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Türksayar AAD, Petersmann S, Spintzyk S. The effect of thermomechanical aging on the fracture resistance of additive and subtractive manufactured polyetheretherketone abutments. J Dent 2024:105225. [PMID: 38969266 DOI: 10.1016/j.jdent.2024.105225] [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: 02/17/2024] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024] Open
Abstract
OBJECTIVES To evaluate the fracture resistance (FR) of polyetheretherketone (PEEK) abutments produced by additive and subtractive methods compared to milled zirconia abutments. METHODS Custom abutments were designed on Ti-base abutments and produced from three different materials, namely additively manufactured PEEK (PEEK-AM), subtractively manufactured PEEK (PEEK-SM), and zirconia (N=60). PEEK-AM abutments were printed using PEEK filaments (VESTAKEEP®i4 3DF-T, Evonik Industries AG) on a M150 Medical 3D Printer (ORION AM) by fused filament fabrication (FFF). All surface treatments were carried out according to the manufacturer's instructions. All abutments were cemented on Ti-bases with hybrid abutment cement and then restored with milled zirconia crowns. Each subgroup was divided into non-aged and aged subgroups (n=10). The aged groups were subjected to thermomechanical aging (49 N, 5-55°C, 1.2 million cycles). FR tests were performed by using a universal testing machine. Data were statistically analyzed with one-way and two-way ANOVA and t-test. RESULTS The survival rate of the specimens after aging was determined as 100%. It was found that both the material and aging had a significant effect on the FR (p<.001). There was a statistical difference among the fracture values of the groups (p<0.001). In both the aged and non-aged groups, PEEK-AM showed the statistically lowest FR, while the highest FR was seen in the zirconia group, which was significantly higher than the PEEK-SM (p<0.001). CONCLUSION Hybrid abutments were successfully manufactured, and extrusion-based processed PEEK seems to be a good alternative to subtractive processed PEEK. However, since subtractive manufacturing still appears to be superior, further developments in additive manufacturing are needed to further improve the quality of 3D-printed PEEK parts, especially in terms of accuracy and bonding between adjacent layers. CLINICAL SIGNIFICANCE Additively manufactured PEEK abutments have the potential to be an alternative for implant-supported restorations in the posterior region.
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Affiliation(s)
- Almira Ada Diken Türksayar
- Department of Prosthodontics, Biruni University, Faculty of Dentistry, İstanbul, Turkey; ADMiRE Research Center, Carinthia University of Applied Sciences, Europastrasse, 9524 Villach, Austria.
| | - Sandra Petersmann
- ADMiRE Research Center, Carinthia University of Applied Sciences, Europastrasse, 9524 Villach, Austria
| | - Sebastian Spintzyk
- ADMiRE Research Center, Carinthia University of Applied Sciences, Europastrasse, 9524 Villach, Austria
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de Matos JDM, Lopes GDRS, Nakano LJN, Ramos NDC, Vasconcelos JELD, Bottino MA, Tribst JPM. Biomechanical evaluation of 3-unit fixed partial dentures on monotype and two-piece zirconia dental implants. Comput Methods Biomech Biomed Engin 2021; 25:239-246. [PMID: 34559574 DOI: 10.1080/10255842.2021.1946798] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study aimed to evaluate the biomechanical behavior, stress distributions and bone microstrain of fixed partial dentures (FPD) with ceramic abutments supported on monotype zirconia implants, titanium implants and two-piece zirconia implants, using finite element analysis. A three-dimensional model of the jaw was simulated containing 1.0 mm thick cortical bone and cancellous bone tissue. A FPD and implant models (4.1 x 10 mm) were modeled containing a cement-retained implant abutment. These models were replicated in three groups with similar geometries: Titanium Implant and Zirconia Abutment (Ti-Zr); Zirconia Implant and Zirconia Abutment (Zr-Zr) and Monotype Zirconia Implant (Zr-S). An axial load of 300 N was applied to the center of the first premolar. The microstrain (με) and the Von-Mises stress (MPa) were assumed as failures criteria. For the three groups, a higher stress concentration was observed in the region of FPD connectors. The Ti-Zr group showed a higher stress concentration in the prosthesis and implant when compared to the other groups. However, the smaller elastic modulus of the titanium implant, in relation to the zirconia, provided a lower stress in the abutment and in the prosthetic screw. The monotype implant system allowed a more homogeneous stress distribution and its strain were predominantly located in the cervical region of the peri-implant bone tissue. Monotype or two-piece zirconia implants can be used for rehabilitation with FPD. However, the absence of separation between implant and abutment in the monotype system avoids the stress concentration in the prosthetic screw and reduced the peri-implant bone strain.
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Affiliation(s)
- Jefferson David Melo de Matos
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Sao Paulo, Brazil
| | - Guilherme da Rocha Scalzer Lopes
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Sao Paulo, Brazil
| | - Leonardo Jiro Nomura Nakano
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Sao Paulo, Brazil
| | - Nathália de Carvalho Ramos
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Sao Paulo, Brazil.,Department of Dentistry, Universidade São Francisco (USF), Bragança Paulista, Brazil
| | | | - Marco Antonio Bottino
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Sao Paulo, Brazil
| | - João Paulo Mendes Tribst
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Sao Paulo, Brazil.,Department of Dentistry, University of Taubaté (UNITAU), Taubaté, Brazil
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Review on Development and Dental Applications of Polyetheretherketone-Based Biomaterials and Restorations. MATERIALS 2021; 14:ma14020408. [PMID: 33467576 PMCID: PMC7830426 DOI: 10.3390/ma14020408] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 12/15/2022]
Abstract
Polyetheretherketone (PEEK) is an important high-performance thermoplastic. Its excellent strength, stiffness, toughness, fatigue resistance, biocompatibility, chemical stability and radiolucency have made PEEK attractive in dental and orthopedic applications. However, PEEK has an inherently hydrophobic and chemically inert surface, which has restricted its widespread use in clinical applications, especially in bonding with dental resin composites. Cutting edge research on novel methods to improve PEEK applications in dentistry, including oral implant, prosthodontics and orthodontics, is reviewed in this article. In addition, this article also discusses innovative surface modifications of PEEK, which are a focus area of active investigations. Furthermore, this article also discusses the necessary future studies and clinical trials for the use of PEEK in the human oral environment to investigate its feasibility and long-term performance.
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Bethke A, Pieralli S, Kohal RJ, Burkhardt F, von Stein-Lausnitz M, Vach K, Spies BC. Fracture Resistance of Zirconia Oral Implants In Vitro: A Systematic Review and Meta-Analysis. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E562. [PMID: 31991565 PMCID: PMC7040771 DOI: 10.3390/ma13030562] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/15/2020] [Accepted: 01/21/2020] [Indexed: 12/27/2022]
Abstract
Various protocols are available to preclinically assess the fracture resistance of zirconia oral implants. The objective of the present review was to determine the impact of different treatments (dynamic loading, hydrothermal aging) and implant features (e.g., material, design or manufacturing) on the fracture resistance of zirconia implants. An electronic screening of two databases (MEDLINE/Pubmed, Embase) was performed. Investigations including > 5 screw-shaped implants providing information to calculate the bending moment at the time point of static loading to fracture were considered. Data was extracted and meta-analyses were conducted using multilevel mixed-effects generalized linear models (GLMs). The Šidák method was used to correct for multiple testing. The initial search resulted in 1864 articles, and finally 19 investigations loading 731 zirconia implants to fracture were analyzed. In general, fracture resistance was affected by the implant design (1-piece > 2-piece, p = 0.004), material (alumina-toughened zirconia/ATZ > yttria-stabilized tetragonal zirconia polycrystal/Y-TZP, p = 0.002) and abutment preparation (untouched > modified/grinded, p < 0.001). In case of 2-piece implants, the amount of dynamic loading cycles prior to static loading (p < 0.001) or anatomical crown supply (p < 0.001) negatively affected the outcome. No impact was found for hydrothermal aging. Heterogeneous findings of the present review highlight the importance of thoroughly and individually evaluating the fracture resistance of every zirconia implant system prior to market release.
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Affiliation(s)
- Annalena Bethke
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
| | - Stefano Pieralli
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
| | - Felix Burkhardt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
| | - Manja von Stein-Lausnitz
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Stefan-Meier-Str. 26, 79104 Freiburg, Germany;
| | - Benedikt Christopher Spies
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
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