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Getting Closer to Mass Production of Bones, Organs, and Implants (bloomberg.com)
335 points by jgrahamc on Apr 28, 2017 | hide | past | web | favorite | 56 comments

Airway is mentioned, but this is one of the hardest parts to manufacture. Very little clinical success in this area so far: http://www.bbc.co.uk/news/magazine-37311038

That is depressing. I remember seeing an episode of Nova Science Now about it and being so amazed at it that I showed that segment to everyone i knew to get them talking about it...

Really sad to hear that this is also a "can't have nice things" situation.

An acquaintance of mine had a part of her skull replaced by a 3D printed part, made by Materialise. While it sounds spectacular, she was out of the hospital in days, none the worse for wear.

Could you say more about it? For typical holes left by neurosurgical procedures the 3D printing part may be useful for comfort or cosmetics, but I think it is unlikely to be critically important. Surgeons have been using simple metal plates to patch holes in the skull for many decades, and they work pretty well.

Part of her skull was damaged when she was a child. At the time it was replaced by some kind of plastic. But from what I gather it slowly started to deteriorate, until it got infected and pressure built up and it had to be removed/replaced.

From what I can gather it's a piece a little over 10cm in diameter and resides above her ear.

Metal Plates make MRIs a pain.

No, essentially all modern metal implants are non magnetic, e.g., titanium. They go through MRIs all the time.

No, it's still a pain.

Titanium is MR-compatible: the magnet won't rip the plate out of your head, which is good. However, it can cause huge artifacts that obscure things around the titanium implant (and, sometimes, depending on the scan parameters and implant location, elsewhere too).

This is particularly annoying because the implants are often right near the areas you really want to image....

Just based on what they have on their site, no simple metal plate could make the shapes that they do/are working on.


I've read about coral being used as temporary structure for bone replacment but eventually the patient's own bone takes over replacing it.

You'd think a liver would be the easiest organ to grow since in adults a liver can regrow from a healthy piece. That's why you sometimes read about people donating part of their liver.

I think there will always be one big problem and that's the health of the patient. People who need a new organ are so sick they probably won't survive the operation to get a new organ. Anesthetic is like a controlled drug overdose but add age and poor health I can't imagine being an anesthesiologist that's one tough job!

It doesn't regrow the (larger) blood vessels and doesn't maintain the original structure. A liver is essentially two halves with two separate, large blood vessels.

I had figured that once organ replacement becomes a more viable action to take, it could be done much earlier before the patient's health has had a chance to deteriorate as significantly.

why aren't teeth implants and crowns getting cheaper because of 3D Printers

crowns and teeth implants should be a lot easier than other organs or bones

I spoke about this with my dentist, and according to him the research and money is going to ever-greater precision and bio-compatibility. Scanning and imaging the tooth to replace is still part-art and not fully-automated yet. The scanning processes out on the market has not perfected discriminating the tooth from the surrounding tissue, so there is some manual work the dentist performs to shape the replica; there are weird artifacts here and there they shave away and/or re-shape. Bio-compatibility sounds like it is is very close: the latest materials outlast human lifespans, and is tougher than enamel, with very small populations that adversely react to the materials.

The part-art comment is certainly true. I have a 3D milled ceramic crown that was done years ago during the early days of the technology. It is absolutely great in every way, and has been since day 1. My wife went to the same dentist a few months later, another 3D milled ceramic crown. Same guy, same machine. The crown had an awful fit, was never right, and she had it replaced with a different technology within 6 months. Getting to three-9's reliability is hard for all of us.

Gold amalgams outlasted the human lifespan too. As usual, the problem is the interface: eventually, a bacterium will slip its way in between, ferment some lactose, and drop the pH, eventually dissolving away enough of the native enamel for a friend to join, and away the positive feedback loop goes.

Heh, Outlast humans lifetimes for now.

Because a 3d printer isn't going to be vastly better than a milling machine.


(especially for such a small amount of material, material with a lot of requirements, bio-compatibility, durability, etc)

Not much competition I would imagine as well as "installation" costs

Cost of an implant, at least in the US, is a small part of the total procedure cost (dentist's fees, malpractice insurance, etc.). Total implant price tag (shared between patient and his insurance), might be $5k for a single tooth.

This is prohibitive for many people. I wonder if advances in robotics can be coupled with lower implant costs to provide a significantly lower cost alternative. Robotics can help lower dentist fees (lower skill level) and also limit or eliminate malpractice risks by limiting human's role.

Not everyone would want the robot-driven implant from just out of dental school nurse, but I think it can be a decent option for many patients.

According to my dentist, implants are getting cheaper or are about to get cheaper, because several important patents have expired and dentists are training to do in-office implants with generic screws.

In addition to maxerickson's point, a lot of the bill goes into paying the dental professionals who do the implanting. It's a (minor) surgical procedure.

My dentist has a jar in his waiting room full of the stems left over from all the crowns he's placed (he uses the CEREC system). No idea why he thinks people would be interested in seeing them while they wait, but I observe that each one represents about $1800 in billing revenue. And there's hundreds of them in there.

The material is interesting - it starts off as a lavender color, but after curing in the oven you get a shade which is a close match to your natural tooth color (they have charts/samples to pick a match before the milling is done).


> each one represents about $1800 in billing revenue.

Do you mean that it costs a patient USD1800 to get a crown?

I have two crowns both made and installed at the same dental practice in Drammen, Norway, using, I think, the CEREC system. At one time he had a screen mounted above the couch so that you could see it being shaped while you waited.

Including the initial consultation, the crown itself, and the fitting I paid about NOK5000 each. That's about USD580 at today's exchange rate, about USD750 at the rate that was in force when I had them done.

> Do you mean that it costs a patient USD1800 to get a crown?

That's what he charges and gets paid. Of that, the insurance company will pay around half, with the patient paying the rest.

Compared to medical billing in the US, it's a miracle of clarity. I suspect because people are more willing to change dentists, and even with a sore tooth, they're willing to pick someone who is better/cheaper. So there's some price pressure by the customer.

It's important to note that in the US (not sure about Norway), the revenue from a procedure, and the out of pocket cost that a person pays is not the same due to insurance. A procedure could cost a very small amount out of pocket, but still provide significant revenue to a doctor if is insurance is paying for a large portion of the procedure.

i guess the 1800 per crown also include the root canal treatment

i think it is usually around 600-800 USD for the root canal treatment and around 1000 for the crown

Ah, perhaps we are talking about different things here. My crowns are just that, quite a lot of the original tooth is still there.

But it still seems to me that you are being seriously ripped off in the US.

What's a crown worth though?

Dentists have been successful in limiting the number of dentists, so decent ones can charge good money.

The terrifying thing is that they tend to do a lot more out of pocket business than doctors/hospitals and so the prices for dental care are generally lower than the prices for similar healthcare (they often do first appointment x-rays for free, or for cheap; hospitals will charge $200+ just for something that needs 2 or 3 x-rays).

A 3D Printer cannot print a material which will crumble, melt or break during the printing process. This excludes a lot of materials due to the pressure/temperature required in order to achieve cohesion. Natural teeth are made of a nanostructured material (dense hydroxyapatite nanorods in a less dense hydroxyapatite matrix) which is the sort of thing that cannot be 3D-printed.

Some dentists have an in house cnc/cmm type machine and make your crowns on-site (takes two weeks but are better quality). Mine still sends them out, costs me about $400 out of pocket, insurance covers the other 50%.

"Who: Engineering Ph.D. dropout ..."

In other words, an ordinary professional engineer, who considered extending his formal education? Bit of a gaffe, there.

"getting closer"... that's not much to go on.

If you read the article skeptically, there isn't any news here - nothing that hasn't been reported prior to the last 2 or 3 years.

The big news will be when we can fabricate complex organs, significant patches of skin with features like hair follicles or fingerprints, etc. Notice that even the liver reference was just some liver tissue that was implanted in a mouse - not an actual liver or a human trial.

Has there been a term coined yet for people with these parts? I don't believe it would be classified as a cyborg since these are not machine-type parts. Although the parts are ironically produced by machines.

A car with replacement parts is still a car.


Sure: transplant recipient.

well those are implants rather than transplants.

Booo! :)

What about Synborg or Synthorg? Maybe Pseudosynth.

How about we call them human beings instead of trying to create a label and separate them from the rest of society.

We should look back into history to determine a name. Might I suggest "pirates", because those blokes usually had a bunch of fake parts.

For organs, it is just a transplant but for bones there isn't a huge difference between this and someone getting steel rods.


Guinea pig?

J/k. I like "biot" that someone else mentioned.

Borg-again humans?

rehumans ?

organorgs ?

Cyborgs? :)

I wonder if they'll be able to produce some of these parts in-place, inside the body, as part of the surgery. Otherwise, some parts may be too hard to implant.

I'm very excited for this technology. But not as much as hockey players, who would love to be able to have their teeth replaced.

Hello 6 million dollar man.

> Ten-year old Organovo [...] has received more than $100 million in funding

I couldn't help but think of Juicero's $120m to design a flat mechanical press.

(yes, supply chain etc, but still...)

Uh except Organovo is trying to solve a much harder problem and has been around for a while AND has proven success? What point are you trying to make besides superficial snark because some funding numbers quoted in the article are similar?

I think ricardobeat is pointing out that it says something about the current VC climate that something as dumb as Juiecero got $20 million more funding than something as potentially important as Organivo.


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