conference lecture in Prosthodontics department

1. PEEK material as an option
in managing difficult implants
positions and angulation
By
Dr.Osama Askar
BDS. MSC. PHD. Faculty of Dentistry
Mansoura University

2. • PEEK was firstly developed by group of English scientists
In 1978
• In 1980s PEEK was first used in industrial applications in
the manufacture of aircraft, turbine blades, piston parts,
cable insulation, and compressor plate valves.
• In 1992s PEEK was introduced in dental applications.
PEEK History

3. Air crafts
Engine parts
Propellers
Tubes
Cable holders
Gears

4. What is
PAEK
Polyaryletherketone (PAEK).Is a partially crystalline,
thermoplastic high temperature-resistant & high-performance
plastic with a melting temperature of approximately 334°C
(has high temperature stability)

5. What is
PAEK
It Is polyarayle with Kentone group and ether group
Ketone Ether Aryle or benzen

6. PEK
PEEK
PEkK
PEkEKK

7. Carbon fiber modified PEEK
CFR-PEEK
• PEEK can easily be modified by including other materials.
For example, carbon fiber insertion may increase the
elastic modulus to 18 GPa which make its modulus of
elasticity comparable to the cortical bone (14 Gpa) and
the dentin.
Carbon fiber reinforced PEEK Plate

8. Glass fiber modified PEEK
GFR-PEEK
• Glass fiber reinfocement can increase modulus of
elasticity of PEEK to 12 GPa.
• 10% glass fibers with diameters ranging from a few
microns to ten microns.
• It is mainly used as dental implants.

9. Ceramic modified PEEK BioHPP
(Bioactive High performance polymer)
It is a modified PEEK polymer by adding special ceramic
filler (0.3 to 0.5μm) by 20%of total volume
PEEK molecule
Ceramic filler
Adding ceramic filler improved the mechanical and physical
properties of PEEK as follow

10. • The modulus of elasticity is 4GPa which is close to
sponge bone which decrease shielding stresses
between PEEK implant and surrounding bone.
Elasticity comparison for bone/framework materials
• BioHPP is suitable for patients with allergies because of
its very low water solubility of < 0.3 mg/mmand its low
reactivity to other materials so more color stability.
Ceramic modified PEEK BioHPP
(Bioactive High performance polymer)

11. • BioHPP has excellent stability, optimal polishing
properties and low plaque affinity
• It is extremely low in weight and have high abrasion
resistance
Zoidis P, and Papathanasiou l.The Use
of a Modified Poly-Ether-Ether-
Ketone (PEEK) as an Alternative
Framework Material for Removable
Dental Prostheses. A Clinical
Report.Journal of Prosthodontics 0
(2015) 1–5,2015
Ceramic modified PEEK BioHPP
(Bioactive High performance polymer)

12. • Crack resistance and biocompatibility
• It is Radiolucent which allow accurate peri-implant
bone evaluation
Ceramic modified PEEK BioHPP
(Bioactive High performance polymer)

13. PEEK as dental Implant
Nano sized coated PEEK
implant with hydroxyapatite
particles
Need improvement in properties

14. • PEEK material is bio-
innert
• PEEK material has low
wet-ability which is very
important in bioactivity
with surrounding tissues
which can be enhanced
by UV exposure
• PEEK has low modulus
of elasticity
Why we
need to
modify
PEEK
when used
as implant

15. Rahmitasari F, Ishida Y, Kurahashi K, Matsuda T, Watanabe M and Ichikawa T. PEEK with Reinforced Materials and Modifications for Dental Im

16. Al2O2 Flouroapatite
Ceramic
Bio-HPP
Carbon fibers
Glass fibers
Zr
Hydroxyapatite
TiO2
PEEK enhancement
materials

17. PEEK Enhancement techniques
Nano-
structured
surface
Bioactive
nano-
composites
electron beam
deposition
(Ti,TiO2)
Plasma-
spraying
Spin-coating
with nano-HAp
Tio2/PEEK HAF/PEEK
Plasma
immersion ion
implantation
Plasma gas
surface
roughness

18. Nano-
structured
surface
Spin-coating
with nano-HAp
PEEK Enhancement techniques
(a) Spin-coating is a method for coating a thin layer of nanoscale
hydroxyapatite on PEEK surface .
In this process nano hydroxyapatite dissolved in organic solvents is slowly
dropped onto the surface of an implant rotating at high speeds .
Upon heat-treatment(300oC) a thin layer of (HAp) is formed on the
implants.

19. Nano-
structured
surface
PEEK Enhancement techniques
Plasma-spraying
▪ Hydroxyapatite particles or titanium
are sprayed onto the surface of an
implant through a plasma torch.
▪ But High temperatures could
damage PEEK structure due to its
relatively low melting temperature
(335°C)
Plasma: is coating molten particles
material (ceramic, metal, or polymers)
on a surface with high velocity.

20. Nano-
structured
surface
PEEK Enhancement techniques
In this process, low-pressure gases (Oxygen, argon and ammonia) are used
to introduce nano-level surface roughness on the surface of PEEK
implants.
This induces more hydrophilicity for a better material–tissue interaction .
Plasma gas
surface
roughness

21. Nano-
structured
surface
PEEK Enhancement techniques
Plasma ion
immersion
implantation
(Tio2)
A substrate(PEEK) placed in plasma
chamber contain plasma particles of
(Tio2) connected to high voltage under
vacuumed condition can get coated by
a thin layer of the particles of that
material.

22. Nano-
structured
surface
PEEK Enhancement techniques
• Involves decomposing and depositing a very thin, nano- rough layer
of a material on a substrate by exposing the material to a beam of
electrons.
• It increase the hydrophilicity leading to enhanced cellular
proliferation.
electron beam
deposition
(Ti,TiO2)

23. PEEK Enhancement techniques
Bioactive
nano-
composites
Tio2/PEEK
Nano-hydroxyapatite, Nano-hydroxyfluroapatite and Nano-titanium oxide
particles can be incorporated to PEEK by melt-blending and compression molding
techniques
HAF/PEEK

24. PEEK applications and uses
PEEK
In Orthopedics and
maxillofacial

25. PEEK applications and uses
As a dental implant
and implant
abutment

26. Removable partial
denture
PEEK applications and uses

27. Orthodontic wires
but increase gauge
twice of NiTi
PEEK applications and uses

28. Pediatric space
maintainer
PEEK applications and uses

29. Inserts for
attachments
instead of nylon
and rubber
PEEK applications and uses

30. Fixed detachable
and fixed bridges
PEEK applications and uses

31. BioHPP construction
techniques
CAD / CAM
Injection
molding tech.
New 3D
printed

32. CAD / CAM

35. PEEK CAD CAM
blocks with different
colors

36. New 3D
printed
Inject jet technique

39. Injection
molding tech.
Bredent BioHPP lost injection molding
technique

40. Missing all upper teeth

41. Fixture level primary impression

42. Tentative jaw relation

43. Tentative jaw relation

44. Verification
jig and
special tray

45. Duralay bar sawed then splinted intraorally by
using cold cured zero shrinkage composite

46. Final impression using open tray fixture
level impression

47. Checking the passive fit of new duralay
bar constructed after final impression

48. Jaw relation
and bite
registration

49. Wax try in to
upper
anterior teeth

50. Final prosthesis insertion

51. Trial
setting
and mold
formation
Duplication
with
burnout
resin
Preparing
the
duplicate
frame
work and
setting the
artificial
veneers
and
formation
of silicon

52. Veneers
removal
and
spruing the
framework
Resin
framework
burnout
Injection
of molten
PEKK
Deflasking
finishing
and
polishing
and

53. Setting the
veneer
guided
with the
silicon
mold
Cementati
on with Ti-
base
abutments
Contourin
g and
finishing
using
colored
flowable
composite
s

54. References
Zoidis P, and Papathanasiou l.The Use of a Modified Poly-Ether-Ether-Ketone (PEEK) as an Alternative Framework Material for
Removable Dental Prostheses. A Clinical Report.Journal of Prosthodontics 0 (2015) 1–5,2015.
Rahmitasari F, Ishida Y, Kurahashi K, Matsuda T, Watanabe M and Ichikawa T. PEEK with Reinforced Materials and Modifications for Dental Im
Johansson P, Jimbo R, Kozai Y, Sakurai T, Kjellin P, Currie F and Wennerberg A. Nanosized Hydroxyapatite Coating on PEEK Implants Enhances E
Rahmitasari F, Ishida Y, Kurahashi K, Matsuda T, Watanabe Mand Ichikawa T.PEEK with Reinforced Materials and Modifications for Dental Imp
BECHIR E, BECHIR A , GIOGA A, MANU R, BURCEA A,TEODORA DASCALU I. The Advantages of BioHPP Polymer as
Superstructure Material in Oral Implantology. MATERIALE PLASTICE 53No.3 2016.
Mohamed Mahmoud Abdul-Monem Abdul-Aziz. Dental Biomaterials assistant lecturer Spring 2018. POLYETHER-ETHER-KETONE (PEEK)
APPLICATIONS IN CLINICAL DENTISTRY. Slideshare