Retention force of polyetheretherketone and cobalt-chrome-molybdenum removable dental prosthesis clasps after artificial aging.

OBJECTIVES: To examine the retention force of removable dental prosthesis (RDP) clasps made from polyetheretherketone (PEEK) and cobalt-chrome-molybdenum (CoCrMo, control group) after storage in water and artificial aging. MATERIALS AND METHODS: For each material, 15 Bonwill clasps with retentive buccal and reciprocal lingual arms situated between the second pre- and first molar were manufactured by milling (Dentokeep [PEEKmilled1], NT digital implant technology; breCAM BioHPP Blank [PEEKmilled2], bredent), pressing (BioHPP Granulat for 2 press [PEEKpressed], bredent), or casting (remanium GM 800+ [CoCrMo], Dentaurum); N = 60, n = 15/subgroup. A total of 50 retention force measurements were performed for each specimen per aging level (initial; after storage [30 days, 37 °C] and 10,000 thermal cycles; after storage [60 days, 37 °C] and 20,000 thermal cycles) in a pull-off test. Data were statistically analyzed using one-way ANOVA, post hoc Scheffé and mixed models (p < 0.05). RESULTS: Initial, PEEKpressed (80.2 ± 35.2) and PEEKmilled1 (98.9 ± 40.3) presented the lowest results, while PEEKmilled2 (170.2 ± 51.8) showed the highest values. After artificial aging, the highest retention force was observed for the control group (131.4 ± 56.8). The influence of artificial aging was significantly higher for PEEK-based materials. While PEEKmilled2 and PEEKpressed showed an initial decline in retention force, all other groups presented no impact or an increase in retention force over a repetitive insertion and removal of the clasps. CONCLUSIONS: Within the tested PEEK materials, PEEKmilled2 presented superior results than PEEKpressed. Although CoCrMo showed higher values after artificial aging, all materials exhibited sufficient retention to recommend usage under clinical conditions. CLINICAL RELEVANCE: As RDPs are still employed for a wide range of indications, esthetic alternatives to conventional CoCrMo clasps are sought.

Is the high-performance thermoplastic polyetheretherketone indicated as a clasp material for removable dental prostheses?

OBJECTIVES: To investigate the retention force of polyetheretherketone (PEEK) removable dental prosthesis clasps in comparison with a cobalt-chrome-molybdenum control group after storage in artificial saliva. MATERIALS AND METHODS: Clasps were milled (Dentokeep (PEEKmilled1), NT digital implant technology; breCAM BioHPP Blank (PEEKmilled2), bredent), pressed (BioHPP Granulat for 2 press (PEEKpressed), bredent), or cast (remanium GM 800+ (cobalt-chrome-molybdenum), Dentaurum); N = 60, n = 15/subgroup. Retention force was examined 50 times/specimen in a pull-off test using the universal testing machine (Zwick 1445), where pull-off force was applied with a crosshead speed of 5 mm/minute until the maximum force dropped by 10%, at different aging levels: (1) initial, after storage in artificial saliva for (2) 90 and (3) 180 days. Statistical analysis was performed using one-way ANOVA followed by post hoc Scheffé-test and mixed models (p < 0.05). RESULTS: Cobalt-chrome-molybdenum presented the highest retention force. No differences were observed between polyetheretherketone materials. Cobalt-chrome-molybdenum showed a significant decrease of its values after artificial aging, while polyetheretherketone materials presented similar results over the course of aging. Regarding a repetitive insertion and removal, even though PEEKmilled2 and cobalt-chrome-molybdenum showed an initial increase, ultimately, a decrease in retention force was observed for all tested groups. CONCLUSIONS: Although the control group showed significantly higher results, the retention force of polyetheretherketone materials indicate a potential clinical application. Neither the manufacturing process nor artificial aging showed an impact on the retention force of polyetheretherketone clasps. CLINICAL RELEVANCE: Mechanical properties of novel removable dental prosthesis clasp materials devised to meet the growing esthetic demands of patients need to be investigated to ensure a successful long-term clinical application.