Keskin Aynil, Kayssoun Ammar
Int J Oral Maxillofac Implants. 2025 May 29;40(3):371-381. doi: 10.11607/jomi.11005.
To evaluate the influence of using polyetheretherketone (PEEK) copings and/or three different dental restorative materials for the success of tooth-and-implant-supported fixed partial dentures (TISFPDs) in the maxillary posterior region under static loading via 3D finite element analysis (3D FEA).
Six 3D FEA models were designed for the extraction of maxillary first and second molars. The following elements were modeled: bone, implant, abutment, PEEK copings, second premolar, periodontal ligament (PDL), and six three-unit TISFPDs with different restorative materials (porcelain-fused-to metal [PFM], PEEK-composite [PC], monolithic zirconia [MZ]). Then PEEK copings were modeled to be cemented onto the implants as a double-crown system for the first three groups (PFMPEEK, PCPEEK, and MZPEEK), whereas the next three groups (PFM, PC, and MZ) excluded a PEEK coping in their designs. The prostheses were loaded twice-once vertically and once obliquely. From the determined points, 250 N for vertical loading (0 degrees to the long axis) and 200 N for the oblique loading (30 degrees to the long axis) were applied. Von Mises stresses and maximum and minimum principal stress values were analyzed.
Regardless of the material used for the suprastructure, the maximum average stress was reduced by the use of PEEK copings. Considering the maximum stress distribution, PC appeared to have the highest stresses on the cortical bone, implant, and screw. Additionally, the von Mises stresses formed in the PDL model were lower when a PEEK coping was included in the design of the TISFPD, reducing the risk of intrusion.
The stress distribution was positively affected by the PEEK coping in the TISFPD design, reducing bone resorption and failure. This elastic material generated lower stresses at the bone and implant, and no significant effect was found on stresses around natural teeth.
通过三维有限元分析（3D FEA），评估使用聚醚醚酮（PEEK）冠套和/或三种不同的牙科修复材料对上颌后牙区牙-种植体支持的固定局部义齿（TISFPDs）在静态加载下成功的影响。
设计六个3D FEA模型，用于上颌第一和第二磨牙的拔除。模拟了以下部件：骨、种植体、基牙、PEEK冠套、第二前磨牙、牙周膜（PDL）以及六个采用不同修复材料（烤瓷熔附金属[PFM]、PEEK复合材料[PC]、全瓷氧化锆[MZ]）的三单位TISFPDs。然后，在前三组（PFMPEEK、PCPEEK和MZPEEK）中，将PEEK冠套模拟为作为双冠系统粘结到种植体上，而后三组（PFM、PC和MZ）在设计中不包括PEEK冠套。假体加载两次——一次垂直加载，一次倾斜加载。从确定的点施加垂直加载250 N（与长轴成0度）和倾斜加载200 N（与长轴成30度）。分析了冯·米塞斯应力以及最大和最小主应力值。
无论上部结构使用何种材料，使用PEEK冠套均降低了最大平均应力。考虑最大应力分布，PC在皮质骨、种植体和螺钉上的应力似乎最高。此外，当TISFPD设计中包括PEEK冠套时，在PDL模型中形成的冯·米塞斯应力较低，降低了侵入风险。
PEEK冠套在TISFPD设计中对应力分布有积极影响，减少了骨吸收和失败。这种弹性材料在骨和种植体处产生较低的应力，并且对天然牙周围的应力没有显著影响。
