difficult anatomy. An interactive (low cost, fast) 3D print allowing deliberate surgical practice can be used to improve interventional simulation and planning. BACKGROUND: Endovascular treatment of complex aortic aneurysms is technically challenging, especially in case of narrow aortic lumen or significant aortic angulation (hostile anatomy). The risk of complications such as graft kinking and target vessel occlusion is difficult to assess based solely on traditional software measuring methods and remain highly dependent on surgeon skills and expertise. METHODS: A patient with juxtarenal AAA with hostile anatomy had a 3-dimensional printed model constructed preoperatively according to computed tomography images. Endovascular graft implantation in the 3D printed aorta with a standard T-Branch Cook (Cook® Medical, Bloomington, IN, USA) was performed preoperatively in the simulation laboratory enabling optimized feasibility, surgical planning and intraoperative decision making. RESULTS: The 3D printed aortic model proved to be radio-opaque and allowed simulation of branched endovascular aortic repair (BREVAR). The assessment of intervention feasibility, as well as optimal branch position and orientation was found to be useful for surgeon confidence and the actual intervention in the patient. There was a remarkable agreement between the 3D printed model and both CT and X-ray angiographic images. Although the technical success was achieved as planned, a previously deployed renal stent caused unexpected difficulty in advancing the renal stent, which was not observed in the 3D model simulation. CONCLUSION: The 3D printed aortic models can be useful for determining feasibility, optimizing planning and intraoperative decision making in hostile anatomy improving the outcome. Despite already offering satisfying accuracy at present, further advancements could enhance the 3D model capability to replicate minor anatomical deformities and variations in tissue density.