PEEK versus Metallic Attachment-Retained Obturators for Patient Satisfaction: A Randomized Controlled Trial

Different Polymers for the Base of Removable Dentures? Part I: A Narrative Review of Mechanical and Physical Properties

Even before considering their introduction into the mouth, the choice of materials for the optimization of the prosthesis depends on specific parameters such as their biocompatibility, solidity, resistance, and longevity. In the first part of this two-part review, we approach the various mechanical characteristics that affect this choice, which are closely related to the manufacturing process. Among the materials currently available, it is mainly polymers that are suitable for this use in this field. Historically, the most widely used polymer has been polymethyl methacrylate (PMMA), but more recently, polyamides (nylon) and polyether ether ketone (PEEK) have provided interesting advantages. The incorporation of certain molecules into these polymers will lead to modifications aimed at improving the mechanical properties of the prosthetic bases. In the second part of the review, the safety aspects of prostheses in the oral ecosystem (fragility of the undercuts of soft/hard tissues, neutral pH of saliva, and stability of the microbiota) are addressed. The microbial colonization of the prosthesis, in relation to the composition of the material used and its surface conditions (roughness, hydrophilicity), is of primary importance. Whatever the material and manufacturing process chosen, the coating or finishes dependent on the surface condition remain essential (polishing, non-stick coating) for limiting microbial colonization. The objective of this narrative review is to compile an inventory of the mechanical and physical properties as well as the clinical conditions likely to guide the choice between polymers for the base of removable prostheses.

Clinical Applications of Polyetheretherketone in Removable Dental Prostheses: Accuracy, Characteristics, and Performance

The high-performance thermoplastic polyetheretherketone (PEEK) has excellent mechanical properties, biocompatibility, chemical stability, and radiolucency. The present article comprehensively reviews various applications of PEEK in removable dental prostheses, including in removable partial dentures (RPDs) (frameworks and clasps), double-crown RPDs, and obturators. The clinical performance of PEEK in removable dental prostheses is shown to be satisfactory and promising based on the short-term clinical evidence and technical complications are scarce. Moreover, the accuracy of RPDs is a vital factor for their long-term success rate. PEEK in removable dental prostheses is fabricated using the conventional lost-wax technique and CAD/CAM milling, which produces a good fit. Furthermore, fused deposition modeling is considered to be one of the most practical additive techniques. PEEK in removable prostheses produced by this technique exhibits good results in terms of the framework fit. However, in light of the paucity of evidence regarding other additive techniques, these manufacturers cannot yet be endorsed. Surface roughness, bacterial retention, color stability, and wear resistance should also be considered when attempting to increase the survival rates of PEEK removable prostheses. In addition, pastes represent an effective method for PEEK polishing to obtain a reduced surface roughness, which facilitates lower bacterial retention. As compared to other composite materials, PEEK is less likely to become discolored or deteriorate due to wear abrasion.

Patient Satisfaction regarding Conventional One-Piece Versus Two-Piece Magnet-Retained Obturator for Patients with Complete Edentulism: A Preliminary Crossover Clinical Trial

Purpose:

This study aimed at evaluating patients' satisfaction with conventional one-piece obturators versus two-piece magnet-retained obturators in completely edentulous patient maxillectomy cases.

Materials and Methods:

Ten completely edentulous participants with hemimaxillectomy (8 males and 2 females) were selected in a crossover study. Participants received a conventional obturator one-piece and two-piece obturators connected by magnet attachment in alternate periods (sequences A‐B and B‐A), and outcomes were assessed after 1 week, 3 months, and 6 months Evaluation was made using Obturator Functioning Scale (OFS) and Oral Health Impact Profile for edentulous people (OHIP-EDENT). One way ANOVA test and multivariate analysis of variance with a general linear model with repeated measures was used to test the impact of the group, time, and order on each of the studied scores (α=.05).

Results:

Magnet design showed a statistically significant lower score (P <.050) than the conventional design regarding the overall satisfaction score of OFS along all follow-up periods. Concerning OHIP-EDENT, the magnet design showed a statistically significant lower score (P <.050) than the conventional design regarding total functional limitations, total physical pain, and total social disability along all follow-up periods while for total psychological discomfort, total physical disability, and total handicap, no statistically significant difference was observed between both groups (P >.050).

Conclusion:

Two-pieces magnet-retained obturator could provide better satisfaction and better restoration of orofacial function than the conventional one to manage completely edentulous patients.

Clinical Trial Registration Number:

NCT05066828

Insufficient Evidence to Ascertain the Long-Term Survival of PEEK Dental Prostheses: A Systematic Review of Clinical Studies

Introduction: Polyetheretherketone (PEEK) is a polymer that is used in the construction of orthopaedic and dental implants. It is also used to construct removable and fixed dental prostheses due to its superior mechanical and esthetic properties compared to conventional materials. This systematic review aims to analyse and appraise the literature concerning PEEK dental prostheses critically. Methods: The following focused question was constructed ‘Are dental prostheses made of PEEK inferior to those made of other materials in terms of clinical- and patient-reported outcomes?’. The CONSORT (Consolidated Standards of Reporting Trials) tool was used for the quality assessment of the randomised clinical trials. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) quality assessment tool was used to assess the quality of observational studies and the case reports were evaluated using the CARE (Case Report) guidelines. Results: A total of 12 studies were included in this review. Two case studies received an overall grade of medium and the overall quality of six studies was graded as ‘low’. All three observational studies and the only randomised controlled trial received scores of ‘medium’. Conclusion: PEEK-based dental prostheses may provide a viable and more esthetic alternative to conventional prosthodontic appliances. However, within the limitations of this study is the evidence to ascertain the long-term viability of PEEK-based dental prostheses. Future studies should focus on conducting large-scale, multicenter trials to compare the survival rate of PEEK prostheses to that of conventionally available prosthodontic appliances.