Dental and Surgical Applications of Selective Laser Melting

Medical Applications of SLM

Dr. Richard Bibb

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

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

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

Successes – Several cases done, test fitted to patients and

results published

RPD Case 1

Designed on 3D patient data

using SensAble

FreeForm

software

Designed

according to

established

dental technology protocols

RPD Case 1

Made using SLM in F75 Co-Cr

Fitted the patient

cast very well

Polishing

revealed

excellent density

Good clasping

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

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

RPD Case 2

Close up showing the accurate fitting

of the clasps

Successfully test

fitted to the patient in clinic – next

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

www.cartis.org

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

Surgical Guide

Case 1

This case was

planned on CT

data using 3D CAD

It required to stages

Stage 1 – Le Fort 1

Osteotomy

Surgical Guide

Case 1

This case was

planned on CT

data using 3D CAD

Stage 2 – another

osteotomy to reduce the maxilla

by 4 mm

Surgical Guide

Case 1

This case was

planned on CT

data using 3D CAD

Stage 2 – another

osteotomy to reduce the maxilla

by 4 mm

Surgical Guide

Case 2

Another Le Fort 1

osteotomy case

was planned on

CT data using 3D

A different guide

design was

attempted

Surgical Guide

Case 3

The following

cases are for

osseointegrated

implant placement

The implants are

used to fix

prosthetic ears like

this one

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

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

Surgical Guide

Case 3

The guide was

made using SLM in

316L stainless

The guide was

used in surgery

and the result was

successful

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

Surgical Guide

Case 4

The implant

positions are

planned as before

and the guide

designed

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

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

1st attempt at and SLM bar

SLA substructure

ThermoJet wax pattern

Prosthetic

Retention

Improved bar

made by Liverpool

University on the

SLM 100

Precise fit and

good polished

surface finish

make this clinically acceptable

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

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

Dental and Surgical Applications of Selective Laser Melting

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