Castro 1 Adrian Castro Dr.

Jennifer Roudabush UNIV 200 2014 March 25 Why Printing Your Body Trumps Prosthesis Today The average cost of having a prosthetic leg made for a patient equals to about $50,000, an amount that an average US Citizen can make in a year, according to the United States Department of Labor. Fortunately for those amputees who need a prosthetic limb, technological advances have led to printing limbs for a fraction of the average cost. 3D printing, also referred to as rapid manufacturing or organ printing, is the process in which a machine printer can create any structure, organ, limb, or object based on a three-dimensional digital image on a computer program by layering scaffolding made out of inexpensive materials such as cloth, wax, or even cells. This process has revolutionized the methods of prosthesis where a man-made limb is made with expensive material, took weeks to create, and would need to be replaced after several years. 3D printing, however, has been engineered to create limbs for an extremely low cost, greatly reduced production time, increased durability, and equal functionality to do all that a prosthetic limb or transplanted organ could do today, thus being a more

Castro 2 beneficial method of prosthesis compared to modern prosthesis today. 3D printers have existed for over 30 years and are increasing in popularity in modern times. The first published account of a printed solid model was made by Hideo Kodama of Nagoya Municipal Industrial Research Institute in 1982 (RedOrbit.com). Since then, the price of a 3D printer has decreased from $20,000 to only $500, being available to the average consumers (RedOrbit.com). 3D printers were first used to print basic three-dimensional models. In todays day and age, 3D printers are now being used to build any object imaginable, from limbs to kidneys to even skin. 3D printers have a wide arrangement of objects it is able to print. In regards to prosthesis, 3D printing has already been proved viable in several medical applications including the manufacture of eyeglasses, custom prosthetic devices and dental implants (Schubert et al, 159). Modern prosthesis, on the

other hand, is only limited to body parts made of expensive Kevlar and plastics and have to rely on dentures made of waxes and metals. Even outside of prosthesis, 3D printers show that There are many potential uses for 3D printing in medicine, including ophthalmology A number of recent reviews have been published and include 3D printing and culture of cells, blood vessels and vascular networks, bandages, bones, ears,

Castro 3 exoskeletons, windpipes, dental prosthetics including a jaw bone, and future corneas entirely new organs to treat specified diseases such as diabetes, creating prosthetics that look like the body part they are replacing or supporting, stem cells, testing of new drugs using printed tissues, and customized drugs (Schubert et al, 160). 3D printing has surpassed prosthesis in terms of variety, showing that 3D printing can do more than what prosthesis can do. Prosthesis can only stand in for a model limb. 3D printing on the other hand has the ability to create objects, organs, clothes, and prosthetic limbs alike. Depending on the limb or body part, a prosthetic part can cost thousands of dollars. For example, the price of a prosthetic arm ranges from $3,000 to $30,000 (Disabled World). These prices are fixated on the material of the prosthetic and hiring a person to make the prosthetic. Examples of materials used to make prosthetics include plastic polymer, fiberglass, Kevlar, or carbon fiber. These materials, such as Kevlar, are on the higher spectrum of prosthetics in terms of the cost of the overall limb due to the quality of the material. With 3D printing, people are using materials such as paper, metal alloys, rubber, or plasters to reduce the costs of making 3D models. Using cloths or plastics provides prosthetics at an extremely reduced cost. In April 2012, Daniel Omar, a 14 year old Sudanese boy has his hand severed due to a bomb attack in

Castro 4 Sudan. Mike Ebeling, CEO of Not Impossible Labs, used his consumer-grade 3D printer to replace Omars hand with a prosthetic hand free of charge while the materials to make the hand totaled to only $100 (CNN Opinion). The expenses resulted to be low due to the prosthesis being made completely of plastic. Because 3D printers can use cheap materials, prosthetics can be made with extremely low costs. 3D Printing is also being used in hospitals to grow organs, also known as organ printing. Because organ transplants are in such high demand but with low supply, 3D printers have been engineered to print organs using cells, polymers, and other forms of scaffolding. Engineering 3D printers to create organs can serve organ transplants to those who need them, lowering the demand for organs immensely. For example, uses of alginate, a sugar found in brown algae, can be grown to provide structuring for printed organs. In a 2013 study, Alginate is a naturally occurring anionic polymer with many attractive features for biomedical applications, including low cost, excellent biocompatibility, low toxicity, and a variety of cross-linking and biomolecular tethering flexibility (Duan et al, 1257). Because Alginate can be found in nature, this kind of material can be harvested and utilized to create these organs, thus reducing the costs and demands of organ transplants.

Castro 5 3D printing has also provided the job market with more careers in prosthesis. The cost of making printed prosthetics may be substantially lower, but finding printers to use as a method to educate students turns out to be costly. According to a study in 2010, 3D printed anatomical models human body parts were being used to train students in surgical procedures and studying the human body. In this educational method, The preoperative simulation of a specific and complex surgery (used on a Rapid Produced model) provides a unique opportunity to employ surgical steps in order to determining the best operating strategy, again increasing the surgeons confidence during the operation. (Rengier et al, 339). This system gives surgeon hands-on experience on conducting surgeries. However, the available number of (anatomical) models at a university or hospital is very limited by costs (Reinger et al, 340). Assuming that the costs of these printers are substantially high due to being higher end to educate at universities, using these printers are considered to be large investments. The investment of the printer, however, should be seen as putting money into a cause that will further improve upon the application of 3D printing in prosthetics in order to build accurate, costefficient models for those in need of a prosthetic limb. All in all, purchasing 3D printers to manufacture limbs comes at a cost, but because 3D printing provides more jobs in the job

Castro 6 market, traditional prosthesis appears unnecessary in comparison. In prosthesis today, according to the Center for Independent Rehabilitative Services, making a temporary prosthetic leg takes a week to make. A permanent prosthetic leg normally requires three or four trial fittings upon manufacturing and distributing to the patient. A 3D printer has the ability to create objects such as a model leg in only a couple of days in comparison to traditional prosthesis. With the use of a machine instead of human labor, a 3D printer can create dentures and replacement teeth in mass production. The dental lab that made these dentures states, With rapid production techniques, the dental laboratory can easily reach a production rate of over 150 units per hour (Sun and Zhang, 642). As

revealed, in junction with computer programming, decreased manpower, and 3D printing accuracy, a 3D printer can create objects in massive portions. Revealed in a study of works in 3D printed color imaging of skin, One of the biggest advantages of 3D printing systems is their ability to directly interconnect with advanced manufacturing techniques and allow custom made production, with excellent accuracy and savings in both time and cost (Xiao et al, 2043). Anthony Atala, a renowned tissue

engineer with expertise in organ printing, stated, A human kidney only takes 7 hours to print. With all of these different

Castro 7 kinds of objects printed out in short times, statistics showed that these objects have been proven to be more durable than prosthesis used today. With quicker production time, 3D printing proves to have its advantages over the process of creating a traditional prosthesis. In relation to the alginate scaffolding, however, The chemical crosslinking performed in this study is a global process difficult to control and will limit the print time available (Duan et al, 1263). Because alginate is an uncommon material to produce with, it will take time to perfect the method of using alginate in scaffolding to print organs. It comes to show that the different types of materials that are used have an effect on the time needed to produce 3D printed objects. A 3D printed prosthesis has the same functionality of a traditional prosthetic limb along with an increase in durability. Bioprinted organs have also become engineered to become a viable replacement for transplanted organs. 3D printing is also being investigated as a potential source to repair or replace defective organs, such as kidneys, heart or skin. In addition, it also has the potential to create entirely new organs which would perform the same biological functions as the diseased, non-functioning organ such as a pancreas in the case of diabetes (Schubert et al, 160). For example, Atala states,

In fact, in the last 10 years, the number of patients requiring

Castro 8 an organ has doubled, while in the same time, the actual number of transplants has barely gone up (Atala). To fix this problem, Atala has made an organ printer, as stated previously, designed to increase the number of organ transplants in the world. These organs are grown using a scaffolding and growth of the patients cell tissue. This is extremely important, as this would decrease the amount of patients who need transplants in the matter of months. After receiving his printed kidney 10 years after his transplant surgery, Luke Massella, one of Atalas patients, paid his respects, saying, So after the surgery, life got a lot better for me. I was able to do more things. I was able to wrestle in high school. I became the captain of the team, and that was great. I was able to be a normal kid with my friends. And because they used my own cells to build this bladder, it's going to be with me. I've got it for life, so I'm all set (Atala). A prosthetic does not have to be a limb; any model that can fully replace a limb, or in this case an organ, is considered prosthesis. Instead of having to wait 10 years for a transplanted organ, technology has reached the point where printing organs is a speedy, accessible, viable replacement for those in need of a prosthetic organ due to being able to perform and exceed the same functions as a normal prosthetic or transplant is capable of. In a study conducted for manufacturing a bionic ear, the 3D printer has the ability to three-

Castro 9 dimensionally interweave biological tissue with functional electronics enabl[ing] the creation of bionic organs [to possess] enhanced functionalities over their human counterparts (Mannoor et al, 2634). As this ear is printed, the cells and scaffolding within the ear is engineered with great accuracy with the ability to provide the same functions as a normal ear would have. With this, with the combination of neural technology and biological functionality, a 3D printed ear would be able to replace a human ear, whereas a prosthetic ear would only go as far as being a placeholder for where an ear would be on the head of a human, not being able to fulfill the functions of an ear at all. The revolution of 3D printing is making its renowned appearance in the medical world. 3D printing, rapid manufacturing, and rapid printing will soon become viable replacements for the methods of prosthetics being used today. 3D printers create prosthetics in lower costs by using inexpensive materials, provides full functionality that can be given by a regular prosthesis, can be made in an exponentially lower amount of time, and has the versatility to manufacture a huge variety of objects. 3D printing also provides a surplus amount of new jobs in the job market, teaching people the ways to make these 3D printed objects in the prosthetic fields or as an entrepreneur in the independent job market. As a result, 3D

Castro 10 printing will soon become an investment to monitor for years to come as it journeys on its way to becoming the replacement to traditional prosthesis while transforming the biomedical and business field.

Castro 11 BIBLIOGRAPHY Duan B, Hockaday LA, Kang KH, Butcher JT. 2013. 3D Bioprinting of heterogeneous aortic valve conduits with alginate/gelatin hydrogels. J Biomed Mater Res Part A 2013:101A:12551264. Sun, Jian, and Fu-Qiang Zhang. "The Application of Rapid Prototyping in Prosthodontics." Wiley Online Library. Wiley Online Library, 4 Feb. 2012. Web. 29 Apr. 2014. Printing a Human Kidney. Dir. Anthony Atala. Perf. Anthony Atala. TED. TED, Mar. 2011. Web. 15 Mar. 14. McCracken, Harry. "How a TIME Article Led to the Invention of a $100 3D-Printed Artificial Limb." Academic Search Complete. Time.com, 8 Jan. 2014. Web. 18 Mar. 2014. Wagner, Dainty, Haugue, Tuck, and Ong. "The Effects of New Technology Adoption on Employee Skills in the Prosthetics Profession." Taylor and Francis Online. N.p., 02 Oct. 2008. Web. 18 Mar. 2014. Schubert, C., MC Van Langeveld, and LA Donoso. "Innovations in 3D Printing: A 3D Overview from Optics to Organs." PubMed. N.p., 28 Nov. 2013. Web.

Castro 12 Rengier, F., A. Mehndiratta, H. Von Tengg-Kobligk, CM Zechmann, R. Unterhinninghofen, HU Kauczor, and FL Giesel. "3D Printing Based on Imaging Data: Review of Medical Applications." PubMed.org. US National Library of Medicine, 15 May 2010. Web. 18 Mar. 2014. Manu S. Mannoor, Ziwen Jiang, Teena James, Yong Lin Kong, Karen A. Malatesta, Winston O. Soboyejo, Naveen Verma, David H. Gracias, and Michael C. McAlpine. 3D Printed Bionic Ears. Nano Letters 2013 13 (6), 2634-2639