Titanium, zirconia, and polyetheretherketone (PEEK) as a dental implant material

Khurshid, Zohaib; Hafeji, Saudah; Tekin, Samet; Habib, Syed Rashid; Ullah, Rizwan; Sefat, Farshid; Zafar, Muhammad Sohail

doi:10.1016/b978-0-12-819586-4.00002-0

Cited by 14 publications

(10 citation statements)

References 111 publications

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“…Titanium (Ti) is the golden standard material for fabricating dental implants due to its superior biocompatibility, mechanical properties, and promising long-term survival rates ( Cao et al, 2019 ; Haugen & Chen, 2022 ; Najeeb et al, 2016 ; Rokaya et al, 2022 ; Sivaraman et al, 2018 ). However, the mechanical and elastic modulus differences between bone and titanium can cause bone loss and “stress shielding” ( Khurshid et al, 2020 ). Moreover, Ti implants’ grayish appearance may result in peri-implant mucosa discoloration, particularly in patients with thin gingival phenotypes ( Wang et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

“…A previous study reported that the early fracture of Zr implants, caused by poor mechanical properties, may limit its clinical application ( Sivaraman et al, 2018 ). Recently, the flaws in the mechanical properties and insufficient strength in Zr were addressed by adding stabilizers such as yttrium oxide, cerium oxide, and magnesium oxide ( Burkhardt et al, 2021 ; Khurshid et al, 2020 ; Pardun et al, 2015 ; Shan et al, 2022 ). Although Zr implants demonstrated some stability and resistance to fracture, it remained controversial whether they could be widely used in the clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Clinical performance of zirconium implants compared to titanium implants: a systematic review and meta-analysis of randomized controlled trials

Duan

Zhang

et al. 2023

PeerJ

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Purpose To quantitatively assess and compare the clinical outcomes, including survival rate, success rate, and peri-implant indices of titanium and zirconium implants in randomized controlled trials. Methods The electronic databases searched included the Cochrane Central Register of Controlled Trials (CENTRAL), Medline via Ovid, EMBASE, and Web of Science. Randomized controlled trials (RCTs) that reported the effects of zirconium implants on primary outcomes, such as survival rate, success rate, marginal bone loss (MBL), and probing pocket depth (PPD), compared to titanium implants were included in this review. Two reviewers independently screened and selected the records, assessed their quality, and extracted the data from the included studies. Results A total of four studies from six publications reviewed were included. Two of the comparative studies were assessed at minimal risk of bias. Zirconium implants may have a lower survival rate (risk ratio (RR) = 0.91, CI [0.82–1.02], P = 0.100, I2 = 0%) and a significantly lower success rate than titanium implants (RR = 0.87, CI [0.78–0.98], P = 0.030, I2 = 0%). In addition, there was no difference between the titanium and zirconium implants in terms of MBL, PPD, bleeding on probing (BOP), plaque index (PI), and pink esthetic score (PES) (for MBL, MD = 0.25, CI [0.02–0.49], P = 0.033, I2 = 0%; for PPD, MD = −0.07, CI [−0.19–0.05], P = 0.250, I2 = 31%). Conclusion Zirconium implants may have higher failure rates due to their mechanical weakness. Zirconium implants should be strictly assessed before they enter the market. Further studies are required to confirm these findings.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical performance of zirconium implants compared to titanium implants: a systematic review and meta-analysis of randomized controlled trials

Duan

Zhang

et al. 2023

PeerJ

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“…Implant materials have reported the following data: (I) for SS 316 L steel, an average of 202 GPa; (II) for Titanium alloy Ti6Al4V, an average of 110 GPa [ 8 , 9 ]; (III) for ZrO 2 3-YSZ, 210÷240 GPa; and (IV) for Al 2 O 3 , 380 GPa. For alternative materials on the PEEK matrix, depending on the volume share and filler chemistry, ranges from 5 GPa (TiO 2 -PEEK) to 6 GPa (lithium ceramic-SiO 2 -PEEK) to approximately 36 GPa (CF-PEEK) have been observed [ 10 , 11 ]. In orthopaedics, the corrosion and diffusion of metallic ions in the body have received considerable attention.…”

Section: Introductionmentioning

confidence: 99%

Alumina and Zirconia-Reinforced Polyamide PA-12 Composites for Biomedical Additive Manufacturing

et al. 2021

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This work aimed to prepare a composite with a polyamide (PA) matrix and surface-modified ZrO2 or Al2O3 to be used as ceramic fillers (CFs). Those composites contained 30 wt.% ceramic powder to 70 wt.% polymer. Possible applications for this type of composite include bioengineering applications especially in the fields of dental prosthetics and orthopaedics. The ceramic fillers were subjected to chemical surface modification with Piranha Solution and suspension in 10 M sodium hydroxide and Si3N4 to achieve the highest possible surface development and to introduce additional functional groups. This was to improve the bonding between the CFs and the polymer matrix. Both CFs were examined for particle size distribution (PSD), functional groups (FTIR), chemical composition (XPS), phase composition (XRD), and morphology and chemical composition (SEM/EDS). Filaments were created from the powders prepared in this way and were then used for 3D FDM printing. Samples were subjected to mechanical tests (tensility, hardness) and soaking tests in a high-pressure autoclave in artificial saliva for 14, 21, and 29 days.

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“…In addition, PEEK has an elastic modulus comparable to natural bone, effectively avoiding "stress shielding." Moreover, PEEK's color palette can match those of the teeth, and it is easy to process due to its good ductility (Khurshid et al, 2020;da Cruz et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

In vitro physicochemical and biological properties of titanium alloy, zirconia, polyetheretherketone, and carbon fiber-reinforced polyetheretherketone

Xing

Lin

et al. 2022

Front. Mater.

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Implant repair is a common means to restore the normal function of the hard tissues (bone or teeth). At present, the commonly and potentially used implant materials include titanium alloy (Ti), zirconia (Zr), polyetheretherketone (PEEK), and 30% carbon fiber reinforced PEEK (CFR-PEEK). This study compares their physicochemical and biological properties, including surface morphology, contact angle, nano hardness, elastic modulus, and the impact on the proliferation and osteogenic differentiation of bone marrow mesenchyml stem cell. Additionally, the differences in bacteria adhesion rates among materials were compared. CFR-PEEK had the highest contact angle, followed by PEEK, Zr, and Ti. Zr had the highest nano hardness and modulus of elasticity, followed by Ti, CRF-PEEK, and PEEK. There was no statistically significant difference in cytotoxicity among materials based on the liquid extract test. However, the relative cell proliferation rate on the surface of CFR-PEEK was slightly lower than that of Ti and Zr. Moreover, alkaline phosphatase activity, extracellular matrix mineralization, and osteogenic gene expression with the Ti and Zr materials were higher than with the PEEK and CFR-PEEK materials at Day 7, and Zr showed the highest osteogenic gene expression level among materials at Day 14. Ti had the greatest number of bacterial colonies that adhered to it, followed by Zr, CFR-PEEK, and PEEK. While the mechanical properties of PEEK and CFR-PEEK were closer to bone tissue and their anti-adhesion effect against bacteria was better than those of Ti and Zr, modification methods are needed to improve the osteogenic properties of these biopolymers.

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Titanium, zirconia, and polyetheretherketone (PEEK) as a dental implant material

Cited by 14 publications

References 111 publications

Clinical performance of zirconium implants compared to titanium implants: a systematic review and meta-analysis of randomized controlled trials

Clinical performance of zirconium implants compared to titanium implants: a systematic review and meta-analysis of randomized controlled trials

Alumina and Zirconia-Reinforced Polyamide PA-12 Composites for Biomedical Additive Manufacturing

In vitro physicochemical and biological properties of titanium alloy, zirconia, polyetheretherketone, and carbon fiber-reinforced polyetheretherketone

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