Abstract
The purpose of this research is to compare the cytotoxicity of polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) with conventional dental implant–abutment materials, namely titanium alloy (Ti-6Al-4V) and yttria-stabilized tetragonal zirconia polycrystal (Y-TZP), to evaluate the cell metabolic activity, cytotoxicity, and inflammation potential of human oral fibroblasts (HOF) on these materials. Disk-shaped specimens were designed and prepared via a dental computer-aided manufacturing technology system. Surface topography, roughness, and free energy were investigated by atomic force microscope and contact angle analyzer; cell metabolic activity and cytotoxicity by MTT assay; and morphological changes by scanning electron microscopy (SEM). The effect of pro-inflammatory gene expression was evaluated by RT-qPCR. The obtained data were analyzed with one-way analysis of variance and post-hoc Tukey’s honest significant difference tests. PEEK and PEKK exhibited higher submicron surface roughness (0.04 μm) and hydrophobicity (>80°) than the control. Although the cell activity of PEEK was lower than that of Ti-6Al-4V and Y-TZP for the first 24 h (p < 0.05), after 48 h there was no difference (p > 0.05). According to the cell cytotoxicity and the pro-inflammatory cytokine gene expression assays, there was no difference between the materials (p > 0.05). SEM observations indicated that HOF adhered poorly to PEKK but properly to Ti-6Al-4V, Y-TZP, and PEEK. PEEK and PEKK show comparable epithelial biological responses to Ti-6Al-4V and Y-TZP as implant–abutment materials. Between the two polymeric materials, the PEEK surface, where the HOF showed better cell metabolic activity and cytotoxicity, was a more promising implant–abutment material.
Highlights
Polyaryletherketone (PAEK) is a semi-crystalline high-performance thermoplastic polymer whose molecular backbone is linked by phenylene rings, oxygen bridges (R-O-R), and carbonyl groups (R-CO-R) [1]
PEEK (Ra = 0.04 μm) and PEKK (Ra = 0.04 μm) presented higher submicron roughness compared to the Ti-6Al-4V (Ra = 0.02 μm) and yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) (Ra = 0.01 μm) groups
The FE-scanning electron microscopy (SEM) microphotographs of surface morphologies are shown in the second row of Figure 1
Summary
Polyaryletherketone (PAEK) is a semi-crystalline high-performance thermoplastic polymer whose molecular backbone is linked by phenylene rings (aryl), oxygen bridges (R-O-R), and carbonyl groups (R-CO-R) [1]. Titanium osteosynthesis materials may cause complications over time and may need to be removed [14]; owing to the natural properties of PEEK, it can be used as a bone substitute in tissue engineering [15]. When applying PEEK as an alternative implant–abutment material to replace traditional materials, titanium alloy, or recent widely used materials, zirconium dioxide can be used as an implant–abutment material to reduce the risk of failure, eliminate concerns about metal allergies, and improve patient safety and esthetic satisfaction, thereby improving quality of life [10,16]
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