Foreword xiii Preface xv 1 Introduction to 3D Printing in Healthcare 1 1.1 Introduction 1 1.2 The Revolutionary Rise of 3D Printing Technology 7 1.3 3D Printing Revolution Engineering 7 1.4 3D Printer Types for Additive Manufacturing 9 1.5 3D Printing in the Healthcare Industry 9 1.6 Early-Phase Drug Development 10 1.7 Customized Drugs 10 1.8 Advanced Pharmacological Treatments 11 1.9 Community Medicine 11 1.10 Clinical Pharmacy Practice 11 1.11 3D Printing Process and Product Variable Optimization 12 1.12 Recent Trends in 3D Printing Regulation 12 1.13 Conclusion 13 References 14 2 3D Printing in Medical Science 19 2.1 Introduction 19 2.2 Present Clinical Applications 21 2.3 3D-Printed Models in CHD 21 2.4 Cardiovascular Disease Models in 3D Printing 22 2.5 Tumor in 3D-Printed Models 23 2.6 3D-Printed Models in the Development of CT Scanning Procedures 24 2.7 Pharmaceutical 3D-Printing Technologies 24 2.8 Challenges Facing Printed Pharmaceuticals 25 2.8.1 A Developing Sector 27 2.9 Opportunities and Limitations of Using 3D Printing in Healthcare 28 2.10 Conclusion and Future Direction 31 References 31 3 3D Printing in Fabrication of Dosage Form 37 3.1 Introduction 37 3.2 History 39 3.3 Advantages 39 3.4 Limitations and Challenges 40 3.5 Personalized Dosage Form 41 3.6 Bio-Inks 41 3.7 Applications in Healthcare 41 3.8 3D Printing Techniques 42 3.8.1 Binder Deposition 42 3.8.2 Material Jetting 43 3.8.3 Extrusion 43 3.8.4 Powder Bed Fusion 43 3.8.5 Photopolymerization (Stereolithography) 44 3.8.6 Pen-Based 3D Printing 44 3.9 Comparison to the Conventional Manufacturing Technique 44 3.10 Comparisons between Various 3D Printing Techniques 44 3.10.1 Basic 3D Printing Procedure 44 3.10.1.1 Designing 45 3.10.1.2 Creating a Machine-Readable Format 45 3.10.1.3 Raw Material Processing 45 3.10.1.4 Actual Printing 45 3.10.2 Various Dosage Forms 45 3.10.3 Immediate-Release Tablet 45 3.11 Bilayer Tablets 46 3.11.1 Capsule 46 3.11.2 Polypill 46 3.11.3 Sedds 47 3.11.4 Implants 47 3.12 Benefits of Various Disorders 47 3.12.1 Cancer 47 3.12.2 Diabetes 48 3.13 Cardiovascular Diseases 48 3.14 Neurodegenerative Diseases 49 3.15 Other Diseases 49 3.16 Regulatory Issues 50 3.17 Conclusions 50 References 51 4 The Potential of 3D-Printed Anatomical Model for Surgical Planning 59 4.1 Introduction 59 4.2 3D-Printed Approaches: Anatomical Simulations 61 4.2.1 Orthopedic Tissue 61 4.2.2 Heart Valve 62 4.2.3 Neurosurgery 62 4.2.4 Malignant Tissues 62 4.3 Congenital Anomalies: Surgical Planning 63 4.4 Anatomical Training With 3D-Printed Models 63 4.5 Advantages, Challenges, and Ethical Concerns 63 4.6 Fundamentals of 3D Printing 64 4.7 Additive Manufacturing Techniques 65 4.8 Surgical Applications 66 4.8.1 Craniofacial and Nervous Systems 66 4.8.1.1 Head and Neck 66 4.8.1.2 Brain and Spinal Cord 68 4.9 Cardiovascular System 68 4.9.1 Cardiothoracic 68 4.9.2 Vascular 70 4.10 Clinical Applications in Preoperative Planning 70 4.11 Cardiovascular Surgery 70 4.12 Neurosurgery 71 4.13 Craniomaxillofacial Surgery 72 4.14 Orthopedic Surgery 73 4.15 Interventional Radiology 73 4.16 Other Interventions 73 4.17 Conclusion 75 References 75 5 Customized Implants and Prosthetics with 3D Printing 85 5.1 Introduction 85 5.2 Image Acquisition and Prosthesis Design 88 5.3 Manufacturing the TAV Prosthesis 89 5.4 Patient Information 89 5.5 Commonly Used 3D Printing Technologies in the Medical Field 89 5.5.1 Fused Deposition Modeling or Free Form Fabrication 90 5.5.2 Extrusion-Based Bioprinting 90 5.6 Material Sintering 91 5.7 Process Chain for Customized Prosthetics and Implants 92 5.7.1 Product Requirements 92 5.7.2 Design Process 92 5.8 Applications 93 5.8.1 Endoprostheses 93 5.8.2 Patient-Specific Surgical Guides 94 5.8.3 Knee Implants 94 5.8.4 Spinal Implants 95 5.9 3D Printing Technology for a Customized Implant and Prosthesis Production 95 5.10 Benefits of 3D-Printing-Customized Implants and Prostheses 96 5.11 Limitations and Future Directions 97 5.12 Conclusion 97 References 97 6 Advanced Drug Delivery Systems with 3D Printing 101 6.1 Introduction 101 6.2 Modern 3D-Printing Technologies 104 6.2.1 Vat Photopolymerization-Based 3D Printing 104 6.3 SLA-Printed Drug Delivery Devices 104 6.4 DLP-Printed Drug Delivery Devices 105 6.5 CLIP-Printed Drug Delivery Devices 105 6.6 TPP-Printed Drug Delivery Devices 106 6.7 FDM for Advanced Drug Delivery Applications 107 6.8 Local Drug Delivery Devices 107 6.8.1 Implanted Medical Medication Delivery Systems (Long-Term Organ and Drug-Eluting Devices) 107 6.9 Surgical Intervention and Postoperative Implants 108 6.10 Challenges and Future Perspectives 109 6.11 The Multi-Material Additive Manufacturing Technique 109 6.11.1 Microneedles 110 6.11.2 Soft Robots 110 6.11.3 Implants 110 6.12 Regulatory Issues of Drug Delivery Medical Device 111 6.13 Scalability and Cost Factors 112 6.14 Conclusion 114 References 114 7 Exploring the Fabrication of 3D-Printed Scaffolds for Tissue Engineering 121 7.1 Introduction 121 7.2 Scaffold Architecture Design 123 7.2.1 Scaffold Library 123 7.2.2 Functionally Graded Scaffold 124 7.2.3 Design for Vascularization 125 7.3 Scaffold-Based Technique 126 7.3.1 Polymeric Scaffolds 126 7.3.2 Hydrogel System 127 7.3.3 Inorganic Scaffolds 128 7.4 Scaffold-Free Approach 130 7.5 Bioreactor 131 7.6 Design Considerations 132 7.6.1 Scaffold Materials 132 7.6.2 Bio-Ink 132 7.6.3 Bioprinters 133 7.7 Conclusion 133 References 134 8 Personalized Medicine with 3D Printing 143 8.1 Introduction 143 8.2 History of 3D Printing 146 8.3 Technologies for 3D Printing in Pharmaceutical Research and Development 147 8.3.1 The Inkjet Printing Process 147 8.3.2 Continuous Inkjet Printer 147 8.3.3 Drop-on-Demand Inkjet Printer 147 8.3.4 Thermal Inkjet Printer 148 8.3.5 Piezoelectric Inkjet Printer 148 8.4 Medicinal Applications for Inkjet Printers 148 8.5 Binder Jet Printing 150 8.6 Medicinal Applications for Binder Jet Printing 150 8.7 Fused Deposition Modeling 151 8.8 Selective Laser Sintering 152 8.9 Pressure-Assisted Micro-Syringe 152 8.10 The Possibility of 3D Printing in Individualized Medicine 153 8.11 Dose Personalization 153 8.12 Modifying Release Profiles 154 8.13 Combination Tablets—Polypills 155 8.14 3D Printing for Everybody 156 8.14.1 Medical Pediatric Treatment 156 8.14.2 Tending to Geriatrics 156 8.15 3D Printing in a Clinical Setting 157 8.15.1 Challenges 157 8.15.2 Technology 157 8.15.3 Safety Aspects 158 8.15.4 Clinical Pharmacy Practice 158 8.16 Regulatory Aspects 158 8.17 Conclusion 159 References 160 9 3D Printing Techniques in a Medical Setting 167 9.1 Introduction 167 9.2 Medical 3D Printing on Four Different Levels 168 9.2.1 Organ Models for Preoperative Diagnosis and Treatment Evaluation 168 9.2.2 Permanent Non-Bioactive Implants 170 9.3 Fabricating Local Bioactive and Biodegradable Scaffolds 172 9.4 Characteristics of Scaffolds 173 9.4.1 Indirect Cell Assembly 173 9.4.2 Direct Cell Assembly 174 9.5 Enhancing the Mechanical Properties of Scaffolds 176 9.6 Directly Printing Tissue and Organs 176 9.7 Biomedical Material in 3D Printing 177 9.8 Medical Metal Materials 177 9.9 Medical Polymer Materials 178 9.10 Medical Ceramic Materials 179 9.11 Limitations 180 9.12 Conclusions and Future Directions 180 References 181 10 3D Printing in Hospital Administration and Management 187 10.1 Introduction 187 10.2 Role of 3D Printing in Medicine 189 10.3 What Can Go Wrong 189 10.4 Techniques for 3D Printing in Clinical Settings 191 10.5 Design Input and Output 191 10.6 Production Process and QA 193 10.7 Image Acquisition 194 10.8 Segmentation 194 10.9 Printing the Model 195 10.10 Validation and Verification of Processes 196 10.11 Collaboration Between Medical Professionals 196 10.12 Unique Obstacles and Regulatory Issues 197 10.13 Conclusion 198 References 198 11 Emerging Applications of 3D Printing in Plastic Surgery 205 11.1 Introduction 206 11.2 3D Printing 207 11.3 3D Printing in Medicine 208 11.4 Preoperative Planning 209 11.5 Intraoperative Guidance 209 11.5.1 Education 209 11.5.2 Customized Prosthesis 209 11.5.3 Allied Health 210 11.6 Bioprinting for Plastic Surgery Applications 210 11.6.1 Skin Wounds 210 11.7 3D Printing in Plastic and Reconstructive Surgery 212 11.8 Preoperative Planning: Soft Tissue Mapping 212 11.9 Preoperative Planning: Vascular Mapping 213 11.10 Preoperative Planning: Bony Mapping 214 11.11 Intraoperative Guidance 214 11.12 Surgical Training 215 11.13 Patient Education 216 11.14 Patient-Specific Prosthesis 216 11.15 Conclusion 217 References 218 12 Safety, Efficacy, and Point-of-Care for 3D Printing in Healthcare 229 12.1 Introduction 229 12.2 The Call for Standardization and Guidelines 231 12.3 Applications and Benefits of Medical 3D Printing 231 12.4 Deciding to Become a POC Manufacturer 233 12.5 Obtaining 3D-Printing Management Support 235 12.6 Setting Up a Platform to Assist POC 3D Printing 236 12.6.1 Training and Staff 236 12.6.2 Facility Requirements: Area, Building, and Power 237 12.6.3 Sterilization 238 12.6.4 Quality Management System 238 12.6.5 Regulatory Considerations 239 12.7 Powder-Based Binding Method 240 12.8 Conclusion 241 References 241 13 3D Printing in Robotic Urosurgery 249 13.1 Introduction 249 13.2 Potential Urological Applications 251 13.3 Patient-Specific 3D Models Help Experienced Surgeons Plan, Practice, and Guide Complicated Procedures 252 13.3.1 Pre-Operative Strategy 252 13.3.2 Surgical Training 253 13.4 Surgical Training Using 3D Generic Technique Models 254 13.5 Patient Education and Counseling 257 13.6 Conclusion 258 References 259 14 3D Printing in Ophthalmology 263 14.1 Introduction 263 14.2 External Eye Illness and Corneal Disease 265 14.3 Corneal Tissue Bioprinting 266 14.4 Drug Delivery 268 14.5 Glaucoma 268 14.6 Drug-Eluting Implants 269 14.7 Minimally Invasive Glaucoma Surgery Devices 269 14.7.1 Retina 270 14.7.2 Lids and Orbit 271 14.8 Regulatory Considerations 273 14.9 Expert Opinion and Future Directions 273 14.10 Conclusions 274 References 275 Index 279

The main goal of this book is to explore the application of 3D printing in medicine and healthcare that could revolutionize drug development and medical equipment production and also improve supply chains, pharmaceuticals, and healthcare. In the fields of medicine, pharmaceuticals, surgical planning, and personalized medical treatment, the novel emergence of 3D printing technology has opened a wide range of potential applications. With personalized solutions that were previously impossible, 3D printing has opened up novel possibilities in patient care, from developing unique medications to manufacturing prosthetics and implants that are particular to each patient. The 14 chapters in this volume present the reader with an array of subjects including: the evolution and background of 3D printing, charting its extraordinary path from its inauspicious origins to its current significance in the field of healthcare. Also discussed are the many kinds of 3D printers that are employed in additive manufacturing, as well as how they are modified for usage in medical settings;the current developments in medical science brought about by 3D printing technology, including the clinical uses of 3D printed models in different medical domains, ranging from cardiovascular illness to tumors, and congenital heart disease;personalized medicine and the creation of dosage forms utilizing 3D printing methods, the benefits and drawbacks of various 3D printing technologies and the applications of these technologies in healthcare, including the creation of immediate-release tablets, capsules, and implants for a range of illnesses;the possibilities of 3D printed anatomical models for surgical planning, the roles of 3D printing technologies that are used to produce surgical guides, knee implants, spinal implants, and other patient-specific applications;the current developments in 3D printed medication delivery devices including regulatory concerns;the field of personalized medicine using 3D printing, and discusses organ models for preoperative diagnostics, permanent non-bioactive implants, local bioactive and biodegradable scaffolds, and direct printing of tissues and organs;the different specialized uses of 3D printing in the medical field, covering topics including hospital management and administration, surgical training for urological operations, ophthalmology, and preserving safety and efficacy in point-of-care. Audience The book will be widely read by all healthcare professionals, biomedical engineers, researchers, and graduate students who are seeking to expand their knowledge of efficient techniques of 3D printing technology in the healthcare sector.