3. Polymers in 3D printing industry

materials [8]. Inkjet printers also use light to photopolymerize ink drops into complex shapes [9]. Extensive reviews on these processing and 3D printing technologies have been published elsewhere [4, 5, 10–14]. This chapter focuses on

Since the 1980s, 3D printing has become very popular as a result of the rapid manufacturing of components with architectures designed to meet

layer-by-layer fashion, often without the need of post-processing such as machining. As a general scheme, AM starts with the design of a virtual object using CAD (computer-aided design) software that generates a STL (stereolithography, named after Charles Hull's SLA process) file format [15]. A slicer program interprets the STL file and converts it into g-code (e.g. Slic3r, 3DPrinterOS, MakerBot Print, and others). The computer controls the stage and dispenser of the 3D printer allowing prototypes to be manufactured. Rapid prototyping allows one to refine product ideas while saving significant time and money because it allows for iterations prior to creating a final product. Optimization via an iterative process involves touching and feeling the prototype, in real time, in order to finalize the shape and geometry, leading to a final product. Characterization methods during iterations and on the final design include optical microscopy, SEM, and mechanical tests. Others methods, such as bio-compatibility

(cell-adhesion and proliferation) and electrical performance are performed depending on the application. Figure 1 demonstrates a general scheme for the AM process. Despite the many advances in AM, the technology still has many challenges that need to be addressed. These challenges are related to the speed of the processes (which in many cases is slower than injection molding processes and machining), cost of the machines, and limited feedstock. However, advantages outweigh the challenges due to the fact that AM allows for compositional flexibility, complex macro and microstructures, and easy modeling and optimization. As a result, industries including biomedical engineering, transportation, and the military have adopted AM as the main manufacturing method for the printing of prototypes and

General scheme for the use of additive manufacturing processes, from the choice of material to the final product. The 3D printing of parts involves the use of a computer-assisted design software that generates a STL file format that is then sliced and formatted into gcode. The computer controls the stage and dispenser to generate materials with specific architectures, e.g. faced-centered tetragonal cushion using direct ink writing (a) and diamond

specific applications. AM allows for the manufacturing of a variety of shapes in a

applications that use AM for the 3D printing of polymeric materials.

2. 3D printing general process

Functional Materials

final parts [16, 17].

Figure 1.

4

structure using FDM (b).

Careful attention is imperative when choosing a material to print a given part. While there are a variety of commercially available polymers, not one polymer is inclusive and will give one the properties needed for a specific application. Furthermore, a single AM technique is not capable of printing any one individual polymer available in the market. The selection of material depends on the application and the customers' needs. Figure 2 lists the decision criteria for the selection of a material. One must take into consideration the environment at which the part will be exposed and the properties required (e.g. temperature, mechanical load, humidity, chemical exposure, radiation, UV light), the processability, 3D printing method, and availability.

Polymers have become consumer goods, for they are used to manufacture bottles, toys, tools, bags, phones, computers, tools, cushions, electronics and transportation components [18]. Thus, it makes sense that efforts have focused on developing materials that can be 3D printed, which allows for rapid manufacturing [2–4, 17]. Table 1 lists commercially available polymers used in some of the AM processes. Polycarbonate (PC), acrylonitrile butadiene styrene (ABS), poly ether ester ketone (PEEK), polyetherimide (ULTEM) and Nylon are common polymers used in processes requiring thermoplastics, or plastics that are processed by heating to a semi-liquid state and close to the melting point. Upon extrusion, the printed layers fuse and solidify. AM techniques that use thermoplastics are Fused-Deposition Modeling (FDM), Jetting (InkJet), and Selective Laser Sintering (SLS). SLA and Direct Ink Writing (DIW) use thermosetting polymers in their liquid state, or polymers that become solids after curing. A chemical reaction occurs prior to the melting point, resulting in a solid-state material. In SLA and DIW, polymers are formulated to meet specific properties, most importantly rheological. For example, each layer should be self-supporting and should allow for the printing of multiple layers while retaining the designed geometry [14, 19–21]. Rheologically, this corresponds to a resin that has a yield stress at high oscillatory stresses, such that the

Figure 2. Material selection chart for product design and manufacturing.


Some examples of biomedical devices developed using 3D printing are implants,

Comments

PLA, PCLA, PLGA FDM Scaffolds. Biodegradable. Can add fillers, e.g. HA, for

improved cell adhesion and mechanical properties

SLS Biodegradable scaffolds. Improved mechanical properties

Biodegradable scaffolds. Can add fillers and cells for improved cell adhesion and mechanical properties

Polymers used for tissue and organ fabrication need to have various functions in order to (1) allow for cell attachment and migration, (2) transfer growth factors and waste products, (3) maintain its shape while cells are growing and (4) maintain adequate mechanical properties. Wu et al. [34] reported the generation of a

biopolymeric material based on chitosan dissolved in an acid mixture of acetic acid, lactic acid, and citric acid. This biomaterial was 3D printed using an ink-writing technique, then dried under vacuum and neutralized to remove any acid residue. The structure of the scaffold was characterized using confocal laser scanning microscopy and the images showed wrinkles attributed to the volume change. Tensile mechanical tests show that the printed material exhibits a strain to failure of 400% under tensile load and a 7.5 MPa ultimate strength when in its neutralized form. Furthermore, the 3D printed material allows for excellent cell adhesion, growth, and proliferation, as demonstrated using the Live-Dead staining method,

Luo et al. [35] reported the 3D printing of a bioceramic hollow struts-packed

scaffold using an extrusion typ. 3D printer and a shell/core nozzle. The ink contained Ca7Si2P2O16, alginate and Pluronic F-127. After printing, the ink was dried overnight and sintered for 3 hours at 1400°C to remove the alginate and F-127 materials. The morphology was analyzed using an optical microscope. The micropores and the microstructure of the pores were characterized using SEM. The fabricated scaffolds (16/23 shell/core size) were subjected to mechanical testing and

exhibited a compressive strength of 5 MPa, comparable to cancellous bone

integration and bone formation was detected with micro-CT.

(2–12 MPa), and a modulus of 160 MPa. The scaffold had high porosity (65–85%), adjusted with the core/shell size nozzles. The high porosity and surface area (up to

surface of the scaffold, as determined by SEM. Finally, the in-vivo bone formation study in a rabbit demonstrated that the bioceramic implant allows for good cell

Lewis' team at Harvard University 3D printed a tympanic membrane scaffold composed of PDMS, PLA, and PCL based materials using a DIW technique [36]. The team demonstrated that it is possible to design and fabricate materials with similar properties when compared to human specimens. The high frequency displacement and acoustics were organized by concentric rings for each 3D printed graft, and it was very dependent on the patterns and mechanical properties, characterized via digital opto-electronic holography, laser Doppler vibrometry, and dynamic mechanical analysis. In a different study, the team 3D printed cellular materials with vascular networks for flow [37]. The 3D printed structure was fabricated using an ink composed of Pluronic F-127, GelMA (gelatin methacrylate to allow for UV curing) and fibroblast cell culture. After curing, the Pluronic F-127

/g) allowed for cell adhesion and proliferation on the outer and inner

prosthetics, dental, orthodontics, hearing aids, and drug release tissues.

Polymers and processes used for the additive manufacturing of biomedical devices.

fluorescence microscopy, and SEM.

Material 3D printing

Functional 3D Printed Polymeric Materials DOI: http://dx.doi.org/10.5772/intechopen.80686

Collagen, alginate, PEG, fibrin, chitosan

PCL, methacrylate copolymers

Table 2.

techniques

Inkjet, extrusion

6500 mm<sup>2</sup>

7

Table 1.

List of polymers used for 3D printing applications.

resin is solid-like at rest (low stress) and liquid like during flow (high stress) [7]. One of the main challenges in the polymer 3D printing industry is the limited feedstock available for purchase. Polymers listed in Table 1 cannot be used in all applications. Particularly, polymers in the pure state lack mechanical strength for load-bearing applications. The addition of fillers, such as silica [22, 23] and carbon fibers [24, 25], is often used to generate materials with high mechanical strength. Furthermore, the incorporation of additives enhances materials properties by adding functionality to the parts that include getter [20], UV and radiation resistance [26–28], and anti-fouling properties [29–31].

### 4. Biomedical engineering applications for 3D printing

The biomedical market represents 11% of the total AM market share today, and will be a strong driver for AM development and growth [32]. Since the early 2000s, there has been increased interest in using 3D printing to fabricate hard tissues (bones, teeth, cartilage) and soft tissues (organs, skin, and others) [2–4, 16, 33]. The manufacturing of prostheses and scaffolds with complex geometries is especially important for regenerative medicine, where a porous scaffold is implanted into the patient to serve as a template for tissue to regenerate while the implant degrades slowly in the body. Other implants need to stay in place for the lifetime of the patient. 3D printing allows for the rapid manufacturing of customized prosthetics and implants with controlled architectures. The structure can be designed through the translation of x-ray, MRI, and CT images into STL file formats. The STL file can be processed by software and a design can be generated based on the patient's specific needs. Metals are commonly used to generate prosthetics for bone reconstruction. ABS and PLA are the most suitable non-biodegradable polymers used for the manufacturing of scaffolds. However, materials used in medicine must enable cell adhesion, growth, and differentiation. Current feedstock for biomaterials is limited to collagen, gelatin, fibrin, and chitosan, which are similar to natural tissue, have high affinity to cells and are highly hydrated. The main challenge with these soft natural polymers is their low mechanical strength [33]. In biomedical engineering, the main focus has been on the development of biopolymeric materials for tissue and scaffold generations with improved flexibility, strength, and patient compatibility in order to prevent implant rejection and toxicity. Some polymeric mixtures include living cells isolated from the patient and grown in the laboratory. These types of polymers are often hydrogels suitable for ink jet 3D printing technologies. Table 2 shows various polymers used for biomedical applications.


#### Table 2.

resin is solid-like at rest (low stress) and liquid like during flow (high stress) [7]. One of the main challenges in the polymer 3D printing industry is the limited feedstock available for purchase. Polymers listed in Table 1 cannot be used in all applications. Particularly, polymers in the pure state lack mechanical strength for load-bearing applications. The addition of fillers, such as silica [22, 23] and carbon fibers [24, 25], is often used to generate materials with high mechanical strength. Furthermore, the incorporation of additives enhances materials properties by adding functionality to the parts that include getter [20], UV and radiation resis-

The biomedical market represents 11% of the total AM market share today, and will be a strong driver for AM development and growth [32]. Since the early 2000s, there has been increased interest in using 3D printing to fabricate hard tissues (bones, teeth, cartilage) and soft tissues (organs, skin, and others) [2–4, 16, 33]. The manufacturing of prostheses and scaffolds with complex geometries is especially important for regenerative medicine, where a porous scaffold is implanted into the patient to serve as a template for tissue to regenerate while the implant degrades slowly in the body. Other implants need to stay in place for the lifetime of the patient. 3D printing allows for the rapid manufacturing of customized prosthetics and implants with controlled architectures. The structure can be designed through the translation of x-ray, MRI, and CT images into STL file formats. The STL file can be processed by software and a design can be generated based on the patient's specific needs. Metals are commonly used to generate prosthetics for bone reconstruction. ABS and PLA are the most suitable non-biodegradable polymers used for the manufacturing of scaffolds. However, materials used in medicine must enable cell adhesion, growth, and differentiation. Current feedstock for biomaterials is limited to collagen, gelatin, fibrin, and chitosan, which are similar to natural tissue, have high affinity to cells and are highly hydrated. The main challenge with these soft natural polymers is their low mechanical strength [33]. In biomedical engineering, the main focus has been on the development of biopolymeric materials for tissue and scaffold generations with improved flexibility, strength, and patient compatibility in order to prevent implant rejection and toxicity. Some polymeric mixtures include living cells isolated from the patient and grown in the laboratory. These types of polymers are often hydrogels suitable for ink jet 3D printing technologies. Table 2 shows various polymers used for biomedical applications.

tance [26–28], and anti-fouling properties [29–31].

Process Physical state of

starting material

Jetting Photocuring Solid ABS, ASA, PCL, PLA, Vero

SLA Photocuring Liquid Thermosetting- acrylates and epoxy

Solid PCL, PLA

Feedstock

Solid PC, ABS, PLA, ULTEM, Nylon, Carbonfilled Nylon, ASA

liquid Thermosetting- any material with

adequate viscosity

AM technology

Direct Writing

Table 1.

6

FDM Melting-

Functional Materials

SLS Melting-

solidifying

solidifying

Extrusion-heat/ UV curing

List of polymers used for 3D printing applications.

4. Biomedical engineering applications for 3D printing

Polymers and processes used for the additive manufacturing of biomedical devices.

Some examples of biomedical devices developed using 3D printing are implants, prosthetics, dental, orthodontics, hearing aids, and drug release tissues.

Polymers used for tissue and organ fabrication need to have various functions in order to (1) allow for cell attachment and migration, (2) transfer growth factors and waste products, (3) maintain its shape while cells are growing and (4) maintain adequate mechanical properties. Wu et al. [34] reported the generation of a biopolymeric material based on chitosan dissolved in an acid mixture of acetic acid, lactic acid, and citric acid. This biomaterial was 3D printed using an ink-writing technique, then dried under vacuum and neutralized to remove any acid residue. The structure of the scaffold was characterized using confocal laser scanning microscopy and the images showed wrinkles attributed to the volume change. Tensile mechanical tests show that the printed material exhibits a strain to failure of 400% under tensile load and a 7.5 MPa ultimate strength when in its neutralized form. Furthermore, the 3D printed material allows for excellent cell adhesion, growth, and proliferation, as demonstrated using the Live-Dead staining method, fluorescence microscopy, and SEM.

Luo et al. [35] reported the 3D printing of a bioceramic hollow struts-packed scaffold using an extrusion typ. 3D printer and a shell/core nozzle. The ink contained Ca7Si2P2O16, alginate and Pluronic F-127. After printing, the ink was dried overnight and sintered for 3 hours at 1400°C to remove the alginate and F-127 materials. The morphology was analyzed using an optical microscope. The micropores and the microstructure of the pores were characterized using SEM. The fabricated scaffolds (16/23 shell/core size) were subjected to mechanical testing and exhibited a compressive strength of 5 MPa, comparable to cancellous bone (2–12 MPa), and a modulus of 160 MPa. The scaffold had high porosity (65–85%), adjusted with the core/shell size nozzles. The high porosity and surface area (up to 6500 mm<sup>2</sup> /g) allowed for cell adhesion and proliferation on the outer and inner surface of the scaffold, as determined by SEM. Finally, the in-vivo bone formation study in a rabbit demonstrated that the bioceramic implant allows for good cell integration and bone formation was detected with micro-CT.

Lewis' team at Harvard University 3D printed a tympanic membrane scaffold composed of PDMS, PLA, and PCL based materials using a DIW technique [36]. The team demonstrated that it is possible to design and fabricate materials with similar properties when compared to human specimens. The high frequency displacement and acoustics were organized by concentric rings for each 3D printed graft, and it was very dependent on the patterns and mechanical properties, characterized via digital opto-electronic holography, laser Doppler vibrometry, and dynamic mechanical analysis. In a different study, the team 3D printed cellular materials with vascular networks for flow [37]. The 3D printed structure was fabricated using an ink composed of Pluronic F-127, GelMA (gelatin methacrylate to allow for UV curing) and fibroblast cell culture. After curing, the Pluronic F-127 was removed by cooling to 4°C, yielding open channels that represent the vascular networks. Lewis' team demonstrated that blood and other cellular liquids can flow through the channels with minimal death of cells.

bio-printed scaffolds and tissues for clinical applications to reduce cost for tissue

One of the most promising fields in the future of AM is the aerospace industry. According to Wohlers' report, this industry account for almost 20% of the total AM market today [32]. Aerospace applications typically require light weight and high strength materials. The importance of AM relies on the reduced cost, increased flexibility of design, and increase in a variety of products to meet customer needs. Additive manufacturing is an important technology that enables the design and manufacturing of complex structured products with improved mechanical strength and lower weight, at a lower cost and reduced lead-time. The aerospace industry has replaced the conventional manufacturing methods of molding and machining with 3D printing technology for small scale production. At a small production scale, AM

The aerospace industry implemented the use of AM approximately 20 years ago [51]. The main use for 3D printing has been focused on prototyping, modeling and producing jigs, fixtures and tools [17]. Furthermore, AM is used to build replacement parts on-demand when required. The ability to build on-demand spare components reduces costs for the production of parts that may never be used due to them becoming obsolete to new technology, which also saves warehouse storage space. For example, BAE Systems is currently 3D printing window breather pipes used in jetliners [52]. These pipes cost 40% less than pipes manufactured using injection molding processes and are manufactured on an as-needed basis. Recently, NASA designed a rover, named Desert RATS, that can support humans in a pressurized cabin in space [53]. The rover is intended to transport humans to Mars. It contains 70 3D printed parts that include flame-retardant vents and housings, camera mounts, large pod doors, front bumpers, complex electronics, and others. The materials used for the 3D printing of the part used in the rover were ABS, PCABS and PC, and were printed using a FDM Stratasys 3D printer. Piper Aircraft manufactures tools using PC that can withstand hydroforming pressures of 3000 to 6000 psi. Aurora Flight Science additively manufactured wings that weigh one third of the fully dense metal components [54]. Some wings have integrated electronics. Lepron generated 200 different designs for use in piloted helicopters [17]. It is foreseen that aerospace companies will replace small components with 3D printed parts, thus reducing the weight of the machines. Some examples are arm

Companies have adopted AM for fast production without making substantial changes to their products [17]. This modification is mostly due to the fast-changing market and low cost of generating such small builds. Several challenges would have to be overcome to facilitate the growth of AM. Some of these challenges include: (1) current speed of AM machines is slow for bulk production; (2) few polymeric material options; and (3) current machines do not allow for the manufacturing of large components [17, 55]. In the future, it is expected that companies will pursue a completely different business model by performing product customization for endproduct while maintaining the on-demand part supply. Future work will focus on the development of multifunctional structures with complex geometries, which allows for novel solutions for complicated problems. AM techniques, such as using functionally graded materials, can be used in order to tailor the mechanical and/or

engineering [49]. Manufacturing AM artificial organs, which includes multifunctionality (i.e. bionic ear [50]), will revolutionize the field of 3D

5. Additive manufacturing in the aerospace industry

offers effectively low-cost design and assembly [17].

rests, seat belts, food trays, and many others [17].

9

printing for biomedical applications.

Functional 3D Printed Polymeric Materials DOI: http://dx.doi.org/10.5772/intechopen.80686

Patients with skin burns and thick wound injuries often suffer from long term recovery and extensive and expensive treatments. The autologous split-thickness skin graft (ASSG) is the technique most often used to treat large wounds [38]. A skin tissue is place in the injured area and assists with the wound closure and healing. This technique relies on the removal of a piece of skin from a different part of the patient's body and reapplying it on the place of injury. The drawback with ASSG is that it is limited by the size of donor sites and also creates another place of injury [38]. 3D printing of biomaterials would alleviate the problems related to ASSG. Skin cells are cultured in a laboratory and mixed with biocompatible polymers for bioprinting. In 2012, Koch Singh et al. [39] reported the 3D printing of skin using a laser-based inkjet printing method. The inks were composed of blood plasma/alginate solution and fibroblast/keratinocytes/collagen biomaterials. Collagen is the main component of the extracellular matrix (ECM) in skin. The team proved that the laser-based printing method does not harm the cells by performing proliferation of the cells in histologic sections 10 days after printing. Ki-67 staining, which includes the protein present in cells during their active cell cycle phases, shows that proliferating cells can be found in all regions, verifying vitality. In addition, a build-up of basal lamina, cell adhesion and proliferation- sign of tissue generation was observed.

The dental industry is taking advantage of 3D printing technologies for restoratives, implants, and orthodontics purposes. Currently, professionals in the dental field have access to 3D printers and it is possible to print designs in a clinical environment. A CT scan is used to generate a defined shape based on the patient's morphology and quickly fabricate and replace a missing tooth [40]. 3D printing is used for the manufacturing of aligners, braces, dental implants, and crowns [40]. Biocompatible materials are used for the fabrication of dental parts using 3D printing, e.g. polylactic acid, polycaprolactone and polyglycolide, and acrylates [3]. It is possible to fabricate dental implants with antibacterial properties by the incorporation of additives, such as quaternary ammonium salts [41–43]. At the age of 23, Amos Dudley fabricated his own orthodontic aligners while he was a student at New Jersey Institute of Technology [44]. He used equipment available at the institute to scan and print models of his teeth. A non-toxic plastic was used to mold and eventually generate 12 clear aligners. Amos had access to a Stratasys Dimension 1200 3D printer and used a mixture of alginate powder and PermaStone as the resin to print the aligners, which were tested by fitting them on his teeth. While it was not a trivial problem to solve, Amos proved the ability of 3D printing orthodontic materials for teeth alignment.

AM has been widely used in the biomedical industry and will continue to impact work in the future. Some challenges will persist, such as regulatory issues, limited materials, and inconsistent quality [45]. AM biomedical products require FDA approval, which can be time consuming and difficult to obtain [46]. Biocompatibility will require the development of new techniques and materials to produce high quality, high performing AM materials [47]. Furthermore, mechanical properties of AM materials need to be well assessed such that final properties can have reliable and reproducible behaviors. Further development for on-demand and patient-specific applications will be exciting work in this field. For example, designing patient-specific implants following a CT-scan will result in quick results [48]. Complex parts with specific mechanical properties and biocompatibility can be constructed on demand and with multifunctional components if needed. AM Research and development may help to improve

#### Functional 3D Printed Polymeric Materials DOI: http://dx.doi.org/10.5772/intechopen.80686

was removed by cooling to 4°C, yielding open channels that represent the vascular networks. Lewis' team demonstrated that blood and other cellular liquids can flow

Patients with skin burns and thick wound injuries often suffer from long term recovery and extensive and expensive treatments. The autologous split-thickness skin graft (ASSG) is the technique most often used to treat large wounds [38]. A skin tissue is place in the injured area and assists with the wound closure and healing. This technique relies on the removal of a piece of skin from a different part of the patient's body and reapplying it on the place of injury. The drawback with ASSG is that it is limited by the size of donor sites and also creates another place of injury [38]. 3D printing of biomaterials would alleviate the problems related to ASSG. Skin cells are cultured in a laboratory and mixed with biocompatible polymers for bioprinting. In 2012, Koch Singh et al. [39] reported the 3D printing of skin using a laser-based inkjet printing method. The inks were composed of blood plasma/alginate solution and fibroblast/keratinocytes/collagen biomaterials. Collagen is the main component of the extracellular matrix (ECM) in skin. The team proved that the laser-based printing method does not harm the cells by performing proliferation of the cells in histologic sections 10 days after printing. Ki-67 staining, which includes the protein present in cells during their active cell cycle phases, shows that proliferating cells can be found in all regions, verifying vitality. In addition, a build-up of basal lamina, cell adhesion and proliferation- sign of tissue

The dental industry is taking advantage of 3D printing technologies for restoratives, implants, and orthodontics purposes. Currently, professionals in the dental field have access to 3D printers and it is possible to print designs in a clinical environment. A CT scan is used to generate a defined shape based on the patient's morphology and quickly fabricate and replace a missing tooth [40]. 3D printing is used for the manufacturing of aligners, braces, dental implants, and crowns [40]. Biocompatible materials are used for the fabrication of dental parts using 3D printing, e.g. polylactic acid, polycaprolactone and polyglycolide, and acrylates [3]. It is possible to fabricate dental implants with antibacterial properties by the incorporation of additives, such as quaternary ammonium salts [41–43]. At the age of 23, Amos Dudley fabricated his own orthodontic aligners while he was a student at New Jersey Institute of Technology [44]. He used equipment available at the institute to scan and print models of his teeth. A non-toxic plastic was used to mold and eventually generate 12 clear aligners. Amos had access to a Stratasys Dimension 1200 3D printer and used a mixture of alginate powder and PermaStone as the resin to print the aligners, which were tested by fitting them on his teeth. While it was not a trivial problem to solve, Amos proved the ability of 3D printing orthodontic

AM has been widely used in the biomedical industry and will continue to impact work in the future. Some challenges will persist, such as regulatory issues, limited materials, and inconsistent quality [45]. AM biomedical products require FDA approval, which can be time consuming and difficult to obtain [46]. Biocompatibility will require the development of new techniques and materials to produce high quality, high performing AM materials [47]. Furthermore, mechanical properties of AM materials need to be well assessed such that final properties can have reliable and reproducible behaviors. Further development for on-demand and patient-specific applications will be exciting work in this field. For example, designing patient-specific implants following a CT-scan will result in quick results [48]. Complex parts with specific mechanical properties and biocompatibility can be constructed on demand and with multifunctional components if needed. AM Research and development may help to improve

through the channels with minimal death of cells.

generation was observed.

Functional Materials

materials for teeth alignment.

8

bio-printed scaffolds and tissues for clinical applications to reduce cost for tissue engineering [49]. Manufacturing AM artificial organs, which includes multifunctionality (i.e. bionic ear [50]), will revolutionize the field of 3D printing for biomedical applications.
