Department of Oral and Maxillofacial Surgery, University Hospital Zurich, Rämistr. 100, 8091, Zurich, Switzerland.
Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Oral Maxillofac Surg. 2024 Jun;28(2):795-802. doi: 10.1007/s10006-024-01208-3. Epub 2024 Jan 12.
With respect to the European Union 2017 amendment of the Medical Device Regulations (MDR), this overview article presents recommendations concerning medical 3D printing in oral and maxillofacial surgery (OMFS).
The MDR were screened for applicability of the rules to medical in-house 3D printing. Applicable regulations were summarized and compared to the status of medical use of 3D printing in OMFS in Germany. Recommendations were made for MDR concerning medical 3D printing.
In-house printed models, surgical guides, and implants fall under the category of Class I-III, depending on their invasive and active properties. In-house medical 3D printing for custom-made medical devices is possible under certain prerogatives: (1) the product is not being used in another facility, (2) appropriate quality systems are applied, (3) the reason for omitting commercial products is documented, (4) information about its use is supplied to the responsible authority, (5) there is a publicly accessible declaration of origin, identification, and conformity to the MDR, (6) there are records of manufacturing site, process and performance data, (7) all products are produced according to the requirements proclaimed before, and (8) there is an evaluation of clinical use and correction of possible issues.
Several aspects must be addressed for in house medical 3D printing, according to the MDR. Devising MDR related to medical 3D printing is a growing challenge. The implementation of recommendations in OMFS could help practitioners to overcome the challenges and become aware of the in-house production and application of 3D printed devices.
本文针对 2017 年欧盟对《医疗器械法规》(MDR)的修订,就口腔颌面外科(OMFS)中 3D 打印的医学应用提出相关建议。
本文筛选了 MDR 中适用于 3D 打印的规则,并对其进行总结,同时将这些规则与德国 OMFS 中 3D 打印的医学应用现状进行对比。最后,本文针对 MDR 中有关 3D 打印的医学应用提出了相关建议。
根据其侵入性和主动性的不同,内部打印模型、手术导板和植入物被归入 I 类-III 类医疗器械。在符合特定前提条件下,可对定制的医疗器械进行内部 3D 打印:(1)产品未在其他医疗机构使用,(2)应用了适当的质量体系,(3)记录未使用商业化产品的原因,(4)向主管部门提供有关其使用的信息,(5)有公开可获取的来源声明、识别和符合 MDR 的信息,(6)有制造场所、过程和性能数据的记录,(7)所有产品都根据之前宣称的要求进行生产,(8)对临床使用进行评估,并纠正可能存在的问题。
根据 MDR,内部医疗 3D 打印需要满足多个方面的要求。制定与医疗 3D 打印相关的 MDR 是一个不断发展的挑战。在 OMFS 中实施这些建议,可能有助于临床医生克服挑战,提高对 3D 打印设备内部生产和应用的认识。