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Luo Y, Qiu L, Geng M, Zhang W. Retention and fatigue performance of modified polyetheretherketone clasps for removable prosthesis. J Mech Behav Biomed Mater 2024; 154:106539. [PMID: 38598917 DOI: 10.1016/j.jmbbm.2024.106539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE Polyetheretherketone (PEEK) is considered as an alternative to metal material for removable partial denture (RPD). However, the retentive force is not strong as a metal RPD. This study investigated the retention and fatigue performance of PEEK clasps with different proportions of clasp arm engaging the undercut to verify a new strategy to improve their clinical performance. METHODS Three groups (n = 10/group) of PEEK clasps with their terminal 1/3, 2/3 and the whole of retentive arms engaging the undercut were fabricated along with a group (n = 10) of conventional cobalt-chrome (CoCr) clasps as control group. Retentive forces were measured by universal testing machine initially and at an interval of 1500 cycles for a total of 15,000 fatigue cycles. The fatigue cycles were conducted by repeated insertion and removal of the clasp using fatigue testing machine. Each clasp was scanned by Trios3 scanner before and after fatigue test to obtain digital models. The deformation of the clasp was evaluated by root mean square (RMS) through aligning the two models in Geomagic wrap (2021). Scanning electron microscopy (SEM) and finite element analysis were carried out to observe the abrasion and the von Mises stress of the clasp arm. Kruskal-Wallis H test was used to compare the retentive forces and the RMSs of the studied groups followed by Bonferroni multiple comparisons. RESULTS The whole of PEEK clasp arm engaging the undercut provided higher mean retentive forces (7.99 ± 2.02 N) than other PEEK clasp groups (P < 0.001) and was closer to CoCr clasps (11.88 ± 2.05 N). The RMSs of PEEK clasps were lower than CoCr clasps (P < 0.05) while the differences among PEEK clasps were of no statistical significance (P > 0.05). SEM showed that evidences of surface abrasion were observed on the section that engaged the undercut for all groups of clasps. The stress concentration mainly occurred on the initial part of the retentive arm. The maximum von Mises stress of each group was below the compressive strength of PEEK. CONCLUSIONS Proportions of PEEK clasp arm engaging the undercut positively influenced the retentive force and the fatigue resistance of PEEK clasps was superior than CoCr clasps. It is a feasible method to improve the retention of PEEK clasps by increasing the proportion of clasp arm engaging the undercut. Clinical trials are needed to further verify this innovation.
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Affiliation(s)
- Yichen Luo
- Department of Oral Special Consultation, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, PR China; State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases (Nanjing Medical University), Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, PR China
| | - Lin Qiu
- Department of Oral Special Consultation, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, PR China; State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases (Nanjing Medical University), Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, PR China
| | - Mingzhu Geng
- Department of Oral Special Consultation, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, PR China; State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases (Nanjing Medical University), Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, PR China
| | - Wei Zhang
- Department of Oral Special Consultation, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, PR China; State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases (Nanjing Medical University), Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, PR China.
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Luo C, Liu Y, Peng B, Chen M, Liu Z, Li Z, Kuang H, Gong B, Li Z, Sun H. PEEK for Oral Applications: Recent Advances in Mechanical and Adhesive Properties. Polymers (Basel) 2023; 15:386. [PMID: 36679266 PMCID: PMC9864167 DOI: 10.3390/polym15020386] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023] Open
Abstract
Polyetheretherketone (PEEK) is a thermoplastic material widely used in engineering applications due to its good biomechanical properties and high temperature stability. Compared to traditional metal and ceramic dental materials, PEEK dental implants exhibit less stress shielding, thus better matching the mechanical properties of bone. As a promising medical material, PEEK can be used as implant abutments, removable and fixed prostheses, and maxillofacial prostheses. It can be blended with materials such as fibers and ceramics to improve its mechanical strength for better clinical dental applications. Compared to conventional pressed and CAD/CAM milling fabrication, 3D-printed PEEK exhibits excellent flexural and tensile strength and parameters such as printing temperature and speed can affect its mechanical properties. However, the bioinert nature of PEEK can make adhesive bonding difficult. The bond strength can be improved by roughening or introducing functional groups on the PEEK surface by sandblasting, acid etching, plasma treatment, laser treatment, and adhesive systems. This paper provides a comprehensive overview of the research progress on the mechanical properties of PEEK for dental applications in the context of specific applications, composites, and their preparation processes. In addition, the research on the adhesive properties of PEEK over the past few years is highlighted. Thus, this review aims to build a conceptual and practical toolkit for the study of the mechanical and adhesive properties of PEEK materials. More importantly, it provides a rationale and a general new basis for the application of PEEK in the dental field.
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Affiliation(s)
- Chengfeng Luo
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Ying Liu
- The Affiliated Taian City Central Hospital of Qingdao University, Taian 271000, China
| | - Bo Peng
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Menghao Chen
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Zhaogang Liu
- The Affiliated Taian City Central Hospital of Qingdao University, Taian 271000, China
| | - Zhanglong Li
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Hai Kuang
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning 530021, China
- Key Laboratory of Research and Application of Stomatological Equipment (College of Stomatology, Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning 530021, China
| | - Baijuan Gong
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Zhimin Li
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Hongchen Sun
- Hospital of Stomatology, Jilin University, Changchun 130021, China
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Liu Y, Fang M, Zhao R, Liu H, Li K, Tian M, Niu L, Xie R, Bai S. Clinical Applications of Polyetheretherketone in Removable Dental Prostheses: Accuracy, Characteristics, and Performance. Polymers (Basel) 2022; 14:polym14214615. [PMID: 36365609 PMCID: PMC9654455 DOI: 10.3390/polym14214615] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
The high-performance thermoplastic polyetheretherketone (PEEK) has excellent mechanical properties, biocompatibility, chemical stability, and radiolucency. The present article comprehensively reviews various applications of PEEK in removable dental prostheses, including in removable partial dentures (RPDs) (frameworks and clasps), double-crown RPDs, and obturators. The clinical performance of PEEK in removable dental prostheses is shown to be satisfactory and promising based on the short-term clinical evidence and technical complications are scarce. Moreover, the accuracy of RPDs is a vital factor for their long-term success rate. PEEK in removable dental prostheses is fabricated using the conventional lost-wax technique and CAD/CAM milling, which produces a good fit. Furthermore, fused deposition modeling is considered to be one of the most practical additive techniques. PEEK in removable prostheses produced by this technique exhibits good results in terms of the framework fit. However, in light of the paucity of evidence regarding other additive techniques, these manufacturers cannot yet be endorsed. Surface roughness, bacterial retention, color stability, and wear resistance should also be considered when attempting to increase the survival rates of PEEK removable prostheses. In addition, pastes represent an effective method for PEEK polishing to obtain a reduced surface roughness, which facilitates lower bacterial retention. As compared to other composite materials, PEEK is less likely to become discolored or deteriorate due to wear abrasion.
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Affiliation(s)
- Yuchen Liu
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Ming Fang
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Correspondence: (M.F.); (S.B.)
| | - Ruifeng Zhao
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Hengyan Liu
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Kangjie Li
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Min Tian
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Lina Niu
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Rui Xie
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Shizhu Bai
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Correspondence: (M.F.); (S.B.)
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