3D Bioprinting: Printing Parts for Bodies

By ARC Centre of Excellence for Electromaterials Science

In January 2012, a little boy's life was saved by a 3D printer.

Kaiba Gionfriddo was born with a rare defect. When he was just six weeks old, his left bonchial tube collapsed. He stopped breathing. His parents rushed him to the hospital, where he was resuscitated. But over the next weeks, the attacks continued to recur. Kaiba’s parents were told that, without help, he could die.

Kaiba’s doctors then took an extraordinary step. They contacted tissue engineering researchers at the University of Michigan. The scientists took a CT scan of Kaiba’s airways and used the data create a life-saving implant, using a 3D printer, which was a perfect fit. The implant saved Kaiba's life, and now he has the strong breathing of a healthy baby boy.

This incredible story is an early example of a new clinical paradigm in biomedicine: 3D bio-printing. It may be only a few years before every major hospital contains 3D printing capabilities.

This e-book will tell the story of this revolution. It is written for a general audience, using animations and videos to explain the technology. Case studies of incredible stories, such as Kaiba's, illustrate the impact that has already been made on real lives. Along the way we will answer questions such as: What is 3D printing? How does it work? Is it really possible to print living cells? Can we print an organ? Could we print the human body? And in a time when new body parts can be printed on demand, where is the line between healing and enhancement—and should we cross it?

• Language: English
• Publisher: ARC Centre of Excellence for Electromaterials Science
• Release date: Dec 15, 2014
• ISBN: 9780646928678

Book preview

3D Bioprinting: Printing Parts for Bodies

By Gordon G Wallace, Rhys Cornock, Cathal D O’Connell, Stephen Beirne, Frederic Gilbert and Susan Dodds

Copyright

Published by the ARC Centre of Excellence for Electromaterials Science at Smashwords.

Copyright © 2014 Gordon G Wallace, Rhys Cornock, Cathal D O’Connell, Stephen Beirne, Susan Dodds, Frederic Gilbert.

Original animations are copyright © 2014 Mats Bjorklund.

Smashwords Edition, License Notes

This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each recipient. If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to your favorite ebook retailer and purchase your own copy. Thank you for respecting the hard work of this author.

Acknowledgements

We live in the midst of a scientific and engineering revolution that will impact on manufacturing as we know it.

In particular, the impact on biomedical science will be profound.

We scientists, engineers and ethicists who have co-authored this book are inspired by the clinicians with whom we have the pleasure to work with. It is these individuals who have highlighted the need for materials and fabrication breakthroughs to advance medical science.

These pioneers include Professor Peter Choong (Orthopaedic surgeon) (who provides the foreword to this manuscript), Professor Mark Cook (Neurologist), Professor Michael Coote (Ophthalmologist) and Professor Stephen O’Leary (ENT).

The genesis of our adventures in this clinical world can be traced to the inspiration Professor Graeme Clark (inventor of the multi electrode cochlea implant) provided over many years.

We also thank those colleagues who formally provided comments on our manuscript: Anita Quigley, Chee Too, Chris Richards, Fletcher Thompson, Jeremy Crook, Jordan Wallace, Kerry Gilmore, Michael Higgins, Simon Moulton and Toni Campbell.

We thank Phil Smugreski for important work behind the scenes. We also extend our gratitude to all of our colleagues in the ARC Centre of Excellence for Electromaterials Science – their collegiality and ongoing support makes this adventure incredibly enjoyable!

Contents

Foreword

Preface: The Additive Fabrication Revolution

Chapter 1: Putting stuff in the body: Biomaterials, Bionics and Tissue Engineering

Chapter 2: Materials and machinery for 3D Printing

Chapter 3: The Story So Far - Case Studies of 3D Printing in Medicine

Chapter 4: Printing bits for bodies

Chapter 5: Ethics, Policy and Social Engagement

Chapter 6: The Future

About the Authors

Foreword

Science does not know its debt to imagination.

Ralph Waldo Emerson

Degeneration, disease, cancer and trauma are the conditions that determine not only human longevity but also function. What gives life its fulfillment is the ability for each person to express himself or herself, not only emotionally and spiritually, but also physically. Independence and freedom to move are highly dependent on normally functioning systems.

Repair, regeneration and re-engineering are the stepping-stones in the pursuit of cure of many conditions. Science and medicine have converged in the 21st century to bring together the advances in stem cell science, cell biology, biomaterials and advanced additive manufacturing to potentially recreate functional organs that closely replicate the human situation. It is the imagination of both clinicians and scientists that have pushed the envelope of knowledge to the point where dreams are becoming reality not only for those entrusted to care for the sick but also those with disease.

This e-book writes about those dreams and how the collective of biomaterial science, advanced manufacturing and cell biology are being focused by clinical challenges, and how each advance inspires further work that ultimately leads to solutions previously thought impossible. The interactions of scientists and physicians that gave rise to the miracle of Kaiba where the construction of a dissolvable scaffold to support his weak and soft airway allowing him to breath and avoid certain death is a classic example of this. 

Modern multidisciplinary treatment will now see an important real-time role for the scientist who will provide contemporary solutions to help tackle complex conditions. In 6 chapters, Professor Wallace and his team describe the ability of modern science to dissect out clinical problems into its component parts (anatomic, structural, physiologic, functional), and then point to real-world solutions that have given birth to the new discipline of nano-techno-medicine. 

This book has been framed in a way to lead the reader through the technology of advanced additive biofabrication, then opening onto the requirements of the technology to make biofabrication useful for its clinical task with examples of how biofabrication has been used to solve clinical problems. Professor Wallace and his team have also highlighted the important ethical issues that this and frequently other new technology brings to ensure that important questions are raised around the appropriateness and applicability of leading edge advances in our community today and into the future.

Written in an extremely engaging style, with easy to understand language, this e-book opens the world of high-end science to those at all levels that may be interested in the field. Examples described show the versatility of this technology and how the previously unimaginable can quickly become a reality. 

What this ebook highlights is the importance of the tight bond and collaboration that is required between scientists and clinicians for successful research and translation. There is no doubt that this work will be an inspiration to those in or entering this field of research, and gives much hope to those afflicted by degeneration, disease, cancer and trauma, and for the teams of clinicians striving to provide the best treatments. 

Prof. Peter Choong

Melbourne, September 2014

Professor Peter F.M. Choong, MBBS, MD FRACS, FAOrthA is the Sir Hugh Devine Chair of Surgery and Head of the Department of Surgery at the University of Melbourne, Director of Orthopaedics at St. Vincent's Hospital, Melbourne, and the Chair of the Bone and Soft Tissue Tumour Unit at the Peter MacCallum Cancer Centre.

Preface: The Additive Fabrication Revolution

Toolmaking goes back at least 2.5 million years when homo habilis first struck flakes from small stones to fashion crude ‘choppers’ for cutting plants and meat. However, the invention of toolmaking did not cause a revolution overnight. It took almost a million years for the chopper to develop into the bifacial ‘hand-axe’, with flakes chipped from both faces to leave a sharper edge. Throughout history, humans have developed new tools to solve problems. They have used new tools to create better tools and so on. From those crude choppers 2.6 million years ago humans have made tools, to make tools to make the device you are reading this ebook on today. 

A 3D printer is a new kind of tool capable of transforming the user (who might not have any training or experience in engineering or craftsmanship) into a master-crafts person. It enables the thought-to-thing process to be achieved in an extraordinarily short period of time. If the printer is paired with a 3D scanner, the user can replicate the shape of almost any object. Alternatively, using 3D drawings, the user can create structures which are not possible by any other means. A 3D printer can, quite literally, turn your imagination into reality.

What is 3D Printing?

Almost all of the tools of daily life (furniture, machinery, electronics) are made by shaping small parts and then fitting or joining them together. The parts have (usually) been created by chipping away from a larger block—that is, by the ‘subtraction’ of material. 3D printing is different. In engineering terms, it is ‘additive manufacturing’. The distinction between ‘subtractive’ and ’additive’ is not mere pedantry. The ability to create objects from the bottom-up leads to unprecedented capabilities for industry.

Our definition: A 3D printer is a computer controlled robotic system which creates three-dimensional objects through the layer-by-layer addition of material.

When and how was it invented?

The story of 3D printing begins in the early 1980’s with an American engineer smearing glue onto a table.  Chuck Hull was working with a special type of polymer which could be coated onto a surface in liquid form and then solidified using UV light—a process which can be used to give a table-top a hard veneer. Hull was the first to realize how this material could be used to print in three dimensions, and so changed the world.

What he did was simple. Firstly, he smeared the liquid polymer on a surface. Then, instead of illuminating the whole surface to create a solid coating, he used a small UV torch to draw a pattern with the light beam. The pattern of solidified polymer lay there in the coating, a pattern drawn in invisible ink. After washing away the liquid with a solvent, the pattern revealed itself. This was interesting, yet still only 2D. He repeated the experiment. This time, after drawing a pattern within the layer of liquid, he coated a second layer of liquid polymer on top. He drew a second pattern on top of the first. When he dissolved away the liquid this time, the solid parts were revealed, stacked on top of one another, a free-standing, solid, three-dimensional structure. He was drawing in 3D.

In his patent application, Hull called the technique ‘stereolithography’. The word derives from the Ancient Greek stereos meaning ‘solid’ and the word ‘lithography’, which is used in modern engineering to refer to any patterning process. He built the very first machine capable of automating the process—a robot which maneuvered the UV light source to draw pre-defined patterns in a bath of liquid polymer. A movable stage lowered the working area so that each layer was laid on top of the one before. Hull also developed the software to control the process. He even invented the special file format (termed .stl for ‘standard tessellation language’) which can convert a computer aided design (CAD) drawing into a 3D printable format. It does do by dividing the drawing up into thousands of triangles, which can then be sliced and stacked on top of one another like a paper sculpture.

Since Hull’s stereo lithography (as described in Figure 0.1), the concept of printing in three dimensions has been extended to many hundreds of materials; including many different polymers exhibiting a range of mechanical properties, various metals (including steel and titanium), and even more unusual materials such as cement, sugar and chocolate. The proliferation of printable materials has ensured 3D printing is equally intriguing to both the hobbyist and the seasoned engineer.

The New Design Paradigm: Why 3D printing is a Revolution

It has been said that 3D printing will alter manufacturing more than anything since Henry Ford’s assembly line, thereby ushering in the ‘Third Industrial Revolution’. Let’s see why.

Rapid Prototyping

3D printing has actually been around for about 30 years, already causing dramatic changes in the world of manufacturing. Its initial impact has been as the enabling technology for ‘rapid prototyping’, the rapid creation of new product designs. Using 3D printing, the time required to modify a test-product is dramatically reduced, to the extent that they can be built in a matter of hours rather than weeks. This greatly increases the frequency of prototype iterations (e.g. the step from version 1.1 to version 1.2) and shortens the time to market. The engineering firm Dyson (inventors of the bagless vacuum cleaner, and the Airblade hand-dryer) have been early adopters of rapid prototyping. Car manufacturers, such as Ford, also speed up the design of new vehicles in this way. Besides saving time, products are developed with a much lower price tag, at least for the prototyping phase. In recent years, research organisations have implemented 3D printing to accelerate experimental programs. The ability to design and fabricate unique experimental componentry at the bench has revolutionised many laboratories.

Flexibility

3D printers have the potential to be the ultimate problem solver. If deployed in a remote rural area, for example, a printer could be used to quickly fashion the tools and parts needed to fix a faulty irrigation system, or any other machine for that matter. NASA plans to send a 3D printer up to the International Space Station in 2014. It will be used by astronauts to create replacement parts and tools on demand, thereby reducing the multitudes of spares they need