Wang Biyao, Huang Minghao, Zhang Kaige, Xu Yan, Zhang Xinwen, Shi Liye, Yan Xu
The VIP Department, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, No.117 North street Nanjing Road, Shenyang, 110002, China.
Department of Oral Implantology, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China.
BMC Oral Health. 2025 May 10;25(1):706. doi: 10.1186/s12903-025-06089-w.
Polyetheretherketone (PEEK) and its fiber-reinforced composites have been indicated as ideal post-and-cores materials due to its mechanical properties. However, the laboratory evidences of post-and-cores restored with fiber-reinforced PEEK are lacking.
A total of 120 extracted mandibular premolars were treated endodontically and divided into six groups restored with different post-and-core materials (N = 20): (1) prefabricated quartz fiber-reinforced composite (QFRC), (2) polymer-infiltrated ceramic (PIC), (3) cobalt chromium (CoCr), (4) PEEK, (5) 30% glass fiber-reinforced PEEK (GFR-PEEK), and (6) 30% carbon fiber-reinforced PEEK (CFR-PEEK). Stress distribution was analyzed by finite element analysis (FEA). Then, each group was then divided into two subgroups (n = 10): static loading test and fatigue loading test. The static failure load (SFL) was analyzed by one-way analysis of variance (ANOVA) with least-significant difference (LSD) multiple comparison tests. The fatigue failure load (FFL) and cycles for failure (CFF) were evaluated by Kaplan-Meier survival analysis (P < 0.05).
Groups PEEK, GFR-PEEK, and CFR-PEEK exhibited lower maximum peak principal stress and better stress distribution than Group CoCr. The SFL of Groups PEEK and QFRC did not differ from each other, and both were lower than those of Groups CoCr, GFR-PEEK, and CFR-PEEK. In the fatigue loading test, Group CoCr exhibited the best survival; however, with the progression of fatigue, the survival probabilities of Groups PEEK and its composites were close to that of Group CoCr. In all groups apart from Group CoCr, the rate of repairable failure modes was higher than that of irreparable ones.
Customized post-and-cores manufactured with PEEK and its fiber-reinforced composites showed superior biomechanical performance, making them potential alternatives for the restoration of massive tooth defects.
This study provides a theoretical basis for clinicians to select post-and-core materials for different root canal morphology residual roots and helps to reduce the occurrence of complications such as root fracture and post core debonding.
聚醚醚酮（PEEK）及其纤维增强复合材料因其机械性能被视为理想的桩核材料。然而，缺乏纤维增强PEEK修复桩核的实验室证据。
选取120颗拔除的下颌前磨牙进行根管治疗，分为六组，用不同的桩核材料进行修复（每组20颗）：（1）预制石英纤维增强复合材料（QFRC），（2）聚合物渗透陶瓷（PIC），（3）钴铬合金（CoCr），（4）PEEK，（5）30%玻璃纤维增强PEEK（GFR-PEEK），（6）30%碳纤维增强PEEK（CFR-PEEK）。通过有限元分析（FEA）分析应力分布。然后，每组再分为两个亚组（每组10颗）：静态加载试验和疲劳加载试验。采用单因素方差分析（ANOVA）和最小显著差异（LSD）多重比较检验分析静态破坏载荷（SFL）。通过Kaplan-Meier生存分析评估疲劳破坏载荷（FFL）和破坏循环次数（CFF）（P<0.05）。
PEEK组、GFR-PEEK组和CFR-PEEK组的最大主应力峰值较低，应力分布优于CoCr组。PEEK组和QFRC组的SFL无差异，且均低于CoCr组、GFR-PEEK组和CFR-PEEK组。在疲劳加载试验中，CoCr组的生存率最高；然而，随着疲劳的进展，PEEK组及其复合材料组的生存率接近CoCr组。除CoCr组外，所有组的可修复破坏模式发生率均高于不可修复破坏模式。
用PEEK及其纤维增强复合材料制作的定制桩核具有优异的生物力学性能，使其成为修复大面积牙齿缺损的潜在替代材料。
本研究为临床医生为不同根管形态的残根选择桩核材料提供了理论依据，有助于减少根折和桩核脱落等并发症的发生。
