3D Printing in Healthcare: Tissues, Drugs, Implants & Food

Signals is?where we explore the frontiers of learning & technology in healthcare, inspired by the people we meet on?T Minus 10

This week we're exploring 3D printing in healthcare, a frontier that's as much science as it is science-fiction. As a sci-fi nerd, I had an absolute blast exploring this one. We're living in a world where Isaac Asimov's concept of "kitchens" (1955), the "replicators" of Star Trek (1966-), and even Neal Stephenson's "matter compilers" (1995) are morphing from the pages of fiction into our tangible reality. But it's not just about food or arbitrary objects anymore — it's about human health and life-changing medical advancements. Telemedicine, robotic surgery, and bionic limbs, once seeds of imagination, are now transforming millions of lives. 3D printing is cut from similar cloth, and is well on its way from page to practice.

Today, we'll explore how 3D printing is making its mark in healthcare. We'll look at breakthrough signals you'll need to see to believe and explore how they might change the future of healthcare as we know it. From organ printing to life-saving ventilator parts during COVID and addressing global food insecurity, I hope you'll finish this piece feeling as optimistic as I do about our future. Bit by bit, layer by layer, the future is ours for the making.

A (very) brief history

3D printing, a concept that sprouted in the 1980s with the innovation of pioneers like Chuck Hull and Scott Crump, took nearly two decades to transform from groundbreaking technologies into commercial printers. Hull's development of stereolithography (SLA) and Crump's patenting of fused deposition modeling (FDM) paved the way for the establishment of industry leaders like 3D Systems and Stratasys. [1,2]

This transformative technology also set the stage for advances in the medical world. While we're not yet at the point of 3D printing functioning kidneys — despite the first functional kidney structures being grown from stem cells in 2002 — the progress in 3D bioprinting since then promises a future where such complex feats are within reach. [3]

Avi Reichental, who served as President and CEO of 3D Systems for 12 years, has been a significant player in this space. Under his leadership, 3D Systems experienced six-fold growth in revenues. In a past life I actually covered the company (NYSE: DDD) as an equities trader at the end of Avi's tenure as CEO. More recently, he co-founded NEXA3D, focusing on using 3D printing to sustainably digitize supply chains, a topic he addressed in a popular 2014 TED Talk and discussed on LinkedIn just this week. [4] With over 2 million views on his TED Talk, Reichental's vision for the future of 3D printing is clear:

"The big idea is not that 3D printing is going to catapult us into the future, but rather it is going... to usher in a new era of localized, distributed manufacturing that is based on digital fabrication." [5]

3D Printing, by the numbers

• Global market size and growth: The global 3D printing market size was valued at $17 billion in 2022 and is projected to grow at a compound annual growth rate (CAGR) of 23.3% from 2023 to 2030. [6]
• Medical market: As of 2019, the market for medical 3D printing, including materials, services, software and hardware was estimated to be worth $1.25 billion. [7]
• Orthopedics: The orthopedics 3D printing market was valued at?$691 million in 2018?and is predicted to grow into a $3.7 billion market by 2027. [8]
• Install base: As of 2021 the US had the largest installed base of 3D printers of 422,000 units worldwide. [9]
• Costs: The original SLA-1 commercial printer cost upwards of $300,000 when it hit the market in 1988. Until the 2010s, commercial printers averaged around $50,000. In 2023, the top commercial printers carry 4-figure price tags and many of the best consumer-grade printers are under $500. [10]
• 2009: After the launch of Kickstarter in 2009, several personal 3D printing companies seeded their way into existence, including Micro (2014) and 101Hero (2016), which aimed to make the world's most affordable printer at $49. That same year Makerbot was founded to make 3D printing more affordable and accessible with its desktop solutions.
• Investment: Venture funding for these companies reached $1.5 billion in the first six months of 2022, the most of any year except 2021, when more than $2 billion was raised, according to PitchBook data. [11]

Signals

1. Personalized Medicine

Companies using 3D printing to create customized prosthetics, orthotics, implants and surgical guides, tailored to the specific needs of individual patients, enhancing surgical precision and overall patient outcomes.

Companies & News

• Materialise is one of the largest 3D printing companies globally and has a significant presence in the medical field. Materialise's medical division specializes in creating patient-specific implants, surgical guides, and medical imaging software. In a recent blog post about enabling personalized 3D printed solutions at scale, the company said "since the launch of our Mimics software in 1993, we estimate that our planning software and the introduction of 3D-printed devices have helped more than 10 million patients, directly or indirectly." [12]
• Anatomics is a Melbourne-based medical device company that got its start with a $1,200 research grant in 1991 to create its first 3D printed model from CT data. Today they offer a wide range of devices and software for surgical applications , including patient-specific and off-the-shelf implants. [13]
• Xilloc Medical specializes in patient-specific implants and prosthetics to help reconstruct parts of the human skeleton. Though Maikel Beerens founded the company in 2011, he got his start as a young biomedical engineer working on the world's first 3D printed complete jaw implant with Maastricht University Medical Centre. Today it looks like Maikel's stepped into the CTIO role and the 12-person company is hiring production engineers in Netherlands (in case you're looking!).

2. Bioprinting and Tissue Engineering

These companies are focused on the cutting-edge field of bioprinting, utilizing 3D printing technology to create living tissues and organs, advancing regenerative medicine and the development of patient-specific transplants.

Companies & News

• Trestle Biotherapeutics (based here in San Diego) recently licensed technology from Harvard's Wyss Institute that it intends to use to create kidney cell transplants that help get people off dialysis. One day, they hope the process will yield full organs. [14]
• Johnson & Johnson recently signed a joint development deal with Korea-based T&R Biofab. T&R says that it has the core technology to develop artificial skin and organs such as the heart and liver. [15]
• Organovo is pioneering 3D human tissues for drug discovery. Their technology (still in the clinical trial stage) can 3D bioprint tissues that closely mimic human biology and disease. After announcing its first inflammatory bowel disease (IBD) model last year, the company just announced their FXR program (lead molecule for IBD) has received FDA clinical trial authorization for a Phase 2 trial in ulcerative colitis (UC). [16]
• A.D.A.M. was founded in 2018 by 3D printing company Kwambio and WeFund Ventures in Ukraine. The initial vision of the company was to create a carshop-like infrastructure where any part of the human body can be treated like a replaceable part. A.D.A.M. aims to land regulatory clearance for its bone implants in 2023 and begin sales in 2024. Up next: blood vessels, heart valves, and bronchial implants. [17] (s/o to Melinda B. C. for flagging A.D.A.M.'s work!)
• Brinter develops durable and functional 3D bioprinted implants that mimic native cartilage. They also offer a modular 3D bioprinter engineered for a wide range of applications. The Brinter team recently published a book chapter on the future of 3D bioprinting in case you're interested. [18] I had a chance to meet CEO Tom A. at LSI USA in March. His unique background across gaming, tech, and software stood out and planted the initial seed for this piece.

3. Medication and Drug Delivery

This category includes companies that leverage 3D printing to create personalized medications or develop innovative drug delivery systems, enabling precise dosing and improved patient compliance. Though incumbents are excited about this tech and have entered partnerships to explore commercial potential, scale challenges remain given large pharma's search for 'blockbuster drugs' and billions of tablets per year.

Companies & News

• Aprecia Pharmaceuticals describes itself as a unique drug delivery technology platform that aims to reduces pill burden and makes medicines easier to take. They used their proprietary 3D printing platform and ZipDose? technology to print the first FDA-approved 3D printed drug, Spritam. Spritam was specifically designed to be taken by patients that might otherwise have difficulty swallowing a pill (e.g. elderly patients). [19] Combine easy-to-take with higher dosages and you can see why pharma, patients, and investors alike are excited about customizable, 3D printed medications.

• FABRX was created by leading academics at University College London (UCL), with a passion for developing better medicines using 3D printing. Earlier this year they launched a subsidiary in Spain focused on developing AI-powered, bespoke software called FABRX·AI. Co-Founder and CEO Alvaro Goyanes shared his thoughts on the future of this space in a 2020 paper:

"3D printing will be a basic tool in the virtuous cycle of personalized medicine." [20]

4. Surgical Tools and Devices

Companies in this category develop 3D-printed surgical tools and devices that improve surgical procedures, enabling greater precision and efficiency in various surgical interventions.

Companies & News

• Carbon uses a proprietary 3D printing technology called Digital Light Synthesis? to support a wide range of industries, including life sciences and medical device companies. They've partnered with companies like BD to reduce print time by 55% and use 7% less material. A recent case study shows the Carbon parts were actually the first use of additive manufacturing (AM) at BD. [21]
• The COVID-19 pandemic drove adoption in this space. 3D printing proved to be a reliable alternative for fast innovation and local manufacturing, especially as global supply chains faltered. A now-infamous example of this came from Italy during the height of the COVID outbreak. A hospital in Brescia ran out of ventilator valves. They needed them, and fast. The only problem was each valve normally costs $11,000. Enter a local startup called Isinnova. Within 6 hours they designed and created replacement valves for $1 and saved countless lives in the process. Naturally, legal battles ensued with the original part manufacturer. [22]
• Last year Smith & Nephew purchased Engage Surgical and its novel knee replacement tech in a deal valued at up to $135 million. Engage Surgical’s Partial Knee System uses 3D-printed implants featuring porous surfaces that can bind more naturally to the bone without requiring cement. Excess bone cement can come loose over time and not only leave debris floating in the joint but also speed up the erosion of the implants. [23]

5. 3D Printing Food

Companies in this category are using 3D printing technology to deposit layers of edible material into specific designs that mimic (and replace) the foods we're used to. Companies are exploring its use in customizing nutritional content, creating intricate food designs, catering to dietary restrictions, and even pioneering lab-grown meat alternatives.

Companies & News

• A recent Axios piece shows how some researchers are using an additive manufacturing process similar to standard 3D printing — except it's done using edible materials. Some see this as potentially helping to solve problems in global food production that drive food insecurity. [24]
• A research lab at Columbia just published a paper in Nature and revealed their seven-ingredient 3D slice of peanut butter-banana cheesecake with a cherry drizzle (photo below). [25]

Opportunities for 3D Printed Food

• Customized Nutrition: 3D food printers could potentially mix and match ingredients to cater to individual nutritional needs.
• Complex Designs: These printers can create intricate designs and structures that would be difficult to achieve by hand.
• Accessibility: For those with physical limitations or a lack of cooking skills, 3D food printers could simplify meal preparation.
• Efficiency: 3D food printing may allow for more efficient use of ingredients and potentially reduce food waste.
• New Experiences: It could introduce new textures and experiences in food, pushing the boundaries of culinary arts.

Barriers for 3D Printed Food

• Speed: 3D food printing is often slower than traditional cooking methods (though the Beehex Pizza Printer pops out pies in less than five minutes). The bitter reality is affordable home 3D printers for digital cooking are probably a decade or so away. [26]
• Limited Ingredients: The range of ingredients compatible with 3D food printers is currently pretty limited based on the technique used (extrusion-based vs. laser sintering vs. inkjet).
• Consumer Acceptance: Some people may be wary of food produced by a machine, especially in cultures where traditional cooking and cooking methods are deeply valued. A 2018 paper provides a fascinating look into these themes around 3D-printed meat and insect-based foods. [27]
• Regulation and Food Safety: There could be regulatory and safety hurdles to overcome, particularly when it comes to commercial use.

*An important question posed in the same Axios piece mentioned above relates to the other side of these sorts of tech-forward, pioneering investments. That these solutions might be viewed as overlooking people who are still in need of basic milk, cheese, bread, wheat and fruits.

"I think we're making a leap, and that leap will probably be viewed as being ignored." [24]

Voices

Research. This section is dedicated to the pioneers of fabrication and additive manufacturing in its many [fab]ulous forms. From the first applications of SLA to the most cutting-edge approaches to bioprinting, food, tissue engineering and drug development, these are a few of the humans building a better future brick by brick.

• Charles "Chuck" Hull: inventor of SLA, co-founder of 3D Systems

Scott Crump : inventor of FDM, Founder/President of Stratasys Jennifer Lewis : Harvard Wyss Institute, microscale bioprinting Hod Lipson : Columbia, robotics, AI, digital design & manufacturing Jos Malda : UMC Utrecht, biofabrication and biomaterials design Anthony Atala : Wake Forest Institute for Regenerative Medicine Shlomo Magdassi : Hebrew University, 3D printing center Gabor Forgacs : 3D bioprinting pioneer, co-founder Organovo Lijie (Grace) Zhang : GWU Research, 3D/4D bioengineering Sam Pashneh-Tala : Uni Sheffield, tissue engineering Amy E. Alexander : Mayo Clinic, patient-specific 3DP bioengineering Luca Rosalia : HST PhD, Stanford postdoc, soft robotics

Author's note: Are you working in similar fields or following these researchers? Please let me know so I can include your names and share your work with those interested! Comment below and share this piece here on LinkedIn.

Key Terms

3D printing is a technology that creates physical objects from digital designs, layer by layer, using various materials like plastic, metal, similar to building with Lego blocks.

Additive Manufacturing: This term emphasizes the process of building objects layer by layer, or "adding" material rather than removing it.

Rapid Prototyping: When 3D printing is used to quickly create a prototype or model, it's often referred to as rapid prototyping.

Desktop Fabrication: This term is often used when referring to smaller, consumer-grade 3D printers that can fit on a desktop.

Stereolithography (SLA): The original type of 3D printing technology invented by Chuck Hull that uses a light source to solidify a liquid resin, layer by layer.

Fused Deposition Modeling (FDM): This is a specific type of 3D printing technology where a plastic filament is melted and extruded layer by layer to build the object. Sometimes called fused filament fabrication (FFF).

3D Printing vs. 3D Bioprinting: What's the Difference?

Trends

Investments. A 2019 keynote at the Additive Manufacturing Strategies summit discussed the future of 3D printing in medicine and dentistry. SmarTech's VP of research shared a few interesting takeaways on the medical market in particular. At the time, hospital groups were driving a lot of investment in terms of printers, software, and services. [28]

Orthopedics is projected to account for 40% to 55% of the entire medical 3D printing opportunity through 2027, but medical devices may provide the broadest scope of opportunity."

KYC - Know Your Costs. At the outset of this piece I showed a graph that illustrates the decreasing costs of 3D printing over time. While directionally true, it's too simplistic to be useful. If you look at most use cases published by major medical device companies who have introduced additive manufacturing to their business from prototyping to production, it's all about knowing where 3D printing generates cost-efficiencies at scale. So if you're thinking about where this fits into your business or industry, consider the graph below in tandem with known production costs for your [space]. [29]

3D Printed Food. If this is your jam, I recommend reading this recent paper on perspectives, analyses, and progress in additive manufacturing of food. [30]

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References

1. Development of 3D bioprinting: From printing methods to biomedical applications (AJPS , 2020)
2. Inventor of FDM 3D Printing and Co-Founder of Stratasys, Scott Crump, Inducted in to the TCT Hall of Fame (Stratasys , 2017)
3. "Functional" kidneys grown from stem cells (New Scientist , 2002)
4. Pioneering Sustainability Through Additive Manufacturing (Avi Reichental on LinkedIn , 2023)
5. Avi Reichental: What's Next in 3D Printing? (TED )
6. 3D Printing Market Size, Share & Trends Analysis Report (Grand View Research , 2022)
7. SmarTech Dental and Medical 3D Printing Trend and Forecast Presentations at AMS 2019 (3DPrint.com , AMS 2019
8. 3dpbm hosts webinar on key opportunities for 3D printed orthopedic implants (VoxelMatters )
9. Ultimaker Annual 3D Printing Sentiment Index reports increase in 3D Printing Implementation in 2020 (Manufactur3D )
10. The Evolution of 3D Printing: Past, Present, and Future (3D Printing )
11. Funding for 3D printing grows in lockstep with ambitions (PitchBook , 2022)
12. Mass Personalization for Medical Device Therapy: How to Go from Successfully Treating One Patient to One Million (Materialise White Paper )
13. Anatomics Overview (Anatomics )
14. Trestle Biotherapeutics Licenses Kidney Implant 3D Bioprinting Tech from Harvard (3D Printing Industry , 2022)
15. T&R Biofab, J&J Innovation to co-develop 3D bio-printing surgical solution (Korea Biomed , 2022)
16. Organovo Announces FXR Program (Organovo )
17. A.D.A.M. (About us )
18. Chapter 12 - Future solutions for osteoarthritis using 3D bioprinting of articular cartilage (HSP & 3DP , 2023)
19. Aprecia: Redefining Fast Melt for Pharma (Aprecia White Paper)
20. Merck, Aprecia, and FABRX on Transitioning 3D Printed Pharmaceuticals from Lab to Clinic (3D Printing , 2021)
21. Production of Single-Cell Genomic Analysis System Components at BD (Carbon )
22. Covid-19: start-up that saved lives with 3D-printed valve may face legal action (Medical Device Network )
23. Smith & Nephew kicks in $135M for 3D-printed, cementless knee implant maker Engage Surgical (Fierce Biotech , 2022)
24. A new dimension for food security (Axios , 2023)
25. The future of software-controlled cooking (Nature , 2023)
26. When can you buy a 3D food printer? Soon, expert reveals (Interesting Engineering )
27. Food of the Future? Consumer Responses to the Idea of 3D-Printed Meat and Insect-Based Foods (Food and Foodways , 2018)
28. Translating 3D printed pharmaceuticals: From hype to real-world clinical applications (Advanced Drug Delivery Reviews , 2021)
29. The Real Cost of 3D Printing (3DPrint.com , 2020)
30. Perspectives, analyses, and progress in additive manufacturing of food (Physics of Food , 2023)

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