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Chen J, Xiao J, Han X, Sima X, Guo W. An HA/PEEK scaffold with modified crystallinity via 3D-bioprinting for multiple applications in hard tissue engineering. Biomed Mater 2023; 18:065021. [PMID: 37852224 DOI: 10.1088/1748-605x/ad0476] [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: 06/06/2023] [Accepted: 10/18/2023] [Indexed: 10/20/2023]
Abstract
Hard tissues, especially teeth and bones, are highly mineralized and the large-scale defect or total loss of them is irreversible. There is still no ideal strategy for the reconstruction of various hard tissue defects that can achieve the balance between biological and mechanical properties. Polyether ether ketone (PEEK) has the potential to substitute for natural hard tissue in defect areas but is limited by its biological inertness. The addition of hydroxyapatite (HA) can significantly improve the osteogenic properties and osteointegration of PEEK materials. But the mechanical properties of HA/PEEK scaffolds are far from satisfaction making scaffolds easy to fracture. We put forward a strategy to balance the mechanical and biological properties of HA/PEEK scaffolds via the regulation of the inner crystallinity and HA mixing ratio and we systematically evaluated the modified HA/PEEK scaffolds through material characterization,in vitroandin vivoexperiments. And we found that the 20%HA/PEEK scaffolds with low crystallinity achieved the required strength and elasticity, and exhibited the characteristics of promoting the proliferation, migration and osteogenic differentiation of bone marrow mesenchymal stem cells. The results of the implantation of beagles' teeth, mandible and rib showed that the 20%HA/PEEK scaffold with low crystallinity could well withstand the local complex force in the defect area and combine well with natural bone tissue, which made it a candidate for a practical versatile hard tissue engineering scaffold.
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Affiliation(s)
- Jiahao Chen
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Jingyi Xiao
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Xue Han
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Xiutian Sima
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Weihua Guo
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Yunnan Key Laboratory of Stomatology, Affiliated Hospital of Stomatology, School of Stomatology, Kunming Medical University, Kunming, People's Republic of China
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Hung CCU, Costa RC, Pereira G, Abdo VL, Noronha MDS, Retamal-Valdes B, Bertolini M, Feres M, Shibli JA, Barão VAR, Souza JGS. Oral microbial colonization on titanium and polyetheretherketone dental implant healing abutments: An in vitro and in vivo study. J Prosthet Dent 2023:S0022-3913(23)00538-3. [PMID: 37716897 DOI: 10.1016/j.prosdent.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 09/18/2023]
Abstract
STATEMENT OF PROBLEM Although polyetheretherketone (PEEK) implant healing abutments have become popular because of their esthetic, mechanical, and chemical properties, studies analyzing oral polymicrobial adhesion to PEEK abutments are lacking. PURPOSE The purpose of this in vitro and in vivo study was to evaluate oral microbial adhesion and colonization on titanium (Ti) and PEEK healing abutments. MATERIAL AND METHODS Ti (N=35) and PEEK substrates (N=35) were evaluated in vitro in terms of the initial adhesion (1 hour) or biofilm accumulation (48 hours) of Candida albicans and a polymicrobial inoculum using stimulated human saliva to mimic a diverse oral microbiome. Surface decontamination ability was evaluated after 24 hours of in vitro biofilm formation after exposure to an erbium-doped yttrium aluminum garnet (Er:YAG) laser. Conventional and flowable composite resin veneering on PEEK was also tested for microbial adhesion. In addition, an in vivo model with 3 healthy volunteers was conducted by using a palatal appliance containing the tested materials (3 or 4 specimens of each material per appliance) for 2 days to evaluate the effect of substrate on the microbial profile. Biofilms were evaluated by live cell counts and scanning electron microscopy images, and the microbial profile by Checkerboard deoxyribonucleic acid (DNA)-DNA hybridization. The t test and Mann-Whitney test were used to compare the groups (α=.05). RESULTS PEEK and Ti materials showed similar fungal adhesion (P>.05). Although the PEEK surface limited the initial in vitro polymicrobial adhesion (approximately 2 times less) compared with Ti (P=.040), after 48 hours of biofilm accumulation, the microbial load was statistically similar (P=.209). Er:YAG laser decontamination was more effective on PEEK than on Ti surfaces, reducing approximately 11 times more microbial accumulation (P=.019). Both composite resins tested showed similar microbial adhesion (1 hour). In vivo, the PEEK material showed reduced levels of 6 bacterial species (P<.05), including the putative pathogen Treponema denticola. CONCLUSIONS Although PEEK and Ti had similar bacterial and fungus biofilm attachment and accumulation, PEEK promoted a host-compatible microbial profile with a significantly reduced T. denticola load.
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Affiliation(s)
- Celeste Cecilia Urdaniga Hung
- PhD student, Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, São Paulo, Brazil
| | - Raphael Cavalcante Costa
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Gabriele Pereira
- Graduate student, Guarulhos University (UnG), Guarulhos, São Paulo, Brazil
| | - Victória Lopes Abdo
- PhD student, Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, São Paulo, Brazil
| | - Mayara do Santos Noronha
- Postdoctoral Fellow, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Belén Retamal-Valdes
- Professor, Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, São Paulo, Brazil
| | - Martinna Bertolini
- Professor, Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - Magda Feres
- Chair, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Mass
| | - Jamil Awad Shibli
- Professor, Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, São Paulo, Brazil
| | - Valentim A R Barão
- Associate Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - João Gabriel Silva Souza
- Professor, Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, São Paulo, Brazil; and Professor, Dental Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Minas Gerais, Brazil..
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Luo C, Liu Y, Peng B, Chen M, Liu Z, Li Z, Kuang H, Gong B, Li Z, Sun H. PEEK for Oral Applications: Recent Advances in Mechanical and Adhesive Properties. Polymers (Basel) 2023; 15:386. [PMID: 36679266 PMCID: PMC9864167 DOI: 10.3390/polym15020386] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023] Open
Abstract
Polyetheretherketone (PEEK) is a thermoplastic material widely used in engineering applications due to its good biomechanical properties and high temperature stability. Compared to traditional metal and ceramic dental materials, PEEK dental implants exhibit less stress shielding, thus better matching the mechanical properties of bone. As a promising medical material, PEEK can be used as implant abutments, removable and fixed prostheses, and maxillofacial prostheses. It can be blended with materials such as fibers and ceramics to improve its mechanical strength for better clinical dental applications. Compared to conventional pressed and CAD/CAM milling fabrication, 3D-printed PEEK exhibits excellent flexural and tensile strength and parameters such as printing temperature and speed can affect its mechanical properties. However, the bioinert nature of PEEK can make adhesive bonding difficult. The bond strength can be improved by roughening or introducing functional groups on the PEEK surface by sandblasting, acid etching, plasma treatment, laser treatment, and adhesive systems. This paper provides a comprehensive overview of the research progress on the mechanical properties of PEEK for dental applications in the context of specific applications, composites, and their preparation processes. In addition, the research on the adhesive properties of PEEK over the past few years is highlighted. Thus, this review aims to build a conceptual and practical toolkit for the study of the mechanical and adhesive properties of PEEK materials. More importantly, it provides a rationale and a general new basis for the application of PEEK in the dental field.
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Affiliation(s)
- Chengfeng Luo
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Ying Liu
- The Affiliated Taian City Central Hospital of Qingdao University, Taian 271000, China
| | - Bo Peng
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Menghao Chen
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Zhaogang Liu
- The Affiliated Taian City Central Hospital of Qingdao University, Taian 271000, China
| | - Zhanglong Li
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Hai Kuang
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning 530021, China
- Key Laboratory of Research and Application of Stomatological Equipment (College of Stomatology, Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning 530021, China
| | - Baijuan Gong
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Zhimin Li
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Hongchen Sun
- Hospital of Stomatology, Jilin University, Changchun 130021, China
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Demirci F, Bahce E. The effects of HAp coating layer on mechanical and optical properties at bonding interface of high-performance polymers. J Mech Behav Biomed Mater 2023; 137:105539. [PMID: 36343522 DOI: 10.1016/j.jmbbm.2022.105539] [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: 08/25/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE The effect of hydroxyapatite (HAp) coating layer on mechanical and optical properties at bonding interface of high-performance polymers (HPPs) used in computer-aided design (CAD)/computer-aided manufacture (CAM) technology was investigated in this in vitro study. MATERIALS AND METHODS Two hundred-twenty specimens were divided into two material groups (n = 110): polyetheretherketone (PEEK, KERA® starPEEK) and polyetherketoneketone (PEKK, Pekkton® ivory). For mechanical testing, each group was divided into five surface pretreatment subgroups and a control group (n = 10): HAp coating (1%,3%, 5%, and 10% concentrations) and sandblasting with 110-μm Al2O3 particles. For optical testing, each group was divided into five subgroups (n = 10): HAp coating (1%, 3%, 5%, and 10% concentrations) and control. The effects of the HAp coating on the optical changes and shear bond strength (SBS) of the specimens were investigated. Data was statistically analyzed by one-way ANOVA and Tukey's post-hoc test. Failure modes and surface properties of the specimens were examined by scanning electron microscopy (SEM) and coupled electron dispersive spectroscopy (EDS). RESULTS Average translucency and color change values increased with increasing HAp coating concentration in HPPs. As a result of the data, statistically significant differences were observed in terms of the effect of the HAp coating on SBS of HPPs (p < 0.05). Failure modes were examined, and mixed failure mode was observed. CONCLUSION HAp coating can contribute to the improvement of both the optical properties and bond strength of the HPPs to resin composite. CLINICAL SIGNIFICANCE Adhesion and color problems of high performance polymers are still under discussion. In order to solve these problems, generally focused on surface modifications of these polymers, but the effect of the HAp coating has not been investigated.
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Affiliation(s)
- Fatih Demirci
- Department of Prosthodontics, Faculty of Dentistry, Inonu University, Malatya, 44280, Turkey
| | - Erkan Bahce
- Department of Mechanical Engineering, Faculty of Engineering, Inonu University, Malatya, Turkey.
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Wang B, Huang M, Dang P, Xie J, Zhang X, Yan X. PEEK in Fixed Dental Prostheses: Application and Adhesion Improvement. Polymers (Basel) 2022; 14:polym14122323. [PMID: 35745900 PMCID: PMC9228596 DOI: 10.3390/polym14122323] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 01/27/2023] Open
Abstract
Polyetheretherketone (PEEK) has been widely applied in fixed dental prostheses, comprising crowns, fixed partial dentures, and post-and-core. PEEK’s excellent mechanical properties facilitate better stress distribution than conventional materials, protecting the abutment teeth. However, the stiffness of PEEK is not sufficient, which can be improved via fiber reinforcement. PEEK is biocompatible. It is nonmutagenic, noncytotoxic, and nonallergenic. However, the chemical stability of PEEK is a double-edged sword. On the one hand, PEEK is nondegradable and intraoral corrosion is minimized. On the other hand, the inert surface makes adhesive bonding difficult. Numerous strategies for improving the adhesive properties of PEEK have been explored, including acid etching, plasma treatment, airborne particle abrasion, laser treatment, and adhesive systems.
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Affiliation(s)
- Biyao Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
| | - Minghao Huang
- Liaoning Provincial Key Laboratory of Oral Diseases, Center of Implant Dentistry, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China;
| | - Pengrui Dang
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
| | - Jiahui Xie
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
| | - Xinwen Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, Center of Implant Dentistry, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China;
- Correspondence: (X.Z.); (X.Y.); Tel.: +86-024-31927731 (X.Z.); +86-024-31927715 (X.Y.)
| | - Xu Yan
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
- Correspondence: (X.Z.); (X.Y.); Tel.: +86-024-31927731 (X.Z.); +86-024-31927715 (X.Y.)
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