Ortega-Martínez Jordi, Delgado Luis M, Ortiz-Hernández Mónica, Punset Miquel, Cano-Batalla Jordi, Cayon Miguel Roig, Cabratosa-Termes Josep
Assistant Professor, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain.
Assistant Professor, Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Barcelona, Spain.
J Prosthet Dent. 2022 Mar;127(3):470-476. doi: 10.1016/j.prosdent.2020.09.033. Epub 2020 Dec 9.
Polyetheretherketone (PEEK) has been advocated to replace metal components in dentistry. Although PEEK is a high-performance polymer with a white color, adequate biological response, and resistance to fracture, data to support PEEK as an alternative material for implant abutments are lacking.
The purpose of this in vitro study was to assess the mechanical and functional properties of PEEK implant abutments as a nonmetallic alternative to titanium abutments, which presents esthetic limitations and greater difficulty to customize clinically.
Implant abutments manufactured by using PEEK (n=24) or titanium grade 5 (n=24) were attached to MIS Implants type M4 3.75×16 mm with an internal screw tightened to 25 Ncm. Screw loosening and microleakage was assessed by submersion in a 2% methylene blue solution for 48 hours at 37 °C. Both groups were compared with and without applying dynamic loading; fatigue testing was performed following the International Organization for Standardization (ISO) 14801:2016 standard. All specimens were observed under a stereomicroscope at ×8 magnification. Statistically significant differences among the PEEK and titanium implant abutments were tested with 2-factor ANOVA and the chi-square analysis for nonpaired and paired data, respectively (α=.05).
The implant abutments made of titanium were better in all mechanical tests. The torque loss of titanium abutments was approximately 10%, while PEEK showed a significantly higher (P<.05) torque loss of up to 50%. Moreover, 91.6% of the titanium abutments did not present microleakage, while there was no specimen of PEEK abutments without microleakage, once subjected to dynamic loading (P<.05).
Titanium implant abutments (Ti6Al4V) were better in all tests performed. However, PEEK abutments may be suitable for long-term interim restorations, especially in the anterior area, in patients without parafunction.
聚醚醚酮（PEEK）已被提倡用于替代牙科中的金属部件。尽管PEEK是一种具有白色外观、良好生物反应和抗断裂性能的高性能聚合物，但缺乏支持PEEK作为种植体基台替代材料的数据。
本体外研究的目的是评估PEEK种植体基台作为钛基台的非金属替代品的机械和功能特性，钛基台存在美学局限性且临床定制难度更大。
使用PEEK（n = 24）或5级钛（n = 24）制造的种植体基台通过内部螺丝以25 Ncm的扭矩拧紧至MIS M4 3.75×16 mm型种植体上。通过在37°C下于2%亚甲蓝溶液中浸泡48小时来评估螺丝松动和微渗漏情况。对两组分别在施加和不施加动态载荷的情况下进行比较；按照国际标准化组织（ISO）14801:2016标准进行疲劳测试。所有标本在×8放大倍数的立体显微镜下观察。分别使用双因素方差分析和卡方分析对PEEK和钛种植体基台之间的统计学显著差异进行非配对和配对数据测试（α = 0.05）。
在所有机械测试中，钛制成的种植体基台表现更好。钛基台的扭矩损失约为10%，而PEEK的扭矩损失高达50%，显著更高（P < 0.05）。此外，91.6%的钛基台未出现微渗漏，而一旦施加动态载荷，没有PEEK基台标本无微渗漏（P < 0.05）。
在所有进行的测试中，钛种植体基台（Ti6Al4V）表现更好。然而，PEEK基台可能适用于长期临时修复，特别是在前牙区，适用于无功能异常的患者。
