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This work aims to present the design of a new continuous tool-path strategy for open-source low-cost fused deposition modeling (FDM) machines, such as Fab@Home or RepRap; and the development of an innovative integrated tool to design and fabricate customized tracheal stents with any FDM machine and six patient parameters. Both contributions were validated and implemented by obtaining a customized medical-grade silicone tracheal stent.

For the design of the new deposition strategy, a Python programming language was used. The new tool-path strategy was proposed as a continuous path to avoid drops and gaps and to improve the accuracy of the final model. Meanwhile, patient parameters were obtained by medical doctors and introduced into the innovative integrated system. On the one hand, one mold generated automatically, and viewed with Matlab® software, was fabricated with a Fab@Home machine, optimized with the continuous tool-path strategy. On the other hand, the same generated mold was viewed in SolidWorks/Excel software and was fabricated using a commercial FDM machine. Finally, the mold was filled with medical grade silicone, and a silicone tracheal stent was obtained.

Path planning for extrusion technologies is still a major concern, especially for open-source FDM machines. The results obtained in this work show the benefits of applying the newly developed continuous tool-path strategy to optimize the performance and efficiency of these machines. In addition, the proposed innovative integrated system allows the fabrication of customized tracheal stents rapidly and affordably.

The possibility of obtaining customized tracheal stents is a worthy challenge. Medical doctors could play a more active role and interact during the design process, helping to obtain more suitable stents. The method proposed herein would provide the opportunity to obtain real values from the trachea of a patient in the operating room and quickly fabricate a customized stent that would fit the patient's trachea perfectly.

The results obtained in this work are relevant and have future applications in both the medical and the additive manufacturing fields. The optimized tool-path strategy can help to improve and enhance the use of low-cost FDM machines. Moreover, the innovative automatic design approach to fabricate tracheal stents may open new market opportunities in the medical device field.

The purpose of this paper is to focus on tracheal stent production with the aim of investigating the available devices and improving their performances. The biomedical field is a continuously growing area of the market always in search of the most innovative and competitive solutions for healthcare. Beside the actual critical period of the world economy, it shows continuous improvements in research and innovation.

Within a market analysis and the collaboration between engineering and biomedical research fields, it was outlined a new product concept able to satisfy the patient’s and physician’s requirements with the focus on the enhancement of the stent anchorage. As a result, the concept of a custom- or tailor-made stent was identified as a potential solution. Moreover, additive technologies were identified as the economically sustainable processes for manufacturing these innovative stents. In the present paper, different types of stents were derived from the proposed concept, they were designed, manufactured and their anchorage capability was tested. In particular, the procedures adopted for their design are described and discussed. Moreover, silicone fused deposition modelling was adopted and two types of deposition method, namely, layer-by-layer and continuous, were used to manufacture the devices identifying their pro, cons and limits. Finally, the stents were tested against migration and results were compared with one of the most widely used today.

The results show how additive manufacturing allowed to manufacture more efficient and migration resistant stents.

It is expected that this new stent design will reduce the risk of complications in stenting, as granulation, thanks to a more uniform stress distribution on the trachea tissues. These improved characteristics will allow to enhance the quality of both the product and the patient’s healthcare.

This paper aims to discuss the successful fabrication of customized tubular scaffolds for tracheal tissue engineering with a novel route using solvent-based extrusion 3D printing.

The manufacturing approach involved extrusion of polymeric ink over a rotating predefined pattern to construct customized tubular structure of polycaprolactone (PCL) and polyurethane (PU). Dimensional deviation in thickness of scaffolds were calculated for various layer thicknesses of 3D printing. Physical and chemical properties of scaffolds were investigated by scanning electron microscope (SEM), contact angle measurement, Fourier Transform Infrared Spectroscopy (FTIR) and X-ray diffraction (XRD). Mechanical characterizations were performed, and the results were compared to the reported properties of human native trachea from previous reports. Additionally, in vitro cytotoxicity of the fabricated scaffolds was studied in terms of cell proliferation, cell adhesion and hemagglutination assay.

The developed fabrication route was flexible and accurate by printing customized tubular scaffolds of various scales. Physiochemical results showed good miscibility of PCL/PU blend, and decrease in crystalline nature of blend with the addition of PU. Preliminary mechanical assessments illustrated comparable mechanical properties with the native human trachea. Longitudinal compression test reported outstanding strength and flexibility to maintain an unobstructed lumen, necessary for the patency. Furthermore, the scaffolds were found to be biocompatible to promote cell adhesion and proliferation from the in vitro cytotoxicity results.

The attempt can potentially meet the demand for flexible tubular scaffolds that ease the concerns such as availability of suitable organ donors.

3D printing over accurate predefined templates to fabricate customized grafts gives novelty to the present method. Various customized scaffolds were compared with conventional cylindrical scaffold in terms of flexibility.

Tracheobronchial stents are commonly used in airway management as a form of palliation for obstruction. This form of therapy immediately relieves the patients from life‐threatening conditions and significantly improves their quality of life. In the cases of complex tracheobronchial obstruction, customised airway stents are required for effective palliation. In this work, an Airway Stent Customisation Protocol (ASCP) is introduced.

It describes two variant routes that use a combination of rapid prototyping (RP) and rapid tooling (RT) techniques to fabricate customised airway stents in short lead times. The ASCP allows the stents to be tailored in terms of geometry, and distending strength. A brief comparison between the ASCP and other RP/RT manufacturing routes is also carried out.

The ability to customise airway stents in short lead times is important as it allows surgeons to swiftly treat life‐threatening conditions arising from tracheobronchial obstructions. It is shown that the ASCP is capable of providing relief to patients quickly. The application of RP and RT in the ASCP has not only allowed shorter response time to patients, but has also allowed the stents to be produced at a relatively low cost.

Tracheobronchial stents are commonly used in patients facing advanced stages of cancer. Focuses on a time and cost‐effective solution that is provided to improve their quality of life.

The purpose of the paper was to present a specific case study of how 3D printing was introduced in the chest wall construction process of a specific patient with unique medical condition. A life-size 3D model of the patient’s chest wall was 3D printed for pre-surgical planning. The intent was to eliminate the need for operative exposure to map the pathological area. The model was used for preoperative visualization and formation of a 1-mm thick titanium plate implant, which was placed in the patient during chest wall reconstructive surgery. The purpose of the surgery was to relive debilitating chronic pain due to right scapular entrapment.

The patient was born with a twisted spine. Over time, it progressed to severe and debilitating scoliosis, which required the use of a thoracic brace. Computerized tomography (CT) data were converted to a 3D printed model. The model was used to size and form a 1-mm thick titanium plate implant. It was also used to determine the ideal location for placement of the plate during thoracotomy preoperatively.

The surgery, aided by the model, was successful and resulted in a significantly smaller incision. The techniques reduced invasiveness and enabled the doctors to conduct the procedure efficiently and decreased surgery time. The patient experienced relief of the chronic debilitating pain and no longer need the thoracic brace.

The 3D model facilitated pre-operative planning and modeling of the implant. It also enabled accurate incision locations of the thoracotomy site and placement of the implant. Although chest wall reconstruction surgeries have been undertaken, this paper documents a specific case study of chest wall construction fora specific patient with unique pathological conditions.

This paper aims to focus on developing a theoretical framework for the analysis of factors influencing additive manufacturing (AM) in the health-care domain.

A total of 18 factors are considered through extensive literature review and the relationship between each factor is studied using total interpretive structural modeling (TISM) and the model is logically developed. TISM model is developed using appropriate expert inputs. In addition, cross-impact matrix multiplication applied to classification (MICMAC) analysis is conducted to group the factors.

It was found that “ease of design” and “research and development” are the two most important factors with the highest driving power and dependencies. Through MICMAC analysis, the significance of factors is studied.

The study has been done based on inputs from academic experts and industry practitioners. The inferences from the study have practical relevance.

The development of a structural model for the analysis of factors influencing AM in the health-care domain is the original contribution of the authors.

The purpose of this study is to highlight the direct fabrication of rapid tooling (RT) with desired mechanical, tribological and thermal properties using fused deposition modelling (FDM) process. Further, the review paper demonstrated development procedure of alternative feedstock filament of low-cost composite material for FDM to extend the range of RT applications.

The alternative materials for FDM and their processing requirements for fabrication in filament form as reported by various researchers have been summarized. The literature demonstrates the role of various post-processing techniques on surface finish of FDM prints. Further, low-cost materials for feedstock filament have been investigated experimentally to check their adaptability/suitability for commercial FDM setup. The approach was to realize the requirements of FDM (melt flow rate, flexibility, stiffness, glass transition temperature and mechanical strength), necessary for the successful run of an alternative filament. The effect of constituents (additives, plasticizers, surfactants and fillers) in polymeric matrix on mechanical, tribological and thermal properties has been investigated.

It is possible to develop composite material feedstock as filament for commercial FDM setup without changing its hardware and software. Surface finish of the parts can further be improved by applying various post-processing techniques. Most of the composite parts have high mechanical strength, hardness, thermal stability, wear resistant and better bond formation than standard material parts.

Future research may be focused on improving the surface quality of parts fabricated with composite feedstock, solving issues related to the uniform distribution of filled materials during the fabrication of feedstock filament which in turns further increases mechanical strength, high dimensional stability of composite filament and transferring the technology from laboratory scale to various industrial applications.

Potential applications of direct fabrication with RT includes rapid manufacturing (RM) of metal-filled parts and ceramic-filled parts (which have complex shape and cannot be rapidly made by any other manufacturing techniques) in the field of biomedical and dentistry.

This new manufacturing methodology is based on the proper selection and processing of various materials and additives to form high-performance, low-cost composite material feedstock filament (which fulfil the necessary requirements of FDM process). Finally, newly developed feedstock filament material has both quantitative and qualitative advantage in RT and RM applications as compared to standard material filament.

Shape memory materials are functional materials having a good number of applications due to their unique features of programmable material technology such as self-stretching, self-assembly and self-tightening. Advancements in today’s technology led to the easy fabrication of such novel materials using 3D printing techniques. When an external stimulus causes a 3D printed specimen to change shape on its own, this process is known as 4D printing. This study aims to investigate the effect of graphene nano platelet (GNPs) on the shape memory behaviour of shape memory photo polymer composites (SMPPCs) and to optimize the shape-changing response by using the Taguchi method.

SMPPCs are synthesized by blending different weight fractions (Wt.%) of flexible or soft photopolymer (FPP) resin with hard photopolymer (HPP) resin, then reinforced with GNPs at various Wt.% to the blended PP resin, and then fabricated using masked stereolithography (MSLA) apparatus. The shape memory test is conducted to assess the shape recovery time (T), shape fixity ratio (R_f), shape recovery ratio (R_r) and shape recovery rate (V_r) using Taguchi analysis by constructing an L9 orthogonal array with parameters such as Wt.% of a blend of FPP and HPP resin, Wt.% of GNPs and holding time.

SMPPCs with A3, B3 and C2 result in a faster T with 2 s, whereas SMPPCs with A1, B1 and C3 result in a longer T with 21 s. The factors A and B are ranked as the most significant in the Pareto charts that were obtained, whereas C is not significant. It can be seen from the heatmap plot that when factors A and B increase, T is decreasing and V_r is increasing. The optimum parameters for T and V_r are A3, B3 and C2 at the same time for R_f and R_r are A1, B3 and C1.

Faster shape recovery results from a higher Wt.% of FPP resin in a blend than over a true HPP resin. This is because the flexible polymer links in FPP resin activate more quickly over time. However, a minimum amount of HPP resin also needs to be maintained because it plays a role in producing higher R_f and V_r. The use of GNPs as reinforcement accelerates the T because nanographene conducts heat more quickly, releasing the temporary shape of the specimen more quickly.

The use of FPP and HPP resin blends, fabricating the 4D-printed SMPPCs specimens with MSLA technology, investigating the effect of GNPs and optimizing the process parameters using Taguchi and the work was validated using confirmation tests and regression analysis, which increases the originality and novelty.

There are many investigations in design methodologies, but there are also divergences and convergences as there are so many points of view. This study aims to evaluate to corroborate and deepen other researchers’ findings, dissipate divergences and provide directing to future work on the subject from a methodological and convergent perspective.

This study analyzes the previous reviews (about 15 reviews) and based on the consensus and the classifications provided by these authors, a significant sample of research is analyzed in the design for additive manufacturing (DFAM) theme (approximately 80 articles until June of 2017 and approximately 280–300 articles until February of 2019) through descriptive statistics, to corroborate and deepen the findings of other researchers.

Throughout this work, this paper found statistics indicating that the main areas studied are: multiple objective optimizations, execution of the design, general DFAM and DFAM for functional performance. Among the main conclusions: there is a lack of innovation in the products developed with the methodologies, there is a lack of exhaustivity in the methodologies, there are few efforts to include environmental aspects in the methodologies, many of the methods include economic and cost evaluation, but are not very explicit and broad (sustainability evaluation), it is necessary to consider a greater variety of functions, among other conclusions

The novelty in this study is the methodology. It is very objective, comprehensive and quantitative. The starting point is not the case studies nor the qualitative criteria, but the figures and quantities of methodologies. The main contribution of this review article is to guide future work on the subject from a methodological and convergent perspective and this article provides a broad database with articles containing information on many issues to make decisions: design methodology; optimization; processes, selection of parts and materials; cost and product management; mechanical, electrical and thermal properties; health and environmental impact, etc.

Additive manufacturing has rapidly developed in terms of technology and its application in various types of industries. With this rapid development, there has been significant research in the area of materials. This has led to the invention of Smart Materials (SMs). The 4D printing is basically 3D printing of these SMs. This paper aims to focus on novel materials and their useful application in various industries using the technology of 4D printing.

Research studies in 4D printing have increased since the time when this idea was first introduced in the year 2013. The present research study will deeply focus on the introduction to 4D printing, types of SMs and its application based on the various types of stimulus. The application of each type of SM has been explained along with its functioning with respect to the stimulus.

SMs have multiple functional applications pertaining to appropriate industries. The 4D printed parts have a distinctive capability to change its shape and self-assembly to carry out a specific function according to the requirement. Afterward, the fabricated part can recover to its 3D printed “memorized” shape once it is triggered by the stimulus.

The present study highlights the various capabilities of SMs, which is used as a raw material in 4D printing.