Structure, properties, and bioactivity of 3D printed PAEKs for implant applications: A systematic review

Abstract

Additive manufacturing (AM) of high temperature polymers, specifically polyaryletherketones (PAEK), is gaining significant attention for medical implant applications. As 3D printing systems evolve toward point of care manufacturing, research on this topic continues to expand. Specific regulatory guidance is being developed for the safe management of 3D printing systems in a hospital environment. PAEK implants can benefit from many advantages of AM such as design freedom, material and antibacterial drug incorporation, and enhanced bioactivity provided by cancellous bone‐like porous designs. In addition to AM PAEK bioactivity, the biomechanical strength of 3D printed implants is crucial to their performance and thus widely studied. In this review, we discuss the printing conditions that have been investigated so far for additively manufactured PAEK implant applications. The effect of processing parameters on the biomechanical strength of implants is summarized, and the bioactivity of PAEKs, along with material and drug incorporation, is also covered in detail. Finally, the therapeutic areas in which 3D printed PAEK implants are investigated and utilized are reviewed.

A Multi-Criteria Assessment Strategy for 3D Printed Porous Polyetheretherketone (PEEK) Patient-Specific Implants for Orbital Wall Reconstruction

“…The assessment factor helped differentiate between configurations and resulted in a composite assessment based on performance score. Furthermore, it was noticed that regardless of the implant thicknesses, the thermoformed PEEK mesh implants maintain the patient-specific shape, and recontouring can only be achieved when reheated up to 300 • C. As PEEK is a high-temperature thermoplastic biomaterial with good mechanical strength, rigidity, stiffness, and dimensional stability properties [19,27,29,33], the insertion process during surgery must prevent deformation of the mesh contour. During the insertion process, the PEEK mesh implants may require rotation to be adequately positioned for a stable recontouring of the orbital walls.…”

“…Over the last years, Polyetheretherketone (PEEK), a high-performance polymer, has gained significant popularity in reconstructive surgeries [24][25][26][27]. PEEK possesses a bonelike modulus of elasticity, excellent biocompatibility, high yield strength, and fatigue resistance, making it an appealing biomaterial for personalized implants in craniomaxillofacial surgery [28][29][30]. The adoption of PEEK for PSIs production was influenced by its favorable properties, including radiolucent characteristics with no artifact in medical imaging, stiffness, lightweight, and conventional computer-aided design/computer-aided manufacturing (CAD/CAM) procedures, specifically milling [25,30].…”

“…Material extrusion-based or fused filament fabrication (FFF) 3D printing technology has previously been confined to low-temperature thermoplastics; however, the latest advances have enabled printing of high-temperature, implantable-grade thermoplastic polymers such as PEEK, paving the way for a more sophisticated generation of biomaterials. Implementing FFF at the POC offers numerous advantages such as less material wastage, easy operator training, faster implant production, increased cost-effectiveness, and patient specificity [25,26,29,43].…”

A Multi-Criteria Assessment Strategy for 3d Printed Porous Polyetheretherketone (Peek) Patient-Specific Implants for Orbital Wall Reconstruction

“…Over the last years, Polyetheretherketone (PEEK), a high-performance polymer, has gained significant popularity in reconstructive surgeries [15][16][17][18]. PEEK possesses a bonelike modulus of elasticity, excellent biocompatibility, high yield strength, and fatigue resistance, making it an appealing biomaterial for personalized implants in craniomaxillofacial surgery [19][20][21]. However, hydrophobicity and bioinertness of PEEK can limit its bioactivity and have been a cause for clinical concern [22,23].…”

“…Material extrusion-based or fused filament fabrication (FFF) 3D printing technology has previously been confined to low-temperature thermoplastics; however, the latest advances have enabled printing of high-temperature, implantable-grade thermoplastic polymers such as PEEK, paving the way for a more sophisticated generation of biomaterials. Implementing FFF at the POC offers numerous advantages such as less material wastage, easy operator training, faster implant production, increased cost-effectiveness, and patient specificity [16,17,20,32].…”