Abstract
Polyether ether ketone (PEEK) has been frequently used in spinal surgery with good clinical results. The material has a low elastic modulus and is radiolucent. However, in oral implantology PEEK has displayed inferior ability to osseointegrate compared to titanium materials. One idea to reinforce PEEK would be to coat it with hydroxyapatite (HA), a ceramic material of good biocompatibility. In the present study we analyzed HA-coated PEEK tibial implants via histology and radiography when following up at 3 and 12 weeks. Of the 48 implants, 24 were HA-coated PEEK screws (test) and another 24 implants served as uncoated PEEK controls. HA-coated PEEK implants were always osseointegrated. The total bone area (BA) was higher for test compared to control implants at 3 (p < 0.05) and 12 weeks (p < 0.05). Mean bone implant contact (BIC) percentage was significantly higher (p = 0.024) for the test compared to control implants at 3 weeks and higher without statistical significance at 12 weeks. The effect of HA-coating was concluded to be significant with respect to early bone formation, and HA-coated PEEK implants may represent a good material to serve as bone anchored clinical devices.
Highlights
The search for the optimal replacement for human bone began with metallic devices in orthopedic, dental and trauma applications [1,2,3]
To reproduce the mechanical stress elicited when HA-coated and control Polyether ether ketone (PEEK) implants were inserted in Sawbone material, we monitored the torque during insertion of the implants
Even if the coated and uncoated implants have different chemistries and nanostructures, the frictional forces seem most similar for the tested implants
Summary
The search for the optimal replacement for human bone began with metallic devices in orthopedic, dental and trauma applications [1,2,3]. A mechanical mismatch between bone and metallic implants was another concern. The stiffness of metal implants creates abnormal forces on the adjacent structures, sometimes resulting in stress shielding and segment degeneration [4,5] Some of these unfavorable properties of metallic implants have been shown to cause osteolysis, allergenicity and implant detachment [6,7,8]. PEEK may be machined or molded into any shape and size [6,9,10,11,12,13] Regardless of these attributes, PEEK is relatively bio-inert and hydrophobic and has been found to osseointegrate poorly in its pure form [9,14]
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