Additive Manufacturing of Metal Load-Bearing Implants 2: Surface Modification and Clinical Challenges

Additive manufacturing (AM) permits sustainable production of personalized load-bearing metal implants with complex structures. Regulations prescribe that implants have to meet strict requirements to not harm patients, and production technique should allow the certification of their performance. Process, materials, operating parameters, and customization to patient's needs could limit AM. Layer-by-layer material deposition and repeated thermal cycles may make outer surface of AM implants chemically and physically uneven and rough, eliciting biological response of host tissue and hindering therapeutic success. In this paper, we discuss the clinical challenges that AM must overcome to replace traditional techniques in implant and prostheses design. Additive manufacturing makes it possible to produce sustainable and personalized metal implants with intricate designs. Interaction between implants and surrounding tissues, question the broader adoption of additive manufacturing over traditional manufacturing: in this second paper, the clinical challenges are addressed. image