1
|
Rodzeń K, O’Donnell E, Hasson F, McIlhagger A, Meenan BJ, Ullah J, Strachota B, Strachota A, Duffy S, Boyd A. Advanced 3D Printing of Polyetherketoneketone Hydroxyapatite Composites via Fused Filament Fabrication with Increased Interlayer Connection. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3161. [PMID: 38998244 PMCID: PMC11242051 DOI: 10.3390/ma17133161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 07/14/2024]
Abstract
Additively manufactured implants, surgical guides, and medical devices that would have direct contact with the human body require predictable behaviour when stress is applied during their standard operation. Products built with Fused Filament Fabrication (FFF) possess orthotropic characteristics, thus, it is necessary to determine the properties that can be achieved in the XY- and Z-directions of printing. A concentration of 10 wt% of hydroxyapatite (HA) in polyetherketoneketone (PEKK) matrix was selected as the most promising biomaterial supporting cell attachment for medical applications and was characterized with an Ultimate Tensile Strength (UTS) of 78.3 MPa and 43.9 MPa in the XY- and Z-directions of 3D printing, respectively. The effect of the filler on the crystallization kinetics, which is a key parameter for the selection of semicrystalline materials suitable for 3D printing, was explained. This work clearly shows that only in situ crystallization provides the ability to build parts with a more thermodynamically stable primary form of crystallites.
Collapse
Affiliation(s)
- Krzysztof Rodzeń
- School of Engineering, Ulster University, York St, Belfast BT15 1ED, UK; (E.O.); (F.H.); (A.M.); (B.J.M.); (J.U.); (S.D.)
| | - Eiméar O’Donnell
- School of Engineering, Ulster University, York St, Belfast BT15 1ED, UK; (E.O.); (F.H.); (A.M.); (B.J.M.); (J.U.); (S.D.)
| | - Frances Hasson
- School of Engineering, Ulster University, York St, Belfast BT15 1ED, UK; (E.O.); (F.H.); (A.M.); (B.J.M.); (J.U.); (S.D.)
| | - Alistair McIlhagger
- School of Engineering, Ulster University, York St, Belfast BT15 1ED, UK; (E.O.); (F.H.); (A.M.); (B.J.M.); (J.U.); (S.D.)
| | - Brian J. Meenan
- School of Engineering, Ulster University, York St, Belfast BT15 1ED, UK; (E.O.); (F.H.); (A.M.); (B.J.M.); (J.U.); (S.D.)
| | - Jawad Ullah
- School of Engineering, Ulster University, York St, Belfast BT15 1ED, UK; (E.O.); (F.H.); (A.M.); (B.J.M.); (J.U.); (S.D.)
| | - Beata Strachota
- Institute of Macromolecular Chemistry v.v.i., Academy of Sciences of the Czech Republic, Heyrovskeho nam. 2, 162 00 Praha, Czech Republic; (B.S.); (A.S.)
| | - Adam Strachota
- Institute of Macromolecular Chemistry v.v.i., Academy of Sciences of the Czech Republic, Heyrovskeho nam. 2, 162 00 Praha, Czech Republic; (B.S.); (A.S.)
| | - Sean Duffy
- School of Engineering, Ulster University, York St, Belfast BT15 1ED, UK; (E.O.); (F.H.); (A.M.); (B.J.M.); (J.U.); (S.D.)
| | - Adrian Boyd
- School of Engineering, Ulster University, York St, Belfast BT15 1ED, UK; (E.O.); (F.H.); (A.M.); (B.J.M.); (J.U.); (S.D.)
| |
Collapse
|
2
|
Gama LT, Bezerra AP, Schimmel M, Rodrigues Garcia RCM, de Luca Canto G, Gonçalves TMSV. Clinical performance of polymer frameworks in dental prostheses: A systematic review. J Prosthet Dent 2024; 131:579-590. [PMID: 35422333 DOI: 10.1016/j.prosdent.2022.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/07/2022] [Accepted: 03/07/2022] [Indexed: 12/11/2022]
Abstract
STATEMENT OF PROBLEM High-performance polymers including polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) have been used as substitutes for metal frameworks in dental prostheses. However, the clinical performance of polymer-based frameworks is still uncertain. PURPOSE The purpose of this systematic review was to compare the clinical performance of PEEK and PEKK with that of metal frameworks for different dental prostheses. MATERIAL AND METHODS This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases and non-peer-reviewed literature (without language or follow-up restrictions) were searched for studies conducted before February 2022. Only clinical studies, either randomized clinical trials (RCTs) or nonrandomized clinical trials (N-RCTs), comparing the clinical performance of polymer and metal frameworks were included. The risk of bias and certainty of the evidence were assessed with the RoB 2.0, ROBINS-I, and GRADE. Biologic (plaque and gingival indices, probing depth, bleeding scores, implant stability quotient, marginal bone loss) and mechanical outcomes (ridge base relation, prosthetic marginal gap, and fracture) were assessed. RESULTS Only 9 studies (7 RCTs and 2 N-RCTs) were included, all with moderate to serious risk of bias and low to very low certainty of evidence. No meta-analysis was possible, but qualitative analysis revealed lower plaque and gingival indices, probing depth, and marginal bone loss, with higher survival rates for implant-supported fixed prostheses and overdentures fabricated with PEEK than for metal frameworks. No significant differences were found between groups for removable partial dentures. The marginal fit of PEEK frameworks was also better for single crowns. Three fractures were reported in the 3 PEKK fixed dental prostheses with cantilevers. CONCLUSIONS PEEK and PEKK seem to be promising materials for dental prostheses, with acceptable response from the periodontal tissue. However, further well-designed studies are necessary to better understand their clinical and long-term limitations.
Collapse
Affiliation(s)
- Lorena Tavares Gama
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Adriana Pinto Bezerra
- PhD student, Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Martin Schimmel
- Full Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern (UNIBE), Bern, Switzerland; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Renata Cunha Matheus Rodrigues Garcia
- Full Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Graziela de Luca Canto
- Full Professor, Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | | |
Collapse
|
3
|
Serino G, Distefano F, Zanetti EM, Pascoletti G, Epasto G. Multiscale Mechanical Characterization of Polyether-2-ketone (PEKK) for Biomedical Application. Bioengineering (Basel) 2024; 11:244. [PMID: 38534517 DOI: 10.3390/bioengineering11030244] [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: 12/21/2023] [Revised: 02/01/2024] [Accepted: 02/23/2024] [Indexed: 03/28/2024] Open
Abstract
Polyether-ether-2-ketone (PEKK) is a high-performance thermoplastic polymer used in various fields, from aerospace to medical applications, due to its exceptional mechanical and thermal properties. Nonetheless, the mechanical behavior of 3D-printed PEKK still deserves to be more thoroughly investigated, especially in view of its production by 3D printing, where mechanical properties measured at different scales are likely to be correlated to one another and to all play a major role in determining biomechanical properties, which include mechanical strength on one side and osteointegration ability on the other side. This work explores the mechanical behavior of 3D-printed PEKK through a multiscale approach, having performed both nanoindentation tests and standard tensile and compression tests, where a detailed view of strain distribution was achieved through Digital Image Correlation (DIC) techniques. Furthermore, for specimens tested up to failure, their fractured surfaces were analyzed through Scanning Electron Microscopy (SEM) to clearly outline fracture modes. Additionally, the internal structure of 3D-printed PEKK was explored through Computed Tomography (CT) imaging, providing a three-dimensional view of the internal structure and the presence of voids and other imperfections. Finally, surface morphology was analyzed through confocal microscopy. The multiscale approach adopted in the present work offers information about the global and local behavior of the PEKK, also assessing its material properties down to the nanoscale. Due to its novelty as a polymeric material, no previous studies have approached a multiscale analysis of 3D-printed PEKK. The findings of this study contribute to a comprehensive understanding of 3D-printed PEKK along with criteria for process optimization in order to customize its properties to meet specific application requirements. This research not only advances the knowledge of PEKK as a 3D-printing material but also provides insights into the multifaceted nature of multiscale material characterization.
Collapse
Affiliation(s)
- Gianpaolo Serino
- Department of Mechanical and Aerospace Engineering (DIMEAS), Politecnico di Torino, 10129 Turin, Italy
- PolitoBIOMed Laboratory, Politecnico di Torino, 10129 Torino, Italy
| | - Fabio Distefano
- Department of Engineering, University of Messina, Contrada Di Dio, 98166 Messina, Italy
| | | | - Giulia Pascoletti
- Department of Engineering, University of Perugia, 06125 Perugia, Italy
| | - Gabriella Epasto
- Department of Engineering, University of Messina, Contrada Di Dio, 98166 Messina, Italy
| |
Collapse
|
4
|
Chen M, Ren M, Shi Y, Liu X, Wei H. State-of-the-art polyetheretherketone three-dimensional printing and multifunctional modification for dental implants. Front Bioeng Biotechnol 2023; 11:1271629. [PMID: 37929192 PMCID: PMC10621213 DOI: 10.3389/fbioe.2023.1271629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
Polyetheretherketone (PEEK) is a high-performance thermoplastic polymer with an elastic modulus close to that of the jawbone. PEEK has the potential to become a new dental implant material for special patients due to its radiolucency, chemical stability, color similarity to teeth, and low allergy rate. However, the aromatic main chain and lack of surface charge and chemical functional groups make PEEK hydrophobic and biologically inert, which hinders subsequent protein adsorption and osteoblast adhesion and differentiation. This will be detrimental to the deposition and mineralization of apatite on the surface of PEEK and limit its clinical application. Researchers have explored different modification methods to effectively improve the biomechanical, antibacterial, immunomodulatory, angiogenic, antioxidative, osteogenic and anti-osteoclastogenic, and soft tissue adhesion properties. This review comprehensively summarizes the latest research progress in material property advantages, three-dimensional printing synthesis, and functional modification of PEEK in the fields of implant dentistry and provides solutions for existing difficulties. We confirm the broad prospects of PEEK as a dental implant material to promote the clinical conversion of PEEK-based dental implants.
Collapse
Affiliation(s)
- Meiqing Chen
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Mei Ren
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yingqi Shi
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xiuyu Liu
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Hongtao Wei
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Dua R, Sharufa O, Terry J, Dunn W, Khurana I, Vadivel J, Zhang Y, Donahue HJ. Surface modification of Polyether-ether-ketone for enhanced cell response: a chemical etching approach. Front Bioeng Biotechnol 2023; 11:1202499. [PMID: 37744253 PMCID: PMC10517429 DOI: 10.3389/fbioe.2023.1202499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023] Open
Abstract
Polyether-ether-ketone (PEEK) is increasingly becoming popular in medicine because of its excellent mechanical strength, dimensional stability, and chemical resistance properties. However, PEEK being bioinert, has weak bone osseointegration properties, limiting its clinical applications. In this study, a porous PEEK structure was developed using a chemical etching method with 98 wt% sulfuric acids and three post-treatments were performed to improve bone cell adhesion and proliferation. Four groups of PEEK samples were prepared for the study: Control (untreated; Group 1); Etched with sulfuric acid and washed with distilled water (Group 2); Etched with sulfuric acid and washed with acetone and distilled water (Group 3); and Etched with sulfuric acid and washed with 4 wt% sodium hydroxide and distilled water (Group 4). Surface characterization of the different groups was evaluated for surface topology, porosity, roughness, and wettability using various techniques, including scanning electron microscopy, profilometer, and goniometer. Further chemical characterization was done using Energy-dispersive X-ray spectroscopy to analyze the elements on the surface of each group. Bone cell studies were conducted using cell toxicity and alkaline phosphatase activity (ALP) assays. The SEM analysis of the different groups revealed porous structures in the treatment groups, while the control group showed a flat topology. There was no statistically significant difference between the pore size within the treated groups. This was further confirmed by the roughness values measured with the profilometer. We found a statistically significant increase in the roughness from 7.22 × 10-3 μm for the control group to the roughness range of 0.1 µm for the treated groups (Groups 2-4). EDX analysis revealed the presence of a 0.1% weight concentration of sodium on the surface of Group 4, while sulfur weight percentage concentration was 1.1%, 0.1%, and 1.4% in groups 2, 3, and 4, respectively, indicating different surface chemistry on the surface due to different post-treatments. Cell toxicity decreased, and ALP activity increased in groups 3 and 4 over 7 days compared with the control group. It is demonstrated that the surface modification of PEEK using a chemical etching method with post-processing with either acetone or sodium hydroxide provides a nano-porous structure with improved properties, leading to enhanced osteoblastic cell differentiation and osteogenic potential.
Collapse
Affiliation(s)
- Rupak Dua
- American Dental Association Science and Research Institute (ADASRI), Gaithersburg, MD, United States
- Department of Chemical Engineering, Hampton University, Hampton, VA, United States
| | - Onessa Sharufa
- Department of Chemical Engineering, Hampton University, Hampton, VA, United States
| | - Joi Terry
- Department of Biology, Hampton University, Hampton, VA, United States
| | - William Dunn
- The New Horizons Governor’s School for Science and Technology, Hampton, VA, United States
| | - Indu Khurana
- Department of Economics and Business, Hampden-Sydney College, Hampden-Sydney, VA, United States
| | - Jagasivamani Vadivel
- Department of Chemical Engineering, Hampton University, Hampton, VA, United States
| | - Yue Zhang
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, United States
| | - Henry J. Donahue
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, United States
| |
Collapse
|
7
|
Zhang Z, Shao J, Gao Y, Li Y, Liu T, Yang M. Research progress and future prospects of antimicrobial modified polyetheretherketone (PEEK) for the treatment of bone infections. Front Bioeng Biotechnol 2023; 11:1244184. [PMID: 37600311 PMCID: PMC10436002 DOI: 10.3389/fbioe.2023.1244184] [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: 06/22/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Infection of the bone is a difficult problem in orthopedic diseases. The key and basis of the treatment of bone infection is the effective control of local infection, as well as the elimination of infection focus and dead cavities. The most commonly used approach utilized for the prevention and management of bone infection is the application of antibiotic bone cement. However, the incorporation of antibiotics into the cement matrix has been found to considerably compromise the mechanical characteristics of bone cement. Moreover, some investigations have indicated that the antibiotic release rate of antibiotic bone cement is relatively low. Polyetheretherketone (PEEK) and its composites have been considered to perfectly address the challenges above, according to its favorable biomechanical characteristics and diverse surface functionalizations. This article provides a comprehensive overview of the recent advancements in the antimicrobial modification of PEEK composites in the field of antibacterial therapy of bone infection. Furthermore, the potential application of PEEK-modified materials in clinical treatment was discussed and predicted.
Collapse
Affiliation(s)
- Ziyi Zhang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Junxing Shao
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Yu Gao
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Yuhuan Li
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Te Liu
- Scientific Research Center, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Modi Yang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| |
Collapse
|
8
|
Tan X, Wang Z, Yang X, Yu P, Sun M, Zhao Y, Yu H. Enhancing cell adhesive and antibacterial activities of glass-fibre-reinforced polyetherketoneketone through Mg and Ag PIII. Regen Biomater 2023; 10:rbad066. [PMID: 37489146 PMCID: PMC10363026 DOI: 10.1093/rb/rbad066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/24/2023] [Accepted: 06/29/2023] [Indexed: 07/26/2023] Open
Abstract
Glass-fibre-reinforced polyetherketoneketone (PEKK-GF) shows great potential for application as a dental implant restoration material; however, its surface bioinertness and poor antibacterial properties limit its integration with peri-implant soft tissue, which is critical in the long-term success of implant restoration. Herein, functional magnesium (Mg) and silver (Ag) ions were introduced into PEKK-GF by plasma immersion ion implantation (PIII). Surface characterization confirmed that the surface morphology of PEKK-GF was not visibly affected by PIII treatment. Further tests revealed that PIII changed the wettability and electrochemical environment of the PEKK-GF surface and enabled the release of Mg2+ and Ag+ modulated by Giavanni effect. In vitro experiments showed that Mg/Ag PIII-treated PEKK-GF promoted the proliferation and adhesion of human gingival fibroblasts and upregulated the expression of adhesion-related genes and proteins. In addition, the treated samples inhibited the metabolic viability and adhesion of Streptococcus mutans and Porphyromonas gingivalis on their surfaces, distorting bacterial morphology. Mg/Ag PIII surface treatment improved the soft tissue integration and antibacterial activities of PEKK-GF, which will further support and broaden its adoption in dentistry.
Collapse
Affiliation(s)
| | | | - Xin Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ping Yu
- Department of Stomatology, Chengdu Second People’s Hospital, Chengdu, China
| | - Manlin Sun
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuwei Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Haiyang Yu
- Correspondence address. Tel: +86 0 18980685999, E-mail:
| |
Collapse
|
9
|
Qian B, Ji K, Lu W, Wu G, Tan B, Jing J, Ji J. Polyetherketoneketone, a high-performance polymer for splinting mobile teeth: A clinical report. J Prosthet Dent 2023:S0022-3913(23)00120-8. [PMID: 37003942 DOI: 10.1016/j.prosdent.2023.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 04/03/2023]
Abstract
A digital workflow for fabricating a polyetherketoneketone (PEKK) periodontal splint is described. The antibacterial properties of PEKK and the precision and efficiency of digital technology led to the provision of a splint with no adverse effects on oral hygiene or periodontal maintenance during a 2-year follow-up.
Collapse
Affiliation(s)
- Bingzhi Qian
- Resident, Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China; Resident, Department of Orthodontics, Hangzhou Stomatology Hospital, Hangzhou, Zhejiang, PR China
| | - Kun Ji
- Associate Professor, Department of Pediatric Dentistry, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China
| | - Wei Lu
- Associate Professor, Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China
| | - Guofeng Wu
- Professor, Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China
| | - Baochun Tan
- Professor, Department of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China
| | - Jianlong Jing
- Technician, Department of Dental laboratory, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China
| | - Jun Ji
- Professor, Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China.
| |
Collapse
|
10
|
Bächle J, Merle C, Hahnel S, Rosentritt M. Bacterial Adhesion on Dental Polymers as a Function of Manufacturing Techniques. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2373. [PMID: 36984253 PMCID: PMC10054275 DOI: 10.3390/ma16062373] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
The microbiological behavior of dental polymer materials is crucial to secure the clinical success of dental restorations. Here, the manufacturing process and the machining can play a decisive role. This study investigated the bacterial adhesion on dental polymers as a function of manufacturing techniques (additive/subtractive) and different polishing protocols. Specimens were made from polyaryletherketone (PEEK, PEKK, and AKP), resin-based CAD/CAM materials (composite and PMMA), and printed methacrylate (MA)-based materials. Surface roughness (Rz; Ra) was determined using a laser scanning microscope, and SFE/contact angles were measured using the sessile drop method. After salivary pellicle formation, in vitro biofilm formation was initiated by exposing the specimens to suspensions of Streptococcus mutans (S. mutans) and Streptococcus sanguinis (S. sanguinis). Adherent bacteria were quantified using a fluorometric assay. One-way ANOVA analysis found significant influences (p < 0.001) for the individual parameters (treatment and material) and their combinations for both types of bacteria. Stronger polishing led to significantly (p < 0.001) less adhesion of S. sanguinis (Pearson correlation PC = -0.240) and S. mutans (PC = -0.206). A highly significant (p = 0.010, PC = 0.135) correlation between S. sanguinis adhesion and Rz was identified. Post hoc analysis revealed significant higher bacterial adhesion for vertically printed MA specimens compared to horizontally printed specimens. Furthermore, significant higher adhesion of S. sanguinis on pressed PEEK was revealed comparing to the other manufacturing methods (milling, injection molding, and 3D printing). The milled PAEK samples showed similar bacterial adhesion. In general, the resin-based materials, composites, and PAEKs showed different bacterial adhesion. Fabrication methods were shown to play a critical role; the pressed PEEK showed the highest initial accumulations. Horizontal DLP fabrication reduced bacterial adhesion. Roughness < 10 µm or polishing appear to be essential for reducing bacterial adhesion.
Collapse
|
11
|
Polyetherketoneketone Mesh for Alveolar Bone Augmentation: Geometric Parameter Design and Finite Element Analysis. JOURNAL OF HEALTHCARE ENGINEERING 2023; 2023:8487380. [PMID: 36760836 PMCID: PMC9904908 DOI: 10.1155/2023/8487380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/28/2022] [Accepted: 11/24/2022] [Indexed: 02/04/2023]
Abstract
Objective To evaluate the mechanical properties of porous polyetherketoneketone (PEKK) meshes with different thicknesses, pore sizes, and porosities through finite element analysis to provide an optimal PEKK design for alveolar bone augmentation in the posterior mandibular region. Methods A three-dimensional evaluation model of severe alveolar bone defects in the mandibular posterior was constructed based on cone beam computerized tomography (CBCT) data. Then, PEKK meshes with different structural designs were obtained. Two key parameters were set with different values: five levels of thickness (0.2 mm, 0.3 mm, 0.4 mm, 0.5 mm, and 0.6 mm) and three levels of pore size (1 mm, 2 mm, and 3 mm) with a corresponding porosity of 19.18%-42.67%. A 100 N physiological force was simultaneously loaded by finite element analysis (FEA), and the deformation and stress data were outputted for further analysis. Results The deformation and stress of the PEKK meshes are negatively correlated with the changes in thickness and positively correlated with the changes in pore size. The FEA results show that the maximum deformation, equivalent stress, and maximum principal stress of the PEKK meshes are 0.168 mm-0.478 mm, 49.243 MPa-124.890 MPa, and 31.549 MPa-104.200 MPa, respectively. The PEKK mesh group with a thickness of 0.2 mm, pore size of 3 mm, and porosity of 42.67% is in danger of plastic deformation or even fracture during use. Conclusion According to the FEA results, the PEKK meshes with larger thicknesses and smaller pore sizes and porosities behave better. In consideration of reducing soft tissue stimulation and promoting bone regeneration, an ultrathin porous PEKK mesh with a pore size of no more than 3 mm, porosity of no more than 42.67%, and thickness of 0.2 mm can be used clinically to meet the mechanical performance requirements of the guided bone regeneration (GBR) structure.
Collapse
|
12
|
Preparation and Characterization of a Polyetherketoneketone/Hydroxyapatite Hybrid for Dental Applications. J Funct Biomater 2022; 13:jfb13040220. [PMID: 36412861 PMCID: PMC9680429 DOI: 10.3390/jfb13040220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
Here, we developed a new synthetic method for the production of a new class of polymeric inorganic hybrid biomaterial that has potential for dental implant applications and, in general, other orthopedic applications owing to its excellent mechanical properties and biomechanical compatibility. The new hybrid biomaterial is a composite consisting of polyetherketoneketone (PEKK) and hydroxyapatite (HA). This hybrid material boasts several unique features, including its high HA loading (up to 50 wt%), which is close to that of natural human bone; the homogeneous HA distribution in the PEKK matrix without phase separation; and the fact that the addition of HA has no effect on the molecular weight of PEKK. Nanoindentation analysis was used to investigate the mechanical properties of the composite, and its nano/microstructure variations were investigated through a structural model developed here. Through nanoindentation technology, the newly developed PEKK/HA hybrid biomaterial has an indentation modulus of 12.1 ± 2.5 GPa and a hardness of 0.42 ± 0.09 GPa, which are comparable with those of human bone. Overall, the new PEKK/HA biomaterial exhibits excellent biomechanical compatibility and shows great promise for application to dental and orthopedic devices.
Collapse
|
13
|
Maloo LM, Toshniwal SH, Reche A, Paul P, Wanjari MB. A Sneak Peek Toward Polyaryletherketone (PAEK) Polymer: A Review. Cureus 2022; 14:e31042. [DOI: 10.7759/cureus.31042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022] Open
|
14
|
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: 10] [Impact Index Per Article: 5.0] [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.
Collapse
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.
| |
Collapse
|
15
|
Lee WF, Wang LY, Renn TY, Yang JC, Fang LS, Lee YH, Peng PW. Characterization and Antibacterial Properties of Polyetherketoneketone Coated with a Silver Nanoparticle-in-Epoxy Lining. Polymers (Basel) 2022; 14:polym14142906. [PMID: 35890681 PMCID: PMC9323652 DOI: 10.3390/polym14142906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/25/2022] [Accepted: 07/01/2022] [Indexed: 12/07/2022] Open
Abstract
Polyetherketoneketone (PEKK) is an alternative material for use in removable partial denture frameworks; these frameworks must exhibit antibacterial properties to reduce the risk of periodontal disease. In the present study, silver nanoparticles (AgNPs) were synthesized via the reduction of silver nitrate with sodium borohydride in a solution containing polyvinyl pyrrolidone (PVP). Transmission electron microscope images and dynamic light scattering confirmed that metallic nanoparticles had been created with an average size of 32 nm. Furthermore, the coating of the PEKK polymeric substrate with 0.5% AgNPs was carried out using an epoxy resin lining at room temperature. Fourier transform infrared (FTIR) spectra confirmed the successful transfer of the AgNP-in-resin lining onto the polymeric substrate. Scanning electron microscopy and atomic force microscopy confirmed that the AgNPs had been uniformly deposited onto the PEKK specimens. Finally, the antibacterial activity of the specimens was tested against Porphyromonas gingivalis. An inhibition zone of 22.5 mm and an antibacterial rate of 83.47% were found for the PEKK coated with 0.5% AgNPs (0.5% Ag-PEKK) compared to an untreated polyetheretherketone (PEEK) substrate, evidencing that 0.5% Ag-PEKK has potential antibacterial properties for implant applications.
Collapse
Affiliation(s)
- Wei-Fang Lee
- School of Dental Technology, Taipei Medical University, Taipei 11031, Taiwan;
| | - Lu-Ying Wang
- Institute of Organic and Polymeric Materials, National Taipei University of Technology, Taipei 10608, Taiwan;
| | - Ting-Yi Renn
- Department of Oral and Maxillofacial Pathobiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 739-8511, Japan;
| | - Jen-Chang Yang
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11052, Taiwan;
| | | | - Yi-Huan Lee
- Institute of Organic and Polymeric Materials, National Taipei University of Technology, Taipei 10608, Taiwan;
- Correspondence: (Y.-H.L.); (P.-W.P.); Tel.: +886-2-27712171 (ext. 2410) (Y.-H.L.); +886-2-27361661 (ext. 5130) (P.-W.P.)
| | - Pei-Wen Peng
- School of Dental Technology, Taipei Medical University, Taipei 11031, Taiwan;
- Correspondence: (Y.-H.L.); (P.-W.P.); Tel.: +886-2-27712171 (ext. 2410) (Y.-H.L.); +886-2-27361661 (ext. 5130) (P.-W.P.)
| |
Collapse
|
16
|
Wang Y, Zhang S, Nie B, Qu X, Yue B. Approaches to Biofunctionalize Polyetheretherketone for Antibacterial: A Review. Front Bioeng Biotechnol 2022; 10:895288. [PMID: 35646862 PMCID: PMC9136111 DOI: 10.3389/fbioe.2022.895288] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022] Open
Abstract
Due to excellent mechanical properties and similar elastic modulus compared with human cortical bone, polyetheretherketone (PEEK) has become one of the most promising orthopedic implant materials. However, implant-associated infections (IAIs) remain a challenging issue since PEEK is bio-inert. In order to fabricate an antibacterial bio-functional surface, modifications of PEEK had been widely investigated. This review summarizes the modification strategies to biofunctionalize PEEK for antibacterial. We will begin with reviewing different approaches, such as surface-coating modifications and controlled release of antimicrobials. Furthermore, blending modifications and 3D printing technology were discussed. Finally, we compare the effects among different approaches. We aimed to provide an in-depth understanding of the antibacterial modification and optimize the design of the PEEK orthopedic implant.
Collapse
Affiliation(s)
- Yihan Wang
- Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Department of Orthopedics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shutao Zhang
- Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Department of Orthopedics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Bin’en Nie
- Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Department of Orthopedics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xinhua Qu
- Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Department of Orthopedics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Bing Yue
- Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Department of Orthopedics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- *Correspondence: Bing Yue,
| |
Collapse
|
17
|
Thanigachalam M, Muthusamy Subramanian AV. Evaluation of PEEK-TiO 2- SiO 2 nanocomposite as biomedical implants with regard to in-vitro biocompatibility and material characterization. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2022; 33:727-746. [PMID: 34861127 DOI: 10.1080/09205063.2021.2014028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Polyether Ether Ketone (PEEK) exhibits superior mechanical and biological safety characteristics, and its biological inertness significantly restricts its applicability in biomedical applications. Recent researches included active ceramic particles to enhance biological activity and broaden the application range of bioactive composites in medical implants. During the current investigation, acrylic acid-functionalized ceramic TiO2 and SiO2 nanoparticles (NP) were used to reinforce the PEEK matrix. The PEEK/TiO2/SiO2 (PTS) nanocomposite was fabricated using plastic injection moulding process. Different functional groups and crystal plane orientations of the composite were found through FTIR and XRD. The morphological and elemental analysis were carried out using FESEM and the EDAX mapping technique. The thermal stability of the composite was investigated through TGA and DSC analysis. The mean diameter of the inhibition zone of PTS polymer composite is 18.125 mm and 16.375 mm against E. coli and B. subtilis, respectively, which is higher than that of the mean diameter of the inhibition zone of PEEK. In-vitro direct and indirect cytotoxicity studies were carried using the MG-63 cell line and found the cell viability as 94.30% and cytotoxicity as 5.70% on PTS nanocomposite. Cell adhesion study was carried out using MG-63 cell line on the composite surface. That demonstrated the good cell adherence and cell proliferation those were observed through SEM morphologies. Thus, the newly developed composite serves as a potential candidate in biomedical applications.
Collapse
Affiliation(s)
- Mugilan Thanigachalam
- Department of Mechanical Engineering, Government College of Technology, Coimbatore, India
| | | |
Collapse
|
18
|
Adingo S, Yu JR, Xuelu L, Li X, Jing S, Xiaong Z. Variation of soil microbial carbon use efficiency (CUE) and its Influence mechanism in the context of global environmental change: a review. PeerJ 2021; 9:e12131. [PMID: 34721956 PMCID: PMC8522642 DOI: 10.7717/peerj.12131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/17/2021] [Indexed: 12/05/2022] Open
Abstract
Soil microbial carbon utilization efficiency (CUE) is the efficiency with which microorganisms convert absorbed carbon (C) into their own biomass C, also referred to as microorganism growth efficiency. Soil microbial CUE is a critical physiological and ecological parameter in the ecosystem’s C cycle, influencing the processes of C retention, turnover, soil mineralization, and greenhouse gas emission. Understanding the variation of soil microbial CUE and its influence mechanism in the context of global environmental change is critical for a better understanding of the ecosystem’s C cycle process and its response to global changes. In this review, the definition of CUE and its measurement methods are reviewed, and the research progress of soil microbial CUE variation and influencing factors is primarily reviewed and analyzed. Soil microbial CUE is usually expressed as the ratio of microbial growth and absorption, which is divided into methods based on the microbial growth rate, microbial biomass, substrate absorption rate, and substrate concentration change, and varies from 0.2 to 0.8. Thermodynamics, ecological environmental factors, substrate nutrient quality and availability, stoichiometric balance, and microbial community composition all influence this variation. In the future, soil microbial CUE research should focus on quantitative analysis of trace metabolic components, analysis of the regulation mechanism of biological-environmental interactions, and optimization of the carbon cycle model of microorganisms’ dynamic physiological response process.
Collapse
Affiliation(s)
- Samuel Adingo
- College of Forestry, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Jie-Ru Yu
- College of Resources and Environment, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Liu Xuelu
- College of Resources and Environment, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Xiaodan Li
- School of Management, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Sun Jing
- College of Resources and Environment, Gansu Agricultural University, Lanzhou, Gansu, China
| | - Zhang Xiaong
- College of Forestry, Gansu Agricultural University, Lanzhou, Gansu, China
| |
Collapse
|
19
|
Mochalski J, Fröhls C, Keilig L, Bourauel C, Dörsam I. Experimental and numerical investigations of fracture and fatigue behaviour of implant-supported bars with distal extension made of three different materials. BIOMED ENG-BIOMED TE 2021; 66:305-316. [PMID: 34062636 DOI: 10.1515/bmt-2020-0157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 11/13/2020] [Indexed: 11/15/2022]
Abstract
The aim of this study was to investigate experimentally the fatigue and stability of three bar materials with distal extension at the molar region and to numerically analyse the biomechanical properties of the bar materials connected to overdentures in a patient individual model. A milled bar was designed for the mandible on four implants in the canine and second premolar region. Three bar materials were investigated: titanium (Ti), cobalt chromium (CoCr), and polyetherketonketon (PEKK). Firstly, static and fatigue tests were performed based on EN ISO 14801 in a commercial permanent loading set-up. Unilateral axial force was applied on the distal extension of the bars. Secondly, numerical models were created. Different bar materials and loading scenarios were analysed. The static fracture limit of the three materials was 1,750 N, 780 N, 310 N for Ti, CoCr, and PEKK, respectively. The Wöhler curves showed comparable fatigue limits of 200 N, 160 N, and 150 N for titanium, CoCr, and PEKK, respectively. The stress at the distal extension was 2,600 MPa (Ti), 1,000 MPa (CoCr), and 270 MPa (PEKK). All loading simulations with the PEKK bar showed higher stresses in the implants and in the bone bed as well as higher displacements of the over denture in comparison to metal bars. PEKK showed different mechanical behaviour compared to Ti and CoCr. The distribution of stresses within the PEKK bar was wider than the area of loading which probably leads to fatigue of the whole bar and not only the part under load.
Collapse
Affiliation(s)
| | | | - Ludger Keilig
- Oral Technology, University of Bonn, Bonn, Germany.,Department of Prosthetic Dentistry, Preclinical Education and Materials Science, Dental School, University of Bonn, Bonn, Germany
| | | | - Istabrak Dörsam
- Oral Technology, University of Bonn, Bonn, Germany.,Department of Prosthetic Dentistry, Preclinical Education and Materials Science, Dental School, University of Bonn, Bonn, Germany
| |
Collapse
|
20
|
Accuracy of patient-specific temporal implants using PEKK. J Craniomaxillofac Surg 2021; 49:943-949. [PMID: 34099374 DOI: 10.1016/j.jcms.2021.05.001] [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: 08/09/2020] [Revised: 02/15/2021] [Accepted: 05/13/2021] [Indexed: 10/21/2022] Open
Abstract
The main aim of this study was to evaluate the accuracy of immediate CAD/CAM reconstruction of the temporal hollowing following temporalis muscle surgery, using a patient-specific implant (PSI) PEKK model. This case series included ten patients who underwent maxillofacial reconstruction using temporalis muscle flap (TMF). The study involved the preoperative planning and fabrication of the temporal implant using virtual surgical planning software. The planning was based on multislice CT scans, from which DICOM files were used to fabricate a 3D model of the temporalis muscle using polyetherketoneketone (PEKK). The patients were followed up for 12 months, to check for any signs of infection or mobilization, and to assess accuracy. At the end of the follow-up period, all the patients showed acceptance of the external appearance, with no signs of infection or rejection. These customized implants were measured and compared with their original 3D preoperative planning using a point-based analysis. This revealed a mean difference (±SD) of 0.0373 (±0.3036) mm and a median difference (Q1 to Q3) of 0.0809 (-0.2108 to 0.2769) mm. The study demonstrated that a highly accurate duplication of PSIs can be achieved using this template-molding workflow. The use of PEKK PSIs resulted in uneventful healing and esthetic acceptance by the patients and, therefore, is a relevant treatment option when temporal hollowing has to be corrected.
Collapse
|
21
|
Sartini S, Permana AD, Mitra S, Tareq AM, Salim E, Ahmad I, Harapan H, Emran TB, Nainu F. Current State and Promising Opportunities on Pharmaceutical Approaches in the Treatment of Polymicrobial Diseases. Pathogens 2021; 10:245. [PMID: 33672615 PMCID: PMC7924209 DOI: 10.3390/pathogens10020245] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/10/2021] [Accepted: 02/18/2021] [Indexed: 12/18/2022] Open
Abstract
In recent years, the emergence of newly identified acute and chronic infectious disorders caused by diverse combinations of pathogens, termed polymicrobial diseases, has had catastrophic consequences for humans. Antimicrobial agents have been clinically proven to be effective in the pharmacological treatment of polymicrobial diseases. Unfortunately, an increasing trend in the emergence of multi-drug-resistant pathogens and limited options for delivery of antimicrobial drugs might seriously impact humans' efforts to combat polymicrobial diseases in the coming decades. New antimicrobial agents with novel mechanism(s) of action and new pharmaceutical formulations or delivery systems to target infected sites are urgently required. In this review, we discuss the prospective use of novel antimicrobial compounds isolated from natural products to treat polymicrobial infections, mainly via mechanisms related to inhibition of biofilm formation. Drug-delivery systems developed to deliver antimicrobial compounds to both intracellular and extracellular pathogens are discussed. We further discuss the effectiveness of several biofilm-targeted delivery strategies to eliminate polymicrobial biofilms. At the end, we review the applications and promising opportunities for various drug-delivery systems, when compared to conventional antimicrobial therapy, as a pharmacological means to treat polymicrobial diseases.
Collapse
Affiliation(s)
- Sartini Sartini
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia; (S.S.); (A.D.P.)
| | - Andi Dian Permana
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia; (S.S.); (A.D.P.)
| | - Saikat Mitra
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1000, Bangladesh; or
| | - Abu Montakim Tareq
- Department of Pharmacy, International Islamic University Chittagong, Chittagong 4318, Bangladesh; or
| | - Emil Salim
- Faculty of Pharmacy, Universitas Sumatera Utara, North Sumatera 20155, Indonesia;
| | - Islamudin Ahmad
- Faculty of Pharmacy, Universitas Mulawarman, East Kalimantan 75119, Indonesia;
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia;
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong 4381, Bangladesh;
| | - Firzan Nainu
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia; (S.S.); (A.D.P.)
| |
Collapse
|
22
|
Gu X, Sun X, Sun Y, Wang J, Liu Y, Yu K, Wang Y, Zhou Y. Bioinspired Modifications of PEEK Implants for Bone Tissue Engineering. Front Bioeng Biotechnol 2021; 8:631616. [PMID: 33511108 PMCID: PMC7835420 DOI: 10.3389/fbioe.2020.631616] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/10/2020] [Indexed: 12/15/2022] Open
Abstract
In recent years, polyetheretherketone (PEEK) has been increasingly employed as an implant material in clinical applications. Although PEEK is biocompatible, chemically stable, and radiolucent and has an elastic modulus similar to that of natural bone, it suffers from poor integration with surrounding bone tissue after implantation. To improve the bioactivity of PEEK, numerous strategies for functionalizing the PEEK surface and changing the PEEK structure have been proposed. Inspired by the components, structure, and function of bone tissue, this review discusses strategies to enhance the biocompatibility of PEEK implants and provides direction for fabricating multifunctional implants in the future.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Yanmin Zhou
- Department of Oral Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| |
Collapse
|
23
|
Li P, Gao Z, Tan Z, Xiao J, Wei L, Chen Y. New developments in anti-biofilm intervention towards effective management of orthopedic device related infections (ODRI's). BIOFOULING 2021; 37:1-35. [PMID: 33618584 DOI: 10.1080/08927014.2020.1869725] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 12/15/2020] [Accepted: 12/20/2020] [Indexed: 06/12/2023]
Abstract
Orthopedic device related infections (ODRI's) represent a difficult to treat situation owing to their biofilm based nature. Biofilm infections once established are difficult to eradicate even with an aggressive treatment regimen due to their recalcitrance towards antibiotics and immune attack. The involvement of antibiotic resistant pathogens as the etiological agent further worsens the overall clinical picture, pressing on the need to look into alternative treatment strategies. The present review highlightes the microbiological challenges associated with treatment of ODRI's due to biofilm formation on the implant surface. Further, it details the newer anti-infective modalities that work either by preventing biofilm formation and/or through effective disruption of the mature biofilms formed on the medical implant. The study, therefore aims to provide a comprehensive insight into the newer anti-biofilm interventions (non-antibiotic approaches) and a better understanding of their mechanism of action essential for improved management of orthopedic implant infections.
Collapse
Affiliation(s)
- Ping Li
- Department of Orthopedics, Ya'an People's Hospital, Yaan City, China
| | - Zhenwu Gao
- Department of Orthopedics, Shanxi Bethune Hospital, Taiyuan City, China
| | - Zhenwei Tan
- Department of Orthopedics, Western Theater Air Force Hospital of PLA, Chengdu, China
| | - Jun Xiao
- Department of Orthopedics, Ya'an People's Hospital, Yaan City, China
| | - Li Wei
- Nursing Department, Three Gorges Hospital Affiliated to Chongqing University, Chongqing, China
| | - Yirui Chen
- Department of Orthopedics, Three Gorges Hospital Affiliated to Chongqing University, Chongqing, China
| |
Collapse
|
24
|
Alqurashi H, Khurshid Z, Syed AUY, Rashid Habib S, Rokaya D, Zafar MS. Polyetherketoneketone (PEKK): An emerging biomaterial for oral implants and dental prostheses. J Adv Res 2020; 28:87-95. [PMID: 33384878 PMCID: PMC7770505 DOI: 10.1016/j.jare.2020.09.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/29/2020] [Accepted: 09/08/2020] [Indexed: 12/16/2022] Open
Abstract
Polyetherketoneketone (PEKK) is a new evolving polymeric material. The present article comprehensively reviewed an overview of various applications of PEKK in prosthodontics and oral implantology, highlighting its prospects for clinical applications. PEKK biomaterials is an elastic material with good shock absorbance and fracture resistance and present ultra-high performance among all thermoplastic composites for excellent mechanical strength, chemical resistance, and high thermal stability. Available articles on PEKK for dental applications were reviewed from January 1957 to August 2020) using MEDLINE/PubMed, Web of Science, and ScienceDirect resources. PEKK presents suitable physical, mechanical, and chemical properties for applications in prosthodontics and oral implantology. PEKK has good potential for a wide range of dental applications, including tooth restorations, crowns, bridge, endoposts, denture framework, implant-supported fixed prosthesis, and dental implants. PEKK dental implants have shown lesser stress shielding compared to titanium for dental implant applications. Further modifications and improving material properties can result in broader applications in the field of dentistry. Long term evaluations are needed as PEKK is recently applied in dentistry, and there are limited studies published on PEKK.
Collapse
Affiliation(s)
- Hatim Alqurashi
- School of Clinical Dentistry, University of Sheffield, United Kingdom.,Department of Preventive Dental Sciences, School of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Azeem Ul Yaqin Syed
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Syed Rashid Habib
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Dinesh Rokaya
- Department of Clinical Dentistry, Walailak University International College of Dentistry, Bangkok 10400, Thailand
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Madinah Al Munawwarah, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| |
Collapse
|
25
|
Zeller B, Stöckli S, Zaugg LK, Astasov‐Frauenhoffer M, Hauser‐Gerspach I, Waltimo T, Zitzmann NU. Biofilm formation on metal alloys, zirconia and polyetherketoneketone as implant materials in vivo. Clin Oral Implants Res 2020; 31:1078-1086. [DOI: 10.1111/clr.13654] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Barbara Zeller
- Department of Reconstructive Dentistry University Center for Dental Medicine University of Basel Basel Switzerland
| | - Simone Stöckli
- Department of Oral Health and Medicine University Center for Dental Medicine University of Basel Basel Switzerland
| | - Lucia K. Zaugg
- Department of Reconstructive Dentistry University Center for Dental Medicine University of Basel Basel Switzerland
| | | | - Irmgard Hauser‐Gerspach
- Department Research University Center for Dental Medicine University of Basel Basel Switzerland
| | - Tuomas Waltimo
- Department of Oral Health and Medicine University Center for Dental Medicine University of Basel Basel Switzerland
| | - Nicola U. Zitzmann
- Department of Reconstructive Dentistry University Center for Dental Medicine University of Basel Basel Switzerland
| |
Collapse
|
26
|
Cheng KJ, Liu YF, Wang R, Zhang JX, Jiang XF, Dong XT, Xu X. Topological optimization of 3D printed bone analog with PEKK for surgical mandibular reconstruction. J Mech Behav Biomed Mater 2020; 107:103758. [DOI: 10.1016/j.jmbbm.2020.103758] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/30/2020] [Indexed: 12/23/2022]
|
27
|
Ganji K, Toumeh T, Sghaireen M, Mathew M, Nagy A, Rao K. A review on biofilm and biomaterials: Prosthodontics and periodontics perspective. J Int Oral Health 2020. [DOI: 10.4103/jioh.jioh_199_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
28
|
Ye J, Deng J, Chen Y, Yang T, Zhu Y, Wu C, Wu T, Jia J, Cheng X, Wang X. Cicada and catkin inspired dual biomimetic antibacterial structure for the surface modification of implant material. Biomater Sci 2019; 7:2826-2832. [PMID: 31065627 DOI: 10.1039/c9bm00082h] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Implant infections frequently occur in various kinds of surgery. Apart from antibiotics, the surface modification of implant material is a promising avenue to resolve this global problem. An ideal implant interface is expected to possess good biocompatibility, as well as broad-spectrum and long-term bacterial inhibition capabilities. Here, a delicate cicada and catkin inspired dual biomimetic structure was proposed, for the first time, to improve the antibacterial properties of implant material. By using poly(ether-ether-ketone) (PEEK) as a model implant, the relative in vitro and in vivo evaluations demonstrated that this dual biomimetic structure could simultaneously provide less bacterial adhesion, wider antimicrobial range and longer antibacterial durability. Meanwhile, the modified implant also retained ideal biocompatibility. Most importantly, the relative dual biomimetic structure engineering process could be accomplished through a simple, economic and fast hydrothermal chemical reaction, which might have an impact on the development of future biomedical materials.
Collapse
Affiliation(s)
- Jing Ye
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Nanchang University, NanChang, 330006, P.R. China.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Gvetadze RS, Dmitrieva NA, Voronin AN. [Adhesion of microorganisms to various dental materials used to form a gum contour in implant-retained restorations]. STOMATOLOGII︠A︡ 2019; 98:118-123. [PMID: 31701941 DOI: 10.17116/stomat201998051118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The article the literature review on dental materials for the manufacture of gum formers used in dental implantology. Adhesion of microorganisms to titanium, PMMA and PEEK resins is discussed. According to published studies PEEK polymer is characterized by a similar bacterial contamination compared to titanium but shows lower degree of contamination when compared to acrylic resins in equal conditions.
Collapse
Affiliation(s)
- R Sh Gvetadze
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - N A Dmitrieva
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A N Voronin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| |
Collapse
|
30
|
|
31
|
Ozyilmaz OY, Akin C. Effect of cleansers on denture base resins’ structural properties. J Appl Biomater Funct Mater 2019; 17:2280800019827797. [DOI: 10.1177/2280800019827797] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: We assessed the effect of different available denture cleansers on the roughness and hardness of polyetherketoneketone, thermoinjection-molded polyamide, and polymethylmethacrylate. Materials and Methods: A total of 150 disc-shaped specimens were fabricated (10 mm × 2 mm) from these three denture base resins, and divided into five subgroups ( n = 10) according to immersion procedures. One of these groups subjected to distilled water served as control, whereas other groups were subjected to daily cleansing with four denture cleansers (Corega, Protefix, Curaprox, and Perlodent) for 8 h a day for 140 days. The surface roughness and hardness values of specimens were recorded by measuring twice at baseline, and again after application of chemical solutions. Topography alterations after treatments were assessed with scanning electron microscopy. The data were subjected to statistical analysis and comparison among groups was done using Kruskal Wallis and Wilcoxon Signed Ranks tests. P-value <0.05 was considered significant. Results: The surface roughness of polyetherketoneketone, polymethylmethacrylate, and polyamide dentures was increased significantly by chemical solutions of denture cleansers. While the hardness value of polyetherketoneketone was not affected significantly after immersion in denture cleansers, those of polymethylmethacrylate and polyamide decreased significantly. Compared with Curaprox, the effervescent tablets significantly altered the surface hardness and roughness of polyamide. Conclusion: Denture cleansers can considerably alter the surface roughness and hardness of denture base resins and should be used carefully depending on the material.
Collapse
Affiliation(s)
- Ozgun Yusuf Ozyilmaz
- Department of Prosthodontics, Faculty of Dentistry, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Ceyda Akin
- Department of Prosthodontics, Faculty of Dentistry, Necmettin Erbakan University, Karatay, Konya, Turkey
| |
Collapse
|