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1. OUFU
Use of PEEK in Implantology: A Review of Literature. # 2160
School of Dentistry
Oclusion, Fixed Prosthesis and Dental Materials
Post-Graduation Program in Clinical Dentistry
Email:neves@triang.com.br
Federal University of Uberlândia – – Uberlândia-MG – Brazil
*A.C.Brant Filho, D.S. Meireles, M.S.Prudente,T.A.P.N. Carneiro, J.P. Cougoulic, R.J.Almeida, F.D. Neves
Polyetheretherketone (PEEK) is an aromatic, rigid,
semi-crystaline thermoplastic with good mechanical
properties and bone like-stiffness, as well as good
biocompatibility. Dental material field and implant
dentistry have encouraged investigations of new
materials to use as a replacement for dental roots.
The aim of this study is to investigate in the dental
literature, if there are some research and works on
PEEK use in oral implantology.
Keywords : PEEK dental , PEEK oral, PEEK oral implantology
Inclusion criteria: all articles related about in vitro and in vivo research about
PEEK in oral implantology.
Exlcusion criteria: articles not related to dental field.
Database search in PUBMED (www.pubmed.com), IADR abstracts
( h t t p : / / i a d r . c o n f e x . c o m / i a d r / s e a r c h . e p l ) , P a t e n t s
(http://www.freepatentsonline.com/), and Manual search .
Financial support granted by Federal University of Uberlândia-School of Dentistry - FOUFU, CAPES.
82 studies were obtained in the inicial search: 71 were discarded as they did not fit in the search criteria and 10 were kept and are listed below.
Authors In
Vitro
In
Vivo
Material Analysis Results
Lee et all, 2012
Physical and
Mechanical
Properties
yes no (A) GFR-PEEK (Glass Fiber)
(B) CFR-PEEK (Carbon Fiber)
(C) Pure Titatnium (grade 4)
Fatigue tests norm ISO 14801:2003
FEA - GFR-PEEK coating Zirconia &
Titanium - GFR-PEEK 0.5mm thick
and 5mm long in Ti and Zirconia.
FEA- Strain Energy Density (SED)
FEA- von-Misses
GFR-PEEK fractured at 320 N
CFR-PEEK not fractured
Pure Titanium not fractured
FEA - SED Ti coated GFR-PEEK implants reduce
stress shielding
Peek coating showed lower von-Mises stress
than the bone in direct contact with Ti implant
Sarot et al, 2009
Physical and
Mechanical
Properties
yes no (A) Ti-Implant & Ti-Abutment
(B) Ti-Implant & CFR-PEEK Abutment
(C) CFR-PEEK-Impant & Ti-Abutment
(D) CFR-PEEK-Impant & CFR-PEEK-
Abutment
3D-FEA - Cortical + trabecular
alveolar bone to evalute stress
distribution near the peri-implant
bone in A,B,C,D
von-Misses Analysis in 3D FEA
CFR-PEEK implants (C&D) presented higher load
concentration in the cervical portion and on the
cortical bone than the Titanium implants (A&B)
Abutment material had no interference
Spintig, Mueller &
Abert, 2008
Physical and
Mechanical
Properties
Tribology
yes no 45 PEEK specimens (2x10x10mm)
2/3 grinded with bioceramics (1/3 Glass
Bone (GB) & 1/3 Tricalcium phosphate
(TCP)
1/3 (15) control group. PEEK Only
Vickers hardness (VH)
Roughness (Ra, Rz, Rmax)
Surface Wettabillity
SEM- micrographs
EDX- analysis and statistics
2
VH 27.87kg/mm to 38.31kg/mm
bioceramics
Roughness increased with a ratio 1: 1.34: 8.33
(untreated:TCP:GB)
Improve in wettabillity
EDX- significant change in surface (TCP GB)
2
PEEK + grinded
Cook et al, 1995
Physical and
Mechanical
Properties
Tribology
yes yes 40 cilindrical implants 4,0mm diameter
and 10mm lengh made of PEEK coated
0
and uncoated with Titanium 2000 A
4 Mongrel dogs
1- Pull Out Test
2- Bone Contact Area
3- Roughness
1- uncoated and coated no diference at 8 weeks
2- uncoated= 51.55 to 54.83% / coated= 60.18%
to 66.7%
3-no difference found on roughness
Koch et al, 2010
Biocompatibillity
no yes Zirconia,
Zirconia sol gel (Ca+TiO2),
Peek
Titanium
6 Mongrel dogs
Histomorphometric
Bone to Implant Contact (BIC) was
measured
Median BIC Zirconia = 59.24%
Median BIC Zirconia Sol gel = 58.34%
Median BIC Titanium = 41.22%
Median BIC PEEK = 26.82%
Wu et al, 2012
Physical and
Mechanical
Properties
Biocompatibillity
yes yes 2
(A) PEEK + n-TiO Ra< 0,1
2 2
(B) PEEK + n-TiO blasted TiO Ra=1µm -
2.2µm
(C) Unfilled PEEK - control group
µm 1- Physical and Chemical
caracterization
2- Cytocompatibillity in vitro
3- Biocompatibillity in vivo /
Microcomputed tomography (MCT)
1- Optical density value is higher p<0.05 in
roughness group (B)
2- Better Cell attachment in (B) group.
3- Bone volume is twice in (B) group MCT
Barkarmo et al, 2011
Biocompatibillity
no yes (A) PEEK - control group
(B) PEEK coated nano Hidroxyapatite
(HA)
10 New Zealand rabbits
Follow up 12 weeks
Scanning Electron Microscopy - SEM
Atomic Force Microscopy - AFM
X-Ray Photoelectron Spectroscopy -
XPS
SEM - nano Ha thin layer in PEEK
XPS confirmed nano HA in PEEK which showed
Ca/P ratio of 1.67
HA/PEEK better integrated but no statistical
significance as showed
Harmand et al, 2004
Biocompatibillity
no yes 2
Composite TiOPEEK + ß-TCP + Cell attachment and proliferation
SEM
Biocompatible as ISO 10993
Harmand et al, 2010
Biocompatibillity
no yes BIOPIK ®
3 clinical cases in humans with 11 PEEK
implants
X-RAY evaluation Lack of prospective study
Marya et al, 2012
Biocompatibillity
no yes BIOPIK ®
3 clinical cases in humans with 3 PEEK
implants
X-RAY evaluation Unitary cases, lack of radiopacity, lack of
prospective study, immediate loading
PEEK is a material that is being used to produce dental implants
(BIOPIK®). However, the results still have to be validated by
scientific community and more research has to be done on the real
advantages of its use.
2
BIOPIK® Implant System is made of PEEK/ ß-TCP / TiO