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EL-Awady AA, ElHabbak KS, Mohamed HR, Elwan AE, Adly KS, Abdalla MA, Kamal EM, Alameldin AL. Effect of Different Primers on the Shear Bond Strength of Orthodontic Brackets Bonded to Reinforced Polyetheretherketone (PEEK) Substrate. Dent J (Basel) 2024; 12:188. [PMID: 38920889 PMCID: PMC11202904 DOI: 10.3390/dj12060188] [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: 05/09/2024] [Revised: 06/09/2024] [Accepted: 06/18/2024] [Indexed: 06/27/2024] Open
Abstract
This in vitro study assessed the effect of different primers on the shear bond strength (SBS) and adhesive remnant index (ARI) of orthodontic brackets bonded to reinforced polyetheretherketone (PEEK) substrate. A total of 40 specimens were randomly distributed to two groups based on the primer used for orthodontic bonding: group 1 (control)-Transbond XT adhesive with Visio.link primer and group 2 (test)-orthodontic adhesive (Transbond XT) with traditional orthodontic primer. After bonding, specimens were thermocycled followed by SBS testing and ARI scoring of debonded specimens. Data were analyzed using the unpaired independent t-test and the Chi-square test. Group 1 specimens showed significantly higher SBS values (21.38 ± 1.48 MPa) compared to group 2 specimens (18.63 ± 1.29 MPa) (p < 0.0001). Adhesive remnant index scores showed no significant variations in bond failure modes and distributions between groups. The SBS obtained by the tested primers exceeded the clinically recommended value. Consequently, there is a comparable clinical application for both tested primers in orthodontic bonding, especially the traditional orthodontic primer, where the availability of Visio.link in clinical practice is not ensured.
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Affiliation(s)
- Ahmed Akram EL-Awady
- Department of Orthodontics, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo 11651, Egypt
| | - Khaled Samy ElHabbak
- Department of Orthodontics, Faculty of Oral and Dental Medicine, MTI University, Cairo 4416301, Egypt;
| | - Hussein Ramadan Mohamed
- Crown and Bridge Department, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo 11651, Egypt; (H.R.M.); (A.E.E.); (K.S.A.); (A.L.A.)
| | - Ahmed Elsayed Elwan
- Crown and Bridge Department, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo 11651, Egypt; (H.R.M.); (A.E.E.); (K.S.A.); (A.L.A.)
| | - Karim Sherif Adly
- Crown and Bridge Department, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo 11651, Egypt; (H.R.M.); (A.E.E.); (K.S.A.); (A.L.A.)
| | - Moamen Ahmed Abdalla
- Department of Substitutive Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia;
| | - Ehab Mohamed Kamal
- Operative Dentistry Department, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo 11651, Egypt;
| | - Ahmed Leithy Alameldin
- Crown and Bridge Department, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo 11651, Egypt; (H.R.M.); (A.E.E.); (K.S.A.); (A.L.A.)
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Huang H, Liu X, Wang J, Suo M, Zhang J, Sun T, Wang H, Liu C, Li Z. Strategies to improve the performance of polyetheretherketone (PEEK) as orthopedic implants: from surface modification to addition of bioactive materials. J Mater Chem B 2024; 12:4533-4552. [PMID: 38477504 DOI: 10.1039/d3tb02740f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Polyetheretherketone (PEEK), as a high-performance polymer, is widely used for bone defect repair due to its homogeneous modulus of elasticity of human bone, good biocompatibility, excellent chemical stability and projectability. However, the highly hydrophobic surface of PEEK is biologically inert, which makes it difficult for cells and proteins to attach, and is accompanied by the development of infections that ultimately lead to failure of PEEK implants. In order to further enhance the potential of PEEK as an orthopedic implant, researchers have explored modification methods such as surface modification by physical and chemical means and the addition of bioactive substances to PEEK-based materials to enhance the mechanical properties, osteogenic activity and antimicrobial properties of PEEK. However, these current modification methods still have obvious shortcomings in terms of cost, maneuverability, stability and cytotoxicity, which still need to be explored by researchers. This paper reviews some of the modification methods that have been used to improve the performance of PEEK over the last three years in anticipation of the need for researchers to design PEEK orthopedic implants that better meet clinical needs.
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Affiliation(s)
- Huagui Huang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
- Division of Energy Materials (DNL22), Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China.
| | - Xin Liu
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
| | - Jinzuo Wang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
| | - Moran Suo
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
| | - Jing Zhang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
| | - Tianze Sun
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
| | - Honghua Wang
- Division of Energy Materials (DNL22), Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China.
| | - Chengde Liu
- Department of Polymer Science & Materials, Dalian University of Technology, Dalian, People's Republic of China.
| | - Zhonghai Li
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
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Adeeb Gabra EN, Sadek HMA, Hamdy AM, Wahsh MM. Effect of surface treatment and resin cement type on the bond strength of polyetheretherketone to lithium disilicate ceramic. BMC Oral Health 2024; 24:513. [PMID: 38698366 PMCID: PMC11064278 DOI: 10.1186/s12903-024-04269-8] [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: 02/12/2024] [Accepted: 04/17/2024] [Indexed: 05/05/2024] Open
Abstract
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.
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Affiliation(s)
- Engy N Adeeb Gabra
- Lecturer at Fixed Prosthodontics Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
| | | | | | - Marwa M Wahsh
- Fixed Prosthodontics Department, Faculty of Dentistry, Ain Shams University, Galala University, Cairo, Egypt
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Gökay GD, Aladağ SÜ. Comparison of the shear bond strengths of two different polyetheretherketone (PEEK) framework materials and CAD-CAM veneer materials. BMC Oral Health 2024; 24:444. [PMID: 38609958 PMCID: PMC11010332 DOI: 10.1186/s12903-024-04247-0] [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: 02/12/2024] [Accepted: 04/10/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND This study evaluated the shear bond strength (SBS) of two different polyetheretherketone (PEEK) and CAD-CAM materials after aging. METHODS A total of 42 frameworks were designed and milled from 2 different PEEK discs (Copra Peek, P and BioHPP, B). P and B frameworks were divided into 3 subgroups (n = 7). 14 slices were prepared each from feldspathic ceramic (Vitablocs Mark II, VM), hybrid nanoceramic (Cerasmart, CS), and polymer-infiltrated ceramic (Vita Enamic, VE) blocks. After surface preparations, the slices were cemented to P and B surfaces. The samples were subjected to thermal aging (5000 cycles). SBS of all the samples was measured. Fractured surfaces were examined by SEM/EDX analysis. The Shapiro-Wilk, Two-way Robust ANOVA and Bonferroni correction tests were used to analyze the data (a = .05). RESULTS Frameworks, ceramics, and frameworks x ceramics had significant differences (p < 0.05). The highest SBS value was seen in B-VM (p < 0.05). VM offered the highest SBS with both P and B. The differences between P-VM, P-CS, P-VE and B-CS and B-VE were insignificant (p > 0.05). According to EDX analysis, ytterbium and fluorine was seen in B content, unlike P. While VM and CS contained fluorine, barium, and aluminum; sodium and aluminum were observed in the VE structure. CONCLUSION Bonding of P and B with VM offers higher SBS. VM, CS and VE did not make any difference in SBS for P, however VM showed a significant difference for B.
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Affiliation(s)
- Gonca Deste Gökay
- Department of Prosthodontics, Faculty of Dentistry, Bursa Uludağ University, Bursa, Turkey
| | - Seda Üstün Aladağ
- Department of Prosthodontics, Faculty of Dentistry, Bursa Uludağ University, Bursa, Turkey.
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Yilmaz B, Gouveia D, Schimmel M, Lu WE, Özcan M, Abou-Ayash S. Effect of adhesive system, resin cement, heat-pressing technique, and thermomechanical aging on the adhesion between titanium base and a high-performance polymer. J Prosthet Dent 2024; 131:468-474. [PMID: 35513915 DOI: 10.1016/j.prosdent.2022.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
| | - Diogo Gouveia
- Assistant Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
| | - Martin Schimmel
- Professor and Head, Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland; Senior Lecturer, Extra muros, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Wei-En Lu
- PhD Candidate, Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio
| | - Mutlu Özcan
- Professor and Head, Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Samir Abou-Ayash
- Senior Lecturer and Head, Section of Digital Implant and Reconstructive Dentistry, Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.
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Alqahtani MA. Conditioning of PEEK Implant Abutment Surfaces Using Photodynamic Therapy, Nd:YAG Laser, and Conventional Methods to Evaluate Shear Bond Strength. Photobiomodul Photomed Laser Surg 2024; 42:90-95. [PMID: 38112690 DOI: 10.1089/photob.2023.0118] [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] [Indexed: 12/21/2023] Open
Abstract
Objective: This study was done to evaluate shear bond strength (SBS) and modes of failures after different surface treatment modalities on polyetheretherketone (PEEK) implant abutments. Materials and methods: Seventy-five PEEK implant abutment specimens were randomly distributed into five groups based on surface treatment methods: Group I: No treatment, Group II: methylene blue-mediated photodynamic therapy (MB-PDT), Group III: neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, Group IV: Sulfuric acid (H2SO4), and Group V: Sandblasting (Sb). The measurements for SBS and failure modes for PEEK implant abutment specimens were evaluated via Universal Testing Machine and Stereomicroscope, respectively. Two-way analysis of variance and Tukey's post-hoc test (p > 0.05) were used for the statistical analysis. Moreover, the Shapiro-Wilk normality test was also performed for normality. Results: The SBS mean values and standard deviations in megapascals (MPa) for PEEK abutment specimens with different surface pretreatment groups are shown in Table 1 and Fig. 1. The control group had the lowest SBS (9.67 ± 2.1 MPa), while the highest SBS was observed in Group II (MB-PDT; 17.21 ± 1.32 MPa). SBS values for Group IV (H2SO4; 15.83 ± 0.63 MPa) and Group III (Nd:YAG laser; 16.91 ± 2.10 MPa) were similar to Group II (MB-PDT; p > 0.05). The SBS values for the sandblasted specimens (13.90 ± 1.87 MPa) were not significantly different from the control group (p > 0.05). Conclusions: The PEEK implant abutment surfaces treated with MB-PDT and Nd:YAG laser expressed significantly improved SBS.
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Affiliation(s)
- Mohammed Ayedh Alqahtani
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Arvai R, Baroudi K, Duarte L, Diamantino PJS, Gimenez MG, Phillippi AG, Saavedra GDSFA, Waghon ZML, Gonçalves TMSV. New adhesive protocol improves shear bond strength of Polyetherketoneketone (PEKK). Dent Mater 2024; 40:3-8. [PMID: 37858419 DOI: 10.1016/j.dental.2023.10.001] [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: 03/24/2023] [Revised: 08/31/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
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.
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Affiliation(s)
- Robert Arvai
- Bio-Emulation Group, Andreou Londou 28, 25100 Aigio, Greece
| | - Kusai Baroudi
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE; Postgraduate Program, College of Dentistry, University of Taubate, Taubate, Brazil
| | - Laís Duarte
- Department of Dentistry, Federal University of Santa Catarina (UFSC), R. Eng. Agronômico Andrei Cristian Ferreira, s/n, CEP: 88040-900, Trindade, Florianópolis, SC, Brazil
| | - Pedro Jacy Santos Diamantino
- Department of Dental Materials, São Paulo State University (UNESP), Av. Eng. Francisco José Longo, 777, CEP 12245-000, Jardim São Dimas, São José dos Campos, SP, Brazil
| | - Mariana Gadelho Gimenez
- Department of Dental Materials, São Paulo State University (UNESP), Av. Eng. Francisco José Longo, 777, CEP 12245-000, Jardim São Dimas, São José dos Campos, SP, Brazil
| | - Analucia Gebler Phillippi
- Department of Dentistry, Federal University of Santa Catarina (UFSC), R. Eng. Agronômico Andrei Cristian Ferreira, s/n, CEP: 88040-900, Trindade, Florianópolis, SC, Brazil.
| | | | - Zuila Maria Lobato Waghon
- Department of Dentistry, Federal University of Santa Catarina (UFSC), R. Eng. Agronômico Andrei Cristian Ferreira, s/n, CEP: 88040-900, Trindade, Florianópolis, SC, Brazil
| | - Thais Marques Simek Vega Gonçalves
- Department of Dentistry, Federal University of Santa Catarina (UFSC), R. Eng. Agronômico Andrei Cristian Ferreira, s/n, CEP: 88040-900, Trindade, Florianópolis, SC, Brazil
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de Araújo Nobre M, Moura Guedes C, Almeida R, Silva A, Sereno N. The All-on-4 Concept Using Polyetheretherketone (PEEK)-Acrylic Resin Prostheses: Follow-Up Results of the Development Group at 5 Years and the Routine Group at One Year. Biomedicines 2023; 11:3013. [PMID: 38002014 PMCID: PMC10669282 DOI: 10.3390/biomedicines11113013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND It is necessary to investigate the application of polymer materials in implant dentistry. The aim of this study was to examine the outcome of full-arch polyetheretherketone (PEEK)-acrylic resin implant-supported prostheses. METHODS Seventy-six patients were rehabilitated consecutively with 100 full-arch implant-supported prostheses of PEEK-acrylic resin (a development group (DG): 37 patients with 5 years of follow-up; a routine group (RG): 39 patients with 1 year of follow-up). The primary outcome measure was prosthetic survival. Secondary outcome measures were implant survival, marginal bone loss, biological complications, prosthetic complications, veneer adhesion, plaque levels, bleeding levels, and a patient subjective evaluation (including the Oral Health Impact Profile for the RG). RESULTS In both groups, prosthetic (DG: 93.6%; RG: 100%) and implant survival (DG: 98.9%; RG: 99.5%) were high, and marginal bone loss was low (DG: 0.54 mm; RG: 0.28 mm). The veneer adhesion rate was 28.6% of prostheses in DG (RG = 0%). Mechanical complications occurred in 49% and 11.8% of prostheses in DG and RG, respectively. Biological complications, plaque, and bleeding levels were low in both groups. The subjective patient evaluation was excellent in both groups (8.6 < DG < 8.8; 9.3 < RG < 9.5; OHIP = 1.38). CONCLUSIONS Within the limitations of this study, PEEK can be considered a viable prosthetic alternative.
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Affiliation(s)
- Miguel de Araújo Nobre
- Research, Development and Education Department, MALO CLINIC, Avenida dos Combatentes, 43, Level 11, 1600-042 Lisboa, Portugal
| | - Carlos Moura Guedes
- Research, Prosthodontic Department, MALO CLINIC, Avenida dos Combatentes, 43, Level 10, 1600-042 Lisboa, Portugal; (C.M.G.); (R.A.)
| | - Ricardo Almeida
- Research, Prosthodontic Department, MALO CLINIC, Avenida dos Combatentes, 43, Level 10, 1600-042 Lisboa, Portugal; (C.M.G.); (R.A.)
| | - António Silva
- MALO CLINIC Ceramics, Avenida dos Combatentes, 43, Level 11, 1600-042 Lisboa, Portugal;
| | - Nuno Sereno
- Invibio Biomaterial Solutions & JUVORA, Global Technology Center, Hillhouse International, Thornton, Cleveleys FY5 4QD, UK;
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Jung BY, Park WS, Woo CW, Jeong SA. Zirconia-veneered polyetherketoneketone frameworks of implant-supported complete arch fixed dental prostheses: A report on 5 patients. J Prosthet Dent 2023; 130:419-433. [PMID: 36109259 DOI: 10.1016/j.prosdent.2022.07.013] [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: 03/20/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 10/14/2022]
Abstract
Metal frameworks have been used for implant-supported complete arch fixed dental prostheses (ISCFDPs) for maxillary or mandibular edentulous arches with a crown height space of more than 15 mm. However, technical difficulties in the casting, weight, and lack of passivity of the metal have led dentists and dental laboratory technicians to choose materials with different biomechanical properties, including polyetheretherketone (PEEK) and polyetherketoneketone (PEKK). This clinical report describes the design of ISCFDPs using PEKK frameworks, the number of cantilevers, the condition of the opposing dentition, and the incidence of complications, including zirconia crown or PEKK framework fracture, as well as the clinical outcomes of 5 patients observed prospectively over 8 to 65 months. No mechanical complications of PEKK-made ISCFDPs opposing removable prostheses occurred, regardless of the presence of cantilevers. The ISCFDPs that opposed natural dentition or a combination of the natural dentition and fixed prostheses showed different clinical outcomes depending on the length of cantilevers and the number and location of pontics.
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Affiliation(s)
- Bock-Young Jung
- Professor, Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea.
| | - Won-Se Park
- Professor, Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Chang-Woo Woo
- Laboratory Technician, Central Dental Laboratory, Yonsei University Dental Hospital, Seoul, Republic of Korea
| | - Sol-Ah Jeong
- Researcher, Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
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Attia MA, Blunt L, Bills P, Tawfik A, Radawn M. Micro-CT analysis of marginal and internal fit of milled and pressed polyetheretherketone single crowns. J Prosthet Dent 2023:S0022-3913(23)00183-X. [PMID: 37072286 DOI: 10.1016/j.prosdent.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 04/20/2023]
Abstract
STATEMENT OF PROBLEM Polyetheretherketone (PEEK) has been increasingly used as a framework material in prosthetic dentistry. However, data on the marginal and internal fit of PEEK restorations fabricated by using either the computer-aided design and computer-aided manufacturing (CAD-CAM) or heat-pressing technique are sparse. PURPOSE The aim of this in vitro study was to assess the marginal and internal fit of milled and pressed PEEK single crowns by using microcomputed tomography (μCT). MATERIAL AND METHODS A custom-made, single stainless-steel die was designed to replicate a maxillary first premolar prepared for a ceramic crown. PEEK copings (N=30) were fabricated and allocated to 3 groups (n=10) according to the fabrication technique: milled from a prefabricated PEEK blank, heat pressed from PEEK pellets, and heat pressed from PEEK granules. All copings were veneered with a composite resin material. The marginal fit was recorded at 4 predetermined points and the internal fit at 8 predetermined points on each crown by using μCT. Two-way ANOVA, pair-wise Tukey honestly significant difference (HSD), and simple main effect tests were used for statistical analysis of the data (α=.05). RESULTS Concerning marginal fit, the milled crowns demonstrated the best marginal fit overall (44 ±3 μm), followed by those pressed from pellets (92 ±3 μm), and finally by those pressed from granules (137 ±7 μm) (P<.001). The interaction between the effects of the fabrication technique and the measurement point on the marginal fit was not statistically significant (P=.142). The milled crowns demonstrated the lowest mean gap values overall, followed by those pressed from pellets and those pressed from granules (P<.001). The interaction between the effects of the fabrication technique and the measurement point on the internal fit was statistically significant (P<.001). Except for the distal occlusal gap and mesial occlusal gap, all tested groups showed a statistically significant difference (P<.001). In addition, statistically significant differences were observed among all measurement points in different fabrication techniques (P<.001). CONCLUSIONS The marginal and internal fit of milled PEEK crowns was significantly better than pressed crowns. However, both CAD-CAM and heat-pressing techniques produced PEEK crowns with a clinically acceptable marginal and internal fit. The mean marginal gap of the PEEK crowns pressed from granules was above the range of clinically acceptable value.
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Affiliation(s)
- Mazen A Attia
- Associate Professor, Department of Fixed Prosthodontics, Faculty of Dentistry, Beni-Suef University, Beni-Suef, Egypt.
| | - Liam Blunt
- Professor, EPSRC Future Advanced Metrology Hub, University of Huddersfield, Huddersfield, United Kingdom
| | - Paul Bills
- Professor, EPSRC Future Advanced Metrology Hub, University of Huddersfield, Huddersfield, United Kingdom
| | - Ahmed Tawfik
- PhD Researcher, EPSRC Future Advanced Metrology Hub, University of Huddersfield, Huddersfield, United Kingdom
| | - Mohamed Radawn
- Lecturer, Department of Fixed Prosthodontics, Faculty of Dentistry, Beni-Suef University, Beni-Suef, Egypt
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Alsadon O, Moorehead R, Almansour H, Bangalore D, Alageel O, Wood D. Surface Characteristics and Adhesion of Veneering Composite Resin to PAEK-Based Substructure Restorative Materials. J Prosthodont 2023; 32:147-153. [PMID: 35340086 DOI: 10.1111/jopr.13511] [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: 11/04/2021] [Accepted: 03/20/2022] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Omar Alsadon
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Engineer Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Robert Moorehead
- The Henry Royce Institute and Department of Materials Science and Engineering, University of Sheffield, Sheffield, UK
| | - Haitham Almansour
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Durgesh Bangalore
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Omar Alageel
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Duncan Wood
- Academic Unit of Restorative Dentistry, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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12
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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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13
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Pidhatika B, Widyaya VT, Nalam PC, Swasono YA, Ardhani R. Surface Modifications of High-Performance Polymer Polyetheretherketone (PEEK) to Improve Its Biological Performance in Dentistry. Polymers (Basel) 2022; 14:polym14245526. [PMID: 36559893 PMCID: PMC9787615 DOI: 10.3390/polym14245526] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/17/2022] [Accepted: 11/20/2022] [Indexed: 12/23/2022] Open
Abstract
This comprehensive review focuses on polyetheretherketone (PEEK), a synthetic thermoplastic polymer, for applications in dentistry. As a high-performance polymer, PEEK is intrinsically robust yet biocompatible, making it an ideal substitute for titanium-the current gold standard in dentistry. PEEK, however, is also inert due to its low surface energy and brings challenges when employed in dentistry. Inert PEEK often falls short of achieving a few critical requirements of clinical dental materials, such as adhesiveness, osseoconductivity, antibacterial properties, and resistance to tribocorrosion. This study aims to review these properties and explore the various surface modification strategies that enhance the performance of PEEK. Literatures searches were conducted on Google Scholar, Research Gate, and PubMed databases using PEEK, polyetheretherketone, osseointegration of PEEK, PEEK in dentistry, tribology of PEEK, surface modifications, dental applications, bonding strength, surface topography, adhesive in dentistry, and dental implant as keywords. Literature on the topics of surface modification to increase adhesiveness, tribology, and osseointegration of PEEK were included in the review. The unavailability of full texts was considered when excluding literature. Surface modifications via chemical strategies (such as sulfonation, plasma treatment, UV treatment, surface coating, surface polymerization, etc.) and/or physical approaches (such as sandblasting, laser treatment, accelerated neutral atom beam, layer-by-layer assembly, particle leaching, etc.) discussed in the literature are summarized and compared. Further, approaches such as the incorporation of bioactive materials, e.g., osteogenic agents, antibacterial agents, etc., to enhance the abovementioned desired properties are explored. This review presents surface modification as a critical and essential approach to enhance the biological performance of PEEK in dentistry by retaining its mechanical robustness.
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Affiliation(s)
- Bidhari Pidhatika
- Research Center for Polymer Technology, National Research and Innovation Agency, Republic of Indonesia PRTPL BRIN Indonesia, Serpong, Tangerang Selatan 15314, Indonesia
- Collaborative Research Center for Biomedical Scaffolds, National Research and Innovation Agency of the Republic Indonesia and Universitas Gadjah Mada, Jalan Denta No. 1, Sekip Utara, Yogyakarta 55281, Indonesia
| | - Vania Tanda Widyaya
- Research Center for Polymer Technology, National Research and Innovation Agency, Republic of Indonesia PRTPL BRIN Indonesia, Serpong, Tangerang Selatan 15314, Indonesia
| | - Prathima C. Nalam
- Department of Materials Design and Innovation, University at Buffalo, Buffalo, NY 14260-1900, USA
| | - Yogi Angga Swasono
- Research Center for Polymer Technology, National Research and Innovation Agency, Republic of Indonesia PRTPL BRIN Indonesia, Serpong, Tangerang Selatan 15314, Indonesia
| | - Retno Ardhani
- Department of Dental Biomedical Science, Faculty of Dentistry, Universitas Gadjah Mada, Jalan Denta No. 1, Sekip Utara, Yogyakarta 55281, Indonesia
- Correspondence:
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14
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Adhesion concepts and techniques for laboratory-processed indirect dental restorations. Saudi Dent J 2022; 34:661-668. [PMID: 36570573 PMCID: PMC9767842 DOI: 10.1016/j.sdentj.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/19/2022] Open
Abstract
The purpose of this review was to analyze the existing literature on surface conditioning of the veneering surface of substructure restorative materials in dental laboratories. New technologies are constantly improving the treatment options for fabricating dental restorations, and new materials and adhesion procedures are being offered to clinicians and dental technologists. To establish a reliable adhesion between the veneer and substructure in the dental laboratory, various surface treatment procedures and adhesion promoters are employed. The composition of a material influences the adhesion approach selected, and implementing a reliable adhesion strategy is critical for the predictability of veneered indirect dental restorations. However, surface treatment of a wide range of available material options can be challenging. Therefore, understanding various adhesion processes for different restorative materials may assist dental technologists in selecting the best and appropriate surface conditioning protocol for each dental restorative material category.
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15
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Gouveia D, Yilmaz B, Cevik P, Johnston WM. Using Kubelka-Munk reflectance theory to predict optimal pink composite thickness and shade with an opaqued PEEK background for a final gingival color: An in vitro study. Dent Mater 2022; 38:1452-1458. [DOI: 10.1016/j.dental.2022.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 06/12/2022] [Accepted: 06/22/2022] [Indexed: 11/03/2022]
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16
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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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17
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Karaokutan I, Cinel Şahin S, Sagesen HLE. Impact of Resin Cement and Adhesive Systems on the Bond Strength of Polyetheretherketone Dental Restorations. MEANDROS MEDICAL AND DENTAL JOURNAL 2022. [DOI: 10.4274/meandros.galenos.2021.55823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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18
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Zhang J, Yi Y, Wang C, Ding L, Wang R, Wu G. Effect of Acid-Etching Duration on the Adhesive Performance of Printed Polyetheretherketone to Veneering Resin. Polymers (Basel) 2021; 13:polym13203509. [PMID: 34685268 PMCID: PMC8538367 DOI: 10.3390/polym13203509] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/05/2021] [Accepted: 10/09/2021] [Indexed: 02/07/2023] Open
Abstract
Three-dimensional printing polyetheretherketone (PEEK) provides a new choice for dental prostheses, while its appropriate bonding procedure and adhesive performance are still unclear. This study aimed to investigate the adhesive performance of printed polyetheretherketone (PEEK) after acid etching to veneering resin. In total, 182 PEEK specimens (including 91 printed and 91 milled specimens) were distributed to 14 subgroups (n = 13/subgroup), according to the manufacturing process and surface treatment. The specimens were polished and etched with sulfuric acid for 0, 5, 30, 60, 90, 120, and 300 s, respectively. Two specimens in each subgroup were observed under a scanning electron microscope (SEM) for surface and cross-section morphology separately. Then, the specimens were treated with a bonding primer, and one specimen in each subgroup was prepared for cross-sectional observation under SEM. The residual 10 specimens of each subgroup bonded with veneering resin were tested with the shear bond strength tests (SBS) and failure modes analysis. Statistical analysis was performed by one-way ANOVA followed by the SNK-q post hoc test (p < 0.05). The etched pores on the PEEK surface were broadened and deepened under SEM over time. Printed PEEK etched for 30 s obtained the best SBS-to-veneering-resin ratio (27.90 ± 3.48 MPa) among the printed subgroups (p < 0.05) and had no statistical differences compared with milled PEEK etched for 30 s. The SBS of the milled subgroups etched from 5 to 120 s were over 29 MPa without significant between-group statistical differences. Hence, printed PEEK can be coarsened effectively by 30 s of sulfuric acid etching. The adhesion efficacy of printed PEEK to veneering resin was qualified for clinical requirements of polymer-based fixed dentures.
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Affiliation(s)
- Jiaqi Zhang
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, China; (J.Z.); (Y.Y.); (C.W.); (L.D.); (R.W.)
| | - Yingjie Yi
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, China; (J.Z.); (Y.Y.); (C.W.); (L.D.); (R.W.)
| | - Chenwei Wang
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, China; (J.Z.); (Y.Y.); (C.W.); (L.D.); (R.W.)
| | - Ling Ding
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, China; (J.Z.); (Y.Y.); (C.W.); (L.D.); (R.W.)
| | - Ruijin Wang
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, China; (J.Z.); (Y.Y.); (C.W.); (L.D.); (R.W.)
| | - Guofeng Wu
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, China; (J.Z.); (Y.Y.); (C.W.); (L.D.); (R.W.)
- Digital Engineering Center of Stomatology and Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, China
- Correspondence:
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