Systematic Development in Medical by Using 3D Printing Technology: A Brief Review

1. Introduction

Three-dimensional (3D) bio-printing is the alteration of an old infuse printer. Today, it is quickly extending, new printers and printing materials offer novel conceivable outcomes, and new energizing applications show up. Human services, car, aviation, and guard businesses are the most striking zones of 3DP applications. This paper discusses the utilization of 3D printing in medical solutions that upset how tasks are completed, disturbing prosthesis and embeds showcases and dentistry, etc. Today, 3D printing improves human lives in many ways, with immense scope of medicinal applications (Dodziuk, 2016; Xu et al., 2018). Printing entire complex organs for transplants may not be possible today. However, with a quick development rate, it is successfully utilized in orthopaedic inserts, tissue with blood vessels, personalized prosthetics, skin grafting, patient-particular reproductions of different parts (veins, bones, and organs), customized surgical tools and guides, etc. With proper 3D printers/equipment, designers and after generation masters transforms thoughts directly into our hand. Whether anyone wants to build a single thin slice of the object or a pre-arranged number of parts, the correct group and innovation team can produce the part with 3D printers (Ozbolat, 2013). From the extraordinary applications of 3D printing in medicine, it can be anticipated that the entire human body may be cloned by 3D printing. Bio-printing needs include material choice and development configuration, printed build protection, process determination, versatility and displaying, bio-printing-instigated cell damage administration, post-printing tissue combination and development, and printed development assessment (Zehnder, 2015; Da Xu, 2011).

There are numerous potential uses for 3D imprinting in prescription, and it is fundamentally changing how patients are treated for different conditions. The extent of 3D printing constrained to show printing as well as incorporate 3D printing of cells, veins and vascular systems, printed swathes, fake bones, ears, body exoskeletons, sustenance channels and windpipes, dental prosthetics, for example, jaw bone, and future corneas altogether new organs that might be utilized to regard numerous issues, for example, diabetes, test drugs/meds on to the printed tissues, making prosthetic that resemble the body part to supplant or supporting harmed body part, foundational microorganisms, and even to print redid drugs (Overmeyer et al., 2011; Da Xu, 2022). 3D printing is instrumental in the medical field because this procedure can be utilized to make any organ. By utilizing cells (basic unit) from the patient’s very own tissue, the issues of tissue dismissal caused by fiery reactions could be eliminated and also, there is no need for patients to make long-lasting, invulnerable suppressants (medicines to avoid tissue dismissal).

2. Reasons for 3D Printing in Medical

3D printing in pharmaceuticals can give numerous advantages, including the personalization and customization of restorative parts/items, medications, and hardware/equipment; expanded efficiency; cost-adequacy; the democratization of process outline fabricating; upgraded cooperation, etc. Table 1 describes some of the key benefits of using 3D printing in medicine.

3. Current Status and Growth of 3D Printing in Medical

Research is continuously growing on 3D printing in medicine. Taking data from Scopus, find that 3390 research papers have been published since January 2022 by searching keywords such as “3D Printing” “medical”. The first paper on 3D printing in the medical field was published in 1972, and the second research paper was published in 2002. Then in 2003, no paper was published in this year. From 2004 to 2012, there was only little improvement in publications. In 2004 (5), 2005 (3), 2006 (6), 2007 (5), 2008 (5), 2009 (9), 2010 (7), 2011 (6), 2012 (7) papers was published in these years. Then there is a rapid increment in publications from 2012 to January 2022. In 2013 (27), 2014 (82), 2015 (127), 2016 (241), 2017 (320), 2018 (465), 2019 (550), 2020 (703), 2021 (765) and up to 20 January 2022, 58 papers are published so far.

Various journals and sources published papers on 3D printing in the medical field. Here, we mentioned the top five published research papers on 3D printing in medicine. The maximum contribution of 78 publications is done by “Progress in Biomedical Optics and Imaging Proceedings of SPIE” and placed first. Chinese Journal of Tissue Engineering Research has 58 publications. “Materials” and “Polymers” have 55 and 42, and the Proceedings of SPIE, The International Society For Optical Engineering, have 33 publications.

Different areas provide contributions to 3D printing in medical. Scopus has been analyzed that the medical field gives the maximum contribution of 22%. Engineering field contributes 21%, Material science (14%), Physics and Astronomy (8%), Biochemistry, Genetics and Molecular Biology (7%), Computer Science (7%), Chemical Engineering (4%) and other areas also have 17% of contribution in the medical field by using 3D printing. These other areas include Chemistry, Pharmacology, Toxicology and Pharmaceutics, Mathematics, Social Sciences, Health Professions, Dentistry, Business, Management and Accounting, Energy, Environmental Science, Decision Sciences, Neuroscience, Agricultural and Biological Sciences, Immunology and Microbiology, Multidisciplinary, Nursing, Arts and Humanities, Earth and Planetary Sciences, Economics, Econometrics and Finance, Veterinary and Psychology.

Scopus data has been analysed that 3D printing is continuously growing in the medical field, and all areas are contributing in the medical field by using 3D printing.

4. Development of Biological Organ with 3D Printing Technology

3D bio-printing offers individuals imperative preferences like exceedingly exact cell position and high computerized control of speed, goals, cell fixation, drop volume, breadth of printed cells, etc. Making a bio-restorative part is hugely unpredictable, and numerous bio-printers are being utilized for organ development. However, the essential system of almost all the bioprinters is the same, which is described below.

4.1. Make 2D/3D image data of the desired organ

The picture investigation system (computed tomography (CT)/magnetic resonance imaging (MRI) scan) is utilized to create a bio-restorative picture of the internal body parts, say organs or tissues, etc. (Noorani, 2006; Krug et al., 2010; Marro, 2016). Different algorithms and calculations are executed to examine the extraneous properties of the desired organ or organ under study. This image is then further processed (reverse engineering) to make it usable for bio-AM techniques, as the captured images carry only the shape/topology information, and they often lack the interior compositional data, which is vital for biological use (Marangalou et al., 2013; Dias et al., 2014).

4.2. Data digitization and optimization for bio-printing

The digital picture obtained in the last step is further processed (design internal organ structure) according to required pore size and primary structural/organ porosity, etc. (bio-restorative picture according to organ microstructure) as they differ with tissue/organ to tissue/organ, their capacity, size, and functionality, etc. (Sobral et al., 2011). Also, the digital data file (image information) needed to be approved (acknowledge RP design) and optimized following bio-printers, and a proper investigation system was utilized to remove errors. STL conversion introduces errors in chordal blunders, extra data, dangling faces, truncation mistakes, cut holes, etc. (Izatt et al., 2007; Wang et al., 2016).

4.3. Create or select bio-printing procedure

Asin market, various RP strategies are available, and each has its quality, restrictions and applications. The selection of machine/material relies upon the motivation behind manufacturing the models (Milovanovic and Trajanovic, 2007). Some applications (apparatuses or inserts) require models that can be disinfected or stay good with human tissue-like biomaterials. Some to fabricate gadgets that supplant components of the body in safe and solid way-cranial plates and acetabular inserts; some utilized where protection from wear is essential-dental embeds and crowns; some requires where dependability, adaptability, and controlled porosity are requested-tissue repair, etc. (Starly et al., 2005). So picking the privilege RP system as per the interest of application is essential so that prerequisites of a medicinal application like precision, surface complete, cost, the visual appearance of inner structures, number of wanted hues in the model, quality, accessibility of materials and mechanical properties, can be guaranteed and achieved successfully.

4.4. Detach the stem cells from a specific patient

The bio-printers uses cells (basic organ unit) to print the organ, so the vital issue is cell sources (human body consists of about 200 cell types) stem cells (as they can differentiate into other cell types) are used for this (Yang et al., 2002; Butscher et al., 2011). These microorganisms turn into the essential hotspot for bio-printing due to their high suitability, viability, and short duration of the process. The stem cells are detached from the patient body as the use of patient-specific cells removes/decreases the chances of organ rejection by the body’s immune system (Seitz et al., 2005; Bartolo et al., 2009).

4.5. Grow the immature cells into organ-particular cells

The detached stem cells differentiate and grow in controlled conditions. Different body organs perform different functions and have a unique structure, so stem cells are grown into the required cell type. Choosing the suitable stem cells for bio-printing the right organs is a fundamental requirement of bio-printers. For example, embryonic stem cells, mesenchymal stem cells, umbilical vein endothelial cells, etc., can be used in bio-printing depending upon the conditions for printed organs to function (Xu et al., 2011; Gaebel et al., 2011).

4.6. Prepare bio-ink with organ cells and other required cells/agents

There is an excess of 200 cells in humans, and these cells frame unique and muddled tissues/organs. It is hard to reproduce the intricate and functional 3D part (tissues/organs) without selecting useful cells. So after growing required cells, they are utilized as bio-ink for immediate 3D bio-printing. The printing environment and other agents/materials such as hydrogel, alginate-gelatin, etc. (Van Den Bulcke et al., 2000; Chung et al., 2013; Ahmed, 2015) are used to keep up cell reasonability/viability/biocompatibility and cell–cell connections (to improves printable properties), as excess use of high temperature/pressure or unfavorable natural environment can cause cell death (Butscher et al., 2011; Schuurman et al., 2013; Koo and Kim, 2016). So proper use and selection of cells, agents, printing environment, etc., is done to print the required organ successfully.

4.7. Bio-print the organ/cells

In the wake of setting up the printing strategy (inkjet, extrusion, laser-assisted medical-printing, etc.) and choosing required material (like PEEK for craniofacial implants, titanium for dental implants, biocompatible polymers, collagen and chitosan for skin, cells, and organs, say human bone marrow stromal cells, etc.), machine, technique and so on print the required organ/tissue, inserts, detailed guides. The printed part is then post prepared whenever required to get the coveted properties (Pfister et al., 2004; Gu et al., 2015; Sharma, 2018; Jang et al., 2018).

4.8. Put printed part into the bioreactor and then transplantation of the organ

Keeping in mind the end goal to diminish entanglements related with the debasement of bio-materials, dismissal of the organ by the immune system, came about poisonous results, and so forth. It is essential to assess and test the organ before implantation in the patient body (Ahn et al., 2016; Ahsan et al., 2017). Notwithstanding tests, hypothetical methodologies, either scientific or computational, should be investigated to portray the cell-driven morphogenesis, so the organ is kept in the bioreactor (controlled conditions) to study metabolic and practical properties and after the organ get settled/stabilized. It starts working completely (tissue coordination including anastomosis and innervation), then transplanted into the human body (Skardal and Atala, 2015; Huang and Schmid, 2018; Haleem and Javaid, 2019).

5. Phases of 3D Printing Development in Medical

With the mechanical development and new advancements in the most recent two decades, the medicinal issues are being comprehended substantially simpler than before. The odds of achievement in the complicated medical procedure are high with 3D printing innovation in therapeutic. There are various precedents where 3D printing helps accomplish the coveted outcome in the medical field (Emmer et al., 2018; Fatma et al., 2021). The writing audit recommends how the 3D printing innovation changes with time and new progressions/advancements. With the presentation of 3D printing innovation in 1989, it was utilized for the age of new thoughts and checking the plans, and it was named fast prototyping. However, with further advancement simultaneously and upgrades, it has picked up its utilization in every one of the fields, and here the development pattern of this innovation on the therapeutic field is demonstrated how it has changed with the time and mechanical headway. The phases of its advancements demonstrate how this innovation develops for restorative applications.

5.1. Phase I: Idea generation

In the first stage of development, 3D printing was presented in the restorative/medical field, and it was being utilized for idea generation, thinking about reason, and giving subtle elements of the organ. Amid this stage, the models were printed and used to consider the state of the affliction as two-dimensional (2D) imaging systems remain confined in their ability to address the staggering 3D associations present in helper organ (as unpredictable structure involved a wide range of kinds of system, it has not been conceivable to examine the inside in detail without appropriate 3D picture/model). Also, 2D images are unable to empower complex healing strategies, so the utilization of 3D printed demonstrate changed the pathway entirely, and 3D printed models fill as a crucial instructive device to improve the restorative network’s comprehension for ailments (Abdelkarim et al., 2018) and utilization of 3D printed models change surgical idea generation/planning and increases certainty about the methodology/medical procedure/results (Kim et al., 2008; Javaid and Haleem, 2020).

5.2. Phase II: Surgical training, education and planning

Acquiring all-around learning of human organ structures and using this data inside the clinical setting is necessary for therapeutic science. As a rule, distinctive therapeutic pictures are utilized with life structures models, dead bodies, and human bones for an instructive reason. Be that as it may, now 3D printing developments are utilized as an instrument for the instruction of learners, specialists, surgeons, doctors, etc. (teaching through the utilization of an assortment of printed resources), and they are coordinated with other clinical technologists for better arranging of primary activities. The CT information is used to have the region of anatomical structures and to make virtual 3D models. Lastly, virtual models are converted into physical 3D printed models (Abdullah et al., 2015). 3D printed models (instructive and preparing models) fill as a necessary instructive contraption to upgrade the discernment for ailments (Hashem et al., 2015). Through the presence of 3D printing, specialists can manage and take a gander at amending confinements.

Additionally, 3D printing is the most monetarily keen strategy for getting a far-reaching careful organ model to examine reason or operation practice. The RP-created restorative model empowers the 3D portrayal of an anatomical part, improves the idea of preoperative masterminding and helps the assurance of the entire watchful procedure and prosthetic. It gives a chance to envision inconsistencies, rehearse careful strategy, foresee issues that may emerge, and enhance quality by decreasing slip-ups. Also, this development makes the officially manual errands altogether snappier, exact and more affordable (Mcmenamin et al., 2014).

5.3. Phase III: Design of implants, inserts and surgical tools

The business created inserts are of standard size and shape, so they should be modified physically during a medical procedure and require further experimentation to custom fit them to various patients. Likewise, slight confound between interfaces results in the embed relaxing and disappointment/failure. Anyway, with the incorporation of PC supported plan (CAD), 3D printing, and imaging frameworks (CT or MRI), the patient CT pictures are examined and handled utilizing different software to create an altered or patient particular embed using added substance producing method, which evacuates every one of these issues (Al-Ahmari et al., 2015). The progression of AM and therapeutic programming can manufacture any elaborate plan embed structures, devices, embeds, and so forth with a high degree of precision (Crafts et al., 2017). Utilizing AM method, it is workable for the specialists and designers to deliver natural and exclusively estimated prostheses, inserts, surgical tools, etc., with an assortment of biocompatible material (Matsuno et al., 2001; Hutmacher et al., 2004). As added substance producing advances are persistently developing, fabricating costs are diminishing, and the mechanical and compound properties of the made parts are ending up better.

5.4. Phase IV: Innovation, research and development

The AM showcase is developing quickly in the restorative field because of the rising rate of medical procedures, increment mindfulness and propels innovation (Ebert et al., 2011). The virtual recreation of embed append deep down with the patient’s actual conditions are approved. On the off chance that any progressions are required, then the embed configuration is reprocessed utilizing copies. Once the site records of the embed outline and structure are approved, the physical inserts are manufactured (Banerjee et al., 2014). Analysts are moving their attitude toward 3D printing (say multi-material AM), one kind of methodology demonstrating that the innovation is starting to progress past an innovative work arranged into certifiable applications. Throughout a single component, properties like hardness, corrosion resistance, and environmental adaptation can be defined in areas that require it the most. These new processes allow for exciting multi-functional parts to be built that were never possible through traditional, single material AM processes. AM of metals, ceramics, and polymers is currently being evaluated to combine multiple materials in one operation and has already produced never-before-produced parts. 3D printing opens a new era of advancement and innovation in the medicinal field like printing organs in space/zero gravity (Boling, 2016; Harbaugh, 2017). The recently building nano-structures and miniaturized scale permeable materials (bio-compatible new materials) are being utilized and examined, keeping in mind the end goal to thoroughly investigate potential outcomes of their more precise and robust use in therapeutic science (Dobrzański, 2015; Lunsford et al., 2016). This method is additionally being utilized in scientific/forensic science to tackle riddles. It turns out to be considerably less demanding to thoroughly check and further build up any new or existing thought or research because of 3D printing. Indeed, even the printed part can be tried in labs or on creatures (whenever permitted) which again helps in innovative work.

5.5. Phase V: Live surgery and complex organs

This stage is in advancement, and with further improvement of 3D printing, it is predicted that live medical procedures will be finished utilizing 3D printers. In which the harmed part will be imprinted straightforwardly onto the patient body. Exceptionally mind-boggling and completely utilitarian body organs will be printed in perused to utilize shape (Jagadeesh, 2018). It will not be required to test them or place them in the bio-reactor before being utilized. Anyway, today it appears to be incomprehensible; however, the after effect of the ongoing advancement of these developments demonstrates that 3D printing is the destiny of medicinal science. One late improvement demonstrates the way is intense yet unrealistic as the fourth era of bio-materials is being printed expertly. Likewise, they are savvy/smart or bio-mimetic materials that can improve themselves to emulate healthy tissue’s required extracellular lattice properties (Holzapfel et al., 2013; Kurzmann et al., 2017; Ghidini, 2018). Scientists also hope to have the capacity to print living, wearable computational stages, practically identical to microchips, which would pass motions/information between various cells forward and backwards to monitor their conditions (Lisowska, 2018). The printed biological cells (live surgery) on the skin wound have already been done successfully, and soon it will be used for the human being as per the latest developments (Austin-Morgan, 2016; Zhu et al., 2018; Miri et al., 2018).

6. Discussion on Findings

At first 3D printing was created for a generation of reproduced models; the innovation has experienced massive enhancements and is progressively being utilized to generate end-utilize parts in different fields, including biomedical. Restorative applications of additive manufacturing extend and revolutionize the health/medical industry. It is being used in organ and tissue manufacture; production of prosthetics, medical inserts, and anatomical models; and pharmaceutical research concerning medicate measurements structures, conveyance, usage, and discovery. The accomplishment of reconstructive embed medical procedure relies upon the preoperative assessment of the imperfection, the plan and assembling of embed, and the ability of the working specialist. The utilization of 3D printing systems with medical streamline the complex, careful process, preparing, careful arranging, diminish task time, careful blunders, and most critical the pressure and torment of the patient by lessening the number of embed modifications. 3D printing innovation is a valuable instrument for the precise generation of typical and neurotic life systems models to improve therapeutic instruction and prepare restorative understudies. Advances in research have prompted more vigorous materials, fast tooling, and expansion to new territories, quite in design, science, and miniaturized scale innovation where AM capacities have empowered new regions of research. From the modern viewpoint (materials, protein treatments, and antibodies), the biological research needs fluctuate by application. They can be identified with anti-infection materials, medicines for disease, and capable asset materials. At the same time, the assembling inquires about requirements likewise shift by application and may cover the scaling of endeavors (up and out), greener and less vitality escalated generation, quality control and metrology, and lessened expense.

7. Limitation

Accomplishing medical parts printing needs lots of investment, time and heaps of cells and with an extensive period, ensuring the precision of printing and the cell viability, one of the challenges this technique faces (Marcos et al., 2006). Another challenging issue is evaluating the printed part as biological parts are needed to evaluate and test safely before implantation in the patient body. Many literary works are available about printing the vital organs, but there is no report/study about the performance/working of the printed tissues, cells, organs, etc. (Chang et al., 2011; Murphy and Atala, 2014). The source of the cell (raw material) for bio-printing the organ is also a critical issue restricting bio-printers growth. The conveyance or supply of nerves to a printed thick tissue cannot be overlooked. Procedures to advance innervation amid and after bio-printing must be contemplated for organ printing to be a reality. Since the angiogenesis procedure needs time, powerful vascularization of thick tissues has been an extraordinary test, requiring further research work (Hench and Thompson, 2010).

8. Future Scope

With its undeniable all-inclusive common sense and proficiency, it is trying to foresee how the 3D printing procedure will progress in the coming years. 3D printing includes three basic ideas for a progressive thought: all-inclusive, down to earth, and proficient. When we think about how “general” 3D printing is and what regions it has just affected, the effect is very striking. As it might be an incredible jump from metal, polymer, and artistic materials, envision having the capacity to 3D print nourishment. Being able to think about the sustenance, transfer it to a printer, and see it consequently print our feast straightforwardly before we are never again an idea for what’s to come. Food, organs, metal inserts, tools, etc., are printed utilizing 3D printing with next to zero material waste, showing the reasonableness and proficiency of the procedure. These energizing innovations and research networks guarantee to change the scene of the medicinal business. Multidisciplinary scientists are designing new 3D printers to print tissues onto the arteries/veins or organs directly in the patient body during operation. Some researchers are exploring the capabilities or limitations of these innovations that are required to reconstitute organ-level capacity with micron accuracy. Another future trend is the development of is four-dimensional (4D) printing, in which the printed object will reassemble itself in other defined shapes depending upon some other changing factors (like humidity, temperature, time, etc.).

9. Conclusion

With the presentation of 3D imprinting in the therapeutic field, the treatment procedure turns out to be much simple, and it opens a new period of advancement and gives an entire better approach to the treatment of numerous issues like organ lack, skin creation, bone substitution, and some more. With the development of this innovation, it will soon be conceivable to print every last piece of the human body with an organically the same organ that can be utilized for transplantation. The reconciliation of CT or MRI, CAD, and other 3D producing techniques considers the improvement and creation of physical 3D models of any unpredictable structure for the utilization in careful practice, pre-agent arranging and practice. It is seen from the advanced stage that the usage of 3D printing has changed from thought age to live medical procedure. The development pattern and change in added substance production demonstrate that 3D printing innovation can change the destiny of restorative science entirely, and its outcome is incredibly encouraging. Here, in this research author talks about the present cutting-edge bio-printing and its ongoing innovation towards manufacturing of living organs/transplants/tissues, etc., so that organs can be created utilizing 3D printing. Even though the innovation demonstrates many guarantees, there is as yet far to go to understand this hopeful vision fundamentally. Defeating ebb and flow obstacles in cell innovation, bio-fabricating innovation, and advancements for in vivo coordination is fundamental for growing consistently digital innovation from foundational microorganism detachment to transplantation.