Medical

Bosch Advanced Ceramics is a leader in the production of highly innovative medical components thanks to its expertise in the field of additive manufacturing of ceramics. Recently, the company successfully tackled a challenging project: the manufacture of ultra-thin ceramic insulating sleeves for a laparoscopic tool with a wall thickness of 90 µm, to be used in minimally invasive procedures.

By using Lithoz CeraFab printers, Bosch Advanced Ceramics were not only able to increase series production to 50,000 components per year, but also produce an impressive 1,400 parts on one build platform. LCM technology made it possible to meet the stringent medical standards while providing superior material performance, including chemical resistance and extended durability.

Cleft palates are among the most frequent congenital diseases in the western world. Roughly, 1 in 1000 children suffer from an underdeveloped palate at birth, resulting in a pathological opening in the hard and soft palate and sometimes causing compromised lip structures. This disease can range from an incomplete defect in the soft palate to a bilateral complete lip and cleft palate. Patients suffer from frequent infections due to germs that can enter the adjacent tissues from the mouth, as well as experiencing speech and respiratory difficulties and psychosocial issues.

Current treatment options involve a temporary palatal obturator for the cleft palate and surgery for the cleft lip. However, these options are often inadequate as they do not permanently solve the underlying issue.

Researchers and companies have developed a new treatment option based on resorbable ceramic materials to replace the missing bone in the palatal area and combine it with soft materials to help the closure of the oral mucosa. Patient-specific designs and interconnected open porous geometries, in combination with established materials like hydroxy apatite and tricalcium phosphate, can guarantee a complete healing of the congenial bone defect and thus improve childrens' lives.

Osteoarthritis is one of the ten most disabling diseases in industrialised countries and can make hip replacement necessary. A common complication of traditional hip replacement is implant loosening due to stress shielding. One possible solution to these problems is short stems to preserve more healthy bone and minimise stress shielding.

In the course of an Open Call activity within the framework of the European InkPlant Projekt, Lithoz, Universidad Politécnica de Madrid and Universidad de Piura followed this approach to optimize the design for patient-specific short femoral stems and manufacture them via LCM technology from the bioceramics alumina-toughened zirconia (ATZ). This well-established biocompatible ceramic is especially suitable because of its high strength and low wear. The design process underwent several steps including a topological optimization resulting in a failure probability of less than 9*10^-10 and a weight reduction of more than 43%.

The 3D printing of high-performance ATZ enabled the manufacture of this innovative femoral stem implant in an efficient and easy way. Lithoz, together with the University partners, helped find a new treatment option for one of the most disabling diseases in developed countries.

Minimal invasive surgery procedures allow for faster patient recovery, but require even smaller and more complex tools. High endurance and delicate features are required, particularly in the case of arthroscopy. Ceramics exhibit outstanding properties in terms of wear resistance, hardness and electrical insulation. Among other properties, these make ceramics the ideal material for surgical tools.

The manufacture of this arthroscopic shaver made of alumina-toughened zirconia (ATZ) would not be possible without the design freedom of Lithography-based Ceramic Manufacturing. The application perfectly illustrates the delicate features that can be achieved, such as rinsing channels, a guide for a fiber optic, as well as incredibly sharp cutting geometries.

Even small deviations in the length or angle during healing of long bones can cause pain and severely restrict functionality. It is therefore vital to achieve absolute precision during the treatment of the defect to enhance or restore the patient's quality of life. This makes LCM technology the perfect choice for manufacturing such long bone implants.

3D-printed ceramic bone replacements from hydroxy apatite, like this ulnar wedge implant, offer patient-specific scaffolds which are replaced with new bone by the human body over time. Tricalcium phosphate is also available as a faster resorbable alternative. Due to their similarity to the mineral components of bone, LithaBone products have optimal biocompatibility and osteoconductivity and are therefore the ideal material for bone replacement even for critical size bone defects.

Arthritis and other diseases of joints wear which results in massive pain and mobility restrictions. By treatment with artificial joints, patients can regain their mobility and live their lives pain-free.

3D-printed ceramic implants, such as these finger joints from alumina-toughened zirconia (ATZ), show very good tribological properties which lead to high endurance without debris. Thanks to an interconnected lattice structure, the implant is safely fixed due to excellent osseointegration. In addition, except for titanium, the critical biodistribution from abrassion of metal implants into the human body is completely avoided, making ceramics a safe alternative.

Atrophy, i.e. missing bone volume, of the jaw is the long-term result of tooth loss. This loss of bone also prevents the replacement of these teeth with the current gold standard – dental implants - necessitating surgery to augment the volume of local bone with either harvested bone grafts or other materials.

One very promising novel approach is treatment with a 3D-printed bioresorbable multi-material patient-specific implant, i.e. made to perfectly integrate with the patient’s anatomy. The INKplant Project aims to develop this new treatment approach by combining the best properties of two established augmentation materials - tricalcium phosphate and hydroxyapatite - in one custom 3D-printed implant. Tricalcium phosphate promotes the fast ingrowth and generation of the jawbone due to its faster resorption time. The hydroxyapatite shell ensures the mechanical and volume stability of the implant during healing and replaces the membrane as a barrier against premature ingrowth of soft tissue, which would prevent bone formation.

This novel implant is designed to deliver predictable results and enable a quicker surgical procedure with reduced pain and swelling, benefitting the patient.

In intensiver Zusammenarbeit mit den Anwendern bisheriger Knochenersatzkeramiken entwickelte Lithoz das neue LithaBone HA 480. 3D gedruckte Teile aus Hydroxylapatit sind hervorragend resorbierbar, dank wichtiger Verbesserungen eignen sie sich bestens für den Knochenaufbau im medizinischen Bereich:

- Significantly improved mechanical stability for dimensionally stable bone replacements

- Significantly increased geometric flexibility

- Significantly higher wall thicknesses of up to 10 mm

- 10-fold longer shelf-life

Silicon nitride is regarded as the optimum biocompatible high-performance ceramic, which has found its way from the aerospace industry into medicine. Due to its high strength, good osseointegrative properties and, of course, excellent biocompatibility, it is ideal for long-lasting implants.

It is used in orthopaedics and neurosurgery. In the latter, for example, it is used for the production of so-called spinal cages (interfusion bodies). This type of implant is used for the treatment of herniated discs for surgical spinal fusion.

The intracardiac pump made of bioinert aluminum oxide supplies the heart with blood after a heart attack or heart surgery. The application was developed by TU Wien and the Medical University of Vienna.

The alumina material used, LithaLox HP 500, is characterized by high mechanical strength and wear resistance as well as low surface roughness (Ra = 0.4 µm). This can reduce the formation of blood clots. The pump is driven by helium and ensures blood supply during the healing phase without electric current, which should prevent thermal damage to the surrounding tissue.

Bioinert high-performance ceramics with perfect surface quality can, for example, minimize cell interaction on components with direct blood contact and prevent blood clotting.

A car accident resulting in a craniocerebral trauma might result in the need of pressure relief surgery (trepanation) to save the patient’s life. The cranial bone area removed must be replaced.

3D printing offers the possibility to produce patient-specific bioresorbable implants for faster healing. Furthermore, 3D printing allows the creation of an interconnected pore network where the size and shape of pores can be specifically designed to best support the healing process. Cells can enter these pores and form new blood vessels, subsequently encouraging resorption of the implant and the regeneration of native bone tissue. All this can be done without harming any animals as the materials are of non-animal sources and thus are vegan.