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Review
. 2023 Oct 19:11:1271629.
doi: 10.3389/fbioe.2023.1271629. eCollection 2023.

State-of-the-art polyetheretherketone three-dimensional printing and multifunctional modification for dental implants

Meiqing Chen  1 , Mei Ren  1 , Yingqi Shi  1 , Xiuyu Liu  2 , Hongtao Wei  1
Affiliations
Review

State-of-the-art polyetheretherketone three-dimensional printing and multifunctional modification for dental implants

Meiqing Chen et al. Front Bioeng Biotechnol. .

Abstract

Polyetheretherketone (PEEK) is a high-performance thermoplastic polymer with an elastic modulus close to that of the jawbone. PEEK has the potential to become a new dental implant material for special patients due to its radiolucency, chemical stability, color similarity to teeth, and low allergy rate. However, the aromatic main chain and lack of surface charge and chemical functional groups make PEEK hydrophobic and biologically inert, which hinders subsequent protein adsorption and osteoblast adhesion and differentiation. This will be detrimental to the deposition and mineralization of apatite on the surface of PEEK and limit its clinical application. Researchers have explored different modification methods to effectively improve the biomechanical, antibacterial, immunomodulatory, angiogenic, antioxidative, osteogenic and anti-osteoclastogenic, and soft tissue adhesion properties. This review comprehensively summarizes the latest research progress in material property advantages, three-dimensional printing synthesis, and functional modification of PEEK in the fields of implant dentistry and provides solutions for existing difficulties. We confirm the broad prospects of PEEK as a dental implant material to promote the clinical conversion of PEEK-based dental implants.

Keywords: biological activity; dental implants; functional modification; polyetheretherketone; three-dimensional printing.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
PEEK property, manufacture, and modification.
FIGURE 2
FIGURE 2
Molecular structure of PEEK (Ma et al., 2020).
FIGURE 3
FIGURE 3
Surface porous PEEK structure with a solid interior by FDM. (A) Left view. (B) Front view. (C) Top view. (D) Isometric view.
FIGURE 4
FIGURE 4
(A) Changes in PEEK chemical bonds after different plasma treatments (Fu et al., 2021a). (B) Bending (a) and tensile (b) strength tests of 30 wt% short CF-reinforced PEEK and 60 wt% continuous CF-reinforced PEEK (Zhou et al., 2022). (C) π–π* conjugations between PEEK and GO (He et al., 2019).
FIGURE 5
FIGURE 5
(A) PEEK was soaked in a mussel foot protein (Mfp)-mimic peptide with a clickable azido terminal and bio-orthogonally clicked AMP and OGP on azide-modified PEEK in different feeding molar ratios to achieve dual functions of antibacterial property and repair. (B) (a) The coating consists of a PDA nanolayer, GO nanosheets, and APN protein. (b) Verification of triple activity (Deng et al., 2020). (C) Mechanism of UV photoinsertion (Buwalda et al., 2020).
FIGURE 6
FIGURE 6
(A) Key signaling transduction cascades induced by pH 1.8 (Gao et al., 2020). (B) Concentration of iNOs and NO. (b) Expression of osteogenic-related genes. (c) Interaction of materials, macrophages, and mBMSCs (Liu et al., 2022). (C) Under the presence of bacteria, the production of ROS increases SB content and macrophage activity. SB mainly induces macrophage polarization toward M2 and promotes osteogenesis (Yue et al., 2018).
FIGURE 7
FIGURE 7
(A) Quenching of OH radicals by 30%BP-CS solutions (left) and coatings (right) (Borgolte et al., 2022). (B) Under OS conditions: (a) Cell viability, (b) ROS in cells, (c) cell morphology staining, and (d) average cell area (Li et al., 2023). (C) Material preparation and in vivo bone integration (Wang et al., 2021a). (D) Mechanism of tissue damage and targeting mitochondria to promote osteogenesis in DM (Wang et al., 2021b).
FIGURE 8
FIGURE 8
(A) Schematic diagram of the programmed regulation of early anti-inflammatory and late osteogenesis. (B) In vitro release assay. (C) Expression of autophagy-related genes after cultivating for 3 days. (D) Expression of autophagy-related genes after inducing for 9 days (Zheng et al., 2022).
FIGURE 9
FIGURE 9
(A) Expression and quantification of HIP-3α in wild-type mice (a and b). Expression and quantification of HIF-1β in wild-type mice (c and d). Expression and quantification of HIP-3α in 29cb2−/− mice (e and f). Expression and quantification of HIF-1β in 29cb2−/− mice (g and h) (Huang et al., 2022). (B) Silver nanoparticles (nAg) are coated onto copper oxide microspheres (μCuO) through PDA; then, μCuO/nAg was loaded onto silk fibroin (SF) and spun onto the surface of SPEEK with polymerized PDA (SP-CuO/Ag) (Yan et al., 2020). (C) Schematic diagram of material synthesis and evaluation (Lyu, 2022). (D) Mechanism of Mg2+-PEEK scaffold osteogenesis and angiogenesis (Wei et al., 2023).
FIGURE 10
FIGURE 10
(A) Cross-section of the buccal and coronal part of the tooth and implant. Similar anatomical components (sulcular epithelium, junctional epithelium, and connective tissue) can be seen (Gheisarifar et al., 2021). (B) Histological sections of the peri-implant mucosa after 8 weeks of healing. (a) Sulcular epithelium. (b) Barrier epithelium. (c) Connective tissue (d). Epithelial layer. (e) Connective tissue (Ivanovski and Lee, 2018). (C) (a) Ra of Ti and PEEK samples before (gray) and after (light gray) air-plasma treatment. (b) Wettability of samples before (dark gray) and after (light gray) air-plasma treatment. (c) Cell adhesion of NIH-3T3 cells. (d) Proliferation of NIH-3T3 cells ((-P_S; -P_S; black dot-Ti_S; ◦-Ti_S; black triangle-Ti_L; triangle-Ti_L) (Porrelli et al., 2021).
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