This article provides an overview of currently available metal AM processes for the medical industry; outlines a step-by-step review of the typical workflow for design, manufacturing, evaluation, and implantation of patient-specific AM devices; and examines the existing research trends in medical applications of AM with specific focus on metallic biomedical implants. Finally, challenges and opportunities for future developments in AM pertaining to the medical field are also explored.

Three-dimensional plotting of biomaterials (also known as bioprinting) has been a major milestone for scientists and engineers working in nanobiotechnology, nanoscience, and nanomedicine. It is typically classified into two major categories, depending on the plotting principle, as contact and noncontact techniques. This article focuses on the working principles of contact and noncontact printing methods along with their advantages, disadvantages, applications, and challenges. Contact printing methods include micro-plotter, pen printing, screen printing, nanoimprint printing, flexography printing, and gravure printing. Noncontact printing methods include extrusion printing, droplet printing, laser-based polymerization, and laser-based cell transfer. The wide variety of printable biomaterials, such as DNA, peptides, proteins, lipids, and cells, also are discussed.

This article discusses alginate/gelatin-based bioinks in 3D bioprinting applications, providing a summary of the most relevant previous work in the field. It presents advanced compositions to enhance functionality and/or optimize hydrogels for 3D bioprinting. The article discusses advanced printing techniques for alginate/gelatin-based bioinks.

Due to its layer-by-layer process, 3D printing enables the formation of complex geometries using multiple materials. Three-dimensional printing for bone tissue engineering is called bioprinting and refers to the use of material-transfer processes for patterning and assembling biologically relevant materials, molecules, cells, tissues, and biodegradable biomaterials with a prescribed organization to accomplish one or more biological functions. Currently, 3D bioprinting constructs can be classified into two categories: acellular and cellular. This article introduces and discusses these two approaches based on the suitable materials for these constructs and the fabrication processes used to manufacture them. The materials are grouped into polymers, metals, and hydrogels. The article also summarizes the commonly used 3D printing techniques for these materials, as well as cell types used for various applications. Lastly, current challenges in tissue engineering are discussed.

Additive manufacturing (AM) technologies print three-dimensional (3D) parts through layer-by-layer deposition based on the digital input provided by a computer-aided design file. This article focuses on the binder jet printing process, common biomaterials used in this AM technique, and the clinical applications relevant to these systems. It reviews the challenges and future directions of binder-jetting-based 3D printing.

The field of bioprinting is a subset of additive manufacturing (AM) that is rapidly expanding to meet the needs of regenerative medicine and tissue engineering. Bioprinting encompasses a broad spectrum of issues, from cell expansion and novel bioink development to cell/stem cell printing, from organoid-based tissue organization to bioprinting of human-scale tissue structures, and from building cell/tissue/organ-on-a-chip to biomanufacturing of multicellular engineered living systems. This article focuses on two challenges regarding bioprinting: bioinks and crosslinking. It describes the methods for characterizing the performance of bioink formulations and the effectiveness of crosslinking strategies. The topics covered include modalities of bioprinting, characteristics of bioink, rheological properties of bioink sols, rheological measurements, mathematical models of bioink rheology, postfabrication polymer network mechanics, mechanical properties of crosslinked bioinks, and printability of bioinks. Finally, specific strategies used for crosslinking bioinks, as well as some emerging strategies to further improve bioinks and their crosslinking, are summarized.

The use of 3D bioprinting techniques has contributed to the development of novel cellular patterns and constructs in vitro, ex vivo, and even in vivo. There are three main bioprinting techniques: inkjet printing, extrusion printing (also known as bioextrusion), laser-induced forward transfer (LIFT) printing, which is also known as modified LIFT printing, matrix-assisted pulsed-laser evaporation direct write, and laser-based printing (laser-assisted bioprinting, or biological laser printing). This article provides an overview of the LIFT process, including the LIFT process introduction, different implementations, jetting dynamics, printability phase diagrams, and printing process simulations. Additionally, materials involved during LIFT are introduced in terms of bioink materials and energy-absorbing layer materials. Also, the printing of single cells and 2D and 3D constructs is introduced, showcasing the current state of the art with the ultimate goal for tissue- and organ-printing applications.

Inkjet printing is extremely precise in terms of the ejected microdroplets (picoliter volume), contributing an unparalleled lateral resolution. Additionally, the benefits of high-speed deposition, contactless ink delivery, and the use of a range of ink materials endorse this technique as suitable for high-throughput 3D manufacturing. This article provides an overview of inkjet 3D printing (also referred to as 3D inkjetting). It then highlights the major components and accessories used in commercial and laboratory-based 3D inkjet printers. Next, the article describes the process physics of the transient phenomena involved in both binder-jetting- and direct-inkjetting-based 3D printing. It then discusses the scope and advantages of 3D inkjetting in the manufacturing of metallic, ceramic, and polymer-based biomaterials. The article also discusses several approaches and methodologies to examine the in vitro cytocompatibility and in vivo biocompatibility of both binder-jetted and direct-inkjetted scaffolds for biomedical applications. Finally, it discusses the challenges and troubleshooting methodologies in 3D inkjetting of biomaterials.

Microvalve jetting, with its advantages of low cost, ease of operation, high printing speed, and ability to process living cells with high viability, has been primarily used for fabricating high-throughput drug-screening models, in vitro cellular structures for fundamental cell biology research, and cell-laden structures for regenerating tissues or organs in the human body after disease or trauma. This article provides an overview of microvalve jetting of biomaterials, including operational parameters. The jetting technologies covered are inkjet printing, microvalve jetting, and laser-assisted jetting. The parameters covered include nozzle size (nozzle inner diameter), pneumatic pressure, valve-opening time, and printing speed of microvalve jetting. Subsequently, the article discusses biomaterials for microvalve jetting in terms of biomaterial definition, required properties for a suitable biomaterial, currently used biomaterials, and cells and cellular structures. Additionally, applications of microvalve jetting in biomedical engineering are presented, which include cellular and RNA analysis, high-throughput drug screening, and tissue engineering.

This article focuses on the pneumatic extrusion-based system for biomaterials. It provides an overview of additive manufacturing (AM) processes, followed by sections covering steps and major approaches for the 3D bioprinting process. Then, the article discusses the types, processes, advantages, limitations, and applications of AM technology and extrusion-based approaches. Next, it provides information on the research on extrusion-based printing. Finally, the article provides a comparison of the extrusion-based approach with other approaches.

This article discusses electrospinning as a method for obtaining nanofibers, some of the challenges and limitations of the technique, advancements in the field, and how it may be used in key functional applications. The key drawbacks of traditional electrospinning processes include relatively slow speed of nanofiber production, low product yield, and relatively high cost. The article also addresses novel high-throughput techniques and methods designed for the scalable synthesis of nanofibers and nanofibrous mats that are of reasonable cost.

This article discusses the state of the art in the 3D bioprinting field. It examines the printability of protein-based biopolymers and provides key printing parameters, along with a brief description of the main current 3D bioprinting approaches. The article presents some studies investigating 3D bioprinting of naturally derived proteins for the production of structurally and functionally biomimetic scaffolds, which create a microenvironment for cells resembling that of the native tissues. It describes key structural proteins processed in the form of hydrogels, such as collagen, silk, fibrin, and others such as elastin, decellularized matrix, and Matrigel (Corning), which are used as biomaterials.

This article discusses the mechanisms of metal and alloy biocompatibility. It provides information on early testing and experience with metals in medical device applications. The article describes the response of implant and particulate materials to severe corrosion. It provides a description of metal binding and its effects on metabolic processes. Hypersensitive responses to metal ions are also reviewed. The article concludes with a discussion on the possible cancer-causing effects of metallic biomaterials.

This article focuses on ceramics, glasses, glass-ceramics, and their derivatives, that is, inorganic-organic hybrids, in the forms of solid or porous bodies, oxide layers/coatings, and particles with sizes ranging from nanometers to micrometers, or even millimetres. These include inert crystalline ceramics, porous ceramics, calcium phosphate ceramics, and bioactive glasses. The article discusses the compositions of ceramics and carbon-base implant materials, and examines their differences in processing and structure. It describes the chemical and microstructural basis for their differences in physical properties, and relates the properties and hard-tissue response to particular clinical applications. The article also provides information on the glass or glass-ceramic particles used in cancer treatments.

This article reviews the corrosion interactions between biomedical alloys, in particular iron-base, titanium-base, and cobalt-base alloys, in complex geometries and in applications where there are significant cyclic stresses and potential for wear and fretting motion. It discusses the nature of these metal surfaces and their propensity for corrosion reactions when combined with similar or different alloys in complex restrictive environments within the human body and under loading conditions. The article describes the factors that influence mechanically assisted crevice corrosion. It reviews the tests developed to investigate the aspects of mechanically assisted corrosion of metallic biomaterials: the scratch test and the in vitro fretting corrosion test.

This article outlines the selection criteria for choosing an implant material for biomedical devices in orthopedic, dental, soft-tissue, and cardiovascular applications. It details the development of various implants, such as metallic, ceramic, and polymeric implants. The article discusses specific problems associated with implant manufacturing processes and the consequent compromises in the properties of functionally graded implants. It describes the manufacturing of the functionally-graded hip implant by using the LENS process. The article reviews four different types of tissue responses to the biomaterial. It discusses the testing methods of implant failure, such as in vitro and in vivo assessment of tissue compatibility.

This article provides an overview of the fundamentals of tribology. It describes the advantages, disadvantages, and applications of the pin-on-disk method, which is the most commonly used configuration for testing biomaterials and for the reproducible measurement of friction and wear. The article illustrates a practical tribocorrosion setup that allows a user to perform wear tests in corrosive environments under well-defined electrochemical conditions and at controlled temperature. It explains the effect of changes in electrical contact resistance on tribological mode. The article discusses various in vivo environmental conditions in tribological tests. Some typical examples of biomaterials testing are also provided.

Polymers offer a wide range of choices for medical applications because of their versatility in properties and processing. This article provides an overview of polymeric materials and the characteristics that make them a unique class of materials. It describes the ways to classify polymers, including the polymerization method, how the material deforms, or molecular origin or stability. The article contains tables that list common medical polymers used in medical devices. It explains the medical polymer selection criteria and regulatory aspects of materials selection failure analysis and prevention. Failure analysis and prevention processes to determine the root cause of failures that arise at different stages of the product life cycle are reviewed. The article describes the mechanisms of plastic product failure analysis. It discusses the trends in the use of medical polymers, such as high-performance polymers for implants, tissue engineering, and bioresorbable polymers.

This article provides a background to the biological evaluation of medical devices. It discusses what the ISO 10993 standards require for polymeric biomaterials and presents examples of qualitative and quantitative tests that can be used to satisfy these requirements. The article describes infrared (IR) and thermal analyses that are used extensively to fingerprint polymeric materials. It also presents a discussion on the chemical characterization and risk assessment of extracts. Background information on risk assessments of extracts is also included. The four basic steps that are commonly used in the risk assessment process are discussed. These include hazard identification, dose-response assessment, and exposure assessment, and risk characterization.