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CHA PTE R
14
Using 3-D Printing and Bioprinting
Technologies for Personalized Implants
,†
‡
Julien Barthes* , Edwin-Joffrey Courtial , Esteban Brenet*, Celine Blandine
‡
,†
Muller* , Helena Knopf-Marques* ,†,§ , Christophe Marquette ,
Nihal Engin Vrana* ,†
†
*INSERM UMR 1121, 11 rue Humann, Strasbourg, France Protip Medical, 8 Place de l’H^opital, Strasbourg, France
‡ §
e
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3dFAB Universit Lyon 1—CNRS 5246 ICBMS, Lyon, France Universit de Strasbourg, Facult de Chirurgie Dentaire,
e
F ed eration de M edecine Translationnelle de Strasbourg, F ed eration de Recherche Mat eriaux et Nanosciences Grand Est,
Strasbourg, France
14.1 INTRODUCTION
The last two centuries have seen a steady increase in average life expectancy all around the world, particularly due
to the advances such as antibiotics, vaccines, availability of better healthcare, and improved hygiene. However, the
aging societies pose another health risk, chronic diseases. Some of these diseases can be handled by pharmaceutical
means and rehabilitation. But in some cases, the damage to a given tissue/organ (the knees, pancreas, kidney, etc.) is so
extensive that there is a need for either a device that can take over the function of the tissue/organ (such as femur
implants or dialysis systems) or completely replacement of the malfunctioning organ (transplantation). As there is
a persistent donor, shortage for transplants and the current implants are not potential remedies for several diseases;
over the last 40years, a new field tissue engineering and regenerative medicine (TERM) has grown with the promise of
providing tissues/organs on demand without any potential risk of rejection or disease transmission using cells and
materials in configurations that can take over tissue function and can be fully or partially integrated with the host.
The advances in the TERM field resulted in the availability of many artificial tissues (particularly skin, cartilage, and
bone) and organs (such as the gall bladder), which has been applied successfully in clinical settings [1]. However, the
most success was generally obtained where the tissue structure is mostly isotropic, the cell types are either limited or
organized in a spatially distinct manner, and the function is structural [2]. The more complex organs with mechanically
active parts where high degree of innervation and synchronization is required or organs with complex biochemical
functions have not been strong points of regenerative medicine. One of the roadblocks in this aspect is the precise con-
trol of cellular spatial distribution and microscale material properties. The recent answer to these challenges has been
the development of 3-D printing systems that can simultaneously handle the cellular component either alone or
together with biomaterials. The simultaneous printing of cells and materials or cell aggregates is called bioprinting.
Bioprinting is a well-known technology that assembles the cells and natural or synthetic cell matrices [3], by integrating
living materials, motion control, computer-aided design software, and biomaterials together to achieve highly accurate
biomimetic constructs [3, 4]. In this chapter, we will first provide the available bioprinting methods together with spe-
cific examples related to the development of artificial tissues/organ with bioprinting. Then, we will continue with 3-D
printing of implantable devices that does not contain cells for structural support where anatomical dispersity of
patients necessitates personalization and use of 3-D printing methods is picking up the pace.
Advances in Biomechanics and Tissue Regeneration 269 © 2019 Elsevier Inc. All rights reserved.
https://doi.org/10.1016/B978-0-12-816390-0.00014-5