Mouth Scanned for Same-Day Crown

Image Credit:  http://www.cockeysvilledentist.net/

Recently, I broke yet another tooth which required - of course - another crown.  But this time was different.  Today, after my dentist did the standard tooth preparation, a licensed technician scanned my tooth using a hand-held 3D scanner and then downloaded the CAD file onto the computer right next to my chair.  I got to watch her manipulate the 3D model - the dental office knew I have a 3D printing company, so they humored me.  She explained how she first determines the borders and then calculates the bite (using a scan of the tooth's chewing mate).  She then proceeded to determine the best tooth shape to ensure a proper rough fit.

The procedure used was a great example of a hybrid manufacturing process because once the file was ready, the tooth was made using subtractive instead of additive manufacturing.  A block was milled to the correct size and then further reduced by hand through successive mouth fittings.  Once the ideal fit was achieved, the uncured porcelain crown was baked for a mere 20 minutes and then glued permanently (hopefully) into my mouth.

It would have been really cool if it had been 3D printed, but honestly, this process took less time, so for now, that's good enough for me.

Skill Gap Recognized as Challenge to Additive Manufacturing

BY THE NUMBERS

17.4 million: Jobs supported by manufacturing in the United States

12: The percentage of manufacturing in the nation's GDP

$77,000: The average salary of manufacturing workers

$60,000: The average salary of entry-level manufacturing engineers

17: The percent of Americans who view manufacturing as a viable career choice

Source: National Institute of Standards and Technology, courtesy of Orange Count Register

My parents and brothers own a small box-making plant in Pittsburgh. When I was young, we would play in the scrap piles, sweep the floors, and do odd jobs to pass the time while our parents worked.  Because of this unique experience - and because Pittsburgh was a major steel producer - I knew that manufacturing was a good career choice - if you could get the work.  Unfortunately, it earned a bad reputation in the 70s, 80s, and 90s as more companies offshored and consolidated their production facilities.  I myself left the field to teach when I had to oversee Nabisco's Pittsburgh plant closing.

This experience is one reason I'm very excited about Additive Manufacturing (3D printing).  It uses advanced technology, requires high-skilled labor and conserves raw materials... things I hope will attract another generation of U.S. makers... but first, this generation will need to learn the skills required to design, scan and make 3D printed prototypes, parts, tools and models. Increasingly, schools, like some in Orange County, recognize the importance of ensuring enough workers have those skills.

According to Orange County Register reporter Tomoya Shamira, the Dean of the UC Irvine School of Engineering Dr. George Washington describes his students' experiences,

"Students at UCI receive training in a host of additive manufacturing technologies such as selective laser sintering and stereolithography."  

And this is fueling an interest in manufacturing... 

"CI engineering professor Marc Madou said 3D printing is helping young people become interested in manufacturing, partly because they can turn their design into a physical model quickly."

But not all jobs will require an engineering degree which highlights the need to partner with local community colleges as well...

"While advanced technologies are changing the manufacturing landscape, there’s growing demand for experienced welders and machinists as U.S. companies are bringing their manufacturing back home. Two-thirds of manufacturers said they couldn’t find qualified workers, according to a survey conducted by the Manufacturing Institute and Deloitte Consulting."

 

3D Printing Lets Visitors Enjoy Ancient Ruins Without Ruining Them

Image Credit:  3dprintingindustry.com

Weeks before the Egyptian Revolution, I had the opportunity of a lifetime to visit Cairo.  When I visited the pyramids, I was shocked to see so many people climbing all over them.  I had imagined we wouldn't be allowed to touch, let alone scale, something so ancient and valuable.  

Such access has taken a toll on another Egyptian site:  the burial chamber of the Pharaoh Tutankhamun.  

"It was the constant changes, caused by the humidity of the breath and temperature of the visitors that had started to make the paint on the walls crack, and the plaster to fail.

It was decided that if something wasn't done, the chamber would deteriorate to the point where valuable artifacts would be lost."

Fortunately, 3D printing has come to its rescue.  A Spanish-based 3D printing company undertook a five-year project to thoroughly 3D scan the tomb's interior and 3D print an exact replica.

Perhaps one of the most extensive examples of using additive manufacturing to preserve history, the Egyptian project is just one of many such efforts.  For years, the Smithsonian Institution has also been scanning and printing a number of its artifacts:  Smithsonian X 3D allows individuals to remotely "navigate, explore and manipulate 3D collection objects"  And other museums have begun to reproduce valuables to make exhibits more interactive and accessible.

FDA Considers Approach to Additive Manufacturing of Medical Devices

Patient-specific printed splints are used to treat life-threatening thoracic constrictions.  Work done at the University of Michigan involves laser sintering bio compatible, bio absorbable materials. 

The official purpose of this week's FDA-sponsored workshop was "to provide a forum for FDA, medical device manufacturers, additive manufacturing companies and academia to discuss technical challenges and solutions of 3D printing."  In other words, the FDA wants "input to help it determine technical assessments that should be considered for additively manufactured devices to provide a transparent evaluation process for future submissions."

The FDA is trying to stay current with advanced manufacturing technologies that are revolutionizing patient care and, in some cases, democratizing its availability...  When a next-door neighbor can print a medical device in his or her basement, that clearly has many positive and negative implications that need to be considered.  

Ignoring the regulatory implications for a moment (I'll get to those shortly), the presentations were fascinating.  In particular, I was intrigued and inspired by the Post-Printing speakers and Clinical Perspectives projects.  

STERIS representative Dr. Brodbeck cautioned that the complex designs and materials now being created with additive manufacturing make sterilization practices challenging.  How will the manufacturer know if the implant is sterile or if the agent has been adequately removed or if it is suitable? Some materials and designs, for example, cannot tolerate acids, heat or pressure. 

Wake Forest Presenter Dr. Yoo shares his institution's research on bioprinting

Dr Boland from the University of Texas El Paso shared his team's work on 3D printed tissues. Using inkjet technology, the researchers are evaluating the variables involved in successfully printing skin.  Another bio-printing project being undertaken at Wake Forest by Dr. Yoo involves constructing bladder-shaped prints using bladder cell biopsies and scaffolding.  And Dr. Liacouras at Walter Reed discussed his institution's practice of using 3D printing to create surgical guides and custom implants.

Since RapidMade creates anatomical models, one project, near and dear to my heart - pun intended - is work done at Children's National Hospital by Drs. Krieger and Olivieri.  The physicians use printed cardiac models to "inform clinical decisions" ie. evaluate conditions, plan surgeries, and reduce operating time. 

As interesting as the presentations were, the subsequent discussions were arguably more important.  In an attempt to identify and address all significant impacts of additive manufacturing on medical device production, the subject was organized into pre-printing (input), printing (process) and post-printing (output) considerations.  Panelists and other stakeholders shared their concerns and viewpoints on each topic in an attempt to inform and persuade FDA decision makers.

An interesting (but expected) outcome was the relative positions of the various stakeholders. Well establish and large manufacturers proposed validation procedures:  material testing, process operating guidelines, quality control,  traceability programs, etc.  Independent makers argued that this approach would impede, if not eliminate, their ability to provide low-cost prosthetic devices.

Coming from the highly regulated food industry, I completely understand and accept the need to adopt similar measures for some additively manufactured medical devices.  An implant is going into someone's body, so the manufacturer needs to evaluate and assure the quality of raw materials, processing procedures and finished product.  But this means, as in the food industry, the manufacturer needs to know the composition of materials.  Suppliers cannot hide behind proprietary formulations.  If manufacturers are expected to certify that a device is safe, they need to know what ingredients are in the materials they are using.

Hopefully, the FDA will also agree with the GE representative who suggested that manufacturers should be expected to certify the components and not the process.  What matters is whether or not the device is safe, not what process was used to make it.  Another distinction should be the product's risk level.  Devices should continue to be classified as I, II or III and that classification, not the process used, should determine its level of regulation.

If you are interested in submitting comments to the FDA on this topic, email them to  http://www.regulations.gov .

3D Scans and Prints Show Patients What to Expect from Plastic Surgery

Dr. Avsar holds facial mask (Photo Credit: 3Dprint.com

If you've ever had plastic surgery - or had to decide whether to have it - you understand the anxiety of not knowing what you'll look like.  After being diagnosed with nasal skin cancer , I had MOHS surgery to remove the basal cell carcinoma, and while the surgery itself was successful, the skin flap used to cover the site left an obvious scar and collapsed (misaligned) nostril.  Subsequent procedures improved its appearance, but my plastic surgeon is recommending rhinoplasty to correct the deviated septum.  

Having faced (pun intended) three surgeries and post-op care, I'm not keen to go through it again - although it'd be nice to breathe better.  Yet I worry about what it will look like.  Drawings can't capture or convey exactly how my nose (with its thickened scar tissue and pulled nostril) will appear.

But now, a cosmetic surgeon is 3D scanning his patient's faces, manipulating the resulting 3D models to depict their post-operative appearances and printing "before" and "after" masks on a 3D Systems Colorjet printer.  What makes this such an effective tool is that it is a replica of the patient in his or her current and future states, reducing the unknown.

Will 3D Printing Replace or Augment Craftsmanship?

Grand Concourse Restaurant:  Photo Credit:  Muer.com

In my hometown of Pittsburgh, there is a beautiful restaurant, the Grand Concourse in Station Square.  It is the site of the former Pittsburgh and Lake Erie Railroad Station.  My grandfather was a cabinet maker for the railroad, and my grandmother once told me, years later, that one of his accomplishments was the refurbishment of its ornate ceiling.  A section of the elaborate crown molding, made of marble I believe, had been destroyed.  My grandfather created a replica out of wood which was such a close match, one couldn't pick out the faux molding.  I imagine the hours of labor that went into this important project and wonder how my grandfather would have reacted to our now being able to quickly scan the molding and print a copy overnight.

Many believe that the craftsmanship of that generation has largely been lost, replaced by mass produced materials.  But perhaps 3D printing will spur a high-tech revival.  Access to 3D scanning and additive manufacturing technologies already allow us to re-create artifacts that have been lost to time.   RapidMade often gets requests to replicate facades and other architectural features.  We once printed replacement stove handles for an antique oven.  And now, digital designs and additive manufacturing enable artisans to imagine and create exotic and unique objects that would have been difficult, if not impossible, to be made in my grandfather's time.

Custom 3D Models Effective Tool to Plan and Discuss Surgeries

Image Credit:  3DPrint.com

Last month, a relative underwent what was expected to be a routine ablation procedure:  9 1/2 hours and 3 a-fib episodes later, the surgery finally finished.  Despite CT scans, X rays and EKGs, the surgeons encountered "structural issues" that complicated the operation.  I thought afterward if they had had a 3D print of his heart, they might have anticipated and planned contingencies based on what they saw.  Apparently I'm not alone in this believe...

A masters student from Drexel, Jason Kirk, released a study, "3D Printed Cardiac Imaging Data," that suggests that patients and surgeons benefit from reviewing patient-specific 3D printed replicas of their organs prior to consenting to surgery.  Feedback given to the researcher indicates that a majority of surgeons find 3D models more effective than 2D illustrations in sharing information and facilitating discussions.  According to Kirk, “Cardiac anatomy replicas can be used to facilitate Doctor/Patient communication and supplement contemporary visualization techniques by providing accurate three dimensional data which offers additional haptic and spatial feedback specific to the patient’s anatomy and pathology.”

But how is the replica made?  CT scans and MiMiC software are used to create custom 3D prints that can include cut aways to show the internal structure of the organs.  And the practice is becoming more popular:  RapidMade recently created lung models for a research center interested in using them for patient education.

"Crash Course" in 3D Printing and Additive Manufacturing

3D Printing and Additive Manufacturing Glossary

The terms 3D printing and additive manufacturing are used interchangeably. They refer to a group of new technologies and processes that allow parts, models, and (in some cases) assemblies to be built three dimensionally.
Additive manufacturing is often best explained by how it differs from other types of production. Metal machining is a common and proven form of subtractive manufacturing: you start with a block of metal and cut away material until you are left with the desired design. Additive manufacturing, on the other hand, builds from a 3D model and only adds material where it is needed.
This is done by slicing a CAD modeled object into thin layers, sometimes as thin as 16 microns (0.0006in), and building each layer in succession. This unique manner of creating things allows for amazing new designs and geometries not previously possible with traditional manufacturing. For instance:
- Parts can now be made that have incredibly complex internal structures that cut out weight        while maintaining structural integrity
- Many design constraints (like requiring draft and undercuts) that limit traditional manufacturing  are obsolete
- Additively manufactured parts can be post-processed with traditional processes to improve  functionality or aesthetics
- Original masters for traditional casting processes can be produced easily and quickly
- Interlocking parts can be created without the need for assembly

3D printing is currently a hot topic. It's a rapidly growing market expected to reach $20 billion by 2020. Deemed “The New Manufacturing Revolution” by The Economist and Wired, additive manufacturing will dramatically affect the way things are made in the near future. Some experts believe it will help reinvigorate American manufacturing, while others believe it will democratize production of goods and every house will have its own 3D printer.
Whatever the future holds, see the reverse side of this sheet for a brief glossary of terms that will help you navigate the worlds of additive manufacturing.

Common Acronyms
FDM: short for fused deposition modeling (tradmarked by Stratsys) and also known as fused filament fabrication (FFF). See: material extrusion, thermoplastic
SLS: short for selective laser sintering. See: powder bed fusion
DMLS: short for direct metal laser sintering. See: powder bed fusion
SLA: short for stereolithography apparatus. See: vat photopolymerization

Types of additive manufacturing
Vat photopolymerization: this process builds parts by using light to selectively cure layers of  material in a vat of photopolymer.
Material jetting: this process builds parts by depositing small droplets of photopolymer    (similar  to an inkjet printer) which are then cured by exposure to light.
Binder jetting: this process creates objects by squirting a binding agent into a powdered material.
Material extrusion: this process creates objects by extruding thin filaments of thermoplastic to build layers. It is often likened to a tube of toothpaste or a syringe.
Powder bed fusion: this process selectively melts fine layers of powdered plastic or metal into solid objects using a laser.
Sheet lamination: this process builds parts by trimming sheets of material and binding them together in layers.
Directed energy deposition: This process builds or repairs parts by using focused thermal energy to fuse materials as they are deposited on a substrate.
Materials
thermoplastic: plastic that softens when heated and solidifies when cooled
photopolymer: a liquid plastic that hardens permanently when exposed to light

Common Materials

Material                   Strength               Flexibility              Surface Finish           Feature Detail
Zcorp Composite1   ★★★☆☆☆           ★☆☆☆☆☆            ★★★☆☆☆                 ★★★★☆☆
FDM Plastic              ★★★★☆☆           ★★★☆☆☆            ★☆☆☆☆☆                 ★★☆☆☆☆
Objet Plastic2           ★★☆☆☆☆           ★★★★★★            ★★★★★★                 ★★★★★★
SLS Plastic               ★★★★☆☆            ★★★★☆☆            ★★★☆☆☆                 ★★★☆☆☆
Printed Metal            ★★★★★☆           ★★☆☆☆☆             ★★☆☆☆☆                 ★★☆☆☆☆
DMLS Metal              ★★★★★★           ★★☆☆☆☆             ★★★☆☆☆                 ★★★☆☆☆
SLA Plastic                ★★★☆☆☆           ★★★☆☆☆             ★★★★☆☆                 ★★★★☆☆
1 ZCorp printers are one of the few processes that can create colored objects and can even reproduce photographs and modeling textures
2 Objet can print rigid (Shore D) and soft (Shore A) materials, giving it a flexibility range up to the maximum

Surgeons Use 3D Printed Models to Plan Surgery

3D model of cancerous kidney courtesy of 3DPrinter.Net

In a previous blog, we discussed how 3D printing is helping surgeons train to perform specific procedures.  More recently, they have begun using them to plan patient surgeries as well.  Having 3D models made from a patient's CAT scans allows doctors to literally do a "dry run" which enables them to reduce the time spent in the operating room - and more importantly - increase the surgeon's accuracy.   These benefits are helping Japanese oncologist surgeons battle kidney cancer.

"By using CT scans, the surgeons were able to produce 3D scans of the patient’s kidney. The information was then sent to a 3D printer, and a 3D model of the kidney was produced. The transparent 3D printed kidney model allows surgeons to see exactly where the patient’s blood vessels are"

Knowing the exact location of blood vessels reduces the time required to disrupt blood flow which typically takes an average of 22 minutes.  Working with models beforehand lowered the time required by as much as 64%.  If one physician's estimates of $147/minute are to be believed, that could save as much as $2,000 in operating room costs - more than the $500 - $1,500 cost associated with 3D modeling and printing a patient's organ.  When one considers the additional benefit of improved accuracy, any improvement derived in surgery outcomes makes the approach potentially life saving and well worth the cost.

3D Printing Helping Decommission Nuclear Power Plants

Image Credit:  Wikipedia/Engineer.com

One under-appreciated benefit of 3D printing is being able to 3D scan and reproduce obsolete parts - either through traditional or additive manufacturing.  For example, we've been working with the State of Oregon to reverse engineer, improve and manufacture obsolete parts for some of its correctional facilities - saving several thousand dollars for each cell door that is refurbished rather than replaced.

This same approach is now being used in England to decommission nuclear power plants.

"Sellafeld recently designed a new lid for one of its 40-ton nuclear waste export flasks. By using 3D scanning engineers were able to quickly and accurately recreate the geometry of a legacy component, saving time and thousands of dollars. From those 3D scans a new lid will be printed, saving even further costs.

That’s only one example of the way 3D printing will be used to curb expenses, engineers expect AM to play a big roll in a number of future component redesigns in both plastic and metal.

Given that the estimated cost of the two plants’ decommissioning has ballooned to $118 billion, any savings that can be wrung out of the project will be greatly appreciated by the UK taxpayers."

High-profile cases like this will hopefully help reduce one hurdle to adoption:  getting agencies to appreciate the potential cost, time and ecological savings associated with reverse engineering and additive manufacturing of obsolete parts.  

Save Thousands and Make a Splash at Tradeshows!

Monitor produced for close to half the cost of and in far less time than traditional manufacturing

Exhibiting at tradeshows, while rewarding, can be very expensive and stressful:  transporting and staging large equipment can consume a large portion of a company’s marketing budget.  But it doesn’t have to.  Using 3D printing techniques, firms can get to-scale, full-color prototypes and models of their equipment that can easily be carried and displayed on site. 

The Client:

FlatHED, Inc. is an industrial design company which specializes in designing appealing and sleek consumer goods that are also cost effective to manufacture.

The Need: 

Not all cost-effective designs for manufacture are cost-effective in small quantities for tests and tradeshows.  FlatHED designed an all-in-one computer that would house electronics that their customer wanted to show off at a trade show.  To CNC machine the design out of aluminum would have cost over $10,000 for just one unit and then they  would have been left with an unfinished, heavy part covered in tool marks.  They needed two working devices and had only $8,000 to budget for both, so they turned to RapidMade™.  

 The Solution: 

Working with FlatHED to modify the design for a special mix of manufacturing methods, RapidMade™ was able to create a finished product out of ABS plastic, ceramic, and sheet metal.  The final part was indistinguishable from the metal design and finished with high quality automotive gloss and matte finish paint, contained all the electronic components, held the weight of a heavy computer monitor, and (most importantly) cost slightly over half the original $8,000 budget. 

To-scale, full-color model shows internal components of large equipment

The Client:

Cornell Pump Company produces some of the best pumps in the business and attends over a dozen trade shows every year for food processing, mining, agriculture, and other industries that require pumping. 

The Need:

Cornell has had great success shipping and displaying their actual pumps for view at these shows, but they wanted a way to show potential customers the inner mechanics of the pumps in an attention-getting way.

 The Solution:

Cornell asked RapidMade™ to produce tabletop models of their large pumps with color coding and cutaways.  Customers can see the inner components and compare the colors with a labeled legend near the pump.  Having a tool that helps to explain the mechanics of the pumps is a valuable sales tool; it helps customers connect the dots for application.  Seeing the 3D printed colored replica also draws the attention of browsing show attendees.  On top of all of that, the ceramic model can be easily carried under the arm of a tradeshow representative, eliminating the need for expensive shipping.

3D Printed Casts

The technique is antiquated and could use a little something of a shake up thanks to new technology.

Setting castings in plaster is centuries old and has a variety of uncomfortable problems. Scanning and imaging of the body are common place in the medical field in order to diagnose injuries and illnesses, but the ability to create prosthesis and custom fixtures directly from those scans is brand spanking new, from printed bones and teeth implants to entire artificial limbs. The parts either fit to the contours of your body or are exact replicas of the body part which they replace. 

This technique now produces a superior cast taken directly from a 3D scan of the broken body part and 3D prints a cast from the digital negative. The cast is designed with snap fits which enclose the arm, keeping it from moving, but making it accessible to air and hands. Much more comfortble.

Just another simple example where the medical field can benefit from applying new technologies (additive manufacturing/3D printing) to ones that are already pervasive in the medical field (3D scanning and imaging.)