AMFaces: Advanced Additive Manufacturing of User-Focused Facial Prostheses with Real-Life Colour Appearance

当患者因某些癌症或意外伤害（如鼻子、嘴唇、眼睛、耳朵或皮肤）而接受治疗时，就需要使用面部假体。假肢的质量对病人来说自然是非常重要的，既能保护受影响的区域，又能给他们信心，自尊，提高生活质量。随着癌症发病率的增加、人口老龄化和患者期望的提高，对面部假体的需求正在迅速增长。在英国，目前有超过50万人患有面部毁容，每年约有2500名新患者需要面部修复术。雪上加霜的是，假肢每12-18个月就需要更换一次，因为它们会退化和变色。目前，面部假体的生产技术要求高，时间长，最终产品仅取决于少数经验丰富的颌面假体专家的技能。他们的数量可能会进一步减少，因为20%的劳动力将在未来5年内退休。迫切需要一种新的方法，以及时和具有成本效益的方式为患者提供一致的高质量假肢。然而，也存在着重大挑战。迄今为止，没有任何现代制造方法能够控制医用级硅树脂以高保真度再现面部皮肤组织，并具有必要的柔软度、颜色、表面纹理和灵活性。事实上，即使使用最新的数字成像技术，也没有很好的3D面部皮肤模型。为了应对这些挑战，我们汇集了一个由来自五所大学的专家和早期职业研究人员（ecr）组成的多学科团队，他们的专业知识对成功的结果至关重要：颌面和口腔外科的临床医生，3D打印（增材制造或AM）的科学家和工程师，重建科学，生物材料，色彩科学和成像。该项目的多学科性质将使ecr在不同的研究领域获得更广泛的知识、技能和领导力培训，并得到各自领域前沿研究人员的指导。我们的工作需要一些创新：-为所有种族引入面部皮肤颜色、纹理、3D形状和半透明的3D高光谱成像和计算机建模-开发用于制造医用硅胶部件的混合增材制造系统，对皮肤表面颜色和纹理进行微米级建模-将物理建模数据转换为数字管道增材制造打印机控制-制定具有改进寿命的新型医用硅胶和着色剂-在整个过程中保持以患者为中心的方法。在生产过程的每个阶段都有患者的反馈。这些进步的紧密整合是实现我们目标的核心，能够根据需求及时交付定制的超逼真面部假体。研究结果将主要通过两个NHS基金会信托基金（曼彻斯特大学和伦敦盖伊和圣托马斯）提供，并将支持区域NHS假肢服务和慈善机构网络。我们会与本地中小企业合作，促进可持续的研究发展和进一步投资。我们将与临床、科学和工程界，特别是与资源有限的发展中国家分享我们的技术创新。

Facial prostheses are needed when patients are treated for certain cancers or accidental injuries affecting, for example, the nose, lips, eyes, ears, or skin. The quality of prostheses is naturally very important for patients, both protecting the affected area and giving them confidence, self-esteem, and an improved quality of life. The demand for facial prostheses is growing rapidly, with increases in cancer rates, an ageing population, and rising patient expectations. Within the UK, there are currently over half a million people with facial disfigurement, and each year about 2,500 new patients need facial prostheses. Compounding the problem, prostheses need to be renewed every 12-18 months as they degrade and discolour.At present the production of facial prostheses is technically demanding and lengthy, with the end-product depending on the skill of only a few highly experienced maxillofacial prosthetists. Their number is likely to diminish further with 20% of the workforce due to retire over the next 5 years. A new approach is needed urgently to deliver consistent high-quality prostheses to patients in a timely and cost-effective manner. There are, though, significant challenges. To date, no modern manufacturing method has managed to control medical grade silicone to reproduce facial skin tissue with the necessary softness, colour, surface texture, and flexibility, all in high fidelity. In fact, there is no good computer model for 3D facial skin appearance, even with the latest digital imaging techniques. To meet these challenges, we have brought together a multidisciplinary team of experts and early career researchers (ECRs) from five universities whose expertise is essential for a successful outcome: clinicians in maxillofacial and oral surgery, scientists and engineers in 3D printing (additive manufacture or AM), reconstructive science, biomaterials, colour science, and imaging. The multidisciplinary nature of this project will allow ECRs to gain broader knowledge, skills, and leadership training in different research areas, mentored by researchers at the forefront of their fields.Our work entails several innovations: - introducing 3D hyperspectral imaging and computer modelling of facial skin colour, texture, 3D shape, and translucency for all ethnicities - developing hybrid AM systems for manufacturing medical silicone parts with micron-level modelling of skin surface colour and texture - transforming physical modelling data to digital pipeline AM printer control - formulating new medical silicones and colorants with improved longevity - maintaining throughout a patient-centred approach, with patient feedback incorporated at every stage of the manufacturing process. The tight integration of these advances is central to achieving our goal, enabling the prompt delivery of bespoke ultra-realistic facial prostheses on demand. The results of the research will be delivered mainly through two NHS Foundation Trusts (Manchester University and Guy's and St Thomas', London) and will support regional NHS networks for prosthetic services and charities. We will work with local SMEs to facilitate sustainable research development and further investment. We will share our technological innovations with the clinical, scientific, and engineering communities, especially with developing countries with limited resources.