Dental and Surgical Applications of Selective Laser Melting

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1 Dental and Surgical Applications of Selective Laser Melting Dr. Richard Bibb

2 Rapid Manufacturing The following examples adhere to this conference s definition of RM They are end use parts, made directly from CAD data using a layer additive manufacturing method These cases exploit RM to produce custom-fitting end-use medical devices for both short-term and long-term applications

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4 SLM research at PDR Design rules feature capabilities and design guidance Support generation strategies and part orientation Materials composition, particle size, distribution, etc. Performance including tensile and fatigue testing Surface finishing rapid, labour free finishing techniques Reliability and repeatability Powder quality, handling and storage

5 Removable Partial Denture Frameworks Why? To investigate moving to an entirely digital design and build procedure in dental technology How? Using 3D Scanning, advanced CAD and SLM Obstacles Case studies time consuming, finding our own way! Successes Several cases done, test fitted to patients and results published

6 RPD Case 1 Designed on 3D patient data using SensAble FreeForm software Designed according to established dental technology protocols In collaboration with UWIC Centre for Dental Technology

7 RPD Case 1 Made using SLM in F75 Co-Cr Fitted the patient cast very well Polishing revealed excellent density Good clasping force In collaboration with UWIC Centre for Dental Technology

8 RPD Case 2 RPDs are oriented such that the supports are minimised and whilst not contacting the fitting surface In collaboration with UWIC Centre for Dental Technology

9 RPD Case 2 This case was successfully build in both 316L Stainless Steel and F75 Co-Cr Co-Cr provides better clasp force and withstands repeated use better than 316L In collaboration with UWIC Centre for Dental Technology

10 RPD Case 2 Close up showing the accurate fitting of the clasps Successfully test fitted to the patient in clinic next slide In collaboration with UWIC Centre for Dental Technology

11 In collaboration with UWIC Centre for Dental Technology

12 The following cases were conducted by the Centre for Applied Reconstructive Technologies in Surgery CARTIS is a collaborative joint venture between the Maxillofacial Unit of Morriston Hospital and PDR

13 Custom fitting surgical guides Why? To transfer computer-aided surgical planning to the operating room accurately How? Using CT data, advanced CAD and SLM Obstacles designing the templates to account for the restrictive environment of a surgical incision Successes 10 cases conducted for osteotomy and drilling in UK and USA, results presented and published

14 Surgical Guide Case 1 This case was planned on CT data using 3D CAD It required to stages Stage 1 Le Fort 1 Osteotomy

15 Surgical Guide Case 1 This case was planned on CT data using 3D CAD It required to stages Stage 2 another osteotomy to reduce the maxilla by 4 mm

16 Surgical Guide Case 1 This case was planned on CT data using 3D CAD It required to stages Stage 2 another osteotomy to reduce the maxilla by 4 mm

17 Surgical Guide Case 2 Another Le Fort 1 osteotomy case was planned on CT data using 3D CAD A different guide design was attempted

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19 Surgical Guide Case 3 The following cases are for osseointegrated implant placement The implants are used to fix prosthetic ears like this one

20 Surgical Guide Case 3 The prosthetic ear clips onto the bar which is held to the skull with the implants Exact placement of the implants is critical

21 Surgical Guide Case 3 The implant positions are planned by the surgeon and prosthetist The guide is designed to include orientation and patient name (removed) from the images

22 Surgical Guide Case 3 The guide was made using SLM in 316L stainless steel The guide was used in surgery and the result was successful

23 Surgical Guide Case 3 The holes are drilled precisely and the implants fitted Once the bone has healed abutments are screwed to these implants and protrude through the skin

24 Surgical Guide Case 4 The implant positions are planned as before and the guide designed

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26 Prosthetic retention Why? as part of research into the computer-aided design and manufacture of maxillofacial prostheses How? SLM has been used to attempt to create the retention elements of the prostheses Obstacles working at a very small scale, very accuracy required Successes some cases attempted and results published but work is on going

27 Prosthetic Retention Soft tissue, facial prosthesis design using scan data and FreeForm CAD Bar made in 316L Stainless Steel by SLM, other RP processes used for other components

28 1 st attempt at and SLM bar SLA substructure ThermoJet wax pattern

29 Prosthetic Retention Improved bar made by Liverpool University on the SLM 100 Precise fit and good polished surface finish make this clinically acceptable

30 Discussion SLM has proved a successful or clinically feasible RM method for these end-use medical devices More work is required to fully realise its potential RM requires scan data, advanced CAD, new design and clinical protocols in an integrated approach More work is needed to produce a more highly efficient work flow

31 Conclusions PDR research has shown that SLM is a feasible RM process for a range of medical, dental and surgical devices We have recently improved our build processes to produce virtually 100% dense parts Further research will improve the process with specific attention on reliability, repeatability, speed and surface finishing