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SPECIAL CLINICAL SECTION: PEDIATRICS Dr. Mark Greenwood Dr. Sally Schuette Dr. Pamela Erickson Dr. Gayathri Sambasiv an Dr. Thekla Swanson Dr. Lisa Abadeer Dr. Daniel Fallon w w w.childrensdent.com Burnsville 952-435-4102 Minnetonka 952-932-0920 Tooth decay can begin as soon as teeth emerge in an infant's mouth. It can progress rapidly, causing pain and even harming the permanent teeth that are developing under the gums. Left untreated, decay can destroy the teeth of an infant or young child and can affect a child's general health. •How to care for their infant's or toddler 's mouth •Appropriate use of fluoride for their child •Ways to prevent trauma to the face, teeth and gums •Teething and development milestones •The relationship between diet and oral health A dental visit lets parents discuss: Edina 952-831-4400 The American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend the first dental visit should occur shortly after the first tooth erupts or around the age of one. Gentle, enjoyable, quality dental care for infants, children & teens still entirely individual, with intricacies that even experienced pediatric physi- cians may never have seen before. That makes the opportunity to hold and touch a 3-D rendering of the anomaly all the more important. The Rapid Prototyping Center at the University of Louisville J.B. Speed School of Engineering used a MakerBot 3-D printer to create a replica of Roland's heart that was 50 percent larger than the original and separated into three pieces. Dr. Austin used it to plan his approach before surgery, reducing the amount of time the child would need to be under anesthesia. The model cost about $600 to produce. "Once I had a model, I knew almost exactly what I needed to do and how I could do it," Dr. Austin said in a February interview with The Courier-Journal. "Being able to determine exactly what that abnor- mality is, in a three-dimensional way, is going to be very helpful for children with complicated hearts." Looking Ahead Pediatric specialists are looking into improvements in efficiency, reduction of radiation exposure for imaging and new uses of implantable, biodegradable, 3-D-printed structures. At Children's National, Cochenour uses a program called 3-matic from Materialise to create the renderings that become 3-D models. This computer-aided design anatomy program evolves as Cochenour and other engineers apply it to new cases. Each new application supports Materialise's efforts by providing user insights as the company seeks to build a stronger software suite. This collaborative development model is particularly helpful for improving the time-consuming process of segmenta- tion — a detailed phase of the 3-D process that requires physicians and engineers to carefully identify the tissue in images they want the program to recognize and recreate. New algorithms could speed this process, lessen the time burden on physicians and further reduce the cost of creating 3-D medical devices. "Biodegradables are really where the future is," Cochenour says. "The goal is to eventually be able to 3-D-print cus- tomizable implants. We've already done some mouse studies with biodegradable grafts. Hopefully those can make it to the market in the next five to 10 years." A few cases have been successful already. For example, Glen Green, MD, with the University of Michigan, has used biodegradable devices to help two children with collapsed airways due to tracheobronchomalacia. These complex splints were designed to provide a clear airway and then slowly dissolve as patients' growing bodies developed enough to naturally support breathing. No additional procedures are expected to be necessary. Beyond anatomic models and bio- degradable implants, 3-D printing's potential applications for pediatrics remain somewhat speculative. Specialists and engineers will continue to imagine the possibilities, and if innovation continues on its current trajectory, the technology will prove to be a manufac- turer of healing for more children. ■ M D N E W S . CO M ■ MD NEWS Minnesota | 1 5