Biofilm Formation on the Surface of (Poly)Ether-Ether-Ketone and In Vitro Antimicrobial Efficacy of Photodynamic Therapy on Peri-Implant Mucositis

Abstract

Poly-ether-ether-ketone (PEEK) is an aesthetically pleasing natural material with good biocompatibility and shock absorption characteristics. The application of PEEK as a dental implant or abutment is expected to reduce the risk of failure and enhance aesthetics. Given that approximately one in 15 patients have allergic reactions to antibiotics, photodynamic therapy (PDT) has been gaining attention as an alternative treatment. Herein, the applicability of PEEK dental implants or abutments was investigated using material analyses, biofilm formation assay, and cell viability tests. The possible use of PDT for peri-implant mucositis was evaluated with the biofilm removal assay. The obtained data were analyzed based on the multivariate analysis of variance, paired t-tests, and the Pearson correlation coefficient (α = 0.05). The results revealed that PEEK was significantly less conducive to the formation of biofilms with S. mutans and A. actinomycetemcomitan (p < 0.001) but exhibited comparable MG-63 (human osteoblast-like) osteoblast cell viability (p > 0.05) to the other materials. PDT had similar antimicrobial efficacy and yielded similar biofilm removal effects to antibiotics. Altogether, these findings suggest that PEEK has attractive features and can serve as an alternative material for dental implants or abutments. In cases where peri-implant mucositis occurs, PDT can be used as an accessible therapeutic approach.

Effect of Various Retentive Element Materials on Retention of Mandibular Implant-Retained Overdentures

“…Katzer discovered that PEEK fiber material is biocompatible and not cytotoxic to cells after incubating it with strains of Salmonella bacterium [36]. Moreover, Peng investigated biofilm growth on the surface of PEEK and discovered that it is less conducive to biofilm formation [37].…”

Evaluating the Effect of Different Polymer and Composite Abutments on the Color Accuracy of Multilayer Pre-Colored Zirconia Polycrystal Dental Prosthesis

“…Many studies have pointed out the potential of PAEK materials in dental applications, as their mechanical properties are close to those of human hard tissue and bone making them a good substrate for dental restorations and teeth [14,17]. Peng et al [43] evaluated the antibacterial effect of PAEK materials by testing their ability to form a biofilm. The results showed that PAEK did not easily generate biofilms.…”

In Vitro Assessment of the Cell Metabolic Activity, Cytotoxicity, Cell Attachment, and Inflammatory Reaction of Human Oral Fibroblasts on Polyetheretherketone (PEEK) Implant–Abutment

“…Bone remodeling around dental implants is regulated according to the load applied on the implant fixture. Previous experiments that discussed the cytotoxicity of PEEK for MG-63 concluded that the cell metabolic activity of MG-63 on PEEK was similar to Ti-6Al-4V and Y-TZP [ 26 ]. Titanium dental implants are currently viewed as the gold standard in dental implantology.…”

“…Polizzi et al [ 43 ] indicated that chlorhexidine allows good control of the clinical indices. Peng et al [ 26 ] confirmed that the risk of bacterial biofilm of PEEK was less than that of Ti-6Al-4V, and that biofilm removal efficiency through treatment with photodynamic therapy on formed S. mutans and A. actinomycetemcomitans biofilms was more effective than with Ti-6Al-4V and Y-TZP [ 23 ]. PEEK had less reaction to bacteria and comparable biofilm removal ability via a non-antibiotic drug [ 26 , 43 ]; thus, replacing Ti-6Al-4V and Y-TZP with PEEK and PEKK might help alleviate inflammation.…”

“…Based on the various merits discussed above, as well as its comfortability and stability in the oral cavity, PEEK is an alternative dental material for implant–abutments that is worthy of discussion [ 1 , 4 , 13 ]. In a previous study, the authors discussed the biofilm formation characteristics of PEEK and some oral bacteria, confirming that PEEK is not prone to biofilm formation [ 26 ]; nevertheless, the biological response of oral cells and fibroblasts to PEEK remains to be verified. The present experiment discusses the possibility of applying PEEK materials in dental implantology.…”