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Fig 1.

QbD systematic product and process design development flow chart showing principal steps.

Adapted from [27, 34].

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Fig 1 Expand

Fig 2.

Search strategy and selection of the studies.

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Fig 3.

(a) Studies’ main objective, PU: Process understanding, PO: Prediction and optimization, RER: Reduction of experimental runs, DRM: development of robust manufacturing; (b) Percentage of reduction of experimental runs per paper; (c) QbD steps implemented in the reviewed studies.

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Fig 3 Expand

Table 1.

The ideal eight quality dimensions of 3D printed bone implants.

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Table 1 Expand

Table 2.

Performance indicators of bone substitutes.

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Table 3.

Summary of the ideal CQA of custom 3D printed bone implants and scaffolds.

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Table 3 Expand

Fig 4.

General process flow diagram of custom 3D printed bone prostheses and scaffolds.

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Fig 5.

Detailed process flow diagram for the design and fabrication of custom 3D printed bone prostheses and scaffolds.

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Table 4.

Example of FDA recommended initial ISO 10993 biocompatibility evaluation endpoints for medical devices in contact with bone tissue and blood.

Adapted from [200].

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Table 5.

Linking CPP activities with CQA groups.

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Table 6.

Linking CMA with CQA groups.

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Fig 6.

Flow chart of selected quality risk assessment tools, and scope of present study.

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Fig 7.

Ishikawa diagram, summary of causes of non-conformity to the quality of custom 3D printed bone implants.

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Table 7.

RBS of the causes of quality non-conformity in custom 3D printed bone prostheses.

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