PEEK versus Metallic Attachment-Retained Obturators for Patient Satisfaction: A Randomized Controlled Trial.

Asharaf Email Eskander,Mohamed Yahia Sharaf

doi:10.1055/s-0041-1731839

Abstract

Objective The aim of the study was patients’ satisfaction evaluation and radiographic evaluation of the terminal abutments of attachment-retained maxillary obturators with metal framework versus milled polyetheretherketone (PEEK) framework in the management of maxillectomy cases. Materials and Methods Eighteen participants were randomly divided into three parallel groups ( n = 6). Participants of the PEEK group received attachment-retained obturators with milled PEEK framework, the metal group received an attachment-retained obturator with a metallic framework, and the conventional group received conventional clasp-retained obturators with a metallic framework (Control group). The evaluation included was radiographic evaluation and patients’ satisfaction in this study included two scales—”The Obturator Functioning Scale” and “The European Organization for Research and Treatment of Cancer Head and Neck 35” using one-way ANOVA test. Results Both PEEK and metal groups showed a statistically significant lower mean bone loss ( p <0.050) compared with the conventional group during all follow-up periods. There is no statistically significant difference between the PEEK and metal groups during all follow-up periods. Regarding patient satisfaction, both the PEEK and metal groups showed a statistically significant decrease score ( p <0.050) compared with the conventional group in various aspects of patients’ satisfaction scales as satisfaction with the look and difficulty of talking to the public, and noticeable clasps. In comparison, the PEEK group showed a statistically significant decrease score ( p <0.050) than the metal group with respect to satisfaction with the look along all follow-up periods. Conclusions PEEK attachment-retained maxillary definitive obturators could be considered a promising treatment modality for patients with acquired maxillary defects with regard to esthetics and satisfaction.

Highlights

Prosthetic rehabilitation of acquired maxillary defects represents a challenging mission for both the prosthodontist and psychologically traumatized patients
It was reported that the prosthetic rehabilitation of a maxillary defect with an obturator retained by extracoronal resilient attachments could be of value in conserving tooth structure and satisfying both esthetic and functional aspects.[32]
PEEK is characterized by lower water absorption, solubility, and nearly no biofilm formation, which is a critical factor for the hygienic nature of prostheses, especially in the maxillofacial prosthesis

Summary

Introduction

Prosthetic rehabilitation of acquired maxillary defects represents a challenging mission for both the prosthodontist and psychologically traumatized patients. Attachments are superior to conventional clasping for improving esthetics, retention, as well as quality of life, especially if incisors are terminal abutments and adjacent to a large defect.[7,28,29,30,31] It was reported that the prosthetic rehabilitation of a maxillary defect with an obturator retained by extracoronal resilient attachments could be of value in conserving tooth structure and satisfying both esthetic and functional aspects.[32] Besides, it helped in achieving stability It reduced the leverage for the remaining teeth adjacent to the defect.[1] Recently, the need for knowledge of the multidimensional impact of maxillofacial tumors on a patient’s life has led to an increased need to evaluate the quality of life and patient satisfaction. PEEK is an exciting alternative to traditional alloys.[34,35,36] PEEK is a biocompatible material that has been used widely in the prosthetic field as implants, provisional abutments, implant-supported bar, clamp material, bridges, or crowns.[37,38,39,40] There are two methods for PEEK processing either milling out of blanks using computer-aided design/computer-aided manufacturing (CAD/CAM) or vacuum pressing.[41]

Methods

Results

Conclusion