In 2012, Princess Moshoane's life changed drastically when she and her aunt were attacked outside their home in Midrand. They were faced with two hijackers, and in a moment of panic, Princess Moshoane turned and ran. Within seconds, she heard a loud bang and fell to the ground.

“It was only when I got up and saw the blood pouring down my side that I realised that I have been shot in the face,” she later recounted.  

The assailant’s bullet shattered her lower and upper jaws, damaged her tongue and removed several teeth. Later, in the operating theatre, surgeons had to remove more teeth to repair the shattered jaws. At that point, she was left with a hole in her mouth where her upper and lower frontal teeth and jaws would typically be.

Moshoane’s life felt like it was over before it had begun. “When you’re 22 years old, you still want to live. You still want to go out with friends. I still had dreams. How am I going to smile? My confidence was dead. I wouldn’t go outside. I’d just go to work and come back home because I still had to earn money for my family,” she said.

Seven years after the shooting, she received the good news she had been waiting for. Thanks to new technology, her smile could be restored.

How CUT uses additive manufacturing to create medical breakthroughs

The Central University of Technology’s (CUT) Centre for Rapid Prototyping and Manufacturing (CRPM), in collaboration with the Germany-based industrial 3D printing company Electro Optical Systems (EOS) and the Carl and Emily Fuchs Foundation, raised the money to build her a new jaw and teeth using additive manufacturing (3D printing).

Unlike the old printers we all know, additive manufacturing builds a 3-dimensional prototype based on a software design. It has been used in architecture, food creation, fine machining tools, parts manufacture, furniture creation, art, and, most promisingly, medical treatments. In recent years, 3D printing has been used to create artificial limbs, spinal cord cages, facial reconstructions, and more.

Some of 3D printing’s most promising achievements in recent years have been made in medical treatments, and South African universities are at the forefront of that process. The Central University of Technology is part of this exciting new research.  

The CRPM, located at the CUT Bloemfontein campus, was established in 1997 as part of a research initiative. The unit imported a laser sintering machine from Germany, a high-precision printer capable of manufacturing incredibly complex parts. At the time, it was only the fifth such machine in South Africa. Soon, the CRPM was offering rapid prototyping to local manufacturers, which helped fulfil one of the university's missions: to introduce new technology to the South African manufacturing industry.

The CRPM can now tackle increasingly complex medical challenges. Luan Adams of Pretoria was diagnosed with sinus cancer in 2009. The surgeons removed his nose and part of his face when they operated on him to remove the tumour. The procedure required several operations and skin grafts, which left his face severely damaged. The team at CUT was able to create a new prototype or model of a reconstructed nose and face using Computer-Aided Design (CAD), which was specifically designed for Adams’ needs. The model was then fitted onto him with the help of Professor Cules Van den Heever, a maxillofacial prosthodontist, to recreate the damaged part of his face.

“About two to three years ago, through CUT CRPM, we printed a planning model for Luan, and that is where the treatment started,” said Van den Heever. “We decided that the airwaves are more important than the mouth at this stage, so we did what is called a runectomy, or removal of what was left of the nose so he could breathe. We made him a new facial prosthesis to make him socially acceptable; as you can see, the upper lip is still not in an ideal position, and the facial contour is not ideal, but at least it’s a start.”

The partnership between Van den Heever and CUT has now assisted several people in need of this kind of surgery. Dr. Gerrie Booysen, director at the CRPM, said, "We're not just making things; we're making a difference in people's lives."

The work being done at CRPM is some of the most advanced in the world, according to Prof. Cules. He said: “We have the patient pool here in South Africa but, because of fear of the unknown, lack of government resources and socio-economic circumstances, a lot of patients are being left out. We have a unique situation where people are diagnosed very late, we see these huge extensive tumors which you don’t see anywhere else in the world so, in a sense, this is a world leader, and it is sad that this work is done and there is no recognition.”

CUT’s collaboration with the government is advancing 3D printing across South African industries

A technology demonstrator called MedAdd (additive manufacturing of medical devices) has now been established at CUT in partnership with the Department of Science and Innovation. It will help South Africa compete internationally by aiding the local medical device industry with the latest technology, infrastructure, expertise, and skills. MedAdd is a vital part of the department’s corporate social investment strategy to assist people who need advanced medical solutions with 3D printing to improve their health and quality of life. Moshoane and Adams are among thousands of South Africans whose lives can be dramatically improved through this partnership.

MedAdd is working with Cape Health Technology Park, the South African Medical Technology Industry Association, the Medical Device Manufacturers of South Africa, and the National Medical Devices and Diagnostic Technology Innovation Cluster to ensure a national impact. The impact of this partnership on CUT is anticipated to be big, including enhancing the current equipment and capabilities at CUT, enabling CUT, academic partners and local companies to demonstrate reproducibility and scale-up of innovative medical device products, be available for small companies to industrialise new products, de-risking their innovative development before full-fledged commercialisation; and to enable students, researchers and industry personnel to develop the required skills for the development of this new technology and new industry.

In March 2023, MedAdd began collaborating with dentists and dental technicians. The technology offers 3D-printed cobalt-chrome removable partial denture frames and bars. This collaboration will not only significantly improve the skill set of these medical professionals in the area. Still, it will also enable CUT to research and develop prototypes for dental operations. Dr Booysen said at the initiative's launch: “This, in turn, could lead to job creation and increased market competitiveness by adopting digital workflows. Digital dentistry is still in its infancy phase in the country, and various research projects on materials and applications have been conducted to widen the knowledge of our academics in this field.”

This impact will be felt outside of medical devices, as the technology has applications, especially in rapid tooling (which allows for manufacturing prototypes to be produced at a fraction of the time and cost that is usual in conventional manufacturing processes), precision tool manufacturing and prototyping. For instance, an architect can now design a building in incredible detail using software and then have a scale model printed within a few hours, a process which, under normal conditions, could take weeks.

Given that this technology is relatively new in South Africa, what CRPM has been able to achieve has been remarkable for people like Princess Moshoane and Luan Adams, it is nothing short of astonishing. As Adams put it: “I don’t have big dreams now. I just take it one day at a time. You don’t know where you’ll be tomorrow. One of my dreams is to stop seeing the doctor a lot.” Thanks to CUT’s cutting-edge technology, that dream could soon be a reality for Adams.

Uploaded: 30 April 2024