In India, professions are often compartmentalised, with doctors and dentists primarily seen as healers. Defying this norm are Dr Adersh G.A., assistant professor at the department of surgery at PMS Dental College in Thiruvananthapuram, and Shivadhath R.P., a house surgeon at the same college. Their passion extends beyond traditional dentistry, to innovating and crafting novel medical solutions. Together, they have pioneered the world’s first clinical 3D bone graft printer, OsseoCraft, which is poised to revolutionise bone reconstructive surgery globally.
“Bone reconstruction for cases of bone loss typically involves the use of material like titanium and certain plastics. But they just provided support for existing bone or tissue, rather than fostering bone regeneration,” says Adersh, who co-founded the startup Pionomed Biogenix with Shivadhath. “Unlike these conventional options, the material we employ possesses unique properties that stimulate bone growth. It is osseo-conductive, which means it attracts bone formation. Consequently, when these particles are implanted in the body, bone forms around them, making this product unique.”
Moreover, this 3D-printed graft significantly reduces operative time compared to traditional methods like bone harvesting from other parts of the body. “For example, in cases of accidents or cancer surgeries resulting in bone loss, traditional approaches necessitate complex microvascular surgeries to transplant bone from elsewhere in the body,” says Adersh.
The duo utilises CT images of the patient to reconstruct the lost bone via 3D printing, directly implanting it into the patient’s body. The 3D printing process resembles that of a robotic system. “As we feed the reconstruction material into the machine, it is melted by an extruder heating to 200 to 300 degrees Celsius, deposited layer by layer according to the design programmed into the system,” says Adersh.
The reconstruction material contains hydroxyapatite molecules, a common component found in natural bone. “When implanted, the material attracts blood, facilitating the absorption of bone-forming factors. Subsequently, bone formation occurs around the implanted material,” he says.
Shivadhath highlights the cost-effectiveness of this printing technology compared to traditional titanium-based bone reconstruction materials. “A titanium graft can cost between Rs3,000 to Rs5,000 per graft, whereas we charge only Rs500 per graft,” he says. “Titanium, while strong, can sometimes weaken surrounding tissues due to its strength surpassing that of natural bone. Our material possesses strength comparable to natural bone, resulting in faster healing and improved surgical outcomes.”
Each graft produced by Pionomed Biogenix is customised to meet the unique requirements of individual patients, eliminating the need for on-table manipulations.
The concept behind the 3D printing-based bone graft was born during a contemplative phase Adersh had when he was an intern. “As a surgeon, I frequently encountered cases necessitating bone grafting or harvesting from alternative sites in the body. This process often extended surgeries by an additional five to six hours, and introduced complications such as donor site morbidity. Reflecting on these challenges, I sought a solution that could effectively substitute natural bone without resorting to metals or plastics. This journey led me to conceptualise a mechanism for producing grafts composed of a material engineered to emulate the properties and functionality of natural bone tissue,” he says.
Adersh’s father is a pioneering dental mechanic in Kerala known for crafting artificial teeth. “My father introduced me to dentistry,” he says. “Growing up in a family that owned a dental lab, I was exposed to various dental procedures from a young age, sparking my interest in the field.” Shivadhath says “fate” brought him to dentistry; he has a longstanding fascination with engineering as well. “In my second year [as undergraduate], I delved into research, eventually securing the first BDS student idea grant from the Kerala Startup Mission in 2022 for a gypsum recycling plant,” he says. “My innovation significantly reduced the cost of gypsum recycling. As I continued with my research, I crossed paths with Adersh, and our collaboration began.”
The award-winning duo’s 3D printer is now in use at PMS for reconstruction surgeries in the head and neck region. Additionally, the team has initiated discussions with several hospital chains and has forged partnerships with institutions like Apollo Hospitals, Hyderabad. Priced at Rs10.5 lakh, their printer offers a cost-effective solution compared to similar models abroad, which often integrate stem cell technology with 3D printing.
“We are aiming to provide an Internet of Things-based printer to hospitals, enabling remote planning and file creation, streamlining their workflow,” says Adersh. “For hospitals unable to invest in the printer, we offer the option to print grafts at PMS and deliver them.”
The entire journey, from conception to regulatory approval, spanned five years for this 3D printer featuring bioactive materials. The project received support from PMS’s engineering team and various other startups. Under Pionomed Biogenix, the duo is spearheading 12 innovative medical technology projects, including robotic exoskeletons, wheelchair-accessible dental chairs, and dental gypsum waste recycling plants. Additionally, they plan to venture into sustainable energy and establish a robotics centre, expanding their innovative endeavours. They are also chasing a world record―3D printing the largest artificial teeth using recycled plastics, leveraging their unique technology.