1
|
Ghanem N, Ali H, Bahrli N, Hassan H. Clinical performance of custom-milled polyetherketoneketone (PEKK) posts and cores: A 12-month follow-up randomized controlled pilot study. Clin Exp Dent Res 2024; 10:e854. [PMID: 38433309 PMCID: PMC10909799 DOI: 10.1002/cre2.854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/12/2023] [Accepted: 01/26/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVES Comparing the survival rate and the cumulative success rates of custom-milled polyetherketone ketone posts and cores (MPP) with prefabricated fiber posts (PFP) in restoring compromised endodontically treated premolars. MATERIAL AND METHODS This was a randomized, double-blind, parallel, two-arm controlled pilot study. A total of 24 patients (12 males, 12 females), each had a compromised lower premolar, needed a root canal treatment and to be restored with post and core. Patients were randomly allocated into two groups, MPP-group: restored with MPP, and PFP-group: restored with PFP and composite cores. After that, premolars were restored with single porcelain fused to metal (PFM) crowns. Clinical and radiographic follow-ups were conducted after 3, 6, and 12 months. The Kaplan-Meier, log-Rank, and χ2 tests were used to investigate differences between the two groups at the 0.05 significance level. RESULTS The survival rate after 12 months in the MPP and PFP groups was 66.7% and 100%, respectively. Meanwhile, the cumulative success rates were 63.6% and 100% in the same order. The log-rank test showed a significant difference between the two groups (p = .031). The difference in cumulative success rates was also significant, as the χ2 test revealed (p = .011). CONCLUSION The PFP group showed a higher success rate than the MPP group and according to the failure types, PEKK posts seem to be inferior to PFP in terms of the mechanical properties and bonding to resin mechanism. TRIAL REGISTRATION ISRCTN, ISRCTN13456471. October, 14, 2019. (https://doi.org/10.1186/ISRCTN13456471ISRCTN13456471).
Collapse
Affiliation(s)
- Naif Ghanem
- Department of Fixed Prosthodontics, Faculty of DentistryTishreen UniversityLatakiaSyria
| | - Hasan Ali
- Department of Pediatric Dentistry, Faculty of DentistryTishreen UniversityLatakiaSyria
| | - Nasser Bahrli
- Department of Fixed Prosthodontics, Faculty of DentistryTishreen UniversityLatakiaSyria
| | - Hazem Hassan
- Department of Orthodontics, Faculty of DentistryTishreen UniversityLatakiaSyria
| |
Collapse
|
2
|
Ahmad SM, Dawood SN, Dalloo GAM, Al-Barazanchi TRH. Evaluation of mechanical properties of different polyetheretherketone endodontic post systems: an in vitro study. BMC Oral Health 2023; 23:537. [PMID: 37542242 PMCID: PMC10401823 DOI: 10.1186/s12903-023-03193-7] [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: 02/23/2023] [Accepted: 06/30/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Survival of endodontically treated teeth depends on an efficient restoration of the missing tooth structure. OBJECTIVES This study aimed to investigate the mechanical properties of different endodontic post systems. MATERIALS AND METHODS Human permanent maxillary central incisors (no.=58) were decoronated and root-filled. The specimens with prepared root canals were randomly divided into Group P: Polyether Ether Ketone (PEEK) post and composite core and Group C: custom-made post-core of PEEK. The cementation of the posts was carried out using self-adhesive resin cement. Nano-hybrid composite resin was used for core fabrication. After cementation, the specimens from each group were randomly divided into two subgroups according to the types of tests utilized: 14 from each group were for the fracture strength test, which was restored with IPS e-max CAD crown, and 15 from each group for the pullout resistance test. A universal testing machine was used for the test performance. RESULTS The fracture resistance test showed that the values significantly differed among tested posts (P = 0.013). Group P showed the highest fracture resistance. Group C exhibited higher mean pullout resistance values than the other group (P) (P = 0.059). In the two-piece PEEK post and composite core, the predominant type of failure was a core fracture, while in the one-piece PEEK post-core, most types of failures were either in the crown or in the post. CONCLUSIONS The prefabricated posts are more resistant to fracture than the custom-made posts, with fracture and displacement mainly of the core. In contrast, both showed similar pullout resistance.
Collapse
Affiliation(s)
- Shawbo Muhamd Ahmad
- Department of Conservative Dentistry, College of Dentistry, University of Sulaimani, Sulaimaniyah, 0046, Iraq
| | - Shilan Nawzad Dawood
- Department of Conservative Dentistry, College of Dentistry, University of Sulaimani, Sulaimaniyah, 0046, Iraq
| | | | | |
Collapse
|
3
|
Zol SM, Alauddin MS, Said Z, Mohd Ghazali MI, Hao-Ern L, Mohd Farid DA, Zahari NAH, Al-Khadim AHA, Abdul Aziz AH. Description of Poly(aryl-ether-ketone) Materials (PAEKs), Polyetheretherketone (PEEK) and Polyetherketoneketone (PEKK) for Application as a Dental Material: A Materials Science Review. Polymers (Basel) 2023; 15:polym15092170. [PMID: 37177316 PMCID: PMC10180673 DOI: 10.3390/polym15092170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/17/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Poly(aryl-ether-ketone) materials (PAEKs), a class of high-performance polymers comprised of polyetheretherketone (PEEK) and polyetherketoneketone (PEKK), have attracted interest in standard dental procedures due to their inherent characteristics in terms of mechanical and biological properties. Polyetheretherketone (PEEK) is a restorative dental material widely used for prosthetic frameworks due to its superior physical, mechanical, aesthetic, and handling features. Meanwhile, polyetherketoneketone (PEKK) is a semi-crystalline thermoplastic embraced in the additive manufacturing market. In the present review study, a new way to fabricate high-performance polymers, particularly PEEK and PEKK, is demonstrated using additive manufacturing digital dental technology, or 3-dimensional (3D) printing. The focus in this literature review will encompass an investigation of the chemical, mechanical, and biological properties of HPPs, particularly PEEK and PEKK, along with their application particularly in dentistry. High-performance polymers have gained popularity in denture prosthesis in advance dentistry due to their flexibility in terms of manufacturing and the growing interest in utilizing additive manufacturing in denture fabrication. Further, this review also explores the literature regarding the properties of high-performance polymers (HPP) compared to previous reported polymers in terms of the dental material along with the current advancement of the digital designing and manufacturing.
Collapse
Affiliation(s)
- Syazwani Mohamad Zol
- Faculty of Dentistry, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur 55100, Malaysia
| | - Muhammad Syafiq Alauddin
- Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur 55100, Malaysia
| | - Zulfahmi Said
- Department of Basic Sciences and Oral Biology, Faculty of Dentistry, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur 55100, Malaysia
| | - Mohd Ifwat Mohd Ghazali
- SMART RG, Faculty of Science and Technology (FST), Universiti Sains Islam Malaysia (USIM), Nilai 71800, Malaysia
| | - Lee Hao-Ern
- Faculty of Dentistry, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur 55100, Malaysia
| | | | | | - Aws Hashim Ali Al-Khadim
- Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur 55100, Malaysia
| | - Azrul Hafiz Abdul Aziz
- Department of Paediatrics Dentistry and Orthodontics, Faculty of Dentistry, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur 55100, Malaysia
| |
Collapse
|
4
|
Kole S, Ergun G. Bond strength of various post-core restorations with different lengths and diameters following cycle loading. J Mech Behav Biomed Mater 2023; 142:105804. [PMID: 37062099 DOI: 10.1016/j.jmbbm.2023.105804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/20/2023] [Accepted: 03/23/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE This in vitro study aims to evaluate the bonding strengths of Polyether ether ketone (PEEK), Polyether ketone (PEKK), Fiber, and Zirconia (ZrO2) post-core restorations with posts in different diameter and length following chewing simulator. MATERIALS AND METHODS Endodontic treatment was performed on 256 intact maxillary central teeth. The test specimens were prepared in four groups according to the types of materials: Glass fiber post-composite core (FB-n:64), Zirconia post-core (Zr-n:64), PEEK post-core (PE-n:64), and PEKK post-core (PK-n:64). The groups were divided into four subgroups according to diameter and length (n:16): Group 1: 10 mm length 1.75 mm diameter, Group 2: 10 mm length 1.5 mm diameter, Group 3: 7 mm length 1.75 mm diameter, Group 4: 7 mm length 1.5 mm diameter. Custom PEKK, PEEK, Zirconia post-cores, and Zirconia crowns were milled on the CAD/CAM. The post-cores and crowns were cemented to the teeth with dual-cure resin cement. After that, all subgroups were divided into control and cyclic loading groups. During the cycling, the control test group was kept in distilled water at 37±1oC before the push-out test. Half of the specimens were loaded with 250,000 cycles and 50 N with a chewing simulator. All test specimens had 1.5 mm sections taken from their roots. Then, the push-out test was applied to these sections for bond strength. Data were analyzed by Mann-Whitney U test, Shapiro-Wilk, Kruskal-Wallis's test, and Chi-Square. The statistical significance level was determined as 0.05. RESULTS The bond strength of all test groups decreased after the cycling loading. The bond strength values of zirconia posts showed a statistically significant difference (p < 0.05). The 10 mm length 1.75 mm diameter posts made of Zirconium had the highest bond strength observed in all control and cyclic loading groups of test specimens (9.74 MPa-6.25 MPa). The PEEK test specimens with a 7 mm length and 1.75 mm diameter showed the weakest bond strength in all control and cyclic loading groups (5.44 MPa-3.37 MPa). The average of the cervical region's bond strength values was statistically significantly higher than the apical region (p < 0.05). CONCLUSION Within the limitations of this study, one-piece custom-milled Zirconia post-cores appear promising, as they perform well under functional forces, especially in the anterior region. In addition, custom-milled PEKK post-cores might be considered a suitable alternative to prefabricated fiber-reinforced posts.
Collapse
Affiliation(s)
- Serife Kole
- , Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.
| | - Gulfem Ergun
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| |
Collapse
|
5
|
Maloo LM, Toshniwal SH, Reche A, Paul P, Wanjari MB. A Sneak Peek Toward Polyaryletherketone (PAEK) Polymer: A Review. Cureus 2022; 14:e31042. [DOI: 10.7759/cureus.31042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022] Open
|
6
|
Abdelfattah Mohamed AM, El Homossany MEMB, Abdelmoniem SM, Abdelrahman TY. Comparison of tensile bond strength of ball attachments made of different materials to root canal dentin after chewing simulation. BMC Oral Health 2022; 22:254. [PMID: 35751090 PMCID: PMC9229525 DOI: 10.1186/s12903-022-02282-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Debonding of ball attachments is one of the complications that annoy teeth supported overdenture wearers. The polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) polymers are widely applied in the dental field. The purpose of the current study was to compare the tensile bond strength of ball attachments made of such materials and the commonly used titanium ones after 5 years of overdenture insertion and removal (5000 cycles) in addition to chewing simulation (1,200,000 cycle). METHODS Extracted mandibular canines (N = 60) were randomly allocated into three groups and received ball attachments; titanium (group TI; N = 20), PEEK (group PE; N = 20), PEKK (group PK; N = 20). In each group, the samples were divided into two subgroups whereas tensile bond strength was measured pre aging (T0; n = 10) and post aging (T1; n = 10). Tensile bond strength was measured by the Pull out test using the Universal testing machine. Failure mode analysis was determined by examination of the samples' surfaces under 65X stereomicroscope. The resulting data followed normal distribution and the significance level was set at (α = 0.05). RESULTS One Way Anova showed statistically significant difference between the three groups (P < .00001). PostHoc Tukey test showed statistically significant difference between the groups TI and PE, TI and PK and no statistically significant difference between the groups PE and PK. Paired t test showed statistically significant difference in the tensile bond strength pre and post aging in each group. CONCLUSIONS PEEK and PEKK ball attachments could be concluded to have a higher tensile bond strength compared to the titanium ones when bonded to root dentin. Tensile bond strength of such attachments may decrease with aging as well. Clinically, the higher tensile bond strength may have a lesser rate of debonding and thus reduced patient apprehension.
Collapse
Affiliation(s)
- Ahmed Mostafa Abdelfattah Mohamed
- Oral and Maxilofacial Prosthodontics Department, Faculty of Dentistry, AinShams University, Organization of African Unity Street, Cairo, 11561, Egypt.
| | | | | | | |
Collapse
|
7
|
Accuracy of Digital Impression Taking with Intraoral Scanners and Fabrication of CAD/CAM Posts and Cores in a Fully Digital Workflow. MATERIALS 2022; 15:ma15124199. [PMID: 35744261 PMCID: PMC9228234 DOI: 10.3390/ma15124199] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 01/16/2023]
Abstract
Current intraoral scanners (IOS) enable direct impression taking for computer-aided de-sign/computer-aided manufacturing (CAD/CAM) posts and cores (P+C) with subsequent milling out of monolithic materials. The aim of this in vitro study was to systematically investigate the accuracy of CAD/CAM-P+C in a fully digital workflow, considering different IOS impression methods (Primescan (PRI), Trios4 without (TRI) and with scanpost (TRI+SP)) (Part A), and CAD/CAM milling of zirconium dioxid (ZIR) and resin composite (COM)-P+C (Part B). Five human models were developed in this study. Micro-CT imaging was used as a reference (REF). For Part A, the models were scanned 12 times for each impression method. Then, IOS datasets (n = 180) were superimposed with REF, and scan accuracy was determined using 3D software (GOMInspect). For Part B, one CAD/CAM-P+C (n = 30) was milled for each model, impression method, and material. The triple-scan method was applied using an industrial scanner (ATOS) to determine the accuracy of the fit. Statistical analysis was performed using analysis of variance (ANOVA, p < 0.05). Part A showed for PRI significantly lower accuracy than TRI and TRI+SP (p < 0.05). The data of Part B revealed significantly higher accuracy for ZIR than for COM (p < 0.05). Within the limitations of this study, CAD/CAM-P+C of the ZIR can be recommended for fabrication in a fully digital workflow regarding the accuracy of fit.
Collapse
|
8
|
Alqurashi H, Khurshid Z, Syed AUY, Rashid Habib S, Rokaya D, Zafar MS. Polyetherketoneketone (PEKK): An emerging biomaterial for oral implants and dental prostheses. J Adv Res 2020; 28:87-95. [PMID: 33384878 PMCID: PMC7770505 DOI: 10.1016/j.jare.2020.09.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/29/2020] [Accepted: 09/08/2020] [Indexed: 12/16/2022] Open
Abstract
Polyetherketoneketone (PEKK) is a new evolving polymeric material. The present article comprehensively reviewed an overview of various applications of PEKK in prosthodontics and oral implantology, highlighting its prospects for clinical applications. PEKK biomaterials is an elastic material with good shock absorbance and fracture resistance and present ultra-high performance among all thermoplastic composites for excellent mechanical strength, chemical resistance, and high thermal stability. Available articles on PEKK for dental applications were reviewed from January 1957 to August 2020) using MEDLINE/PubMed, Web of Science, and ScienceDirect resources. PEKK presents suitable physical, mechanical, and chemical properties for applications in prosthodontics and oral implantology. PEKK has good potential for a wide range of dental applications, including tooth restorations, crowns, bridge, endoposts, denture framework, implant-supported fixed prosthesis, and dental implants. PEKK dental implants have shown lesser stress shielding compared to titanium for dental implant applications. Further modifications and improving material properties can result in broader applications in the field of dentistry. Long term evaluations are needed as PEKK is recently applied in dentistry, and there are limited studies published on PEKK.
Collapse
Affiliation(s)
- Hatim Alqurashi
- School of Clinical Dentistry, University of Sheffield, United Kingdom.,Department of Preventive Dental Sciences, School of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Azeem Ul Yaqin Syed
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Syed Rashid Habib
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Dinesh Rokaya
- Department of Clinical Dentistry, Walailak University International College of Dentistry, Bangkok 10400, Thailand
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Madinah Al Munawwarah, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| |
Collapse
|
9
|
Ozyilmaz OY, Kara O, Akin C. Evaluation of various denture cleansers on color stability and surface topography of polyetherketoneketone, polyamide, and polymethylmethacrylate. Microsc Res Tech 2020; 84:3-11. [PMID: 32757255 DOI: 10.1002/jemt.23558] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/27/2020] [Accepted: 07/07/2020] [Indexed: 11/08/2022]
Abstract
The aim of this study was to evaluate the effect of sodium perborate effervescent tablets and citric acid solution on the color stability and surface topography of a new generation of high-performance polymer polyetherketoneketone (PEKK), thermoinjection-molded polyamide, and polymethylmethacrylate (PMMA). Fifty disc-shaped specimens were fabricated (10 mm × 2 mm) from PEKK (P group), polyamide (D group), and PMMA (M group). These groups were divided into five subgroups (n = 10) according to the storage media. The test groups were immersed in the following solutions: distilled water (Control), Corega, Protefix, Perlodent, and Curaprox. The color stability values (ΔE) were measured using a spectrophotometer before and after immersion in distilled water and four different denture cleansers for 8 hr/day for 140 days. Topography alterations after treatments were assessed with scanning electron microscopy (SEM). Data were analyzed by one-way analysis of variance (ANOVA) followed by Tukey's Honest Significant Difference test. The p < .05 was considered significant. All denture cleansers increased the ΔE values relative to the baseline values in the M, D, and P groups (p < .05). The Perlodent denture cleanser demonstrated the highest ΔE value in all groups, which was unacceptable. Curaprox denture cleanser showed the lowest ΔE value in the M and D groups (p < .05). Curaprox in all groups showed a ∆E value less than 3.7. For patients who have PEKK- and polyamide-based prosthesis, the use of citric acid-based cleansers may be more recommended than sodium perborate-containing cleansers because of its clinically acceptable color changes on polymers in terms of color stability.
Collapse
Affiliation(s)
- Ozgun Yusuf Ozyilmaz
- Department of Prosthodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Ozlem Kara
- Department of Prosthodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Ceyda Akin
- Department of Prosthodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| |
Collapse
|