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Deste Gökay G, Oyar P, Gökçimen G, Durkan R. Static and dynamic stress analysis of different crown materials on a titanium base abutment in an implant-supported single crown: a 3D finite element analysis. BMC Oral Health 2024; 24:545. [PMID: 38730391 PMCID: PMC11088090 DOI: 10.1186/s12903-024-04328-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/03/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND This Finite Element Analysis was conducted to analyze the biomechanical behaviors of titanium base abutments and several crown materials with respect to fatigue lifetime and stress distribution in implants and prosthetic components. METHODS Five distinct designs of implant-supported single crowns were modeled, including a polyetheretherketone (PEEK), polymer-infiltrated ceramic network, monolithic lithium disilicate, and precrystallized and crystallized zirconia-reinforced lithium silicates supported by a titanium base abutment. For the static load, a 100 N oblique load was applied to the buccal incline of the palatal cusp of the maxillary right first premolar. The dynamic load was applied in the same way as in static loading with a frequency of 1 Hz. The principal stresses in the peripheral bone as well as the von Mises stresses and fatigue strength of the implants, abutments, prosthetic screws, and crowns were assessed. RESULTS All of the models had comparable von Mises stress values from the implants and abutments, as well as comparable maximum and minimum principal stress values from the cortical and trabecular bones. The PEEK crown showed the lowest stress (46.89 MPa) in the cervical region. The prosthetic screws and implants exhibited the highest von Mises stress among the models. The lithium disilicate crown model had approximately 9.5 times more cycles to fatique values for implants and 1.7 times more cycles to fatique values for abutments than for the lowest ones. CONCLUSIONS With the promise of at least ten years of clinical success and favorable stress distributions in implants and prosthetic components, clinicians can suggest using an implant-supported lithium disilicate crown with a titanium base abutment.
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Affiliation(s)
- Gonca Deste Gökay
- Department of Prosthodontics, Faculty of Dentistry, Bursa Uludag University, Bursa, Türkiye.
| | - Perihan Oyar
- Dental Prosthetics Technology, School of Health Services, Hacettepe University, Ankara, Türkiye
| | - Gülsüm Gökçimen
- Department of Prosthodontics, Ankara 75Th Year Oral and Dental Health Hospital, Ankara, Türkiye
| | - Rukiye Durkan
- Department of Prosthodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Türkiye
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Aboelfadl A, Keilig L, Ebeid K, Ahmed MAM, Nouh I, Refaie A, Bourauel C. Biomechanical behavior of implant retained prostheses in the posterior maxilla using different materials: a finite element study. BMC Oral Health 2024; 24:455. [PMID: 38622680 PMCID: PMC11020654 DOI: 10.1186/s12903-024-04142-8] [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: 01/13/2024] [Accepted: 03/13/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND The aim of this study is to evaluate the biomechanical behavior of the mesial and distal off-axial extensions of implant-retained prostheses in the posterior maxilla with different prosthetic materials using finite element analysis (FEA). METHODS Three dimensional (3D) finite element models with three implant configurations and prosthetic designs (fixed-fixed, mesial cantilever, and distal cantilever) were designed and modelled depending upon cone beam computed tomography (CBCT) images of an intact maxilla of an anonymous patient. Implant prostheses with two materials; Monolithic zirconia (Zr) and polyetherketoneketone (PEKK) were also modeled .The 3D modeling software Mimics Innovation Suite (Mimics 14.0 / 3-matic 7.01; Materialise, Leuven, Belgium) was used. All the models were imported into the FE package Marc/Mentat (ver. 2015; MSC Software, Los Angeles, Calif). Then, individual models were subjected to separate axial loads of 300 N. Von mises stress values were computed for the prostheses, implants, and bone under axial loading. RESULTS The highest von Mises stresses in implant (111.6 MPa) and bone (100.0 MPa) were recorded in distal cantilever model with PEKK material, while the lowest values in implant (48.9 MPa) and bone (19.6 MPa) were displayed in fixed fixed model with zirconia material. The distal cantilever model with zirconia material yielded the most elevated levels of von Mises stresses within the prosthesis (105 MPa), while the least stresses in prosthesis (35.4 MPa) were recorded in fixed fixed models with PEKK material. CONCLUSIONS In the light of this study, the combination of fixed fixed implant prosthesis without cantilever using a rigid zirconia material exhibits better biomechanical behavior and stress distribution around bone and implants. As a prosthetic material, low elastic modulus PEKK transmitted more stress to implants and surrounding bone especially with distal cantilever.
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Affiliation(s)
- Ahmad Aboelfadl
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany.
| | - Ludger Keilig
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
- Department of Dental Prosthetics, Propaedeutics and Material Science, Dental School, University Hospital Bonn, Bonn, Germany
| | - Kamal Ebeid
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | | | - Ingy Nouh
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Ashraf Refaie
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
- Department of Fixed Prosthodontics, Fayoum University, Fayoum, Egypt
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Verma V, Hazari P, Verma P. Do implants made of polyetheretherketone and its composites have reduced stress shielding effects compared to other dental implant materials? A systematic review. Evid Based Dent 2023; 24:193-194. [PMID: 37749243 DOI: 10.1038/s41432-023-00935-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 09/05/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE The present systematic review was executed to evaluate the stress shielding effect of PEEK and its composite dental implants as compared to other implant (titanium and zirconia) materials in peri-implant bone. MATERIALS AND METHOD The comprehensive online literature search was conducted on PubMed, Google Scholar, and Web of Science from January 2011 to January 2023. A total of 43 in vitro studies were identified related to the raised question. In all, 34 studies were excluded as they included in vitro studies focusing on stress distribution in prosthesis framework, abutments, crown, and on biological properties such as cell adhesion, etc. Only eight studies after full-text screening were included in the present systematic review. RESULTS The data extracted from included studies showed that PEEK and its composite materials, have a less stress shielding effect due to their low modulus of elasticity resulting in higher stress concentration and strain in the peri-implant bone as compared to titanium and zirconia implant materials. CONCLUSION The PEEK and its composites can be used as an alternative material in the esthetic region and in those who have an allergy to metal implants. However, due to the low elastic modulus of PEEK, a homogenous stress distribution is not observed along the entire length of the implant. Further studies are required to improve the composition of PEEK material so that a homogenous reduction of stress shielding effect along the whole length of a dental implant can be achieved.
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Affiliation(s)
- Varsha Verma
- Department of Prosthodontics and Crown & Bridge, People's Dental Academy, Bhopal, Madhya Pradesh, India.
| | - Puja Hazari
- Department of Prosthodontics and Crown & Bridge, People's Dental Academy, Bhopal, Madhya Pradesh, India
| | - Puja Verma
- School of Humanities and Engineering Sciences, MIT Academy of Engineering, Alandi, Pune, Maharashtra, India
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Lee PC, Peng TY, Ma TL, Chiang KY, Mine Y, Lee IT, Yu CC, Chen SF, Yu JH. Effect of Various Airborne Particle Abrasion Conditions on Bonding between Polyether-Ether-Ketone (PEEK) and Dental Resin Cement. Polymers (Basel) 2023; 15:polym15092114. [PMID: 37177258 PMCID: PMC10181231 DOI: 10.3390/polym15092114] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/15/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
The effects of alumina particle size and jet pressure on the bond strength of polyetheretherketone (PEEK) were examined to determine the airborne particle abrasion parameters with minimal effects on PEEK and to achieve optimal bond strength, as a reference for future clinical use. An alumina particle with four particle sizes and three jet pressures was used to air-abrade PEEK. Surface roughness (Ra), morphology, chemical structure, and wettability were analyzed using a stylus profilometer, scanning electron microscope, X-ray diffractometer, and contact angle analyzer, respectively. The shear bond strength (SBS) of PEEK and dental resin cement was analyzed using a universal testing machine (n = 10). The failure modes and debonded fracture surfaces were observed using optical microscopy. Airborne particle abrasion increased the Ra and hydrophobicity of PEEK and deposited alumina residues. The SBS generally decreased after thermal cycling. A large particle size damaged the PEEK surface. The effects of different particle sizes and jet pressures on the SBS were only significant in certain groups. Adhesive failure was the main mode for all groups. Within the limitations of this study, 110 μm grain-sized alumina particles combined with a jet pressure of 2 bar prevented damage to PEEK, providing sufficient SBS and bonding durability between PEEK and dental resin cement.
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Affiliation(s)
- Pao-Chieh Lee
- School of Dentistry, College of Dentistry, China Medical University, Taichung 40402, Taiwan
| | - Tzu-Yu Peng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Tien-Li Ma
- Department of Materials Science and Engineering, National Taiwan University, Taipei 10617, Taiwan
| | - Kuan-Yu Chiang
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yuichi Mine
- Department of Medical Systems Engineering, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - I-Ta Lee
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Chang-Chiang Yu
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Happy Dental Clinic, Taichung 42950, Taiwan
| | - Su-Feng Chen
- School of Dentistry, College of Dentistry, China Medical University, Taichung 40402, Taiwan
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Jian-Hong Yu
- School of Dentistry, College of Dentistry, China Medical University, Taichung 40402, Taiwan
- Research Center of Digital Oral Science and Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
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Yang Y, Liu Y, Yuan X, Ren M, Chen X, Luo L, Zheng L, Liu Y. Three-dimensional finite element analysis of stress distribution on short implants with different bone conditions and osseointegration rates. BMC Oral Health 2023; 23:220. [PMID: 37061667 PMCID: PMC10105927 DOI: 10.1186/s12903-023-02945-9] [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: 12/15/2022] [Accepted: 04/05/2023] [Indexed: 04/17/2023] Open
Abstract
OBJECTIVE This experiment aimed to investigate the effects of bone conditions and osseointegration rates on the stress distribution of short implants using finite element analysis and also to provide some reference for the application of short implants from a biomechanical prospect. MATERIALS AND METHODS Anisotropic jaw bone models with three bone conditions and 4.1 × 6 mm implant models were created, and four osseointegration rates were simulated. Stress and strain for the implants and jaws were calculated during vertical or oblique loading. RESULTS The cortical bone area around the implant neck was most stressed. The maximum von Mises stress in cortical bone increased with bone deterioration and osseointegration rate, with maximum values of 144.32 MPa and 203.94 MPa for vertical and inclined loading, respectively. The osseointegration rate had the greatest effect on the maximum principal stress in cortical bone of type III bone, with its value increasing by 63.8% at a 100% osseointegration rate versus a 25% osseointegration rate. The maximum and minimum principal stresses under inclined load are 1.3 ~ 1.7 and 1.4 ~ 1.8 times, respectively, those under vertical load. The stress on the jaw bone did not exceed the threshold when the osseointegration rate was ≥ 50% for Type II and 100% for Type III. High strain zones are found in cancellous bone, and the maximum strain increases as the bone condition deteriorate and the rate of osseointegration decreases. CONCLUSIONS The maximum stress in the jaw bone increases as the bone condition deteriorates and the osseointegration rate increases. Increased osseointegration rate reduces cancellous bone strain and improves implant stability without exceeding the yield strength of the cortical bone. When the bone condition is good, and the osseointegration ratio is relatively high, 6 mm short implants can be used. In clinical practice, incline loading is an unfavorable loading condition, and axial loading should be used as much as possible.
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Affiliation(s)
- Yunhe Yang
- Graduate School of Dalian Medical University, Dalian, China
| | - Yuchen Liu
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
| | - Xi Yuan
- Graduate School of Dalian University, Dalian, China
| | - Mingfa Ren
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
- State Key Laboratory of Structural Analysis for Industrial Equipment, Dalian University of Technology, Dalian, China
| | - Xiaodong Chen
- Department of Prosthodontics, Dalian Stomatological Hospital, Dalian, 116021, China
| | - Lailong Luo
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
| | - Lang Zheng
- Graduate School of Dalian University, Dalian, China
| | - Yang Liu
- Department of Prosthodontics, Dalian Stomatological Hospital, Dalian, 116021, China.
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PEEK for Oral Applications: Recent Advances in Mechanical and Adhesive Properties. Polymers (Basel) 2023; 15:polym15020386. [PMID: 36679266 PMCID: PMC9864167 DOI: 10.3390/polym15020386] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023] Open
Abstract
Polyetheretherketone (PEEK) is a thermoplastic material widely used in engineering applications due to its good biomechanical properties and high temperature stability. Compared to traditional metal and ceramic dental materials, PEEK dental implants exhibit less stress shielding, thus better matching the mechanical properties of bone. As a promising medical material, PEEK can be used as implant abutments, removable and fixed prostheses, and maxillofacial prostheses. It can be blended with materials such as fibers and ceramics to improve its mechanical strength for better clinical dental applications. Compared to conventional pressed and CAD/CAM milling fabrication, 3D-printed PEEK exhibits excellent flexural and tensile strength and parameters such as printing temperature and speed can affect its mechanical properties. However, the bioinert nature of PEEK can make adhesive bonding difficult. The bond strength can be improved by roughening or introducing functional groups on the PEEK surface by sandblasting, acid etching, plasma treatment, laser treatment, and adhesive systems. This paper provides a comprehensive overview of the research progress on the mechanical properties of PEEK for dental applications in the context of specific applications, composites, and their preparation processes. In addition, the research on the adhesive properties of PEEK over the past few years is highlighted. Thus, this review aims to build a conceptual and practical toolkit for the study of the mechanical and adhesive properties of PEEK materials. More importantly, it provides a rationale and a general new basis for the application of PEEK in the dental field.
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Zhang S, Long J, Chen L, Zhang J, Fan Y, Shi J, Huang Y. Treatment methods toward improving the anti-infection ability of poly(etheretherketone) implants for medical applications. Colloids Surf B Biointerfaces 2022; 218:112769. [PMID: 35994991 DOI: 10.1016/j.colsurfb.2022.112769] [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: 06/30/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 10/15/2022]
Abstract
Due to its favorable chemical stability, biocompatibility, and mechanical properties, Poly(etheretherketone) (PEEK) is a promising material for repairing bone and dental hard tissue defects. However, there are critical disadvantages: PEEK is biologically and chemically inert, which influences osseointegration of implants and bonding strength of prostheses, and its mechanical properties still cannot meet the requirements for some medical applications. Furthermore, bacterial infections and inflammatory reactions often accompany bone defects caused by trauma or inflammation or teeth loss caused by periodontitis. Previous studies mainly focused on enhancing PEEK's bioactivity and mechanical performance, but PEEK also lacks effective anti-infection ability. Thus, it is necessary to improve its anti-infection ability, and this is considered in this paper from two aspects. The first is to inhibit the attachment and growth of bacteria on the material, and the second is to endow the material with immunoregulatory ability, which means mobilizing the host immune system to protect tissue from inflammation. In this review, we analyze and discuss the existing treatment methods to improve the antibacterial and immunomodulatory abilities of PEEK addressing their limitations, relevant future challenges, and required research efforts.
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Affiliation(s)
- Shuqi Zhang
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
| | - Jiazhen Long
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
| | - Lin Chen
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
| | - Jie Zhang
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
| | - Yunjian Fan
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
| | - Jiayu Shi
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
| | - Yuanjin Huang
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
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Stress Distribution Pattern in Zygomatic Implants Supporting Different Superstructure Materials. MATERIALS 2022; 15:ma15144953. [PMID: 35888420 PMCID: PMC9323759 DOI: 10.3390/ma15144953] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 12/25/2022]
Abstract
The aim of this study was to assess and compare the stress–strain pattern of zygomatic dental implants supporting different superstructures using 3D finite element analysis (FEA). A model of a tridimensional edentulous maxilla with four dental implants was designed using the computer-aided design (CAD) software. Two standard and two zygomatic implants were positioned to support the U-shaped bar superstructure. In the computer-aided engineering (CAE) software, different materials have been simulated for the superstructure: cobalt–chrome (CoCr) alloy, titanium alloy (Ti), zirconia (Zr), carbon-fiber polymers (CF) and polyetheretherketone (PEEK). An axial load of 500 N was applied in the posterior regions near the zygomatic implants. Considering the mechanical response of the bone tissue, all superstructure materials resulted in homogeneous strain and thus could reconstruct the edentulous maxilla. However, with the aim to reduce the stress in the zygomatic implants and prosthetic screws, stiffer materials, such Zr, CoCr and Ti, appeared to be a preferable option.
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Influence of Different Restoring Materials on Stress Distribution in Prosthesis on Implants: A Review of Finite Element Studies. Eur J Dent 2022; 17:1-6. [PMID: 35728615 PMCID: PMC9949929 DOI: 10.1055/s-0042-1747955] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The selection of material used on the occlusal surface of implant-supported prostheses is important, as these materials can transmit destructive forces to the interface between the alveolar bone and the implant. Different prosthetic materials are suggested for implant-supported prostheses. The choice of prosthetic material is a controversial issue, and there is a consensus that implant survival is not affected by the prosthetic material. Three-dimensional finite element studies are often used in dentistry to estimate the stress distribution that occurs in the implant system, peri-implant bone, and prosthetic components. To analyze the influence of the prosthetic restorative material on the stresses in bone tissue and peri-implant through a literature review of three-dimensional finite element studies. The search for articles was performed in the PubMed/Medline database up to November 2021. The selected articles were independently evaluated by two different reviewers. The information collected was author and year of publication, dimensions of implants used, the material used in the prosthetic crown, simulated force and direction, and conclusion and effect. After searching, 14 studies were selected for full reading, and based on the inclusion and exclusion criteria, all could be included in this review. The articles were based on evidence-based laboratory medicine. After analyzing these articles, it was concluded that the prosthetic materials used on the occlusal surface do not interfere with the destruction of stresses to the bone and peri-implant tissue, both in single prostheses and protocol-type prostheses, when three-dimensional finite element method is used.
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The Structural Integrity and Fracture Behaviour of Teeth Restored with PEEK and Lithium-Disilicate Glass Ceramic Crowns. Polymers (Basel) 2022; 14:polym14051001. [PMID: 35267824 PMCID: PMC8914752 DOI: 10.3390/polym14051001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 11/23/2022] Open
Abstract
Polyetheretherketone (PEEK) is a unique polymer material which has recently been introduced to dentistry. This study aimed to assess the structural integrity of PEEK as a posterior tooth crown and compared it with ceramic-based material. A total of 31 monolithic CAD-CAM PEEK (JuvoraTM, Strumann, Andover, MA, USA) crowns and 31 lithium disilicate (IPS e.max®CAD, Voclar Vivadent AG, Liechtenstein) crowns were created and cemented on dentin-like teeth (AlphaDie®MF, Schütz Dental GmbH, Rosbach, Germany) in a precise procedure mimicking the physical and mechanical properties of natural teeth and periodontal ligaments. A static compressive strength test using a universal testing machine and a dynamic fatigue test using a chewing simulator machine were used until crown failure to assess the fracture behaviour by mode of fracture (fractographic analysis) and 3D digital subtraction analysis. The results showed that PEEK has a greater fracture resistance than IPS e.max®CAD by 2060 N to 703 N. Additionally, in fatigue limit, IPS e.max®CAD showed a constant failure under 2.0 Kg (=320 N) before 5000 chewing cycles while PEEK survived at a significantly higher load > 11 Kg (930 N). Furthermore, PEEK showed a continued survival at >1,250,000 cycles while the mean fatigue life of IPS e.max®CAD was around 133,470 cycles. PEEK illustrated a significantly less catastrophic failure mode with some plastic deformation at the fractographic stereomicroscope and in the 3D digital subtraction analysis. Using PEEK for crowns looks very promising, however, further clinical studies are required to assure this study’s results.
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Peng TY, Shih YH, Hsia SM, Wang TH, Li PJ, Lin DJ, Sun KT, Chiu KC, Shieh TM. In Vitro Assessment of the Cell Metabolic Activity, Cytotoxicity, Cell Attachment, and Inflammatory Reaction of Human Oral Fibroblasts on Polyetheretherketone (PEEK) Implant-Abutment. Polymers (Basel) 2021; 13:polym13172995. [PMID: 34503035 PMCID: PMC8433877 DOI: 10.3390/polym13172995] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 08/28/2021] [Accepted: 08/31/2021] [Indexed: 12/03/2022] Open
Abstract
The purpose of this research is to compare the cytotoxicity of polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) with conventional dental implant–abutment materials, namely titanium alloy (Ti-6Al-4V) and yttria-stabilized tetragonal zirconia polycrystal (Y-TZP), to evaluate the cell metabolic activity, cytotoxicity, and inflammation potential of human oral fibroblasts (HOF) on these materials. Disk-shaped specimens were designed and prepared via a dental computer-aided manufacturing technology system. Surface topography, roughness, and free energy were investigated by atomic force microscope and contact angle analyzer; cell metabolic activity and cytotoxicity by MTT assay; and morphological changes by scanning electron microscopy (SEM). The effect of pro-inflammatory gene expression was evaluated by RT-qPCR. The obtained data were analyzed with one-way analysis of variance and post-hoc Tukey’s honest significant difference tests. PEEK and PEKK exhibited higher submicron surface roughness (0.04 μm) and hydrophobicity (>80°) than the control. Although the cell activity of PEEK was lower than that of Ti-6Al-4V and Y-TZP for the first 24 h (p < 0.05), after 48 h there was no difference (p > 0.05). According to the cell cytotoxicity and the pro-inflammatory cytokine gene expression assays, there was no difference between the materials (p > 0.05). SEM observations indicated that HOF adhered poorly to PEKK but properly to Ti-6Al-4V, Y-TZP, and PEEK. PEEK and PEKK show comparable epithelial biological responses to Ti-6Al-4V and Y-TZP as implant–abutment materials. Between the two polymeric materials, the PEEK surface, where the HOF showed better cell metabolic activity and cytotoxicity, was a more promising implant–abutment material.
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Affiliation(s)
- Tzu-Yu Peng
- School of Dentistry, College of Dentistry, China Medical University, Taichung 40402, Taiwan; (T.-Y.P.); (P.-J.L.); (D.-J.L.); (K.-T.S.)
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yin-Hwa Shih
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan;
| | - Shih-Min Hsia
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 11031, Taiwan;
| | - Tong-Hong Wang
- Tissue Bank, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan;
| | - Po-Jung Li
- School of Dentistry, College of Dentistry, China Medical University, Taichung 40402, Taiwan; (T.-Y.P.); (P.-J.L.); (D.-J.L.); (K.-T.S.)
| | - Dan-Jae Lin
- School of Dentistry, College of Dentistry, China Medical University, Taichung 40402, Taiwan; (T.-Y.P.); (P.-J.L.); (D.-J.L.); (K.-T.S.)
| | - Kuo-Ting Sun
- School of Dentistry, College of Dentistry, China Medical University, Taichung 40402, Taiwan; (T.-Y.P.); (P.-J.L.); (D.-J.L.); (K.-T.S.)
| | - Kuo-Chou Chiu
- Division of Oral Diagnosis and Family Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; or
| | - Tzong-Ming Shieh
- School of Dentistry, College of Dentistry, China Medical University, Taichung 40402, Taiwan; (T.-Y.P.); (P.-J.L.); (D.-J.L.); (K.-T.S.)
- Correspondence: ; Tel.: +886-4-2205-3366 (ext. 2316)
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