Medical 3D Printing: Leveraging the Established for the Emerging

In spite of the similar goals to improve and save lives, established medical 3D printing (established being defined here as 3D printing of guides, models, prosthetics, patient assist devices, and permanent implants) and emerging tissue-restorative 3D printing/bioprinting (with or without living cells) are frequently treated independently of each other. With different communities, professional societies and events, terminology and language, and technical disciplines, it remains rare for these two ends of the spectrum to closely interact – and it is indeed a spectrum. This lack of interaction is unfortunate, as the established medical 3D printing communities continue to lay a strong foundation from which the emerging tissue-restorative 3D printing communities can further build upon but may not be aware.

Conversely, many of the new technologies, processes, and materials as well as deep biological understanding being advanced on the emerging tissue-restorative side of 3D printing could be leveraged to improve established 3D printing processes. The good news, however, is that the interaction between the two ends of the spectrum can be readily improved, supporting the development, translation, and use of even more life improving and saving treatments. To begin building this interaction, it is important to understand how what is being done today in the established medical 3D printing community can be connected to the emerging 3D printing community, and vice versa.

The ever-expanding use of established medical 3D printing to diagnose, assist, teach, train, and even restore function through prosthetic explants or tissue-replacing implants is greatly validating of not only its clinical benefits, but also its increasing exposure to and access by medical personnel. This validation and increased exposure and access has not occurred spontaneously but could in fact be significantly attributed to the years of concerted efforts by passionate individuals and supporting organizations, giving their time and resources to increase training and awareness, establish consistency and standards, and even press for insurance reimbursement and financial support pathways. This has created routes that further define workforce development, technical processes, regulatory processes, and means of logistically and financially moving the technologies and their products into the hands of clinicians and their staff. Whether it be off-the-shelf or patient-matched, off-site or point-of-care produced, the process by which established 3D-printed medical devices are designed and created, including patient imaging, image processing, 3D model design, the actual act of 3D printing, post-processing, and sterilization (or aseptic handling) has matured significantly and can and should be leveraged for development and adoption of tissue-restorative 3D-printed/bioprinted structures.

While relatively newer than the established side of the spectrum, tissue-restorative 3D printing/bioprinting continues to advance rapidly due to accelerated progress related to new fabrication and characterization tools, improved understanding of cell and tissue-level biology, and increased appreciation for and ability to measure extracellular microstructure. The convergence of these new techniques with new biological understanding have resulted in the development of new biomaterials that emulate tissue microstructure and are able to interact with the body’s cells in a way that traditional materials cannot.  With these advances, commercialized, acellular (does not include living cells) 3D-printed tissue-restorative and regenerative products are on the near horizon, with cellularized, living tissue-restorative and regenerative structures not far behind.

Overcoming the challenges related to tissue-restoration and regeneration has yielded and continues to yield new knowledge, techniques, materials, and approaches to implant design and capabilities that would otherwise remain unexplored in established medical 3D printing. A These new approaches and capabilities can be directly applied to established medical manufacturing, yielding more structurally and tactically accurate models for surgical training and planning and improved patient-matched permanent implants. Thus, although the materials, the final outputted design, and the ultimate end use may differ from what is used in established medical 3d printing, the core of the pathway for tissue-restorative 3D printing/bioprinting from design to machine, to clinician, to patient remain the same or very similar.

Without a doubt, there is still much that must be done to advance tissue-restorative 3D printing/bioprinting to the same level of ubiquity as present-day, established medical 3D printing, and established medical 3D printing (despite using the term “established” here) still has a long way to go to reach its full potential. With the possibility to create and apply implants that fully restore or replace the function of damaged or missing tissues or organs, mitigate recurrence of cancers, treat systemic, chronic pathologies, and greatly improve and save lives, it behooves all of those in the tissue-restorative/bioprinting 3D printing end of the spectrum to learn from the established medical 3D printing community and what they have achieved and how.

Similarly, to those on the established medical 3D printing end of the spectrum who may feel you don’t have much to share with the tissue-restorative/bioprinting side or don’t have much to learn, you in fact very much do. Share knowledge. Share experiences. Attend events together. Learn each other’s terminologies. And support each other as part of the larger medical 3D printing community to continue to create and deliver life improving and saving treatments to those who need them most.

Join the discussion at the AM Medical Summit, November 1-3 in Minneapolis.