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Arslan E, Caglar I. Enhancing PEEK bond strength: the impact of chemical and mechanical surface modifications on surface characteristics and phase transformation. BMC Oral Health 2025; 25:511. [PMID: 40211271 PMCID: PMC11983897 DOI: 10.1186/s12903-025-05933-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Accepted: 04/02/2025] [Indexed: 04/12/2025] Open
Abstract
OBJECTIVES This study investigated the effects of different surface modifications on surface roughness, phase transformation, and bond strength of polyetheretherketone (PEEK) to composite resin. MATERIALS AND METHODS A total of 140 specimens measuring 10 mm × 10 mm × 2 mm were fabricated from PEEK blocks (BioHPP; Bredent GmbH & Co KG, Germany). Seven groups were randomly formed from the specimens: C) untreated control group, (SE) sulfuric acid application (Merck KGa, Darmstadt, Germany), (PE) piranha solution application (Albar Chemistry, Kocaeli, Turkey), (S) sandblasting with Al2O3 particle (Zhermack, Rovigo, Italy), (T) tribochemical silica coating (3 M ESPE, Seefeld, Germany), (L) Er-YAG laser treatment (LightWalker AT, Fotona, Slovenia), and (P) plasma treatment (Kinpen, Neoplas, Germany) (n = 20). Surface topography was examined using a profilometer device (Taylor Hobson, Leicester, England). Surface images of the specimens were captured using Scanning Electron Microscopy (SEM) (JSM- 6610, Jeol, USA). Phase change analysis was conducted on each group using an X-Ray Diffractometer device (Rigaku SmartLab Diffraktometer, Tokyo, Japan). After thermal aging, shear bond strength was tested using a Universal Test Machine (Model 3340, Instron Corp., Wycombe, UK). Data were analyzed with One-way analysis of variance (ANOVA) test; comparisons were made with Tukey's multiple comparison test, with a significance level of 0.05. RESULTS Group S (3.09 ± 0.40 μm) exhibited significantly higher surface roughness values compared to the other groups (p < 0.05). Group SE (13.28 ± 1.69 MPa) exhibited significantly higher shear bond strength values than the other groups (p < 0.05). No statistically significant correlation was found between surface roughness and bond strength data (p > 0.05). According to XRD results, Group S and Group L differ from the other groups in having a slightly higher intensity and broader peaks. CONCLUSIONS All surface modification methods enhanced the bond strength between PEEK to composite resin. However, Group L and Group S revealed different XRD patterns from the control group. Tribochemical silica coating can be a reliable alternative method for acid applications due to its stable phase structure and high bond strength.
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Affiliation(s)
- Emel Arslan
- Department of Prosthodontic, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, 14030, Turkey.
| | - Ipek Caglar
- Department of Prosthodontic, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, 53020, Turkey
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Boukhris H, Ben Hadj Khalifa A, Hajjami H, Boudegga Ben Youssef S. The effect of surface treatments on the bond strength of polyetheretherketone posts: a systematic review protocol. F1000Res 2025; 13:951. [PMID: 40255479 PMCID: PMC12008716 DOI: 10.12688/f1000research.154750.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2025] [Indexed: 04/22/2025] Open
Abstract
Background Polyetheretherketone (PEEK) is widely used in the biomedical field due to its outstanding biological and mechanical properties. Originally employed as a temporary abutment in implantology, recent research has expanded its indications for more definitive applications, such as frameworks and dental post and core. However, PEEK's inert nature and low surface energy pose challenges for adhesion, necessitating surface modifications. Various physical and chemical modification techniques, including acid etching (e.g., 98% sulfuric acid), sandblasting with alumina oxide (Al₂O₃), plasma treatment, laser irradiation, silanization, and air abrasion with silica-coated particles, have been proposed to enhance PEEK's bonding performance. Despite numerous clinical investigations, standardized protocols for surface treatment remain lacking. This systematic review aims to assess the impact of surface treatments on the bonding performance of PEEK posts. Methods A detailed search of the literature will be conducted across several databases including PubMed, Scopus and clinical trial registries. Additional databases such as Cochrane Central, EMBASE, Web of Science and EBSCO will also be included. The search strategy will target controlled randomized studies and non-randomized clinical trials evaluating the impact of surface treatments on PEEK post adhesion strength. The Newcastle-Ottawa Scale (NOS) will be used to assess bias in non-randomized studies, while the Cochrane Risk of Bias (ROB II) tool will be employed for evaluating randomized controlled trials. Data extraction will focus on study design, treatment methods, outcomes and results.This systematic review protocol will adhere to the guidelines for systematic reviews outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Discussion The discussion will explore the implications of findings on clinical practice, highlighting the importance of enhancing PEEK's bioactivity and surface energy to improve bonding efficacy in dental procedures. Moreover, it will suggest areas for future research to advance dental materials science, aiming to optimize the utilization of PEEK in dental applications. Systematic review registration PROSPERO: CRD42024529783 (Registered on 08/04/2024).
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Affiliation(s)
- Hanen Boukhris
- Department of prosthodontics, LR12SP10, University of Monastir, Faculty of Dental Medicine, Monastir, Monastir, Tunisia
| | - Aymen Ben Hadj Khalifa
- Department of Dental Anatomy, University of Monastir, Faculty of Dental Medicine, Monastir, Monastir, Tunisia
| | - Hayet Hajjami
- Department of prosthodontics, LR12SP10, University of Monastir, Faculty of Dental Medicine, Monastir, Monastir, Tunisia
| | - Souha Boudegga Ben Youssef
- department of oral surgery, LR12SP10, University of Monastir, Faculty of Dental Medicine, Monastir, Monastir, Tunisia
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Diken Türksayar AA, Schulnig S, Spintzyk S, Yeşil Kurt İB. Investigating the influence of infill pattern and layer height on the mechanical and bonding behavior of additively manufactured PEEK for dental applications. J Prosthet Dent 2025:S0022-3913(25)00246-X. [PMID: 40169346 DOI: 10.1016/j.prosdent.2025.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Revised: 03/05/2025] [Accepted: 03/07/2025] [Indexed: 04/03/2025]
Abstract
STATEMENT OF PROBLEM Current knowledge regarding the influence of infill pattern and layer height on the flexural and shear bond strength of polyetheretherketone (PEEK) manufactured via fused filament fabrication technology remains limited. PURPOSE The purpose of this in vitro study was to investigate the impact of infill pattern and layer height on the shear bond strength (SBS) and the flexural strength (FS) of additively manufactured PEEK bars and disks relevant to dental applications. MATERIAL AND METHODS The PEEK specimens were prepared in 9 groups (n=10), whereby different layer heights (0.1, 0.2, and 0.3 mm) and different infill patterns (±30, ±45 lines, concentric) were used. The surface roughness (Ra) was recorded with a confocal microscope. For the SBS test, resin composites were applied on the disk surface. All the specimens were subjected to thermal aging. The SBS and FS test was performed through a universal testing device. Two-way ANOVA, 1-way ANOVA, post hoc Tukey, and Tamhane tests were used for statistical analysis. (α=.05) RESULTS: The highest SBS values were observed at a layer height of 0.1 mm. The infill pattern had a significant effect on FS at all layer heights (0.1 mm P=.016, 0.2 mm P=.010, 0.3 mm P=.010). While the highest FS values at a 0.1-mm layer height were observed in the concentric pattern, no significant difference was identified between the L45 and L30 groups (P=.186). CONCLUSIONS Lower layer heights strongly influenced the Ra, SBS and FS, with the highest SBS achieved with a layer height of 0.1 mm. To improve the mechanical properties of PEEK, the process parameters for additive manufacturing should be optimized.
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Affiliation(s)
- Almira Ada Diken Türksayar
- Associate Professor and Department Head, Department of Prosthodontics, Biruni University, Faculty of Dentistry, İstanbul, Turkey; and Guest Researcher, ADMiRE Research Center, Carinthia University of Applied Sciences, Villach, Austria
| | - Sandra Schulnig
- Senior Researcher, ADMiRE Research Center, Carinthia University of Applied Sciences, Villach, Austria
| | - Sebastian Spintzyk
- Associate Professor, ADMiRE Research Center, Carinthia University of Applied Sciences, Villach, Austria.
| | - İrem Beril Yeşil Kurt
- Doctoral student, Department of Prosthodontics, Biruni University, Faculty of Dentistry, İstanbul, Turkey
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Htay TP, Peampring C, Thammajaruk P. Surface modification of polyether ether ketone (PEEK) via sulfonation and hydroxyapatite coating: impact on shear bond strength with resin composite. Clin Oral Investig 2025; 29:184. [PMID: 40088300 DOI: 10.1007/s00784-025-06256-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Accepted: 02/28/2025] [Indexed: 03/17/2025]
Abstract
PURPOSE This study evaluates the effects of various polyetheretherketone (PEEK) surface treatments on its shear bond strength (SBS) with flowable resin composite. METHODS A total of 120 PEEK disks were categorized into five groups: untreated PEEK (control), sandblasted with 50 μm alumina (Sa PEEK), etched with 98% sulfuric acid for 1 min (S PEEK), hydroxyapatite-coated sulfonated PEEK (HA PEEK), and phosphoric acid-etched HA-coated PEEK (HAP PEEK). Each group was subdivided into two groups (n = 12): Scotchbond Universal Plus (Scb) and Single Bond Universal (Sib) adhesive application and bond with flowable resin composite. SBS was evaluated after thermocycling for 5000 cycles and the results were analyzed using two-way and one-way ANOVA, followed by Tukey's HSD (α = 0.05). Failure mode was analyzed using light and scanning electron microscope. Surface roughness and contact angle analysis of each surface treatment were also done. RESULTS HA PEEK exhibited the highest SBS in both Scb and Sib, while untreated PEEK showed the lowest. The effect of bonding agent can be seen only in S PEEK group where Sib demonstrated significantly higher SBS (P < 0.05) than Scb. Cohesive and mixed failures were observed in HA PEEK and HAP PEEK groups and others showed mostly adhesive failure. The wettability of PEEK increased after surface treatment except for Sa PEEK. CONCLUSIONS HA PEEK consistently achieved the highest SBS, indicating that combining sulfonation with HA coating is an effective strategy to enhance bonding between PEEK and flowable resin composite.
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Affiliation(s)
- Thae Phyu Htay
- The Department of Prosthetic Dentistry, Faculty of Dentistry, Prince of Songkla University, HatYai, Songkhla, 90110, Thailand
| | - Chaimongkon Peampring
- The Department of Prosthetic Dentistry, Faculty of Dentistry, Prince of Songkla University, HatYai, Songkhla, 90110, Thailand.
| | - Putsadeeporn Thammajaruk
- The Department of Prosthetic Dentistry, Faculty of Dentistry, Prince of Songkla University, HatYai, Songkhla, 90110, Thailand
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Alnafaiy SM, Labban N, Albaijan R, AlKahtani RN, Al-Aali KA, Abozaed HW, Alturki NY, Alenezi JE. Evaluation of Shear Bond Strength and Failure Modes of Lithium Disilicate Ceramic Veneering Material to Different High-Performance Polymers. Polymers (Basel) 2025; 17:554. [PMID: 40076048 PMCID: PMC11901903 DOI: 10.3390/polym17050554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2025] [Revised: 02/16/2025] [Accepted: 02/19/2025] [Indexed: 03/14/2025] Open
Abstract
This study assessed the shear bond strength (SBS) and failure modes of lithium disilicate ceramic veneering material to different high-performance polymers. Thirty-six square specimens measuring 7 × 7 × 2 ± 0.05 mm were prepared from pure polyetheretherketone (PEEK), Bio-high performance PEEK (BioHPP) and Trilor discs. Polymer specimens were air-borne abraded utilizing aluminum oxide particles, cleaned, and a bonding agent was applied (visio. link). The veneering LDC material (3 × 2 mm) was milled, hydrofluoric acid etched (9.5%) and primed (Clearfil ceramic). The LDC was bonded to the polymer specimens using dual-cured resin cement (Panavia V5) and light polymerized. The bonded specimens were subjected to 5000 cycles of physiological aging by thermocycling, and the SBS test was performed in a universal testing machine at 0.5 mm/min cross-head speed. The debonded specimens were analyzed to determine the primary bond failure sites (adhesive, mixed or cohesive). Data analysis was performed using one-way ANOVA and a post hoc Tukey test (α ≤ 0.05). The BioHPP material demonstrated the highest SBS values (23.94 ± 1.43 MPa), and the Trilor group recorded the lowest SBS values (17.09 ± 1.07 MPa). The PEEK group showed a mean SBS of 21.21 ± 1.51 MPa. The SBS comparison showed significant variations across all material groups (p < 0.001). Regarding failure modes, adhesive failure was observed in 40% of BioHPP and PEEK specimens and 90% of Trilor specimens. The cohesive failure occurred in 50% of PEEK and 30% of BioHPP specimens, while the Trilor specimens showed no cohesive failure. Mixed failures were reported in 30% of BioHPP and 10% of PEEK and Trilor specimens. The BioHPP material demonstrated high SBS followed by PEEK and Trilor. The SBS between the tested materials was statistically significant. However, the SBS of the tested implant framework materials was above the limit stipulated by the ISO 10477 standard (5 MPa) and the clinically acceptable range of 10-12 MPa.
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Affiliation(s)
- Sarah M. Alnafaiy
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (R.N.A.); (K.A.A.-A.)
| | - Nawaf Labban
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
| | - Refal Albaijan
- Department of Prosthodontics, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (R.A.); (H.W.A.)
| | - Rawan N. AlKahtani
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (R.N.A.); (K.A.A.-A.)
| | - Khulud A. Al-Aali
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (R.N.A.); (K.A.A.-A.)
| | - Heba Wageh Abozaed
- Department of Prosthodontics, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (R.A.); (H.W.A.)
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt
| | - Nada Y. Alturki
- Dental Intern, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (N.Y.A.); (J.E.A.)
| | - Jomana E. Alenezi
- Dental Intern, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (N.Y.A.); (J.E.A.)
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Qasim SSB, Akbar AA, Sadeqi HA, Baig MR. Surface Characterization of Bone-Level and Tissue-Level PEEK and Titanium Dental Implant Scan Bodies After Repeated Autoclave Sterilization Cycles. Dent J (Basel) 2024; 12:392. [PMID: 39727449 DOI: 10.3390/dj12120392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Revised: 11/19/2024] [Accepted: 11/25/2024] [Indexed: 12/28/2024] Open
Abstract
Background: Sterilization is required for any biomedical device intended to be used in contact with the human body. Several studies have reported alterations in the bulk and surface properties of such devices after repeated sterilization cycles. These surface modifications may influence other clinical parameters. Therefore, the aim of this study was to investigate the surface and chemical properties of implant scan bodies (SBs) after consecutive autoclave sterilization procedures. Methods: The objective was to analyze the scan bodies using Fourier transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) for chemical analysis and an optical profilometer to analyze the surface roughness. Results: FTIR spectra depicted the appearance of peak at 1741 and 1100 cm-1 due to the diphenyl ether band disappearance. The XPS spectra showed alterations in the elemental composition after autoclaving and roughness were significantly reduced in PEEK BL and TL SBs. Conclusions: These results indicated that some surface modifications were induced by repeated sterilization cycles.
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Affiliation(s)
- Syed Saad Bin Qasim
- Department of Bioclinical Sciences, College of Dentistry, Kuwait University, Safat 13110, Kuwait
| | - Aqdar A Akbar
- Department of General Dental Practice, College of Dentistry, Kuwait University, Safat 13110, Kuwait
| | - Haneen A Sadeqi
- Department of Restorative Sciences, College of Dentistry, Kuwait University, Safat 13110, Kuwait
| | - Mirza Rustum Baig
- Department of Restorative Sciences, College of Dentistry, Kuwait University, Safat 13110, Kuwait
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Asik B, Ozyilmaz OY. Effects of various laser applications on surface roughness and bond strength to veneering composites of polyether ether ketone (PEEK) and polyether ketone ketone (PEKK) materials. Lasers Med Sci 2024; 39:269. [PMID: 39500765 DOI: 10.1007/s10103-024-04213-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/15/2024] [Indexed: 02/01/2025]
Abstract
The aim of this study was to investigate the bond strength between PEEK/PEKK and composite resins after various laser treatments and to compare the effectiveness of lasers on these polymers. 130 disc-shaped PEEK and PEKK blocks were obtained (10 mm diameter-4 mm height). One sample from each group (10 in total) was selected for scanning electron microscopy (SEM) analysis. The samples were randomly divided into 5 different surface treatment groups for each material (PEEK and PEKK): Er: YAG laser, Nd: YAG laser, diode laser, femtosecond laser and control (no surface treatment) (n = 12). Baseline and post-treatment surface roughness measurements were performed using a profilometer. The composite resin was bonded and SBS was measured. Comparisons among the groups were conducted via Kruskal-Wallis, one-way ANOVA; Tukey and Dunn tests were used as a post hoc test (p ≤ 0.05). All lasers significantly increased the roughness values of the PEEK and PEKK samples. In terms of shear bond strength; the Er: YAG and femtosecond laser groups had the highest values and the Nd: YAG, diode and control groups had the lowest values of the PEEK samples (p ≤ 0.05). The control group had the highest bond strength values and the femtosecond group had the lowest values for PEKK samples (p ≤ 0.05). All laser treatments increased the surface roughness of the PEEK and PEKK. Lasers increased the bond strength of PEEK to the veneering composite resin and decreased the bond strength values of PEKK. This shows that lasers behave differently in PEEK and PEKK materials.
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Affiliation(s)
- Burcu Asik
- Department of Prosthodontics, School of Dentistry, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Ozgun Yusuf Ozyilmaz
- Department of Prosthodontics, School of Dentistry, Bezmialem Vakif University, Istanbul, 34093, Turkey.
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Kuttuva Balasubramanian Sivaprakash Babu AD, Singaravel Chidambara Nathan A, Balasubramanium MK. Effect of laser surface treatment on shear bond strength between polyetheretherketone and heat-activated polymethylmethacrylate resin. J Prosthodont 2024; 33:490-496. [PMID: 37578028 DOI: 10.1111/jopr.13744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 08/11/2023] [Indexed: 08/15/2023] Open
Abstract
PURPOSE To compare the shear bond strength between polyetheretherketone (PEEK) and heat activated polymethylmethacrylate (PMMA) resin after laser treatment. MATERIALS AND METHODS A total of 128 PEEK discs were fabricated (10 mm diameter and 2 mm thickness) and allocated into two groups. Group 1 was subjected to surface treatment followed by thermal cycling for 5000 cycles and group 2 was subjected to surface treatment followed by thermal cycling for 10,000 cycles. Each group was further subdivided into four subgroups (n = 16) which were: no surface treatment; primer treatment; acid etching; and laser surface treatment. PEEK was then bonded with PMMA resin using the conventional flasking technique. The shear bond strength was evaluated using a universal testing machine with a crosshead speed of 1 mm/min. Statistical analysis was done using one-way ANOVA for comparing within groups, followed by Tukey HSD test. Student's T-test was done to evaluate between the two groups. RESULTS In group 1, the highest shear bond strength was exhibited by the laser group (19.08 ± 0.16 MPa) followed by the acid etch group (14.84 ± 0.23 MPa), and the primer group (6.43 ± 0.20 MPa), while the least shear bond strength was observed in the no surface treatment group (4.98 ± 0.34 MPa) which was found to be significant (p < 0.05). In group 2, the highest shear bond strength was observed in the laser group (18.21 ± 0.23 MPa) followed by the acid etch group (13.77 ± 0.48 MPa), and the primer group (6.04 ± 0.11 MPa), while the least shear bond strength was observed in no surface treatment group (4.35 ± 0.21 MPa) which was found to be significant (p < 0.05). CONCLUSION The shear bond strength between PEEK and PMMA resin was highest for specimens that were surface treated with laser and followed by specimens treated with acid etching, primer application, and without surface treatment, respectively. Increasing thermal cycling from 5000 cycles to 10,000 cycles also reduced the bond strength.
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Adeeb Gabra EN, Sadek HMA, Hamdy AM, Wahsh MM. Effect of surface treatment and resin cement type on the bond strength of polyetheretherketone to lithium disilicate ceramic. BMC Oral Health 2024; 24:513. [PMID: 38698366 PMCID: PMC11064278 DOI: 10.1186/s12903-024-04269-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/17/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND This study aims to evaluate the effect of surface treatment and resin cement on the shear bond strength (SBS) and mode of failure of polyetheretherketone (PEEK) to lithium disilicate ceramic (LDC). This is suggested to study alternative veneering of PEEK frameworks with a ceramic material. METHODS eighty discs were prepared from PEEK blank and from lithium disilicate ceramic. Samples were divided into four groups according to surface treatment: Group (A) air abraded with 110 μm Al2O3, Group (AP) air abrasion and primer application, Group (S) 98% sulfuric acid etching for 60 s, Group (SP) Sulfuric acid and primer. Each group was subdivided into two subgroups based on resin cement type used for bonding LDC:1) subgroup (L) self- adhesive resin cement and 2) subgroup (B) conventional resin cement (n = 10). Thermocycling was done for all samples. The bond strength was assessed using the shear bond strength test (SBS). Failure mode analysis was done at 50X magnification with a stereomicroscope. Samples were chosen from each group for scanning electron microscope (SEM). The three-way nested ANOVA followed by Tukey's post hoc test were used for statistical analysis of results. Comparisons of effects were done utilizing one way ANOVA and (p < 0.05). RESULTS The highest mean of shear bond strength values was demonstrated in Group of air abrasion with primer application using conventional resin cement (APB) (12.21 ± 2.14 MPa). Sulfuric acid groups showed lower shear bond strength values and the majority failed in thermocycling especially when no primer was applied. The failure mode analysis showed that the predominant failure type was adhesive failure between cement and PEEK, while the remaining was mixed failure between cement and PEEK. CONCLUSION The air abrasion followed by primer application and conventional resin cement used for bonding Lithium Disilicate to PEEK achieved the best bond strength. Primer application did not have an effect when self-adhesive resin cement was used in air-abraded groups. Priming step is mandatory whenever sulfuric acid etching surface treatment is utilized for PEEK.
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Affiliation(s)
- Engy N Adeeb Gabra
- Lecturer at Fixed Prosthodontics Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
| | | | | | - Marwa M Wahsh
- Fixed Prosthodontics Department, Faculty of Dentistry, Ain Shams University, Galala University, Cairo, Egypt
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Gökay GD, Aladağ SÜ. Comparison of the shear bond strengths of two different polyetheretherketone (PEEK) framework materials and CAD-CAM veneer materials. BMC Oral Health 2024; 24:444. [PMID: 38609958 PMCID: PMC11010332 DOI: 10.1186/s12903-024-04247-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/10/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND This study evaluated the shear bond strength (SBS) of two different polyetheretherketone (PEEK) and CAD-CAM materials after aging. METHODS A total of 42 frameworks were designed and milled from 2 different PEEK discs (Copra Peek, P and BioHPP, B). P and B frameworks were divided into 3 subgroups (n = 7). 14 slices were prepared each from feldspathic ceramic (Vitablocs Mark II, VM), hybrid nanoceramic (Cerasmart, CS), and polymer-infiltrated ceramic (Vita Enamic, VE) blocks. After surface preparations, the slices were cemented to P and B surfaces. The samples were subjected to thermal aging (5000 cycles). SBS of all the samples was measured. Fractured surfaces were examined by SEM/EDX analysis. The Shapiro-Wilk, Two-way Robust ANOVA and Bonferroni correction tests were used to analyze the data (a = .05). RESULTS Frameworks, ceramics, and frameworks x ceramics had significant differences (p < 0.05). The highest SBS value was seen in B-VM (p < 0.05). VM offered the highest SBS with both P and B. The differences between P-VM, P-CS, P-VE and B-CS and B-VE were insignificant (p > 0.05). According to EDX analysis, ytterbium and fluorine was seen in B content, unlike P. While VM and CS contained fluorine, barium, and aluminum; sodium and aluminum were observed in the VE structure. CONCLUSION Bonding of P and B with VM offers higher SBS. VM, CS and VE did not make any difference in SBS for P, however VM showed a significant difference for B.
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Affiliation(s)
- Gonca Deste Gökay
- Department of Prosthodontics, Faculty of Dentistry, Bursa Uludağ University, Bursa, Turkey
| | - Seda Üstün Aladağ
- Department of Prosthodontics, Faculty of Dentistry, Bursa Uludağ University, Bursa, Turkey.
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Huang HY, Feng SW, Chiang KY, Li YC, Peng TY, Nikawa H. Effects of various functional monomers' reaction on the surface characteristics and bonding performance of polyetheretherketone. J Prosthodont Res 2024; 68:319-325. [PMID: 37574275 DOI: 10.2186/jpr.jpr_d_23_00063] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
PURPOSE Polyetheretherketone (PEEK) is a new polymeric material that has received significant attention in dentistry because of its mechanical properties, biocompatibility, and aesthetics. However, the bonding performance of PEEK to other materials is not preferable. This study aimed to analyze the variations in the surface characteristics of PEEK under the chemical action of primers containing different functional monomers or polymers and to evaluate the bonding performance of PEEK and dental cement. METHODS Disk-shaped PEEK samples were prepared by dental milling, blasting with alumina oxide, and covering with primers containing functional monomers or polymers. The surface characteristics of the samples were analyzed by microscopy and spectroscopy. The shear bond strength (SBS) between PEEK and dental cement, with and without thermocycling, was tested using a universal testing machine. Finally, the data were statistically analyzed and compared. RESULTS Functional monomers or polymers were successfully bonded to the surface of PEEK. This treatment significantly improved its hydrophilicity and surface free energy (P < 0.05). The primer containing pentaerythritol triacrylate had the highest SBS without thermocycling (13.89 MPa). Meanwhile, the primers containing urethane dimethacrylate (UDMA) and methyl methacrylate (MMA) (abbreviated as the HC group) showed the highest SBS and lowest reduction (25.51%) after thermocycling. Notably, all the testing groups achieved the ISO10477 standard of 5 MPa. After thermocycling, adhesive failure accounted for the largest proportion of failures in all the groups except the HC group. CONCLUSIONS The chemical priming treatment can significantly improve the SBS of PEEK and dental cement. Moreover, a primer containing both UDMA and MMA can provide improved bonding for PEEK materials.
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Affiliation(s)
- Huei-Yu Huang
- Department of Dentistry, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sheng-Wei Feng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Yu Chiang
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yun-Chen Li
- Department of Dentistry, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
| | - Tzu-Yu Peng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hiroki Nikawa
- Department of Oral Biology & Engineering, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan
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Rakotoaridina K, Delrieu J, Pages P, Vergé T, Nasr K, Canceill T. Evaluation of Poly(etheretherketone) Post's Mechanical Strength in Comparison with Three Metal-Free Biomaterials: An In Vitro Study. Polymers (Basel) 2023; 15:3583. [PMID: 37688208 PMCID: PMC10489626 DOI: 10.3390/polym15173583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/26/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
The thinking about metallic replacement has begun in a global context of reducing metallic alloys' use in odontology. Among the materials proposed for their replacement, poly(etheretherketone) may present interesting properties, especially in removable dentures' frames. The purpose of this study is to evaluate fracture resistance of PEEK posts-and-cores compared to non-metallic CAD/CAM materials and fiber glass posts. Forty extracted maxillary central incisors were prepared to receive posts. Samples were divided into four groups depending on whether they had been reconstructed with LuxaCam® PEEK, Enamic®, Numerys GF® or LuxaPost®. Samples were submitted to an oblique compressive test and results were statistically analyzed with ANOVA and Student's tests (or non-parametric tests depending on the conditions). Glass fiber posts and Numerys GF® reveal a significantly higher fracture resistance than LuxaCam® PEEK and Enamic®. No exclusively dental fracture has been noted for the Enamic group, which significantly distinguishes these samples from the three other groups. In our study, it appears that the conception of posts and cores with hybrid ceramic never conducts to a unique tooth fracture. By weighting the results according to the materials used, our data, obtained for the first time on this type of PEEK block, cannot confirm the possibility of using PEEK for inlay-core conception, excepted for specific cases when the material is considered in a patient presenting allergies or systemic disease contraindicating resin or metal.
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Affiliation(s)
- Kévin Rakotoaridina
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Julien Delrieu
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Paul Pages
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Thierry Vergé
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Karim Nasr
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Thibault Canceill
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
- CNRS UMR 5085, INPT, Faculté de Pharmacie, CIRIMAT, Université Toulouse III Paul Sabatier, 35 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
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13
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Erjavec AK, Črešnar KP, Švab I, Vuherer T, Žigon M, Brunčko M. Determination of Shear Bond Strength between PEEK Composites and Veneering Composites for the Production of Dental Restorations. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16093286. [PMID: 37176168 PMCID: PMC10178894 DOI: 10.3390/ma16093286] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
We studied the shear bond strength (SBS) of two PEEK composites (BioHPP, BioHPP plus) with three veneering composites: Visio.lign, SR Nexco and VITA VM LC, depending on the surface treatment: untreated, sandblasted with 110 μm Al2O3, sandblasted and cleaned ultrasonically in 80% ethanol, with or without adhesive Visio.link, with applied Visio.link and MKZ primer. For the BioHPP plus, differential scanning calorimetry (DSC) revealed a slightly lower glass transition temperature (Tg 150.4 ± 0.4 °C) and higher melting temperature (Tm 339.4 ± 0.6 °C) than those of BioHPP (Tg 151.3 ± 1.3 °C, Tm 338.7 ± 0.2 °C). The dynamical mechanical analysis (DMA) revealed a slightly higher storage modulus of BioHPP (E' 4.258 ± 0.093 GPa) than of BioHPP plus (E' 4.193 ± 0.09 GPa). The roughness was the highest for the untreated BioHPP plus, and the lowest for the polished BioHPP. The highest hydrophobicity was achieved on the sandblasted BioHPP plus, whereas the highest hydrophilicity was found on the untreated BioHPP. The highest SBSs were determined for BioHPP and Visio.lign, adhesive Visio.link (26.31 ± 4.17 MPa) or MKZ primer (25.59 ± 3.17 MPa), with VITA VM LC, MKZ primer and Visio.link (25.51 ± 1.94 MPa), and ultrasonically cleaned, with Visio.link (26.28 ± 2.94 MPa). For BioHPP plus, the highest SBS was determined for a sandblasted surface, cleaned ultrasonically, with the SR Nexco and Visio.link (23.39 ± 2.80 MPa).
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Affiliation(s)
| | - Klementina Pušnik Črešnar
- Faculty of Polymer Technology, Ozare 19, 2380 Slovenj Gradec, Slovenia
- Faculty of Mechanical Engineering, University of Maribor, Smetanova ulica 17, 2000 Maribor, Slovenia
| | - Iztok Švab
- Isokon d.o.o., Industrijska cesta 16, 3210 Slovenske Konjice, Slovenia
| | - Tomaž Vuherer
- Faculty of Mechanical Engineering, University of Maribor, Smetanova ulica 17, 2000 Maribor, Slovenia
| | - Majda Žigon
- Faculty of Polymer Technology, Ozare 19, 2380 Slovenj Gradec, Slovenia
| | - Mihael Brunčko
- Faculty of Mechanical Engineering, University of Maribor, Smetanova ulica 17, 2000 Maribor, Slovenia
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Nagi N, Fouda AM, Bourauel C. Comparative evaluation of internal fit and marginal gap of endocrowns using lithium disilicate and polyether ether ketone materials - an in vitro study. BMC Oral Health 2023; 23:207. [PMID: 37029396 PMCID: PMC10082505 DOI: 10.1186/s12903-023-02857-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/06/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND The aim of the study was to investigate the effect of material and occlusal preparation design on the internal fit and marginal gap of endocrowns made of Polyether ether ketone (PEEK) and lithium disilicate. METHODS 32 endocrowns were fabricated on prepared mandibular molars and divided into two groups (n = 16) according to the material. Group L: lithium disilicate and Group P: PEEK. Each group was further subdivided into two subgroups (n = 8) according to the occlusal preparation design: full occlusal coverage (LF and PF) and partial occlusal coverage (LP and PP). Samples were analyzed using microcomputed tomography (µCT) with a voxel size of 6 μm to evaluate internal fit, and an optical microscope was used to evaluate the marginal gap. Data were collected, tabulated, and statistically analyzed. Numerical data were described as mean and standard deviation and compared using the ANOVA test. The level of significance was set at α P ≤ 0.05. RESULTS All groups' internal fit and marginal gaps values were within the acceptable clinical range. However, the lithium disilicates group recorded statistically significantly higher mean internal gap values than the PEEK groups. Regardless of the material, the difference between the two occlusal designs was not statistically significant in both internal fit and marginal gap records. CONCLUSION Within the limitations of this study, PEEK endocrown restorations revealed better internal fit and marginal gap than lithium disilicate endocrown restorations. The marginal and internal fit of both lithium disilicate and PEEK endocrown restorations were within the clinically acceptable range. The occlusal preparation design had no influence on the internal fit and marginal gap of the endocrown restoration.
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Affiliation(s)
- Nermeen Nagi
- Bonn University, Bonn, Germany.
- Faculty of Dentistry, Galala University, Suez, Egypt.
- Faculty of Dentistry, Fayoum University, Fayoum, Egypt.
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15
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Turkkal F, Culhaoglu AK, Sahin V. Composite-veneering of polyether-ether-ketone (PEEK): evaluating the effects of different surface modification methods on surface roughness, wettability, and bond strength. Lasers Med Sci 2023; 38:95. [PMID: 36995426 DOI: 10.1007/s10103-023-03749-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 12/03/2022] [Indexed: 03/31/2023]
Abstract
This study aimed to evaluate the effects of different surface modification methods on the surface roughness, contact angle, and bond strength of composite-veneer materials of polyether-ether-ketone (PEEK). Fifty-five specimens (n = 11) with a size of 7 × 7 × 2 mm were cut out from PEEK discs. The specimens were divided into five groups with different surface treatments: no treatment (NO) (control group), sulfuric acid (SA), plasma (P), femtosecond laser (FS), and Nd-YAG laser (NY). After the surface treatments, the specimens were checked for roughness, contact angle, and bond strength of the composite-veneer material. Data were analyzed with the Welch test for roughness, contact angle, and bond strength parameters. Individual Pearson correlation tests were executed for all surface treatment groups to determine any significant correlations among roughness, contact angle, and bond strength parameters (P < .001). Roughness, contact angle, and bond strength values were affected by surface modification methods (P < .001). In comparison to the control group, NY and FS treatments increased the surface roughness and bond strength; they also provided bond strength values comparable to the SA group. When the relationship between the variables was examined, no correlation was seen between roughness, contact angle, and bond strength values for the NY, SA, and control groups (P > .05); however, significant correlations were determined between the contact angle and surface roughness values for the P and FS groups (P < .05). Femtosecond and Nd-YAG laser treatments are viable surface modification alternatives to the sulfuric acid treatment for the PEEK material.
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Affiliation(s)
| | - Ahmet Kursad Culhaoglu
- Department of Prosthodontics, Faculty of Dentistry, Kırıkkale University, Yenisehir Mah, Celebi Sokak No: 1, 71450, Kırıkkale, Türkiye.
- Department of Prosthodontics, Faculty of Dentistry, Sağlık Bilimleri Gülhane Univesity, Emrah Mah. 06018 Etlik/Keçiören/ANKARA, Ankara, Türkiye.
| | - Volkan Sahin
- Department of Prosthodontics, Faculty of Dentistry, Kırıkkale University, Yenisehir Mah, Celebi Sokak No: 1, 71450, Kırıkkale, Türkiye
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16
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Kiliç M, Dede DÖ, Küçükekenci AS. Comparing the shear bond strength of veneering materials to the PAEKs after surface treatments. BMC Oral Health 2023; 23:185. [PMID: 36997970 PMCID: PMC10064678 DOI: 10.1186/s12903-023-02879-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/13/2023] [Indexed: 04/01/2023] Open
Abstract
Abstract
Background
This study aimed to evaluate the impact of various surface treatments on the shear bond strength (SBS) of polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) polymers to indirect laboratory composite (ILC) and lithium disilicate ceramic (LDC) veneering materials.
Methods
Polymer specimens (7 × 7x2 mm) were sectioned from PEEK and PEKK discs (N = 294) and randomly allocated to 7 groups (n = 20); untreated (Cnt), plasma (Pls), 98% sulfuric acid (Sa), sandblasting with 110 µm Al2O3 (Sb), tribochemical silica coating with 110 µm silica modified Al2O3 (Tbc), Sb + Sa, Tbc + Sa. Scanning electron microscopy assessments were performed on one sample of each treatment group, and veneering materials were applied to the remaining specimens (n = 10). The specimens were subjected to the SBS test after being soaked in distilled water (24 h, 37 °C). Three-way ANOVA, independent sample t-test, and Tukey HSD test were performed for statistical analyses (α = .05).
Results
The surface treatment, polymer, veneering material types, and their interactions were significant on SBS results according to the 3-way ANOVA (p < 0.001). The SBS values of ILC veneered groups were significantly higher than LDC groups, regardless of surface treatment and polymer type (p < 0.05). The highest SBS values were obtained for Sa-applied ILC veneered PEEK (21.55 ± 1.45 MPa) and PEKK (17.04 ± 1.99 MPa) polymer groups (p < 0.05).
Conclusion
The effect of surface treatment and veneering materials may be significant on the SBS values of PAEKs. Therefore, the application parameters of surface treatments should be more specified for the applied veneering material and polymer type.
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17
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Effect of Adhesion Conditions on the Shear Bond Strength of 3D Printing Resins after Thermocycling Used for Definitive Prosthesis. Polymers (Basel) 2023; 15:polym15061390. [PMID: 36987170 PMCID: PMC10056338 DOI: 10.3390/polym15061390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 03/12/2023] Open
Abstract
Three-dimensional (3D) printing polymers such as urethane dimethacrylate (UDMA) and ethoxylated bisphenol A dimethacrylate (Bis-EMA) are typically used in definitive prosthesis and require surface treatments before bonding. However, surface treatment and adhesion conditions often affect long-term use. Herein, polymers were divided into Groups 1 and 2 for the UDMA and Bis-EMA components, respectively. The shear bond strength (SBS) between two types of 3D printing resins and resin cements was measured using Rely X Ultimate Cement and Rely X U200, according to adhesion conditions such as single bond universal (SBU) and airborne-particle abrasion (APA) treatments. Thermocycling was performed to evaluate the long-term stability. Sample surface changes were observed using a scanning electron microscope and surface roughness measuring instrument. The effect of interaction between the resin material and adhesion conditions on the SBS was analyzed via a two-way analysis of variance. The optimal adhesion condition for Group 1 was achieved when U200 was used after APA and SBU, whereas Group 2 was not significantly affected by the adhesion conditions. After thermocycling, the SBS significantly decreased in Group 1 without APA treatment and in the entire Group 2. Additionally, porosity, along with increased roughness, was observed on both material surfaces after APA.
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18
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Alsadon O, Moorehead R, Almansour H, Bangalore D, Alageel O, Wood D. Surface Characteristics and Adhesion of Veneering Composite Resin to PAEK-Based Substructure Restorative Materials. J Prosthodont 2023; 32:147-153. [PMID: 35340086 DOI: 10.1111/jopr.13511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/20/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To evaluate and compare the shear bond strength (SBS) of composite veneering material to polyetherketoneketone (PEKK), polyetheretherketone (PEEK), zirconia (YZ), and nickel-chromium alloy (NiCr) substructure restorative materials. MATERIALS AND METHODS Forty samples (12 × 2 mm) were prepared from four materials: PEKK, PEEK, zirconia, and NiCr alloy (n = 10). The Vickers hardness was evaluated before preparing the surface for bonding by shot-blasting using 110 μm Al2 O3 particles. The surface roughness (Ra) of each sample was determined using a noncontact optical profilometer. The veneering resin was bonded onto each sample following primer application. The prepared samples were then subjected to an SBS test using a universal testing machine at 0.5 mm/min crosshead speed. Failure modes and surface topography following debonding were assessed. The data were statistically analyzed using ANOVA and Tukey's post-hoc comparison test (p < 0.05). RESULTS: The highest and lowest mean surface roughness was observed in PEEK (3.45 ±0.13 μm) and NiCr (1.87 ±0.07 μm) materials, respectively. A significant difference in roughness values was observed between the materials except for NiCr and YZ (p = 0.547). Concerning SBS, PEEK and NiCr exhibited the highest (16.23 ±0.96 MPa) and lowest (10.1 ±0.63 MPa) values. The mean difference in SBS indicated a statistically significant difference between the material groups (p < 0.01). CONCLUSIONS PEKK materials demonstrated significantly lower SBS than PEEK and significantly higher SBS values than conventional zirconia and alloy materials. A positive and significant correlation between mean roughness and SBS was observed, but the causality could be either intrinsic to the material or the roughness.
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Affiliation(s)
- Omar Alsadon
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Engineer Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Robert Moorehead
- The Henry Royce Institute and Department of Materials Science and Engineering, University of Sheffield, Sheffield, UK
| | - Haitham Almansour
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Durgesh Bangalore
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Omar Alageel
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Duncan Wood
- Academic Unit of Restorative Dentistry, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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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 (Basel) 2023; 15:386. [PMID: 36679266 PMCID: PMC9864167 DOI: 10.3390/polym15020386] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023] Open
Abstract
Polyetheretherketone (PEEK) is a thermoplastic material widely used in engineering applications due to its good biomechanical properties and high temperature stability. Compared to traditional metal and ceramic dental materials, PEEK dental implants exhibit less stress shielding, thus better matching the mechanical properties of bone. As a promising medical material, PEEK can be used as implant abutments, removable and fixed prostheses, and maxillofacial prostheses. It can be blended with materials such as fibers and ceramics to improve its mechanical strength for better clinical dental applications. Compared to conventional pressed and CAD/CAM milling fabrication, 3D-printed PEEK exhibits excellent flexural and tensile strength and parameters such as printing temperature and speed can affect its mechanical properties. However, the bioinert nature of PEEK can make adhesive bonding difficult. The bond strength can be improved by roughening or introducing functional groups on the PEEK surface by sandblasting, acid etching, plasma treatment, laser treatment, and adhesive systems. This paper provides a comprehensive overview of the research progress on the mechanical properties of PEEK for dental applications in the context of specific applications, composites, and their preparation processes. In addition, the research on the adhesive properties of PEEK over the past few years is highlighted. Thus, this review aims to build a conceptual and practical toolkit for the study of the mechanical and adhesive properties of PEEK materials. More importantly, it provides a rationale and a general new basis for the application of PEEK in the dental field.
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Affiliation(s)
- Chengfeng Luo
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Ying Liu
- The Affiliated Taian City Central Hospital of Qingdao University, Taian 271000, China
| | - Bo Peng
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Menghao Chen
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Zhaogang Liu
- The Affiliated Taian City Central Hospital of Qingdao University, Taian 271000, China
| | - Zhanglong Li
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Hai Kuang
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning 530021, China
- Key Laboratory of Research and Application of Stomatological Equipment (College of Stomatology, Guangxi Medical University), Education Department of Guangxi Zhuang Autonomous Region, Nanning 530021, China
| | - Baijuan Gong
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Zhimin Li
- School of Stomatology, China Medical University, Shenyang 110002, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Hongchen Sun
- Hospital of Stomatology, Jilin University, Changchun 130021, China
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Demirci F, Bahce E. The effects of HAp coating layer on mechanical and optical properties at bonding interface of high-performance polymers. J Mech Behav Biomed Mater 2023; 137:105539. [PMID: 36343522 DOI: 10.1016/j.jmbbm.2022.105539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE The effect of hydroxyapatite (HAp) coating layer on mechanical and optical properties at bonding interface of high-performance polymers (HPPs) used in computer-aided design (CAD)/computer-aided manufacture (CAM) technology was investigated in this in vitro study. MATERIALS AND METHODS Two hundred-twenty specimens were divided into two material groups (n = 110): polyetheretherketone (PEEK, KERA® starPEEK) and polyetherketoneketone (PEKK, Pekkton® ivory). For mechanical testing, each group was divided into five surface pretreatment subgroups and a control group (n = 10): HAp coating (1%,3%, 5%, and 10% concentrations) and sandblasting with 110-μm Al2O3 particles. For optical testing, each group was divided into five subgroups (n = 10): HAp coating (1%, 3%, 5%, and 10% concentrations) and control. The effects of the HAp coating on the optical changes and shear bond strength (SBS) of the specimens were investigated. Data was statistically analyzed by one-way ANOVA and Tukey's post-hoc test. Failure modes and surface properties of the specimens were examined by scanning electron microscopy (SEM) and coupled electron dispersive spectroscopy (EDS). RESULTS Average translucency and color change values increased with increasing HAp coating concentration in HPPs. As a result of the data, statistically significant differences were observed in terms of the effect of the HAp coating on SBS of HPPs (p < 0.05). Failure modes were examined, and mixed failure mode was observed. CONCLUSION HAp coating can contribute to the improvement of both the optical properties and bond strength of the HPPs to resin composite. CLINICAL SIGNIFICANCE Adhesion and color problems of high performance polymers are still under discussion. In order to solve these problems, generally focused on surface modifications of these polymers, but the effect of the HAp coating has not been investigated.
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Affiliation(s)
- Fatih Demirci
- Department of Prosthodontics, Faculty of Dentistry, Inonu University, Malatya, 44280, Turkey
| | - Erkan Bahce
- Department of Mechanical Engineering, Faculty of Engineering, Inonu University, Malatya, Turkey.
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21
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Pidhatika B, Widyaya VT, Nalam PC, Swasono YA, Ardhani R. Surface Modifications of High-Performance Polymer Polyetheretherketone (PEEK) to Improve Its Biological Performance in Dentistry. Polymers (Basel) 2022; 14:polym14245526. [PMID: 36559893 PMCID: PMC9787615 DOI: 10.3390/polym14245526] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/17/2022] [Accepted: 11/20/2022] [Indexed: 12/23/2022] Open
Abstract
This comprehensive review focuses on polyetheretherketone (PEEK), a synthetic thermoplastic polymer, for applications in dentistry. As a high-performance polymer, PEEK is intrinsically robust yet biocompatible, making it an ideal substitute for titanium-the current gold standard in dentistry. PEEK, however, is also inert due to its low surface energy and brings challenges when employed in dentistry. Inert PEEK often falls short of achieving a few critical requirements of clinical dental materials, such as adhesiveness, osseoconductivity, antibacterial properties, and resistance to tribocorrosion. This study aims to review these properties and explore the various surface modification strategies that enhance the performance of PEEK. Literatures searches were conducted on Google Scholar, Research Gate, and PubMed databases using PEEK, polyetheretherketone, osseointegration of PEEK, PEEK in dentistry, tribology of PEEK, surface modifications, dental applications, bonding strength, surface topography, adhesive in dentistry, and dental implant as keywords. Literature on the topics of surface modification to increase adhesiveness, tribology, and osseointegration of PEEK were included in the review. The unavailability of full texts was considered when excluding literature. Surface modifications via chemical strategies (such as sulfonation, plasma treatment, UV treatment, surface coating, surface polymerization, etc.) and/or physical approaches (such as sandblasting, laser treatment, accelerated neutral atom beam, layer-by-layer assembly, particle leaching, etc.) discussed in the literature are summarized and compared. Further, approaches such as the incorporation of bioactive materials, e.g., osteogenic agents, antibacterial agents, etc., to enhance the abovementioned desired properties are explored. This review presents surface modification as a critical and essential approach to enhance the biological performance of PEEK in dentistry by retaining its mechanical robustness.
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Affiliation(s)
- Bidhari Pidhatika
- Research Center for Polymer Technology, National Research and Innovation Agency, Republic of Indonesia PRTPL BRIN Indonesia, Serpong, Tangerang Selatan 15314, Indonesia
- Collaborative Research Center for Biomedical Scaffolds, National Research and Innovation Agency of the Republic Indonesia and Universitas Gadjah Mada, Jalan Denta No. 1, Sekip Utara, Yogyakarta 55281, Indonesia
| | - Vania Tanda Widyaya
- Research Center for Polymer Technology, National Research and Innovation Agency, Republic of Indonesia PRTPL BRIN Indonesia, Serpong, Tangerang Selatan 15314, Indonesia
| | - Prathima C. Nalam
- Department of Materials Design and Innovation, University at Buffalo, Buffalo, NY 14260-1900, USA
| | - Yogi Angga Swasono
- Research Center for Polymer Technology, National Research and Innovation Agency, Republic of Indonesia PRTPL BRIN Indonesia, Serpong, Tangerang Selatan 15314, Indonesia
| | - Retno Ardhani
- Department of Dental Biomedical Science, Faculty of Dentistry, Universitas Gadjah Mada, Jalan Denta No. 1, Sekip Utara, Yogyakarta 55281, Indonesia
- Correspondence:
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Wang D, Han X, Luo F, Thieringer FM, Xu Y, Ou G, Spintzyk S. Adhesive Property of 3D-Printed PEEK Abutments: Effects of Surface Treatment and Temporary Crown Material on Shear Bond Strength. J Funct Biomater 2022; 13:jfb13040288. [PMID: 36547548 PMCID: PMC9786111 DOI: 10.3390/jfb13040288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
Three-dimensionally printed polyetheretherketone (PEEK) materials are promising for fabricating customized dental abutments. This study aimed to investigate the adhesive property of a 3D-printed PEEK material. The effects of surface treatment and temporary crown materials on shear bond strength were evaluated. A total of 108 PEEK discs were 3D printed by fused-filament fabrication. Surface treatments, including sandblasting, abrasive paper grinding, and CO2 laser ablation, were applied to the PEEK discs, with the untreated specimens set as the control. Afterward, the surface topographies of each group were investigated by scanning electron microscopy (SEM, n = 1) and roughness measurements (n = 7). After preparing the bonding specimens with three temporary crown materials (Artificial teeth resin (ATR), 3M™ Filtek™ Supreme Flowable Restorative (FR), and Cool Temp NATURAL (CTN)), the shear bond strength was measured (n = 6), and the failure modes were analyzed by microscopy and SEM. The results showed that ATR exhibited a significantly higher shear bond strength compared to FR and CTN (p < 0.01), and the PEEK surfaces treated by sandblasting and abrasive paper grinding showed a statistically higher shear bond strength compared to the control (p < 0.05). For clinical application, the ATR material and subtractive surface treatments are recommended for 3D-printed PEEK abutments.
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Affiliation(s)
- Dingjie Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xingting Han
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Technology of Stomatology, 22 Zhongguancun Avenue South, Beijing 100081, China
| | - Feng Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Florian M. Thieringer
- Medical Additive Manufacturing Research Group, Hightech Research Center, Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
| | - Yichen Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (Y.X.); (G.O.)
| | - Guomin Ou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (Y.X.); (G.O.)
| | - Sebastian Spintzyk
- ADMiRE Research Center—Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, 9524 Villach, Austria
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Wang B, Huang M, Dang P, Xie J, Zhang X, Yan X. PEEK in Fixed Dental Prostheses: Application and Adhesion Improvement. Polymers (Basel) 2022; 14:polym14122323. [PMID: 35745900 PMCID: PMC9228596 DOI: 10.3390/polym14122323] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 01/27/2023] Open
Abstract
Polyetheretherketone (PEEK) has been widely applied in fixed dental prostheses, comprising crowns, fixed partial dentures, and post-and-core. PEEK’s excellent mechanical properties facilitate better stress distribution than conventional materials, protecting the abutment teeth. However, the stiffness of PEEK is not sufficient, which can be improved via fiber reinforcement. PEEK is biocompatible. It is nonmutagenic, noncytotoxic, and nonallergenic. However, the chemical stability of PEEK is a double-edged sword. On the one hand, PEEK is nondegradable and intraoral corrosion is minimized. On the other hand, the inert surface makes adhesive bonding difficult. Numerous strategies for improving the adhesive properties of PEEK have been explored, including acid etching, plasma treatment, airborne particle abrasion, laser treatment, and adhesive systems.
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Affiliation(s)
- Biyao Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
| | - Minghao Huang
- Liaoning Provincial Key Laboratory of Oral Diseases, Center of Implant Dentistry, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China;
| | - Pengrui Dang
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
| | - Jiahui Xie
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
| | - Xinwen Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, Center of Implant Dentistry, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China;
- Correspondence: (X.Z.); (X.Y.); Tel.: +86-024-31927731 (X.Z.); +86-024-31927715 (X.Y.)
| | - Xu Yan
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
- Correspondence: (X.Z.); (X.Y.); Tel.: +86-024-31927731 (X.Z.); +86-024-31927715 (X.Y.)
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Kimura H, Tsuka H, Morita K, Hirata I, Nishio F, Abekura H, Doi K, Tsuga K. Nd:YVO 4 laser groove treatment can improve the shear bond strength between dental PEEK and adhesive resin cement with an adhesive system. Dent Mater J 2022; 41:382-391. [PMID: 35082179 DOI: 10.4012/dmj.2020-036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to investigate the effect of various surface treatments on the shear bond strength between dental polyetheretherketone (PEEK) and adhesive resin cement. Two hundred and forty specimens were randomly classified into four groups: no treatment, sandblasted, sulfuric-acid-etched, and laser-grooved treatment. Each group was classified into two adhesive resin cement subgroups. Surface roughness, water contact angle, shear bond strength, and failure mode were measured; SEM and XPS results were obtained. The data were statistically analyzed using one-way or two-way analysis of variance and Tukey's honest significant difference test (α=0.05). Laser-grooved PEEK surface showed regular grooves and carbonization by thermal degradation; the surface roughness as well as water contact angle of were the highest in all groups. Shear bond strength values were significantly higher in the laser-groove-treated and sulfuric-acid-etched groups. Laser-groove-treated specimens showed cohesive failure. Laser-grooved treatment can improve shear bond strength between PEEK and adhesive resin cement.
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Affiliation(s)
- Hitomi Kimura
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Hiroki Tsuka
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Koji Morita
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Isao Hirata
- Department of Biomaterials, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Fumiko Nishio
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Hitoshi Abekura
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Kazuya Doi
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University
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Use of Nd:YVO4 laser, Photodynamic therapy, Sulfuric acid and sand blasting on improving bond integrity of PEEK to resin cement with adhesive. Photodiagnosis Photodyn Ther 2022; 39:102865. [DOI: 10.1016/j.pdpdt.2022.102865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 11/24/2022]
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26
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Omaish HHM, Abdelhamid AM, Neena AF. Comparison of the strain developed around implants with angled abutments with two reinforced polymeric CAD-CAM superstructure materials: An in vitro comparative study. J Prosthet Dent 2022; 127:634.e1-634.e8. [DOI: 10.1016/j.prosdent.2022.01.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/29/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
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Taha D, Safwat F, Wahsh M. Effect of combining different surface treatments on the surface characteristics of polyetheretherketone-based core materials and shear bond strength to a veneering composite resin. J Prosthet Dent 2022; 127:599.e1-599.e7. [DOI: 10.1016/j.prosdent.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 11/30/2022]
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Godil AZ, Kazi AI, Wadwan SA, Gandhi KY, Dugal RJS. Comparative evaluation of marginal and internal fit of endocrowns using lithium disilicate and polyetheretherketone computer-aided design - computer-aided manufacturing (CAD-CAM) materials: An in vitro study. J Conserv Dent 2021; 24:190-194. [PMID: 34759588 PMCID: PMC8562835 DOI: 10.4103/jcd.jcd_547_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 01/17/2021] [Accepted: 02/19/2021] [Indexed: 11/12/2022] Open
Abstract
Purpose: To evaluate the marginal and internal fit of endocrowns with different computer-aided design/computer-aided manufacturing (CAD-CAM) materials by measuring them with a stereomicroscope (μm). Materials and Methods: A mandibular first molar typodont tooth was prepared to receive an endocrown. The preparation was scanned using an extra-oral scanner. Endocrowns (n = 20) were fabricated using lithium disilicate (IPS e. max CAD LT block; CEREC Ivoclar Vivadent, Liechtenstein) and polyetheretherketone (PEEK) (breCAM. BioHPP®; Bredent, UK) using CAD-CAM technique. Marginal gap was evaluated using a stereomicroscope at the midpoint of all four surfaces (mid buccal, mid lingual, mid mesial, mid distal). This was followed by sectioning of the endocrowns in a sagittal plane along with the prepared tooth to evaluate the internal fit at four different points (A, B, C, D) using a stereomicroscope. Statistical analysis was performed using one-way analysis of variance test. Results: Mean values of marginal gap of lithium disilicate and PEEK endocrowns are 56.6 ± 6.1 μm and 81.3 ± 10.1 μm, respectively. Mean value internal gaps of lithium disilicate and PEEK endocrowns are 158.2 ± 11.1 μm and 199.1 ± 13 μm, respectively. Results in the present study have shown that the marginal and internal fits of lithium disilicate endocrowns are superior to that of PEEK endocrowns. Conclusions: Based on the outcomes of this in vitro study, the marginal and internal fit of lithium disilicate endocrowns is better than PEEK endocrowns. The marginal gap clinically acceptable is <120 μm. The marginal gap values recorded in this study are within the acceptable range for both materials.
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Affiliation(s)
- Aamir Zahid Godil
- Department of Prosthodontics and Crown and Bridge, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Arshi Ilyas Kazi
- Department of Prosthodontics and Crown and Bridge, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Sanaa Akhlaq Wadwan
- Department of Prosthodontics and Crown and Bridge, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Kashif Yusuf Gandhi
- Department of Prosthodontics and Crown and Bridge, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Ramandeep J S Dugal
- Department of Prosthodontics and Crown and Bridge, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
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Repair Bond Strength of Composite Resin to Aged Resin and Glass-Matrix CAD/CAM Ceramic Materials Using Two Different Repair Systems. COATINGS 2021. [DOI: 10.3390/coatings11111331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study evaluates the repair bond strength of resin-matrix and glass-matrix CAD/CAM ceramic materials based on two repair systems. Thirty specimens measuring 2.5 mm in thickness were prepared from Crystal Ultra (CU), Vita Enamic (EN), Lava Ultimate (LU), Cerasmart (CS), and Vitablocs Mark II (VM2) materials and aged for 5000 thermal cycles. Specimens were randomly allocated into three groups: control, Monobond-S (MS) primer, and Monobond Etch & Prime (MEP). Composite resin (Tetric N Ceram) (5 mm in diameter and 2 mm thick) was packed and light-cured onto treated specimen surfaces. Subsequently, the specimens’ shear bond strength (SBS) was evaluated, and failure modes was recorded. Statistical analysis was performed using factorial ANOVA and Tukey’s post hoc tests (a = 0.05). The factorial ANOVA revealed significant interactions between the material type and repair system, which was significant (p < 0.01). The highest and lowest SBS were obtained for CU (27.09 ± 1.11) and VM2 (4.30 ± 0.59) in MS and control groups, respectively. In all the groups, CU demonstrated higher SBS, whereas VM2 demonstrated lower SBS. There were no significant differences in SBS between EN and LU, and CS and CU in all the study groups (p > 0.05). The Monobond-S repair system provided non-significantly higher SBS compared to the MEP systems, except for VM2 and LU materials. The new resin-matrix CAD/CAM material demonstrated the highest SBS compared to the other materials for both conventional and MEP repair systems. Both repair systems showed clinically acceptable bond strength and allowed for successful repair of the resin-matrix ceramic materials.
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30
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Ozkan Ata S, Akay C, Ata N. Evaluation of bond strength of polyether ether ketone (PEEK) to composite resin on hypobaric and hyperbaric conditions. INT J POLYM MATER PO 2021. [DOI: 10.1080/00914037.2021.1960343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Secil Ozkan Ata
- Department of Prosthodontics, Oral and Dental Health Hospital, Eskisehir, Turkey
| | - Canan Akay
- Department of Prosthodontics, Faculty of Dentistry, Eskişehir Osmangazi University, Eskisehir, Turkey
- Advanced Material Technologies Application and Research Center, Osmangazi University, Eskisehir, Turkey
- Translational Medicine Research and Clinical Center, Osmangazi University, Eskisehir, Turkey
| | - Nazim Ata
- Aeromedical Research and Training Center, Eskisehir, Turkey
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Tian R, Zhu G, Lv Y, Wu T, Ren T, Ma Z, Zhang S. Experimental study and numerical simulation for the interaction between laser and PEEK with different crystallinity. HIGH PERFORM POLYM 2021. [DOI: 10.1177/0954008321996771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Polyetheretherketone (PEEK) sheets with the thickness of 0.5 mm were prepared by compression molding process using Victrex PEEK-450PF, and then PEEK sheets with different crystallinities were obtained by controlling the cooling rate. The optical characteristics of the samples were respectively measured by laser power meter, UV-VIS-IR spectrophotometer. And with the process parameters of laser power density of 245 W/cm2 and moving speed of 5 mm/s, the effect of crystallinity on the laser energy absorption of PEEK and the influence of laser irradiation on the crystallization properties of PEEK sheets were systematically studied. Finally, numerical model of laser energy absorption by PEEK was constructed with COMSOL software. The results show that the reflectivity of PEEK will increase with the increase of crystallinity, while the transmittance decreases. The pure PEEK sheets do not strongly absorb the laser at the wavelength of 1070 nm and the amorphous PEEK is more likely to be ablated. Carbonized samples during the laser irradiation was taken for XRD test and found to be amorphous. After laser irradiation, the crystallinity of the semi-crystalline PEEK material will decrease, but the originally amorphous peek crystallinity will increase slightly. Besides, the numerical simulation results are in good agreement with the experimental results.
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Affiliation(s)
- Renjie Tian
- School of Chemistry and Chemical Engineering, Northwestern Polytechnical University, Xi’an, China
| | - Guangming Zhu
- School of Chemistry and Chemical Engineering, Northwestern Polytechnical University, Xi’an, China
| | - Yuwei Lv
- State Key Laboratory of Laser Interaction with Matter, Northwest Institute of Nuclear Technology, Xi’an, China
| | - Taotao Wu
- State Key Laboratory of Laser Interaction with Matter, Northwest Institute of Nuclear Technology, Xi’an, China
| | - Tianning Ren
- School of Chemistry and Chemical Engineering, Northwestern Polytechnical University, Xi’an, China
| | - Zhiliang Ma
- State Key Laboratory of Laser Interaction with Matter, Northwest Institute of Nuclear Technology, Xi’an, China
| | - Shuang Zhang
- State Key Laboratory of Laser Interaction with Matter, Northwest Institute of Nuclear Technology, Xi’an, China
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Surface roughness of high-performance polymers used for fixed implant-supported prostheses. J Prosthet Dent 2021; 126:254.e1-254.e6. [PMID: 33583619 DOI: 10.1016/j.prosdent.2020.11.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM High-performance polymers have been recommended by their manufacturers as a framework material for implant-supported fixed prostheses. However, little is known about the surface roughness of high-performance polymers in different compositions and whether they require layering with a composite resin or acrylic resin on the tissue surface. PURPOSE The purpose of this in vitro study was to evaluate the surface roughness of different computer-aided design and computer-aided manufacture (CAD-CAM) high-performance polymers and the effect of polishing on their surface roughness. MATERIAL AND METHODS Seventy high-performance polymer specimens (n=10) for 4 different polyetheretherketone (PEEK) brands (BRE, CP, ZZ, J), 1 polyetherketoneketone (PEKK) (PK), and 2 different fiber-reinforced composite resin (FRC) materials (T, TR) were milled from 7×8×30-mm CAD-CAM blocks. The surface roughness (Ra) of each specimen was measured on the same surfaces after milling (baseline) and after polishing by using a contact profilometer. Two-way repeated measures ANOVA (MIXED procedure) and the Bonferroni corrected t test (α=.05) were used to analyze the surface roughness data. RESULTS No significant differences were found among high-performance polymers when the baseline surface roughness measurements of the materials were compared (P>.05). All materials (BRE, PK, CP, T, TR, ZZ), except for a PEEK material (J) (P<.05), had no significant differences in their surface roughness before and after polishing. After polishing, the surface roughness of the J PEEK material was higher than that of CP, PK, T, and ZZ (P<.05). CONCLUSIONS The surface roughness of high-performance polymers in different compositions after milling was similar. Polishing increased the surface roughness of only one PEEK (J) material. All surface roughness values were above the clinical acceptability threshold of 0.2 μm.
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Dede DÖ, Küçükekenci AS, Kahveci Ç. Influence of chairside surface treatments on the shear bond strength of PEKK polymer to veneering resin materials: An in vitro study. J Prosthet Dent 2021; 125:703.e1-703.e7. [PMID: 33551138 DOI: 10.1016/j.prosdent.2020.10.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022]
Abstract
STATEMENT OF PROBLEM High-performance thermoplastics have been adopted as an alternative restorative material to metal or ceramics. However, a straightforward surface modification process to provide a durable bond strength between the polymer and the veneering material is lacking. PURPOSE The purpose of this in vitro study was to evaluate the shear bond strength (SBS) of different veneering resin materials to polyetherketoneketone (PEKK) after different surface treatments. MATERIAL AND METHODS Rectangular (7×7×2 mm) PEKK specimens (N=120) were randomly allocated to the following 6 groups (n=20): untreated (Cnt); nonthermal plasma (NTP) treated; tribochemical silica airborne-particle abrasion with 30-μm silica-modified Al2O3 (Tbc); abraded with a coarse-grit diamond rotary instrument (Ab); tribochemical silica airborne-particle abrasion + plasma treated (Tbc_NTP); abraded + plasma treated (Ab_NTP). After a bonding agent (PEKK Bond) was applied to the specimens, each group was divided into 2 subgroups according to the applied veneering resin materials: polymethylmethacrylate (PMMA) and nanohybrid composite resin (NHC, n=10). The specimens were stored in water for 24 hours at 37 °C and subjected to the SBS test by using a universal testing machine, and failure modes were evaluated using a stereomicroscope. Two-way analysis of variance (ANOVA) was performed followed by the Tukey honestly significant difference (HSD) test to statistically analyze the data (α=.05). RESULTS The 2-way ANOVA showed that surface treatment methods, veneering material, and their interactions were significantly different on the SBS values (P<.001). The highest SBS values were determined for the Tbc and Tbc_NTP treatment groups not only for PMMA (10.71 to 11.63 MPa) but also for NHC (19.80 to 20.60 MPa) veneering resin materials (P<.05). CONCLUSIONS The bonding capacity of PEKK to the PMMA and NHC veneering resin materials can be significantly improved by using tribochemical silica airborne-particle abrasion alone or with nonthermal plasma surface treatment techniques. Furthermore, using NHC veneering resin material is recommended over PMMA.
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Affiliation(s)
- Doğu Ömür Dede
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey.
| | - Ahmet Serkan Küçükekenci
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - Çiğdem Kahveci
- Research Assistant, Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
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Kürkçüoğlu I, Küçükeşmen HC, Ozkir SE, Yilmaz B. Effect of surface treatment on roughness and bond strength of
CAD‐CAM
multidirectional glass fiber‐reinforced composite resin used for implant‐supported prostheses. POLYM INT 2021. [DOI: 10.1002/pi.6173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Işın Kürkçüoğlu
- Faculty of Dentistry, Department of Prosthodontics Suleyman Demirel University Isparta Turkey
| | - Hakkı Cenker Küçükeşmen
- Faculty of Dentistry, Department of Prosthodontics Suleyman Demirel University Isparta Turkey
| | - Serhat Emre Ozkir
- Faculty of Dentistry, Department of Prosthodontics Osmangazi University Eskişehir Turkey
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Bern Bern Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine University of Bern Bern Switzerland
- Division of Restorative and Prosthetic Dentistry The Ohio State University Columbus OH USA
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Attia MA, Shokry TE, Abdel-Aziz M. Effect of different surface treatments on the bond strength of milled polyetheretherketone posts. J Prosthet Dent 2021; 127:866-874. [PMID: 33495042 DOI: 10.1016/j.prosdent.2020.08.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 12/01/2022]
Abstract
STATEMENT OF PROBLEM Polyetheretherketone (PEEK) can be used as a framework material for removable and fixed dental prostheses. However, information about the use of PEEK as a post-and-core restoration is scarce. PURPOSE The purpose of this in vitro study was to evaluate the effect of different surface treatments on the push-out bond strength of milled polyetheretherketone posts to resin cement. MATERIAL AND METHODS Sixty intact human maxillary central incisors were selected and endodontically treated, and standardized post spaces were prepared. Sixty PEEK posts were milled from a prefabricated PEEK blank by using a computer-aided design and computer-aided manufacturing (CAD-CAM) system and divided into 3 groups (n=15) according to the surface treatment: acid etching by using 98% sulfuric acid (AE); airborne-particle abrasion by using 50-μm Al2O3 (AA); nonthermal plasma treatment (NTP); in addition, PEEK posts (n=15) received no treatment (NT) and served as a control. All posts were bonded by using a self-adhesive resin cement. Three sections (coronal, middle, and apical) were obtained for each specimen. Push-out bond strength measurements (MPa) for each section were recorded by using a universal testing machine at a crosshead speed of 0.5 mm/min until failure occurred. The post-cement interfaces and failure modes were evaluated by using scanning electron microscopy. The data obtained were statistically analyzed by using 1-way ANOVA and the pair-wise Tukey (HSD) test to study the difference between group mean values (α=.05). RESULTS The overall mean ±standard deviation of the push-out bond strength was 11 ±2 MPa for AE group, 6 ±1 MPa for AA group, 5 ±1 MPa for NTP group, and 3 ±1 MPa for NT group. A statistically significant difference was found among all groups subjected to different surface treatments as indicated by the ANOVA test (P<.001). The pair-wise Tukey honestly significant difference (HSD) test showed a significant difference among the AE group and all groups (P<.001); however, no significant difference was observed between the AA and NTP groups (P>.05). Moreover, a significant difference was observed among all root sections (P<.001). CONCLUSIONS Surface treatment of PEEK posts with 98% sulfuric acid for 60 seconds showed significantly higher bond strength values than those in other groups. The bond strength of PEEK posts to resin cement was significantly higher in the coronal section than that in other sections.
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Affiliation(s)
- Mazen A Attia
- Associate Professor, Department of Fixed Prosthodontics, Faculty of Dentistry, Beni-Suef University, Beni-Suef, Egypt.
| | - Tamer E Shokry
- Professor, Department of Fixed Prosthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Abdel-Aziz
- Associate Professor, Department of Fixed Prosthodontics, Faculty of Dental Surgery, Ahram Canadian University, Cairo, Egypt
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Review on Development and Dental Applications of Polyetheretherketone-Based Biomaterials and Restorations. MATERIALS 2021; 14:ma14020408. [PMID: 33467576 PMCID: PMC7830426 DOI: 10.3390/ma14020408] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 12/15/2022]
Abstract
Polyetheretherketone (PEEK) is an important high-performance thermoplastic. Its excellent strength, stiffness, toughness, fatigue resistance, biocompatibility, chemical stability and radiolucency have made PEEK attractive in dental and orthopedic applications. However, PEEK has an inherently hydrophobic and chemically inert surface, which has restricted its widespread use in clinical applications, especially in bonding with dental resin composites. Cutting edge research on novel methods to improve PEEK applications in dentistry, including oral implant, prosthodontics and orthodontics, is reviewed in this article. In addition, this article also discusses innovative surface modifications of PEEK, which are a focus area of active investigations. Furthermore, this article also discusses the necessary future studies and clinical trials for the use of PEEK in the human oral environment to investigate its feasibility and long-term performance.
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Zidan S, Silikas N, Haider J, Alhotan A, Jahantigh J, Yates J. Assessing Tensile Bond Strength Between Denture Teeth and Nano-Zirconia Impregnated PMMA Denture Base. Int J Nanomedicine 2020; 15:9611-9625. [PMID: 33293810 PMCID: PMC7718964 DOI: 10.2147/ijn.s273541] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/10/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose This study evaluated tensile bond strength (TBS) between anterior acrylic teeth and denture bases made of high-impact heat-cured acrylic resin (HI PMMA) impregnated with zirconia nanoparticles. Materials and Methods A total of 30 specimens (each specimen containing a set of six upper anterior teeth) were fabricated from HI PMMA denture base acrylic resin reinforced with different weight concentrations of zirconia nanoparticles: 0% (control), 1.5%, 3%, 5%, 7% and 10%. TBS was tested according to a British standard (BS EN ISO 22112: 2017). A one-way analysis of variance (ANOVA) was employed with a Tukey post-hoc test. Results TBS values between the anterior teeth (central and lateral incisors and canine) and HI-PMMA denture base groups containing 7 wt.% (261.5 ± 66.0 N, 172.5 ± 57.4 N and 271.9 ± 86.3 N) and 10 wt.% (332.1 ± 122.9 N, 165.4 ± 48.7 N and 301.6 ± 73.2 N) zirconia were significantly lower compared to the control group (645.4 ± 84.8 N, 306.1 ± 81.6 N and 496.7 ± 179.1 N) and the other nanocomposite groups. However, TBS values for HI PMMA with 1.5 wt.% (534.4 ± 115.3 N, 304.7 ± 86.4 N, 514.0 ± 143.2 N), 3 wt.% (685.7 ± 159.6 N, 281.1 ± 78.3 N, 462.6 ± 122.1 N) and 5 wt.% (514.5 ± 134.3 N, 229.8 ± 67.3 N, 387.2 ± 99.4 N) zirconia showed slightly lower values than that of the control group but these were not significant. Failure modes between the teeth and denture base nanocomposites were predominantly cohesive fractures, which were clinically acceptable according to the Standard. Conclusion The addition of zirconia nanoparticles to HI PMMA denture base at high concentration (7 wt.% and 10 wt. %) significantly (p<0.05) reduced the bonding strength for all types of anterior teeth compared to the control group.
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Affiliation(s)
- Saleh Zidan
- Dentistry, School of Medical Sciences, University of Manchester, Manchester M13 9PL, UK.,Department of Dental Materials, Faculty of Dentistry, Sebha University, Sebha, Libya
| | - Nikolaos Silikas
- Dentistry, School of Medical Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Julfikar Haider
- Department of Engineering, Manchester Metropolitan University, Manchester M1 5GD, UK
| | - Abdulaziz Alhotan
- Dentistry, School of Medical Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Javad Jahantigh
- Dentistry, School of Medical Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Julian Yates
- Dentistry, School of Medical Sciences, University of Manchester, Manchester M13 9PL, UK
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Jin HY, Teng MH, Wang ZJ, Li X, Liang JY, Wang WX, Jiang S, Zhao BD. Comparative evaluation of BioHPP and titanium as a framework veneered with composite resin for implant-supported fixed dental prostheses. J Prosthet Dent 2019; 122:383-388. [DOI: 10.1016/j.prosdent.2019.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/01/2019] [Accepted: 03/04/2019] [Indexed: 12/13/2022]
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Tsuka H, Morita K, Kato K, Kimura H, Abekura H, Hirata I, Kato K, Tsuga K. Effect of laser groove treatment on shear bond strength of resin-based luting agent to polyetheretherketone (PEEK). J Prosthodont Res 2018; 63:52-57. [PMID: 30220621 DOI: 10.1016/j.jpor.2018.08.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 08/03/2018] [Accepted: 08/05/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE The mechanical properties of polyetheretherketone (PEEK) are ideally suited for fixed dental prostheses. However, PEEK typically has low adhesion strength to resin-based luting agent. This study assessed the shear bond strength between laser groove treated PEEK and resin-based luting agent. METHODS A total of 230 specimens were randomly divided into five groups (n=46): no-treatment, air abrasion treatment, 100μm-deep, 150μm-deep, and 200μm-deep laser groove treatments. The surface roughness was measured, scanning electron microscopy was used to observe the specimen surfaces, and X-ray photoelectron spectroscopy (XPS) was used to analyze the surfaces. Each group was divided into four resin-based luting agent subgroups: Panavia V5, RelyX Ultimate Resin Cement, G-CEM Link Force, and Super-Bond C&B. After the resin-based luting agent was bonded to the specimens, the bond strength was measured using shear tests and the failure modes were assessed by stereomicroscopy. The surfaces were also observed by scanning electron microscopy (SEM) after the shear bond strength measurements. The data were statistically analyzed using a two-way analysis of variance and Tukey's honest significant difference test (α=0.05). RESULTS The PEEK surface after laser groove treatment groups exhibited the highest mean Ra values. In the XPS analysis, the laser treated PEEK surface exhibited an effective surface composition for bonding with resin-based luting agent. The shear bond strengths for the laser groove treated samples were significantly higher (p<0.05) than those of the no-treatment and air abrasion treatment groups. CONCLUSIONS The shear bond strength between PEEK and resin-based luting agent was substantially improved by laser groove treatment.
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Affiliation(s)
- Hiroki Tsuka
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Koji Morita
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kan Kato
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hitomi Kimura
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hitoshi Abekura
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Isao Hirata
- Department of Biomaterials, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Koichi Kato
- Department of Biomaterials, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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