Additive manufacturing

 Pros NoseThousands of patients in the developing world suffering from terrible facial disfigurement could soon gain access to life-changing soft tissue prostheses using a technology developed by material scientists and clinicians at the University of Sheffield in collaboration with a private sector partner.

Until now, access to such prostheses has largely been restricted to countries with dedicated oral maxillofacial centres staffed with highly skilled technicians. Even where such centres exist, the art of building a new nose or ear remains an uncomfortable and time-consuming process for the patient, involving intrusive and labour-intensive techniques.

‘We knew there had to be a better, more modern way of making soft tissue prostheses, but we weren’t sure how it could be done,’ says the University of Sheffield’s Professor Ric van Noort.

As a materials scientist in the School of Clinical Dentistry, he was familiar with the use of 3D technology to make customized implants, but he was intrigued by the possibilities of using additive manufacturing technologies to create soft tissue prostheses.

A chance meeting at an international conference led van Noort and his colleagues to strike up a partnership with a Sheffield-based industrial design company, Fripp Design and Research. It has proved a fruitful relationship.

‘From the start we approached this problem from a multi-disciplinary perspective. There was a strong spirit of collaboration bringing together the knowledge and experience of clinicians, technicians, people like myself with material science backgrounds, and the design team at Fripp Design and Research. We couldn’t have been done it any other way,’ says van Noort.

With funding from a number of sources, including a Translation Award from the Wellcome Trust, the group was able to develop a prosthesis that was both strong and flexible using materials that were unlikely to trigger an adverse reaction in the patient.

‘There were so many technical hurdles to overcome,’ says van Noort. Not least of which was the need to ensure that the colour and texture of the prosthesis matched perfectly the patient’s specific skin. All their hard work paid off, however, when they produced a prototype replacement nose for a nasal cancer patient.

‘She was delighted. In the past she had had to undergo an invasive process that could take all morning. We told her that all she would need to do was sit down and have her picture taken,’ says van Noort. There was no need to have an impression taken of her face with plaster of Paris.

Using computer aided design software developed by Fripp Design and Research, these images were than fed in to a sophisticated ‘printer’ that built layer upon layer of a material that had the right texture, colour and biocompatibility.

‘The parts that come out of the printer are like pastry: very fragile and absorbent,’ says Managing Director Tom Fripp. And because they contain a smaller proportion of silicone than traditional hand-crafted noses, the prostheses made by additive manufacturing are much lighter.

‘The patient noticed immediately how comfortable the nose felt and how the more feathered edge made it easier to blend into her face,’ says Fripp. Even better for the long-term care of the patient is that this technology enables ‘product profiles’ to be stored electronically so that replacements can be printed directly at the push of a button.

And this is one of the key benefits of this technology. ‘All we need is the 3D and 2D colour data to print out a new nose or ear here in the UK and then we can courier it back to the patient who might be anywhere in the world,’ says van Noort. The next stage of the work is to undertake clinical trials so that hopefully the technology will soon become a reality for the thousands of people around the world who still lack access to any kind of prosthesis. ‘That is our goal,’ he added.

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