Un caso impresionante que nos habla de nuevas tecnologías y esperanzas en cirugía plástica y reconstructiva. via NewScientist.
An 83-year-old Belgian woman is able to chew, speak and breathe normally again after a machine printed her a new jawbone. Made from a fine titanium powder sculpted by a precision laser beam, her replacement jaw has proven as functional as her own used to be before a potent infection, called osteomyelitis, all but destroyed it.
The medics behind the feat say it is a first. “This is a world premiere, the first time a patient‐specific implant has replaced the entire lower jaw,” says Jules Poukens, the researcher who led the operation at Biomed, the biomedical research department of the University of Hasselt, in Belgium. “It’s a cautious, but firm step.”
Until now, the largest 3D-printed implant is thought to have been half of a man’s upper jawbone, in a 2008 operation in Finland.
In this operation, a 3D printed titanium scaffold was steeped in stem cells and allowed to grow biocompatible tissue inside the abdomen of the recipient. Then, in 2009, researchers reportedsuccessfully printing copies of whole thumb bones – opening the way for the replacement of smashed digits using information from MRI scans.
Poukens’ team worked with researchers in Belgium and the Netherlands and a 3D printing firm called Layerwise in Leuven, Belgium, which specialises in printing with ultrastrong titanium to make dental implants (like bridges and crowns) and facial and spinal bone implants.
By using an MRI scan of their patient’s ailing jawbone to get the shape right, they fed it to a laser sintering 3D printer which fused tiny titanium particles layer by layer until the shape of her jawbone was recreated. It was then coated in a biocompatible ceramic layer. No detail was spared: it even had dimples and cavities that promoted muscle attachment, and sleeves that allowed mandibular nerves to pass through – plus support structures for dental implants the patient might need in future.
The team were astonished at the success of the four-hour jaw implant operation, which took place in June 2011 but which has only just been revealed. “Shortly after waking up from the anaesthetic the patient spoke a few words, and the day was able to speak and swallow normally again,” says Poukens.
It’s only the start, predicts Layerwise managing director Peter Mercelis. “Patient‐specific implants can potentially be applied on a much wider scale than transplantation of human bone structures.”
Since 3D printers can create layers of material only micrometres thick, and from just about any material, researchers are investigating ways to print skin grafts for burns victims from them – and how to build up whole organs from depositing cells in the correct shape.