Introduction: Polyetheretherketone (PEEK) is a polymer that is used in the construction of orthopaedic and dental implants. It is also used to construct removable and fixed dental prostheses due to its superior mechanical and esthetic properties compared to conventional materials. This systematic review aims to analyse and appraise the literature concerning PEEK dental prostheses critically. Methods: The following focused question was constructed ‘Are dental prostheses made of PEEK inferior to those made of other materials in terms of clinical- and patient-reported outcomes?’. The CONSORT (Consolidated Standards of Reporting Trials) tool was used for the quality assessment of the randomised clinical trials. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) quality assessment tool was used to assess the quality of observational studies and the case reports were evaluated using the CARE (Case Report) guidelines. Results: A total of 12 studies were included in this review. Two case studies received an overall grade of medium and the overall quality of six studies was graded as ‘low’. All three observational studies and the only randomised controlled trial received scores of ‘medium’. Conclusion: PEEK-based dental prostheses may provide a viable and more esthetic alternative to conventional prosthodontic appliances. However, within the limitations of this study is the evidence to ascertain the long-term viability of PEEK-based dental prostheses. Future studies should focus on conducting large-scale, multicenter trials to compare the survival rate of PEEK prostheses to that of conventionally available prosthodontic appliances.

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Purpose:The aim was to compare the effect of using different number of implants (two and four implants) on marginal bone loss around implant in implant -bar supported mandibular overdenture.Material and methods: Twelve edentulous patients were randomly divided into two groups. Group I received two implants-bar supported overdenture while group II received 4 Implantsbar supported overdenture. Fixtures were surgically inserted with its top level 0.5mm below the crestal bone level. Each patient was recalled two months after implant insertion for superstructure placement. Crestal bone loss around the implants were measured on CBCT images taken at time of final prosthesis pick-up, 3 months, 6 months and 12 months after overdenture pickup. Repeatedmeasure ANOVA with Tukey post hoc test was used to compare between the two groups at the different time points.Results: There was a significant main effect of time on bone resorption (p<0.001). however, there was no significant main effect of group on bone resorption (p= 0.132). There was no significant interaction between time and group. Multiple comparisons showed a significant difference between the baseline and 12 month time point in each group (p=0.006 and p=0.041, respectively). Also, there was a significant difference in bone resorption between the two groups at 12 month time point (p=0.044). Conclusion:Four implants-bar supported overdenture provided better preservation of marginal bone than two implants-bar supported overdenture. Therefore, its recommended for clinicians to consider the design of four implants-bar supported overdenture specially when the bone of jaw is compromised.

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Aim:The purpose of this study was to evaluate clinical and radiographical outcomes of computer guided flapless versus Free hand flap surgery for implants used to anchor All-on-4 fixed prosthesis in atrophied mandible. Materials and methods:Twelve completely edentulous patients with atrophied mandibular ridges were randomly assigned into two groups Group1 (Free hand flap surgery, control): received 4 implants using the All on four protocol and free hand flap surgery and metal guide. Group2 (computer guided flapless surgery, study): received 4 implants using computer guided flapless surgery and stereolithographic surgical guide. Implants were immediately loaded by acrylic prosthesis then full arch ceramometal fixed prosthesis was used as a final restoration. Plaque Index, Gingival Index, pocket depth, stability of the implants, and crestal bone loss were evaluated at baseline, 3, 6, and 12 months after loading. Results:The survival rate of the implants after one year was 95.8% and 91.7% for group 1 and group 2. For both groups, implant stability significantly decreased from insertion to 3 months, and increased again at six months. For both techniques, crestal bone loss significantly increased with time. For all time intervals, flap group showed significant higher plaque index, gingival index, probing depth and crestal bone resorption than flapless group. Conclusion:Within the limits of this short-term randomized trial regarding the small sample size, computer guided flapless approach may be recommended for all on four implant rehabilitation of edentulous mandibles than conventional flap surgical approach as it was associated with favorable clinical and radiographical peri-implant parameters.

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