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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5361_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Aim and Scope
- •Preface
- •Acknowledgments
- •Contents
- •Contributors
- •About the Editors
- •1.1 Introduction
- •1.2.1 Friction
- •1.2.1.3 Friction Under Lubricated Conditions
- •1.7.1 Joint Tribology
- •1.7.2 Skin Tribology
- •1.7.3 Oral Tribology
- •1.8 Summary
- •References
- •2.1 Introduction
- •2.3.1 Fluid Pressurization/Fluid-Film Lubrication
- •2.3.2 Boundary Lubrication
- •2.3.3 Hydrodynamic Lubrication
- •2.3.4 Squeeze-Film Lubrication
- •2.3.5 Synovial Fluid
- •2.3.6 Hydration Lubrication
- •2.5.2 Scaffolds
- •2.5.3 Synthetic Polymer
- •2.5.4 Polyacrylamide
- •2.5.5 PEG Hydrogel
- •2.5.6 PVA Hydrogel
- •2.5.7 Double Network Hydrogel
- •2.5.8 Triple Network Hydrogel
- •2.6.1 Polyacrylamide
- •2.6.2 PEG Hydrogel
- •2.6.3 PVA Hydrogel
- •2.6.4 Double Network Hydrogel
- •2.6.5 Triple Network Hydrogel
- •2.7.1 Mechanical Properties
- •2.7.2 Structural Properties
- •2.8 Conclusion
- •References
- •3.1 Introduction
- •3.3.1 Label-Based Biosensors
- •3.3.2 Label-Free Biosensors
- •3.4 Different Nanobiosensing Techniques
- •3.4.1 Optical Sensing
- •3.4.2 Electrochemical/Electrical Sensing
- •3.4.3 Magnetic Sensing
- •3.4.4 Mass-Based Sensing
- •3.6.2 Neurodegenerative Diseases
- •3.6.3 Infectious Diseases
- •3.6.4 Metabolic Diseases
- •References
- •4.1 Introduction
- •4.2.1 Surface Functionalization
- •4.2.2 Bioconjugation
- •4.3 Synthesis Approach
- •4.3.1 Hydrothermal Method
- •4.3.2 Chemical Vapor Deposition (CVD)
- •4.3.3 Wet Chemical Method
- •4.4 Plasmonic Black Bodies (PBBs)
- •4.4.1 Gold NP (AuNPs)-Based PBB
- •4.4.2 Silver NPs (Ag NPs)-Based PBB
- •4.4.3 Platinum NPs (Pt NPs)-Based PBB
- •4.5 Biomimetic NP
- •4.6 Upconverting NP (UCNP)
- •4.6.1 Synthesis
- •4.7 Inorganic NP
- •4.7.1 Synthesis
- •4.8 Photothermal Therapy (PTT)
- •4.9 Conclusion
- •References
- •5.1 Introduction
- •5.2 Human Skin
- •5.10 Future Scope
- •5.11 Conclusion
- •References
- •6.1 Introduction
- •6.1.1 Class 1
- •6.1.2 Class 2
- •6.1.3 Class 3
- •6.4.1.1 Surface Patterning
- •6.4.1.2 Direct-Write Patterning
- •6.4.1.5 Dip-Pen Nanotechnology
- •6.4.1.7 Composing Using Beams
- •6.4.1.8 Direct Write Photolithography (DWP)
- •6.4.1.9 Light-Beam Lithography Electron
- •6.4.1.10 Focused Ion Beam Lithography
- •6.4.2 Fabrication Techniques
- •6.4.2.4 Non-invasive Glucose Monitoring Devices Technique
- •6.4.2.6 Cost-Effective Electrochemical Voltametric Sensors Techniques
- •6.4.2.7 Three-Dimensional (3D) Printing Techniques
- •6.4.2.8 UV-LED Stereolithography Printer Technique
- •6.4.2.9 4D Printing Techniques
- •6.4.2.10 Advanced Biomedical Techniques Involving Biorobots
- •References
- •7.1 Introduction
- •7.6 Mechanical Biocompatibility Challenges
- •7.7 Poor Bio-Printing Resolution
- •7.9 Limited Biomaterial Selection
- •7.11 Conclusion
- •8.2 Animal Tribology
- •8.2.1 Joint
- •8.2.3 Integumentary Change
- •References
- •8.1 Introduction
- •8.3.1 Nanotribology
- •8.4 Green Tribology
- •8.5 Conclusion
- •References
- •9.1 Introduction
- •9.2 Bio-Tribological Issues
- •9.3.2 Bone Fracture Fixation
- •9.3.4 Cardiovascular Devices
- •9.3.5 Minimal Invasive Surgical Devices
- •References
- •10.1 Introduction
- •10.2.2.1 Structural Integrity
- •10.2.2.2 Controlled Release Properties
- •10.2.2.3 Enhanced Drug Loading Capacity
- •10.2.2.4 Tailored Material Properties
- •10.2.3.1 Biocompatibility
- •10.2.3.3 Mechanical Properties
- •10.2.3.4 Drug Compatibility
- •10.2.3.5 Fabrication Compatibility
- •10.3.1 Matrix Material Properties
- •10.3.4 Biocompatibility Assessment
- •10.3.4.1 In Vitro Cell Culture Studies
- •10.3.4.2 Hemocompatibility Studies
- •10.3.4.3 In Vivo Animal Studies
- •10.3.4.4 Histological Analysis
- •10.3.4.5 Immune Response Evaluation
- •10.3.4.6 Biodegradation Assessment
- •10.4 Surface Engineering Considerations
- •10.4.2.1 Surface Coatings
- •10.4.2.2 Plasma Treatment
- •10.4.2.3 Surface Grafting
- •10.4.2.4 Dip Coating
- •10.4.2.5 Spray Coating System
- •10.4.2.6 Electrotreated Coating
- •10.4.2.9 Microfabrication Techniques
- •10.4.2.10 Surface Roughness Control
- •10.5.1.2 Mechanical Properties
- •10.5.1.3 Surface Characteristics
- •10.5.1.4 Release Kinetics Analysis
- •10.5.1.5 Biological Compatibility
- •10.5.1.7 Other Analyses
- •10.6 Advanced Fabrication Techniques
- •10.8 Conclusion
- •References
- •11.1 Introduction
- •11.2 Shape Memory Alloys (SMA)
- •11.3 Shape Memory Polymers
- •11.3.1 Heat
- •11.3.2 Light
- •11.3.3 Magnetic Field
- •11.4 Shape-Changing Hydrogels
- •11.5 Biomedical Applications
- •11.6 Conclusion
- •References
- •12.1 Introduction
- •12.3 Bioresorbable Orthopedic Implants
- •12.4.1 Polylactides
- •12.4.2 Poly (Ortho Esters)
- •12.4.3 Polyphosphoesters
- •12.4.4 Polyphosphazenes
- •12.4.5 Polycaprolactone
- •12.4.6 Polyurethanes
- •12.4.7 Polycarbonates
- •12.5.1 Compression Molding
- •12.5.2 Transfer Molding
- •12.5.3 Injection Molding
- •12.5.4 Extrusion
- •12.5.5 Blow Molding
- •12.5.6 Calendering Process
- •12.5.7 Fiber Spinning
- •12.5.8 Thermoforming
- •12.5.9 Polymer Foaming
- •12.7 Challenges
- •12.8 Conclusion
- •References
- •13.1 Introduction
- •13.3.1.1 Total Hip Replacement (THR)
- •13.3.2 Resurfacing Hip Replacement (RHR)
- •13.5.1 Adhesive Wear
- •13.5.2 Abrasive Wear
- •13.5.3 Fatigue Wear
- •13.5.4 Corrosion/Oxidative Wear
- •13.5.5 Surface Cracking
- •13.6.1 Metallic Implants
- •13.6.1.1 Stainless Steel
- •13.6.1.2 Co-Cr Alloys
- •13.6.1.3 Ti-Alloy
- •13.6.2 Ceramic Implants
- •13.6.3 Polymer Implants
- •13.6.4 Composite Implants
- •13.6.5.2 Surface Coatings
- •13.7.2.1 Hydrodynamic Lubrication
- •13.7.2.2 Boundary Lubrication
- •13.7.2.3 Elastohydrodynamic Lubrication
- •13.7.3 Biomimetic Lubrication Approaches
- •13.7.3.1 Replicating Natural Lubrication Mechanisms
- •13.7.4.1 Implant Wear
- •13.7.4.3 Synovial Fluid Degradation
- •13.8.1 Hydroxyapatite Coatings
- •13.8.1.1 Bone Integration
- •13.8.1.2 Implant Stability
- •13.8.1.4 Biocompatibility
- •13.8.2 Diamond-Like Carbon Coatings
- •13.8.3 Metal Nitride Coatings
- •13.8.4 Polymeric Coatings
- •13.8.5 Nanocomposite Coatings
- •13.9.1 Pin-on-Disk Testing
- •13.9.2 Hip Joint Simulators
- •13.9.3 Knee Joint Simulators
- •13.9.4 Tribo-Corrosion Testing
- •13.9.5 Wear Debris Analysis Techniques
- •13.9.5.1 Scanning Electron Microscopy (SEM)
- •13.9.5.2 Energy-Dispersive X-Ray Spectroscopy (EDS)
- •13.10.1.1 Tailored Geometries
- •13.10.1.2 Improved Wear Characteristics
- •13.10.1.3 Accelerated Innovation
- •13.10.2.1 Real-Time Wear Monitoring
- •13.10.2.2 Functionality Assessment
- •13.10.2.3 Implant Status Monitoring
- •13.10.2.4 Patient-Centric Healthcare
- •13.10.3.1 Advanced Biomaterials
- •13.10.3.4 Multidisciplinary Approaches
- •13.10.4.1 Wear Data Analysis
- •13.10.4.2 Predictive Wear Patterns
- •13.10.4.3 Early Intervention Strategies
- •13.10.4.4 Personalized Treatment Plans
- •13.11 Conclusion
- •References
- •14.1 Introduction
- •14.2.1 Powder Bed Fusion (PBF)
- •14.2.2 Directed Energy Deposition
- •14.3.1 Extrusion-Based AM
- •14.5 Biomanufacturing
- •14.5.1 Tissue Engineering
- •14.5.2 Organ-on-a-Chip Models
- •14.6 Conclusion
- •References
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Chapter 14
Challenges andPerspective
ofManufacturing Techniques
inBiomedical Applications
YusufOlatunjiWaidi , NipunJain , SaswatChowdhury ,
RanjitBarua , SamirDas , ArbindPrasad , andSudiptoDatta
Abstract The technology of additive manufacturing is used in various sectors like
construction, biomedical engineering, healthcare, aerospace, and many more.
Because of the many advantages of this technology, this is being widely used in the
healthcare industry. For example this is used in organ printing, disease modeling,
surgery, tissue engineering, veterinary medicine, pharmaceuticals and customized
implants. In this chapter, we shall briey discuss the problems of this technology in
the healthcare sector and its future prospects.
Keywords Additive manufacturing · 3D printing · Biomedical devices · Tissue
engineering · Disease modelling
Authors “Yusuf Olatunji Waidi”, “Nipun Jain”, and “Saswat Chowdhury” have equally contributed
to this chapter.
Y. O. Waidi · N. Jain · S. Datta (*)
Department of Materials Engineering, Indian Institute of Science,
Bangalore, Karnataka, India
e-mail: yusufwaidi@iisc.ac.in; nipunjain@iisc.ac.in
S. Chowdhury
Department of Bioengineering, Indian Institute of Science, Bangalore, Karnataka, India
e-mail: saswatc@iisc.ac.in
R. Barua
Centre for Healthcare Science and Technology, Indian Institute of Engineering Science and
Technology, Howrah, West Bengal, India
S. Das
Biomaterials and Tissue Engineering Lab, School of Medical Science and Technology Indian
Institute of Technology, Kharagpur, India
A. Prasad
Mechanical Engineering Department, Katihar Engineering College (Under Department of
Science, Technology and Technical Education, Government of Bihar), Katihar, Bihar, India
A. Kumar et al. (eds.), Applications of Biotribology in Biomedical Systems,
https://doi.org/10.1007/978-3-031-58327-8_14
433© The Author(s), under exclusive license to Springer Nature Switzerland AG 2024

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14.1 Introduction
With the advent of more advanced manufacturing technologies concurrent with the
ever-increasing and complex clinical needs, the biomedical devices sector is witnessing a paradigm shift. Currently, different classes of materials, namely metallic,
ceramics, polymeric and composites, are typically used for fabricating medical
devices. In fact, recent times have enabled bio fabrication, i.e., the manufacturing of
biological systems integrated with soft polymeric materials, to be an integral part of
manufacturing. Another development in the biomedical manufacturing space is the
emergence of additive manufacturing technologies that aid in rapidly prototyping
customized medical devices. This is truly the need of the hour, as it overcomes the
limitations of conventional manufacturing processes by providing enormous exibility in design and material candidates, expanding the scope of medical devices.
Different categories of additive manufacturing technologies are available depending
on the class of material used, its physical form, nal desired product requirement,
and properties. Each technique will have its advantages and disadvantages, and
hence, an optimal trade-off is often needed to achieve the desired biomedical device
with the desired properties. Among the multitude of biomedical applications of
additive manufacturing, the most prominent include the creation of anatomical
models and phantoms for surgical training, patient-specic prosthetics and implants,
3D tissue mimetic models for drug testing, biopharmaceuticals for drug delivery,
etc. [1]. The increased adoption of additive manufacturing in the medical eld is due
to its key benets such as customization of medical implants suiting exact patients’
needs, relatively low cost with minimal wastage of material, reduced production
time, and design freedom [2]. Despite these advantages, additive manufacturing has
still not matured enough for large-scale production owing to its relatively low speed
compared to conventional manufacturing processes [3]. However, this can be a
blessing in disguise, especially in the biomedical sector, where high accuracy combined with customization is required in small numbers. This is because of the unique
demands of medicine and personalized therapy that change a lot with patients. The
working principle of most additive manufacturing processes, except the form and
processing of feedstock, remains the same, and it begins with capturing the clinical
data through either Computed Tomography (CT) or Magnetic Resonance Imaging
(MRI) modalities. Afterward, these scanned images are modied into a computeraided design (CAD) model using Digital Imaging and Communications in Medicine
(DICOM) software [4]. The prepared 3D CAD models are then processed through
MIMICS or similar 3D software to assess the optimal tment and generate the
required Standard Triangulation Language (STL) format of the desired implants to
be fed to the printer [5]. Post generation of STL le, the input parameters such as
unit layer thickness, print tool and bed/platform temperature, pressure/ow rate,
print orientation/hatch spacing, raster angle, type of input current, types of lasers (if
any) and its parameters (such as power density), etc., need to be optimized according to the desired nal part accuracy, type of material and printer being used.
Figure14.1 shows the schematic of the entire workow of generating printed parts

14 Challenges andPerspective ofManufacturing Techniques inBiomedical Applications
Fig. 14.1 Workow of a typical additive manufacturing process, leading to the generation of biomedical devices [4]. (Reproduced with permission from Elsevier [4])
435
for various biomedical applications via additive manufacturing (AM). The workow begins with obtaining patient data in the form of CT scans and eventually
completes with printing the customized medical device.
However, some regulatory and scientic challenges associated with AM are persistent to date. This holds true, especially for the medical sector, which has witnessed a surge in the adoption of different AM processes. However, the growth is
rather slow due to the lack of suitable standard procedures. Some of the standards
widely adopted are ASTM F2792−12a, ISO/ASTM DIS 52910.2, ISO/TC 261 and
ISO 17296-4:2014 for processing; ISO 10993-1 and ASTM F 2129 standards for
chemical characterization; ASTM 756 and ISO 10993-6 standards for testing biocompatibility of the implants [5]. However, there are a lot of avenues within AM,
where such standards don’t exist, such as rendering techniques for the generation of
CAD models, slicing software for making STL les, processing parameters, and
choice of printing technique. In this chapter, a detailed overview of the various AM
techniques, the types of materials that can be processed, and their unique challenges
and future scope are enlisted.
14.2 Manufacturing ofMetallic Materials
Metals are a widely used material for many biomedical applications, including
orthopedic implants, spinal cord fusion devices, joint replacement implants, cardiovascular stents and other load-bearing applications [6]. The ideal requirements for
metallic biomaterials include non-toxicity, non-immunogenicity, optimum

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mechanical properties, and high corrosion resistance. A sequence of oxidationreduction reactions occurs between the metal surface and body uids, leading to
possible ion release, allergies, etc. The most widely used metallic biomaterials are
stainless steels, cobalt-chrome alloys, and titanium-based alloys. Stainless steels are
widely used in craniofacial reconstruction as bone plates, intermedullary nails, rods
or screws, owing to their high corrosion resistance, favorable strength and relatively
low price [7]. The most commonly employed stainless steel is 316L.Co-Cr alloys
exhibit high hardness values and wear resistance and hence nd use in load-bearing
bone applications and articial joints, such as complete knee and hip replacement
prostheses and acetabular cups [8]. The next common type of metallic biomaterials
are titanium and titanium-based alloys again in orthopedic implants and accessories
due to their favorable corrosion resistance, high strength-to-density ratio, and
Young’s modulus mimicking native bone tissue compared with other alloys [9].
From a commercial standpoint, pure titanium (CP-Ti) and Ti-6Al-4V alloy are the
most widely used metallic materials for implant development. While pure titanium
is mostly limited to dental applications due to its limited mechanical properties,
Ti-6Al-4V alloy is more favored for hip and knee implants, bone plates, etc., where
good mechanical properties are desired [10].
Magnesium-based biomaterials are also increasingly being used as biodegradable implants, owing to their sufcient tensile strength, fracture resistance, and low
magnesium density [11]. Moreover, the release of magnesium ions favors new bone
formation and is benecial for general metabolism [12]. The biodegradation kinetics of magnesium implants can be tuned by alloying with other elements, like zinc
and calcium.
Historically, a range of conventional techniques have been in place for fabricating metal-based medical devices, such as forging, investment casting, hot rolling,
and machining. However, in the past few decades, additive manufacturing has
replaced the conventional ones. As the name implies, it relies on the addition of
material in a layer-wise manner to yield the nal product from a computer 3D
model. Undoubtedly, the ability to produce implants of near-net sizes that are a better match to the patient’s anatomy is an undisputed advantage in the biomedical
realm, especially in reconstructive surgeries to treat craniofacial fractures for
improved aesthetics and functional performance [13]. 3D printing also promises to
fabricate stable and reproducible architectures with nano-, micro-, and macro-level
hierarchical features better than conventional techniques like gas foaming, freezedrying and electrospinning. Additionally, complex architectures, curved channels,
and functional gradients of properties are some attributes wherein 3D printing can
be used with ease [14]. However, in practice, this is not yet accomplished due to the
inherent processing challenges, like pores collapsing during assembly, which in turn
affects the overall structural stability. To maintain printing accuracy, it is imperative
to reduce printing speeds to ensure near-perfect solidication of the previously
deposited layer before the next layer [15].
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