Page 220 - IJB-8-3

Stakeholder Perspectives on the Current and Future of Additive Manufacturing in Healthcare
capable of supporting their full potential. Such is the case to partner with external organizations,” resulting in
for the limited pool of suppliers, usually constrained to increased University Technology Centers, business lead
AM machine manufacturers [54,55] . Similarly, although collaborations with research (e.g., Catapult centers) or a
technological advances on AM systems are common in supplier driven product and process design. Nevertheless,
the academic field , systems currently in use are limited important differences between manufacturing experts and
[56]
by bed size, build time, technical expertise, and post the rest of the surveyed professionals are still observed,
processing requirements . The previous surveys have suggesting that limited influence of these structures may
[40]
mentioned the scalability of AM as a constraint to cost take place in healthcare.
reduction and future implementation, with numerous
machines required to attain a comparable rate of 3.5. Optimization of AM parts
production to traditional processes [36,57] . While this may One of the fundamental aspects of any manufacturing
be true for AM to fully penetrate all production markets, process comes from understanding the main influencers
it is necessary to recognize that AM has its own natural in both successful and failed products. When asked about
drawbacks and, as any other manufacturing process, the main aspects affected by a printed part when the
it should be used where its inherent benefits can be process was not optimized (Figure 6A and Table S19),
exploited. The main advantages of AM come in the form the overall responses indicated that, geometrical
of rapid production of low volume, highly complex on accuracy, mechanical behavior, repeatability, and surface
demand devices, indicating its preferential use for devices finish would be mostly affected. Small variations between
customized to the individual [39,58] . Thus, AM should be respondents could be observed, although statistical
considered from a different standpoint and, similarly to analysis suggested that similar points of view are shared
the necessity of developing new standards, costs should between experts. It is worth noting that there is a lack of
be observed from a new perspective instead of applying correlation between biological compatibility and surface
previously used mass production models. For instance, finish, which are known to be heavily interrelated .
[28]
machinery costs are expected to account for high shares Optimization of system parameters is reported for
(45 – 75%), raw materials are costly, but are amortized each build by 45.2% of the respondents (46.7%, 40%,
due to efficiency and design optimization, and processes 33.3% or 60% for academic, design, manufacturing,
are highly automated while reducing the need for imports/ and medical, respectively). Nevertheless, it was clear
exports of specific components [3,51] . Consequently, while that standard or master settings are commonly used with
costs are currently an issue in medical applications, these variations only applied when new materials, processes, or
are linked to the early state of the technology. Likewise, parametric research is undertaken. In all cases, parameters
scalability as traditionally considered should be reviewed, are mostly selected based on the technician’s experience or
clearly demonstrated by the limited evaluation of batch manufacturer recommendations, followed by parametric
size as a disadvantage of current AM (Figure 5B). analysis or the use of software tools (Figure 6B and
As a result of limited regulations, manufacturing Table S20). This is especially the case for designers and
firms were required to develop their own capabilities and medical experts, while academics, manufacturers and
specific know-how highly regarded as an asset to ensure medical experts are open to implement different protocols
competitiveness during early AM implementation . for AM optimization. Academics and manufacturing
[36]
Similarly, the new change in paradigm brought from respondents heavily rely on parametric analysis, although
conventional manufacturing seeps into the basic tools the latter also relies on process feedback. Consequently,
commonly used in these applications. CAD software it seems clear that albeit an increased interest in process
operations are heavily reminiscent of conventional monitoring [60,61] , AM is still heavily reliant on experienced
subtractive manufacturing operations [50,59] , but contrast staff and parametric analysis on simple geometries.
with the complex structures desired from AM. This has The limited process monitoring performed supports
led to a need of specialized know-how, clearly recognized this heavy reliance on experience and previous work
as a disadvantage by the surveyed experts (Figure 5B). (Figure 6C and Table 21). When asked how the AM
However, this recognition contrasts with the low score processes were supervised, only 29.5% of all respondents
on education and software obtained from all except indicated that they possessed an in-built monitoring
manufacturing experts (Figure 2B). Part of this may system, while 34.1% referred to system readings and
be a result of AM evolution; nevertheless, partnership 11.4% did not perform any monitoring. The lack of
between academic and external institutions could have reliance on such systems is especially noticeable in
influenced it. A senior manager of an aerospace firm design where no AM process monitoring was done by
that have adopted AM who was recently interviewed by 20% of respondents and mostly using calibration master
Moradlou et al. indicated that “the technology itself is references or previous builds. In contrast, manufacturing
[55]
not seen as a core competency, prompting the company firms always monitored the printing parameters, either
212 International Journal of Bioprinting (2022)–Volume 8, Issue 3