Dental Asia July/August 2022

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BEHIND THE SCENES Bringing 3D printing to the next level for sustainable healing What can 3D printing bring forth to the manufacturing of regenerative implants? Dr Lim Jing, CTO of Osteopore, elaborates more. Three dimensional or 3D printing is an additive manufacturing process that has been around for a while now – but is still guaranteed to attract attention. It produces a physical object from a digital design and has been creating a buzz in the healthcare industry since the 1990s when dental implants and custom prosthetics took off. While there are many different types of 3D printing available, Osteopore has been embracing the technological advantage that 3D printing has over traditional manufacturing techniques. This has enabled us to create a microstructure that is representative of native bone while meeting the gross geometrical needs of the reconstruction area and facilitating technology differentiation from other medical implant providers. It involves harnessing the body’s regenerative capacity to rebuild lost tissues and the bioresorbable materials in Osteopore’s implants leverage the combined technologies of tissue engineering, regenerative medicine and 3D printing techniques. 3D printing technology allows us to make regenerative implants. Osteopore’s bioresorbable implant is the first of its kind to be successfully developed and commercialised for surgical use, and this technology paves the way for the future of healthcare. When used appropriately, the solutions created with 3D printing regularly outperform traditional implant methods in terms of design and associated long-term healthcare costs. 3D printing allows the creation of complex geometries that copy the shape and function of natural bone and allows efficient productisation, particularly in customised implants. Given the complex nature of bone microarchitecture, 3D printing enables production at a cost-effective scale. Pairing advancements in technology and automation enables the production of implants around the clock and even remotely, bringing forth a compelling commercial industrial business case for the technology alongside the medical rationale of what is possible. But most importantly, 3D printing is reshaping what implants can do, and how patients can be treated – often patient comfort and experience during recovery are improved. Additive manufacturing’s role in the medical field continues to develop and mature, and while in some medical specialities the hype of 3D printing has gone down – the value that 3D printing can provide to this field will be recognised once the industry understands and accepts the technology and its benefits. The compelling argument for the technology is that it has the combination of being able to produce something as specific as the biomimetic architecture at Osteopore, as well as its scalability at the same time. Besides being consistent and reproducible, 3D printing allows Osteopore to manufacture products at scale and produce them in a way that meets quality standards. 48 DENTAL ASIA JULY / AUGUST <strong>2022</strong>
BEHIND THE SCENES What is the largest implant Osteopore has printed? The largest implant Osteopore has produced is 36cm in length and was implanted in an Australian patient in Queensland for a shin bone reconstruction surgery. He has since recovered well and can ambulate without crutches. Osteopore honeycomb microstructure BREAKDOWN OF 3D PRINTING Choice of 3D Printing Osteopore utilises Fused Deposition Modelling, or Fused Filament Fabrication as it has been more recently called. This method of 3D printing is so far one of the most reliable and reproducible among other techniques and hence is suited to producing parts and design. In addition, the microstructure that is incorporated into Osteopore products can be consistently reproduced in good quality using this method. Also, the physical properties of parts produced by this method of 3D printing fit well with the needs of the application area. What are the available products? Osteopore’s product portfolio includes Osteomesh, Osteoplug and Osteoplug-C in various sizes. These are available offthe-shelf to allow surgeons quick access to products so that they can treat patients as soon as possible. In addition, Osteopore provides customised implants designed based on the patient’s and surgeon’s treatment plan. What are bone graft substitutes? Traditionally, bone graft substitutes are derived from animal, cadaveric, or synthetic sources. Osteomesh Guided Bone Regeneration They are used to fill bone voids in the skeletal system. Although their particulate nature allows them to fill irregularly sized bone voids easily, they do not provide structural support to the skeletal system. As a result, they are mostly used in smaller areas of bone loss, or areas of lower stress activation. Why is porosity necessary? Porosity is a basic requirement for bone ingrowth and blood vessel ingrowth. It is also representative of the natural structure of bone: a highly porous and interconnected pore system. Without an interconnected pore system, bone tissue may consequently grow around the implant rather than through the implant – this may not lead to the intended outcomes of bridging and providing support to the skeletal system. Are bone graft substitutes porous? They are in a way, but there is a substantial amount of variability depending on how they are packed into the bone void. If they are packed too tightly, the pores become compressed or are isolated, making them unamenable to the ingrowth of tissue. If they are packed too loosely, it may not be ideal for bone formation. How does 3D printing create consistent porosity? 3D printing with Osteopore’s microstructure allows us to define the pore spaces and reproduce them consistently. In this way, the consistency of providing open channels for bone and vessel ingrowth is ensured. How does 3D printing enable the implant to work? The pillars of tissue engineering include scaffolds, cells and growth factors. Osteopore’s technology provides a scaffold that is bioresorbable and designed to allow cells and growth factors to be incorporated at the point of surgery. In our off-the-shelf products, cells and growth factors can grow into the scaffold structure due to the open pore system. How does the Osteopore design facilitate bio-stimulation? The combination of our choice of material, 3D printing technique, and pore design allows the scaffold to withstand some level of compression forces. This is important as it allows these forces to be transmitted to cells for them to experience appropriate levels of mechanical stimulation to aid in bone repair and growth. DA ABOUT THE AUTHOR Dr Lim Jing holds a PhD from Nanyang Technological University, Singapore. Prior to joining Osteopore, Dr Lim researched biomaterials for tissue engineering and regenerative medicine and developed material fabrication platforms. He published 14 articles in internationally peer-reviewed journals during that time. Dr Lim joined Osteopore in December 2014 and has led Osteopore to important regulatory and quality milestones, expanded product and therapy portfolio and contributed to the improvement in manufacturing efficiency. DENTAL ASIA JULY / AUGUST <strong>2022</strong> 49
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Dental Asia July/August 2022

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