Soft tissue response to dental implant closure caps made of either polyetheretherketone (PEEK) or titanium

Abstract

Polyetheretherketone (PEEK) is a popular synthetic thermoplastic polymer for medical applications, but its clinical use suffers from several limitations. Therefore, the aim was to compare the soft tissue response to dental implant closure caps made of PEEK or titanium as evaluated by the occurrence of multinucleated giant cells (MNGCs). Forty-two implants were placed in the maxilla of seven miniature pigs. While commercially pure titanium (Ti) implants had a Ti closure cap, ceramic implants made of either zirconia (Zr) or alumina-toughened zirconia (Zr+Al) received a PEEK closure cap. Histomorphometry was performed to evaluate the number of small and large MNGCs being in contact with the PEEK or the Ti in different compartments of the implant systems. No histological signs of inflammation were noticed, and MNGCs were observed on both PEEK and Ti closure caps and on all three implant types. Significantly higher numbers of MNGCs were found on closure caps made of PEEK than on closure caps made of Ti on the external closure cap surface facing both soft (p=0.0008 for PEEK on Zr and p=0.0016 for PEEK on Zr+Al) and hard tissues (p=0.016 for PEEK on Zr and p=0.003 for PEEK on Zr+Al) as well as in the internal closure cap surface (p=0.014 for PEEK on Zr and p=0.0088 for PEEK on Zr+Al). No statistically significant differences in the number of MNGCs were observed on the three implant types. Significantly more MNGCs were in contact with PEEK than with Ti closure caps.