Tensile properties, tension–tension fatigue and biological response of polyetheretherketone–hydroxyapatite composites for load-bearing orthopedic implants

Bakar, M.S. Abu; Cheng, Ming Huei; Tang, Songchao; Yu, Shucong; Liao, Kin; Tan, Chao; Khor, K.A.; Cheang, P.

doi:10.1016/s0142-9612(03)00028-0

Cited by 354 publications

(230 citation statements)

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“…Lack of bone-implant contact can induce micromotion and inflammation that leads to fibrous layer thickening, osteolysis, and implant loosening [2,13,29,37,48]. Previous studies [1,4,15,16,18,36] have shown that surface modifications such as plasma treatments, coatings, and composites can improve PEEK implant integration, yet many suffer practical limitations such as delamination, instability, and mechanical property tradeoffs.…”

Section: Introductionmentioning

confidence: 99%

Do Surface Porosity and Pore Size Influence Mechanical Properties and Cellular Response to PEEK?

Torstrick

Evans

Stevens

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Despite its widespread use in orthopaedic implants such as soft tissue fasteners and spinal intervertebral implants, polyetheretherketone (PEEK) often suffers from poor osseointegration. Introducing porosity can overcome this limitation by encouraging bone ingrowth; however, the corresponding decrease in implant strength can potentially reduce the implant's ability to bear physiologic loads. We have previously shown, using a single pore size, that limiting porosity to the surface of PEEK implants preserves strength while supporting in vivo osseointegration. However, additional work is needed to investigate the effect of pore size on both the mechanical properties and cellular response to PEEK. Questions/purposes (1) Can surface porous PEEK (PEEK-SP) microstructure be reliably controlled? (2) What is the effect of pore size on the mechanical properties of PEEK-SP? (3) Do surface porosity and pore size influence the cellular response to PEEK? Methods PEEK-SP was created by extruding PEEK through NaCl crystals of three controlled ranges: 200 to 312, 312 to 425, and 425 to 508 lm. Micro-CT was used to characterize the microstructure of PEEK-SP. Tensile, fatigue, and interfacial shear tests were performed to compare the mechanical properties of PEEK-SP with injectionmolded PEEK (PEEK-IM). The cellular response to PEEK-SP, assessed by proliferation, alkaline phosphatase activity, vascular endothelial growth factor production, and calcium content of osteoblast, mesenchymal stem cell, and preosteoblast (MC3T3-E1) cultures, was compared with that of machined smooth PEEK and Ti6Al4V. Results Micro-CT analysis showed that PEEK-SP layers possessed pores that were 284 ± 35 lm, 341 ± 49 lm, and 416 ± 54 lm for each pore size group. Porosity and

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Section: Introductionmentioning

confidence: 99%

Do Surface Porosity and Pore Size Influence Mechanical Properties and Cellular Response to PEEK?

Torstrick

Evans

Stevens

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…13,15 In order to achieve a higher rigidity of the material for dental application, pure PEEK material has been further optimized by blending, filling, and fiber reinforcement. [16][17][18][19] Optimal mechanical properties of the PEEK composite resins were achieved at optimum levels when containing about 7 wt% nano-SiO 2 . Reduced wear rates were obtained with a ZrO 2 content of 7.5 wt%.…”

Section: Clinical Implications Introductionmentioning

confidence: 99%

PEEK surface treatment effects on tensile bond strength to veneering resins

Stawarczyk

Jordan

Schmidlin

et al. 2014

The Journal of Prosthetic Dentistry

156

176

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STATEMENT OF PROBLEM Polyetheretherketone (PEEK) can be used as a framework material for fixed dental prostheses. However, information about the durable bond to veneering resins is still scarce. PURPOSE The purpose of this study was to investigate the effect of chemical treatments of PEEK on tensile bond strength (TBS) to veneering resins with special emphasis on surface free energy (SFE) and surface roughness (SR). MATERIAL AND METHODS Seven-hundred fifty PEEK specimens were fabricated and divided into the following 3 pretreatment groups (n=250/group): etching with sulfuric acid for 60 seconds, etching with piranha acid for 30 seconds, and an unetched control. After pretreatment, SFE was determined by using contact angle measurements and SR with a profilometer (n=10/group). The topography of pretreated PEEK surfaces was examined with scanning electron microscopy. Remaining specimens (n=240 per group) were conditioned with visio.link or Signum PEEK Bond, or were left untreated as the control group. Half of each group was veneered with Sinfony or VITA VM LC (n=40/group), and TBS was measured after storage in distilled water at 37°C for either 24 hours or 60 days. Data were analyzed by 4-way and 1-way ANOVA followed by the Scheffé post hoc test and chi-square test (=.05). RESULTS PEEK specimens etched with sulfuric acid resulted in higher SFE and SR than specimens without pretreatment or etching with piranha acid. Etching with sulfuric acid or piranha acid led to no general recommendations with respect to TBS. Conditioning with visio.link or Signum PEEK Bond significantly increased the TBS (P<.001). PEEK veneered with Sinfony showed significantly higher TBS values than those veneered with VITA VM LC (P<.001). CONCLUSIONS Sufficient TBS for bonding to veneering resin can only be achieved when additional adhesive materials were applied. ABSTRACTStatement of the problem. Polyetheretherketone (PEEK) can be used to support fixed dental prostheses (FDPs). However, information about the durable bond to veneering resins is still scarce.Purpose. The purpose of this study was to investigate the effect of chemical treatments of PEEK on tensile bond strength (TBS) to veneering resins with special emphasis on surface free energy (SFE) and surface roughness (SR). Materials and methods.Seven-hundred-fifty PEEK specimens were fabricated and divided into the following 3 pretreatment groups (n=250/group): etching with sulfuric acid for 60 seconds, piranha acid for 30 seconds, and an unetched control. After pretreatment, SFE was determined by using contact angle measurements and SR with a profilometer (n=10/group).

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“…According to reported tissue reactions around PEEK implants, it is believed that this reactions can be avoided by coating PEEK with materials known for their favorable response in bone tissue, such as calcium phosphates. The new bone formation could be observed adjacent to the bone-implant interface in close apposition in vivo [5]. Calcium phosphate compounds have long been the subject of intensive investigation as bone substitutes and several materials consisting of hydroxyapatite, a-tricalcium phosphate (aTCP), or b-tricalcium phosphate (bTCP) have been clinically applied in various forms [6].…”

Section: Introductionmentioning

confidence: 99%

Effect of βTCP filled polyetheretherketone on osteoblast cell proliferation in vitro

Petrovic

Pohle²,

Münstedt³

et al. 2005

J Biomed Sci

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SummaryNon-resorbable thermoplastic polymers have become more important for reconstructive surgery due to their excellent chemical and physical properties. Polyetheretherketone-b-tricalcium phosphate (bTCP-PEEK) composites were developed as alternative materials for load-bearing applications. This study presents the effect of polyetheretherketone (PEEK) specimens incorporated with 5, 10, 20 and 40 wt% b-tricalcium phosphate (bTCP) and processed by injection molding on cultivated osteoblast cells. Normal human osteoblast (NHOst) cells were seeded onto polymer discs to evaluate cell viability and proliferation after 24, 72 and 120 h of cultivation by employing the WST-1 assay. Standard tissue culture plastic was used as a control. The osteoblast cells were found to be viable in all PEEK groups, while the cell proliferation was progressively inhibited due to the incorporated b-tricalcium phosphate. bTCP-PEEK showed concentration independent decrease of cell proliferation compared to the unfilled PEEK and the control group. In summary, this study confirms the non-toxic nature of pure PEEK, whereas this could not definitely be verified for bTCP-PEEK as a composite material in chosen concentrations of b-tricalcium phosphate in vitro.

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Tensile properties, tension–tension fatigue and biological response of polyetheretherketone–hydroxyapatite composites for load-bearing orthopedic implants

Cited by 354 publications

References 20 publications

Do Surface Porosity and Pore Size Influence Mechanical Properties and Cellular Response to PEEK?

Do Surface Porosity and Pore Size Influence Mechanical Properties and Cellular Response to PEEK?

PEEK surface treatment effects on tensile bond strength to veneering resins

Effect of βTCP filled polyetheretherketone on osteoblast cell proliferation in vitro

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