The Imprint of 3D-Printing in Health: A Students Perspective

In a technology driven world, the abundance of information and ease of communication has influenced every aspect of our lives. Not only has it affected the way we interact as humans, but it provided new outlets for skill development and creativity. One of my favorite expressive outlets is 3D-printing. From designing flower vases to replicating anatomical models, my engagement with 3D-printing allowed me to bring theoretical ideas to life by combining the natural sciences, technology, and art. When I first observed my older brother use a 3D-printer, I was fascinated by the geometric lattice in which the machine ejected thermoplastic, as it closely resembled the molecular arrangement of atoms observed in structures like crystal and bone. My curiosity with both technology and human health, led me to learn more about 3D technology and its applications in research, specifically on improving and enhancing human health.

Introduced in the 1980s as a tool for rapid prototyping, 3D-printing (or additive manufacturing) utilizes computer aided designs or a digital 3D file to construct a three-dimensional object. The object is built layer-by-layer using a wide array of materials including, but not limited to plastics, metals, or hydrogels. These printed layers are then fused to create a desired three-dimensional object. Decades later, this technology has gained more attention and morphed into a powerhouse tool. Advancing in design freedom, you can now print textiles, houses, and even engineer skin tissue. There is no doubt that this technology is rapidly growing, transforming, and advancing every field that it is engaged in.

In medical research, 3D-printing is currently being used to improve and address an array of challenges. For example, the demand for tissue and organ transplants has paved the way for the emergence of 3D-bioengineering. Research experts from various disciplines collaborate to ensure that integral form, function, and biocompatibility are maintained when creating, repairing, and replacing these structures. The first time I 3D-printed a skin graft in the lab, I was astonished by the texture, mobility, and turgor properties that were present, mimicking human skin. To think that cells were encapsulated in the bioink and printed onto a tissue structure, it made me ponder about the future of regenerative medicine and implantation. Would there come a time in which we can take a patient’s own cells and print organs on demand? Can we use 3D-printing to assist in drug delivery? Afterall, nanoscale 3D-printing is a thing–creating structures that are smaller than the width of a human hair. As 3D-Printing is still a novel
approach in medicine, there is much needed laboratory research and clinical translation to be done. However, with the current state of this technology, it’ll be interesting to observe its advancements and how it’ll evolve over time.

Outside of the research, 3D-technology has been implemented in both surgical preparation and
intervention. In dental school, I observed a mandibulectomy with fibula free flap reconstruction. I recall walking into the operating room and a large screen displayed an image of the patient’s fibula, cutting guides were highlighted to fit the custom titanium plates that would eventually replace the patient’s chin. Near the operating table, a 3D-printed mandible was constructed using the patient’s CT scan, displaying the exact size and location of the tumor. During the operation, the surgeon would refer to the 3D mandible and the X-Rays for precise tumor removal. I later learned that virtual surgical planning (VSP) is a common technology used in surgical procedures, with 3D printed models to assist surgeons in the OR. Studies have indicated that the precision offered by 3D-technology not only enhanced surgeon confidence by increasing surgical accuracy, but it also minimized inter-operator variability, protecting the patient from possible risks.

To prepare future health professionals, academic institutions have started to incorporate 3D technology into their curriculum. Virtual reality (VR) simulators, adaptive learning environments, and haptic technologies; all offer new ways of learning that can supplement and improve student engagement. In return, students gain more hands-on experience, increase practice hours, and the concepts of structural anatomy are reinforced. As a first year dental student, I’ve utilized intraoral 3D-scanners to create dental impressions, learn cleft lip procedures with high fidelity 3D-printed surgical simulators, and engaged with 3D-imaging to visualize networks in oral and pharyngeal cancers. My personal experiences with 3D-technology have not only contributed to my education but have enhanced my motivation in learning new techniques and embracing challenges, while ultimately being able to improve patient care and their outcomes in the future.

Ira Rutkow, a surgeon, medical historian, and author of Empire of the Scalpel: The History of Surgery, highlights in his book that the art of surgery is largely characterized by its tools and manual aspects of the craft. From the invention of the X-RAY to the Da Vinci surgical system, medicine will continually evolve with the growth and implementation of new technology. As it is important to be up to date and use technology to assist us, there is a need to acknowledge and appreciate the traditional and laboring aspects of the surgical craft. Whilst 3D-printing and its technologies can augment one’s experience in medicine, it cannot replace the knowledge, judgment, skill, and oversight that is unique to this profession.

In this blog post, I’ve highlighted my personal experiences with 3D-printing, all of which have been positive thus far. However, crucial topics such as ethicality, provider liability, medical errors, barriers to access, and patient privacy will all need to be addressed when incorporating this technology. While 3D-printing has greatly benefited medical research, surgery, and education, we cannot solely rely on this technology to solve problems that we face in medicine, rather use it in conjunction with our current skill sets to improve the profession. Nonetheless, I am eager to learn about the progression of 3D-printing and implement them in my future. Whether it’s customizing care that attends to a patient’s needs or through research. As 3D-printing continues to grow, it’ll foster new opportunities of exploration, generating new ideas and concepts that’ll further define our 3D world.

Lotz JM, Hoffmann F, Lotz J, Heldmann S, Trede D, Oetjen J, Becker M, Ernst G, Maas P, Alexandrov T, Guntinas-Lichius O, Thiele H, von Eggeling F. Integration of 3D multimodal imaging data of a head and neck cancer and advanced feature recognition. Biochim Biophys Acta Proteins Proteom. 2017 Jul;1865(7):946-956. doi: 10.1016/j.bbapap.2016.08.018. Epub 2016 Sep 1. PMID: 27594533.

Meyer-Szary J, Luis MS, Mikulski S, Patel A, Schulz F, Tretiakow D, Fercho J, Jaguszewska K,
Frankiewicz M, Pawłowska E, Targoński R, Szarpak Ł, Dądela K, Sabiniewicz R, Kwiatkowska J. The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical
Professionals-Cross-Sectional Multispecialty Review. Int J Environ Res Public Health. 2022 Mar
11;19(6):3331. doi: 10.3390/ijerph19063331. PMID: 35329016; PMCID: PMC8953417.

Tripathi S, Mandal SS, Bauri S, Maiti P. 3D bioprinting and its innovative approach for biomedical applications. MedComm (2020). 2022 Dec 24;4(1):e194. doi: 10.1002/mco2.194. PMID: 36582305; PMCID: PMC9790048.

Weng T, Zhang W, Xia Y, Wu P, Yang M, Jin R, Xia S, Wang J, You C, Han C, Wang X. 3D bioprinting for skin tissue engineering: Current status and perspectives. J Tissue Eng. 2021 Jul
13;12:20417314211028574. doi: 10.1177/20417314211028574. PMID: 34345398; PMCID:
PMC8283073

Nivea Vang is a first-year dental student attending the University of Minnesota School of Dentistry. Her personal experiences with head/neck trauma and hyperdontia, inspired her pursuit in Oral and Maxillofacial Surgery. She is an Association of Women Surgeons (AWS) member serving on both the Communications and the Outreach committees, as well as an active Community Health Worker at one of the largest multi-specialty Federally Qualified Health Centers (FQHC) in the state of Minnesota. As an advocate for public health and education, she helped initiate Gotcha Glasses! A community outreach program that provides vision screenings and free eyeglasses to school aged children in medically underserved areas. In 2020, she was awarded a NASA Space Grant which allowed her to partake in space aeronautics research. Her passion for research has allowed her to take roles in various projects ranging from cancer pathology to biotechnology, at facilities like Baylor College of Medicine and The University of Minnesota. During her free time she enjoys archery, playing tennis, and reading.