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The Use of PEEK and PEKK in Prosthodontics

Year 2025,
https://doi.org/10.17567/currresdentsci.1419755

Abstract

It is stated that the search for new materials in today's dentistry continues in order to meet aesthetic and functional expectations. As a result of these searches, materials such as PEEK (polyetheretherketone) , PEKK(polyetherketoneketone) and BioHPP(bio high performance polymer) have become widely preferred in dentistry. PEEK is a thermoplastic polymer. It offers features such as durable structure, tissue compatibility and lightness. Therefore, it is attracting interest as a metal alternative and is considered as a promising material in dental treatment applications. In addition, PEEK's biocompatibility properties enable it to be used in the biomedical field. PEEK is a material that resembles natural tooth color and has been used as a biomaterial in orthopedics for many years. PEKK is a newly developing polymeric material. PEKK biomaterials are elastic with excellent shock absorption and fracture resistance, demonstrating ultra-high performance compared to other thermoplastic composites, offering exceptional mechanical strength, chemical resistance, and high thermal stability. BioHPP is a PEEK-based bio high-performance polymer that has been shown as a dental substrate material. It can be used in different areas of dentistry due to its advantages such as excellent physical and aesthetic properties, low weight and biocompatibility. "PEEK and PEKK, which are polymer materials, can be successful alternatives aesthetically, mechanically, and biologically to dental implants, crowns, bridges, and removable denture framework materials in dentistry." However, it is emphasized that they should be used with caution due to insufficient clinical studies. Especially the fatigue stress and long-term performance of PEEK require further research. Therefore, studies based on more comprehensive and reliable clinical data on the use of these materials are needed.
Keywords: Bio HPP, PEEK, polyetheretherketone,PEKK

References

  • 1. Özden S, Demir H. Polieter eter keton (peek) diş hekimliğinde yükselen materyal. NEU Dent J. 2020;2(2):76-85.
  • 2. Zoidis P, Papathanasiou I. Modified PEEK resin-bonded fixed dental prosthesis as an interim restoration after implant placement. J Prosthet Dent. 2016;116(5):637-641.
  • 3. Najeeb S, Zafar MS, Khurshid Z, Siddiqui F. Applications of polyetheretherketone (PEEK) in oral implantology and prosthodontics. J Prosthodont Res. 2016;60(1):12-19.
  • 4. Külünk T, Külünk Ş, Saraç D. Diş Hekimliği Uygulamalarında Polietereterketon. Turk Klin J Prosthodont-Spec Top. 2017;3(3):175-83.
  • 5. Çulhaoğlu AK, Özkır SE, Türkkal F. POLİETER ETER KETON (PEEK) ve DENTAL KULLANIMI. Ata Diş Hek Fak Derg. Ekim 2019;29(4):711-718.
  • 6. Neumann EA, Villar CC, França FM. Fracture resistance of abutment screws made of titanium, polyetheretherketone, and carbon fiber-reinforced polyetheretherketone. Braz Oral Res. 2014;28:S1806-83242014000100239.
  • 7. Seferli Z, Sarıdağ S. PEEK Polimerinin Dişhekimliğinde Kullanımı. Selcuk Dent J. 2020;7(2):354-63.
  • 8. Jin HY, Teng MH, Wang ZJ, et al. Comparative evaluation of BioHPP and titanium as a framework veneered with composite resin for implant-supported fixed dental prostheses. J Prosthet Dent. 2019;122(4):383-388.
  • 9. Choupin T. Mechanical performances of PEKK thermoplastic composites linked to their processing parameters; 2017
  • 10. Huang B, Qian J, Wang G, Cai M. Synthesis and properties of novel copolymers of poly (ether ketone diphenyl ketone ether ketone ketone) and poly (ether amide ether amide ether ketone ketone). Polym Eng Sci 2014;54:1757–64.
  • 11. J.W.H. Bonner, Aromatic polyketones and preparation thereof, U.S. Patent 3,065,205; 1962. p. 1–3.
  • 12. Kewekordes T, Wille S, Kern M. Wear of polyetherketoneketones—influence of titanium dioxide content and antagonistic material. Dent Mater 2018;34:560–7.
  • 13. Najeeb S, Zafar MS, Khurshid Z, Siddiqui F. Applications of polyetheretherketone (PEEK) in oral implantology and prosthodontics. J Prosthodontic Res 2016;60:12–9.
  • 14. DeTolla DH, Andreana S, Patra A, Buhite R, Comella B. Role of the finite element model in dental implants. J Oral Implantol. 2000;26(2):77-81.
  • 15. Hahnel S, Wieser A, Lang R, Rosentritt M. Biofilm formation on the surface of modern implant abutment materials. Clin Oral Implants Res. 2015;26(11):1297-1301.
  • 16. Schwitalla AD, Abou-Emara M, Spintig T, Lackmann J, Müller WD. Finite element analysis of the biomechanical effects of PEEK dental implants on the peri-implant bone. J Biomech. 2015;48(1):1-7.
  • 17. Abdelrehim A, Abdelhakim A, ElDakkak S. Influence of different materials on retention behavior of CAD-CAM fabricated bar attachments. J Prosthet Dent. 2022;128(4):765-775. doi:10.1016/j.prosdent.2021.01.012
  • 18.Iyer, R.S., et al., BIOHPP: PROPERTIES AND APPLICATIONS IN PROSTHODONTICS A REVIEW. Journal of Research in Dentistry, 2020. 7(4): p. 72-76.
  • 19. Chen F, Gatea S, Ou H, Lu B, Long H. Fracture characteristics of PEEK at various stress triaxialities. J Mech Behav Biomed Mater. 2016;64:173-186.
  • 20. Yuan B, Cheng Q, Zhao R, et al. Comparison of osteointegration property between PEKK and PEEK: Effects of surface structure and chemistry. Biomaterials. 2018;170:116-126.
  • 21. Alsadon O, Wood D, Patrick D, Pollington S. Fatigue behavior and damage modes of high performance poly-ether-ketone-ketone PEKK bilayered crowns. J Mech Behav Biomed Mater 2020;110:103957.
  • 22. Dawson JH, Hyde B, Hurst M, Harris BT, Lin W. Polyetherketoneketone (PEKK), a framework material for complete fixed and removable dental prostheses: a clinical report. J Prosthet Dent 2018;119:867–72.
  • 23. Srinivasan M, Kalberer N, Maniewicz S, Muller F. Implant-retained overdentures using an attachment with true-alignment correction: a case series. Int J Prosthodont 2019;32:482–96.
  • 24. Merk S, Wagner C, Stock V, et al. Suitability of Secondary PEEK Telescopic Crowns on Zirconia Primary Crowns: The Influence of Fabrication Method and Taper. Materials (Basel). 2016;9(11):908.
  • 25. Stock V, Wagner C, Merk S, et al. Retention force of differently fabricated telescopic PEEK crowns with different tapers. Dent Mater J. 2016;35(4):594-600.
  • 26. Andrikopoulou E, Zoidis P, Artopoulou II, Doukoudakis A. Modified PEEK Resin Bonded Fixed Dental Prosthesis for a Young Cleft Lip and Palate Patient. J Esthet Restor Dent. 2016;28(4):201-207.
  • 27. Rzanny, A., F. Gobel, and M. Fachet, BioHPP summary of results for material tests. Quintessenz Zahntech MAG, 2013;39 :2-10.
  • 28. Schmidlin PR, Stawarczyk B, Wieland M, Attin T, Hämmerle CH, Fischer J. Effect of different surface pre-treatments and luting materials on shear bond strength to PEEK. Dent Mater. 2010;26(6):553-559.
  • 29. Stawarczyk B, Beuer F, Wimmer T, et al. Polyetheretherketone-a suitable material for fixed dental prostheses?. J Biomed Mater Res B Appl Biomater. 2013;101(7):1209-1216.
  • 30. Zoidis, P., I. Papathanasiou, and G. Polyzois, The use of a modified poly‐ether‐ether‐ketone (PEEK) as an alternative framework material for removable dental prostheses. A clinical report. Journal of Prosthodontics, 2016. 25(7): p. 580-584.
  • 31. Fuhrmann G, Steiner M, Freitag-Wolf S, Kern M. Resin bonding to three types of polyaryletherketones (PAEKs)-durability and influence of surface conditioning. Dent Mater 2014;30:357-63
  • 32. Han KH, Lee JY, Shin SW. Implant- and tooth-supported fixed prostheses using a high-performance polymer (Pekkton) framework. Int J Prosthodont 2016;29:451-4. 21. Bhering CL, Mesquita MF, Kemmoku DT, Noritomi PY, Consani RL, Barão VA.
  • 33. Bacchi A, Consani RL, Mesquita MF, Dos Santos MB. Effect of framework material and vertical misfit on stress distribution in implant-supported partial prosthesis under load application: 3-D finite element analysis. Acta Odontol Scand 2013;71:1243-9
  • 34. Keilig L, Stark H, Bourauel C. Does the material stiffness of novel highperformance polymers for fixed partial dentures influence their biomechanical behavior?. Int J Prosthodont 2016;30:595–7.
  • 35. Behr M, Zeman F, Passauer T, et al. Clinical performance of cast clasp-retained removable partial dentures: a retrospective study. Int J Prosthodont. 2012;25(2):138-144. 36. Tannous F, Steiner M, Shahin R, Kern M. Retentive forces and fatigue resistance of thermoplastic resin clasps. Dent Mater. 2012;28(3):273-278.
  • 37. Costa-Palau S, Torrents-Nicolas J, Brufau-de Barberà M, Cabratosa-Termes J. Use of polyetheretherketone in the fabrication of a maxillary obturator prosthesis: a clinical report. J Prosthet Dent. 2014;112(3):680-682.
  • 38. Lee WF, Chen MS, Peng TY, Huang PC, Nikawa H, Peng PW. Comparative analysis of the retention force and deformation of PEEK and PEKK removable partial denture clasps with different thicknesses and undercut depths. J Prosthet Dent. 2024;131(2):291.e1-291.e9.
  • 39. Sun F, Shen X, Zhou N, et al. A speech bulb prosthesis for a soft palate defect with a polyetherketoneketone (PEKK) framework fabricated by multiple digital techniques: A clinical report. J Prosthet Dent. 2020;124:495–499
  • 40. Fueki K, Ohkubo C, Yatabe M, et al. Clinical application of removable partial dentures using thermoplastic resin. Part II: Material properties and clinical features of non-metal clasp dentures. J Prosthodont Res. 2014;58(2):71-84.
  • 41. Fueki K, Ohkubo C, Yatabe M, et al. Clinical application of removable partial dentures using thermoplastic resin-part I: definition and indication of non-metal clasp dentures. J Prosthodont Res. 2014;58(1):3-10.
  • 42. Elashmawy Y, Aboushelib M, Elshahawy W. Retention of different CAD/CAM endocrowns bonded to severely damaged endodontically treated teeth: An in vitro study. J Indian Prosthodont Soc. 2021;21(3):269-275.
  • 43. Rajamani VK, Reyal SS, Gowda EM, Shashidhar MP. Comparative prospective clinical evaluation of computer aided design/ computer aided manufacturing milled BioHPP PEEK inlays and Zirconia inlays. J Indian Prosthodont Soc. 2021;21(3):240-248.
  • 44. Oh KC, Park JH, Lee JH, Moon HS. Treatment of a mandibular discontinuity defect by using a fibula free flap and an implant-supported fixed complete denture fabricated with a PEKK framework: A clinical report. J Prosthet Dent. 2018;119(6):1021-1024
Year 2025,
https://doi.org/10.17567/currresdentsci.1419755

Abstract

References

  • 1. Özden S, Demir H. Polieter eter keton (peek) diş hekimliğinde yükselen materyal. NEU Dent J. 2020;2(2):76-85.
  • 2. Zoidis P, Papathanasiou I. Modified PEEK resin-bonded fixed dental prosthesis as an interim restoration after implant placement. J Prosthet Dent. 2016;116(5):637-641.
  • 3. Najeeb S, Zafar MS, Khurshid Z, Siddiqui F. Applications of polyetheretherketone (PEEK) in oral implantology and prosthodontics. J Prosthodont Res. 2016;60(1):12-19.
  • 4. Külünk T, Külünk Ş, Saraç D. Diş Hekimliği Uygulamalarında Polietereterketon. Turk Klin J Prosthodont-Spec Top. 2017;3(3):175-83.
  • 5. Çulhaoğlu AK, Özkır SE, Türkkal F. POLİETER ETER KETON (PEEK) ve DENTAL KULLANIMI. Ata Diş Hek Fak Derg. Ekim 2019;29(4):711-718.
  • 6. Neumann EA, Villar CC, França FM. Fracture resistance of abutment screws made of titanium, polyetheretherketone, and carbon fiber-reinforced polyetheretherketone. Braz Oral Res. 2014;28:S1806-83242014000100239.
  • 7. Seferli Z, Sarıdağ S. PEEK Polimerinin Dişhekimliğinde Kullanımı. Selcuk Dent J. 2020;7(2):354-63.
  • 8. Jin HY, Teng MH, Wang ZJ, et al. Comparative evaluation of BioHPP and titanium as a framework veneered with composite resin for implant-supported fixed dental prostheses. J Prosthet Dent. 2019;122(4):383-388.
  • 9. Choupin T. Mechanical performances of PEKK thermoplastic composites linked to their processing parameters; 2017
  • 10. Huang B, Qian J, Wang G, Cai M. Synthesis and properties of novel copolymers of poly (ether ketone diphenyl ketone ether ketone ketone) and poly (ether amide ether amide ether ketone ketone). Polym Eng Sci 2014;54:1757–64.
  • 11. J.W.H. Bonner, Aromatic polyketones and preparation thereof, U.S. Patent 3,065,205; 1962. p. 1–3.
  • 12. Kewekordes T, Wille S, Kern M. Wear of polyetherketoneketones—influence of titanium dioxide content and antagonistic material. Dent Mater 2018;34:560–7.
  • 13. Najeeb S, Zafar MS, Khurshid Z, Siddiqui F. Applications of polyetheretherketone (PEEK) in oral implantology and prosthodontics. J Prosthodontic Res 2016;60:12–9.
  • 14. DeTolla DH, Andreana S, Patra A, Buhite R, Comella B. Role of the finite element model in dental implants. J Oral Implantol. 2000;26(2):77-81.
  • 15. Hahnel S, Wieser A, Lang R, Rosentritt M. Biofilm formation on the surface of modern implant abutment materials. Clin Oral Implants Res. 2015;26(11):1297-1301.
  • 16. Schwitalla AD, Abou-Emara M, Spintig T, Lackmann J, Müller WD. Finite element analysis of the biomechanical effects of PEEK dental implants on the peri-implant bone. J Biomech. 2015;48(1):1-7.
  • 17. Abdelrehim A, Abdelhakim A, ElDakkak S. Influence of different materials on retention behavior of CAD-CAM fabricated bar attachments. J Prosthet Dent. 2022;128(4):765-775. doi:10.1016/j.prosdent.2021.01.012
  • 18.Iyer, R.S., et al., BIOHPP: PROPERTIES AND APPLICATIONS IN PROSTHODONTICS A REVIEW. Journal of Research in Dentistry, 2020. 7(4): p. 72-76.
  • 19. Chen F, Gatea S, Ou H, Lu B, Long H. Fracture characteristics of PEEK at various stress triaxialities. J Mech Behav Biomed Mater. 2016;64:173-186.
  • 20. Yuan B, Cheng Q, Zhao R, et al. Comparison of osteointegration property between PEKK and PEEK: Effects of surface structure and chemistry. Biomaterials. 2018;170:116-126.
  • 21. Alsadon O, Wood D, Patrick D, Pollington S. Fatigue behavior and damage modes of high performance poly-ether-ketone-ketone PEKK bilayered crowns. J Mech Behav Biomed Mater 2020;110:103957.
  • 22. Dawson JH, Hyde B, Hurst M, Harris BT, Lin W. Polyetherketoneketone (PEKK), a framework material for complete fixed and removable dental prostheses: a clinical report. J Prosthet Dent 2018;119:867–72.
  • 23. Srinivasan M, Kalberer N, Maniewicz S, Muller F. Implant-retained overdentures using an attachment with true-alignment correction: a case series. Int J Prosthodont 2019;32:482–96.
  • 24. Merk S, Wagner C, Stock V, et al. Suitability of Secondary PEEK Telescopic Crowns on Zirconia Primary Crowns: The Influence of Fabrication Method and Taper. Materials (Basel). 2016;9(11):908.
  • 25. Stock V, Wagner C, Merk S, et al. Retention force of differently fabricated telescopic PEEK crowns with different tapers. Dent Mater J. 2016;35(4):594-600.
  • 26. Andrikopoulou E, Zoidis P, Artopoulou II, Doukoudakis A. Modified PEEK Resin Bonded Fixed Dental Prosthesis for a Young Cleft Lip and Palate Patient. J Esthet Restor Dent. 2016;28(4):201-207.
  • 27. Rzanny, A., F. Gobel, and M. Fachet, BioHPP summary of results for material tests. Quintessenz Zahntech MAG, 2013;39 :2-10.
  • 28. Schmidlin PR, Stawarczyk B, Wieland M, Attin T, Hämmerle CH, Fischer J. Effect of different surface pre-treatments and luting materials on shear bond strength to PEEK. Dent Mater. 2010;26(6):553-559.
  • 29. Stawarczyk B, Beuer F, Wimmer T, et al. Polyetheretherketone-a suitable material for fixed dental prostheses?. J Biomed Mater Res B Appl Biomater. 2013;101(7):1209-1216.
  • 30. Zoidis, P., I. Papathanasiou, and G. Polyzois, The use of a modified poly‐ether‐ether‐ketone (PEEK) as an alternative framework material for removable dental prostheses. A clinical report. Journal of Prosthodontics, 2016. 25(7): p. 580-584.
  • 31. Fuhrmann G, Steiner M, Freitag-Wolf S, Kern M. Resin bonding to three types of polyaryletherketones (PAEKs)-durability and influence of surface conditioning. Dent Mater 2014;30:357-63
  • 32. Han KH, Lee JY, Shin SW. Implant- and tooth-supported fixed prostheses using a high-performance polymer (Pekkton) framework. Int J Prosthodont 2016;29:451-4. 21. Bhering CL, Mesquita MF, Kemmoku DT, Noritomi PY, Consani RL, Barão VA.
  • 33. Bacchi A, Consani RL, Mesquita MF, Dos Santos MB. Effect of framework material and vertical misfit on stress distribution in implant-supported partial prosthesis under load application: 3-D finite element analysis. Acta Odontol Scand 2013;71:1243-9
  • 34. Keilig L, Stark H, Bourauel C. Does the material stiffness of novel highperformance polymers for fixed partial dentures influence their biomechanical behavior?. Int J Prosthodont 2016;30:595–7.
  • 35. Behr M, Zeman F, Passauer T, et al. Clinical performance of cast clasp-retained removable partial dentures: a retrospective study. Int J Prosthodont. 2012;25(2):138-144. 36. Tannous F, Steiner M, Shahin R, Kern M. Retentive forces and fatigue resistance of thermoplastic resin clasps. Dent Mater. 2012;28(3):273-278.
  • 37. Costa-Palau S, Torrents-Nicolas J, Brufau-de Barberà M, Cabratosa-Termes J. Use of polyetheretherketone in the fabrication of a maxillary obturator prosthesis: a clinical report. J Prosthet Dent. 2014;112(3):680-682.
  • 38. Lee WF, Chen MS, Peng TY, Huang PC, Nikawa H, Peng PW. Comparative analysis of the retention force and deformation of PEEK and PEKK removable partial denture clasps with different thicknesses and undercut depths. J Prosthet Dent. 2024;131(2):291.e1-291.e9.
  • 39. Sun F, Shen X, Zhou N, et al. A speech bulb prosthesis for a soft palate defect with a polyetherketoneketone (PEKK) framework fabricated by multiple digital techniques: A clinical report. J Prosthet Dent. 2020;124:495–499
  • 40. Fueki K, Ohkubo C, Yatabe M, et al. Clinical application of removable partial dentures using thermoplastic resin. Part II: Material properties and clinical features of non-metal clasp dentures. J Prosthodont Res. 2014;58(2):71-84.
  • 41. Fueki K, Ohkubo C, Yatabe M, et al. Clinical application of removable partial dentures using thermoplastic resin-part I: definition and indication of non-metal clasp dentures. J Prosthodont Res. 2014;58(1):3-10.
  • 42. Elashmawy Y, Aboushelib M, Elshahawy W. Retention of different CAD/CAM endocrowns bonded to severely damaged endodontically treated teeth: An in vitro study. J Indian Prosthodont Soc. 2021;21(3):269-275.
  • 43. Rajamani VK, Reyal SS, Gowda EM, Shashidhar MP. Comparative prospective clinical evaluation of computer aided design/ computer aided manufacturing milled BioHPP PEEK inlays and Zirconia inlays. J Indian Prosthodont Soc. 2021;21(3):240-248.
  • 44. Oh KC, Park JH, Lee JH, Moon HS. Treatment of a mandibular discontinuity defect by using a fibula free flap and an implant-supported fixed complete denture fabricated with a PEKK framework: A clinical report. J Prosthet Dent. 2018;119(6):1021-1024
There are 43 citations in total.

Details

Primary Language English
Subjects Prosthodontics
Journal Section Reviews
Authors

Gizem Erdaş

Hatice Özdemir 0000-0001-8512-0471

Early Pub Date December 4, 2024
Publication Date
Submission Date January 14, 2024
Acceptance Date August 13, 2024
Published in Issue Year 2025

Cite

AMA Erdaş G, Özdemir H. The Use of PEEK and PEKK in Prosthodontics. Curr Res Dent Sci. Published online December 1, 2024. doi:10.17567/currresdentsci.1419755

Current Research in Dental Sciences is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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