Research ArticleBioengineering

Mitigation of tracheobronchomalacia with 3D-printed personalized medical devices in pediatric patients

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Science Translational Medicine  29 Apr 2015:
Vol. 7, Issue 285, pp. 285ra64
DOI: 10.1126/scitranslmed.3010825

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Printing in 4D: Personalized implants

The 3D printing revolution is in full swing, with frequent reports of printed kidneys and jaws, dolls and cars, food, and body armor. The new challenge is to make 3D materials evolve in the fourth dimension: time. Such “4D” materials could change in response to temperature, light, or even stress, making them adaptable and enduring. In pediatric medicine, 4D implants become particularly relevant; as the patient grows, so, too, should the material. Morrison et al. used 3D printing technology with a safe, bioresorbable polymer blend to create splints for three pediatric patients with tracheobronchomalacia (TBM)—a condition of excessive collapse of the airways during normal breathing. Currently available fixed-size implants can migrate and require frequent resizing. Thus, the authors used imaging and computational models to design the splints for each TBM patient’s individual geometries, structuring the implants to accommodate airway growth and prevent external compression over a period of time, before being resorbed by the body. In all three patients (one with two airways splinted), the 4D devices were implanted without issue. All four implants were stable and functional after 1 month, and one implant has remained in place, keeping the airway open for over 3 years. This pilot trial demonstrates that the fourth dimension is a reality for 3D-printed materials, and with continued human studies, 4D biomaterials promise to change the way we envision the next generation of regenerative medicine.

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