Soft tissue response to dental implant closure caps made of either polyetheretherketone (PEEK) or titanium

Abstract

Objective Polyetheretherketone (PEEK) is a popular synthetic thermoplastic polymer for medical applications, but its clinical use suffers from several limitations. Therefore, the aim was to compare the soft tissue response to dental implant closure caps made of PEEK or titanium as evaluated by the occurrence of multinucleated giant cells (MNGCs). Material and methods Forty‐two implants were placed in the maxilla of seven miniature pigs. While commercially pure titanium (Ti) implants had a Ti closure cap, ceramic implants made of either zirconia (Zr) or alumina‐toughened zirconia (Zr + Al) received a PEEK closure cap. Histomorphometry was performed to evaluate the number of small and large MNGCs being in contact with the PEEK or the Ti in different compartments of the implant systems. Results No histological signs of inflammation were noticed, and MNGCs were observed on both PEEK and Ti closure caps and on all three implant types. Significantly higher numbers of MNGCs were found on closure caps made of PEEK than on closure caps made of Ti on the external closure cap surface facing both soft (p = 0.0008 for PEEK on Zr and p = 0.0016 for PEEK on Zr + Al) and hard tissues (p = 0.016 for PEEK on Zr and p = 0.003 for PEEK on Zr + Al) as well as in the internal closure cap surface (p = 0.014 for PEEK on Zr and p = 0.0088 for PEEK on Zr + Al). No statistically significant differences in the number of MNGCs were observed on the three implant types. Conclusions Significantly more MNGCs were in contact with PEEK than with Ti closure caps.

Polyetheretherketone versus titanium CAD-CAM framework for implant-supported fixed complete dentures: a retrospective study with up to 5-year follow-up

“…Hahnel et al [44] reported that the oral microflora attached to the PEEK surface was lower than that to zirconia, titanium, and PMMA. Other studies found that the adhesive plaques attached to PEEK healing abutments were reduced compared with titanium abutments, although a similar percentage of adhesive plaques was attached on the two surfaces in vitro studies [45,46]. These findings suggest that high-grade polishing is a key factor in reducing plaque formation.…”

Comparative In Vivo Analysis of the Integration Behavior and Immune Response of Collagen-Based Dental Barrier Membranes for Guided Bone Regeneration (GBR)

“…Various collagen-based membranes are available for GBR procedures in the fields of oral, and maxillofacial surgery [ 34 ]. Although resorbable collagen-based membranes are favored due to the avoidance of a second surgery, some clinical applications require space maintenance of the barrier membrane with stronger tensile strength or a prolonged biodegradation time [ 35 , 36 , 37 ]. The prolonged barrier functionality is usually achieved by the application of non-resorbable synthetic materials based on titanium or PTFE [ 38 , 39 ].…”

Soft tissue response to different abutment materials: A controlled and randomized human study using an experimental model

“…However, the extraction of suitable, standardized samples for histological analysis is technically challenging and might interfere with the overall implant success. As a result, the majority of controlled studies on soft tissue response to different abutment materials has been performed in a preclinical context (e.g., Caballé‐Serrano et al, 2019; Rea et al, 2017; Welander et al, 2008) or only include clinical parameters, which on their own are limitedly suited as surrogate markers for implant success (van Brakel et al, 2014; Coli & Sennerby, 2019)—particularly at early time points.…”