Abstract
In order to generate a high-performance personalized biological fixation plate with matching mechanical properties and biocompatibility, reverse reconstruction and fracture reduction of a femur were performed by combining reverse and forward approaches, and the surface was extracted according to the installation position of the plate to complete plate modeling by shifting, thickening, and performing other operations. Subsequently, topology optimization and three-dimensional (3D) printing were performed, and the properties of the manufactured plate were probed. The results showed that the maximum displacement of the plate was 4.13 mm near the femoral head, the maximum stress was 5.15e2 MPa on both sides of the plate across its entire length, and the stress concentration decreased following topology optimization. The plate with optimized topology and filled with porous structure has a good filling effect. The final mass of the H-shaped plate was 12.05 g, while that of the B-shaped plate was 11.05 g, which dropped by 20.93% and 27.49%, respectively, compared with the original plate. The surface of the 3D-printed plate was bright and new, with a clear pore structure and good lap joint. The B-shaped and H-shaped plates were closely dovetailed with the host bone, which met the assembly requirements. This lays a foundation for the direct application of a high-performance personalized biological fixation plate.
Keywords: Selective laser melting, Bone plate, Topological optimization, Simulation analysis, Forming quality
1. Introduction
118Bone diseases, bone trauma, congenital malformations of the bone, and other bone- related diseases are treated with internal fixation with plates. The properties of these plates are critical for successful osteosynthesis[1]. The two factors that affect the properties of plates are as follows[2,3]: (1) ideal plate material should have high strength, low stiffness, similar elastic modulus to human bone (to avoid “stress shielding”), no toxicity or rejection, and good biocompatibility; (2) in terms of structural design, there should be fewer screw holes for fixation. Several researchers have found that using too many screws might cause stress concentration and damage the plate, whereas using too few 119screws might lead to insufficient stability of the plate system. Recent studies have demonstrated that the use of biological fixation (a combination of porous and solid) in the structural design of a plate could dramatically improve its properties. Following the implantation of a biological fixation plate at the bone site (in addition to satisfying the aforementioned requirements), the interconnected holes in the plate offer space for the growth of new bones, making the plate and fracture site more firmly connected, reducing the contact area between the fracture site and plate, as well as facilitating the metabolic absorption of nutrients and bone healing. Designing and manufacturing personalized biological fixation plates have become a research focus.
Parametric modeling is used to design biological fixation structures. The structural parameters (porosity, surface-area-to-volume ratio, and mean pore size) of biological fixation structures can be adjusted by regulating input parameters, which offers convenience for designing new biological fixation plates[4]. Additive manufacturing (AM or three-dimensional [3D] printing) technology is a technology that slices and stratifies 3D models by using special software, obtains cross-sectional data, imports them into rapid prototyping equipment, and manufactures solid parts by superposing materials layer-by-layer. Through layer-by-layer superposition, it is feasible to manufacture parts with almost any geometric shape using AM technology. It has the advantages of processing single pieces, small batch, complex geometries, and compact structure of finished parts. AM has provided a way to manufacture new biological fixation plates[5,6]. Selective laser melting (SLM) molding technology, on the other hand, is a 3D printing technology based on laser melting metal powder[7].
Zhang et al. designed a plate with a lattice structure for 3D printing based on topology optimization and finite element modeling technology[2]. With the strength being ensured, the weight of the plate with lattice structure can be reduced by about 40%, the thickness of the plate can be modestly lowered, and the stiffness of the plate can be markedly decreased. Furthermore, a plate with a lattice structure can reduce the stress shielding effect of bone. Hu et al. contended that 3D-printed porous metal support prostheses are accurate reconstructions for neoplastic bone defects in the proximal tibia[8]. Biomechanical support under good biological integration can be achieved through careful preoperative design and intraoperative operation. Li et al. studied the effects of the pore size, porosity, pore shape, and surface morphology of a 3D-printed porous titanium alloy bone substitute on bone induction[9]. Jia et al. found that the weight of the solid plate can be reduced by about 40% through lightweight design. The application of porous bone plate increases the average stress of the skeleton by about 4% and reduces the stress shielding effect of the skeleton[10]. Pobloth et al. designed honeycomb 3D titanium alloy grid scaffolds with different stiffnesses and compared bone growth and healing after changing the stiffness of the scaffolds; the honeycomb titanium alloy grid scaffolds reduced the stress shielding effect and promoted regenerative healing of macro-animal skeletons[11]. Wang et al. established a mathematical expression for the relationship between the porosity, the characteristic structural parameters, and the mechanical properties of typical porous structural units, laying a foundation for 3D printing of porous structural implants with gradient modulus[12]. Kanu et al. compared the curative effects of commercial titanium alloy fracture fixation plate and newly developed functionally graded artificial bone plate (isotropic hydroxyapatite). In the study, titanium materials were graded in the direction of thickness to treat femoral fractures in children[13]. Smith et al. manufactured a Ti- 6Al-4V extra low interstitial (ELI) plate using 3D printing and applied it in clinical practice[14]; when a suture tape was tied between the first and second metatarsal bones, the plate protected the second metatarsal bone and corrected the hallux valgus.
There have been studies on the design, 3D printing, and manufacturing of biological fixation plates; however, only a few reported the design and manufacturing of biological fixation plates based on 3D printing, combining shape optimization with topology optimization to achieve high performance (mechanical properties and biocompatibility). Therefore, we investigate the design method and molding technology of personalized biological fixation plates.
2. Materials and methods
2.1. Design constraints
The parts manufactured by 3D printing have higher degrees of freedom than traditional manufacturing. However, this does not mean that it is possible to mold parts with any geometry; designs that do not satisfy the design constraints may lead to processing failure. Based on the findings on the biocompatibility of the geometric and porous structures of SLM-molded parts, along with the actual applications of the bone plate, the design constraints can be divided into four types[15,16].
(1) The constraint of sharp angle and thin wall: considering that the laser spot adopted by SLM-molded parts has a limiting focal size; it is impossible to manufacture parts whose sharp angle and thin wall are smaller than the spot diameter; furthermore, it is challenging to guarantee the mechanical properties of thin-walled parts with small wall thicknesses; they are prone to wear-and-tear and have no practical value.
120(2) Pore feature: since the laser spot has a limiting size affected by the diffusion of the heat-affected zone during laser processing, the width of the welding bead is larger than the spot size; if the pore size is too small, the weld bead will block the pore, and the size of the pore feature perpendicular to the molding direction has a minimum limit.
(3) Biocompatibility requirement: the optimal range of pore sizes of porous structure for osteocytes to grow is about 100 to 1000 μm, and cancellous bone structures can be simulated at a porosity of 50% to 90%, which is most beneficial for new bone to grow in; a larger surface-area-to- volume ratio of porous implants with larger contact areas between the surface of porous implanted bone correlates with a more significant mechanical stimulus applied to new bone.
(4) Draft constraint: for fracture surgeries that require removing the internal fixation plate, shielding should be avoided in the removal direction; however, designs that do not require removing the internal fixation plate are not subjected to this constraint.
2.2. Materials and manufacturing methods
The host bone was printed using an industrial high- precision desktop 3D printer Z-603S made by JG Maker Co., Ltd. to reduce cost. The molding material was polylactic acid, the layer thickness was 0.15 mm, and the filling density was 20%.
Ti-6Al-4V alloy metal powder produced by Wuxi FalconTech Co., Ltd., Jiangsu Province, was used as the molding material of the plate. The composition satisfies the requirements of ASTM F136 and GB/T 13810-2007. The comparison of the compositions is shown in Table 1. The spherical powder was prepared by gas atomization, with an apparent density of ρs of 2.55 g/cm3. The particle size distribution was narrow and concentrated, -22 μm for 90% and -28.5 μm for D50.
Table 1.
Comparison of powder material manufactured in SLM and ASTM F136 standard
| Element | Ti-6Al-4V powder | ASTM F75 standard |
|---|---|---|
| Al | 5.5%-6.5% | 5.5%-6.5% |
| V | 3.5%-4.5% | 3.5%-4.5% |
| Fe | 0.25% | < 0.3% |
| C | 0.08% | < 0.08% |
| N | 0.03% | < 0.05% |
| H | 0.012% | < 0.012% |
| O | < 0.08% | < 0.13% |
| Ti | Balance | Balance |
GYD150 SLM, manufactured by Shenzhen Sunshine Laser & Electronics Technology Co., Ltd., was used as the molding equipment. Argon was used as the protective gas, while the oxygen content was controlled below 0.03%. The processing laser power was 180 W, the scanning speed was 500 mm/s, the scanning interval was 80 μm, the layer thickness was 20 μm, and the X–Y interlayer interlacing strategy was adopted. There were no fewer than three experimental samples for each group.
2.3. Analysis methods
Mimics 20.0 and Inspire 2021 were used for the reverse reconstruction of the femoral prosthesis. The finite element analysis software Inspire was used for the plate’s optimization design (topology optimization). The optimization method used was the variable density method. Biological fixation plates with optimized topology were reconstructed using Rhino software. Data processing and processing risk analysis were conducted on 3D-printed parts using Magics 22.0.
The surface of the 3D-printed plate was treated as follows: sandblasting was performed, followed by rough polishing with sandpaper, and finally, a polishing cloth was used for further polishing. The surface roughness of the bone plate was measured using a 3D topography instrument (MIAOXAM2.5X – 0X). After surface treatment, the surface morphology of the 3D-printed parts was observed using a high-definition VGA electron microscope manufactured by Bocheng Co., Ltd. The SLM molding process parameters were optimized to produce optimized molded parts.
3. Results and discussion
3.1. Reverse reconstruction and simulated repair of femoral prosthesis
3.1.1. Reverse reconstruction of femoral prosthesis
Since the affected sites vary across patients and have complex geometric or curved shapes, in order to increase the degree of fit between the designed implant and affected site, lower the risk of implant loosening, and improve the success rate of implant surgery, it is best to locate the patient’s affected site using medical imaging, such as computed tomography (CT) or magnetic resonance tomography, for 3D reconstruction. In order to obtain the image of the affected site, we used CT or nuclear magnetic resonance to scan the patient’s affected site. We then imported the CT scan images of the affected site of the femur into Mimics. Subsequently, the CT scan images in Mimics were subjected to threshold segmentation, physique manipulation, smoothing, denoising, and other operations. An optimized 3D model was then obtained (Figure 1).
Figure 1.
Reverse reconstruction of the femoral prosthesis.
1213.1.2. Simulated repair of femoral fracture
The reconstructed 3D femoral model was imported into Geomagic Design X for further optimization (clipping, subdivision, smoothing, and holistic repatching, etc.), saved in STL format, and then imported into Inspire software for substantialization, as shown in Figure 2A and B. The plate design in this study was primarily aimed at oblique fractures, since these fractures are common and are considered unstable fractures; additionally, oblique fractures can easily induce displacement and are dangerous. To begin with, we imported the 3D-substantiated femoral prosthesis into Rhino software for segmentation to simulate an oblique fracture. Then, the incision was closed, the fixation position of the plate was determined according to the fracture direction, and the curved surface of the femoral prosthesis was extracted based on the width of common plate, deviated, and thickened by 3 mm. Lastly, six round holes with a diameter of 3.52 mm and different depths were opened on it, so that there would not be any threads in the simulation holes temporarily, as shown in Figure 2C.
Figure 2.
Femoral prosthesis. (A) Reverse reconstruction. (B) Substantiation. (C) Simulated repair of fracture.
3.2. Finite element simulation of the femoral plate
3.2.1. Simulated parameter setting of the femoral plate
The simulated and repaired femoral fracture model was saved in STP format and imported into Inspire software for stress analysis. First, a bolted connection was added between the plate and prosthesis, and the material parameters were set. The femoral prosthesis was set as cortical bone, with an elastic modulus of 17.00e3 MPa, a Poisson’s ratio of 0.30, and a density of 1.23e-6 kg/mm3. The plate and screw were set as TC4, with an elastic modulus of 116.52e3 MPa, a Poisson’s ratio of 0.31, and a density of 1.92e-6 kg/mm3. The loading conditions of the human femur are complex, in which many factors influence those conditions, including the pre-tightening force of the screw, friction force, and the interaction between muscle, ligament, and plate. These forces have three forms: compression, bending, and torsion. When compressing the femoral head, the femur would naturally produce both, bending and torsional forces; hence, bending and torsion need not to be applied separately. Taking adults weighing 70 kg as the research subjects, a one-leg compression load F of 2,100 N (about three times the body weight) was applied to the femoral head. The contact between the other end of the femur and meniscus was partially set as fully fixed (Figure 3). The mesh type was a mixed mesh, and the mesh was divided automatically. The number of divided grids was 471,296.
Figure 3.
Schematic diagram of the femoral prosthesis restraint and load application.
3.2.2. Analysis of the simulation of the femoral plate
The finite element simulation results of the femoral plate are shown in Figure 4. Figure 4A shows that the displacement of the femoral prosthesis decreased from top to bottom, and the maximum displacement was 13.06 mm at the femoral head. Figure 4B shows that the displacement of the plate decreased from top to bottom, and the maximum displacement was 4.09 mm near the femoral head after the femoral displacement was transferred to the plate through screws. When the plate bore three times the weight while standing on one leg, the deformation was small and met the requirements for use. The stress nephograms of the sample and the plate are shown in Figure 4C and D, respectively. We find that the stress was concentrated on the plate after the femoral fracture was repaired, and the maximum stress was 3.90 e2 MPa on both sides of the plate across its entire length. The maximum stress of the plate is less than TC4 yield strength of 8.60e2 MPa, which is within the safety range. There was also a stress concentration near the screw hole inside the plate. The plate’s design was optimized to improve the biocompatibility and reduce the femoral plate’s (TC4 material) weight, which measured 15.24 g.
Figure 4.
Stress analysis of the femoral plate. (A) Nephogram of overall displacement. (B) Nephogram of bone plate displacement. (C) Overall stress nephogram. (D) Stress nephogram of the bone plate.
1223.3. Topology optimization of the femoral plate
3.3.1. Simulated parameter setting of the femoral plate with optimized topology
Simulation parameters such as material, load, and constraint were set in Inspire software similarly to those of solid plates. In order to ensure the integrity of the edge of the screw hole and the outline of the plate following topology optimization, the screw hole and the contour of the plate were segmented. The segmentation command in Inspire was used to segment the screw hole with a thickness of 0.8 mm and the contour of the plate to a thickness of 0.2 mm. The remaining plate part (other than the screw hole and the contour) was set as the design space. Considering that the femoral plate and other factors were likely needed to be removed, the draft constraint was set downward. Since the length and width directions 123of the plate were approximately symmetric, symmetrical constraints were set in these two directions. The constraint and load application of the femoral plate are shown in Figure 5. The optimization target was set to maximize the stiffness, in which the mass target was 30%, and the thickness constraint was 3.5 mm.
Figure 5.
A schematic of the constraint and load application of the femoral plate.
3.3.2. Simulation analysis of the femoral plate with optimized topology
The finite element simulation results of the femoral plate with optimized topology are shown in Figure 6. Figure 6A shows that the displacement trend of the femoral prosthesis was similar to that before topology optimization, which is characterized by a gradual decline from top to bottom. The maximum displacement was 13.23 mm at the femoral head. Figure 6B shows that after femoral displacement was transferred to the plate through screws, the displacement trend of the plate was also similar to that before topology optimization, and the maximum displacement was 4.13 mm near the femoral head. The plate displacement after topology optimization was larger than before optimization; however, the increase was small. The increase of deformation indicates that the stiffness of the plate decreases. The deformation of the bone plate will greatly increase the stress borne by the skeleton and reduce the stress shielding effect of the skeleton. The stress nephograms of the sample (Figure 6C) and the plate (Figure 6D) showed that the stress was concentrated at the plate after the femoral fracture was repaired, and the maximum stress was 5.20e2 MPa on both sides of the plate across its entire length. The stress of the plate after topology optimization is higher than that before optimization, but still less than the yield stress of TC4 of 8.60e2 MPa. Although the stress concentration degree of femur after topology optimization is slightly small (concentrated at the fixed hole), it is found from the stress cloud diagram that the stress of femur after topology optimization of bone plate is increased, which is conducive to stimulating the growth of surrounding bone tissue. There was also a stress concentration near the screw hole inside the plate. The stress concentration of the plate after topology optimization was lower than that before optimization. The weight of the femoral plate (TC4 material) measured about 7.8 g. The weight of the plate after topology optimization was about 48.81% lower than that before optimization.
Figure 6.
Analysis of the femoral bone plate following topology optimization. (A) Nephogram of overall displacement. (B) Nephogram of bone plate displacement. (C) Overall stress nephogram. (D) Stress nephogram of the bone plate.
3.4. Design of the biological fixation plate
When designing a biological fixation plate, the scope of application of different porous structures must be considered, including whether the filled porous structure 124matches the bone plate frame, whether the plate with optimized topology is close, whether the processing requirements are met, and whether the porous structure is beneficial to the improvement of the mechanical properties and biocompatibility of the plate. We chose a porous structure that is suitable for the plate with optimized topology using the methods of simulation and filling of the porous structure. After the selection of H unit, R unit, and B unit with good mechanical properties, we simulated and filled the optimized topology plate according to the generation rules of porous structure (Figure 7). By observing the plates filled with three kinds of porous structures, we found that all the plates were characterized by a close fit between the porous structure and the solid part after the plates with optimized topology were filled with different units. The porosity, mean pore size, and surface-area-to-volume ratio met the design requirements of the porous structure. The porous structures generated by different units on the plate met the processing requirements. However, by examining the processing risks of plates filled with different porous structural units, we found that the maximum diagonal spacing of the H unit (honeycomb unit) was 1 mm, and its shape was approximate to a round hole, which can partly ascertain the success of processing.
Figure 7.
Results of bone plates filled with different porous structural units.
Furthermore, due to its simple structure, we can guarantee the success of processing by adjusting the placement mode (perpendicular to the substrate). After the plates with optimized topology were filled with R unit, the protrusion of the unit node was 0.8 mm, and the overhang angle was close to 40°, which suggests a dangerous processing state. Furthermore, the lap joint between pillars was at risk of breakage. After the plates with optimized topology were filled with B unit, there was protrusion; however, the protrusion was small (0.2 mm). The lap joints between all units of the porous structure of B unit were continuous and met the processing requirements.
Under the condition that the mechanical properties and biocompatibility of the three structural units are able to meet the requirements, H unit may be suitable for surgeries that require removing the plate, and B unit may be suitable for surgeries that do not require removing the plate. The mass test showed that the mass of the H-shaped plate was 12.05 g, which is 20.93% lower than that of the original plate, while the mass of the B-shaped plate was 11.05 g, which is 27.49% lower than that of the original plate. With its strength ensured, there was a sharp decline in the mass of the new plate and an improvement in its biocompatibility. After the plates filled with the porous structure were meshed, it was difficult to make a comparative analysis on stress due to the substantial data size; nevertheless, it was undeniable that the mechanical properties improved compared with those before filling.
3.5. Assembly of the plates and opening of the screw holes
We imported the designed biological fixation plates into Materialise Magics and the femur model for simulated assembly and then conducted a collision test. There was no interference between models, and the fit was good, thus satisfying the use requirements. Previously, we did not set threads at the fixed hole position to facilitate the simulation analysis; however, it is essential to set threads in practical application. The screws were designed based on ASTM F543-07 Standard Specification and Test Methods for Metallic Medical Bone Screws, test method standard, and the actual situation, and screws with a diameter of 3.5 mm were selected. In Figure 8, the arrows indicate the design results. Before the screw hole was set, we closed the holes of the original femur and the femoral plate, imported six screw models, and adjusted the screw position to the original hole position of the plate. Boolean subtraction was performed to finish the setting of the screw hole (Figure 8).
Figure 8.
Assembly of biological fixed bone plate and opening of screw holes.
1253.6.3D Printing molding process of the biological fixation plate
3.6.1. Data processing of the 3D-printed biological fixation plate
Different placement and support addition modes of 3D-printed parts result in further support additions and molded layer thickness of parts; these differences directly affect the molding quality and molding efficiency of parts. When processing the host bone using fused deposition modeling (FDM) technology, the host bone and substrate were placed at an inclination of 10° to promote processing efficiency and avoid a long scanning line. Given the large processing section, the preheating temperature of the substrate was raised appropriately, and a 25% support was added to reduce stress concentration and prevent warpage and deformation. For metal biological fixation plates, according to findings on the placement and support addition modes of SLM-molded parts[15], the plate was tilted 45° relative to the datum plane to prevent stress concentration induced by a long scanning line of the plate and avoid adding support to the inside of the porous structure of the plate.
In order to understand the processing risks of the biological fixation plate, the processing risks were analyzed using Magics software, which revealed that the processing risks of the biological fixation plate mainly occurred at both ends (Figure 9A). No processing risks were detected in other parts, implying that the addition of support was able to satisfy the processing requirements. Since dendriform supports have high strength, little support addition, and small stress concentration, they can be added to the plate that has undergone processing risk analysis. The results of support addition are shown in Figure 9B. We found that the support addition of the plate was concentrated in nonkey parts where the support can be easily removed. The small support addition and powder waste conformed to the support addition principle of SLM-molded parts.
Figure 9.
Data processing of SLM-molded bone plate. (A) Processing risk analysis. (B) Placement and support addition.
3.6.2. Performance of the SLM-molded biological fixation plates
The SLM-molded biological fixation plate is shown in Figure 10. The overall morphology of the plate (Figure 10B) showed that the surface of the plate was bright and new, the pore structure was clear, and the metal feel was good.
Figure 10.
Biological fixed bone plate formed by SLM. (A) Microstructure of B-type bone plate. (B) Overall morphology of bone plate. (C) Microstructure of H-shaped bone plate.
126No obvious warpage or molding defects were found. The roughness of the plate surface was tested and measured at 11 μm. The sample can be directly used after post-treatments, such as thermal treatment, sandblasting, polishing, and anodic oxidation. The surface microstructure of the B-shaped plate (Figure 10A) showed that the structure between the pillars of the porous structures was clear, the lap joint was good, and there was little powder adhesion near the pores, suggesting a high molding effect and surface quality of the SLM-molded B-shaped plate’s porous structure. The microstructure of the H-shaped plate (Figure 10C) showed that the structure between the pillars of the porous structures was clear, the lap joint was good, and the powder adhesion was equivalent to that of the B-shaped plate, which did not influence its use after treatment. These findings suggest that the SLM-molded biological fixation plate can fully satisfy the requirements for use after post-treatment.
3.7. Assembly between the biological fixation plate and host bone
The SLM-molded biological fixation plate was assembled to the FDM-printed host bone to verify matching (Figure 11). We found no apparent contact gap between the B-shaped plate and the host bone as well as the H-shaped plate and the host bone, and they were closely mated. The screw fixation hole was positioned correctly and met the assembly requirements. There was no large interference fit between the plates. This finding suggests that matching the designed plates satisfies the requirements for use.
Figure 11.
Matching test of bone plate. (A) B-type plate. (B) H- type plate.
4. Conclusion
(1) Before the optimization of the plate, the maximum displacement of the femur was 4.09 mm near the femoral head, and the stress was concentrated at the plate. The maximum stress was 9.38e2 MPa on both sides of the plate over its entire length. There was also a stress concentration near the screw hole inside the plate.
(2) After topology optimization, the maximum displacement of the plate was 4.13 mm near the femoral head, and the plate displacement was larger than before optimization; however, the increase was small. The maximum stress was 5.15e2 MPa on both sides of the plate across its entire length, and the stress concentration of the plate after topology optimization was lower than that before optimization.
(3) The surface of the 3D-printed plate was bright and new, the pore structure was clear, and the metal feel 127was good. No obvious warpage, deformation, or molding defects were found. The structure between the pillars of the porous structures was clear, the lap joint was good, and there was little powder adhesion near the pores. There was no apparent contact gap between the B-shaped plate and the host bone as well as the H-shaped plate and the host bone; they were closely mated. The screw fixation hole was positioned correctly and met the assembly requirements.
In order to further understand the design and manufacturing of personalized biological fixation plates, follow-up studies on the design of plates with gradient porous and mixed porous structures, SLM-molded porous structure processing, as well as thermal treatment processing are needed, so as to lay the foundation for direct manufacturing of high-performance biological fixation plates using SLM.
Acknowledgments
None
Funding
This study was funded by the Key Scientific Research Projects of Colleges and Universities in Henan Province (22A460006) and supported by the Analytical and Testing Center of ZKNUC for carrying out microscopic analysis.
Conflict of interest
The authors report no conflicts of interest.
Author contributions
Conceptualization: Zhang Guoqing
Funding acquisition: Zhang Guoqing
Investigation: Zhang Guoqing, Li Junxin, Zhou Xiaoyu
Formal analysis: Zhang Guoqing, Zhou Yongsheng
Writing – original draft: Zhang Guoqing, Zhou Yongsheng
Writing – review & editing: Bai Yuchao
Ethics approval and consent to participate
The bone model in this study was downloaded from the public database of Mimics software, and the data is publicly available, so ethical review is not involved.
Consent for publication
All authors have signed a paper publication agreement for publication in the International Journal of Bioprinting.
Availability of data
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Associated Data
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Data Availability Statement
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.