journal article·2022-11-11Open access

Reliability of Polyetherketoneketone as Definitive Implant-Supported Bridges in the Posterior Region—An In Vitro Study of the Ultimate Fracture Load and Vertical Marginal Discrepancy after Artificial Aging

Surakit Visuttiwattanakorn, Apitchaya Suthamwat, Somchai Urapepon, Sirichai Kiattavorncharoen

Applied Sciences· Volume 12· Issue 22

Abstract

Purpose: This study aims to investigate the ultimate fractural strength and marginal integrity of a three-unit implant-supported fixed partial denture (FPD) framework fabricated of polyetherketoneketone (PEKK) after simulated five-year clinical aging. Materials and Methods: Twelve FPD frameworks were milled (n = 6 per group). All experimental frameworks were cemented on identical stainless-steel abutment models and subjected to five years of clinically simulated thermomechanical aging. The vertical marginal gap values were analyzed using a scanning electron microscope before and after being subjected to each aging condition. A universal testing machine was used to evaluate the ultimate fracture load. Results: A significant increase in marginal gap values of the PEKK group was observed after five years of simulation aging (p < 0.001), while no significant difference was seen in the titanium group (p = 0.071). After thermocycling, the PEKK group showed a higher statistically significant mean marginal gap value (84.99 + 44.28 μm) than before (81.75 + 44.53 μm). The titanium group exhibited superior mechanical strength, with a fracture load significantly higher than that of the PEKK group (3050 + 385.30 and 1359.14 + 205.49 N, respectively). Conclusions: Thermocycling affects the marginal gap discrepancy of PEKK restoration. However, the mean vertical marginal gap values in PEKK and titanium groups after a five-year clinical aging simulation were clinically acceptable. The ultimate fracture load values were higher than the maximum bite force reported in the posterior region. Thus, PEKK could serve as a suitable alternative material to metal in the framework of fixed dental prostheses.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Dental materials and restorations · Dental Implant Techniques and Outcomes · Orthopaedic implants and arthroplasty

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand

Master of Science Program in Implant Dentistry, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand

Department of Prosthodontic, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand

References (50)

Show source-provided references
1. Implant—And Tooth-Supported Fixed Prostheses Using a High-Performance Polymer (Pekkton) Framework10.11607/ijp.4688 ↗
2. Metal-free materials for fixed prosthodontic restorations
3. Ceramic vs. porcelain-fused-to-metal crowns: Give your patients a choice10.14219/jada.archive.1994.0027 ↗
4. Allergic Reactions to Dental Materials-A Systematic Review
5. Polyetherketoneketone (PEKK), a framework material for complete fixed and removable dental prostheses: A clinical report10.1016/j.prosdent.2017.09.008 ↗
6. PEEK biomaterials in trauma, orthopedic, and spinal implants10.1016/j.biomaterials.2007.07.013 ↗
7. Kemmish, D. (2010). Update on the Technology and Applications of Polyaryletherketones, iSmithers, Smithers Rapra Pub.
8. Characterisation of machinable structural polymers in restorative dentistry10.1016/j.dental.2018.06.007 ↗
9. Comparing the optical and mechanical properties of PEKK polymer when CAD/CAM milled and pressed using a ceramic pressing furnace10.1016/j.jmbbm.2018.09.039 ↗
10. PEKK-made indirect temporary crowns and bridges: A clinical pilot study10.1007/s00784-018-2493-z ↗
11. Polyetheretherketone-A suitable material for fixed dental prostheses?10.1002/jbm.b.32932 ↗
12. Fracture Strength of Three-Unit Implant Supported Fixed Partial Dentures with Excessive Crown Height Fabricated from Different Materials
13. The effect of casting and masticatory simulation on strain and misfit of implant-supported metal frameworks10.1016/j.msec.2016.02.035 ↗
14. Creep deformation of restorative resin-composites intended for bulk-fill placement10.1016/j.dental.2012.04.038 ↗
15. Three-unit reinforced polyetheretherketone composite FDPs: Influence of fabrication method on load-bearing capacity and failure types10.4012/dmj.2013-345 ↗
16. Fracture load and failure types of different veneered polyetheretherketone fixed dental prostheses10.1007/s00784-016-1777-4 ↗
17. An in vitro test procedure for evaluating dental restoration systems. 1. A computer-controlled mastication simulator
18. In vitro performance and fracture resistance of CAD/CAM-fabricated implant supported molar crowns10.1007/s00784-016-1898-9 ↗
19. Effect of thermal cycling on flexural properties of carbon-graphite fiber-reinforced polymers10.1016/j.dental.2008.12.007 ↗
20. SEM evaluation of the precision of fit of CAD/CAM zirconia and metal-ceramic posterior crowns10.4012/dmj.2016-305 ↗
21. Evaluation of marginal fit of single implant-supported metal-ceramic crowns prepared by using presintered metal blocks10.1016/j.prosdent.2017.03.015 ↗
22. The estimation of cement film thickness by an in vivo technique10.1038/sj.bdj.4802708 ↗
23. Custom Morse taper zirconia abutments: Influence on marginal fit and torque loss before and after thermomechanical cycling10.1016/j.jmbbm.2017.11.027 ↗
24. A comparative study of marginal fit of copings prepared with various techniques on different implant abutments10.4012/dmj.2015-252 ↗
25. Three-dimensional analysis of marginal and internal fit of copings fabricated with polyetherketoneketone (PEKK) and zirconia10.1016/j.jpor.2016.07.005 ↗
26. Evaluation of the marginal and internal gaps of three different dental prostheses: Comparison of the silicone replica technique and three-dimensional superimposition analysis10.4047/jap.2017.9.3.159 ↗
27. Comparative evaluation of BioHPP and titanium as a framework veneered with composite resin for implant-supported fixed dental prostheses10.1016/j.prosdent.2019.03.003 ↗
28. A systematic approach to standardize artificial aging of resin composite cements10.1016/j.dental.2015.04.015 ↗
29. Changes in marginal gap size of provisional resin crowns after occlusal loading and thermal cycling10.1067/mpr.2000.108027 ↗
30. Comparison of the flexural strength and marginal accuracy of traditional and CAD/CAM interim materials before and after thermal cycling10.1016/j.prosdent.2014.01.012 ↗
31. Long-term effects of storage and thermal cycling on the marginal adaptation of provisional resin crowns: A pilot study10.1016/j.prosdent.2005.12.012 ↗
32. Influence of thermomechanical aging on marginal gap of CAD-CAM and conventional interim restorations10.1016/j.prosdent.2020.03.036 ↗
33. Kemmish, D. (2011). Practical Guide to High. Performance Engineering Plastics, iSmithers, Smithers Rapra Pub.
34. Young, R.J., and Lovell, P.A. (2011). Introduction to Polymers, Taylor & Francis. [3rd ed.].10.1201/9781439894156 ↗
35. Cverna, F., and ASMIMPD Committee (2002). ASM Ready Reference: Thermal Properties of Metals, ASM International.
36. Polymerization shrinkage and hygroscopic expansion of contemporary posterior resin-based filling materials—A comparative study10.1016/j.jdent.2007.07.014 ↗
37. Physicomechanical characterization of polyetheretherketone and current esthetic dental CAD/CAM polymers after aging in different storage media10.1016/j.prosdent.2015.09.004 ↗
38. McKeen, L. (2009). The Effect of Creep and Other Time Related Factors on Plastics and Elastomers, William Andrew Pub.. [2nd ed.].10.1016/B978-0-8155-1585-2.50003-0 ↗
39. The long-term mechanical integrity of non-reinforced PEEK-OPTIMA polymer for demanding spinal applications: Experimental and finite-element analysis10.1007/s00586-005-0915-5 ↗
40. Marginal adaptation of three-unit fixed partial dentures constructed from pressed ceramic systems10.1038/sj.bdj.4811390 ↗
41. Factors Affecting the Film Thickness of Zinc Phosphate Cements
42. The comparison of the marginal gaps of zirconia framework luted with different types of phosphate based-resin cements The comparison of the marginal gaps of zirconia framework luted with different types of phosphate based-resin cements
43. Vertical Marginal Gap Distance of CAD/CAM Milled BioHPP PEEK Coping Veneered by HIPC Compared to Zirconia Coping Veneered by CAD-On lithium disilicate “In-Vitro Study”10.21608/adjc.2020.21032.1043 ↗
44. Accuracy and reliability of methods to measure marginal adaptation of crowns and FDPs: A literature review10.1111/jopr.12006 ↗
45. Determination of the minimum number of marginal gap measurements required for practical in-vitro testing10.1016/S0022-3913(00)70087-4 ↗
46. Marginal adaptation of fixed prosthodontics: A new in vitro 360-degree external examination procedure
47. Fracture strength of all-ceramic lithium disilicate and porcelain-fused-to-metal bridges for molar replacement after dynamic loading
48. Load-Bearing Capacity of Posterior CAD/CAM Implant-Supported Fixed Partial Dentures Fabricated with Different Esthetic Materials10.11607/ijp.6128 ↗
49. Maximum voluntary molar bite force in subjects with normal occlusion10.1093/ejo/cjq097 ↗
50. Bruxism and voluntary maximal bite force in young dentate adults