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Polyetheretherketone (PEEK) is a remarkable biomaterial that has seen a growing use in the field of dentistry. Known for its exceptional qualities, it is highly sought after in implantology. The uses of PEEK span various dental applications such as finger prostheses, removable partial dentures (RPD) and fixed partial dentures (FPD) frameworks, and dental implants. To ensure consistent quality, polyketone-based materials have been refined to meet the stringent requirements of medical applications. PEEK is a high-performance, semi-crystalline polymer known for its resilience and strength. Its natural tooth-color makes it particularly appealing for aesthetic purposes. Traditional methods like injection molding, extrusion, and compression molding are employed in its production. Despite its high cost, the performance advantages of PEEK—like lightweight, high strength, and durability in harsh conditions—justify the investment. PEEK also provides excellent shock absorption, fracture resistance, stress distribution, and osseointegration abilities, making it increasingly popular in the market. Its diverse dental applications include use as implant biomaterial, prosthetic material, abutment material, crowns, and removable partial denture frameworks, offering an all-in-one solution for dentistry. PEEK's compatibility with bioactive materials has proven beneficial not only in life sciences but also in automotive and aeronautical industries. This review aims to explore the characteristics and properties of PEEK, focusing on its use in dental implants, as well as the challenges and benefits associated with this versatile biomaterial.
The dental industry continually seeks to innovate and improve materials to overcome the limitations of current options. PEEK, a high-performance material known for its strength and resilience, serves this purpose well. Its natural tooth-color enhances its appeal in aesthetic applications. For a wide array of fixed and removable dental prostheses produced using CAD-CAM technology, PEEK has been recommended. Its suggested uses even extend to provisional restorations, implant abutments, custom healing abutments, intra-radicular posts, and occlusal splints. Despite the limited number of clinical studies supporting these claims, researchers like Ma et al. describe PEEK as having an aromatic molecular backbone that combines ketone and ether functional groups between aryl rings. While strong, some drawbacks include bulkiness and the loss of natural teeth, which can affect prosthesis retention and patient satisfaction. PEEK's excellent compatibility with bioactive materials makes it useful in fields beyond dentistry, such as automotive and aerospace industries.
This review focuses on understanding PEEK's properties and capabilities as a material for implant prostheses, especially in dental implants. As a semi-crystalline material with a high melting point, PEEK offers excellent thermal and mechanical properties. Its low elastic modulus, similar to human bone, allows it to mitigate stress-related issues.
Polyetheretherketone (PEEK) is a synthetic material valued for its remarkable properties and wide range of applications. These include its use as a biomaterial in dental implants, prosthetics, abutment materials, post and core materials, crowns, and removable partial denture frameworks. PEEK's extensive applications make it an all-inclusive solution for dentistry. Minimizing marginal bone loss during functional loading is critical for the success of dental implants.
Comprehensive Review
Distinct Characteristics of PEEK
PEEK maintains its properties over a wide temperature range and has inherent limited osteoconductive properties. Due to its long-term creep, fatigue resistance, stiffness, and strength, PEEK is employed in orthodontics, prosthodontics, and orthopedic surgeries. Literature suggests that PEEK can be a viable alternative to titanium in orthopedics and trauma care. It shows a low coefficient of friction, high abrasion resistance, and the ability to withstand an array of chemicals and harsh conditions at elevated temperatures. One of its key benefits is its low permeability, steam, water, and brine resistance, coupled with minimal moisture absorption. PEEK's electrical properties are stable across a broad frequency and temperature range, and it is inherently flame-retardant.
PEEK's biocompatibility has been confirmed through numerous studies, making it suitable for oral use. Technological advancements allow PEEK to be manipulated both conventionally and via CAD/CAM processes. Its stress-absorbing and fracture-resistant properties add to its uniqueness and desirability. Because PEEK's modulus of elasticity closely matches that of bone, it is readily accepted as an implant material. Reports of metal toxicity and allergic reactions are less frequent with PEEK due to its low reactivity and solubility. Orthodontists have even used PEEK wires to exert optimal orthodontic force, thus labeling PEEK a high-performance polymer. Additional research into its long-term use, however, remains necessary.
While there are considerable advantages to using PEEK, some limitations do exist. PEEK is a costly material, making it unaffordable for many applications. Specialized machinery is required for its high-temperature processing, adding complexity and sensitivity to the technique. Certain chemicals such as concentrated sulfuric, nitric and chromic acids, as well as sodium and halogens, can damage PEEK. It also has limited UV resistance. While PEEK crowns can reduce stress on the abutment, they may increase stress on the crown, potentially leading to poorly fitted screws or fractures of both the screw and crown. Despite its generally low sensitivity and reactivity, a few cases of PEEK toxicity have been reported.
PEEK can be processed using traditional methods like compression molding, extrusion, and injection molding, but its crystallinity and mechanical properties can be affected by these conditions. Processing PEEK requires temperatures in the range of 370 to 420°C. The absence of periodontal ligaments at the implant-bone interface can occasionally result in excessive stress and porcelain fractures due to reduced proprioception. Factors like the direction and magnitude of the load, prosthetic material, prosthesis design, implant material, bone type, and occlusal forces all contribute to the stress load on the bone, potentially leading to bone resorption.
Traditional implants for repairing bone defects have utilized titanium and its alloys, which offer stability and desirable properties but also come with drawbacks like radiopacity, osteolysis, allergic reactions, and the release of metal ions. Titanium's elastic modulus exceeding 100 GPa helps it buffer stress and reduce adjacent bone resorption. PEEK, and materials based on it, have emerged as alternatives to mitigate these adverse effects. PEEK is notably used in environments that demand high performance and stability.
When modified with fillers, PEEK serves effectively as a material for dental crowns and bridges. In its unmodified form, however, it is bioinert and hydrophobic. To enhance cellular proliferation, fillers are added to change its contact angle and hydrophilicity. Veneering PEEK over titanium prostheses can improve stress resistance, especially at the implant-bone junction.
PEEK has been utilized successfully in endodontics due to its shock-absorbing, fracture-resistant, and stress-distributing properties. These qualities make PEEK ideal for the post-core system, preventing breakage and root fractures. Studies indicate that nano-structured PEEK surfaces created by etching with sulfuric acid and rinsing with distilled water facilitate faster osseointegration.
In dental and medical applications, PEEK's unique chemical structure—with an aromatic backbone and combined ketone and ether functional groups—affords it low elastic modulus and a range of other advantageous properties. Unmodified PEEK is hydrophobic, while modifications can enhance hydrophilicity and cellular proliferation.
In the realm of dentistry, PEEK is used for implants, orthodontic wires, abutments, and both fixed and removable prostheses. PEEK addresses the drawbacks of metallic materials like titanium, offering solutions such as reduced allergic reactions and improved prosthetic performance. Its compatibility with CAD-CAM technology further enhances its utility.
For cranial and maxillofacial bone defects, PEEK is employed due to its high strength and low rates of post-surgical complications. It offers great dimensional stability and resistance to steam sterilization, making it a reliable choice for implants in these regions.
In restorative dentistry, PEEK's white-colored surface requires some shading. Its low surface energy and water-repelling properties can be countered with surface treatments like etching to improve bonding with composites, making it a promising future restorative material.
Figure: Various uses of PEEK in dentistry are indicated by the arrows.
PPS and PEEK are both semicrystalline, high-performance thermoplastics, known for low friction, wear resistance, fatigue resistance, and chemical resistance.
Given their similar properties, it can be challenging to decide between these two materials for your next project. Whether you're an engineering professional or a materials manager, understanding the distinctions between PPS and PEEK can save time and money across various industries.
Understanding PPS
PPS, or polyphenylene sulfide, is a high-temperature thermoplastic polymer. Developed initially by Philips Petroleum employees Dr. H. Wayne Hill Jr. and James T. Hill, PPS is favored for its relatively low cost, ease of use, and advantageous properties. PPS finds applications in seals, valves, medical devices, and home storage containers and is available in sheet, rod, or tube forms.
Advantages and Disadvantages of PPS
Advantages
PPS is inherently flame-resistant without needing added chemical retardants, making it lower-cost compared to formulations like those for PA and PC. It also boasts low water absorption, reducing defect rates and production costs. PPS’s high fluidity and low viscosity result in robust and quickly-produced injection-molded products. The material also has a unique metallic luster and color, adding to its appeal.
Disadvantages
Despite its benefits, PPS does have drawbacks, including difficulty in pigmentation, limiting color options to darker shades. It also has a propensity to form notches and has low tracking resistance.
Understanding PEEK
PEEK stands for polyether ether ketone, an organic semi-crystalline thermoplastic polymer prized for maintaining its properties at high temperatures, with a melting point around 662°F. PEEK’s advantageous properties include high Young’s modulus, high tensile strength, and resistance to thermal, moisture, and environmental degradation. These attributes make PEEK suitable for applications in automotive, aerospace, and chemical processing industries, among others. It’s readily machinable and well-suited for injection molding and can be modified for specific needs like conductivity.
Advantages and Disadvantages of PEEK
Advantages
PEEK is celebrated for its high heat resistance, mechanical properties, dimensional stability, and high rigidity. It offers many advantages such as excellent creep and stress resistance, natural flame retardance, and chemical inertness. PEEK performs well in both wet and electrical environments and is resistant to wear and friction.
Disadvantages
PEEK's complex manufacturing process makes it an expensive option. It also requires high temperatures for processing and degrades under UV exposure.
PPS vs. PEEK: Which Is Better for Your Project?
The decision between PPS and PEEK can be challenging due to their overlapping qualities. Both endure high temperatures and are mechanically robust. However, PEEK is slightly more chemically inert. If uncertain which material best suits your requirements, consulting experts can aid in making an informed choice.
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