This article provides highlights of the general process and workflow of creating a 3D-printed model from a medical image and discusses the applications of additively manufactured materials. It provides a brief background on Food and Drug Administration (FDA) classification and regulation of medical devices, with an emphasis on 3D-printed devices. Then, the article discusses two broad applications of 3D printing in craniofacial surgery: surgery and education. Next, it discusses, with respect to surgical applications, preoperative planning, use in the operating room, surgical guides, and implants. The article includes sections on education that focus on the use of 3D-printed surgical simulators and other tools to teach medical students and residents. It briefly touches on the FDA regulations associated with the respective application of 3D printing in medicine. Lastly, the article briefly discusses the state of medical billing and reimbursement for this service.

This article describes mechanical/electrochemical phenomena related to in vivo degradation of metals used for biomedical applications. It discusses the properties and failure of these materials as they relate to stress-corrosion cracking (SCC) and corrosion fatigue (CF). The article presents the factors related to the use of surgical implants and their deterioration in the body environment, including biomedical aspects, chemical environment, and electrochemical fundamentals needed for characterizing CF and SCC. It provides a discussion on the use of metallic biomaterials in surgical implant applications, such as orthopedic, cardiovascular surgery, and dentistry. It addresses key issues related to the simulation of an in vivo environment, service conditions, and data interpretation. These include the frequency of dynamic loading, electrolyte chemistry, applicable loading modes, cracking mode superposition, and surface area effects. The article explains the fundamentals of CF and SCC, and presents the test findings from laboratory, in vivo, and retrieval studies.

Additive manufacturing (AM), or three-dimensional (3D) printing, is a class of manufacturing processes that create the desired geometries of an object, or an assembly of objects, layer by layer or volumetrically. AM has been used extensively for manufacturing medical devices, due to its versatility to satisfy the specific needs of an intended medical field for the product/device. This article provides a comprehensive review of AM in medical devices by the medical specialty panels of the Food and Drug Administration (FDA) Code of Federal Regulations, Parts 862 to 892, including anesthesiology, ear and nose, general hospital, ophthalmic, plastic surgery, radiology, cardiovascular, orthopedic, dental, neurology, gynecology, obstetrics, physical medicine, urology, toxicology, and pathology. It is classified under these panels, and critical reviews and future outlooks are provided. The application of AM to fabricate medical devices in each panel is reviewed; lastly, a comparison is provided to reveal relevant gaps in each medical field.

Bridging the gap between education and medical practice, centralized hospital-based 3D printing, or what is termed point-of-care (POC) manufacturing, has been rapidly growing in the United States as well as internationally. This article provides insights into the considerations and the current workflow of creating 3D-printed anatomical models at the POC. Case studies are introduced to show the complex range of anatomical models that can be produced while also exploring how patient care benefits. It describes the advanced form of communication in medicine. The advantages as well as pitfalls of using the patient-specific 3D-printed models at the POC are addressed, demonstrating the fundamental knowledge needed to create 3D-printed anatomical models through POC manufacturing.

Additive manufacturing (AM), or three-dimensional printing, has ushered in an era of mass customization in the many different industries in which it is used. The use of the personalized surgical instrument (PSI) is no exception. Initially, PSIs were not a result of the use of AM; rather, what occurred is an improvement in their methods of manufacturing. This article discusses the fundamentals, benefits, manufacturing, and other application examples beyond orthopedics of PSIs. In addition, an outlook of AM in biomedical applications is also covered.

This article provides an overview of the adoption of additively manufactured materials in dentistry. It discusses the practical workflows of a three-dimensional printing technology, vat photopolymerization. Three subgroups of the vat photopolymerization process are laser beam or classic stereolithography apparatus (SLA), direct light processing, and liquid-crystal-display-masked SLA. The article covers two subgroups of 3D printing resins-based appliances, namely intraoral and extraoral appliances. Information on various types of dental appliances and the fabrication of in-office appliances is provided. The article also reviews fourth-dimension printing and discusses the applications of the personalized care model in medicine and dentistry.

Total joint replacement in orthopedic surgery can be achieved by excision, interposition, and replacement arthroplasty. This article details the most common materials used in total replacement synovial joints: metals, ceramics, and ultrahigh molecular weight polyethylene (UHMWPE). The principal physical properties and tribological characteristics of these materials are summarized. The article discusses pin-on-disk experiments and pin-on-plate experiments for determining friction and wear characteristics. It explains the use of various types of joint simulators, such as hip joint simulators and knee joint simulators, to evaluate the performance of engineering tribological components in machine simulators. The article concludes with a section on the in vivo assessment of total joint replacement performance.

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.

This article provides information on biomedical aspects such as active biological responses and the chemical environment characterizing the internal physiological milieu, as well as electrochemical fundamentals needed for characterizing corrosion fatigue (CF) and stress-corrosion cracking (SCC). It discusses some of the mechanical and electrochemical phenomena related to the in vivo degradation of materials used for biomedical applications. These materials include stainless steels, cobalt and titanium-base alloy systems, and dental amalgam. The article addresses key issues related to the simulation of the in vivo environment, service conditions, and data interpretation. The factors influencing susceptibility to CF and SCC are reviewed. The article describes the testing methodology of CF and SCC. It also summarizes findings from laboratory testing, in vivo testing and retrieval studies related to CF and SCC.

This article discusses some of the additive manufacturing (AM) based fabrication of alloys and their respective mechanical, electrochemical, and in vivo performance. Firstly, it briefly discusses the three AM techniques that are most commonly used in the fabrication of metallic biomedical-based devices: binder jetting, powder-bed fusion, and directed-energy deposition. The article then characterizes the electrochemical properties of additive-manufactured/processed cobalt-chromium alloys. This is followed by sections providing an evaluation of the biological response to CoCr alloys in terms of the material and 3D printing fabrication. Discussion on the biological response as a function of direct cellular activity on the surface of CoCr alloys in static conditions (in vitro), in dynamic physiological conditions (in vivo), and in computer-simulated conditions (in silico) are further discussed in detail. Finally, the article provides information on the qualification and certification of AM-processed medical devices.

Powder-bed fusion (PBF) is a group of additive manufacturing (AM) processes that includes selective laser sintering, selective laser melting, and electron beam melting. This article explains the processes and parameters of PBF systems that are used for biomedical applications. It also presents the desirable properties of biomedical devices and the advantages of using PBF systems for biomedical applications.

This article tabulates the chemical composition of iron-base, titanium-base, and cobalt-base alloys and illustrates the microstructures of these materials. It discusses the surface morphology and chemistry of oxide-film-covered alloys and provides insights into the interaction. The article illustrates the interfacial structure of a biomaterial surface contacting with the biological environment. It describes the corrosion behavior of stainless steel, cobalt-base alloy, and titanium alloys. The electrochemical methods used for studying metallic biomaterials corrosion are also discussed. The article concludes with information on the biological consequences of in vivo corrosion and biocompatibility.

This article demonstrates the depth and breadth of commercial and third-party software packages available to simulate metals processes. It provides a representation of the spectrum of applications from simulation of atomic-level effects to manufacturing optimization. The article tabulates the software name, function or process applications, vendor or developer, and website information.

The human internal environment plays a vital role in the friction and wear of implants and prosthetic devices. This article describes the tribological/wear behavior of implants. It discusses the classification of active tribological pairs, namely, amphiarthosis joints and diarthosis joints. The article details the classification of total knee replacement, depending on the type of mechanical stability, including nonconstrained knee replacement, semiconstrained knee replacement, and constrained knee replacement. It also discusses the classifications of passive tribological pairs, namely, total disc replacement in the spine, dental implants, and temporomandibular joint. It describes the various testing methods for characterizing the implant materials used in hip, knee, spine, and dental applications. The article also describes the typical standards used for testing wear behavior of tribological pairs, namely, hip-wear simulation standards, knee-wear simulation standards, and spinal disc-wear simulation standards.

Stainless steels are used for medical implants and surgical tools due to the excellent combination of properties, such as cost, strength, corrosion resistance, and ease of cleaning. This article describes the classifications of stainless steels, such as austenitic stainless steels, martensitic stainless steels, ferritic stainless steels, precipitation-hardening stainless steels, and duplex stainless steels. It contains a table that lists common medical device applications for stainless steels. The article discusses the physical metallurgy and physical and mechanical properties of stainless steels. Medical device considerations for stainless steels, such as fatigue strength, corrosion resistance, and passivation techniques, are reviewed. The article explains the process features of implant-grade stainless steels, including type 316L, type 316LVM, nitrogen-strengthened, ASTM F1314, ASTM F1586, ASTM F2229, and ASTM F2581 stainless steels.

This article provides an overview of additive manufacturing (AM) methods, the three-dimensional (3D)-AM-related market, and the medical additive manufactured applications. It focuses on the current scenario and future developments related to metal AM for medical applications. The discussion covers the benefits of using 3D-AM technology in the medical field, provides specific examples of medical devices fabricated by AM, reviews trends in metal implant development using AM, and presents future prospects for the development of novel high-performance medical devices via metal 3D-additive manufacturing.

Bioprinting has been advancing in the field of tissue engineering as the process for fabricating scaffolds, making use of additive manufacturing technologies. In situ bioprinting (also termed intraoperative bioprinting) is a promising solution to address the limitations of conventional bioprinting approaches. This article discusses the main approaches and technologies for in situ bioprinting. It provides a brief overview of the bioprinting pipeline, highlighting possible solutions to improve currently used approaches. Additionally, case studies of in situ bioprinting are provided and in situ bioprinting future perspectives are discussed.

In the field of medical device development and testing, the corrosion of metallic parts can lead to significant adverse effects on the biocompatibility of the device. This article describes the mechanisms of metal and alloy biocompatibility. It reviews the response of implant metals and particulate materials to corrosion. The effect of metal ions from an implanted device on the human body is also discussed. The article concludes with information on the possible cancer-causing effects of metallic biomaterials.

Vat polymerization is a form of three-dimensional (3D) printing. Historically, it is the oldest additive manufacturing technique, with the development of stereolithography apparatus (SLA) by Charles Hull in 1986. This article outlines the various forms of vat polymerization techniques used for biomedical applications. Due to the complex nature of this printing process, many key print parameters and material properties need to be considered to ensure a successful print. These influential parameters are addressed throughout the article to inform the reader of the considerations that should be taken when using the vat polymerization technique. The article provides information on vat polymerization printer setup, the photo-cross-linking mechanism, and considerations using vat polymerization. In addition, it outlines and discusses the advancements of vat polymerization in the biomedical industry.