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Review J Mater Sci Mater Med . 2016 Jul;27(7):118. doi: 10.1007/s10856-016-5731-4.

Polyetheretherketone (PEEK) for medical applications

Ivan Vladislavov Panayotov 1 , Valérie Orti 2 , Frédéric Cuisinier 2 , Jacques Yachouh 2

Affiliations Expand

Affiliations

• 1 Laboratoire de Bioingénierie et Nanosciences EA 4203, UFR Odontologie, Université de Montpellier, 545 Avenue du Professeur Jean-Louis Viala, 34193, Montpellier Cedex 5, France. ivan.panayotov@gmail.com.

• 2 Laboratoire de Bioingénierie et Nanosciences EA 4203, UFR Odontologie, Université de Montpellier, 545 Avenue du Professeur Jean-Louis Viala, 34193, Montpellier Cedex 5, France.

  Abstract

  Polyetheretherketone (PEEK) is a polyaromatic semi-crystalline thermoplastic polymer with mechanical properties favorable for bio-medical applications. Polyetheretherketone forms: PEEK-LT1, PEEK-LT2, and PEEK-LT3 have already been applied in different surgical fields: spine surgery, orthopedic surgery, maxillo-facial surgery etc. Synthesis of PEEK composites broadens the physicochemical and mechanical properties of PEEK materials. To improve their osteoinductive and antimicrobial capabilities, different types of functionalization of PEEK surfaces and changes in PEEK structure were proposed. PEEK based materials are becoming an important group of biomaterials used for bone and cartilage replacement as well as in a large number of diverse medical fields. The current paper describes the structural changes and the surface functionalization of PEEK materials and their most common biomedical applications. The possibility to use these materials in 3D printing process could increase the scientific interest and their future development as well.

   

   

   

  Clin Implant Dent Relat Res . 2019 Feb;21(1):208-222. doi: 10.1111/cid.12706. Epub 2018 Dec 27.

  PEEK materials as an alternative to titanium in dental implants: A systematic review

  Sunil Mishra 1 , Ramesh Chowdhary 2

  Affiliations Expand

  Affiliations

• 1 Department of Prosthodontics, Peoples College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India.

• 2 Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India.

  Abstract

  Purpose: Evaluation of the available research on PEEK materials to find that whether PEEK material has favorable properties and can enhance osseointegration, so that they can be utilize as implants material.

  Materials and methods: An electronic and structured systematic search was undertaken in May 2018, without any restrictions of time in the Medline/Pubmed, Sci-hub, Ebscohost, Cochrane, and Web of Science databases. To identify other related references further hand search was done. Articles related to PEEK and their applications in implants were only included. Articles not available in abstract form and article other than English language were excluded.

  Results: Initially, the search resulted in 153 papers. Independent screenings of the abstracts were done by the reviewers to identify the articles related to the question in focus. Sixty-two studies were selected out of which 10 were further excluded due to not in English language. Two additional papers were obtained after hand searching, and finally 54 articles were included in the review.

  Conclusions: Surface modification of PEEK seems to enhance the cell adhesion, proliferation, biocompability, and osteogenic properties of PEEK implant materials. PEEK had also influence the biofilm structure and reduces the chances of periimplant inflammations. Further research and more number of controlled clinical trials on PEEK implant is required in near future so that it can replace titanium in future.

  Keywords: carbon fiber-reinforced; fiber-reinforced polyetheretherketone-nanohydroxyapatite; osseointegration; periimplantitis; polyetheretherketone.

  © 2018 Wiley Periodicals, Inc.

   

   

   

   

   

  Review J Prosthodont Res 2016 Jan;60(1):12-9. doi: 10.1016/j.jpor.2015.10.001.

  Applications of polyetheretherketone (PEEK) in oral implantology and prosthodontics

  Shariq Najeeb 1 , Muhammad S Zafar 2 , Zohaib Khurshid 3 , Fahad Siddiqui 4

  Affiliations

• 1 School of Clinical Dentistry, University of Sheffield, United Kingdom.

• 2 Department of Restorative Dentistry, College of Dentistry, Taibah University, Madinah Al Munawwarah, Saudi Arabia. Electronic address: drsohail_78@hotmail.com.

• 3 School of Metallurgy and Materials, University of Birmingham, Edgbaston, Birmingham, UK; Department of Biomedical Engineering, King Faisal University, Al-Hofuf, Saudi Arabia.

• 4 Division of Oral Health & Society, Faculty of Dentistry, McGill University, Montreal, Canada.

  Abstract

  Purpose: Polyetheretherketone (PEEK) is a polymer that has many potential uses in dentistry. The aim of this review was to summarize the outcome of research conducted on the material for dental applications. In addition, future prospects of PEEK in the field of clinical dentistry have been highlighted.

  Study selection: An electronic search was carried out via the PubMed (Medline) database using keywords 'polyetheretherketone', 'dental' and 'dentistry' in combination. Original research papers published in English language in last fifteen year were considered. The studies relevant to our review were critically analyzed and summarized.

  Results: PEEK has been explored for a number of applications for clinical dentistry. For example, PEEK dental implants have exhibited lesser stress shielding compared to titanium dental implants due to closer match of mechanical properties of PEEK and bone. PEEK is a promising material for a number of removable and fixed prosthesis. Furthermore, recent studies have focused improving the bioactivity of PEEK implants at the nanoscale.

  Conclusion: Considering mechanical and physical properties similar to bone, PEEK can be used in many areas of dentistry. Improving the bioactivity of PEEK dental implants without compromising their mechanical properties is a major challenge. Further modifications and improving the material properties may increase its applications in clinical dentistry.

  Keywords: Bioactivity; Implants; PEEK; Polymers; Prosthodontics.

  Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

   

  Review J Med Life

  . Jan-Mar 2019;12(1):5-9. doi: 10.25122/jml-2019-0003.

  The Role of Polyether Ether Ketone (Peek) in Dentistry - A Review

  Lakshmana Bathala 1 , Vaishnavi Majeti 2 , Narendra Rachuri 1 , Nibha Singh 1 , Sirisha Gedela 1

  Affiliations Expand

  Affiliations

• 1 Department of Prosthodontics, Lenora Institute of Dental Sciences, Rajahmundry, India.

• 2 Department of Oral & Maxillofacial Surgery, Lenora Institute of Dental Sciences, Rajahmundry, India.

  Abstract

  This study is aimed to review the applications of Polyether Ether Ketone (PEEK) in dentistry. The increased demand for aesthetics, legislation in some developed countries, few drawbacks with existing materials and clinicians shifting their paradigms towards metal free restorations led space for the metal-free restorations in today's dental practice. An electronic literature search was conducted through Medline via PubMed, Wiley Online library, EBSCOhost, Science Direct, as well as the Google Scholar between January 2010 and March 2018 using the keywords: PEEK, modified PEEK, PEEK and Dental, advantages of PEEK, applications of PEEK in dentistry and PEEK Implants. A total of 103 articles were found in the literature search and out of these, 18 were not related to our study and hence were excluded. Finally, 85 articles were found to be relevant. PEEK has been explained for a number of applications in dental practice. The literature showed that the PEEK material has superior mechanical properties with different uses in various specialties of dentistry.

   

  Keywords: CFR - PEEK- Carbon Fiber Reinforced - Polyether Ether Ketone; Carbon Fiber Reinforced -Poly Ether Ether Ketone (CFR-PEEK); FPD - Fixed Partial Denture; MFP - Maxillofacial Prosthesis; Modified PEEK polymer; Obturator; PEEK - Polyether Ether Ketone; PEEK Implants; Polyether Ether Ketone (PEEK); RPD-Removable Partial Denture; Telescopic Crowns.

   

  Int J Oral Maxillofac Implants . Mar-Apr 2014;29(2):331-7. doi: 10.11607/jomi.2524.

  Cleaning effectiveness of implant prophylaxis instruments

  Petra Schmage, Fisnik Kahili, Ibrahim Nergiz, Thomas M Scorziello, Ursula Platzer, Peter Pfeiffer

  Authors

  Petra Schmage, Fisnik Kahili, Ibrahim Nergiz, Thomas M Scorziello, Ursula Platzer, Peter Pfeiffer

  Abstract

  Purpose: The aim of this study was to evaluate the cleaning effectiveness of implant prophylaxis instruments on polished and acid-etched implant surfaces.

  Materials and methods: Biofilm layers of Streptococcus mutans were grown on a total of 80 titanium disks; 40 disks were polished and 40 were acid-etched. Five disks of each surface were cleaned using each of seven implant prophylaxis instruments: (1) manual plastic curette, (2) manual carbon fiber-reinforced plastic (CFRP) curette, (3) sonic-driven prophylaxis brush, (4) rotating rubber cup with prophylaxis paste, (5) sonic-driven polyether ether ketone (PEEK) plastic tip, (6) ultrasonic-driven PEEK plastic tip, and (7) air polishing with amino acid (glycine) powder. Ten disks (five of each surface type) served as controls. After cleaning, the surfaces with remaining bacteria were assessed by light microscopy. Statistical analyses of the results were performed with one-way and two-way analyses of variance with Bonferroni-Dunn multiple comparisons post hoc analysis (α = .05).

  Results: The cleaning effectiveness of the plastic curette was significantly lower than those of all machine-driven instruments on the polished surface. Significantly lower cleaning effectiveness occurred with the CFRP curette compared to the prophylaxis brush and to both oscillating PEEK plastic tips on the polished surface. The rubber cup provided less cleaning effectiveness compared to the ultrasonic PEEK plastic tip and air polishing on the acid-etched surface. Superior results, with less than 4% of the biofilm remaining, were obtained for both oscillating PEEK plastic tips and air polishing on both implant surfaces. The cleaning ability of the prophylaxis brush, rubber cup, and ultrasonic PEEK plastic tip differed significantly between both surface structures.

  Conclusions: Cleaning effectiveness, ie, less than 4% of the biofilm remaining, was not observed with all tested implant prophylaxis instruments. The cleaning ability of the devices depended on the implant surface structure.

   

  Clin Oral Implants Res . 2019 Jun;30(6):578-587. doi: 10.1111/clr.13446. Epub 2019 May 7.

  The effect of five mechanical instrumentation protocols on implant surface topography and roughness: A scanning electron microscope and confocal laser scanning microscope analysis

  Jae-Kook Cha 1 , Kyeongwon Paeng 1 , Ui-Won Jung 1 , Seong-Ho Choi 1 , Mariano Sanz 2 3 , Ignacio Sanz-Martín 2

  Affiliations

• 1 Department of Periodontology, College of Dentistry, Research Institute for Periodontal Regeneration, Yonsei University, Seoul, Korea.

• 2 Section of graduate Periodontology, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain.

• 3 ETEP (Etiology and Therapy of Periodontal diseases) Research Group, University Complutense of Madrid, Madrid, Spain.

  Authors

  Jae-Kook Cha 1 , Kyeongwon Paeng 1 , Ui-Won Jung 1 , Seong-Ho Choi 1 , Mariano Sanz 2 3 , Ignacio Sanz-Martín 2

  Affiliations

• 1 Department of Periodontology, College of Dentistry, Research Institute for Periodontal Regeneration, Yonsei University, Seoul, Korea.

• 2 Section of graduate Periodontology, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain.

• 3 ETEP (Etiology and Therapy of Periodontal diseases) Research Group, University Complutense of Madrid, Madrid, Spain.

  Abstract

  Objective: To evaluate in vitro the changes in implant surface topography and roughness of commercial implants after instrumentation with five decontamination protocols.

  Material and methods: Seventy-two titanium implants with a sandblasted and acid-etched (SLA) surface were placed 5 mm supra-crestally. Five groups of twelve implants were instrumented with the following protocols: a metal scaler tip (SCAL), a thermoplastic scaler tip (PEEK), a round titanium brush (RBRU), a tufted brush with titanium bristles (TNBRU), and a glycine-based air-powder abrasive (GLYC). A sixth group with untreated implants was used as control. Scanning electron microscope and confocal laser scanning microscope were utilized to evaluate the changes in the implant surfaces.

  Results: The SCAL caused pronounced macroscopic alterations and damage of the implant surface, the PEEK left remnants of the plastic tip in the implant surface, and both titanium brush groups flattened the thread profile, while minimal alterations were observed in the GLYC. When compared to the control group, the roughness parameters (Sa) in the buccal aspect increased in the thread area of SCAL, and a minor reduction was observed in the PEEK while in the other groups, these values remained unchanged. In the valley areas, however the RBRU, TNBRU, and GLYC experienced a significant reduction (smoothening) indicating different accessibility of the decontamination protocols to the thread and valley. Similarly, the buccal aspects had more pronounced changes than those in the palatal aspect.

  Conclusion: Within the limitations of this in vitro investigation, the tested protocols induced different macroscopic alterations and surface roughness changes that varied in the thread and valley area.

  Keywords: confocal microscope; dental implants; peri-implantitis; scanning electron microscope; surface decontamination; surface macrotopography; titanium.

  © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

   

  J Periodontol . 2019 Mar;90(3):241-246. doi: 10.1002/JPER.18-0230. Epub 2018 Nov 14.

  Titanium particles generated during ultrasonic scaling of implants

  Stephen K Harrel 1 , Thomas G Wilson Jr 2 , Mirali Pandya 1 , Thomas G H Diekwisch 1

  Affiliations Expand

  Affiliations

• 1 Periodontal Department, Texas A&M College of Dentistry, Dallas, TX.

• 2 Private Practice, Dallas, TX.

  Abstract

  Background: There is growing concern that titanium particles may play a role in peri-implant breakdown. Ultrasonic scalers are routinely used in the debridement of peri-implant lesions. This in vitro study is designed to evaluate if titanium particles are produced when an ultrasonic scaler is used on an implant.

  Methods: New sandblasted, large grit, acid etched (SLA) coated implants were subjected to ultrasonic scaling with stainless steel, titanium, and PEEK plastic tips. The implants were placed in a holding device and the ultrasonic scaler was positioned on the SLA surface under 25 grams of pressure. The implants were subjected to 30 scaling motions. The ultrasonic coolant water was collected and the number of metallic particles were counted under a light microscope. The particles were confirmed to be titanium via elemental analysis. The implants were visually evaluated for damage to the SLA coating.

  Results: No metallic particles were detected in the water supplied to the ultrasonic scalers (passive control). Metallic particles were detected when implants were subjected to the ultrasonic coolant water only without the scaler tip touching the implant (active control). All implants that were scaled produced metallic particles and showed easily detectable damage to the SLA layer.

  Conclusions: All ultrasonic scaling caused the production of titanium particles and caused damage to the SLA coating of the implant. Ultrasonic scalers should be used with great caution in the treatment of peri-implant conditions and care should be taken to not touch the SLA surface of the implant.

  Keywords: dental implant; titanium; ultrasonic scaler.

  © 2018 American Academy of Periodontology.

   

  J Oral Implantol . 2020 Apr 21. doi: 10.1563/aaid-joi-D-19-00095.

  Cleaning efficacy of polyetheretherketone tips in eliminating cement remnants around implants with different abutment heights

  Cenker Zeki Koyuncuoglu 1 , Haluk Baris Kara 2 , Sinan Akdemir 3 , Becen Demir 4 , Nadin Al-Haj Husain 5 , Mutlu Özcan 6

  Affiliations Expand

  Affiliations

• 1 Assistant Professor, Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey.

• 2 Associate Professor, Department of Proshtetic Dentistry, Faculty of Dentistry, Medipol University, Istanbul, Turkey.

• 3 Lecturer, Dental Prosthetics Technology Program, Health Sciences High School, Medipol University, Istanbul, Turkey.

• 4 Ph.D, Private practice, Istanbul, Turkey.

• 5 Universitat Bern Department of Reconstructive Dentistry and Gerodontology Freiburgstrasse 7 SWITZERLAND Bern Bern 3008 Universitat Bern.

• 6 Assistant Professor, Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey. Professor, Head of Dental Materials Unit, University of Zürich, Center for Dental and Oral Medicine, Clinic for Fixed and Removable Prosth.

  Abstract

  The excess cement not removed following the cementation of fixed implant-supported restorations may cause loss of peri-implant attachment or adjacent bone. The aims of this study were to evaluate the amount of residual cement at different abutment-crown connection levels and to test the cleaning efficacy of poly-ether-ether-ketone (PEEK) ultrasonic tips after cementation. One implant was placed in an anterior central tooth position 5 mm below the gingival margin in an acrylic model, and 32 stone models were obtained with implant analogs. Abutment heights of 1-2 mm and 2.5-4 mm were used on the vestibular and lingual sides, respectively. Crowns were cemented and cleaned, and half of the samples were cleaned again using PEEK tips. The abutment-crown suprastructure was then disconnected, and cleaning efficacy was evaluated. Varying amounts of excess cement were found on all specimens except for the PEEK group with abutment-crown connections 1 mm below the gingival margin. An increase of undetected cement remnants was observed when the restoration margins were located deeper subgingivally. Various amounts of excess cement associated with margin location were detected on the abutment-restoration complex despite meticulous cleaning efforts. Ultrasonic PEEK tips were effective at cleaning the cement remnants around implants to a certain depth.

  Keywords: Abutment heights; Cleaning methods; Implant restorations; PEEK.; excess cement.

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