ABSTRACT
ABSTRACT Based on its mechanical properties, PEEK (polyether-ether-ketone) might be useful in restorative procedures. In oral rehabilitation, its viability has been studied mainly for prostheses and dental implants. Aim: The aim of this study was to evaluate the fit accuracy of dental implant bars made of either PEEK or cobalt-chrome submitted to cycling mechanics. Materials and Method: This was an experimental in vitro study, where units were treated with two implants and mini-abutments, joined by cobalt-chrome or polyether-ether-ketone PEEK bars. A total 20 bars were prepared (n=10 per group) and subjected to mechanical cycling tests (1 million cycles on the distal cantilever of the bar in the vertical direction, 120N and sinusoidal loading, at a frequency of 2Hz). The fit at the abutment/implant interface was measured before and after cycling, and the counter-torque of the vertical screw of the mini abutments was measured after cycling, using a digital torquemeter. Data were analyzed by three-way ANOVA and Tukey's test at 5% significance level. Results: No statistically significant interaction was found among the three factors considered (bar material, implant positioning and mechanical cycling) (p = 0.592). No significant difference was identified in the interaction between bar material and implant positioning (p = 0.321), or between implant positioning and mechanical cycling (p = 0.503). The association between bar material and mechanical cycling was statistically significant (p = 0.007), with the cobalt-chrome bar resulting in greater misfit with mechanical cycling. There was no difference in counter-torque values between groups. Conclusions: The PEEK bar provided better fit of the mini abutments to the implants, even after mechanical cycling. The counter-torque of the screws was similar in all scenarios considered.
RESUMO O PEEK (Poli-éter-éter-cetona) é um material considerado para uso em procedimentos restauradores devido às suas propriedades mecânicas. Na reabilitação oral, sua viabilidade tem sido estudada principalmente para uso em próteses e implantes dentários. Objetivos: O objetivo deste estudo foi avaliar a precisão da adaptação de duas barras diferentes do tipo protocolo confeccionadas em PEEK ou Cobalto-Cromo, após serem submetidas à mecânica ciclística. Materiais e Método: As unidades experimentais foram constituídas por barras confeccionadas em Poli-ether-ether-Ketone (PEEK) e em Cobalto-Cromo (Co-Cr). Trata-se de um estudo experimental, in vitro, onde verificou-se unidades constituídas por dois implantes e mini pilares unidos com barras de Cobalto-Cromo ou PEEK. Foram confeccionados um total de 20 barras (n=10 em cada grupo) e as barras foram submetidas a ensaios de ciclagem mecânica (1 milhão de ciclos no cantilever distal da barra no sentido vertical, 120N e carregamento senoidal, a uma frequência de 2Hz). Antes e após a ciclagem realizou-se a mensuração da desadaptação na interface pilar/implante e após a ciclagem foi medido o contra-torque do parafuso vertical dos mini-pilares através de torquímetro digital TQ 8800 (LT Lutron, Taiwan). Os dados foram submetidos a ANOVA a três critérios e teste de Tukey ao nível de significância a 5%. Resultados: Constatou-se que não houve interação estatisticamente significativa entre os três fatores estudados, ou seja, entre o material da barra, o posicionamento do implante e a ciclagem mecânica (p = 0,592). Também não se identificou diferença estatística significativa da interação entre o material da barra e o posicionamento do implante (p = 0,321), nem entre o posicionamento do implante e a ciclagem mecânica (p = 0,503). Já a associação entre o material da barra e a ciclagem mecânica foi estatisticamente significativa (p = 0,007), onde a barra de Cobalto-Cromo resultou em maior desadaptação com a ciclagem mecânica. Não houve diferença nos valores dos contra-torques entre os grupos. Conclusões: Conclui-se que a barra de protocolo fabricada em PEEK proporcionou melhor adaptação dos mini pilares aos implantes mesmo após a ciclagem mecânica. Por fim, o contra-torque dos parafusos foi semelhante em todos os cenários avaliados.
ABSTRACT
Introduction: To compare the flexural strength of autopolymerizing poly methyl methacrylate resins (PMMA) resin, CAD/CAM milled PMMA and CAD/CAM milled poly ether ether ketone (PEEK) when used as provisional restorative materials for long span situations in full mouth rehabilitation after aging and thermocycling. Materials and Methods: Sixty samples (25 mm × 2 mm × 2 mm) were fabricated using autopolymerizing PMMA resin (GROUP I), CAD/CAM milled PMMA (GROUP II) and PEEK (GROUP III). The groups were subdivided into A and B and subjected to 7 days of aging and 500 cycles of thermocycling (subgroup A) and 14 days of aging and 1000 cycles of thermocycling (subgroup B), respectively, and flexural strength was evaluated using a three?point bend test. The data were analyzed with student t test and pair?wise comparison of mean values was done by ANOVA. Results: The flexural strength of PEEK subjected to 7 days of aging and 500 cycles of thermocycling (III (A) ? 6628.70 MPa) was the highest among all groups followed by PEEK subjected to 14 days of aging and 1000 cycles of thermocycling (III (B) ? 3760.50 MPa). Conclusion: The mean flexural strength of PEEK was statistically significant than the other two materials tested and hence can be recommended for use as a provisional restorative material for long span situations in full mouth rehabilitation. However, the mean flexural strength of PEEK reduced approximately by 44% when subjected to further aging
ABSTRACT
Abstract The aim of this in vitro study was to compare the long-term effect of overnight use of denture cleansers with different chemical compositions on the color stability of denture base polymers (DBPs). The four DBPs evaluated were PEEK (PK group), thermoinjection-molded polyamide (PA group), auto-polymerized polymethylmethacrylate (PMMA) (AP group), and heat-polymerized resin PMMA (HP group). The cleaning agents used were Corega tablet (CT), Protefix tablet (PT), and 0.5% sodium hypochlorite (NaOCl) solution (SH). Distilled water (DW) served as a control. Forty-eight disc-shaped specimens (10mm × 2mm) were prepared from each DBP and randomly immersed in the different storage media (n=12 in each group). Color measurements of the specimens before and after immersion in the denture cleansers were made using a spectrophotometer (VITA Easyshade V). The color changes were measured and recorded in L* a* b*. After 120 d, the CIEDE2000 formula was used to calculate color changes (ΔE00). For analysis of the data, a multivariate analysis of variance was used (p<0.05). The results of the statistical analysis revealed significant color change differences in the DBPs immersed in the various denture cleansers (p<0.05). Groups PA and PK showed the highest values for all solutions. AP-SH showed the highest ΔE00 value in group AP, no significant difference was found between other solutions. In group HP, there was no statistically significant difference between the average ΔE00 values of all solutions. Long-term daily use of the denture cleansers affected the color stability of all the DBPs, although the level of color change was acceptable. Laboratory and clinical studies on the color stability of PEEK are needed to confirm the results of this study.
Resumen El objetivo de este estudio in vitro fue comparar el efecto a largo plazo del uso nocturno de limpiadores de prótesis con diferentes composiciones químicas sobre la estabilidad del color de los polímeros base de prótesis (DBP). Los cuatro DBP evaluados fueron PEEK (grupo PK), poliamida moldeada por termoinyección (grupo PA), polimetilmetacrilato (PMMA) autopolimerizado (grupo AP) y resina PMMA termopolimerizada (grupo HP). Los agentes de limpieza utilizados fueron Corega (CT), Protefix (PT) y la solución de hipoclorito de sodio (NaOCl) al 0,5% (SH). El agua destilada (DW) sirvió de control. Se prepararon 48 especímenes en forma de disco (10mm × 2mm) de cada DBP y se sumergieron al azar en los diferentes medios de almacenamiento (n=12 en cada grupo). Las mediciones del color de las muestras antes y después de la inmersión en los limpiadores de dentaduras se realizaron con un espectrofotómetro (VITA Easyshade V). Los cambios de color se midieron y registraron en L* a* b*. Después de 120 d, se utilizó la fórmula CIEDE2000 para calcular los cambios de color (ΔE00). Para el análisis de los datos, se utilizó un análisis multivariante de la varianza (p<0,05). Los resultados del análisis estadístico revelaron diferencias significativas en el cambio de color de los DBP sumergidos en los distintos limpiadores de dentaduras (p<0,05). Los grupos PA y PK mostraron los valores más altos para todas las soluciones. AP-SH mostró el valor ΔE00 más alto en el grupo AP, no se encontraron diferencias significativas entre las demás soluciones. En el grupo HP, no hubo diferencias estadísticamente significativas entre los valores medios de ΔE00 de todas las soluciones. El uso diario a largo plazo de los limpiadores de dentaduras afectó a la estabilidad del color de todos los DBP, aunque el nivel de cambio de color fue aceptable. Se necesitan estudios de laboratorio y clínicos sobre la estabilidad del color del PEEK para confirmar los resultados de este estudio.
Subject(s)
Polymers , Prosthesis Coloring , Denture Cleansers , Polymethyl MethacrylateABSTRACT
Objective:To investigate the effect of eyebrow arch augmentation with personalized polyether ether ketone (PEEK) implant assisted by endoscope.Methods:From January 2019 to August 2021, 9 patients with low and flat eyebrow arch requiring eyebrow arch augmentation were treated in the plastic surgery department of the Friendship Plastic Surgery Hospital Affiliated to Nanjing Medical University. The cranial and maxillofacial CT scanning data were obtained before operation, the eyebrow arch elevation range and height were designed according to the patient's requirements, and personalized peek implants were manufactured. During the operation, a small temporal hairline incision was used to accurately separate the implantation cavity of individualized peek implants under the periosteum of the eyebrow arch implantation area with the aid of endoscope. Personalized PEEK implants were implanted under endoscope to make them fully fit with the eyebrow arch bone and fixed with titanium nails. Photos were taken and analyzed before and after operation.Results:All patients were followed up for 3 months to 2 years. Their facial expressions were normal, and there were no motor nerve injury, rejection and iatrogenic infection. The patients were satisfied with the postoperative effect. Compared with before operation, the low level of orbital bone in eyebrow area was improved, and the facial contour was three-dimensional and harmonious.Conclusions:The eyebrow arch augmentation with individualized peek implant assisted by endoscope is safe and effective. It can greatly reshape the upper contour of the face, deepen the upper eyelid fossa and improve the convex eye phenomenon, so as to achieve the cosmetic effect of enhancing the three-dimensional sense of the eyebrow orbital area, which is worthy of clinical application.
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Polyetheretherketone (PEEK) has been widely applied in orthopedics because of its excellent mechanical properties, radiolucency, and biocompatibility. However, the bioinertness and poor osteointegration of PEEK have greatly limited its further application. Growing evidence proves that physical factors of implants, including their architecture, surface morphology, stiffness, and mechanical stimulation, matter as much as the composition of their surface chemistry. This review focuses on the multiple strategies for the physical modification of PEEK implants through adjusting their architecture, surface morphology, and stiffness. Many research findings show that transforming the architecture and incorporating reinforcing fillers into PEEK can affect both its mechanical strength and cellular responses. Modified PEEK surfaces at the macro scale and micro/nano scale have positive effects on cell-substrate interactions. More investigations are necessary to reach consensus on the optimal design of PEEK implants and to explore the efficiency of various functional implant surfaces. Soft-tissue integration has been ignored, though evidence shows that physical modifications also improve the adhesion of soft tissue. In the future, ideal PEEK implants should have a desirable topological structure with better surface hydrophilicity and optimum surface chemistry.
Subject(s)
Benzophenones , Ketones/chemistry , Polyethylene Glycols/chemistry , Polymers/chemistry , Surface PropertiesABSTRACT
SUMMARY: Late orbital reconstruction is a complex and challenge for surgeons. The aim of this article is to present complex orbital reconstruction using patient specific implant (PSI) strategy and polyetheretherketone (PEEK). A literature review and a cases series of sequelae after complex orbital trauma are presented; cases with great middle third deformities showing defect in the maxilla, nasal area, body of the zygoma and zygomatic arch were included; in both cases the sequelae was for more than 10 years. Virtual planning and PEEK implants were manufacture using a puzzle (two or three parts) by 3D print or injection. Patients were treated and their surgeries carried out without complications, using a minimal surgical approach. No infections were observed, and after 12 months follow-up they were stable showing normal function. PSI based-PEEK for orbital reconstruction are safe, efficient, effective and to obtain orbital morphology with low complications.
RESUMEN: La reconstrucción tardía de la órbita es un desafío complejo para cirujanos. El objetivo de este artículo fue presentar la reconstrucción orbitaria compleja utilizando implante paciente específico (PSI) y polietereterketona (PEEK). Son presentados una revisión de literatura y una serie de casos con secuelas posteriores a un trauma orbitario complejo; además, son presentados casos con gran deformidad del tercio medio del rostro mostrando defectos en maxila, área nasal, cuerpo del hueso cigomático y arco cigomático; ambos casos de secuela fueron por más de 10 años. Planificación virtual e implantes en PEEK fueron creados usando una estrategia de puzzle (dos o tres partes) por inyección o impresión 3D. Los pacientes fueron tratados y sus cirugías realizadas sin complicaciones usando accesos quirúrgicos reducidos. No se observaron infecciones y después de 12 meses de seguimiento permanecieron estables mostrando función normal. Los PSI para reconstrucción orbitaria son seguros, eficientes, efectivos y recuperan morfología de órbita con bajas complicaciones.
Subject(s)
Humans , Male , Female , Middle Aged , Orbital Diseases/surgery , Plastic Surgery Procedures/methods , Printing, Three-Dimensional , Orbit/injuries , Orbital Diseases/complications , Polymers/chemistry , Benzophenones/chemistry , Biocompatible Materials/chemistry , Treatment Outcome , Orbital ImplantsABSTRACT
ABSTRACT: There is insufficient information about the chairside polishing methods of polyether ether ketone material. Therefore, it is aimed in this study to investigate the effects of different polishing processes on polyether ether ketone surface roughness and hardness. A total of 66 disc-shaped specimens made of polyether ether ketone were used in this study. The specimens were polished conventionally and randomly divided into three groups (n=22). One group was designated as the control group, and no further treatment was applied. In the other two groups, the specimens' surfaces were abraded with diamond burs and polished using two different polishing kits. Their surface roughness and Vickers hardness were measured, and environmental scanning electron microscopy and atomic force microscopy examinations were performed. The data were statistically analysed using analysis of variance and Tukey's honest significant difference test (α=0.05). There were no statistically significant differences between the control and polishing kit groups in terms of either surface roughness or Vickers hardness (p>0.05). The polishing kits can be used reliably and effectively for polishing polyether ether ketone materials.
RESUMEN: No existe información suficiente sobre los métodos de pulido del material poliéter éter cetona. Por tanto, este estudio tiene como objetivo evaluar el efecto de diferentes procedimientos de pulido sobre la rugosidad y dureza de superficie de un material a base de poliéter éter acetona. Un total de 66 muestras en forma de disco fueron realizadas. Los especímenes fueron divididos en tres grupos (n=22). Un grupo fue designado como grupo de control, siendo que no se aplicó ningún tratamiento. En los otros dos grupos, las superficies de las muestras se lijaron con fresas de diamante y se pulieron con dos kits de pulido diferentes. Se investigó la rugosidad de superficie y la dureza Vickers en los diferentes grupos. También fueron evaluadas muestras representativas en microscopía electrónica de barrido y microscopía de fuerza atómica. Los datos se analizaron estadísticamente mediante el análisis de varianza (ANOVA) y el método de Tukey (α=0.05). No hubo diferencias estadísticamente significativas entre los grupos en términos de rugosidad de superficie o Dureza Vickers (p>0,05). Los kits de pulido se pueden utilizar de forma eficaz para el pulido de materiales a base de poliéter éter acetona.
Subject(s)
Polyethylenes , Dental Polishing , Dentifrices/analysisABSTRACT
Objective To make finite element analysis and compressive performance test on three-dimensional (3D) printed personalized poly-ether-ether-ketone (PEEK) condyle prosthesis, so as to analyze stress distribution characteristics and mechanical properties of the prosthesis, and to evaluate its clinical value and prospect. Methods The finite element models of PEEK condyle prosthesis, mandible and fixation screw were established by software such as CBCT, Mimics, Geomagic Studio, SolidWorks and ANSYS Workbench. The maximum mastication force was applied, and the maximum stress of the condyle prosthesis and screw, as well as the stress and strain of the mandible were recorded. In order to simulate the actual clinical situation, a special fixture was designed to test compression performance of the condyle prosthesis prepared by the fused deposition modeling (FDM) and selective laser sintering (SLS) at the rate of 1 mm/min. Results The peak stress of the PEEK condyle prosthesis was 10.733 MPa, which was located at the back of the condyle neck. The peak stress of 5 fixing screws was 9.707 5 MPa, which appeared on the 2# and 5# screws near the trailing edge of the mandibular ascending branch. The peak stress of both the prosthesis and the screw was smaller than its yield strength. The maximum pressure of the condyle prosthesis prepared by FDM and SLS was (3 814.7±442.6) N and (1 193.970±260.350) N, respectively. Compared with the SLS preparation, the FDM prepared prosthesis not only had higher compression strength but also better toughness. Conclusions The 3D printed personalized PEEK condyle prosthesis shows uniform stress distributions and good mechanical properties, which can provide the theoretical basis for PEEK as reconstruction material for repairing temporomandibular joint.
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Objective:To investigate the clinical outcomes of personalized polyetheretherketone (PEEK) implant in the correction of nasolabial fold depression.Methods:A total of 30 patients with nasolabial fold depression (5 males, 25 females, aged 26 to 52 years, mean 36.3 years) admitted to the Affiliated Friendship Plastic Hospital of Nanjing Medical University who want to undergo nasolabial fold augmentation from January 2019 to January 2021. All patients underwent CBCT scan and three-dimensional simulation, the personalized PEEK implant was designed and produced with CAD/CAM technique, the personalized PEEK was implanted during the operation. The patients were followed up for 3-12 months, and the wrinkle score and satisfaction were compared before operation and 3 months and 6 months after operation.Results:The depressions of nasolabial fold were significantly improved in all patients, and there were no complications such as hematoma and infection after operation. During the follow-up, there was no implant displacement or exposure, and the effect was stable and lasting. The scores of wrinkles at 3 months after operation (2.30±0.47) and 6 months after operation (2.17±0.38) were significantly lower than those before operation (4.03±0.67), and the scores of satisfaction were significantly higher than those before operation ( P<0.05). The scores of satisfaction at 3 months after operation (3.97±0.56) and 6 months after operation (4.23±0.57) were significantly higher than those before operation (1.70±0.60). The difference was statistically significant ( P<0.05). Conclusions:3D printing personalized PEEK prosthesis is effective in correcting nasolabial fold depression, and it is safe and stable, so it is recommended for clinical application.
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Objectives: To compare the clinical performance of milled PEEK-based single crowns to zirconia veneered single crowns through evaluation of restoration fracture, margin adaptation, and patient satisfaction. Material and Method: Twenty-four full coverage crowns were fabricated for posterior teeth. The patients were divided into two groups according to crowns' material: Group 1(control group) patients received Zr veneered crowns and Group2 (intervention group) patients received Bio HPP crowns. The preparations were standardized with supra-gingival, chamfer finish line for all teeth. The try-in and provisionalization were performed using CAD/CAM (CAM5-S1) machine with software (Exocad). The restorations were veneered according to manufactures instructions. The restoration surfaces were treated according to the manufacture instructions for each material. Self-adhesive resin cement (by BISCO) was used for both groups for crowns cementation. Fracture, margin integrity and biocompatibility (shade and function) were also evaluated during each recall visit using questionnaire to determine patient satisfaction. These measurements were repeated after two, four, six, eight, ten and twelve months respectively. Results: Fisher's Exact test was used to compare between the two groups; There was no statistically significant difference between the two groups (P-value = 1.000, Effect size = 0.478) for each time period, respectively. Conclusions: Both Zr veneered and Bio HPP crowns revealed successful clinical performance from the clinical performance aspect and patient satisfaction. No significant difference was recorded between the two materials; regarding the clinical performance and patient satisfaction. Therefore, careful checking of the surface of the veneering material one-year post-cementation is recommended (AU)
Objetivo: Comparar o desempenho clínico de coroas unitárias fresadas à base de PEEK com coroas unitárias estratificadas de zircônia por meio da avaliação da fratura da restauração, adaptação marginal e satisfação do paciente. Material e Métodos: Vinte e quatro coroas totais posteriores foram confeccionadas. Os pacientes foram divididos em dois grupos de acordo com o material das coroas: os pacientes do Grupo 1 (grupo controle) receberam coroas estratificadas de Zr e os pacientes do Grupo 2 (grupo de intervenção) receberam coroas BioHPP. Os preparos foram padronizados com linha de término supragengival e chanfro para todos os dentes. O try-in e a provisionalização foram realizados em máquina CAD / CAM (CAM5-S1) com software (Exocad). As restaurações foram estratificadas de acordo com as instruções do fabricante. As superfícies da restauração foram tratadas de acordo com as instruções do fabricante de cada material. O cimento resinoso autoadesivo (BISCO) foi utilizado para a cimentação das coroas em ambos os grupos. Fratura, integridade marginal e biocompatibilidade (tonalidade e função) também foram avaliadas durante cada consulta de retorno usando um questionário para determinar a satisfação do paciente. Essas medições foram repetidas após dois, quatro, seis, oito, dez e doze meses, respectivamente. Resultados: o teste exato de Fisher foi usado para comparação entre os dois grupos; não houve diferença estatisticamente significativa entre os dois grupos (P-valor = 1,000, tamanho do efeito = 0,478) para cada período de tempo, respectivamente. Conclusão: As coroas estratificadas de Zr e BioHPP revelaram um desempenho clínico bem-sucedido do ponto de vista do desempenho clínico e da satisfação do paciente. Nenhuma diferença significativa foi registrada entre os dois materiais; quanto ao desempenho clínico e satisfação do paciente. Portanto, recomenda-se a verificação cuidadosa da superfície do material de estratificação após um ano de cimentação.(AU)
Subject(s)
Humans , Dental Marginal Adaptation , Crowns , Flexural StrengthABSTRACT
Objective: To evaluate the clinical behavior of milled BioHPP PEEK copings veneered with Visio.lign composite resin in comparison with metal copings veneered with feldspathic porcelain as single posterior crowns. Material and Methods: Twenty Four full coverage posterior crowns were fabricated for endodontically treated molars divided into 2 groups according to the material used. Twelve milled BioHPP PEEK-based crowns (Group 1) and Twelve Porcelain Fused to Metal (PFM) crowns (Group 2). The preparations were standardized with an equi-gingival, deep chamfer finish line for all teeth. BioHPP PEEK and metal copings were fabricated by CAD/CAM technology and lost wax technique respectively. These coping were veneered according to manufactures instructions either by special composite resin or low fusing glass ceramic respectively. The restorations were cemented then clinical evaluation of these crowns was assessed regarding mechanical failure, marginal integrity and patient satisfaction every two months for one year. Results: Although two PEEK crowns were fractured, both PEEK and PFM crowns showed similar fracture (mechanical failure) and marginal integrity without significant difference (p > 0.05). BioHPP PEEK-based crowns showed statistically significantly lower patient satisfaction than PFM crowns after six months (p-value = 0.013, Effect size = 1.157) but all the patients were generally satisfied. Conclusion: BioHPP PEEK-based crowns showed clinically similar and accepted mechanical behavior and marginal integrity but less patient's satisfaction than PFM crowns after six months. So BioHPP PEEK-based crowns may be used as an alternative tooth-colored metal-free fixed restoration for one year (AU)
Objetivo: Avaliar o comportamento clínico de copings fresados de BioHPP PEEK com cobertura de resina composta Visio.lign em comparação com copings metálicos cobertos com cerâmica feldspática em coroas unitárias posteriores. Material e Métodos: Vinte e quatro coroas totais posteriores de foram confeccionadas para molares tratados endodonticamente e divididos em 2 grupos de acordo com o material utilizado. Doze coroas fresadas à base de BioHPP PEEK (Grupo 1) e doze coroas de porcelana fundida ao metal (PFM) (Grupo 2). Os preparos foram padronizados para todos os dentes com término de chanfro largo ao nível gengival. BioHPP PEEK e os copings metálicos foram fabricados por tecnologia CAD/CAM e técnica da cera perdida, respectivamente. A aplicação da cobertura sobre os copings foi realizada de acordo com as instruções do fabricante, por resina composta especial ou cerâmica vítrea de baixa fusão, respectivamente. As restaurações foram cimentadas e a avaliação clínica dessas coroas foi realizada quanto à falha mecânica, integridade marginal e satisfação do paciente a cada dois meses durante um ano. Resultados: Embora duas coroas de PEEK tenham sido fraturadas, ambas as coroas de PEEK e PFM apresentaram fraturas semelhantes (falha mecânica) e integridade marginal sem diferença significativa (p > 0,05). As coroas à base de BioHPP PEEK mostraram uma satisfação do paciente significativamente menor do que as coroas PFM após seis meses (valor de p = 0,013; tamanho do efeito = 1,157), mas todos os pacientes estavam geralmente satisfeitos. Conclusão: As coroas à base de BioHPP PEEK, em comparação às coroas PFM, mostraram desempenho clínico similar, aceitável comportamento mecânico e integridade marginal, mas menos satisfação do paciente, após seis meses. Portanto, as coroas à base de BioHPP PEEK podem ser utilizadas como uma alternativa de restauração livre de metal semelhante à cor do dente, por um ano. (AU)
Subject(s)
Patient Satisfaction , Metal Ceramic Alloys , Dental PorcelainABSTRACT
Objective: This study was performed to evaluate the use of PEEK abutments versus zirconium abutments with lithium disilicate superstructure on the esthetic acceptance and peri-implant clinical parameters. Zirconium abutments were found to have high surface roughness even after polishing. This causes a remarkable collapse of the soft tissue papilla that is a primary factor in the Pink Esthetic Score(PES), resulting in failed esthetic restoration in the anterior esthetic zone. Material and Methods:Twenty patients who needed a single implant restoration in the esthetic zone were included in this study. Eighteen patients completed screening, baseline, three-month, six-month, and twelve-month follow-up visits. At the screening visit, the patients were randomly allocated into two groups: Zirconia abutments (A) Group, and PEEK abutments (B) Group, both of which were restored with IPS e.max CAD superstructure. Patients Satisfaction was assessed by visual analogue scale (VAS). Pink esthetics score (PES), modified plaque index (mPI) and modified gingval index (mGI) were also assessed. Results: All implants were successfully osseo-integrated with a 100% survival rate over one year. Patient satisfaction was significantly higher for the PEEK group than the zirconium group. The pink esthetic score showed no statistical significance between both groups. The modified plaque index was significantly lower for the PEEK group than the zirconium group. The modified gingival index showed no statistical difference between both groups. Conclusion: PEEK revealed to be a versatile material to replace zirconium for implant abutments, due to its lower plaque affinity and higher patient satisfaction (AU)
Objetivo: Este estudo foi realizado para avaliar o uso de pilares PEEK versus pilares de zircônia com estrutura de dissilicato de lítio quanto a aceitação estética e parâmetros clínicos peri-implantares. Os pilares de zircônia apresentam alta rugosidade superficial, mesmo após o polimento. Isso causa um colapso notável da papila do tecido mole, que é um fator primário no índice estético rosa (Pink Esthetic Score - PES), resultando em falha na restauração estética na zona estética anterior. Materiais e Métodos:Vinte pacientes que precisavam de um implante unitário na zona estética foram incluídos neste estudo. Dezoito pacientes completaram a triagem, a consulta inicial e as visitas de acompanhamento de três, seis e doze meses. Durante a triagem, os pacientes foram aleatoriamente divididos em dois grupos: Grupo Pilares de Zircônia (A) e Grupo de Pilares PEEK (B), ambos foram restaurados com IPS e.max CAD. A satisfação dos pacientes foi avaliada pela escala visual analógica (VAS). O PES, o índice de placa modificado (mPI) e o índice gengival modificado (mGI) também foram avaliados. Resultados: Todos os implantes foram osseointegrados com sucesso, com uma taxa de sobrevivência de 100% ao longo de um ano. A satisfação do paciente foi significativamente maior para o grupo PEEK quando comparado com o grupo de pilares de zircônia. O índice da estética rosa não apresentou significância estatística entre os dois grupos. O índice de placa modificado foi significativamente menor para o grupo PEEK quando comparado com o grupo de pilares de zircônia. Conclusão: O PEEK revelou-se um material versátil para substituir a zircônia em pilares de implante, devido a sua menor afinidade de placa e maior satisfação do paciente. (AU)
Subject(s)
Humans , Dental Abutments , Patient Satisfaction , Dental Implantation , Dental Implantation, EndosseousABSTRACT
Life is becoming more convenient as advancement in materials has been taking place since the beginning of human history. The increased demand of aesthetics in day to day life and on the other hand disadvantages of the existing materials, clinicians are shifting their paradigms towards metal free restorations. Various researches are going on to identify the ideal restorative material with all the improved mechanical and physical qualities. Advances in the field of dental materials are providing promising results but each material is falling short of being an ideal one. One such material is biomaterials. Biomaterials are mainly used in medical sciences to replace or augment a natural function. Biomaterials are widely used in dentistry, they are divided into four categories metal, composites, polymer and resins. Biomaterials are considered as materials which replace the defects by either replacements or repair. Presently Poly-Ether Ether Ketone (PEEK) is a semi crystalline, synthetic, aromatic, thermoplastic material. Previously, it was used for industrial purposes but due to its excellent properties and biocompatibility, it has been used in medicine and dentistry. There are various applications of PEEK in dentistry such as orthodontic wires and brackets which are made from it to achieve aesthetics and strength. In endodontics PEEK posts and PEEK endocrowns are used when extensive tooth structure loss occurs, even due to its aesthetic property, it is used for anterior restorations. PEEK is a synthetic polymer and is greyish in colour which has a monomer unit of ether ether ketone. In prosthodontics, aesthetics plays an important role. Therefore, PEEK is considered as an alternative option to conventional dental materials because of its aesthetics and it being a scientifically approved material. In prosthodontics, it can be used in removable partial dentures, fixed partial dentures, dental implants and abutments, implant crowns as well as for restoring the maxillofacial defects. This review article describes the various applications of PEEK in prosthodontics in detail.
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BACKGROUND: Polyetheretherketone (PEEK) and Its composites have a unique set of properties, and 3D printing technology can customize personalized Implants according to the patient's condition, and the effective combination of the two plays a significant role In the field of bone repair. OBJECTIVE: To summarize the application status of PEEK and Its composite combined with 3D printing technology In the field of bone repair, and to further predict the application prospects of the effective combination of the two. METHODS: CNKI, PubMed, and Web of Science databases were retrieved with the search terms “PEEK, PEEK composites, bone defect repair, PEEK Implants, PEEK 3D printing, prosthodontlcs” in English and Chinese, respectively, for the articles published from April 1995 to April 2019. Totally 147 articles were searched, and finally 51 eligible articles were enrolled for review in accordance with the inclusion and exclusion criteria. RESULTS AND CONCLUSION: Biologically active materials and the particles or fibers with Improved mechanical properties were Introduced Into the PEEK matrix to prepare its composite. 3D printing technology was used to precisely customize Implants that are highly matched to the patient's defect. The Implants with good biocompatibility, bioactlvity, and mechanical properties exhibited good therapeutic effects In the repair of skull, jaw, spine, lumbar vertebra, artificial joint and oral defects. They Improved patient satisfaction after treatment. This article summarized the application of PEEK, its composite and 3D printing technology In the repair of various bone defects, and expressed its views on the application and prospect of personalized PEEK implants or prostheses prepared with 3D printing technology.
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BACKGROUND: Posterior decompression and pedicle screw fixation combined with interbody fusion is a method for the treatment of cervical vertebral degenerative lesions. There are few reports on the measurement of strain electricity in simulating C5/6 intervertebral disc fusion after pedicle screw removal. OBJECTIVE: To analyze stress and strain immediately after C5/6 discectomy, pedicle screw fixation combined with interbody fusion. METHODS: Eighteen fresh pig cervical specimens were randomly divided into three groups: Bone cage fusion group, PEEK fusion group, and titanium mesh fusion group (n=6). Each group simulated C5/6 discectomy and pedicle screw fixation, and then different fusion cages were used for interbody fusion. Before and after fusion, the resistance strain gauges were attached under the vertebral body at the position of pedicle screw fixation, at the edge of vertebral body at the fusion position of fusion cage, at the edge of adjacent vertebral body. The strain values of each sample were measured under the compression state by static resistance strain gauge. The stress values at each measurement point before and after fusion in posterior fixation with pedicle screws for cervical vertebrae in each group were calculated by material mechanics formula. RESULTS AND CONCLUSION: (1) Under the same load, the strain and stress of each measurement point in the titanium mesh fusion group were smaller than those in the bone cage fusion group and the PEEK fusion group, and the difference was significant (P < 0.05). (2) Under the same load, the strain and stress of each test point in the bone cage fusion group were larger than those in the PEEK fusion group, and the difference was significant (P < 0.05). (3) These results confirm that simulated C5 discectomy in vitro, posterior pedicle screw fixation and implantation of different fusion cages have different changes of stress and strain. The selection of appropriate interbody fusion cage can reduce the effect of stress concentration on adjacent segments.
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Objective: was to evaluate the retentive force, fatigue resistance and deformity of clasps made from two materials cobalt chromium and poly ether ether ketone (PEEK). Material and Methods: sixteen models were fabricated,each one having lower 1st molar. Models were divided into two groups according to materials,group I (GI) for cobalt chromium (Co-Cr) and group II (GII) for PEEK. Each testing models and its clasps were mounted inside universal testing machine, the retention was measured by applying withdrawal force to it by this machine at 5 mm/min. The Fatigue resistance is measured by the reduction in retention through repeated insertion and removal cycles using robota chewing simulator. Removal and insertion cycling of clasps was carried out for 360, 730, 1080, 1,440, 2,116 and 2,880 cycles (corresponding to 3, 6, 9, 12, 18 and 24 months of simulated clinical use of a RPD) to simulate the fatigue resistance test. Deformity was measured before and after each cycling using a digital micrometer. Statistical analysis was done by 2-way-ANOVA test to detect significance effects of each variable. Results: Retention and fatigue resistance, after 360, 730, 1080, 1,440, 2,116 and 2,880 cycles totally the difference between Co-Cr and PEEK groups was statistically non-significant (P = 0.0980> 0.05) where (Co-Cr > PEEK). Deformation results, regardless to evaluation time, Co-Cr group recorded statistically significant higher deformation mean value than PEEK group (P = 0.008 < 0.05).Regardless to material group, deformation mean value changed nonsignificantly by time (P = 0.2882> 0.05). Conclusion: PEEK clasps (1.0 mm in cross section diameter) engage 0.50 mm undercut provide sufficient retention nearly similar that of Co-Cr clasps.(AU)
Objetivo: o objetivo foi avaliar a força de retenção, a resistência à fadiga e a deformidade dos grampos fabricados com dois materiais diferentes: cromo-cobalto (Co-Cr) e poliéter-éter-étercetona (PEEK). Materiais e métodos: dezesseis modelos foram confeccionados, cada um com 1º molar inferior. Os modelos foram divididos em dois grupos de acordo com o material: grupo I Co-Cr e grupo II para PEEK. Cada modelo de teste universal e seus grampos foram montados em uma máquina de teste universal. A retenção foi medida aplicando força de retirada por esta máquina a 5 mm/min. A resistência à fadiga foi medida pela redução na retenção através de ciclos repetidos de inserção e remoção usando um simulador do ciclo de mastigação. O ciclo de remoção e inserção dos grampos foi realizado por 360, 730, 1080, 1.440, 2.116 e 2.880 ciclos (correspondendo a 3, 6, 9, 12, 18 e 24 meses de uso clínico simulado de um RPD) para simular o teste de resistência à fadiga. A deformidade foi medida antes e após cada ciclo, usando um micrômetro digital. A análise estatística foi realizada pelo teste ANOVA de 2 fatores para detectar os efeitos de significância de cada variável. Resultados: A retenção e a resistência à fadiga após 360, 730, 1080, 1.440, 2.116 e 2.880 ciclos entre os grupos Co-Cr e PEEK não mostrou diferença estatisticamente significativa (p = 0,0980> 0,05), onde (Co-Cr> PEEK). Para os resultados da deformação, independentemente do tempo de avaliação, o grupo Co-Cr registrou um valor médio de deformação maior, com diferença estatística significativa, quando comparado com o grupo PEEK (p= 0,008 < 0,05). Independentemente do grupo de material, o valor médio da deformação foi alterado de forma não significativa pelo tempo (p= 0,2882> 0,05). Conclusão: os grampos PEEK (1,0 mm de diâmetro da seção transversal) engatam 0,50 mm retenção quase semelhante à dos grampos Co-Cr (AU)
Subject(s)
Resins, Synthetic , Chromium Alloys , Denture, PartialABSTRACT
Introduction: The demand for metal free restorations may it be fixed or removable has increased manifold in the recent past. BioHPP is one such material that has been introduced recently in the field of prosthodontics. Aim: The aim of this narrative review is to discuss the properties of BioHPP (Biocompatible High Performance Polymer) material and its applications in the field of prosthodontics Materials and Methods: A search strategy was performed on PubMed and Google Scholar with key words: Modified PEEK, BioHPP, Prosthodontic applications. Results: Seventy nine articles were retrieved. After hand search and along with cross reference a total of 84 articles were identified. Ultimately 18 articles were selected and discussed as they met the selection criteria. Conclusion: Within the scope of this review, reported literature showed that BioHPP has proven to be a boon to the field of prosthodontics as a result of its excellent biocompatibility as well as mechanical properties. BioHPP offers a wide range of applications may it be in removable or fixed prosthodontics. With an increase in the number of clinical trials and long term follow up studies, BioHPP might prove to be a material of choice for a variety of prosthodontic applications.
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Problem statement: A significant clinical concern in Co-Cr alloy removable prosthodontics is a failure of bonding with acrylic resins and PEEK is introduced on various materials to overcome this problem. The reason for this study was to examine the denture base acrylic resin bond strength to Co-Cr alloy and PEEK polymer using different surface treatment. Materials and method: Total 60 number of disc-shaped specimens were prepared and divided into 2 main groups according to the type of framework material, 30 specimens for Co-Cr alloy and 30 specimens for PEEK polymer, which were then subdivided into 3 groups each one consist of 10 specimens, according to the type of surface treatments. Each group either had a no surface treatment (control group) or air abrasive group (110 μm of alumina oxide) or acid etch (98% sulfuric acid) group. The specimens were thermocycled (3000 cycles) after applications of heat cured acrylic resin. Results: The results for Co-Cr alloy showed that the air abrasive surface treatments had the highest bond strength mean value followed by the control group (no surface treatment), while the acid surface treatment had the least mean value of bond strength. For PEEK polymer, the results revealed that the acid surface treatment had the highest value of bond strength followed by the air abrasive surface treatment while the control group (no surface treatment) had the least bond strength mean value. Conclusion: Air abrasive surface treatment significantly improved bond strength for both Co-Cr and PEEK, while sulfuric acid treatment show counterproductive result with Co-Cr alloy whereas with PEEK play an important role in bonding mechanism. The use of PEEK framework in combination with heat cured acrylic resin can be recommended as a promising non-metallic alternatives framework material for removable of partial dentures.
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Objective To study the stress distributions of mandible defect by reconstruction with polyetheretherketone (PEEK) and its composite reconstruction plate through three-dimensional finite element analysis. Methods The finite element models of reconstruction plate of titanium alloy, PEEK, carbon-fiber-reinforced polyetheretherketone (CFR)-PEEK with 30% endless carbon fibers and CFR-PEEK with 68% endless carbon fibers were established by CBCT scanning，Mimics software，SolidWorks, Geomagic Studio and ANSYS Workbench software, and titanium alloy served as control. Two occlusal situations were simulated in the mandible model. Loading I: anterior region loading with 300 N; loading II: left posterior region with 300 N. Results The ratio of the maximum Von Mises stress of the reconstructed plate to its yield strength under two load situations: PEEK system ＞ 30%CFR-PEEK system ＞ titanium alloy system ＞ 68% CFR-PEEK system; the maximum stress of the mandible: PEEK system ＞ 30% CFR-PEEK system ＞ titanium alloy system ＞ 68% CFR-PEEK system. In the PEEK system, the maximum Von Mises stress of reconstructed plate and mandibular exceeded its yield strength under loading I; in the other systems, the maximum Von Mises stresses of mandible and reconstruction plate were below the yield strength. Conclusions The reconstruction plate of CFR-PEEK with 68% endless carbon fibers distributed the stresses in a similar manner as the titanium reconstruction plate, which could meet the mechanical strength requirements of mandible defect reconstruction. The fracture risk of the reconstructed plate was lower than that of titanium alloy, but the incidence of stress shielding was slightly higher. The result can provide references for the selection of materials and clinical application of reconstruction plate for mandibular defects.
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Chest wall defect may be caused by many factors such as the resection of tumor and trauma, and the reconstruction of bone-defection is still the key point of thoracic surgery. With the development of material science, more and more new materials have been used in medical practice, which makes huge progress in the surgery of chest wall. However, none of these materials satisfy all the practical needs of the reconstruction. Recently, with the development of the capacity of computer, 3D-printing technology has been gradually used in clinical work, and the idea of individual treatment has been accepted by more and more people. The weakness of these materials may be solved by the new material and the application of individual treatment, which could also make great advance in chest wall surgery. This article will make a summary of the research on the reconstruction of chest wall. .