Effect of different surface pre-treatments and luting materials on shear bond strength to PEEK

PEEK and glass fiber post pushout bond strength and vickers hardness of canal disinfected with curcumin photosensitizer activated by microbubble emulsion and sodium-hypochlorite with EDTA

AIMS

Impact of different post-space disinfectants (Saline, Sodium hypochlorite (NaOCl) followed by ethylene-diamine-tetra-acetic acid (EDTA) and curcumin activated by microbubble emulsion (MBE) on the Vickers hardness (VH) of root canal dentin and extrusion bond strength (EBS) of Glass fiber post (GFP) and PEEK post.

METHODS

Ninety maxillary central incisors having fully formed roots were included. After the specimen's disinfection, root canal treatment was completed. Post space was prepared by removing gutta-percha using gates glidden drills. Teeth were then arbitrarily allocated into three groups based on the methods of disinfection regime used. Group 1: Saline, Group 2: NaOCl+ EDTA and Group 3: Curcumin activated by MBE (n = 30). Analysis of VH of radicular dentin was performed using a micro-Vickers tester on ten samples from each group. After post-space disinfection, twenty specimens from each group were further divided into two subgroups (n = 10) In group-1A 2A, and 3A, GFP was used. Whereas, prefabricated PEEK posts were used in 1B, 2B, and 3B subgroups. The PBS and failure modes were performed using a universal testing machine and stereomicroscope respectively. Data was analyzed using ANOVA and Tukey post hoc test to identify significant variations among groups concerning the MH and EBS of the different posts used (p = 0.05).

RESULTS

Group 2 (5.25 % NaOCl + 17 % EDTA) (0.15 ± 0.02 GPa) treated specimens presented lowest scores of VH. However, Group 1 (Saline) irrigated canals displayed the highest scores of surface hardness (0.25 ± 0.07 GPa). Additionally, a cervical third of 3A (CP activated by MBE + GFP) (11.22 ± 0.79 MPa) presented the highest scores of bond integrity. Whereas Group 1B (Saline + PEEK post) treated specimens presented the lowest scores of PBS (4.15 ± 0.15 MPa).

CONCLUSION

Curcumin activated by microbubble emulsion for disinfection of canal dentin demonstrated favorable VH. Similarly, glass fiber post-cemented in radicular walls disinfected with curcumin activated with MBE showed promising post-bond integrity to the canal dentin.

Effect of surface treatment and resin cement type on the bond strength of polyetheretherketone to lithium disilicate ceramic

BACKGROUND

This study aims to evaluate the effect of surface treatment and resin cement on the shear bond strength (SBS) and mode of failure of polyetheretherketone (PEEK) to lithium disilicate ceramic (LDC). This is suggested to study alternative veneering of PEEK frameworks with a ceramic material.

METHODS

eighty discs were prepared from PEEK blank and from lithium disilicate ceramic. Samples were divided into four groups according to surface treatment: Group (A) air abraded with 110 μm Al2O3, Group (AP) air abrasion and primer application, Group (S) 98% sulfuric acid etching for 60 s, Group (SP) Sulfuric acid and primer. Each group was subdivided into two subgroups based on resin cement type used for bonding LDC:1) subgroup (L) self- adhesive resin cement and 2) subgroup (B) conventional resin cement (n = 10). Thermocycling was done for all samples. The bond strength was assessed using the shear bond strength test (SBS). Failure mode analysis was done at 50X magnification with a stereomicroscope. Samples were chosen from each group for scanning electron microscope (SEM). The three-way nested ANOVA followed by Tukey's post hoc test were used for statistical analysis of results. Comparisons of effects were done utilizing one way ANOVA and (p < 0.05).

RESULTS

The highest mean of shear bond strength values was demonstrated in Group of air abrasion with primer application using conventional resin cement (APB) (12.21 ± 2.14 MPa). Sulfuric acid groups showed lower shear bond strength values and the majority failed in thermocycling especially when no primer was applied. The failure mode analysis showed that the predominant failure type was adhesive failure between cement and PEEK, while the remaining was mixed failure between cement and PEEK.

CONCLUSION

The air abrasion followed by primer application and conventional resin cement used for bonding Lithium Disilicate to PEEK achieved the best bond strength. Primer application did not have an effect when self-adhesive resin cement was used in air-abraded groups. Priming step is mandatory whenever sulfuric acid etching surface treatment is utilized for PEEK.

Effect of adhesive system, resin cement, heat-pressing technique, and thermomechanical aging on the adhesion between titanium base and a high-performance polymer

STATEMENT OF PROBLEM

Even though polyetheretherketone (PEEK) has become popular for various prosthetic indications, a standard adhesive protocol to bond the PEEK to titanium bases has not been yet established. How the heat-pressing technique performs in this respect is also not clear.

PURPOSE

The purpose of this in vitro study was to investigate the effect of an adhesive system-cement combination, the heat-pressing technique, and thermomechanical aging on the retention force between titanium bases and PEEK specimens.

MATERIAL AND METHODS

Sixty 9×11×20-mm PEEK specimens with a titanium base slot integrated into the design were milled to simulate an implant-supported PEEK framework for a cantilevered fixed prosthesis. The specimens were assigned to 8 groups (n=10) according to the titanium base primer (MKZ or Monobond) and resin cement (DTK or Multilink hybrid) used and with or without thermomechanical aging. Twenty PEEK specimens were directly heat-pressed on titanium bases, and half of the specimens were not subjected to thermomechanical aging (n=10). For nonaged groups, the PEEK specimen complex was tightened to an implant analog and secured on a custom-made pull-off device. Retention forces were measured by using the pull-off tensile test in a universal testing machine, and the maximum tensile bond strength (MPa) was calculated. The aged groups were subjected to 5000 cycles of thermal aging (5 °C to 55 °C), and the specimens were clamped to load the extension (cantilever) for 1 200 000 cycles with 120 N and 200 N at 1.5-Hz frequency. After aging, the pull-off test was performed for those specimens that survived thermomechanical aging. A nonparametric Kruskal-Wallis test was used to determine whether there was a difference among the groups, followed by pairwise Wilcoxon rank tests with Bonferroni correction. The Wilcoxon rank test was used to analyze the effect of thermomechanical aging in each adhesive system-cement or heat-press group (α=.05 for all tests).

RESULTS

None of the specimens failed during cyclic loading. According to the Kruskal-Wallis test, the effect of the PEEK-Ti base bonding technique on the retention force in the nonaged (P=.019) and thermomechanically aged groups was significant (P=.010). In the nonaged groups, the heat-pressing technique resulted in a higher retention force than when the specimens were bonded by using the Monobond-Multilink hybrid combination (P=.031). Thermomechanical aging did not significantly affect the results (P>.241). All failures were adhesive, with cement remaining only on the Ti-bases.

CONCLUSIONS

All bonding protocols tested resulted in a stable bond between PEEK and Ti-bases, as all specimens survived thermomechanical aging. The heat-pressing technique resulted in mean bond strength values similar to those obtained with the tested adhesive system-cement combinations with 1 exception; the nonaged heat-pressed groups presented higher bond strength than the Monobond-Multilink hybrid combination. Failure types indicated that the weaker bond was between the PEEK and the cements tested rather than between the titanium base and the cements, regardless of the adhesive system-cement combination.

Effect of laser engraving on shear bond strength of polyetheretherketone to indirect composite and denture-base resins

Background/purpose

Polyetheretherketone (PEEK) is a highly sought-after thermoplastic due to its exceptional mechanical properties and biocompatibility. However, bonding PEEK to indirect composite resin (ICR) or denture-based resin (DBR) can be challenging. Laser engraving technology has shown potential to improve bonding for other materials; thus, this study aims to evaluate its effectiveness for PEEK.

Materials and methods

The experiment involved preparing ingot-shaped PEEK samples, which were then categorized into four groups based on the treatment method employed: without treatment, air abrasion, sulfuric acid etching, and laser engraving (LS). Subsequently, the samples were bonded to ICR or DBR, and their shear bond strength (SBS) was tested with or without thermocycling using a universal testing machine. Furthermore, the failure mode was observed, with statistical analyses conducted to compare the results.

Results

The grid-like microslit structure of LS group displayed the highest SBS for bonding PEEK to ICR or DBR (P < 0.05). During the bonding of PEEK to ICR, resin residue and penetration into the microslits were frequently observed in the LS group, indicating cohesive failure. However, when PEEK was bonded to DBR, mixture failure was frequently observed without thermocycling. After thermocycling, only the LS group showed cohesive failure, while the majority of specimens exhibited mixture failure.

Conclusion

Laser engraving significantly improves the SBS between PEEK and both ICR and DBR. Furthermore, it was observed that resin had penetrated the microslits, indicating that laser engraving has great potential as a surface treatment method.

New adhesive protocol improves shear bond strength of Polyetherketoneketone (PEKK)

OBJECTIVE

Inert surface of Polyetherketoneketone (PEKK) jeopardizes resin bonding. This study aimed to present a new adhesive protocol to improve PEKK bonding.

METHODS

A total of 360 PEKK blocks were milled, polished (maximum roughness of 0.20 µm), and randomly assigned to groups. The new protocol was applied (n = 36) and compared to conventional treatments (no treatment; sandblasting (110-µm Al2O3 and silica); no adhesive; Visiolink (Bredent); and PEKKbond (AnaxDent)) (n = 36). For the new protocol, the surface was blasted (110 µm Al2O3 and 96% isopropyl alcohol at 60 psi), followed by 96% isopropyl alcohol washing, and air drying. PEKKbond was applied (dried for 3 min at 77 °C), followed by Visiolink (dried for 3 min at 60 °C); both light-cured for 3 min (800 mW/cm2). Preopaque (GC Europe) and Opaque (AnaxDent) were applied and light-cured (5 min). Morphological topography was analyzed, and flowable gingiva-colored composite (AnaxGum, AnaxDent) was bonded. All specimens were aged for 24 h and thermocycled (5000 cycles, 5-55 °C). Shear bond strength (SBS) was measured (MPa) and data were analyzed by two-way ANOVA, Tukey, and Weibull moduli estimation (α = 0.05).

RESULTS

The highest SBS values were found in the new protocol (p < 0.05), regardless of aging. Thermocycling reduced SBS (p < 0.05), while Al2O3 and PEKKbond produced higher SBS values than silica and Visiolink, respectively (p < 0.05).

SIGNIFICANCE

The new protocol strongly improves PEKK adhesiveness, and this can reflect in the longevity of prostheses.

PEEK surface treatment on surface roughness and bond integrity to composite resin utilizing Er: YAG, Rosebengal activated by PDT, and aluminum trioxide particles

AIMS

To evaluate the impact of conditioning protocols, aluminum trioxide (Al2O3), Er:YAG laser (EYL), and Rosebengal (RB), on the surface roughness (Ra) and shear bond strength (SBS) of polyetheretherketone (PEEK) attached to composite restorations.

METHOD

Eighty PEEK discs in total were produced and then divided into four groups (n = 20). Group1:Sulfuric acid (SA), Group 2: PDT (RB), Group 3: Al2O3, Group 4 EYL, respectively. The Ra of PEEK discs was evaluated using the surface profilometer. After being luted, the discs were attached to composite resin discs. After that, samples were put to SBS testing on a Universal testing apparatus. A stereo microscope was also used to evaluate the type of breakdown. The data were analyzed using Tukey's test and one-way analysis of variance.

RESULTS

The SA treated group exhibited the highest Ra. Nevertheless, the RB specimens activated by PDT treatment had the lowest mean Ra score. The group that received the treatment of SA exhibited the highest average score of SBS. In contrast, specimens treated with PDT and activated by RB exhibited the lowest levels of bond fidelity. Cohesive failure emerges as the prevailing kind of fracture within the various groups subjected to testing.

CONCLUSION

The utilization of Al2O3, RB activated by PDT, and EYL shows promise as a viable substitute for Sulfuric acid in enhancing the bond integrity of composite cement and surface roughness in PEEK materials.

Novel Carboxylation Method for Polyetheretherketone (PEEK) Surface Modification Using Friedel-Crafts Acylation

Recently, polyetheretherketone (PEEK) has shown promising dental applications. Surface treatment is essential for dental applications owing to its poor surface energy and wettability; however, no consensus on an effective treatment method has been achieved. In this study, we attempted to carboxylate PEEK sample surfaces via Friedel-Crafts acylation using succinic anhydride and AlBr3. The possibility of further chemical modifications using carboxyl groups was examined. The samples were subjected to dehydration-condensation reactions with 1H,1H-pentadecafluorooctylamine and N,N'-dicyclohexylcarbodiimide. Furthermore, the sample's surface properties at each reaction stage were evaluated. An absorption band in the 3300-3500 cm-1 wavenumber region was observed. Additionally, peak suggestive of COOH was observed in the sample spectra. Secondary modification diminished the absorption band in 3300-3500 cm-1 and a clear F1s signal was observed. Thus, Friedel-Crafts acylation with succinic anhydride produced carboxyl groups on the PEEK sample surfaces. Further chemical modification of the carboxyl groups by dehydration-condensation reactions is also possible. Thus, a series of reactions can be employed to impart desired chemical structures to PEEK surfaces.

Poly-Ether Ether-Ketone Post Conditioned with Sulfuric Acid, Rose Bengal Activated by Photodynamic Therapy and Sandblasting on Pushout Bond Strength to Radicular Dentin Luted with Methyl Methacrylate and Composite-Based Cement

Objective: Assessment of post surface conditioners [sulfuric acid (SA), Rose Bengal (RB), and sandblasting (SB)] and different luting cements [methyl methacrylate (MMA)-based cement and composite-based cement] on pushout bond strength (PBS) of poly-ether ether-ketone (PEEK) post bonded to canal dentin. Materials and methods: Endodontic treatment was performed on 120 single-rooted human premolar teeth. The preparation of the post space was performed and 4 mm of gutta-percha was retained in the apical region of the root. One hundred and twenty PEEK posts were fabricated from a PEEK blank utilizing a Computer aided design-Computer aided manufacture (CAD-CAM) system. The PEEK posts were allocated randomly into four groups based on post surface conditioning (n = 30). Group A: SA, Group B: RB, Group C: SB, and Group D: No conditioning (NC). Each group was further divided into two subgroups based on the luting cement used for bonding (n = 15). Group A1, B1, C1, and D1 specimens were cemented using composite-based resin cement. However, Group A2, B2, C2, and D2 posts were luted with MMA-based resin cement. PBS assessment using a universal testing machine was performed. Failure modes were analyzed under a stereomicroscope. The data relating to the effects of surface treatment and luting types of cement were analyzed using one-way analysis of variance (ANOVA) and Tukey's post hoc test (p = 0.05). Results: Coronal section of Group B2: RB+Super-Bond C&B [9.61 ± 0.75 megapascals (MPa)] displayed the highest bond scores of PEEK after root dentin. Whereas it was also discovered that Group D1: NC+Panavia®V5 (2.05 ± 0.72 MPa) presented the lowest PBS scores. Intergroup comparison analysis revealed that Group A2: SA+Super-Bond C&B and Group B2: RB+Super-Bond C&B displayed no significant difference in their bond scores. Conclusions: RB and SA possess the potential to be used as a PEEK post conditioner. MMA-based cement displayed better performance than composite-based cement.

Modulation of implants PEEK to composite resin shear bond strength and surface roughness on pre-treatment with contemporary air abrasion techniques vs photodynamic therapy vs conventional diamond grit bur

AIM

The chief aim of the study was to determine/equate the surface roughness (SRa) and shear bond strength (BS) of pretreated PEEK discs with contemporary air abrasion techniques, photodynamic (PD) therapy by curcumin photosensitizer (PS) and conventional diamond grit straight fissure bur adhered to the composite resin discs.

MATERIAL AND METHOD

Two hundred discs of PEEK were prepared of 6 mm × 2 mm × 10 mm dimension. The discs were randomly divided into five groups (n = 40) for treatment, Group I: treatment with deionized distilled water (control group); Group II: PD therapy using curcumin PS; Group III: discs treated and abraded with air-borne particles (ABP) silica (30 μm particle size) modified alumina (Al); Group IV: ABP of alumina (110 μm particle size); and Group V: The PEEK were finished with 600-μm grit size straight diamond cutting bur installed in high speed hand-piece. The surface profilometer was used to evaluate the values of surface roughness (SRa) of pretreated PEEK discs. The discs were luted and bonded to discs of composite resin. The bonded PEEK samples were placed in Universal testing machine to evaluate shear BS. The type of BS failure for PEEK discs pre-treated with five regimes respectively was evaluated under stereo-microscope. The data was statistically analyzed using one-way ANOVA and the comparisons between mean values of shear BS were evaluated by Tukey's test (ρ≤0.05).

RESULTS

The PEEK samples pre-treated with diamond cutting straight fissure burs displayed statistically significant highest value of SRa values (3.258± 0.785 µm). Similarly, the shear BS was observed to be higher for the PEEK discs pre-treated with straight fissure bur (22.37±0.78 MPa). A comparable difference but not statistically significant difference was observed between PEEK discs pre-treated by curcumin PS and ABP-silica modified alumina (ρ ≥ 0.05).

CONCLUSION

PEEK discs pre-treated with diamond grit straight fissure bur displayed highest values of SRa and shear BS. It was trailed by ABP-Al pre-treated discs; whereas the SRa and shear BS values for the discs pre-treated with ABP-silica modified Al and curcumin PS did not show competitive difference.

Using Peek as a Framework Material for Maxillofacial Silicone Prosthesis: An In Vitro Study

There are often bonding problems between acrylic resins and silicone. PEEK (polyetheretherketone), which is a high-performance polymer, has great potential for the implant, and fixed or removable prosthodontics. The aim of this study was to evaluate the effect of different surface treatments on PEEK to be bonded to maxillofacial silicone elastomers. A total of 48 specimens were fabricated from either PEEK or PMMA (Polymethylmethacrylate) (n = 8). PMMA specimens acted as a positive control group. PEEK specimens were divided into five study groups as surface treatments as control PEEK, silica-coating, plasma etching, grinding, or nano-second fiber laser. Surface topographies were evaluated by scanning electron microscopy (SEM). A platinum-primer was used on top of all specimens including control groups prior to silicone polymerization. The peel bond strength of the specimens to a platinum-type silicone elastomer was tested at a cross-head speed of 5 mm/min. The data were statistically analyzed (α = 0.05). The control PEEK group showed the highest bond strength (p < 0.05) among the groups. No statistical difference was found between control PEEK, grinding, or plasma etching groups (p > 0.05). The lowest bond strength was seen in the laser group, which was not statistically different from silica-coating (p > 0.05), and statistically different from control PEEK, grinding, or plasma groups (p < 0.05). Positive control PMMA specimens had statistically lower bond strength than either control PEEK or plasma etching groups (p < 0.05). All specimens exhibited adhesive failure after a peel test. The study results indicate that PEEK could serve as a potential alternative substructure for implant-retained silicone prostheses.

Influence of surface treatment on repair bond strength of CAD/CAM long-term provisional restorative materials: an in vitro study

BACKGROUND

The surface treatment to improve the repair bond strength may vary because CAD/CAM provisional restoration polymers exhibit a variety of microstructures. This study was conducted to evaluate the effect of surface treatments on the repairability of three different CAD/CAM polymers for long-term provisional restorations.

METHODS

Thirty specimens from each provisional restorative materials (CAD-Temp, Everest C-Temp, and PEEK) were divided into three groups: C: surfaces received no treatment; SB: surfaces were airborne particle abraded with 50 μm aluminum oxide; SB-T: surfaces received the same conditions as group SB in addition to thermocycling before and after treatment. Primer and nanohybrid repair resin composite were applied to the prepared CAD /CAM surfaces. The shear bond strength and the mode of failure were assessed. ANOVA and Tukey's significant difference tests were used to evaluate the data.

RESULTS

The SB group had significantly higher repair SBS values (p < .001) compared to the other groups (C and SB-T). Everest C-Temp significantly recorded the highest repair SBS (17.84 ± 0.19 MPa) in group SB, while the lowest repair SBS values (5.51 ± 1.14 MPa) for CAD-Temp were recorded in group C. PEEK significantly recorded the second highest repair SBS (15.96 ± 0.18) in the SB group.

CONCLUSIONS

Everest C-Temp had the highest repair SBS after an airborne abrasion particle. Thermocycling had no significant effect on the repair SBS for PEEK. Everest C-Temp and PEEK are recommended as long-term durable provisional materials for clinical use.

Surface conditioning of PEEK post using Nd: YVO4 laser, Photodynamic therapy, and sulfuric acid on the pushout bond strength to canal dentin

AIM

To assess the push-out bond strength (PBS) of polyetheretherketone (PEEK) post-to-root dentin using post-surface conditioners i.e., Neodymium-doped yttrium orthovanadate (Nd: YVO4) and Riboflavin (RF) and Rose Bengal (RB) mediated photodynamic therapy (PDT) compared to sulfuric acid (SA).

MATERIALS AND METHODS

Decoronation of forty human single-rooted premolar teeth was performed. Followed by chamber opening, working length (WL) was established at 15 mm. Root canal preparation was completed using ProTaper Ni-Ti rotary system till F3 finishing file along with root canal disinfection. The canals were dried with paper cones followed by obturation using gutta-percha (GP) and AH sealer. Post space was prepared by drilling out 11 mm of GP using a Gates Glidden drill #3. PEEK posts were fabricated using the CAD-CAM system and then randomly allocated into 4 groups based on the post-surface conditioning (n=10). Group 1: SA, group 2: PDT RF, group 3: PDT RB, and group 4: Nd: YVO4 laser. The PEEK post was then cemented in their respective canal. PBS and failure mode assessment were performed using a universal testing machine and stereomicroscope at 40x magnification. The SBS data set was subjected to a one-way analysis of variance (ANOVA) and Tukey's Post Hoc test at a significance level of 0.05.

RESULTS

The samples in group 4 (Nd: YVO4 laser) coronal third (7.99±0.24 MPa) demonstrated the highest PBS. The apical third of samples in group 1 PEEK post surface conditioned with SA (5.15± 0.52 MPa) exhibited the minimum values of PBS. Intergroup comparison analysis showed that samples in group 1 (SA), group 2 (RF activated by PDT), group 3 (RB activated by PDT), and group 4 (Nd: YVO4 laser) demonstrated comparable outcomes of bond scores (p>0.05) CONCLUSION: Neodymium-doped yttrium orthovanadate (Nd: YVO4) and riboflavin and Rose bengal activated by photodynamic therapy (PDT) have been investigated as potential alternatives for the surface conditioning of PEEK (polyetheretherketone) posts.

Determination of Shear Bond Strength between PEEK Composites and Veneering Composites for the Production of Dental Restorations

We studied the shear bond strength (SBS) of two PEEK composites (BioHPP, BioHPP plus) with three veneering composites: Visio.lign, SR Nexco and VITA VM LC, depending on the surface treatment: untreated, sandblasted with 110 μm Al₂O₃, sandblasted and cleaned ultrasonically in 80% ethanol, with or without adhesive Visio.link, with applied Visio.link and MKZ primer. For the BioHPP plus, differential scanning calorimetry (DSC) revealed a slightly lower glass transition temperature (T_g 150.4 ± 0.4 °C) and higher melting temperature (T_m 339.4 ± 0.6 °C) than those of BioHPP (T_g 151.3 ± 1.3 °C, T_m 338.7 ± 0.2 °C). The dynamical mechanical analysis (DMA) revealed a slightly higher storage modulus of BioHPP (E' 4.258 ± 0.093 GPa) than of BioHPP plus (E' 4.193 ± 0.09 GPa). The roughness was the highest for the untreated BioHPP plus, and the lowest for the polished BioHPP. The highest hydrophobicity was achieved on the sandblasted BioHPP plus, whereas the highest hydrophilicity was found on the untreated BioHPP. The highest SBSs were determined for BioHPP and Visio.lign, adhesive Visio.link (26.31 ± 4.17 MPa) or MKZ primer (25.59 ± 3.17 MPa), with VITA VM LC, MKZ primer and Visio.link (25.51 ± 1.94 MPa), and ultrasonically cleaned, with Visio.link (26.28 ± 2.94 MPa). For BioHPP plus, the highest SBS was determined for a sandblasted surface, cleaned ultrasonically, with the SR Nexco and Visio.link (23.39 ± 2.80 MPa).

Comparing the shear bond strength of veneering materials to the PAEKs after surface treatments

Background

This study aimed to evaluate the impact of various surface treatments on the shear bond strength (SBS) of polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) polymers to indirect laboratory composite (ILC) and lithium disilicate ceramic (LDC) veneering materials.

Methods

Polymer specimens (7 × 7x2 mm) were sectioned from PEEK and PEKK discs (N = 294) and randomly allocated to 7 groups (n = 20); untreated (Cnt), plasma (Pls), 98% sulfuric acid (Sa), sandblasting with 110 µm Al2O3 (Sb), tribochemical silica coating with 110 µm silica modified Al2O3 (Tbc), Sb + Sa, Tbc + Sa. Scanning electron microscopy assessments were performed on one sample of each treatment group, and veneering materials were applied to the remaining specimens (n = 10). The specimens were subjected to the SBS test after being soaked in distilled water (24 h, 37 °C). Three-way ANOVA, independent sample t-test, and Tukey HSD test were performed for statistical analyses (α = .05).

Results

The surface treatment, polymer, veneering material types, and their interactions were significant on SBS results according to the 3-way ANOVA (p < 0.001). The SBS values of ILC veneered groups were significantly higher than LDC groups, regardless of surface treatment and polymer type (p < 0.05). The highest SBS values were obtained for Sa-applied ILC veneered PEEK (21.55 ± 1.45 MPa) and PEKK (17.04 ± 1.99 MPa) polymer groups (p < 0.05).

Conclusion

The effect of surface treatment and veneering materials may be significant on the SBS values of PAEKs. Therefore, the application parameters of surface treatments should be more specified for the applied veneering material and polymer type.

Surface Characteristics and Adhesion of Veneering Composite Resin to PAEK-Based Substructure Restorative Materials

PURPOSE

To evaluate and compare the shear bond strength (SBS) of composite veneering material to polyetherketoneketone (PEKK), polyetheretherketone (PEEK), zirconia (YZ), and nickel-chromium alloy (NiCr) substructure restorative materials.

MATERIALS AND METHODS

Forty samples (12 × 2 mm) were prepared from four materials: PEKK, PEEK, zirconia, and NiCr alloy (n = 10). The Vickers hardness was evaluated before preparing the surface for bonding by shot-blasting using 110 μm Al₂ O₃ particles. The surface roughness (Ra) of each sample was determined using a noncontact optical profilometer. The veneering resin was bonded onto each sample following primer application. The prepared samples were then subjected to an SBS test using a universal testing machine at 0.5 mm/min crosshead speed. Failure modes and surface topography following debonding were assessed. The data were statistically analyzed using ANOVA and Tukey's post-hoc comparison test (p < 0.05).  RESULTS: The highest and lowest mean surface roughness was observed in PEEK (3.45 ±0.13 μm) and NiCr (1.87 ±0.07 μm) materials, respectively. A significant difference in roughness values was observed between the materials except for NiCr and YZ (p = 0.547). Concerning SBS, PEEK and NiCr exhibited the highest (16.23 ±0.96 MPa) and lowest (10.1 ±0.63 MPa) values. The mean difference in SBS indicated a statistically significant difference between the material groups (p < 0.01).

CONCLUSIONS

PEKK materials demonstrated significantly lower SBS than PEEK and significantly higher SBS values than conventional zirconia and alloy materials. A positive and significant correlation between mean roughness and SBS was observed, but the causality could be either intrinsic to the material or the roughness.

Use of Piranha Solution as An Alternative Route to Promote Bioactivation of PEEK Surface with Low Functionalization Times

This study aimed to achieve bioactivity on the PEEK surface using piranha solution through a lower functionalization time. For this purpose, the functionalization occurred with piranha solution and 98% sulfuric acid in the proportions of 1:2, 1:1, and 2:1 at periods of 30, 60, and 90 s. The samples treated for longer times at higher concentrations registered the characteristic spectroscopy band associated with sulfonation. Additionally, both chemical treatments allowed the opening of the aromatic ring, increasing the number of functional groups available and making the surface more hydrophilic. The piranha solution treatments with higher concentrations and longer times promoted greater heterogeneity in the surface pores, which affected the roughness of untreated PEEK. Furthermore, the treatments induced calcium deposition on the surface during immersion in SBF fluid. In conclusion, the proposed chemical modifications using sulfuric acid SPEEK 90 and, especially, the piranha solution PEEK-PS 2:1-90, were demonstrated to be promising in promoting the rapid bioactivation of PEEK-based implants.

Clinical report of six-month follow-up after cementing PEEK crown on molars

We conducted a six-month clinical follow-up on computer-aided design/computer-aided manufacturing-fabricated molar polyetheretherketone PEEK crowns to investigate their therapeutic effect. Only the PEEK crowns were examined as our study focused on short-term clinical evaluation of the new PEEK material. Twenty-three cases of PEEK crowns placed on the molars of 20 subjects (7 males and 13 females, mean age: 60.6 ± 14.2 years) were included in the study. The evaluation items were the condition of the crowns at the time of cementation and after six months, patient satisfaction, masticatory ability, and occlusal force. Mann-Whitney U tests with a significance level of 5% were used to examine the difference in glucose concentration by masticatory ability, occlusal pressure, and occlusal force, with and without PEEK crowns. The occlusion, margin fit, and contact of all 23 cases at the time of cementing were good. Six months after cementation, there was no crown desorption, fracture or crack, and prosthodontics was not needed in the 22 cases (one patient dropped out). No wear of the dental antagonist was observed. Patient satisfaction was generally high. There was no significant difference in masticatory ability between the groups with and without PEEK crowns. The subject's occlusal force was within the normal range. PEEK crowns used on molars can replace metal crowns and hold promise for an appropriate and effective treatment.

PEEK and fiberglass intra-radicular posts: influence of resin cement and mechanical cycling on push-out bond strength

OBJECTIVES

To evaluate the bond strength of four types of posts (pre-fabricated fiberglass post, fiberglass post anatomized with composite resin, milled fiberglass post, and milled polyetheretherketone (PEEK) post), and two types of resin cements (conventional and self-adhesive) by assessing immediate bond strength and post-mechanical aging at each root third.

MATERIALS AND METHODS

Bovine endodontically treated roots (16 groups, n = 8) were prepared and the posts were produced and luted; the specimens of aging groups were cycled (300,000 cycles under 50 N load at 1.2 Hz frequency); six slices of each root were obtained; push-out test was performed by using a universal testing machine (500 N load at 1 mm/min cross speed); fracture pattern was classified into five levels. The statistical analyses used were three-way ANOVA, Tukey's test (for bond strength), and Fisher's test (for fracture pattern) (α < 0.05).

RESULTS

Differences were found between the cements for posts (conventional: p < 0.001; self-adhesive: p = 0.002), whereas no difference was found for root region (p = 0.941; p = 0.056, respectively); analysis of each root showed significant differences for cements (p < 0.001), posts (p < 0.001), and mechanical cycling (p = 0.001); in terms of double interaction, differences were found for posts and mechanical cycling (p = 0.005); no other interactions were observed (double or triple); the fracture pattern showed difference between the groups for both cements.

CONCLUSIONS

Milled PEEK posts seem to be a good clinical option, but they require improvement of CAD-CAM technology and advances towards their adhesion.

CLINICAL RELEVANCE

Milled posts are promising and can reduce clinical time for rehabilitation of extensively destroyed teeth.

Comparison of tensile bond strength of ball attachments made of different materials to root canal dentin after chewing simulation

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.

Comparative Evaluation of Tensile Bond Strength of Poly Ether Ether Ketone (PEEK) and Zirconia Copings Using Resin Cement with or without Adhesive: An In Vitro Study

This in vitro research aimed to evaluate the Tensile Bond Strength of Poly Ether Ether Ketone and Zirconia copings using resin cement with or without Visio.link adhesive. From commercially available Zirconia and PEEK, blocks were machined milled using (CAD)/(CAM) to obtain 20 Zirconia and 20 PEEK copings. These specimens were sandblasted using 110 μm of alumina. The two main groups (20 Zirconia and 20 PEEK copings) were divided further into 4 subgroups, GROUP 1 (n = 10) PEEK substructure with self-adhesive resin cement without pretreatment, and GROUP 2 (n = 10) PEEK substructure with self-adhesive resin cement pre-treated with Visio.link adhesive. GROUP 3 (n = 10) Zirconia copings with self-adhesive resin cement without pretreatment. GROUP 4 (n = 10) Zirconia copings with self-adhesive resin cement pre-treated with Visio.link adhesive. Universal testing machine was used to evaluate the tensile bond strength of these copings. The results were analyzed using SPSS software Version 25.0 (SPSS Inc., Chicago, IL, USA). One-way ANOVA and independent t-test were used to compare the mean scores. Statistically significant increase was observed in Tensile Bond Strength of samples when Visio.link adhesive was used. Tensile Bond Strength of PEEK copings and Zirconia copings with Visio.link adhesive is considerably greater than PEEK copings and Zirconia copings without adhesive. The mean Tensile Bond Strength of Zirconia (with or without adhesive) is less as compared to Tensile Bond Strength of PEEK (with or without adhesive), but the difference is not statistically significant.

Nd:YVO4 laser groove treatment can improve the shear bond strength between dental PEEK and adhesive resin cement with an adhesive system

The purpose of this study was to investigate the effect of various surface treatments on the shear bond strength between dental polyetheretherketone (PEEK) and adhesive resin cement. Two hundred and forty specimens were randomly classified into four groups: no treatment, sandblasted, sulfuric-acid-etched, and laser-grooved treatment. Each group was classified into two adhesive resin cement subgroups. Surface roughness, water contact angle, shear bond strength, and failure mode were measured; SEM and XPS results were obtained. The data were statistically analyzed using one-way or two-way analysis of variance and Tukey's honest significant difference test (α=0.05). Laser-grooved PEEK surface showed regular grooves and carbonization by thermal degradation; the surface roughness as well as water contact angle of were the highest in all groups. Shear bond strength values were significantly higher in the laser-groove-treated and sulfuric-acid-etched groups. Laser-groove-treated specimens showed cohesive failure. Laser-grooved treatment can improve shear bond strength between PEEK and adhesive resin cement.

Marginal integrity and clinical evaluation of polyetheretherketone (PEEK) versus lithium disilicate (E-Max) endocrowns

Aim:  Evaluate the marginal integrity and Clinical performance of PEEK endocrowns compared to lithium disilicate (E-Max) ceramic endocrowns. Methodology: Twenty six endocrowns were fabricated for posterior endodontically treated teeth. Patients were divided into two groups according to the material used for fabrication of the restorations; Group 1(control group) received E-Max endocrowns while Group 2 (intervention group) received Bio HPP PEEK endocrowns. The marginal integrity and internal fit were assessed using the silicon replica approach, in which each replica was sectioned into four segments, each with five reference points that were evaluated using a digital microscope at 35X magnification. After final cementation, the clinical performance of the restorations was evaluated according to the USPHS criteria in terms of marginal adaptation, fracture, and retention. These measurements were repeated after three, six, nine and twelve months respectively. Results: The marginal and internal gaps of both groups were within the clinical acceptable range, but E-Max group recorded statistically significant higher internal gap mean value than PEEK group. Regarding the clinical performance all restorations showed 100% alpha and there was no significant difference between both groups for all tested outcomes (Marginal adaptation, fracture, and retention) over one year.

Shear bond characteristics and surface roughness of poly-ether-ether ketone treated with contemporary surface treatment regimes bonded to composite resin

AIM

To evaluate and compare the influence of contemporary surface treatments of air abrasions, sulfuric acid, and Photodynamic therapy (PDT) on the adhesive bonding and surface roughness of Poly-ether-ether-ketone (PEEK) bonded to resin composite.

MATERIAL AND METHODS

One hundred and fifty PEEK (disc-shaped) specimens of 10 mm diameter and 2mm thickness were prepared. Specimens were subjected to the following surface treatments, Control (no treatment), PDT, air abrasion using Alumina particles (110 μm) (AA-AP), Sulfuric acid (SA), and air abrasion using diamond particles (10-20 μm) AA-DP. Surface roughness (Ra) of treated samples were evaluated using surface profilometer. Universal testing machine was used to evaluate shear bond strength after composite resin build-up. Stereomicroscope was utilized for failure analysis of de-bonded samples of all five groups. Statistical analysis was performed utilizing one-way analysis of variance (ANOVA) to measure means and standard deviations of SBS among studied groups and the means of SBS were paralleled by Tukey multiple comparison tests (p>0.05).

RESULTS

The highest SBS was observed by 98% SA (19.25 ± 0.68 MPa). While specimen treated with PDT (11.69 ± 0.12 MPa) showed the lowest SBS. PEEK surface, treated with PDT and AA-DP demonstrated comparable SBS (p>0.05). PEEK when pretreated with 98% SA (2.658 ± 0.658μm) exhibited a significantly higher Ra value as compared to other surface-treated groups (p< 0.05).

CONCLUSION

PEEK surface treated with SA showed the highest SBS and surface roughness compared to other groups. Surface roughness of PEEK treated with PDT, AA-AP, and AA-DP demonstrated no difference in Ra. PEEK surface treatment technique should be further investigated to develop reliable adhesive resin bonding.

Assessment of different surface treatments and shear bond characteristics of poly-ether-ether-ketone: An in vitro SEM analysis

Aim:

The aim of this study is to assess the surface roughness and shear bond characteristics of pol-ether-ether-ketone after different surface treatments.

Setting and Design:

An in vitro, prospective.

Materials and Methods:

One hundred and twenty disc-shaped samples of 10 mm diameter and 2 mm thickness were milled and subjected to following surface treatments: 110 μm alumina particles, 98% concentrated sulfuric acid, and 10–20 μm synthetic diamond particles. Surface characteristics of treated sample were studied under SEM with ×500 and ×1000 magnification. Shear bond strength (SBS) with composite resin discs embedded in acrylic blocks after luting with self-etch resin cement and resin-modified glass ionomer cement (RMGIC) was evaluated using the universal testing machine (Instron®, Massachusetts U. S. A).

Statistical Analysis Used:

The data collected were evaluated using the Analysis of variance and Tukey's honest significant difference post hoc test.

Results:

Highest SBS and SR were noted with self-etch resin cement in the given order: 98% sulfuric acid (2.106 ± 0.186 μm), followed by alumina particles (1.706 ± 0.160 μm) and synthetic diamond particles (1.101 ± 0.167 μm).

Conclusion:

The SBS of self-etch resin cement was higher compared to RMGIC for all three surface treatments done on test samples. Hundred percent samples treated by all three surface treatment methods showed mixed type of failure.

Comparison of the Mechanical Properties of Temporary Abutments Made of Polyetheretherketone and Photopolymeric Resin

Background:

Provisional abutments are widely used in the rehabilitation of dental implants as it allows the use of a provisional crown in order to restore patient aesthetics while the final restoration is being carried out; most of the temporary abutments available on the market are made of titanium alloygrade V (type Ti-6Al-4Va) and polyetheretherketone (PEEK), a material that exhibits very low adhesion to polymethylmethacrylate (PMMA).

Objective:

This research is aimed to compare the mechanical properties of commercially available PEEK abutments and abutments made using an additive technique with photopolymeric resin.

Methods:

Eighteen commercial temporary abutments manufactured in PEEK and eighteen experimental abutments manufactured by 3D printing using photopolymeric resin were used. The two groups of abutments were subjected to compression, bending and adhesion tests using six abutments of each type by test. Statistical analysis was performed with STATA 14 software. The data were analyzed by means of the Wilcoxon Mann-Whitney test, as these were two independent samples of reduced size. Values ​​lower than (p <0.05) were considered statistically significant in all tests and rejected the null hypothesis of equality between the group medians.

Conclusion:

The results indicate that it is possible to make abutments with good mechanical properties in photopolymeric resin (CLEAR FLGP04) using additive techniques to be used as temporary abutments.

Surface Morphology and Mechanical Properties of Polyether Ether Ketone (PEEK) Nanocomposites Reinforced by Nano-Sized Silica (SiO2) for Prosthodontics and Restorative Dentistry

In the field of orthopedics and traumatology, polyether ether ketone (PEEK) serves a significant role as a suitable alternative to traditional metal-based implants like titanium. PEEK is being used more commonly to replace traditional dental products. For bonding with various adhesive agents and preserved teeth, the surface alteration of PEEK was investigated. The aim of this research was to understand how different types and contents of nano-sized silica (SiO2) fillers influenced the surface and mechanical properties of PEEK nanocomposites used in prosthodontics. In this work, PEEK based nanocomposites containing hydrophilic or hydrophobic nano-silica were prepared by a compression molding technique. The influence of nano-SiO2 type and content (10, 20 and 30% wt) on surface properties of the resultant nanocomposites was investigated by the use of scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), surface roughness analysis, and contact angle measurement. The crystalline structures of PEEK/SiO2 nanocomposites were examined by X-ray diffraction (XRD) spectroscopy. Mechanical properties were measured by microhardness, elastic compression modulus, and flexural strength. All nanocomposites showed increased surface roughness compared to pure PEEK. SEM images revealed that nanocomposites filled with low content hydrophobic nano-SiO2 showed uniform dispersion within the PEEK matrix. The introduction of 10 wt% of hydrophobic nano-SiO2 to the PEEK matrix improved elastic modulus, flexural strength, and microhardness, according to the findings. The addition of nano-SiO2 fillers in a higher weight percentage, over 10%, significantly damages the mechanical characteristics of the resultant nanocomposite. On the basis of the obtained results, PEEK/SiO2 nanocomposites loaded with low content hydrophobic nano-SiO2 are recommended as promising candidates for orthopedic and prosthodontics materials.

Evaluation of the failure modes and load-bearing capacity of different surface-treated polyether ether ketone copings veneered with lithium di-silicate compared to polyether ether ketone copings veneered with composite: An in vitro study

Aims:

The purpose of this study is to compare and evaluate the failure modes and load-bearing capacity of different surface-treated polyether ether ketone (PEEK) copings when veneered with lithium di-silicate with that of PEEK veneered with composite.

Settings and Design:

In vitro; comparative study.

Materials and Methods:

Congruently anatomically shaped single unit PEEK copings (n = 40) were fabricated by scanning a prepared typodont tooth. The PEEK copings were subdivided among four groups (n = 10/group). Among all, one group of PEEK coping was veneered with Urethane dimethacrylate (UDMA)-based composite and other groups were veneered with lithium-di-silicate after different surface treatment on peek copings, i.e., (i) composite veneered PEEK fixed dental prosthesis (FDP) (control group: Group PC), (ii) lithium di-silicate veneered PEEK FDP (no surface treatment: Group PCeN), (iii) lithium di-silicate veneered PEEK FDP (sandblasting with 50 μm alumina: Group PCeS), and (iv) lithium di-silicate veneered PEEK FDP (chemical etching with 98% sulfuric acid: Group PCeE). The load-bearing capacity of all specimens was assessed using a universal test machine. All the samples were loaded till the cracking point and load at that point and failure modes were noted down.

Statistical Analysis Used:

One-way ANOVA and post hoc Tukey tests.

Results:

The highest load-bearing capacity was recorded for lithium di-silicate veneered PEEK copings which were chemically etched with 98% sulfuric acid (Group PCeE: 1040.25 ± 77.46) followed by Group PCeS (1017.20 ± 53.70), then Group PC (965 ± 51.57) and least was for Group PCeN (933 ± 97.54). There was a significant reduction in mean load-bearing capacity in Group PCeN (P < 0.05).

Conclusions:

Veneering of PEEK with pressed lithium di-silicate seems to be a viable clinical option in terms of adequate load-bearing capacity. Lithium di-silicate veneered PEEK FDPs were successful against physiological occlusal forces and are a suitable material for FDPs.

Retention of different CAD/CAM endocrowns bonded to severely damaged endodontically treated teeth: An in vitro study

Aim:

Assess the retention of endocrowns fabricated of different CAD/CAM materials.

Settings and Design:

In vitro - comparative study.

Material and Methods:

Root canal treated mandibular first molars were prepared in a standardized method. Standardized endocrowns were manufactured using four CAD-CAM blocks: resin infiltrated ceramic (Vita Enamic), partially stabilized tetragonal zirconia (Katana), lithium disilicate ceramic (IPS e.max CAD), and polyether-ether-keton (PEEK, BioHPP). After proper surface treatment, the restorations were cemented using a resin cement (Panavia F2.0) and were connected to a special attachment unit and secured to a universal testing machine. The amount of axial load required to dislodge the restoration from the tooth structure was measured (n = 12, α = 0.05). Failures were classified as adhesive debonding from the tooth structure without damaging the supporting tooth structure and cohesive fracture of the supporting tooth structure

Statistical Analysis Used:

One-way analysis of variance,Tukey's post hoc test.

Results:

The retention of Vita Enamic (61 ± 11 N) and IPS e.max CAD (58 ± 9 N) was significantly higher (F = 123, P < 0.01) than Katana (33 ± 13) and Peek restorations (23 ± 11). Vita Enamic and IPS e.max CAD were associated with fractured tooth segments during debonding while Katana and PEEK specimens were adhesively debonded from the remaining tooth structure.

Conclusions:

Within the limitations of this study, using lithium disilicate ceramics and resin infiltrated ceramics as restorative materials to fabricate endocrowns to restore severely damaged endodontically treated teeth, recorded significantly higher retention values. Meanwhile, using yttrium partially stabilized zirconia and polyether ether ketones for the same purpose recorded a favorable mode failure which avoided the possibility of tooth fracture.

Fabrication of an implant-retained overdenture with ceramic crowns cemented on a polyetherketoneketone framework: A clinical report

This clinical report describes the treatment of a complex intraoral situation by fabricating a maxillary implant-retained overdenture with a high-performance polymer (polyetherketoneketone) framework and lithium disilicate crowns and mandibular tooth- and implant-supported ceramic restorations. No complications were noted in 2 years, and the patient was satisfied with function and esthetics.

The effect of different storage media on the monomer elution and hardness of CAD/CAM composite blocks

OBJECTIVE

This study aimed to assess the effect of different storage media on the hardness and monomer elution of CAD/CAM composite blocks.

METHODS

Five resin-composite blocks (RCB), one polymer-infiltrated ceramic network (PICN) block (Enamic (EN)), one ceramic-filled poly ether ether ketone (PEEK) block (Dentokeep (DK)), and one feldspathic ceramic block. Microhardness was measured using a Vickers indenter tester (FM-700, Future Tech Corp., Japan). In addition 4 conventional resin-composites were investigated for monomer elution using high performance liquid chromatography (HPLC) after storage in different media for 3 months. The data were analysed by three-way ANOVA, two-way ANOVA, one-way ANOVA, Tukey's post hoc test and the independent t-test (α=0.05 for all tests).

RESULTS

The specimens stored in the water had a hardness reduction ranging from 0.9% to 24.4%. In artificial saliva, the specimens had a hardness reduction ranging from 2.8% to 23.2%. The hardness reduction percentage in 75% Ethanol/Water (E/W) ranged between 3.8% and 35.3%. All materials, except GR (resin-composite block) and DK (Polyetheretherketone (PEEK)), showed a variable extent of monomer elution into 75% E/W with significantly higher amounts eluted from conventional composites. GRA and GND (conventional resin-composites) eluted TEGDMA in artificial saliva and GRA eluted TEGDMA in water.

SIGNIFICANCE

The hardness of CAD/CAM composite blocks was affected by different storage media, and they were not as stable as ceramic, with PICN exhibited superior hardness stability to all of the resin-composite blocks in all the storage media and was comparable to ceramic block. The hardness reduction percentage of the CAD/CAM composite blocks was influenced by the filler loading and resin-matrix composition.Minimal or no monomer elution from CAD/CAM blocks was detected.

Effects of laser modalities on shear bond strengths of composite superstructure to zirconia and PEEK infrastructures: an in vitro study

In the last decade, demand for metal-free esthetic restorations has grown considerably due to the development of materials to fulfill the need for an esthetic prosthesis. We examined the effects of erbium-doped yttrium aluminum garnet (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), and potassium titanyl phosphate (KTP) laser applications on the shear bond strength (SBS) of nanohybrid composite superstructures to zirconia and PEEK infrastructures. Zirconia and PEEK specimens were prepared with CAD/CAM technology in accordance with ISO 11405 standards. The disc-shaped samples were randomly separated into four groups (n = 8) according to applied laser type: no treatment and Er:YAG, Nd:YAG, and KTP lasers. Nanohybrid composite resin was applied as a veneering material to each infrastructure. After surface treatment of infrastructures by the lasers, the SBS test was carried out to determine the bonding of infrastructures, which were also examined with a stereomicroscope. The SBS were significantly higher in the PEEK specimens treated with the studied lasers. Nd:YAG laser was the most effective method, followed by Er:YAG laser and KTP laser. The lowest SBS value was obtained in the no-treatment group. Stereomicroscopically, the studied lasers produced different irregularities on the infrastructures. PEEK as a framework provides meaningfully higher bonding strength to composite resins compared to zirconia. Nd:YAG, Er:YAG, and KTP, in descending order, are efficacious in increasing the attachment of studied structures.

Effect of surface treatment and manufacturing process on the shear bond strength of veneering composite resin to polyetherketoneketone (PEKK) and polyetheretherketone (PEEK)

STATEMENT OF PROBLEM

Polyaryletherketones (PAEKs) are high-performance polymer materials in which polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) are the most used. Although mechanical and shear bonding strength tests have been performed on the 2 materials, studies on the influence of processing on bonding are scarce.

PURPOSE

The purpose of this in vitro study was to determine the influence of the surface treatment and the manufacturing process on the shear bond strength of veneering composite resin to PEKK and PEEK.

MATERIAL AND METHODS

Thirty pressed PEKK, 30 milled PEKK, and 30 milled PEEK specimens were distributed in 6 groups (n=13) as per the manufacturing process and treatment surface. The specimens were either treated with airborne-particle abrasion with 110-μm aluminum oxide, or no surface treatment was applied. Moreover, the PEKK specimens were grouped regarding their manufacturing process, as either milled or heat-pressed. The specimens were all bonded by using a methyl methacrylate-based adhesive (visio.link), and composite resin (Gradia Revolution 2) was bonded to the specimens. An Instron universal machine was used to calculate the shear bond strength between the PEEK or PEKK and the composite resin. Two specimens from each group had their topography modification assessed with a scanning electron microscope. Statistical analysis was performed by using a 3-way ANOVA for multiple comparisons (α=0.05) RESULTS: The groups that were surface treated with 110-μm aluminum oxide (Al₂O₃) before bonding showed significantly higher shear bond strength (P=.001) than the other groups. However, no statistically significant difference was observed among the groups, regardless of the manufacturing process (milled or heat-pressed) (P=.607).

CONCLUSIONS

PEEK and PEKK surfaces treated with 110-μm aluminum oxide airborne-particle abrasion displayed better shear bond strength to composite resin. The manufacturing process (milled or heat-pressed) did not significantly affect the bond strength of PEKK when subjected to the same bonding process.

On the synergistic effect of sulfonic functionalization and acidic adhesive conditioning to enhance the adhesion of PEEK to resin-matrix composites

OBJECTIVE

The objective of this study was to evaluate the combined effect of the sulfuric acid etching and an acidic adhesive conditioning on the shear bond strength of PEEK to a resin-matrix composite.

MATERIALS AND METHODS

Forty PEEK specimens were assigned randomly to 4 groups for H₂SO₄ etching followed by universal adhesive (pH at 2.5) conditioning for 0, 1, 3, and 5 min. Thirty PEEK specimens were divided into 3 groups for only acidic adhesive conditioning for 0, 1, 3, and 5 min. After the light-curing of the adhesive, a nanohybrid resin composite was applied onto the surfaces and then light-cured following the manufacturer`s guidelines. All specimens were stored in distilled water at 37 °C for 24 h mechanical testing. Shear bond strength tests were performed using a universal testing machine. Surfaces were analyzed by SEM, light interferometry, FTIR, and liquid contact angle measurement. Statistical analysis was performed by one-way ANOVA and Tukey's post hoc tests (p < 0.05).

RESULTS

No adhesion was achieved between untreated PEEK a resin-matrix composite, regardless of the adhesive conditioning time points. Shear bond strength of H₂SO₄-etched PEEK to resin-matrix composite increased with time (0 mmin. 4.95 ± 2.86 MPa < 1 min: 9.35 ± 2.26 MPa < 3 min: 17.84 ± 2.82 MPa < 5 min: 21.43 ± 5.00 MPa). SEM images revealed a significant modification of PEEK surface topography after the H₂SO₄ etching.

SIGNIFICANCE

The acidic adhesive was unable to modify the untreated PEEK surface to establish an effective adhesion although a synergistic effect was noticed when the universal (acidic) adhesive was applied over a H₂SO₄-etched PEEK surface, thus improving the PEEK to resin-matrix composite adhesion.

Surface roughness of high-performance polymers used for fixed implant-supported prostheses

STATEMENT OF PROBLEM

High-performance polymers have been recommended by their manufacturers as a framework material for implant-supported fixed prostheses. However, little is known about the surface roughness of high-performance polymers in different compositions and whether they require layering with a composite resin or acrylic resin on the tissue surface.

PURPOSE

The purpose of this in vitro study was to evaluate the surface roughness of different computer-aided design and computer-aided manufacture (CAD-CAM) high-performance polymers and the effect of polishing on their surface roughness.

MATERIAL AND METHODS

Seventy high-performance polymer specimens (n=10) for 4 different polyetheretherketone (PEEK) brands (BRE, CP, ZZ, J), 1 polyetherketoneketone (PEKK) (PK), and 2 different fiber-reinforced composite resin (FRC) materials (T, TR) were milled from 7×8×30-mm CAD-CAM blocks. The surface roughness (Ra) of each specimen was measured on the same surfaces after milling (baseline) and after polishing by using a contact profilometer. Two-way repeated measures ANOVA (MIXED procedure) and the Bonferroni corrected t test (α=.05) were used to analyze the surface roughness data.

RESULTS

No significant differences were found among high-performance polymers when the baseline surface roughness measurements of the materials were compared (P>.05). All materials (BRE, PK, CP, T, TR, ZZ), except for a PEEK material (J) (P<.05), had no significant differences in their surface roughness before and after polishing. After polishing, the surface roughness of the J PEEK material was higher than that of CP, PK, T, and ZZ (P<.05).

CONCLUSIONS

The surface roughness of high-performance polymers in different compositions after milling was similar. Polishing increased the surface roughness of only one PEEK (J) material. All surface roughness values were above the clinical acceptability threshold of 0.2 μm.

Influence of chairside surface treatments on the shear bond strength of PEKK polymer to veneering resin materials: An in vitro study

STATEMENT OF PROBLEM

High-performance thermoplastics have been adopted as an alternative restorative material to metal or ceramics. However, a straightforward surface modification process to provide a durable bond strength between the polymer and the veneering material is lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the shear bond strength (SBS) of different veneering resin materials to polyetherketoneketone (PEKK) after different surface treatments.

MATERIAL AND METHODS

Rectangular (7×7×2 mm) PEKK specimens (N=120) were randomly allocated to the following 6 groups (n=20): untreated (Cnt); nonthermal plasma (NTP) treated; tribochemical silica airborne-particle abrasion with 30-μm silica-modified Al₂O₃ (Tbc); abraded with a coarse-grit diamond rotary instrument (Ab); tribochemical silica airborne-particle abrasion + plasma treated (Tbc_NTP); abraded + plasma treated (Ab_NTP). After a bonding agent (PEKK Bond) was applied to the specimens, each group was divided into 2 subgroups according to the applied veneering resin materials: polymethylmethacrylate (PMMA) and nanohybrid composite resin (NHC, n=10). The specimens were stored in water for 24 hours at 37 °C and subjected to the SBS test by using a universal testing machine, and failure modes were evaluated using a stereomicroscope. Two-way analysis of variance (ANOVA) was performed followed by the Tukey honestly significant difference (HSD) test to statistically analyze the data (α=.05).

RESULTS

The 2-way ANOVA showed that surface treatment methods, veneering material, and their interactions were significantly different on the SBS values (P<.001). The highest SBS values were determined for the Tbc and Tbc_NTP treatment groups not only for PMMA (10.71 to 11.63 MPa) but also for NHC (19.80 to 20.60 MPa) veneering resin materials (P<.05).

CONCLUSIONS

The bonding capacity of PEKK to the PMMA and NHC veneering resin materials can be significantly improved by using tribochemical silica airborne-particle abrasion alone or with nonthermal plasma surface treatment techniques. Furthermore, using NHC veneering resin material is recommended over PMMA.

Repair of resin-veneered polyetheretherketone after veneer fracture

STATEMENT OF PROBLEM

If a composite resin-veneered polyetheretherketone (PEEK) restoration chips or fractures, a repair may be indicated. However, the most appropriate repair protocol for a composite resin-veneered PEEK restoration is unclear.

PURPOSE

The purpose of this in vitro study was to determine the efficacy of airborne-particle abrasion and/or a primer in the repair of composite resin-veneered PEEK prostheses.

MATERIAL AND METHODS

PEEK specimens (N=80) were airborne-particle abraded with alumina before being conditioned with a methyl methacrylate-based primer. A thin layer of opaquer was applied, and a split mold was then filled with a veneering resin. The specimens underwent 5000 thermocycles, and then shear bond strength (SBS) was determined and used as the positive control group. Specimens that failed in either mixed or adhesive modes were contaminated with saliva and then exposed to 4 different repair treatment methods: no airborne-particle abrasion, bonded without a primer (negative control group); airborne-particle abrasion, bonded without a primer; no airborne-particle abrasion, bonded with a primer; and airborne-particle abrasion, bonded with a primer. All specimens had opaquer applied before being veneered. Repaired specimens then underwent thermocycling before SBS testing. Data were analyzed via ANOVA with a Newman-Keuls post hoc test (α=.05).

RESULTS

The SBS values for the negative control were significantly lower than those of all other repair groups and the control group (P<.018). No significant differences in the SBS values were found among these other repair groups or the positive control group (P>.05).

CONCLUSIONS

Composite resin-veneered PEEK restorations or prostheses repaired with airborne-particle abrasion and/or primer can provide SBS comparable with that of the initial SBS.

Fatigue behaviour of dental crowns made from a novel high-performance polymer PEKK

Objectives

The aim of this study was, firstly, to analyse the long-time fatigue behaviour of crowns constructed from a novel polyetherketoneketone (PEKK) polymer, using artificial prepared teeth. Secondly, to determine the effect of the material’s stiffness that used as an artificial prepared tooth on the fatigue life of the PEKK crowns in comparison to human prepared teeth.

Methods

Veneered crowns with a PEKK framework were constructed on three different prepared teeth: artificial polymethyl methacrylate (PMMA) teeth, artificial CoCr teeth and extracted human teeth. As far as applicable, the loading protocol was based on EN ISO 14801:2007 for fatigue testing of dental implants. After initial static fracture tests on three specimens from each group, the remaining crowns were loaded with different force levels until fracture or until 2 × 10⁶ loading cycles were reached. The number of loading cycles until failure was recorded. Wöhler curves were created to display the fatigue limits.

Results

Static fracture limits as well as fatigue limits differed for all three core materials. The static fracture tests resulted in fracture limits of 1200 (± 293) N for the PMMA group, 1330 (± 219) N for the CoCr group and 899 (± 96) N for the human tooth group. Fatigue limits of 770 N, 840 N and 720 N were determined for the PMMA group, CoCr group and human tooth group, respectively.

Conclusions

The determined fatigue limit of above 720 N (depending on the core material) is sufficiently high and a good performance of this crown material is expected in the clinical loading life. The results showed that using artificial teeth instead of natural teeth for fatigue testing of crowns might result in an overestimation of the fatigue limits of the crown material.

Clinical relevance

PEKK-made crowns offer a stable and priceworthy treatment for patients, in particular those that suffer from metal allergy.

Effect of different surface treatments on the bond strength of milled polyetheretherketone posts

STATEMENT OF PROBLEM

Polyetheretherketone (PEEK) can be used as a framework material for removable and fixed dental prostheses. However, information about the use of PEEK as a post-and-core restoration is scarce.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of different surface treatments on the push-out bond strength of milled polyetheretherketone posts to resin cement.

MATERIAL AND METHODS

Sixty intact human maxillary central incisors were selected and endodontically treated, and standardized post spaces were prepared. Sixty PEEK posts were milled from a prefabricated PEEK blank by using a computer-aided design and computer-aided manufacturing (CAD-CAM) system and divided into 3 groups (n=15) according to the surface treatment: acid etching by using 98% sulfuric acid (AE); airborne-particle abrasion by using 50-μm Al₂O₃ (AA); nonthermal plasma treatment (NTP); in addition, PEEK posts (n=15) received no treatment (NT) and served as a control. All posts were bonded by using a self-adhesive resin cement. Three sections (coronal, middle, and apical) were obtained for each specimen. Push-out bond strength measurements (MPa) for each section were recorded by using a universal testing machine at a crosshead speed of 0.5 mm/min until failure occurred. The post-cement interfaces and failure modes were evaluated by using scanning electron microscopy. The data obtained were statistically analyzed by using 1-way ANOVA and the pair-wise Tukey (HSD) test to study the difference between group mean values (α=.05).

RESULTS

The overall mean ±standard deviation of the push-out bond strength was 11 ±2 MPa for AE group, 6 ±1 MPa for AA group, 5 ±1 MPa for NTP group, and 3 ±1 MPa for NT group. A statistically significant difference was found among all groups subjected to different surface treatments as indicated by the ANOVA test (P<.001). The pair-wise Tukey honestly significant difference (HSD) test showed a significant difference among the AE group and all groups (P<.001); however, no significant difference was observed between the AA and NTP groups (P>.05). Moreover, a significant difference was observed among all root sections (P<.001).

CONCLUSIONS

Surface treatment of PEEK posts with 98% sulfuric acid for 60 seconds showed significantly higher bond strength values than those in other groups. The bond strength of PEEK posts to resin cement was significantly higher in the coronal section than that in other sections.

Review on Development and Dental Applications of Polyetheretherketone-Based Biomaterials and Restorations

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.

Effect of pre-coating with methyl methacrylate containing UV photoinitiators on the bond strength of poly(ether ether ketone)

This study investigates the effect of pre-coating with methyl methacrylate (MMA) containing ultraviolet (UV) photoinitiators on the bond strength of poly(ether ether ketone) (PEEK). Cylindrical PEEK blocks were irradiated with 365 nm UV light for 5-20 s after they were coated with MMA containing 0.4-3.0 wt% UV photoinitiators: [1-phenyl-1,2-propanedione (PPD)], [diphenyl(2,4,6-trimethylbenzoyl) (TMDPO)], and [phenyl bis(2,4,6-trimethylbenzoyl) phosphine oxide (BTMPO)]. Pre-coated PEEKs were bonded to PEEK blocks with a MMA-based adhesive resin. The shear bond strength was measured using a universal testing machine. Secondary electron images were captured to observe failure surfaces. The data were analyzed with one- and two-way ANOVA and Tukey's post hoc tests (p<0.05). The highest bond strength (20.7±5.1 MPa) was observed for pre-coating with MMA containing 0.4 wt% BTMPO, for 20 s of UV irradiation. Cohesive failure of the adhesive resin was observed. The use of this pre-coating led to improved bonding performance of PEEK.

Digital fabrication of an adult speech aid prosthesis by using a 3-dimensionally printed polyetheretherketone framework

This article presents a digital fabrication method for a speech aid prosthesis by using a 3D-printed polyetheretherketone (PEEK) framework. The computer-aided design (CAD) of the speech aid prosthesis framework was based on oral scan data. The framework was printed with PEEK filament material supplemented with nanoTiO₂ powder by fused deposition modeling (FDM). A resin preliminary cast was 3D printed, and an altered cast technique was adopted to fabricate the definitive cast. The PEEK framework exhibited precise fit, toothlike color, excellent mechanical properties, and reduced weight as compared with a typical metal framework. This technique describes the successful clinical application of 3D-printed PEEK material for the fabrication of an adult speech aid prosthesis.