PEEK for Oral Applications: Recent Advances in Mechanical and Adhesive Properties
Abstract
:1. Introduction
2. Performance Requirements for Medical Materials
3. Mechanical Properties of PEEK in Dental Applications
3.1. PEEK as an Oral Implant Material
3.1.1. Implants Made of PEEK
3.1.2. PEEK Implant Abutments
3.2. PEEK as an Oral Prosthesis Material
3.2.1. PEEK
3.2.2. CF/PEEK
3.2.3. Other PEEK Composites
3.3. 3D-Printed PEEK in Oral and Maxillofacial Surgery
3.4. Other Oral Applications of PEEK
4. Adhesive Properties of PEEK in Dental Applications
4.1. Surface Treatments
4.2. Adhesive Systems
5. Conclusions and Perspectives
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Properties | Requirements | Brief Introduction | Test Methods | Ref. |
---|---|---|---|---|
Mechanical properties | Elastic modulus (i.e., Young’s modulus, stiffness; GPa) | The ability to resist elastic deformation. It is defined as the ratio of stress to strain and is determined from the initial slope of the stress–strain curve. | - Tensile test - Bending test - Compressive test | [7] |
Tensile strength (MPa) | The ultimate strength of the material during tension. | Tensile test | [20] | |
Elongation (%) | The ability to stretch plastically (i.e., ductility). | Tensile test | [21] | |
Elongation at break (%) | The ratio between the length of a specimen that changes after fracture and the initial length. | Tensile test | [21] | |
Bending strength (MPa) | The ultimate strength of the material during bending. | Bending test | [20] | |
Compressive strength (MPa) | The ultimate strength of the material during compression. | Compressive test | [22] | |
Shear strength (interlaminar and interfacial shear strength (ILSS, IFSS); MPa) | The resistance of the composite to delamination under shear forces parallel to the layers of the laminate, and thus, to the adhesive/adherent interface. | - Shear bonding strength test - Pull-off tensile test | [23,24] | |
Yield strength (MPa) | The ability to withstand stress without plastic deformation (i.e., permanent deformation). | - Tensile test - Compressive test | [21] | |
Toughness (KJ/m2) | The energy of elastic and plastic deformation required to break a material. It increases with strength and ductility. | Impact test | [23] | |
Fatigue strength (Sn; MPa) | The maximum alternating stress that the material can withstand for a long time. | Load-cycle fatigue test | [25] | |
Creep | Under the condition of a constant load below the yield strength, the strain increases with time. | Martens force/depth indentation test | [26] | |
Hardness (indentation hardness, scratch hardness, rebound hardness; MPa) | The ability of a material surface to resist plastic deformation caused by indentation and localized cracking. Rebound hardness means the magnitude of the elastic deformation work of the material. | - Vickers hardness (HV) test - Martens hardness (HM) test - Surface scratch test - Back-jump test | [19] | |
Biological properties | Biocompatibility | The ability of a material to generate an appropriate host response in a specific application. | Cell proliferation, cytotoxicity, and adhesion test | [27] |
Osseointegration | A phenomenon where an implant becomes fused with bone. | Microcomputed tomography (μ-CT) | [28] | |
Chemical properties | Corrosion resistance | The ability to resist damage caused under the action of the surrounding medium. | Potentiodynamic polarization (PDP) and static immersion assay | [29] |
Aging resistance | The ability of polymers to resist deterioration. | Cycles of thermal aging | [26] | |
Physical characteristics | Crystallinity | A specific type of ordered structure in a solid material. Those with little crystallinity are known as amorphous polymers. | Differential scanning calorimetry (DSC) and X-ray diffraction (XRD) | [21] |
Microscopic features | Surface, cross-sectional, and fracture surface characteristics, such as roughness. | Scanning electron microscopy (SEM) | [26,30] | |
Porosity | The ratio of the void volume to total volume. | Water displacement method | [30] | |
Surface tension (N/m) | The ability to cause the surface of a liquid to shrink. | Water contact angle detection | [30] |
Material Characteristics | Materials | Advantages | Disadvantages | Dental Application | Ref. |
---|---|---|---|---|---|
Metal-based materials | Titanium and its alloys (Ti-6Al-4V) | - Improved strength - Biocompatible | - High Young’s moduli - Poor wear resistance - Potentially toxic | - Dental implants and abutments - Inapplicable for orthopedic use (Ti-6Al-4V) | [33] |
Cobalt-based alloys (cobalt-chromium-molybdenum/CoCr-Mo) | - Low rigidity - High yield and tensile strength - Superior wear resistance | - Unaesthetic appearance - Potentially toxic | - Ceramic abutments - Crowns - Clasps | [34] | |
Ceramics | Alumina (Al2O3) (α-aluminum oxide) | - Biocompatible - Wear resistant | - Less compact - Lower flexural strength | - Dental implants - Endodontic posts - Orthodontic brackets | [35] |
Zirconia (ZrO2) | - Highly biocompatible - Good osseointegration - Good aesthetics | High Young’s moduli | - Crowns - Implant abutments | [34] | |
Lithium disilicate | Superior aesthetics and translucency | High Young’s moduli | Crowns | [36] | |
Titanium dioxide (TiO2) nanoparticles | Semipermanent antibacterial agent | Resulting in cytotoxicity in a dose-dependent manner | Oral antibacterial disinfectants, whitening agents, and adhesives | [37,38] | |
Polymers | PEEK | - Good mechanical properties - Good biocompatibility | - Poor surface properties - Poor aesthetic performance | - Dental abutments - Temporary crowns | [7] |
PMMA | - Non-biodegradable and stable aesthetic - Good flexibility | Shrink during polymerization | - Denture base - Crowns | [39] | |
Composites | Carbon-fiber-reinforced PEEK (CF/PEEK) | Higher mechanical strength and wear resistance than PEEK | Relatively weak interlaminar strength | -Fracture fixation -Posts and cores | [40] |
Glass-fiber-reinforced PEEK (GF/PEEK) | Higher rigidity, hardness, and deformation resistance | Poor uniformity | Posts and cores | [41] | |
PEEK /nano-silica (PEEK/nano-SiO2) | Higher elastic modulus | Decreased toughness | Crowns | [42] | |
Hydroxyapatite (HA)/PEEK (HA/PEEK) | Increased compressive strength and modulus with the HA content | Decreased tensile/bending strength | Bone grafting and tissue engineering scaffolds | [43,44] | |
TiO2-reinforced PEEK | - Higher fracture and aging resistance - Improved Martens hardness (HM) | Affected by radiation | Implant-supported, 4-unit cantilever FDP | [45] | |
Polymer-infiltrated ceramic network (PICN) | Comparable fracture toughness and better damage tolerance than glass ceramics | Significantly lower wear resistance than that of tooth enamel | Dental restorations for bruxism patients | [34] |
Materials | Density (g/cm3) | Martens Hardness (HM, N/mm2) | Tensile Strength (MPa) | Elastic Modulus (GPa) | Bending Strength (MPa) | Ref. |
---|---|---|---|---|---|---|
Cortical bone | 1.92 | 104–121 | 6–30 | 225 | [46] | |
Dentin | 3.3 | 468.2 ± 30.77 | 104 | 12–18.6 | [47] | |
Dental enamel | 2263.6 ± 405.16 | 47.5 | 40–83 | [47] | ||
Titanium | 4.5 | 300–400 | 954–976 | 102–110 | [47] | |
CoCr | 6.5 | 1200 | 680 | 205 | 800–1400 | [48] |
PMMA | 1.18 | 180 | 48–76 | 3.6 | 95–105 | [47] |
PEEK | 1.3 | 189.55 ± 16.89 | 87.53–100 | 3–4 | 99.25–170 | [1,22] |
Annealed FDM-printed PEEK | 97.34 | 2.6–3.45 | 104.65 | [22,49] | ||
PEEK/CF (carbon-fiber-reinforced PEEK) | 1.3 | 330.6 ± 21.2 | 6.9–109 | 3.5–58.5 | 264.6 | [50] |
PEEK/GF (30% glass-fiber-reinforced PEEK) | 2.61 | 295.3 ± 12.5 | 94.0 ± 2.0 | 12.38 | 167 | [26] |
Bio-PEAK (PEEK filled with 5% TiO2) | 1.4 | 4.2–4.8 | 190–210 | |||
Dentokeep PEEK (PEEK filled with 20% TiO2) | 1.5 | 191.45 ± 15.49 | 83.1 | 4.24 | [47] | |
breCAM.BioHPP (PEEK filled with 20–30% TiO2) | 1.3 | 197.35 ± 19.9 | 4.2 | 160 | [45] | |
PEEK 450G (PEEK filled with 30% TiO2) | 1.3 | 142 ± 34.7 | 95.21 ± 1.86 | 5.05 | 163 | [50] |
PEEK composite containing 20–30% HA | 1.28 | 49–59 | 5–7 | [51] |
Application | Subcategory | Materials Tested | Outcomes | Ref. |
---|---|---|---|---|
Implant therapy | Implant | - Titanium implant - Ti-PEEK composite implant | Ti-PEEK composite implant was superior in reducing bone resorption (stress shielding). | [54] |
- 2–4 mm HA particles in PEEK - Nanosized HA particles in PEEK | Implants made from PEEK nanocomposite sites have better mechanical properties. | [57] | ||
Abutments | - PEEK - Grade 5 titanium | PEEK abutments are suitable for long-term provisional restorations in the anterior part with no functional impairment. | [31] | |
- Custom PEEK healing abutment - Standard healing caps | The custom PEEK healing abutment created a natural gingival structure and required fewer steps to create an emergency contour. | [7,60] | ||
- Zirconia/lithium silicate/resin-based ceramic/PEEK crowns - Zirconia/PEEK abutment | High-strength rigid zirconia and lithium disilicate ceramics benefit more from a favorable stress distribution when applied on PEEK abutments. | [63] | ||
- Straight/15° angle/25° angle abutment - Porcelain metal (PFM)/PEEK restoration crowns | Molar patients can be given straight abutments combined with PEEK crowns to reduce intraosseous stress concentration. | [65] | ||
Prosthodontic therapy | Crown | - Milled crowns (PEEK, PMMA, and silicate ceramic) - Crown–abutment material combinations | PMMA crowns showed the highest material loss and PEEK had the lowest material loss. | [24] |
Implant-supported, 4-unit fixed restorations | - 20%/30% TiO2-filled PEEK - Veneered resin composite/digital veneering/prefabricated veneering | The highest fracture resistance of the restorations was achieved when 30% TiO2-filled PEEK material was used and prefabricated veneers were applied. | [24,45] | |
Partial dentures | - PMMA - PEEK | PEEK provides a higher Young’s modulus but lower flexural deformation than PMMA, which may reduce the load applied to the underlying tissue. | [81] | |
Clasp | - Shape-optimized PEEK clasp - Standard shape CoCr clasp | -The retention forces provided by the PEEK clasp were adequate for clinical use. There was no significant difference in long-term deformation between the two materials. | [85] | |
Oral and maxillofacial surgery | Mandibular fracture fixation | - CFR-PEEK plate/screw system - Resorbable system | CFR-PEEK plate/screw system reduces the stress on the fixation system and provides more stable fixation. | [125] |
Bone scaffolds | - PEEK - PAEK with carboxyl groups (PAEK-COOH) | PAEK-COOH controllable porous scaffolds had better mechanical strength and are beneficial for promoting cell adhesion. | [28] | |
Other oral applications | Orthodontic wires | - PEEK - Polyether sulfone (PES) - Polyvinylidene fluoride (PVDF) | PEEK orthodontic wires are able to deliver higher orthodontic forces, but at a similar cross-section of that of metallic wires. | [127] |
Cartilage recovery | - PEEK - Sulfonated PEEK (SPK) | SPK favors the secretion of anti-inflammatory cytokines and promotes the recovery of cartilage functions. | [131] |
Material | Surface Treatment | Adhesive | Shear Bonding Strength (SBS; MPa) | Surface Roughness (Ra; μm) | Ref. |
---|---|---|---|---|---|
PEEK | Untreated | Ultrasonic welding (USW) | 16.37 ± 1.69 | [135] | |
Untreated | Visio.link | 3.81 ± 2.71 | 0.69 ± 0.07 | [136] | |
98% H2SO4 etching for 60 s | Silane coupling agent | 19.25 ± 0.68 | 2.658 ± 0.658 | [137] | |
98% H2SO4 etching for 60 s | Visio.link | 15.23 ± 0.6 | 0.61 ± 0.14 | [138] | |
98% H2SO4 etching for 60 s | Ambar Universal Adhesive | 17.84 ± 2.8 | 1.05 ± 0.59 | [139] | |
98% H2SO4 etching for 60 s after Al2O3 sandblasting (50 μm, 2 MPa, 10 s) | Visio.link | 11.72 ± 1.69 | - | [121] | |
Al2O3 sandblasting (50 μm, 2 MPa, 10 s) | Visio.link | 6.43 ± 1.05 | - | [140] | |
Al2O3 sandblasting (110 μm, 0.1 MPa, 10 s) | Silane coupling agent | 14.55 ± 1.25 | 1.552 ± 0.002 | [137] | |
Al2O3 sandblasting (110 μm, 0.1 MPa) | Visio.link | 10.71 ± 0.52 | 0.92 ± 0.12 | [138] | |
Al2O3 sandblasting (110 μm, 2.5 MPa) | Visio.link | 18.29 ± 1.84 | 1.64 ± 0.48 | [136] | |
Oxygen plasma treatment for 3 min | Visio.link | 21.65 ± 5.31 | 0.69 ± 0.22 | [141] | |
Hydrogen–oxygen, 2/1-mixed plasma treatment | - | - | 0.43 ± 0.06 | [142] | |
Argon and oxygen 1:1 process for plasma treatment | Visio.link | 3.76 ± 2.42 | 0.06 ± 0.07 | [136] | |
Argon and oxygen 1:1 process for plasma treatment after sandblasting (110 μm, 2.5 MPa) | Visio.link | 19.8 ± 2.46 | 1.32 ± 0.39 | [136] | |
Photodynamic therapy (PDT) | Silane coupling agent | 11.69 ± 0.12 | 1.254 ± 0.011 | [137] | |
Photodynamic therapy (PDT) | Visio.link | 16.21 ± 0.14 | 14.25 ± 1.21 | [138] | |
Neodymium-doped yttrium orthovanadate (Nd: YVO4) laser treatment | Visio.link | 16.33 ± 0.71 | 15.25 ± 1.58 | [138] | |
3D-printed PEEK | 98% H2SO4 etching for 30 s | Visio.link | 27.90 ± 3.48 | - | [143] |
CAD/CAM-milled PEEK | 98% H2SO4 etching for 60 s | Visio.link | 27.36 | 0.74 ± 0.25 | [144] |
98% H2SO4 etching for 5–120 s | Visio.link | >29 | - | [143] | |
Vestakeep DC4420 (PEEK filled with 20% TiO2) | Argon and oxygen 1:1 process for plasma treatment after sandblasting | Visio.link | 15.86 ± 4.39 | 1.19 ± 0.4 | [136] |
Oxygen plasma treatment for 3 min | Visio.link | 30.95 ± 6.35 | 2.0 ± 0.97 | [141] | |
DC 4450 (filled with 20% TiO2 powder and 1% pigment) | Argon and oxygen 1:1 process for plasma treatment after sandblasting | Visio.link | 9.06 ± 3.1 | 1.83 ± 0.17 | [136] |
Oxygen plasma treatment for 3 min | Visio.link | 34.92 ± 6.55 | 0.93 ± 0.3 | [141] | |
breCAM.BioHPP | Silica-modified sandblasting (30 μm, 0.3 MPa, 15 s) | Visio.link | 8.07 ± 2.54 | 0.42 ± 0.03 | [145] |
Al2O3 sandblasting (110 μm, 0.2 MPa, 15 s) | Visio.link | 10.81 ± 3.06 | 2.26 ± 0.33 | [145] | |
Al2O3 sandblasting (50 μm, 0.25 MPa, 15 s) | Bond.lign | 17.4 ± 2.4 | 2.1 ± 0.2 | [146] | |
Oxygen plasma treatment after sandblasting (50 μm, 0.25 MPa, 15 s) | Bond.lign | 21.2 ± 0.8 | 2.7 ± 0.1 | [146] | |
Erbium-doped yttrium aluminum garnet (ER: YAG) laser treatment after sandblasting (50 μm, 0.25 MPa, 15 s) | Bond.lign | 22.0 ± 1.3 | 2.9 ± 0.1 | [146] |
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Luo, C.; Liu, Y.; Peng, B.; Chen, M.; Liu, Z.; Li, Z.; Kuang, H.; Gong, B.; Li, Z.; Sun, H. PEEK for Oral Applications: Recent Advances in Mechanical and Adhesive Properties. Polymers 2023, 15, 386. https://doi.org/10.3390/polym15020386
Luo C, Liu Y, Peng B, Chen M, Liu Z, Li Z, Kuang H, Gong B, Li Z, Sun H. PEEK for Oral Applications: Recent Advances in Mechanical and Adhesive Properties. Polymers. 2023; 15(2):386. https://doi.org/10.3390/polym15020386
Chicago/Turabian StyleLuo, Chengfeng, Ying Liu, Bo Peng, Menghao Chen, Zhaogang Liu, Zhanglong Li, Hai Kuang, Baijuan Gong, Zhimin Li, and Hongchen Sun. 2023. "PEEK for Oral Applications: Recent Advances in Mechanical and Adhesive Properties" Polymers 15, no. 2: 386. https://doi.org/10.3390/polym15020386