Although we’ve seen 3D printed medical implants made from materials like silicone and chrome-cobalt, the most common metal of choice is titanium due to its low density and high strength. Titanium has been used many times to make 3D-printed jaw implants, which is the specialty of Belgium-based medical device startup CADskills. The startup is focused on patient-specific implants for craniomaxillofacial (CMF) and neurosurgery patients, including its innovative AMSJI, a new generation of subperiosteal implant. AMSJI stands for Additively Manufactured Subperiosteal Jaw Implant (say five times faster), and as a recent case study points out, this 3D-printed titanium jaw implant can improve the lives of people with extreme jaw atrophy.
Bone atrophy poses one of the biggest challenges when making jaw implants – bone density decreases when the upper jaw bone, or maxilla, has no more teeth, making it difficult for the patient the use of a typical dental implant. Many patients use removable dentures, but since they are not attached to anything, they can come loose, cause pain, and even slip out of the patient’s mouth. Surgeons can take bone from a patient and add it to their jawbone, but this invasive option requires many operations.
The customizable AMSJI offers a new alternative to these patients, eliminating the bone grafting process and its months of recovery time. Surgery with the AMSJI only takes an hour, so the patient leaves the operating room with fixed teeth the same day.
Professor Mommaerts from the University of Brussels came up with the idea for AMSJI, and the original versions were made of a stiff cobalt-chromium alloy, which didn’t have many bone-growing properties. Titanium was chosen for its conductivity, bone ingrowth, and biocompatibility, and it’s secured with screws to provide stability. By 3D printing the implant, the process is easier to control and there are many more design possibilities, including the ability to add porous structures.
The startup has only been around for a year, but it’s already starting to make waves – in addition to its AMSJI, CADskills is part of the Family of the Future collaborative effort that was announced just a few weeks ago. CADskills strives to become a leader in patient-specific TMJ and subperiosteal implants, and one of its five-year goals is to create a global network of thought leaders and support surgeons around AMJSI . Therefore, the startup ensures that there are no errors in its current work on the CMF.
“Over the past year, CADskills has meticulously studied each case and we have waited to see how the soft tissues around the implant respond,” said Robin Detaille, COO at CADskills. “We learned from each case and continually worked to perfect the AMSJI design for each new patient.”
CADskills uses Materialize’s Mimics Innovation Suite (MIS) to achieve fast and reliable results for its 3D printed titanium implants. The software suite helps clean up CT scans so that extra titanium plates or dental implants a patient may already have don’t cause scattering, which often happens with normal segmentation software. Implant designs can be imported into Mimics and then positioned correctly on a 3D anatomical model, giving surgeons a better 3D view of exactly how the implant will look with nerve positioning and surrounding soft tissue.
MIS also allows CADskills to import screws and inform surgeons of optimal screw lengths, and the suite is also certified, saving administrative time. The startup’s favorite MIS feature is its intuitive multi-slice editing feature, which makes the whole process much faster overall.
“Compared to competitors, the speed of MIS is magnificent. It is also stable, reliable and certified,” said Ruben van de Sande from CADskills. “The Materialize Mimics support team is fantastic – they are incredibly quick to resolve issues and we know we can count on them. Another advantage of the MIS is that it is user-friendly, which makes it easy to train new employees in its use.
CADskills is confident that the clinical results of its AMSJI will be good and looks forward to bringing the implant to the global market. The startup, which also works with orthopedic patients, is also investigating ways to improve temporomandibular joint prostheses and skull plates, and is considering expanding into the veterinary field. As 3D printed titanium implants have already helped alleviate cruciate ligament conditions in dogs, I think the possibilities for success are wide open. Discuss it on the CADSkills forum on 3DPB.com.
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