Clinical application of 3D-printed PEEK implants for repairing mandibular defects

Liu, Yunpeng; Li, Zhiye; Liu, Tian; Li, Dichen; Lü, Bin; Shi, Changquan; Niu, Qiang; Liu, Fuwei; Kong, Liang; Zhang, Junrui

doi:10.1016/j.jcms.2022.06.002

Cited by 19 publications

(15 citation statements)

References 30 publications

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“…In this case, the defect site is indirect stress-bearing, which would not cause excessive stress to PEEK. If used for stress-bearing mandibular reconstruction, 23 it is necessary to select patients with relatively low masticatory loads and perform rigorous mechanical analysis. Second, compared with titanium, most bacteria, such as Staphylococcus aureus and Streptococcus mutants , showed higher activity and adherence on the PEEK surface and were more likely to form biofilms 24,25 .…”

Section: Discussionmentioning

confidence: 99%

Customed 3D-printed Polyetheretherketone (PEEK) Implant for Secondary Salvage Reconstruction of Mandibular Defects: Case Report and Literature Review

Long

Zhang

Kang

et al. 2023

Journal of Craniofacial Surgery

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Given the insufficient height of single-barrel fibula and inadequate bone volume of double-barrel vascularized fibula in mandibular reconstruction, it is a better choice to combine the upper full-thickness vascularized fibula with the lower half-thickness nonvascularized fibula. However, the nonvascularized fibula may fail due to complications, affecting the facial shape and occlusal function. Polyetheretherketone is a thermoplastic polymer used for bone defect reconstruction due to its good mechanical properties and biocompatibility. This case report mainly presents a secondary salvage reconstruction of the mandible by using customed 3-dimensional-printing polyetheretherketone, which restored the continuity and symmetry of the mandible, improved the patient’s facial shape, and restored functional occlusion through dental implants. After a 28-month follow-up, no complications occurred, and the patient was satisfied with the final restoration.

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Section: Discussionmentioning

confidence: 99%

Customed 3D-printed Polyetheretherketone (PEEK) Implant for Secondary Salvage Reconstruction of Mandibular Defects: Case Report and Literature Review

Long

Zhang

Kang

et al. 2023

Journal of Craniofacial Surgery

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“…After implantation, the surface of the implant has difficulty adhering to cells, resulting in poor bone integration and weak antibacterial performance. These factors significantly impede its clinical application to a large extent . The development of surface engineering provides the possibility of the further development of PEEK as a bioactive implant.…”

Section: Introductionmentioning

confidence: 99%

Multifaceted Materials for Enhanced Osteogenesis and Antimicrobial Properties on Bioplastic Polyetheretherketone Surfaces: A Review

Bai,

Zhao,

Cui

et al. 2024

ACS Omega

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Implant-associated infections and the increasing number of bone implants loosening and falling off after implantation have become urgent global challenges, hence the need for intelligent alternative solutions to combat implant loosening and falling off. The application of polyetheretherketone (PEEK) in biomedical and medical therapy has aroused great interest, especially because its elastic modulus close to bone provides an effective alternative to titanium implants, thereby preventing the possibility of bone implants loosening and falling off due to the mismatch of elastic modulus. In this Review, we provide a comprehensive overview of recent advances in surface modifications to prevent bone binding deficiency and bacterial infection after implantation of bone implants, starting with inorganics for surface modification, followed by organics that can effectively promote bone integration and antimicrobial action. In addition, surface modifications derived from cells and related products of biological activity have been proposed, and there is increasing evidence of clinical potential. Finally, the advantages and future challenges of surface strategies against medical associated poor osseointegration and infection are discussed, with promising prospects for developing novel osseointegration and antimicrobial PEEK materials.

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“…With a tensile strength of 80 MPa and an elastic modulus of nearly 3–4 GPa, the mechanical properties of PEEK are closer to that of the human cortical bone, which has a tensile strength of 104–121 MPa and an elastic modulus of roughly 14 GPa [ 15 ]. PEEK has been used as medical implants in the reconstruction of cranial, mandibular, orthopedic and dental surgeries [ 16 , 17 , 18 , 19 ]. Subtractive manufacturing methods such as computer numerical control (CNC) and injection molding were used to manufacture the PEEK material, but it had many challenges such as material hardening with slightly lower temperatures and a significant amount of wastage [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Design, Analysis, and 3D Printing of a Patient-Specific Polyetheretherketone Implant for the Reconstruction of Zygomatic Deformities

et al. 2023

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The reconstruction of craniomaxillofacial deformities, especially zygomatic bone repair, can be exigent due to the complex anatomical structure and the sensitivity of the crucial organs involved. The need to reconstruct the zygomatic bone in the most precise way is of crucial importance for enhancing the patient outcomes and health care-related quality of life (HRQL). Autogenous bone grafts, despite being the gold standard, do not match bone forms, have limited donor sites and bone volume, and can induce substantial surgical site morbidity, which may lead to adverse outcomes. The goal of this study is to provide an integrated approach that includes various processes, from patient scanning to implant manufacture, for the restoration of zygomatic bone abnormalities utilizing Polyetheretherketone (PEEK) material, while retaining adequate aesthetic and facial symmetry. This study takes an integrated approach, including computer-aided implant design using the mirror reconstruction technique, investigating the biomechanical behavior of the implant under loading conditions, and carrying out a fitting accuracy analysis of the PEEK implant fabricated using state-of-the-art additive manufacturing technology. The findings of the biomechanical analysis results reveal the largest stress of approximately 0.89 MPa, which is relatively low in contrast to the material’s yield strength and tensile strength. A high degree of sturdiness in the implant design is provided by the maximum value of strain and deformation, which is also relatively low at roughly 2.2 × 10−4 and 14 µm. This emphasizes the implant’s capability for load resistance and safety under heavy loading. The 3D-printed PEEK implant observed a maximum deviation of 0.4810 mm in the outside direction, suggesting that the aesthetic result or the fitting precision is adequate. The 3D-printed PEEK implant has the potential to supplant the zygoma bone in cases of severe zygomatic reconstructive deformities, while improving the fit, stability, and strength of the implant.

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Clinical application of 3D-printed PEEK implants for repairing mandibular defects

Cited by 19 publications

References 30 publications

Customed 3D-printed Polyetheretherketone (PEEK) Implant for Secondary Salvage Reconstruction of Mandibular Defects: Case Report and Literature Review

Customed 3D-printed Polyetheretherketone (PEEK) Implant for Secondary Salvage Reconstruction of Mandibular Defects: Case Report and Literature Review

Multifaceted Materials for Enhanced Osteogenesis and Antimicrobial Properties on Bioplastic Polyetheretherketone Surfaces: A Review

Design, Analysis, and 3D Printing of a Patient-Specific Polyetheretherketone Implant for the Reconstruction of Zygomatic Deformities

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